2019 California Standards for Accessible Design Guide (effective January 1, 2020 with July 1, 2021 amendments)

11B-223.1 General.

In licensed medical care facilities and licensed long-term care facilities where the period of stay exceeds twenty-four hours, patient bedrooms or resident sleeping rooms shall be provided in accordance with Sections 11B-223 and 11B-805.

[2010 ADA Standards] 223.1 General. In licensed medical care facilities and licensed long-term care facilities where the period of stay exceeds twenty-four hours, patient or resident sleeping rooms shall be provided in accordance with 223.

Exception: Toilet rooms that are part of critical or intensive care patient sleeping rooms shall not be required to comply with Section 11B-603.

Advisory 11B-223.1 General. Because medical facilities frequently reconfigure spaces to reflect changes in medical specialties, Section 11B-223.1 does not include a provision for dispersion of accessible patient bedrooms or resident sleeping rooms. The lack of a design requirement does not mean that covered entities are not required to provide services to people with disabilities where accessible patient bedrooms or resident sleeping rooms are not dispersed in specialty areas. Locate accessible patient bedrooms or resident sleeping rooms near core areas that are less likely to change over time. While dispersion is not required, the flexibility it provides can be a critical factor in ensuring cost effective compliance with applicable civil rights laws, including titles II and III of the ADA and Section 504 of the Rehabilitation Act of 1973, as amended. Additionally, all types of features and amenities should be dispersed among accessible patient bedrooms or resident sleeping rooms to ensure equal access to and a variety of choices for all patients and residents. ◼

11B-223.1.1 Alterations.

Where patient bedrooms or resident sleeping rooms are altered or added, the requirements of Section 11B-223 shall apply only to the patient bedrooms or resident sleeping rooms being altered or added until the number of patient bedrooms or resident sleeping rooms complies with the minimum number required for new construction.

[2010 ADA Standards] 223.1.1 Alterations. Where sleeping rooms are altered or added, the requirements of 223 shall apply only to the sleeping rooms being altered or added until the number of sleeping rooms complies with the minimum number required for new construction.

Advisory 11B-223.1.1 Alterations. In alterations and additions, the minimum required number is based on the total number of patient bedrooms or resident sleeping rooms altered or added instead of on the total number of patient bedrooms or resident sleeping rooms provided in a facility. As a facility is altered over time, every effort should be made to disperse accessible patient bedrooms or resident sleeping rooms among patient care areas such as pediatrics, cardiac care, maternity, and other units. In this way, people with disabilities can have access to the full-range of services provided by a medical care facility. ◼

11B-223.1.1.1 Area alterations.

Patient bedrooms or resident sleeping rooms added or altered as part of a planned renovation of an entire wing, a department, or other discrete area of an existing medical facility shall comply with Section 11B-805.2 until the number of patient bedrooms or resident sleeping rooms provided within the area of renovation complies with the minimum number required for new construction by Section 11B-223.2 or 11B-223.3.

11B-223.1.1.2 Individual alterations.

Patient bedrooms or resident sleeping rooms added or altered individually, and not as part of an alteration of an entire area, shall comply with Section 11B-805.2, until either: a) the number of patient bedrooms or resident sleeping rooms provided in the department or area containing the individually altered or added patient bedrooms or resident sleeping rooms complies with the minimum number required if the percentage requirements of Section 11B-223.2 or 11B-223.3 were applied to that department or area; or b) the overall number of patient bedrooms or resident sleeping rooms in the facility complies with the minimum number required for new construction by Section 11B-223.2 or 11B-223.3.

11B-223.1.1.3 Toilet and bathing facilities.

Toilet/bathing rooms which are part of patient bedrooms added or altered and required to be accessible shall comply with Section 11B-805.2.4.