Part 400. Rules for Nursing Homes

20 CAR § 400-711. Heating and cooling. (a)(1)(A) The institution shall be equipped with heating and cooling equipment that will maintain a minimum temperature of seventy-five degrees Fahrenheit (75˚F) during winter and eighty degrees Fahrenheit (80˚F) during summer in all patient…

20 CAR § 400-712. Lighting. (a)(1) Each patient's room shall have natural lighting during the day and have general lighting at night. (2) Natural lighting shall be augmented when necessary by artificial illumination. (b) Approved "exit" lights shall be provided at all exit areas …

20 CAR § 400-713. Emergency power. (a)(1) The facility shall provide an emergency source of electrical power necessary to protect the health and safety of patients in the event the normal electrical supply is interrupted. (2) The emergency electrical power system must supply powe…

20 CAR § 400-714. Water service. (a) The water supply used by the institution shall meet the requirements of the Department of Health. (b) There shall be procedures to ensure water to all essential areas in the event of loss of normal water supply. (c) The water service shall be:…

20 CAR § 400-715. Nurses’ station. (a)(1) Nurses' stations shall be provided and so designated that they contain a minimum of sixty square feet (60 sq. ft.) per each thirty-five-bed patient unit, and are not more than one hundred twenty linear feet (120 LF) from each patient room…

20 CAR § 400-716. Janitors’ closets. (a)(1) Janitors' closets shall be provided for each nursing unit, and a separate janitor's closet shall be provided within the kitchen area. (2) These closets shall be provided with: (A) Hot and cold running water; (B) A floor receptor or serv…

20 CAR § 400-717. Nurses’ call system. (a) A nurses' call system comprised of an electric buzzer or light system shall be so designed that the location of a call can be determined from the corridor and nurses' station. (b) In addition, emergency call stations shall be provided in…

20 CAR § 400-718. Fire alarm system. Each nursing home shall have an electrically supervised, manually operated fire alarm system in accordance with Section 6-3 NFPA 101, Life Safety Code handbook that applies to their nursing home.

20 CAR § 400-801. General. (a)(1) A "new institution" is one (1) that had a plan approved by the Office of Long-Term Care and began operation and/or construction or renovation of a building for the purpose of operating an institution on or after the adoption date of this part. (2…

20 CAR § 400-802. Site location, inspection, approvals, and subsoil investigation. (a)(1) The building site: (A) Shall afford good drainage; and (B) Shall not be: (i) Subject to flooding; or (ii) Located near: (a) Insect breeding areas, noise, or other nuisance-producing location…

20 CAR § 400-803. Submission of plans, specifications, and estimates. (a)(1) When construction is contemplated either for new buildings, additions, or major alterations in excess of one hundred thousand dollars ($100,000), plans and specifications shall be submitted in duplicate …

20 CAR § 400-804. Plans and specifications. (a)(1) All institutions licensed under these standards shall be designated and constructed to substantially comply with pertinent local and state: (A) Laws; (B) Codes; (C) Ordinances; and (D) Standards. (2) All new nursing home construc…

20 CAR § 400-805. Codes and standards. The following codes and standards are incorporated into and made a part of this part: (1)(A) The 1973 edition of the National Fire Code (NFPA) applies to new construction and alterations or additions to existing facilities. (B) This edition …

20 CAR § 400-806. Standard patient room and toilet design. (a) Built-in closets shall be provided in each patient room for storage of clothing and other possessions. (b) Each patient bed shall be provided with a suitable fixed light: (1) Equipped with a noncombustible shade to pr…

20 CAR § 400-807. Intensive care room design. (a) Other than requirements set forth for existing structures, 17 CAR § 400-705, an intensive care room shall be mechanically vented to the outside and provided with a standard private toilet and hand-washing facility. (b) The intensi…

20 CAR § 400-808. Corridors. Corridors shall be at least eight feet (8’) wide.

20 CAR § 400-809. Laundry. (a) Laundry in new facilities must provide complete separation (by partition) of the soiled laundry area (including washer) and the clean laundry area. (b) A lavatory with soap and towel dispensers must be provided for the staff in each area, and a rins…

20 CAR § 400-810. Storage. (a) There shall be a minimum of five square feet (5 sq. ft.) per bed for general storage space provided in those cases where built-in closets are provided in patient rooms. (b) It is recommended that this be concentrated in one (1) general area except f…

20 CAR § 400-811. Administrative offices. Separate office space shall be provided for administrative and business functions as follows: (1) Office for the administrator; (2) Office for the director of nursing services; and (3) Office or space for social and activity director.…

20 CAR § 400-812. Resident’s dining and recreation areas. (a) The total area set aside for residents' dining and recreation purposes shall be not less than twenty square feet (20 sq. ft.) per bed. (b) Additional space shall be provided if the facility participates in a day care p…

20 CAR § 400-813. Utility rooms. (a) A separate utility room shall be provided for clean items and soiled items for each nurses' station. (b)(1) Utility rooms shall be mechanically ventilated to the outside and adequately lighted. (2) Two (2) or more electrical convenience outlet…

20 CAR § 400-814. Bedpan room. (a) There shall be at least one (1) bedpan cleaning room. (b) In addition to the bedpan cleaning equipment, hand-washing facilities with blade-handle controls shall be provided. (c) There shall be provisions for equipment sterilization.…

20 CAR § 400-815. Janitors’ closets. (a) Janitors' closets shall be provided for each nursing unit, and a separate janitor's closet shall be provided within the kitchen area. (b) These closets shall be provided with: (1) Hot and cold running water; (2) A floor receptor and servic…

20 CAR § 400-816. Linen closets. Closets for clean linens shall be provided for each nurses' station.

20 CAR § 400-817. Soiled linen closets. (a) Closet for soiled linens shall be provided for each nurses' station. (b) This dirty linen storage shall be in a separate room and ventilated to the outside.

20 CAR § 400-818. Nurses’ call system. (a)(1) In general patient areas, each room shall be served by at least one (1) calling station, and each bed shall be provided with a call button. (2) Two (2) call buttons serving adjacent beds may be served by one (1) calling station. (3) C…

20 CAR § 400-819. Nurses’ station. (a) A nurses’ station shall be provided and so designed that it: (1) Contains a minimum of sixty square feet (60 sq. ft.) per each thirty-five-bed patient unit; and (2) Is not more than one hundred twenty linear feet (120 LF) from each patient r…

20 CAR § 400-820. Fire alarm system. Each nursing home shall be an electrically supervised, manually operated fire alarm system in accordance with Section 6-3 NFPA 101, Life Safety Code handbook that applies to their nursing home.

20 CAR § 400-821. Limitations. The following limitations shall apply: (1)(A) No nursing home shall be connected to any building other than: (i) A general hospital; (ii) A chronic disease hospital; (iii) A rehabilitation facility; (iv) A boarding home; (v) An adult day care; or (v…

20 CAR § 400-822. Ceilings, walls, and floors. (a) Ceilings shall be a minimum of eight feet (8’) (refer to 20 CAR § 400-710 for surfaces). (b) Walls (refer to 20 CAR § 400-710). (c) Floors (refer to 20 CAR § 400-710).

20 CAR § 400-823. Water cooler. (a) An electrically operated water fountain of an approved type shall be provided for each nurses' station. (b) The water fountain shall be accessible to the physically handicapped. (c) Water fountains must be recessed not to obstruct the corridor.…

20 CAR § 400-901. Furnishings. (a) Each patient's bed unit, bath, and toilet shall be provided with a standard type, buzzer/light, nurses' call signal, or, alternatively when a wireless nurse call system is utilized, a call button designed to operate with the wireless nurse call …

20 CAR § 400-902. Linens and bedding. (a) Extra pillows shall be available as need for treatment and/or comfort of patients. (b) Moisture-proof rubber or plastic sheeting shall be provided as necessary to keep mattress or pillows clean or dry. (c)(1) A supply of clean bed linen s…

20 CAR § 400-903. Equipment and supplies. (a) Nursing equipment and supplies shall be: (1) Provided to meet the patients' needs; and (2) Maintained in good condition to ensure adequate nursing care of the patients. (b)(1) In nursing homes licensed as intermediate care facilities,…

20 CAR § 400-904. Care and cleaning of medical supplies and equipment. (a)(1) In homes where commercially packaged sterile disposable items, i.e., dressings, syringes, needles, gloves, catheters, etc., are not provided, a method shall be utilized to achieve sterility for these re…

20 CAR § 400-905. Storage. (a)(1) If bedpans, urinals, and emesis basins are assigned to individual patients, they shall be name labeled and stored in the patient's bedside cabinet. (2) They shall be cleansed after each use and sanitized by an approved method at least weekly. (3)…