SECTIONS
11B-223 Medical care and long-term care facilities
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.
11B-223.1.1.1 Area alterations. Patient bedroom 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.
INTERPRETATION
When patient bedrooms are added or altered, the requirements of Section 11B-223.1.1 shall apply to only the patient bedrooms being added or altered and shall be consistent with the percentages required by Section 11B-223.2.1, 11B-223.2.2, or 11B-223.3.
Example: In a hospital with 100 acute care bedrooms, of which only 5 are currently accessible, 20 acute care patient bedrooms are proposed to be altered in the obstetrics department.
As required by Section 11B-223.1.1.1, two of the altered acute care bedrooms must be made accessible (10 percent of 20 acute care bedrooms). As a result, the facility would then have 7 percent of the acute care patient bedrooms accessible. Future remodel projects would continue to be subject to the 10 percent requirement, until the 10 percent requirement for the entire facility has been met.
If an existing facility is already in compliance with the percentages required by Section 11B-223.2 or 11B-223.3 as calculated for the entire building, then future remodel projects are not required to provide accessibility beyond the percentages required in Sections 11B-223.2 and 11B-223.3.
Example: In a hospital with 100 acute care bedrooms of which 10 are currently accessible, 20 existing acute care obstetrics patient bedrooms are proposed to be altered.
None of the altered obstetrics patient bedrooms need to be made accessible, because the facility can already demonstrate facility-wide compliance. In this case the dispersion requirement in Section 11B-223.2.1 does not trigger additional accessible rooms that would result in exceeding the minimum requirement for the building. Note that the project may not remove accessible patient bedrooms from service if the result would be to drop below the 10 percent requirement.
The requirements in Sections 11B-223.2 and 11B-223.3 are to be calculated independently of each other. For example, an excess of long-term care bedrooms (50 percent required to be accessible) shall not be used to compensate for a lack of general acute care bedrooms (10 percent required to be accessible).
Example: In a hospital with 100 bedrooms, 80 bedrooms are acute care, of which 5 are accessible, and 20 bedrooms are in a distinct part skilled nursing facility (SNF) of which all 20 are currently accessible. The facility proposes to remodel 20 of the acute care patient bedrooms, none of which are currently accessible.
Two of the 20 remodeled bedrooms must be made accessible to meet the 10 percent requirement (10 percent of acute care bedrooms being remodeled). The fact that the facility has exceeded the 50 percent requirement for long-term care patient bedrooms, does not allow the facility to provide less than 10 percent of accessible patient bedrooms in acute care. As a result, the facility would then have 7 accessible acute care bedrooms out of 80, still short of the 10 percent requirement. Future remodel projects would continue to be subject to the 10 percent requirement, until the 10 percent acute care standard has been met.
The requirements in Section 11B-223 are based on patient bedrooms, not patient beds. Placing more than one bed in a patient bedroom does not affect the requirements of Section 11B-223.2 or 11B-223.3.
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