(a) General considerations.

1. (1) Rehabilitation facilities may be organized under:

   1. (A) Hospitals (organized departments of rehabilitation);
   2. (B) Outpatient clinics;
   3. (C) Rehabilitation centers; and
   4. (D) Other facilities designed to serve either single-disability or multiple-disability categories including but not limited to:

(i) Cerebrovascular;

1. (ii) Head trauma;

   1. (iii) Spinal cord injury;

      1. (iv) Amputees;
      2. (v) Complicated fractures;
      3. (vi) Arthritis;
      4. (vii) Neurological degeneration;
      5. (viii) Genetic; and
      6. (ix) Cardiac.

2. (2) In general, rehabilitation hospitals shall have:

   1. (A) Larger space requirements than general hospitals;
   2. (B) Longer lengths of stay; and
   3. (C) Fewer institutional and more residential environments.

(b) General construction considerations. See 20 CAR § 41-146(a), physical facilities.

1. (c) Site location, inspection, approval, and subsoil investigation. See 20 CAR § 41-146(d), physical facilities.

   1. (d) Construction documents. See 20 CAR § 41-146(k), physical facilities.

(f) Functional units and service areas.

1. (1) Required units. Each rehabilitation facility shall:

   1. (A) Contain a medical evaluation unit; and

   2. (B) Provide the following service areas, if the services are not otherwise conveniently accessible to the facility and appropriate to program functions:

      1. (i) Psychological services;
      2. (ii) Social services;
      3. (iii) Vocational services;
      4. (iv) Patient dining, recreation, and day spaces;
      5. (v) Dietary;
      6. (vi) Personal care facilities;
      7. (vii) Space for teaching activities of daily living;
      8. (viii) Administration department;
      9. (ix) Medical records;
      10. (x) Engineering service and equipment areas;
      11. (xi) Laundry services;
      12. (xii) Housekeeping rooms;
      13. (xiii) Employees’ facilities;
      14. (xiv) Nursing unit;
      15. (xv) Physical therapy;
      16. (xvi) Occupational therapy; and
      17. (xvii) Speech and hearing.

2. (2) Optional units.

   1. (A) The following special services areas, if required by the functional program, shall be provided as outlined in this part.

   2. (B) The sizes of the various departments will depend upon the services to be provided:

      1. (i) Sterilizing facilities;
      2. (ii) Prosthetics and orthotics;
      3. (iii) Dental;
      4. (iv) Radiology;
      5. (v) Pharmacy;
      6. (vi) Laboratory;
      7. (vii) Home health;
      8. (viii) Outpatient services; and
      9. (ix) Therapeutic pool.

(g) Evaluation unit.

1. (1) Office or offices for personnel.

2. (2) Examination rooms.

   1. (A) The rooms shall have a minimum floor area of one hundred forty square feet (140 sq. ft.) excluding such spaces as the vestibule, toilet, closet, and work counter, whether fixed or movable.
   2. (B) The minimum room dimension shall be ten feet (10’).

   3. (C) The room shall contain a:

      1. (i) Lavatory or sink equipped for handwashing;
      2. (ii) Work counter and storage facilities; and
      3. (iii) Desk, counter, or shelf space for writing.

3. (3) Evaluation rooms.

   1. (A) The room areas shall be arranged to:

      1. (i) Permit appropriate evaluation of patient needs and progress; and
      2. (ii) Determine specific programs of rehabilitation.

   2. (B) Rooms shall include:

      1. (i) A desk and work area for the evaluators;
      2. (ii) Writing and work space for patients; and
      3. (iii) Storage for supplies.
   3. (C) Where the facility is small and workload light, evaluation may be done in the examination room.

4. (4) Laboratory facilities.

   1. (A) Facilities shall be provided within the rehabilitation department or through contract arrangement with a nearby hospital or laboratory service for:

      1. (i) Hematology;
      2. (ii) Clinical chemistry;
      3. (iii) Urinalysis;
      4. (iv) Cytology;
      5. (v) Pathology; and
      6. (vi) Bacteriology.

   2. (B) If these facilities are provided through contract, the following minimum laboratory services shall be provided in the rehabilitation facility:

      1. (i) Laboratory work counter or counters with a sink and gas and electric service;
      2. (ii) Handwashing stations;
      3. (iii) Storage cabinet or cabinets or closet or closets; and
      4. (iv)

(b) (b) Urine collection rooms shall be equipped with a water closet and lavatory.

1. (c) (c) Blood collection facilities shall have space for a chair and work counter.
2. (5) Imaging facilities. Imaging facilities, if required by the functional program, shall be in accordance with 20 CAR § 41-155, physical facilities — imaging suite.

(h) Psychological service. An office or offices and work space for testing, evaluation, and counseling shall be provided.

1. (i) Social service. Office space or spaces for private interviewing and counseling shall be provided.

(k) Dining, recreation, and day spaces.

1. (1) The following standards shall be met for patient dining, recreation, and day spaces.

2. (2) Areas may be in separate or adjoining spaces:

   1. (A) Inpatients and residents shall have a total of fifty-five square feet (55 sq. ft.) per bed;

   2. (B)

      1. (i) Outpatients.
      2. (ii) If dining is part of the day care program, a total of fifty-five square feet (55 sq. ft.) per person shall be provided.
      3. (iii) If dining is not part of the program, at least thirty-five square feet (35 sq. ft.) per person shall be provided for recreation and day spaces; and

   3. (C) Storage spaces shall be provided for recreation equipment and supplies.

      1. (l) Dietary department. See 20 CAR § 41-162, physical facilities — dietary facilities.
      2. (m) Personal care unit for inpatients.
3. (1) A separate room with appropriate fixtures and utilities shall be provided for patient grooming.
4. (2) The activities for daily living unit may serve this purpose.

(n) Activities for daily living unit.

1. (1) An area for teaching daily living activities shall be provided.

2. (2) It shall include a:

   1. (A) Bedroom;
   2. (B) Bath;
   3. (C) Kitchen; and
   4. (D) Space for training stairs.
3. (3) Equipment shall be functional.
4. (4) The bathroom shall be in addition to other toilet and bathing requirements.
5. (5) The daily living area shall be similar to a residential environment for the purpose of facilitating the patient’s skill for daily living.

(t) Nursing.

1. (1) The nursing units for rehabilitation facilities shall follow the standards as described in 20 CAR § 41-147, physical facilities — patient accommodations — adult medical, surgical — communicable or pulmonary disease, with the following exceptions:

   1. (A)

      1. (i) Patient rooms.
      2. (ii) Minimum areas exclusive of toilet rooms, closets, lockers, wardrobes, alcoves, or vestibules shall be:

(b) (b) One hundred twenty-five square feet (125 sq. ft.) per bed in semiprivate rooms;

1. (B)

   1. (i) Each patient shall have access to a toilet room without having to enter the general corridor area.

      1. (ii) One (1) toilet room shall serve no more than:

(b) (b) Two (2) patient rooms;

1. (iii) The toilet room shall contain a:

(b) (b) Handwashing fixture; and

1. (c) (c) Tub and/or shower;

   1. (iv) The handwashing fixture may be omitted from a toilet room that serves single-bed and two-bed rooms if each such patient’s room contains a handwashing fixture.

      1. (v) Each toilet room shall be of sufficient size to ensure that wheelchair users and staff shall have access; and

   2. (C)

      1. (i) Each patient shall have access to a wardrobe, closet, or locker with minimum clearance of one foot ten inches by one foot eight inches (1’ 10” x 1’ 8”).
      2. (ii) A clothes rod and adjustable shelf shall be provided.

2. (2) Nursing unit service areas shall follow the standards described in 20 CAR § 41-147, physical facilities — patient accommodations — adult medical, surgical — communicable or pulmonary disease, with the following exceptions:

   1. (A)

      1. (i) Patient bathing facilities.
      2. (ii) At least one (1) island-type bathtub and/or gurney shower shall be provided in each nursing unit.
      3. (iii) Each tub and/or shower shall be in an individual room or privacy enclosure that provides space for:

(b) (b) Drying and dressing; and

1. (c) (c) A wheelchair and an assistant.

   1. (iv) Showers in central bathing facilities shall be:

(b) (b) Curb-free; and

1. (c) (c) Designed for use by a wheelchair patient;

   1. (B)

      1. (i) At least one (1) room on each floor containing a nursing unit shall be provided for toilet training.
      2. (ii) It shall be accessible from the nursing corridor.
      3. (iii) A minimum clearance of three feet (3’) shall be provided at the front and at each side of the water closet.
      4. (iv) The room shall also contain a lavatory; and

   2. (C)

      1. (i) Handrails shall be provided on both sides of corridors used by patients.
      2. (ii) A clear distance of one and one-half inches (1 1/2”) shall be provided between the handrail and the wall, and the top of the rail shall be thirty-four inches (34”) minimum and thirty-six inches (36”) maximum above the floor.
      3. (iii) Exceptions for height shall be for special care areas such as those serving children.

(u) Sterilizing facilities. See 20 CAR § 41-168, physical facilities — cleaning and sanitizing carts, employee facilities, and environmental closets.

1. (v) Rehabilitation therapy. See 20 CAR § 41-159, physical facilities — rehabilitation therapy department.

(w) Pharmacy unit. See 20 CAR § 41-161, physical facilities — pharmacy.

1. (x) Details and finishes. See 20 CAR § 41-171, physical facilities — details and finishes.