Chapter 1. General Requirements
§101. Construction Requirements
A. No new jails, prisons or other institutions of detention or incarceration shall hereafter be constructed nor shall major alterations be made to existing jails, prisons or other institutions of detention or incarceration without the prior written approval of, and unless in accordance with plans and specifications approved in advance by, the state health officer.
B. [Formerly paragraph 18:002] All buildings shall be of sound construction. A finish that is easily cleaned shall be applied to all walls, floors, and ceilings.
C. [Formerly paragraph 18:003] All facilities shall be connected to a potable water supply designed, constructed, operated, and maintained in accordance with the provisions of Part XII of this Code.
D. [Formerly paragraph 18:004] All facilities shall be connected to a sewage treatment system designed, constructed, operated, and maintained in accordance with the provision of Part XIII of this Code.
E. [Formerly paragraph 18:005] All plumbing shall be in accordance with the provisions of Part XIV of this Code.
F. [Formerly paragraph 18:006] Running potable water, for drinking purposes, shall be available to each cell and cell block area.
G. [Formerly paragraph 18:007] New construction and renovation shall provide hand washing lavatories, with hot water (not to exceed 110° Fahrenheit) and cold water, delivered through a mixing faucet, in each cell and cell block area except in padded cells.
H. [Formerly paragraph 18:008] New construction and renovations shall provide toilets conforming to the requirements of Part XIV in each cell and cell block area. When prisoners are not allowed free access to the cell block area, a toilet shall be provided in each cell. Padded cells are exempt from this provision.
I. [Formerly paragraph 18:009] Showers, tubs or other bathing facilities, with hot and cold water delivered through a mixing faucet, shall be available to all inmates and shall meet the requirements of Part XIV.
J. [Formerly paragraph 18:010] When inmates are housed in dormitories, sanitary facilities, meeting the requirements of Part XIV shall be provided in accordance with the following.
Toilets
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Urinals*
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Lavatories
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Bathing Facilities (Showers, Tubs, etc.)
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Drinking Fountains
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1 for each 20 male inmates
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1-30 1
31-50 2
51-100 3
101-150 4
over 150
for each additional
50 inmates
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1 for each 16
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**1 for 20
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1 for 75
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1 for each 14 female inmates
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Space between beds:
min. of 28 inches vertically and horizontally for all new construction, renovation and replacement.
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1. *Only for facilities housing males. Trough urinals may be used as long as they meet the requirements of Part XIV.
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2. **The state health officer will consider written appeals based on unusual program schedules.
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K. [Formerly paragraph 18:011] If visitor waiting rooms are provided, a toilet and lavatory shall be provided in a room separate from cell block facilities.
L. [Formerly paragraph 18:012] For all new construction or renovation, a minimum of 48 square feet of floor space shall be provided for each prisoner where he or she is confined for 72 hours or over in any one area at a time.
M. [Formerly paragraph 18:013] There shall be a minimum spacing of 28 inches, horizontally in all directions and vertically, between all beds which are not separated by walls or approved solid partitions.
N. [Formerly paragraph 18:014] All indoor area inhabited or traversed by people shall have a minimum of
20 foot-candles of illumination measured at a level 3 feet above the floor.
O. [Formerly paragraph 18:015] Forced ventilation approved by the state health officer shall be provided throughout all areas. The combustion chambers of all heaters, heating systems, and other fired equipment shall be vented to the atmosphere. Other parts of the heating, cooling, and ventilating system shall be so designed, built, and maintained as to ensure that the pressure in the space from which combustion air is drawn does not become negative with respect to the atmosphere.
P. [Formerly paragraph 18:016] All openings to the outer air shall be protected against the entrance of flies, mosquitoes, rodents, and other insects and vermin by
self-closing doors, closed windows, screening, controlled air currents or other approved means, and shall meet the requirements of Part V of this Code.
3. [formerly paragraph 19:006-2] Rooms used for aerosolized pentamidine treatments or for aerosol treatments designed to induce sputum shall have negative air pressure and at least six changes of room air per hour, accomplished by exhaust ventilation.
D. [Formerly paragraph 19:007] Lighting and Wiring. Usable rooms and general areas of the building shall be lighted with a minimum of 20 foot-candles including rooms where food is prepared and handled. Emergency lighting shall be provided for surgery, delivery, nursery, emergency rooms, intensive care units and for patients requiring mechanical respirators, life support systems or monitoring equipment. Power outlets serviced by emergency power shall be distinguished from non-emergency outlets. The emergency generator shall be checked at least once weekly and records to insure proper operation and maintenance shall be kept for at least one year. Flash lights or battery operated lamps for emergency use shall be available at the nurses' station to hospital personnel and kept in operating condition.
E. [Formerly paragraph 19:008] Toilet Facilities. Each patient shall have access to a toilet room without entering the general corridor area. One toilet room shall serve no more than four beds and no more than two patient rooms. The toilet room shall contain a water closet and a lavatory. The lavatory may be omitted from a toilet room which serves single-bed and two-bed rooms if each such patient's room contains a lavatory. Toilet room air shall be filtered or mechanically exhausted to the outside. This room shall be equipped with hot and cold water under pressure with detergent or antiseptic scrub and individual towels. Toilet rooms shall be provided with waste receptacles which shall remain covered.
AUTHORITY NOTE: Promulgated in accordance with R.S. 40:4 (A)(2)(10) and R.S. 40:5 (1)(2)(3)(10)(17).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1393 (June 2002), repromulgated LR 29:1099 (July 2003).
Chapter 3. Operations and Maintenance
§301. General
[formerly paragraph 19:003]
A. The building shall be in good repair, reflect good housekeeping and shall be free of insects and rodents and when necessary, dust control measures shall be employed. Equipment shall be clean and in good repair for the safety and well being of the patients and employees. Equipment should be properly disinfected or sterilized as required.
B. [Formerly paragraph 19:004] Employee health shall meet the requirements of Part I, §117 and Part II, §§501-503.C.
C. [Formerly paragraph 19:009] Housekeeping. An approved method of cleaning patient rooms, floors, and corridors shall be provided. Use EPA approved hospital grade disinfectant matched to local water conditions; dilute and apply according to manufacturer's directions. Separate cleaning equipment shall be provided for the food preparation and storage area, operating rooms, and delivery rooms. Removable mop heads shall be provided for proper cleaning and disinfection. Wet vacuum operations are encouraged. A mop sink and a sufficient amount of storage area shall be provided to store all cleaning compounds and equipment.
D. [Formerly paragraph 19:010] Storage. There shall be clean storage space throughout the building for all supplies and equipment, which shall include provision for the safe separation of different items and located away from foot traffic and overhead contamination.
E. [Formerly paragraph 19:011] Water Supply. All water supplies shall conform to Part XII of this Code and to the federal drinking water standards. Approved emergency water supply shall be provided or made available in the event of internal or external disaster.
F. [Formerly paragraph 19:012] Food Service. The dietary unit of the hospital shall comply with all the provisions established in Part XXIII of this Code.
AUTHORITY NOTE: Promulgated in accordance with the provisions of R.S. 40:4(A)(10) and R.S. 40:5(3).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1394 (June 2002).
§303. Laundry
[formerly paragraph 19:013]
A. Laundry Room. The clean and dirty laundry areas shall be separated to prevent cross-contamination. Hand-washing facilities shall be provided in each area. Personnel in dirty laundry rooms shall not perform duties in clean laundry rooms. The ventilation systems for the clean and dirty laundry rooms shall be separate. The clean laundry room shall have a positive air pressure and the dirty laundry rooms shall have a negative air pressure with respect to surrounding areas.
B. [Formerly paragraph 19:014] Laundry Movement and Storage. The facility shall make provisions and be responsible for the proper handling, cleaning, disinfection, and storage of linen and other washable items. Laundry carts shall be handled in a way as not to transmit communicable diseases form one section of the hospital to another and the carts shall be properly disinfected. Clean laundry shall be carried in clean carts only and be covered so as to prevent contamination en route. Disposable bags shall be used for the handling of contaminated items from isolation areas. Clean linens shall be placed in a clean bag or other suitable container. A commercial contract for such services with an outside vendor does not relieve the facility from ensuring that these conditions are met.
AUTHORITY NOTE: Promulgated in accordance with the provisions of R.S. 40:4(A)(10)and R.S. 40:5(3).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1394 (June 2002).
§305. Plumbing, Sewage, Garbage, and Waste
[formerly paragraph 19:015]
A. All plumbing shall be installed and maintained in a manner so as to comply with all local and state plumbing codes and regulations, including Part XIV of this Code. Approved equipment shall be provided for cleaning and sanitizing bedpans, if used for more than one patient.
B. [Formerly paragraph 19:016] Sewage shall be disposed of in accordance with Part XIII of this Code and with the Environmental Protection Agency (EPA) and Louisiana Department of Natural Resources (DNR) hazardous waste regulations.
C. [Formerly paragraph 19:017] Garbage and trash shall be stored and disposed of in accordance with Part XXVII of this Code and with DNR regulations. Compactors, dumpsters and other equipment shall be maintained in a sanitary condition.
D. [Formerly paragraph 19:018] Contaminated dressings, surgical, obstetrical and laboratory waste shall be incinerated or sterilized before burial in a landfill. Disposable needles and other "sharps" shall be placed in specifically labeled containers of sufficient thickness to prevent breakthrough and disposed of in an approved manner, preferable incineration.
AUTHORITY NOTE: Promulgated in accordance with the provisions of R.S. 40:4(A)(10) and R.S. 40:5(3).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1395 (June 2002).
§307. Patient Areas
[formerly paragraph 19:019]
A. All new facilities and those undergoing extensive renovation shall have no more than four beds per room in patient areas, excluding nurseries or intensive care units, and shall have at least one isolation room maintained under negative air pressure for every 30 adult beds.
B. [Formerly paragraph 19:020] Bathing Facilities. A tub or shower shall be provided at the ratio of 1 per 10 patients on each floor and conveniently located. Bathroom air shall be mechanically exhausted to the outside or filtered and be clean, disinfected and free of odors. Handgrips and non-slip mats shall be provided for tub and/or showers. Bathrooms fixtures shall meet the standards of Part XIV of this Code. Bathtub and/or shower shall be provided with hot and cold water delivered through a mixing valve.
C. [Formerly paragraph 19:021] All supplies and equipment used in patient care shall be properly cleaned and appropriately stored. They shall be disinfected between uses for different patients. Impervious material which can be readily cleaned and disinfected shall be used to cover beds and pillows. After discharge of a patient, the bed, bedside furniture and equipment shall be properly cleaned and terminally disinfected. Mattresses, blankets and pillows assigned to patients shall be in a sanitary condition. The blankets, towels, sheets and pillow cases used for a patient in isolation shall be collected at the bedside in a double lined bag and taken immediately for laundering after each use.
D. [Formerly paragraph 19:022] Nursing stations shall be clean, have proper storage of medication, provide hand-washing facilities with hot and cold water, soap, towels and waste receptacles. Narcotics shall be stored under a double lock arrangement.
E. [Formerly paragraph 19:023] The handling and storage of ice for patient use shall conform with Part VI of this Code.
AUTHORITY NOTE: Promulgated in accordance with the provisions of R.S. 40:4(A)(10) and R.S. 40:5(3).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1395 (June 2002).
§309. Laboratory
[formerly paragraph 19:024]
A. Microbiological cultures shall be disposed of in an incinerator approved by the Air Permits Division of the DEQ or sterilized prior to disposal. Smoking and eating are not allowed in laboratory areas. Laboratories, especially horizontal work surfaces, shall be cleaned and disinfected at the end of each work day.
B. [formerly paragraph 19:025] Sterilizers of the proper type and necessary capacity for adequate sterilization shall be provided and maintained in a satisfactory condition. The hospital shall adopt a recognized method of verifying sterilizer performance and records shall be kept of the sterilizer operations for at least a year. Quality control of sterilization procedures shall include placement of indicators insuring that heat/time requirements have been met in package interiors and at least weekly live spore testing in steam sterilizers. Live spore testing shall be conducted for each load which is gas sterilized. A mechanism shall be employed for re-sterilizing outdated packs and recalling sterilized supplies in the event of a spore test failure. Clean and sterilized supplies shall be dated and kept separate from soiled and contaminated supplies and equipment.
C. [formerly paragraph 19:026] Blood bank refrigerators shall be kept clean and maintained at a temperature of 1°C to 6°C (33.8°F to 42.8°F), provided with an alarm and used for flood storage only. Time and temperature charts shall be maintained continuously and monitored and recorded daily. These records shall be maintained for at least a year. Alarm devices for refrigerators shall be provided.
AUTHORITY NOTE: Promulgated in accordance with the provisions or R.S. 40:4(A)(10) and R.S. 40:5(2)(3)(5)(15)(17)(20).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1395 (June 2002), amended LR 39:1055 (April 2013).
§311. Radiation Controls
[formerly paragraph 19:027]
A. All equipment and handled materials providing a source of radiation and disposal of radioactive waste shall be shielded as required by the Nuclear Division of DNR office of Environmental Affairs. All radiation equipment operators shall be provided with the proper clothing and equipped with an approved radiation monitoring device. Certificates of registration shall be obtained from DNR's Nuclear Control Board and available for review.
B. [Formerly paragraph 19:028] Dressing rooms and toilet facilities shall be conveniently located for patients.
AUTHORITY NOTE: Promulgated in accordance with the provisions of R.S. 40:4(A)(10) and R.S. 40:5(3).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1395 (June 2002).
§313. Operating Rooms, Delivery Rooms,
Intensive Care Units, Recovery,
Nursery and Emergency Rooms
[formerly paragraph 19:029]
A. Only authorized and properly attired personnel shall be allowed into operating rooms, delivery rooms, recovery rooms, intensive care units and nurseries. Scrub suits for operation room and delivery rooms used should not be worn outside designated areas.
B. [Formerly paragraph 19:030] Operating room and delivery room shall be cleaned and disinfected between uses.
C. [Formerly paragraph 19:031] Adequate hand-washing facilities providing hot and cold running water equipped with mixing faucet, knee, foot, or elbow faucet control shall be provided in or adjacent to these areas. Hand-washing facilities shall not be located in, but rather adjacent to the operating room. Adequate supplies of antiseptic scrub material or detergent shall be maintained for these facilities at all times.
D. [Formerly paragraph 19:032] There shall be adequate provisions for washing instruments and equipment used in these areas. Sterilization procedures shall comply with the stipulation specified in the laboratory §§309-311.A of this Chapter.
E. [Formerly paragraph 19:033] The operating room shall be provided with safety electrical circuits, properly grounded, non-conductive floor surfaces, positive ventilation, and humidity control in accordance with federal construction and life safety standards.
F. [Formerly paragraph 19:034] Handling of equipment and surgical clothing shall be done so as to prevent cross-contamination with other areas.
G. [Formerly paragraph 19:035] Staff Facilities: A separate facility shall be provided for the staff of the operating room, delivery room and nursery. This facility shall include dressing rooms with toilet and lavatory facilities including hot and cold running water, detergent or antiseptic scrub, individual towels and waste receptacles.
AUTHORITY NOTE: Promulgated in accordance with the provisions of R.S. 40:4(A)(10) and R.S. 40:5(3).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1396 (June 2002).
§315. Nursery
[formerly paragraph 19:036]
A. A maximum of 24 infants stations shall be allowed in each full-term nursery room. The nursery shall be maintained at a temperature of approximately 75°F (24°C) and 30-60 percent relative humidity. The nursery shall have a reliable thermometer with records of daily temperatures maintained. Separate nursery rooms shall be provided for well and sick babies. There shall be a suitable designated area for staff hygiene and gowning.
B. [Formerly paragraph 19:037] There shall be a suitable, designated area for the preparation of milk mixtures. This area shall be equipped with a sink, hand-washing facilities and storage space. This sink and lavatory shall be equipped with foot, knee or elbow faucet control with hot and cold water dispensed through a mixing valve.
C. [Formerly paragraph 19:038] Infant formula and other fluids requiring heat sterilization shall be prepared by terminal heat method in a separate room. This is a process by which the completely assembled formula units (bottles filled with formula, with nipples applied and covered with nipple protectors) are exposed to a minimum of 230°F (110°C) for 10 minutes in order to achieve pasteurization.
D. [Formerly paragraph 19:039] The individually bottled formula shall be stored in a refrigerator, specifically designated for that purpose, equipped with a thermometer. The temperature shall be maintained at 40° to 45°F (4° to 7°C).
AUTHORITY NOTE: Promulgated in accordance with the provisions of R.S. 40:4(A)(10) and R.S. 40:5(3).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1396 (June 2002).
§317. Respiratory/Physical Therapy Rooms
[formerly paragraph 19:040]
A. These areas shall be clean at all times and free of materials or equipment not needed to carry out the function required by the respective units. Accommodation shall be made to handle patients under isolation requiring such therapy. Respiratory and hydrotherapy equipment shall be cleaned and disinfected as needed after each use.
AUTHORITY NOTE: Promulgated in accordance with the provisions of R.S. 40:4(A)(10) and R.S. 40:5(3).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1396 (June 2002).
§319. Morgue
[formerly paragraph 19:041]
A. The mortuary table shall be cleaned and disinfected after each use and kept in good repair. A check valve shall be provided in the water supply line upstream from the control valve. A vacuum breaker or siphon breaker of an approved type shall be installed in the water supply line at least
6 inches (15 cm) higher than the aspirator and downstream from the control valve. The aspirator shall be installed at least 6 inches (15 cm) above the highest level at which suction may be taken. An air gap equal to at least one pipe diameter shall be provided between the outlet of the discharge pipe and the overflow rim of the receiving fixture.
B. [Formerly paragraph 19:042] The cold storage vaults shall be clean and in good repair, maintained at less than 45°F (7°C ) and used for no other purpose.
AUTHORITY NOTE: Promulgated in accordance with the provisions of R.S. 40:4(A)(10) and R.S. 40:5(3).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1396 (June 2002).
Chapter 5. General Standards
§501. Space and Bed Standards
[formerly paragraph 19:043]
A. The following space and bed guidelines shall be provided for specific patient care areas.
1. Adult Patient Room
a. 4 beds per room maximum:
b. 100 sq. ft. (9.29 sq. m.) for single room;
c. 80 sq. ft. (7.43 sq. m.) per bed for multi-bed rooms;
d. 3'8" (1.12 m.) minimum clearance at foot of bed in multi-bed rooms.
2. Adult Intensive Care Unit
a. 120 sq. ft. (11.15 sq. m.) for single bed rooms or Intensive Care Unit Cubicles;
b. 7'10" (2.13 m.) clearance between beds.
3. Obstetrical Care―Levels I, II, and III*
a. Labor Room
i. **Minimum of 140 sq. ft. per private room
ii. **Minimum of 100 sq. ft. for each bed in multiple-bed rooms
b. Delivery Room
i. **Minimum of 350 sq. ft. of floor space
4. Neonatal Care (Nursery)
a. Levels I and II*
i. **Maximum of 24 bassinets per nursery room
ii. **Minimum of 2 feet between bassinets
iii. Minimum of 20 sq. ft. per infant in normal newborn area
iv. **Minimum of 40 sq. ft. per infant in admission-observation area
b. Level III* (Newborn Intensive Care)
i. **Minimum of 6 ft. between bassinets or incubators
ii. Minimum of 80 sq. ft. per infant
*Note: Levels are defined in the following document: "Obstetrical and Neonatal Guidelines Regionalization of Perinatal Care in the State of Louisiana," Commission on Perinatal Care, February, 1980, amended February 1982.
**Note: These standards conform to the new guidelines recommended by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists in "Guidelines for Perinatal Care," 1983.
5. Pediatrics
a. 6 cribs/beds maximum per room for pediatric/adolescent room;
b. 60 sq. ft. (5.57 sq. m.) per cribs/beds.
6. Out Patient
a. 80 sq. ft. (7.43 sq. m.) for general and special exam rooms;
b. 120 sq. ft. (11.15 sq. m.) for out patient treatment rooms.
7. Operating Room
a. 360 sq. ft. (33.45 sq. m.) per room.
8. Cystoscopy-Type Room
a. 250 sq. ft. (23.23 sq. m.) per room.
B. [Formerly paragraph 19:044] Present Enforceable Standards with which Hospitals Must Comply Include the Following Parts from This Code
1. Part II. The Control of Diseases
2. Part V. Disease Vector Control
3. Part VII. Milk, Milk Products, and Manufactured Milk Products
4. Part VIII. Frozen Desserts
5. Part IX. Seafood (Marine and Freshwater Animal Food Products)
6. Part XII. Water Supplies
7. Part XIII. Sewage Disposal
8. Part XIV. Plumbing
9. Part XXIII. Retail Food Establishments
10. Part XXVI. Burial, Transportation, Disintermentor or other Disposition of Dead Human Bodies
AUTHORITY NOTE: Promulgated in accordance with the provisions of R.S. 40:4(A)(10) and R.S. 40:5(3).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1396 (June 2002).