[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: 42CFR485.623]



[Page 606-607]

 

                         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

    (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 otherwise 

provided in this section--

    (i) The CAH must meet the applicable provisions of the 2000 edition 

of the Life Safety Code of the National Fire Protection Association. 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 Life Safety Code does not apply to a CAH.

    (2) If CMS finds that the State has a fire and safety code imposed 

by State law that adequately protects patients, CMS may allow the State 

survey agency to apply the State's fire and safety code instead of the 

LSC.

    (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.



[[Page 607]]



    (4) The CAH maintains written evidence of regular inspection and 

approval by State or local fire control agencies.

    (5) Beginning March 13, 2006, a critical access hospital must be in 

compliance with Chapter 9.2.9, Emergency Lighting.

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

does not apply to critical access hospitals.

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

Safety Code to the contrary, a critical access hospital 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 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 change.



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

1997; 68 FR 1387, Jan. 10, 2003; 69 FR 49271, Aug. 11, 2004; 70 FR 

15239, Mar. 25, 2005]