[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR460.72]



[Page 424-425]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 460_PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)--Table 

of Contents

 

               Subpart E_PACE Administrative Requirements

 

Sec. 460.72  Physical environment.



    (a) Space and equipment--(1) Safe design. A PACE center must meet 

the following requirements:

    (i) Be designed, constructed, equipped, and maintained to provide 

for the physical safety of participants, personnel, and visitors.

    (ii) Ensure a safe, sanitary, functional, accessible, and 

comfortable environment for the delivery of services that protects the 

dignity and privacy of the participant.

    (2) Primary care clinic. The PACE center must include sufficient 

suitable space and equipment to provide primary medical care and 

suitable space for team meetings, treatment, therapeutic recreation, 

restorative therapies, socialization, personal care, and dining.

    (3) Equipment maintenance. A PACE organization must establish, 

implement, and maintain a written plan to ensure that all equipment is 

maintained in accordance with the manufacturer's recommendations.

    (b) Fire safety. (1) General rule. Except as otherwise provided in 

this section--

    (i) A PACE center must meet the applicable provisions of the 2000 

edition of the Life Safety Code (LSC) of the National Fire Protection 

Association that apply to the type of setting in which the center is 

located. The Director of the Office of the Federal Register has approved 

the NFPA 101 [reg] 2000 edition of the Life Safety Code, 

issued January 14, 2000, for incorporation by reference in accordance 

with 5 U.S.C. 552(a) and 1 CFR part 51. A copy of the Code is available 

for inspection at the CMS Information Resource Center, 7500 Security 

Boulevard, Baltimore, MD or at the National Archives and Records 

Administration (NARA). For information on the availability of this 

material at NARA, call 202-741-6030, or go to: http://www.archives.gov/

federal--register/code--of--federal--regulations/ibr--locations.html. 

Copies may be obtained from the National Fire Protection Association, 1 

Batterymarch Park, Quincy, MA 02269. If any changes in this edition of 

the Code are incorporated by reference, CMS will publish notice in the 

Federal Register to announce the changes.

    (ii) Chapter 19.3.6.3.2, exception number 2 of the adopted edition 

of the LSC does not apply to PACE centers.

    (2) Exceptions. (i) The Life Safety Code provisions do not apply in 

a State in which CMS determines that a fire and safety code imposed by 

State law adequately protects participants and staff.

    (ii) CMS may waive specific provisions of the Life Safety Code that, 

if rigidly applied, would result in unreasonable hardship on the center, 

but only if the waiver does not adversely affect the health and safety 

of the participants and staff.

    (3) Beginning March 13, 2006, a PACE center must be in compliance 

with Chapter 9.2.9, Emergency Lighting.

    (4) Beginning March 13, 2006, Chapter 19.3.6.3.2, exception number 2 

does not apply to PACE centers.

    (5) Notwithstanding any provisions of the 2000 edition of the Life 

Safety Code to the contrary, a PACE center may install alcohol-based 

hand rub dispensers in its facility if--

    (i) Use of alcohol-based hand rub dispensers does not conflict with 

any State or local codes that prohibit or otherwise restrict the 

placement of alcohol-based hand rub dispensers in health care 

facilities;

    (ii) The dispensers are installed in a manner that minimizes leaks 

and spills that could lead to falls;

    (iii) The dispensers are installed in a manner that adequately 

protects against access by vulnerable populations; and

    (iv) The dispensers are installed in accordance with chapter 

18.3.2.7 or chapter 19.3.2.7 of the 2000 edition of the Life Safety 

Code, as amended by NFPA Temporary Interim Amendment



[[Page 425]]



00-1(101), issued by the Standards Council of the National Fire 

Protection Association on April 15, 2004. The Director of the Office of 

the Federal Register has approved NFPA Temporary Interim Amendment 00-

1(101) for incorporation by reference in accordance with 5 U.S.C. 552(a) 

and 1 CFR part 51. A copy of the amendment is available for inspection 

at the CMS Information Resource Center, 7500 Security Boulevard, 

Baltimore, MD and at 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, 1 Batterymarch Park, 

Quincy, MA 02269. If any additional changes are made to this amendment, 

CMS will publish notice in the Federal Register to announce the changes.

    (c) Emergency and disaster preparedness--(1) Procedures. The PACE 

organization must establish, implement, and maintain documented 

procedures to manage medical and nonmedical emergencies and disasters 

that are likely to threaten the health or safety of the participants, 

staff, or the public.

    (2) Emergencies defined. Emergencies include, but are not limited, 

to the following:

    (i) Fire.

    (ii) Equipment, water, or power failure.

    (iii) Care-related emergencies.

    (iv) Natural disasters likely to occur in the organization's 

geographic area. (An organization is not required to develop emergency 

plans for natural disasters that typically do not affect its geographic 

location.)

    (3) Emergency training. A PACE organization must provide appropriate 

training and periodic orientation to all staff (employees and 

contractors) and participants to ensure that staff demonstrate a 

knowledge of emergency procedures, including informing participants what 

to do, where to go, and whom to contact in case of an emergency.

    (4) Availability of emergency equipment. Emergency equipment, 

including easily portable oxygen, airways, suction, and emergency drugs, 

along with staff who know how to use the equipment, must be on the 

premises of every center at all times and be immediately available. The 

organization must have a documented plan to obtain emergency medical 

assistance from sources outside the center when needed.

    (5) Annual test of emergency and disaster plan. At least annually, a 

PACE organization must actually test, evaluate, and document the 

effectiveness of its emergency and disaster plans.



[64 FR 66279, Nov. 24, 1999, as amended at 68 FR 1386, Jan. 10, 2003; 69 

FR 49266, Aug. 11, 2004; 70 FR 15238, Mar. 25, 2005]