[Code of Federal Regulations]
[Title 42, Volume 3]
[Revised as of October 1, 2002]
From the U.S. Government Printing Office via GPO Access
[CITE: 42CFR485.623]

[Page 592-593]
 
                         TITLE 42--PUBLIC HEALTH
 
  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 
                 HEALTH AND HUMAN SERVICES--(Continued)
 
PART 485--CONDITIONS OF PARTICIPATION: SPECIALIZED PROVIDERS--Table of Contents
 
Subpart F--Conditions of Participation: Critical Access Hospitals (CAHs)
 
Sec. 485.623  Condition of participation: Physical plant and environment.

    (a) Standard: Construction. The CAH is constructed, arranged, and 
maintained to ensure access to and safety of patients, and provides 
adequate space for the provision of direct services.
    (b) Standard: Maintenance. The CAH has housekeeping and preventive 
maintenance programs to ensure that--
    (1) All essential mechanical, electrical, and patient-care equipment 
is maintained in safe operating condition;
    (2) There is proper routine storage and prompt disposal of trash;
    (3) Drugs and biologicals are appropriately stored;
    (4) The premises are clean and orderly; and
    (5) There is proper ventilation, lighting, and temperature control 
in all pharmaceutical, patient care, and food preparation areas.
    (c) Standard: Emergency procedures. The CAH assures the safety of 
patients in non-medical emergencies by--
    (1) Training staff in handling emergencies, including prompt 
reporting of fires, extinguishing of fires, protection and, where 
necessary, evacuation of patients, personnel, and guests, and 
cooperation with fire fighting and disaster authorities;
    (2) Providing for emergency power and lighting in the emergency room 
and for battery lamps and flashlights in other areas;
    (3) Providing for an emergency fuel and water supply; and

[[Page 593]]

    (4) Taking other appropriate measures that are consistent with the 
particular conditions of the area in which the CAH is located.
    (d) Standard: Life safety from fire--(1) Except as provided in 
paragraphs (d)(2) and (d)(3) of this section, the CAH must meet the 
requirements of chapter 12, New Health Care Occupancy, or chapter 13, 
Existing Health Care Occupancy, of the 1985 edition of the Life Safety 
Code of the National Fire Protection Association. Incorporation by 
reference of the 1985 edition of the National Fire Protection 
Association's Life Safety Code (published February 7, 1985; ANSI/NFPA 
101) was approved by the Director of the Federal Register in accordance 
with 5 U.S.C. 552(a) and 1 CFR part 51. The Code is available for 
inspection at the CMS Information Resource Center, 7500 Security 
Boulevard, Room C2-07-13, Central Building, Baltimore, MD 21244-1850, 
and the Office of the Federal Register, 800 North Capitol Street, NW., 
suite 700, Washington, DC. Copies may be obtained from the National Fire 
Protection Association, Batterymarch Park, Quincy, Mass. 02209. If any 
changes in this code are also to be incorporated by reference, a 
document to that effect will be published in the Federal Register.
    (2) Any CAH that as a hospital on or before November 26, 1982, 
complied, with or without waivers, with the requirements of the 1967 
edition of the Life Safety Code, or after November 26, 1982 and on or 
before May 9, 1988, complied with the 1981 edition of the Life Safety 
Code, is considered to be in compliance with this standard as long as 
the CAH continues to remain in compliance with that edition of the Code. 
The 1967 and 1981 Life Safety Codes are available for inspection at the 
CMS Information Resource Center, 7500 Security Boulevard, Room C2-07-13, 
Central Building, Baltimore, MD 21244-1850.
    (3) After consideration of State survey agency findings, CMS may 
waive specific provisions of the Life Safety Code that, if rigidly 
applied, would result in unreasonable hardship on the CAH, but only if 
the waiver does not adversely affect the health and safety of patients.
    (4) The CAH maintains written evidence of regular inspection and 
approval by State or local fire control agencies.

[58 FR 30671, May 26, 1993, as amended at 62 FR 46036, 46037, Aug. 29, 
1997]