[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: 38CFR59.160]

[Page 895-897]
 
            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
 
          CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS (CONTINUED)
 
PART 59--GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES--
Table of Contents
 
Sec. 59.160  Adult day health care requirements.

    As a condition for receiving a grant and grant funds under this part 
for an adult day health care facility, States must meet the requirements 
of this section.
    (a) 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.
    (b) 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.
    (c) Each program will need to design and partition its space to meet 
its own needs, but the following functional areas must be available:
    (1) A dividable multipurpose room or area for group activities, 
including dining, with adequate table setting space.
    (2) Rehabilitation rooms or an area for individual and group 
treatments for occupational therapy, physical therapy, and other 
treatment modalities.
    (3) A kitchen area for refrigerated food storage, the preparation of 
meals and/or training participants in activities of daily living.
    (4) An examination and/or medication room.
    (5) 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. It should be separate from activity areas, near a 
restroom, and supervised.
    (6) Bathing facilities adequate to facilitate bathing of 
participants with functional impairments.
    (7) 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.
    (8) 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.

[[Page 896]]

    (9) An individual room for counseling and interviewing participants 
and family members.
    (10) A reception area.
    (11) 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 a garden area. 
It should be easily supervised by staff.
    (d) Furnishings must be available for all participants. This must 
include functional furniture appropriate to the participants' needs.
    (e) Unless determined by VA as necessary to accommodate an increased 
quality of care for patients, an adult day health care facility project 
may propose a deviation of no more than 10 percent (more or less) from 
the following net square footage for the State to be eligible for a 
grant of 65 percent of the total estimated cost of the project. If the 
project proposes building more than the following net square footage and 
VA makes a determination that it is not needed, the cost of the 
additional net square footage will not be included in the estimated 
total cost of construction.

              Table to Paragraph (e)--Adult Day Health Care
------------------------------------------------------------------------

------------------------------------------------------------------------
I. Support facilities [allowable
 square feet (or metric
 equivalent) per facility for VA
 participation]:
    Program Director..............  200
    Assistant administrator.......  150
    Medical officer, director of    150
     nursing or equivalent.
    Nurse and dictation area......  120
    General administration (each    120
     office/person).
    Clerical staff (each).........  80
    Computer area.................  40
    Conference room (consultation   500 (for each room).
     area, in-service training).
    Lobby/receiving/waiting area    3 (per participant)
     (150 minimum).
    Public/resident toilets (male/  25 (per fixture).
     female).
    Dining area (may be included    20 (per participant).
     in the multipurpose room).
    Vending machines..............  1 (per participant).
    Participant toilets (male/      25 (per fixture).
     female).
    Medical support (staff offices/ 140 (for each room).
     family counseling, etc.).
    Janitor's closet..............  40
    Dividable multipurpose room...  15 (per participant).
    Employee lockers..............  6 (per employee)
    Employee lounge...............  120
    Employee toilets..............  25 (per fixture).
    Physical therapy..............  5 (per participant).
    Office, if required...........  120
    Occupational therapy..........  5 (per participant).
    Office, if required...........  120
    Building maintenance storage..  2.5 (per participant).
    Resident storage..............  6 (per participant).
    General warehouse storage.....  6 (per participant).
    Medical/dietary...............  7 (per participant).
    General laundry \1\...........  ....................................
II. Other Areas:
    Participant quiet room........  3 (per participant).
    Clean utility.................  120
    Soiled utility................  105
    General storage...............  100
    Nurses station, ward secretary  260
    Medication/exam/treatment       75
     rooms.
    Waiting area..................  50
    Program supply and equipment..  50
    Staff toilet..................  25 (per fixture).

[[Page 897]]


    Wheelchair storage............  100
    Kitchen.......................  120
    Janitor's closet..............  40
    Resident laundry..............  125
    Trash collection..............  60
III. Bathing and Toilet
 Facilities:
    (A) Private or shared
     facilities:
        Wheelchair facilities.....  25 (per fixture).
        Standard facilities.......  15 (per fixture).
    (B) Full bathroom.............  75
------------------------------------------------------------------------
\1\ The size to be determined by the Chief Consultant, Geriatrics and
  Extended Care, as necessary to accommodate projected patient care
  needs (must be justified by State in space program analysis).


(Authority: 38 U.S.C. 101, 501, 1710, 1742, 8105, 8131-8137; Sections 2, 
3, 4, and 4a of the Architectural Barriers Act of 1968, as amended, 
Public Law 90-480, 42 U.S.C. 4151-4157)