Michigan Administrative Code

R 325.45199 Standing order; written order; verbal order; telephone order. Rule 199. (1) Treatment rendered to a patient must be in accordance with the specific standing, written, verbal, or telephone order of a physician or other licensed health professional ordering within their…

R 325.45201 Administrative record. Rule 201. (1) A health facility or agency shall maintain administrative records that include all of the following: (a) Daily census records. (b) Staffing records. (c) Incident and accident reports. (d) Transfer of patient to hospital records. (2…

R 325.45203 Patient and administrative records; storage. Rule 203. (1) Patient and administrative records must be preserved and readily available to assure necessary access by appropriate health care professionals and staff to deliver needed care. (2) Records must be secured to a…

R 325.45207 Data collection; informal advisory group. Rule 207. (1) In addition to the collection of information and documents necessary to determine compliance during a licensure survey or complaint investigation, the department may also collect non-personally identifiable patie…

R 325.45211 Laboratory services. Rule 211. Where medically necessary, a health facility or agency shall provide, directly or through contract, laboratory services. These laboratory services must be in compliance with the Clinical Laboratory Improvement Amendments (CLIA) regulatio…

R 325.45213 Radiological and imaging services. Rule 213. (1) Where medically necessary, a health facility or agency shall provide, directly or through contract, radiological and imaging services. (2) These services must be offered on a regular schedule based on the health facilit…

R 325.45215 Pharmacy services. Rule 215. (1) Medical supplies and appliances, durable medical equipment, drugs and biologicals related to patient care and treatment, as identified in the patient's plan of care, must be provided by the health facility or agency while the patient i…

R 325.45217 Dietary services. Rule 217. A health facility or agency that offers dietary services shall do all of the following: (a) Meet all the dietary and nutritional needs of the patient in accordance with the patient assessment and treatment plan. (b) Obtain a diet order for …

R 325.45219 Communication services. Rule 219. A health facility or agency shall assure the availability of appropriate methods and tools to communicate with patients who are non-English speaking or have communication impairments. While a patient is receiving services, a health fa…

R 325.45221 Transportation services. Rule 221. (1) A health facility offering inpatient or residential services shall arrange and provide for appropriate transportation services if diagnostic, medical, or other services are necessary and not available onsite. (2) Excluding a hosp…

R 325.45231 Patient rights and responsibilities; policies and procedures. Rule 231. (1) A health facility or agency shall develop, adopt, implement, post, and distribute written policies and procedures to protect the rights and responsibilities of patients as provided in sections…

R 325.45241 Complaint filed with health facility or agency; procedure. Rule 241. (1) A health facility or agency shall adopt written policies and procedures for the initiation, investigation, and resolution of complaints filed by a patient, or the patient's legal guardian or desi…

R 325.45243 Complaint filed with department; procedure. Rule 243. (1) When a complainant files a complaint with the department pursuant to section 20176 or 21799a of the code, MCL 333.20176 or 333.21799a, it must be filed within 12 months of the alleged violation. If it is not fi…

R 325.45245 Investigation by department. Rule 245. (1) The department shall assign a qualified employee to investigate a health facility or agency for a complaint that alleges violation of state law or rule. (2) An investigation may include, but is not limited to, all of the foll…

R 325.45247 Applicability. Rule 247. (1) The procedures set forth in this subpart apply to the hearings and penalties related to violations under sections 20165, 20166, 20168, 21799b(2), and 21799c of the code, MCL 333.20165, 333.20166, 333.20168, 333.21799b, and 333.21799c. (2) …

R 325.45249 Correction notice; opportunity to show compliance. Rule 249. (1) Before commencing hearing proceedings for denial, limitation, suspension, or revocation of a license pursuant to section 20165 and 20166 of the code, MCL 333.20165 and 333.20166, the department shall giv…

R 325.45251 Discovery and depositions. Rule 251. (1) The same rights to discovery and depositions provided in the Michigan court rules for civil procedure apply to hearings commenced and conducted under section 20165 and 20166 of the code, MCL 333.20165 and 333.20166. The presidi…

R 325.45261 Health facility; construction; hazards. Rule 261. A health facility must be of safe construction and free from hazards to patients, visitors, and staff. History: 2020 AACS.

R 325.45263 Construction permit review; guidelines; adoption by reference. Rule 263. (1) In performing a construction permit review for a health facility, the department shall apply the following guidelines, which are adopted by reference, unless a different standard is otherwise…

R 325.45265 Submission of plans and specifications for a construction permit. Rule 265. (1) To assure compliance with the code and these rules, a health facility shall submit to the department for review and approval or disapproval complete plans and specifications for all the fo…

R 325.45267 Existing licensed health facility; exception. Rule 267. An existing licensed health facility that is not in compliance with the provisions of these rules may be permitted to continue in use so long as the facility is sufficient to protect patient health and safety and…

R 325.45269 Health facility floor plan. Rule 269. A health facility shall keep onsite a floor plan of the facility with a description of rooms showing size, use, door locations, window area, number of beds, and fixed equipment. History: 2020 AACS. R 325.45271 Exterior; ramps; ste…

R 325.45273 Interior; illumination; standards. Rule 273. (1) The applicant or licensee shall comply with the interior illumination standards in Table 1. (2) In addition to the interior illumination standards in Table 1, a health facility shall provide both of the following: (a) N…

R 325.45275 Patient room. Rule 275. (1) A room used for patient living or sleeping purposes must have a minimum total window glass area on the outside walls equal to 10% of the required floor area, and a clear unobstructed window view for a minimum distance of 20 feet from the fa…

R 325.45277 Surgical service; examination room; operating or procedure room. Rule 277. A facility that provides surgical services shall meet all the following requirements: (a) The facility must have enough examination rooms to meet the volume of work to be accomplished. Each sin…

R 325.45279 Surgical patient observation and recovery areas. Rule 279. (1) A facility that provides surgical services must have patient observation and recovery areas in sufficient numbers to accommodate the patient load, with a planned minimum of a 3-hour recovery period and lon…

R 325.45281 Airborne infection isolation patient room. Rule 281. (1) A health facility that accepts patients who require airborne infection isolation must provide 1-bed airborne infection isolation (AII) patient rooms with attached lavatory, water closet, and bathing facility, re…

R 325.45285 Residential health care facilities; special requirements. Rule 285. Residential health care facilities shall meet all the following requirements: (a) A patient room must open to a corridor, lobby, or dayroom. Traffic to and from any room must not be through a sleeping…

R 325.45287 Doors. Rule 287. (1) The minimum clear width for door openings in the means of egress from sleeping rooms, diagnostic and treatment rooms, and nursery rooms must be 41.5 inches. (2) Door openings to patient toilet rooms and other rooms needing access for wheelchairs m…

R 325.45289 Ceiling height. Rule 289. The minimum ceiling height of rooms and corridors must be 7 feet 10 inches, with the following exceptions: (a) Ceilings in storage rooms and toilet rooms must be not less than 7 feet 6 inches in height. (b) Ceiling heights in small, normally …

R 325.45291 Handrails. Rule 291. A handrail with ends returned to the wall must be provided on both sides of a corridor, ramp, or stairway used by patients. History: 2020 AACS. Page 39 Courtesy of Michigan Administrative Rules

R 325.45293 Lobby; waiting area; public toilet rooms; public drinking water. Rule 293. (1) A lobby or waiting area for visitors must be functionally separate from patient care units. (2) Except as provided in subrule (3) of this rule, a health facility shall provide one or more p…

R 325.45295 Personnel areas. Rule 295. (1) A health facility shall provide space for reception, waiting, interviewing, administrative, and business office functions. (2) A health facility shall provide space for admission, interviewing, and consultation functions so located as to…

R 325.45297 Heating, ventilation, and air conditioning. Rule 297. (1) Heating, ventilation, and air conditioning systems must be designed, installed, operated and maintained to meet the requirements of the American Society for Heating Refrigerating and Air Conditioning Engineers …

R 325.45299 Electrical equipment; outlets; receptacles. Rule 299. (1) Electrical equipment must be maintained in good repair and be properly grounded. (2) Duplex electrical outlets with a 3-wire system must be provided in sufficient number and convenient locations to meet the nee…

R 325.45301 Emergency electrical service. Rule 301. (1) A health facility shall have emergency electrical service permanently installed in the facility to provide all the following: (a) Lighting in corridors, exits, operating rooms, procedure rooms, recovery rooms, congregate roo…

R 408.45301 Adoption of federal standard. Rule 5301. (1) Farm field equipment used in agricultural operation shall be as prescribed in paragraphs (a) to (c) of 29 C.F.R. S1928.57, O.S.H.A.safety and health regulations for the guarding of farm field equipment, farmstead equipment,…

R 325.45303 Water supply system. Rule 303. (1) A health facility located in an area served by a public water system shall connect to and use that system. (2) When a public water system is not available, the location and construction of a well and the operation of a private water …

R 325.45305 Elevator. Rule 305. An elevator must be provided where patient care is provided at different floor levels. The cab size of the elevator must be sufficient to accommodate a stretcher and attendant. An elevator must have a minimum cab size of 5 feet 8 inches wide by 9 f…

R 325.45307 Medical waste; biohazard; solid waste; sanitary sewage. Rule 307. (1) A health facility shall comply with the requirements of the medical waste regulatory act, part 138 of the code, MCL 333. 13801 to 333.13832. (2) A health facility shall have a written policy to gove…

R 325.45309 Laundry; linen; ventilation; lavatory; equipment; storage. Rule 309. (1) A health facility that processes its own linen shall have all of the following: (a) A well-ventilated laundry room of sufficient size to allow functional separation of soiled linen holding, laund…

R 325.45311 Storage. Rule 311. (1) Space must be provided sufficient to meet the need for storage of medical equipment, medical supplies, and furniture. (2) Space must be provided sufficient to meet the need for segregation of cleaned and used equipment. (3) A patient toilet room…

R 325.45313 Kitchen; dietary. Rule 313. A health facility shall be in compliance with the food law, 2000 PA 92, MCL 289.1101 to 289.8111 . History: 2020 AACS.

R 325.45315 Integrated pest management. Rule 315. A health facility shall be kept free from insects and vermin utilizing active integrated pest management processes. Insect and vermin control procedures involving the use of insecticides or pesticides must be carried out in a mann…

R 325.45317 General maintenance; cleaning. Rule 317. (1) The premises of a health facility must be maintained in a safe and sanitary condition and in a manner consistent with the public's health and welfare. (2) Floors, walls, and ceilings must be covered and finished in a manner…

R 325.45321 Nurse call system; equipment; telephone. Rule 321. (1) A nurse call system must be provided in each facility. This system must provide call devices of the designated types shown at the locations identified in Table 2. (2) A health facility shall provide a telephone se…

R 325.45323 Security system. Rule 323. A security system must be provided that meets all of the following objectives: (a) To meet the needs of the population served and the services provided. (b) To provide safe ingress and egress to the health facility. (c) To restrict access to…