Transcript Document

Health Facilities Design:
An Overview of Upcoming
Code Changes
David B.Uhaze, RA
Chief - Bureau of
Construction Project Review
NJ Dept. Of Community Affairs
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Introduction
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Bureau of Construction Project Review
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NFPA 101-2012
Department of Health & Senior Services
Guidelines for Design & Construction of
Health Care Facilities 2014
NFPA 99-2012
International Codes
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DCA – Bureau of Construction
Project Review
The Bureau
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Functions as the construction office for all
building types or projects reserved to the
State at NJAC 5:23-3.11
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This includes such projects as:
Healthcare Facilities
Casinos
State Buildings (State colleges, NJTPA, NJT, NJSEA, etc.)
Special Projects (Electrical Generating, Solid Waste Treatment,
Incineration Plants)
Prototypes (Big box stores, banks, etc.)
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DCA – Bureau of Construction
Project Review
Health Care Plan Review Unit
 Performs both a UCC and Licensing review on all projects
submitted
 Will comment on Licensing requirements, but cannot grant waivers
to those requirements
 20 day review cycle for new projects with complete applications
 7 day review cycle for re-submitted projects
 Permitting and inspections are done at the local level
 May grant permission for a Local review of certain projects
 To contact call: Frank Kiani, Supervisor at 609.633.8151
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DCA – Bureau of Construction
Project Review
You can find additional information about the Bureau including
Bureau mailing addresses and phone numbers, a listing of when a
Bureau review and release is required, answers to frequently asked
questions about the plan review and release process, and you can
access all of the necessary forms for submission at the Bureau’s
website:
http://www.nj.gov/dca/divisions/codes/offices/bcpr.html
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NJ Uniform Construction
Code
 Established January 1, 1977 to eliminate
inconsistency and standardize codes throughout NJ
 Establishes uniform administrative procedures for
enforcing construction standards throughout NJ
 Establishes licensing standards and organizational
standards for all NJ Construction Code Officials and
construction departments
 Incorporates adopted national standards as well as NJ
specific standards such as the Rehabilitation Subcode,
the Barrier Free Subcode, the Asbestos Subcode, etc.
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NJ Uniform Construction
Code
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The following codes are currently in effect :
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2009 International Building Code – NJ Edition
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2009 International Mechanical Code
2009 International Fuel Gas Code
2009 National Standard Plumbing Code
2009 International Energy Code
2007 ASHRAE 90.1
2003 ANSI A117.1 (Barrier Free)
NJ Rehabilitation Subcode
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NJ Uniform Construction
Code
Rehab Code Revision – November 7, 2011
At N.J.A.C. 5:23-6.4(c)2, the prohibition against the removal of
existing fire protection systems is deleted from this section for
consistency with the Uniform Fire Code.
This change allows the removal of an existing fire protection system:
 because the system is so antiquated that it can no longer be repaired
 because the existing system is in a building that has undergone a
change of use and the installation of a fire protection system would
not be required in new construction for the same use.
The removal of existing fire protection would require the approval of
both the fire protection subcode official and the fire official; the
applicant would have the right of appeal should the application for
removal be denied.
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NJ Dept. of Health & Senior
Services
 Hospital Licensing
Standards
 Standards for Licensure of
Ambulatory Care Facilities
You can view these standards
and any code change proposals
on the DHSS website at :
http://www.state.nj.us/health/healthfacilities/rules.shtml
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NJ Dept. of Health & Senior
Services
Newly Adopted Standards:
The new rules for Safe Patient Handling apply to hospitals and nursing
homes, and require :
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Minimizing unassisted patient handling through the use of assistive
devices
Establishing a safe patient handling program, committee and plan
Preparation of a Needs Assessment for each patient and each unit within
the facility to determine the need for assistive patient handling.
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Training of healthcare workers in the safe use of patient handling
equipment
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Establishing procedures for injury reporting, investigation,
analysis and recordkeeping
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NJ Dept. of Health & Senior
Services
Newly Adopted Standards:
The new rules for Violence Prevention apply to hospitals and nursing
homes, and require:
 Establishing a violence prevention program, committee and plan
 Completion of an annual violence risk assessment
 Provision of violence prevention training for all employees
 Establishing procedures for incident handling, investigation and
reporting
 Maintaining records of violent acts
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NJ Dept. of Health & Senior
Services
 Issues during Inspections
There are times when, NJDHSS inspectors will cite deficiencies
based on a facility’s compliance with the Uniform Construction Code
and its adopted standards.
The NJDHSS does not have the authority to make “building code”
citations.
In addition, because of the complexity of these codes, they are
sometimes incorrectly cited.
If you have a question regarding a NJDHSS citation which relates to a
“building code” issue, please call the DCA-HCPR office for
clarification before making any corrections
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Facility Guidelines Institute
Guidelines for Design and
Construction of Health Care
Facilities
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Established as a Federal Standard in 1947
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Published through the American Institute
of Architects from 1984 to 2008
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No longer affiliated with the “AIA”
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Now partnered with ASHE
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Currently working on the 2014 Edition
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Facility Guidelines Institute
The Facility Guidelines Institute (FGI) was formed in
1998 in an effort to create a more formal procedure and
process of review and revision, and to ensure the
document is kept current.
The FGI Guidelines Revision Committee welcomes
comments and language revision proposals from all
interested parties.
www.fgiguidelines.org
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The FGI Guidelines 2014
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New revision cycle began in January of 2011
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First full Committee meeting was held in April 2011
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The Public Proposal period ended October 31, 2011
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The next full Committee meeting will be in January 2012
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The last full Committee meeting will be held in April 2013
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This is a consensus process dependent on public input and
public commentary
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The FGI Guidelines 2014
 The revision process involves two opportunities for public
participation.
 During a proposal period, anyone can submit a proposal to
change language in the Guidelines.
 The Facilities Guidelines Revision Committee considers
these proposals and develops a draft manuscript.
 This draft is then posted for public comment, and anyone can
comment on the proposed draft.
 From its review of these comments, the Facilities Guidelines
Revision Committee develops the final manuscript for the
next edition of the Guidelines.
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The FGI Guidelines 2014
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Major topics of Discussion this cycle:
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New book just for Residential Health Care facilities
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Patient & Staff Safety Risk Assessment
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Critical Access Hospitals
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Coordination of Room Sizes & Clearances
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Coordination between inpatient and outpatient requirements
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Medical Imaging
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Obstetric & Pediatric Facilities
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National Fire Protection Assoc.
2012 Editions
 Life Safety Code 101
 Health Care Facilities Code 99
These new NFPA editions must be adopted by the
Center for Medicare & Medicaid Services (CMS)
before they can be used in health care facility design.
CMS has stated that they will be reviewing these standards
for adoption but that it could take up to 20 months.
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NFPA 101- Life Safety Code
2012 Edition
The following changes have been approved:
 In areas with nine or fewer individuals, sliding doors no longer
need a break-away feature, but corridor doors still need latching
and smoke resistance.
 One container of alcohol-based hand gel in each room may be
exempted from the total quantity in a smoke compartment.
 Above handrail height, 6-inch corridor projections of any type
are acceptable.
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NFPA 101- Life Safety Code
2012 Edition
 The section on suites has been reorganized, with the size of new
sleeping suites at 7,500 square feet, or 10,000 square feet if
there is direct visual supervision and the space is fully and
automatically smoke detected.
 Patient room closets of less than 6 square feet do not need to be
sprinklered.
 Larger recycling and linen containers will be permitted, up to 96
gallons in capacity, without being placed in an area protected as
hazardous.
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NFPA 101- Life Safety Code
2012 Edition
 Certain additional items will be permitted to be stored in corridors,
as long as 5 feet of clear width remains and there is a fire plan to
remove the equipment.
 Seating will be allowed in an 8-foot corridor with some restrictions.
(50sf per area, 10ft separation of areas, 6ft clear width maintained)
 Home setting cooking facilities will be permitted to be open to the
corridor. (500cfm exhaust, suppression, grease collection)
 Gas fireplaces will be permitted in fully sprinklered sleeping
compartments with some restrictions. (direct venting, not in
sleeping rooms, controls locked)
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NFPA 99 – Health Care
Facilities Code 2012 Edition
2012 edition of NFPA 99 was rewritten and reorganized completely.
Now includes a "Fundamentals" chapter that addresses risk based on
the type of care provided in the health care organization as follows:
Category 1 - Facility systems failure that is likely to cause major
injury or death of patients or caregivers .
Category 2 - Facility systems failure that is likely to cause minor
injury to patients or caregivers .
Category 3 - Facility systems failure that is not likely to cause injury
to the patients or caregivers, but can cause patient discomfort .
Category 4 – Facility systems failure that has no impact on patients
or caregivers.
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NFPA 99 – Health Care
Facilities Code 2012 Edition
 Operating rooms will now be considered to be “wet procedure
locations” by default. The health care facility will have the
ability to do a risk assessment (which will be explained in the
annex material of NFPA 99) to declare one or more of the ORs to
be dry locations.
 Added testing and inspection requirements for all new and
existing non-stationary medical booms (annually)
 Added text to permit a 0.1 second delay for selective
coordination of the electrical systems in health care occupancies.
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NFPA 99 – Health Care
Facilities Code 2012 Edition
 Permits fuel transfer pumps, receptacles, ventilation fans, louvers
and cooling systems related to generators to be added to the life
safety or critical branch (deleted from equipment branch)
 New section which permits switches in lighting circuits connected
to Life Safety and critical branch as long as they don’t serve as
illumination of egress as required by NFPA 101
 Increases number of required receptacles
• General Care – From 4 to 8
• Critical Care – From 6 to 14
• Operating Rooms – New requirement of 36
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International Building Code
2012 Edition
The following changes have been approved:
 Classifications for health-care related facilities have been
clarified.
 Provisions for incidental-use rooms and spaces have been
clarified.
 Reformatted requirements for protection of vertical openings
through floors.
 Increased capacity for egress components in buildings with
sprinklers & an emergency communication system.
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International Building Code
2012 Edition
 Clarification of when unenclosed stairways can be used as a
part of the means of egress system
 Means of egress provisions unique to special occupancies now
in Chapter 4.
 Wind design requirements extensively revised.
 Wind load maps are now based on ultimate design wind
speeds.
 Updated seismic ground motion maps.
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International Mechanical
Code 2012 Edition
The following changes have been approved:
 New and existing mechanical systems must be maintained in
accordance with ASHRAE/ACCA/ANSI Standard 180.
 Parking garage exhaust now defined as environmental air.
 Includes specifications for grease reservoirs in commercial
cooking exhaust duct systems.
 Requires any combustible material in a return air plenum to be
listed and labeled to verify compliance with ASTM E-84 or UL
723.
 New requirements for evaporative coolers.
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International Code Council
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Ad Hoc Committee on Healthcare
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At Section 806.1 of the IBC, In Groups I-1 and I-2, an exception
is being proposed to the requirement that combustible decorative
materials meet the criteria of NFPA 701
The exception would exempt decorative materials, including, but
not limited to, bulletin boards, artwork, posters, photographs and
paintings in Groups I-1 and I-2 as long as they are less than 20
percent of the wall area.
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At Section 407 of the IBC, Corridors in I-2 occupancies would be
allowed to have open spaces such as but not limited to waiting,
nurse stations, chart areas, patient gathering spaces, or
operational areas of unlimited size provided the contents are low
hazard.
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International Code Council
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Ad Hoc Committee on Healthcare
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At 907.5.2.1 Audible alarms, it is proposed to allow visible alarm
notification appliances in lieu of audible alarm notification
appliances in critical care areas of Group I-2 occupancies that are
in compliance with Section 907.2.6, Exception 2.
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Table 508.2.5, Incidental Accessory Occupancies, is being
reworked to add spaces being currently maintained in healthcare
and ambulatory care occupancies. This should make the table more
relevant and consistent with current operational and programmatic
standards in I-2 occupancies.
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At 1008 ,They are reworking the sections on door locking
arrangements to address security/abduction issues. The changes
will reduce confusion between delayed egress locks and other
types of locks.
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International Code Council
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Ad Hoc Committee on Healthcare
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At 1018.2 Corridor Width, it is proposed to allow low hazard
equipment, carts, and devices that are mobile (attended/in-use
equipment, patient transport and handling devices, emergency
equipment ) that do not encroach upon an effective 5' clear path
provided the organization has a defend in place management plan
to address egress and clearing of corridors in emergency
situations.
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In the IMC at Table 403.3 , they are proposing to delete the 6
spaces identified under “Hospitals, nursing and convalescent
homes” and insert footnote “J” which states the following: “For
hospital ventilation rates refer to ASHRAE Standard 170, Table
7-1 and addenda 1-5.
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Where to Get More Information
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FGI Guidelines
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NJ Uniform Construction Code & Uniform Fire Code
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609.984.0040
www.nj.gov/dca/codes/forms/pubsandsubs.htm
International Codes
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AIA Bookstore 1.800.242.3837, press 4
1.800.214.4321, ext.371
National Fire Protection Association
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1.800.344.3555
http://catalog.nfpa.org
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