TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER c: LONG-TERM CARE FACILITIES
PART 380 SPECIALIZED MENTAL HEALTH REHABILITATION FACILITIES CODE
SECTION 380.670 PHYSICAL PLANT AND ENVIRONMENTAL REQUIREMENTS
Section 380.670 Physical Plant and Environmental Requirements
a) Consumer living areas shall be planned and arranged with an awareness of the prevalence of trauma in people with mental health and substance abuse issues. Evidence-based practices of trauma-informed care shall be adhered to in residential settings.
b) Private meeting space shall be available in each facility for consumers to meet with outside service providers, assessors, family or other persons for other professional purposes in accordance with the consumer's treatment plan.
c) Physical Plant Requirements. The facility shall comply with locally adopted building codes as enforced by local authorities and Chapter 33 of NFPA 101 (see Section 380.110 (a)(1)) and any local fire codes that are more stringent than the NFPA as enforced by local authorities or the Office of the State Fire Marshal. New construction shall comply with Chapter 32 of NFPA 101 (see Section 380.110(a)(1)). The facility shall make available to the Department, upon request, the report of an inspection that has been made by the local authorities or the Office of the State Fire Marshal. The facility shall comply with the following additional NFPA standards:
1) No. 10: Standard for Portable Fire Extinguishers
2) No. 13: Standard for the Installation of Sprinkler Systems
3) No. 25: Standard for the Inspection, Testing and Maintenance of Water-Based Fire Protection Systems
4) No. 54: National Fuel Gas Code
5) No. 70: National Electrical Code
6) No. 72: National Fire Alarm and Signaling Code
7) No. 80: Standard for Fire Doors and Other Opening Protectives
8) No. 90A: Standard for Installation of Air Conditioning and Ventilating Systems
9) No. 96: Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations
10) No. 99: Health Care Facilities Code
11) No. 110: Standard for Emergency and Standby Power Systems
12) No. 220: Standard on Types of Building Construction
13) No. 241: Standard for Safeguarding Construction, Alteration and Demolition
d) Living arrangements shall meet the following additional requirements:
1) A triage center shall provide a secure room within the facility, near the facility entrance, for the assessment of incoming consumers. The triage center shall provide the following:
A) A staff member, available as needed at the entrance of the triage center;
B) A centrally located nurse duty area that gives staff a direct line of site to the consumer, permitting constant observation;
C) A window to the outside that is secured from opening and contains glazing so that, when broken, it will not produce shards of glass that can inflict injury to the consumer or to staff;
D) Features such as electrical outlets, sprinkler heads, doorknobs, light switches, etc., which shall be of a type that prevent a consumer from injuring himself or herself, accidentally or deliberately;
E) Adequate space and furnishings to permit staff to assess and diagnose consumers who present for triage;
F) Separate restroom facilities for men and women, complete with baths or showers and hygiene supplies, including soap, shampoo and deodorant for consumers;
G) A maximum of eight individual areas for interviews and assessment. The physical arrangement of the rooms shall preserve the safety and privacy of each consumer served;
H) Laundry services for consumer use, including laundry detergent;
I) Clean replacement clothing for both male and female consumers, if needed by the consumer;
J) Kitchen equipment to provide hot meals and snacks for consumers; and
K) A toilet room that is accessible from within the triage center. The toilet room shall be equipped with a water closet and lavatory. The door to the toilet room shall be lockable from the outside only.
2) A crisis stabilization unit shall be a separate unit within the facility, if the facility provides more than one level of service. In addition, a crisis stabilization unit shall provide the following:
A) Meeting and therapy rooms that comply with the level of service. The rooms shall be of adequate size and number to accommodate the maximum consumer population of the unit and shall be furnished for the purpose intended;
B) A maximum of 16 beds;
C) Visual monitoring of consumers for safety reasons, when indicated in the consumer's treatment plan;
D) As much privacy for each consumer as is clinically appropriate.
E) Hallways and common areas that are visible from the nurse duty area. If electronic monitoring devices are used, the video recording must be kept for seven days; and
F) Features including, but not limited to, electrical outlets, sprinkler heads, doorknobs, and light switches that prevent a consumer from injuring himself or herself accidentally or deliberately.
3) RRS units shall provide the following:
A) Meeting and therapy rooms in accordance with the level of service. The rooms shall be of adequate size and number to accommodate the maximum consumer population, and shall be furnished for the purpose intended;
B) Bedroom doors that are visible from the nurse duty area;
C) Adequate common space for programming; and
D) Sufficient private space for consumers to meet with assessors, transition staff, and visitors.
4) RSS unit maybe designated as all-male or all-female, for consumers who prefer segregated living arrangements, or for treatment purposes.
5) Transitional Living Units shall provide the following:
A) Meeting and therapy rooms according to the level of service. The rooms shall be of adequate size and number to accommodate the maximum consumer population and shall be furnished for the purpose intended;
B) Bedroom doors that are visible from the nurse duty area; and
C) A distinct unit within a facility.
6) Nurse Duty Area
A) The nurse duty area shall be either a centralized cluster serving more than one level of service in a facility or shall be used as a supportive area within a self-contained level of service.
B) The nurse duty area shall have adequate work counters, storage areas and communication equipment.
C) A hand-washing station convenient to the nurse duty area shall be provided.
D) A lounge and toilet rooms for staff shall be provided.
E) Closets or compartments shall be provided for the safekeeping of coats and personal effects of nursing personnel.
F) Charting facilities shall be provided for nurses and doctors, including work counter and secured file storage.
G) At least one tub or shower shall be provided for each 15 beds that do not have bathing facilities within the consumer's room. Each tub or shower shall be in an individual room that provides space for the private use of the bathing fixture and for drying and dressing.
H) A nourishment station with a sink equipped for hand washing, refrigerator, storage cabinets, ice dispensing equipment, and other equipment/supplies as necessary for serving nourishment between meals shall be provided.
I) A clean utility/work room shall be provided in each nursing area. The clean utility/work room shall contain a work counter, hand- washing sink and storage. A separate designated area shall be provided for clean linen storage. If a cart system is used, an alcove for storage of the cart may be used.
J) A soiled utility/workroom shall be provided and shall contain a hand-washing sink and a waste receptacle.
K) A locked janitor's closet shall be provided for each nurse duty area. The closet shall be for the exclusive use of housekeeping staff and shall be equipped with a floor receptor or service sink and adequate storage space for housekeeping equipment and supplies.
L) Mops and other cleaning supplies used and stored in the nurse areas shall not be used or stored in the kitchen area.
7) The facility shall have a smoke detection system that complies with the Smoke Detector Act.
8) Bathrooms shall be located and equipped to facilitate independence. When needed by the consumer, special assistive devices shall be provided. Bathing and toilet facilities shall provide privacy.
9) Each single individual bedroom shall have at least 75 square feet of net floor area, not including space for closets, bathrooms and clearly definable entryway areas.
A) Each multiple bedroom shall have at least 55 square feet of net floor area per consumer, not including space for closets, bathrooms and clearly definable entryway areas. A minimum of 3 feet of clearance at the foot and sides of each bed shall be provided.
B) Each bedroom within crisis stabilization units, recovery and rehabilitation supports units, and transitional living units shall accommodate no more than two consumers, with 5% of the rooms in the first 18 months, and 10% of the rooms in the first three years, reserved for single occupancy.
C) Reasonable storage space for clothing and other personal belongings shall be provided for each consumer.
D) Each bedroom shall have walls that extend from floor to ceiling, a fire-graded bed that is suitable to the size of the consumer and that provides support and comfort, if beds are provided by the agency, and at least one outside window. The total window area to the outside shall be at least one-tenth of the floor area of the room.
E) Each toilet room shall be equipped with a water closet, a lavatory and a shower or shower/tub combination.
10) The facility shall ensure that living arrangements are free from vermin. Waste and garbage shall be stored, transferred and disposed of in a manner that does not permit the transmission of diseases. Water systems shall comply with the Drinking Water Systems Code, and the facility shall maintain copies of inspections performed by local and State inspectors in regard to health, sanitation and environment.
e) Plumbing, drainage facilities, and drinking water shall be maintained in compliance with the Illinois Plumbing Code.
1) Each facility shall be served by water from a municipal public water supply when available.
A) When a municipal public water supply is not available, the water supply shall comply with the Drinking Water Systems Code.
B) If water is supplied by a well that is not part of a municipal system, the well shall be constructed and maintained in accordance with the Water Well Construction Code and Illinois Water Well Pump Installation Code.
C) Each facility shall have a written agreement with a water company, dairy or other water purveyor to provide an emergency supply of potable water for drinking and culinary purposes.
2) Hot water temperature controls shall be maintained and regulated to prevent scalding, so that the temperature of hot water delivered to the plumbing fixtures that are used by consumers not exceed 115 degrees Farenheit.
3) Minimum hot water temperature shall be maintained at the final rinse section of dishwashing facilities as required by the Food Service Sanitation Code.
4) Suicide-resistant grab bars (for crisis stabilization and triage centers) and other bathroom fixtures shall be maintained at each community toilet, lavatory, shower and bathtub used by consumers and as needed in individual consumer rooms.
5) Toilet, hand-washing and bathing facilities shall be maintained in operating condition and in the number and types specified in construction requirements in effect at the time the building or unit was constructed.
6) If the facility accepts physically handicapped consumers, bathing and toileting appliances in the water closets shall be equipped for use by consumers with physical handicaps. All handicapped accessible facilities shall meet the minimum requirements of the Illinois Accessibility Code and the Americans With Disabilities Act.
f) All rooms, attics, basements, passageways and other spaces shall be provided with artificial illumination in accordance with the National Electrical Code.
1) All consumer rooms and accessible areas of corridors, storerooms, stairways, ramps, exits and entrances shall have lighting for ease of reading, working and passage.
2) The facility shall provide and maintain an emergency electrical system in safe operating condition.
g) Heating, air conditioning and ventilating systems shall be maintained in normal operating condition to provide a comfortable temperature and shall meet the requirements of the American Society of Heating, Refrigerating, and Air Conditioning Engineers Handbook of Fundamental Principles and Handbook of Applications.
1) The mechanical system shall be capable of maintaining a temperature of at least 75 degrees Fahrenheit.
2) The air-conditioning system shall be capable of maintaining an ambient air temperature of between 75 degrees Fahrenheit and 80 degrees Fahrenheit.
h) The facility shall develop a written record of the maintenance history of the heating, air conditioning and ventilation systems, which shall be available for inspection by the Department.
1) A log shall be used to document all maintenance work performed.
2) When maintenance is performed by an equipment service company, the facility shall request a certification that the required work has been performed in accordance with acceptable standards. The certification shall be retained on file in the facility for review by the Department.
i) The facility shall have housekeeping procedures to routinely clean articles and surfaces such as furniture, floors, walls, ceilings, supply and exhaust grills and lighting fixtures.
j) Schedules shall be posted and implemented that indicate areas of the facility that shall be cleaned daily, weekly or monthly.
1) Cleaning supplies and equipment shall be available to housekeeping staff and shall meet the following requirements:
A) Cleaning supplies and equipment shall be stored in rooms for housekeeping use only;
B) Appropriate cleaning agents shall be used for all cleaning;
C) Mop heads shall be removable and changed at least daily; and
D) Cleaning supplies and equipment shall be kept in a secured location/area that is accessed by authorized personnel only.
2) Housekeeping personnel shall be employed to maintain the interior of the facility in a safe, clean, orderly and attractive manner free from offensive odors.
3) Janitor closets, service sinks and storage areas shall be clean and maintained to meet the needs of the facility.
k) If the facility operates a laundry that is separate from consumer-operated washers and dryers for clothes, the facility laundry area shall be located in relationship to other areas so that steam, odors, lint and objectionable noises do not reach consumer areas.
1) The facility laundry area shall be adequate in size, well lighted, ventilated to meet the needs of the facility, and kept clean and sanitary.
2) Laundry equipment shall be kept in good condition, be maintained in a sanitary condition, and have suitable capacity.
3) Laundry areas shall have, at a minimum, the following:
A) Separate rooms for the storage of clean linen and soiled linen;
B) Hand-washing facilities maintained at locations convenient for laundry personnel; and
C) Linen carts labeled "soiled" or "clean" and constructed of washable materials that shall be laundered or suitably cleaned as needed to maintain sanitation.
4) The facility shall implement written procedures for handling, storing, transporting and processing linens. The written procedures shall be posted in the laundry.
5) If the facility does not maintain a laundry service, the facility shall contract only with a commercial laundry that meets the requirements of this Section.
l) The facility, including the grounds, shall be maintained in a clean and sanitary condition and in good condition at all times to ensure the safety and well-being of consumers, staff and visitors.
1) Buildings and grounds shall be free of environmental pollutants and nuisances that may adversely affect the health or welfare of consumers to the extent that is within the reasonable control of the facility.
2) All buildings, fixtures, equipment and spaces shall be maintained in operable condition.
3) Personnel shall be employed to provide preventive maintenance and to carry out the required maintenance program.
4) Equipment shall meet all applicable Occupational Safety and Health Act requirements in effect at the time of purchase. All portable electrical medical equipment designed for 110-120 volts, 60 hertz current, shall be equipped with a 3-wire-grounded power cord with a hospital-grade 3‑prong plug. The cord shall be an integral part of the plug.
5) The facility shall be maintained free from vermin and rodents through operation of a pest control program. The pest control program shall be conducted in the main consumer buildings, all outbuildings on the property and all grounds.
m) The facility shall be responsible for the regular inspection, cleaning or replacement of all filters installed in heating, air conditioning and ventilating systems, as necessary to maintain the systems in normal operating conditions.
1) A written record of inspection, cleaning or replacement shall be maintained and available for inspection by the Department.
2) When filter maintenance is performed by an equipment service company, the facility shall request a certification that the filter has been inspected, cleaned or replaced, with dates noted.
n) Emergency Electrical Requirements
1) To provide electricity during an interruption of the normal electric supply, an emergency source of electricity shall be provided and connected to certain circuits for lighting and power.
2) The source of this emergency electrical service shall be one of the following:
A) A Type 3 Essential Electrical System, in accordance with NFPA 99, when the normal service is supplied by only one central station transmission line; or
B) Automatic battery-operated systems or equipment that will be effective for 90 minutes and will be capable of supplying power for lighting for exit signs, exit corridors, stairways, nurses' areas, the communication system, and all alarm systems.
3) The facility shall provide emergency electrical service for:
A) Illumination of a means of egress as necessary for corridors, passageways, stairways, landings and exit doors and all ways of approach to and through exits, including outside lights;
B) Exit signs and exit directional signs;
C) Fire alarm systems and detection systems;
D) Communication systems that are used for issuing instructions; and
E) Task illumination in the nurse duty area.
1) Floor material in kitchens shall be easily cleanable and shall have wear resistance that is appropriate for the location involved, and shall be water resistant and greaseproof. The kitchen wall base shall be tightly sealed to the wall and floor and shall be constructed without voids or gaps that can accumulate dirt and grime and harbor vermin. Ceiling finishes shall be smooth, sanitary and washable, and shall be able to withstand treatment with harsh chemicals. The ceiling finish shall be capable of being thoroughly cleaned, including any concealed spaces that may be present.
2) Mops and all other cleaning supplies that are used in the kitchen shall not be used or stored anywhere else in the facility. A janitor's closet, equipped with a floor receptor or service sink and adequate storage space for housekeeping equipment and supplies, shall be provided for the kitchen.
3) Equipment and furnishing installations must meet all the requirements of the following:
A) NFPA 56 National Fuel Gas Code;
B) NFPA 70 National Electrical Code; and
C) NFPA 96 Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations.