[Code of Federal Regulations]
[Title 38, Volume 2]
[Revised as of July 1, 2003]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR52.200]

[Page 860-861]
 
            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
 
          CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS (CONTINUED)
 
PART 52--PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES--
Table of Contents
 
                          Subpart D--Standards
 
Sec. 52.200  Physical environment.

    The physical environment must be designed, constructed, equipped, 
and maintained to protect the health and safety of participants, 
personnel and the public.
    (a) Life safety from fire. The facility must meet the applicable 
provisions of the National Fire Protection Association's NFPA 101, Life 
Safety Code, 2000 edition. Incorporation by reference this document was 
approved by the Director of the Federal Register in accordance with 5 
U.S.C. 552(a) and 1 CFR part 51. The document incorporated by reference 
is available for inspection at the Office of the Federal Register, Suite 
700, 800 North Capitol Street, NW, Washington, DC, and the Department of 
Veterans Affairs, Office of Regulations Management (02D), Room 1154, 810 
Vermont Avenue, NW., Washington, DC 20420. Copies may be obtained from 
the National Fire Protection Association, Battery March Park, Quincy, MA 
02269. (For ordering information, call toll-free 1-800-344-3555.)
    (b) Space and equipment. (1) Program management must--
    (i) Provide sufficient space and equipment in dining, health 
services, recreation, and program areas to enable staff to provide 
participants with needed services as required by these standards and as 
identified in each participant's plan of care; and
    (ii) Maintain all essential mechanical, electrical, and patient care 
equipment in safe operating condition.
    (2) Each adult day health care program, when it is co-located in a 
nursing home, domiciliary, or other care facility, must have its own 
separate designated space during operational hours.
    (3) The indoor space for an adult day health care program must be at 
least 100 square feet per participant including office space for staff 
and must be 60 square feet per participant excluding office space for 
staff.

[[Page 861]]

    (4) Each program will need to design and partition its space to meet 
its own needs, but a minimal number of functional areas must be 
available. These include:
    (i) A dividable multipurpose room or area for group activities, 
including dining, with adequate table-setting space.
    (ii) Rehabilitation rooms or an area for individual and group 
treatments for occupational therapy, physical therapy, and other 
treatment modalities.
    (iii) A kitchen area for refrigerated food storage, the preparation 
of meals and/or training participants in activities of daily living.
    (iv) An examination and/or medication room.
    (v) A quiet room (with at least one bed), which functions to isolate 
participants who become ill or disruptive, or who require rest, privacy, 
or observation, must include a bed. It should be separate from activity 
areas, near a restroom, and supervised.
    (vi) Bathing facilities adequate to facilitate bathing of 
participants with functional impairments.
    (vii) Toilet facilities and bathrooms easily accessible to people 
with mobility problems, including participants in wheelchairs. There 
must be at least one toilet for every eight participants. The toilets 
must be equipped for use by persons with limited mobility, easily 
accessible from all programs areas, i.e., preferably within 40 feet from 
that area, designed to allow assistance from one or two staff, and 
barrier-free.
    (viii) Adequate storage space. There should be space to store arts 
and crafts materials, personal clothing and belongings, wheelchairs, 
chairs, individual handiwork, and general supplies. Locked cabinets must 
be provided for files, records, supplies, and medications.
    (ix) An individual room for counseling and interviewing participants 
and family members.
    (x) A reception area.
    (xi) An outside space that is used for outdoor activities that is 
safe, accessible to indoor areas, and accessible to those with a 
disability. This space may include recreational space and garden area. 
It should be easily supervised by staff.
    (c) Furnishings must be available for all participants. This must 
include functional furniture appropriate to the participants' needs. 
Furnishings must be attractive, comfortable, and homelike, while being 
sturdy and safe.
    (d) Participant call system. The coordinator's station must be 
equipped to receive participant calls through a communication system 
from--
    (1) Clinic rooms; and
    (2) Toilet and bathing facilities.
    (e) Other environmental conditions. The program management must 
provide a safe, functional, sanitary, and comfortable environment for 
the participants, staff and the public. The program management must--
    (1) Establish procedures to ensure that water is available to 
essential areas if there is a loss of normal water supply;
    (2) Have adequate outside ventilation by means of windows, or 
mechanical ventilation, or a combination of the two;
    (3) Equip corridors, when available, with firmly-secured handrails 
on each side; and
    (4) Maintain an effective pest control program so that the facility 
is free of pests and rodents.

(Authority: 38 U.S.C. 101, 501, 1741-1743)