19 CSR 30-20.030 - Construction Standards for New Hospitals
PURPOSE: This rule establishes up-to-date construction standards for new hospitals to help ensure accessible, functional, fire-safe, and sanitary facilities.
PUBLISHER'S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here.
(1) New Hospital General Requirements.
(A) A new hospital is one for which plans are
submitted to the Department of Health and Senior Services for review and
approval after January 1, 2018, for the construction of a new facility,
expansion or renovation of an existing hospital or the conversion of an
existing facility not previously and continuously licensed as a hospital under
Chapter 197, RSMo. A new hospital shall be designed to provide all of the
facilities required by this rule and arranged to accommodate all of the
functions required by this rule and to provide comfortable, sanitary,
fire-safe, secure and durable facilities for the patients. In major alteration
projects and additions to an existing licensed hospital, only that part of the
total hospital affected by the project is subject to this rule.
(B) These minimum requirements are not
intended in any way to restrict innovations and improvements in design,
construction or operating techniques. Plans and specifications and operational
procedures which contain deviations from these requirements may be approved if
it is determined that the purposes of the minimum requirements have been
fulfilled. Some facilities may be subject to the requirements of more than one
(1) regulatory agency. While every effort has been made to ensure coordination,
facilities making requests for changes in services and request for new
construction or renovations are cautioned to verify requirements of other
agencies involved.
(C) Requests for
deviations from the requirements of this rule shall be in writing to the
Department of Health and Senior Services. Approvals for deviations shall be in
writing and both requests and approvals shall become a part of the permanent
Department of Health and Senior Services records for the facility.
(D) Alterations or additions to existing
hospitals shall be programmed so construction will minimize disruptions of
existing functions. Access to exits and fire protections shall be maintained so
the safety of the occupants will not be jeopardized during
construction.
(E) The owner of each
new facility or the owner of an existing facility being added to or undergoing
major alterations shall provide a program scope of services which describes
space requirements, staffing patterns, departmental relationships and other
basic information relating to the objectives of the facility. The program may
be general but it shall include a description of each function to be performed,
approximate space needed for these functions and the interrelationship of
various functions and spaces. The program also shall describe how essential
services can be expanded in the future as the demand increases. Appropriate
modifications or deletions in space requirements may be made when services are
shared or purchased, provided the program indicates where the services are
available and how they are to be provided.
(2) Planning and Construction Procedure.
(A) Plans and specifications shall be
prepared for the construction of all new hospitals and additions to and
modifications or reconstruction of existing hospitals. The plans and
specifications shall be prepared by an architect or a professional engineer
licensed to practice in Missouri.
(B) Construction shall be in conformance with
plans and specifications approved by the Engineering Consulting Unit of the
Department of Health and Senior Services. The Department of Health and Senior
Services shall be notified within five (5) days after construction begins. If
construction of the project is not started within one (1) year after the date
of approval of the plans and specifications, the plans and specifications shall
be resubmitted to the Department of Health and Senior Services for its approval
and shall be amended, if necessary, to comply with the then current rules
before construction work commences.
(3) Design and Construction Requirements.
(A) New hospitals or portions of hospitals
constructed or remodeled after the effective date of this amendment shall be
maintained so that the building and its various operating systems comply with
the life safety code standards in 42 CFR Part 482 (2017) and 42 CFR Part 485
(2017), which are incorporated by reference in this rule. The Code of Federal
Regulations is published by the U.S. Government and is available by calling
toll-free (866) 512-1800 or going to http://bookstore.gpo.gov/. The address
is: U.S. Government Publishing Office, U.S. Superintendent of Documents,
Washington, DC 20402-0001. This rule incorporates later amendments and
additions to 42 CFR Part 482 (2017) and 42 CFR Part 485 (2017). This rule does
not incorporate the following chapters of National Fire Protection Association
(NFPA) 99, 2012 edition: chapter 7 - Information Technology and Communications
Systems for Heath Care Facilities; chapter 8 - Plumbing; chapter 12 - Emergency
Management and chapter 13 - Security Management. Existing hospital facilities
constructed prior to the effective date of this amendment shall maintain and
operate the building in compliance with the design and safety regulations in
effect at the time of their construction.
(B) New hospitals or portions of hospitals
constructed or remodeled after the effective date of this amendment must be
constructed so that the building and its various operating systems comply with
the standards contained in The Facility Guidelines Institute (FGI) Guidelines
for the Design and Construction of Health Care Facilities (2010 edition) or the
FGI Guidelines for Design and Construction of Hospitals and Outpatient
Facilities (2014 edition), which are incorporated by reference in this rule and
are published by the FGI at 350 N. Saint Paul Street, Ste. 100, Dallas TX
75201, or so that the building and its various operating systems comply with
other standards and guidelines that provide equivalent design criteria. Prior
to the department granting approval of the construction plans and
specifications required in this rule, the architect or professional engineer
submitting the plans shall identify the equivalent design criteria used. This
rule does not incorporate any subsequent amendments or additions. This rule
does not incorporate the following chapter of FGI, 2010 edition: 1.2-8 -
Commissioning. This rule does not incorporate the following chapter of FGI,
2014 edition: 1.2-7 - Commissioning. Existing hospital facilities constructed
prior to the effective date of this amendment shall maintain and operate the
building in compliance with the design and construction regulations in effect
at the time of their construction.
(4) Additional Requirements
(A) The facility shall have at least two (2)
pressure sterilizers located in the Central Sterile Processing designed to
maintain two hundred fifty degrees Fahrenheit (250 °F) or one hundred
twenty-one degrees Celsius (121 °C) at fifteen pounds (15 lbs.)
pressure.
(B) If a facility is
located outside of a service area or range of a public fire department,
arrangements shall be made to have the nearest fire department respond in the
case of fire. A copy of the agreement shall be kept on file in the facility and
a copy shall be forwarded to the Department of Health and Senior Services. If
the agreement is changed, a copy shall be forwarded to the Department of Health
and Senior Services.
(C) Manual
fire alarm initiating devices shall be installed at each nurses' station or
other patient care control station and at the telephone switchboard.
Notes
*Original authority: 192.005.2, RSMo 1985 and 107.080, RSMo 1953.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.