2022 California Standards for Accessible Design Guide (effective January 1, 2023)

11B-223 Medical care and long-term care facilities

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.

11B-223.2 Hospitals, rehabilitation facilities, psychiatric facilities and detoxification facilities.

Hospitals, rehabilitation facilities, psychiatric facilities and detoxification facilities shall comply with Section 11B-223.2. All public use and common use areas shall be accessible in compliance with this chapter.

[2010 ADA Standards] 223.2 Hospitals, Rehabilitation Facilities, Psychiatric Facilities and Detoxification Facilities. Hospitals, rehabilitation facilities, psychiatric facilities and detoxification facilities shall comply with 223.2.

11B-223.2.1 Facilities not specializing in treating conditions that affect mobility.

In facilities not specializing in treating conditions that affect mobility, including hospitals, psychiatric and detoxification facilities, at least 10 percent, but no fewer than one, of the patient bedrooms or resident sleeping rooms shall provide mobility features complying with Section 11B-805. Accessible patient bedrooms or resident sleeping rooms shall be dispersed in a manner that is proportionate by type of medical specialty.

[2010 ADA Standards] 223.2.1 Facilities Not Specializing in Treating Conditions That Affect Mobility. In facilities not specializing in treating conditions that affect mobility, at least 10 percent, but no fewer than one, of the patient sleeping rooms shall provide mobility features complying with 805.

11B-223.2.2 Facilities specializing in treating conditions that affect mobility.

In facilities specializing in treating conditions that affect mobility, 100 percent of the patient bedrooms shall provide mobility features complying with Section 11B-805.

[2010 ADA Standards] 223.2.2 Facilities Specializing in Treating Conditions That Affect Mobility. In facilities specializing in treating conditions that affect mobility, 100 percent of the patient sleeping rooms shall provide mobility features complying with 805.

Advisory 11B-223.2.2 Facilities specializing in treating conditions that affect mobility. Conditions that affect mobility include conditions requiring the use or assistance of a brace, cane, crutch, prosthetic device, wheelchair, or powered mobility aid; arthritic, neurological, or orthopedic conditions that severely limit one's ability to walk; respiratory diseases and other conditions which may require the use of portable oxygen; and cardiac conditions that impose significant functional limitations. Facilities that may provide treatment for, but that do not specialize in treatment of such conditions, such as general rehabilitation hospitals, are not subject to this requirement but are subject to Section 11B-223.2.1. ◼

11B-223.2.3 On-call rooms.

Where physician or staff on-call sleeping rooms are provided, at least 10 percent, but no fewer than one, of the on-call rooms shall provide mobility features complying with Sections 11B-806.2.3, 11B-806.2.4 and 11B-806.2.6.

11B-223.3 Long-term care facilities.

In licensed long-term care facilities, including skilled nursing facilities, intermediate care facilities and nursing homes, at least 50 percent, but no fewer than one, of each type of patient bedroom or resident sleeping room shall provide mobility features complying with Section 11B-805.

[2010 ADA Standards] 223.3 Long-Term Care Facilities. In licensed long-term care facilities, at least 50 percent, but no fewer than one, of each type of resident sleeping room shall provide mobility features complying with 805.

11B-223.4 Professional offices of health care providers.

Professional offices of health care providers shall comply with Section 11B-805.