Fla. Admin. Code R. 59A-26.019
All new facilities and all additions, renovations and alterations of existing facilities must be in compliance with the following physical plant standards:
(1) Site requirements.
(2) Living unit requirements.
(f) Each client living unit must have three or more bedrooms.
1. Each client must have accessible personal space within the bedroom to accommodate an individual bed and personal furnishings, and to decorate and arrange without disturbing others. This space must also be utilized to store personal possessions.
2. The dimensions and arrangement of the client bedrooms must provide a minimum of three feet wide (0.91 m) clear access space to each bed along at least 75 percent of the length of one side of the bed and must be designed to allow the use of a wheelchair and other portable equipment. In multiple-bed rooms, a clearance of 3 feet 8 inches (1.11 meters) to any fixed obstruction must be available at the foot of each bed to permit the passage of equipment and beds. For beds equipped with a piped in medical gas headwall unit, there must be minimum clearance of 3 feet (0.91m) along the entire length of the bed between both sides of the bed and any other bed, wall or any other fixed obstruction. The maximum number of clients sharing a bedroom shall be two.
(3) Details and finishes.
(4) Mechanical system requirements.
(5) Electrical requirements.
(e) Lighting.
1. All spaces occupied by people, machinery and equipment within buildings, approaches to buildings and parking lots must have electric lighting.
2. Client bedrooms must have general lighting and separate fixed night lighting. The night-light must have a switch at the entrance to each client’s room. A reading light must be provided for each client. Client reading lights, and other fixed lights not switched at the door, must have switch controls convenient for use at the luminary. Wall-mounted switches for control of lighting in client area must be of a quiet operating type.
(f) Receptacles.
1. The facility must provide one general purpose receptacle on a wall to serve each client and one additional receptacle at the head of the bed if a motorized bed is provided.
2. Duplex receptacles for general use must be installed in all general purpose corridors, approximately 50 feet (15.24 meters) apart and within 25 feet (7.62 meters) of corridor ends.
(h) Nurse call systems. Each facility must have a nurse call system that meets the following requirements:
1. A nurse call system must be provided that will register a call from each client bed to the related staff work area(s) by activating a visual signal at the client room door and activating a visual and audible signal in the clean utility, soiled utility, nourishment station, medication prep and the master station of the nursing unit or sub-nursing unit. Audible signals may be temporarily silenced provided subsequent calls automatically reactivate the audible signal. In rooms containing two or more calling stations, indicating lights must be provided for each calling station. In the corridor zone of multi-corridor nursing units, lights must be installed at corridor intersections in the vicinity of staff work areas;
2. An emergency calling station of the pull cord type must be provided and must be conveniently located for client use at each client toilet, bath or shower room, but not inside the shower unless the nurse call device is listed for wet locations. The call signal must be the highest priority and shall be cancelled only at the emergency calling station. The emergency station must activate distinctive audible and visual signals immediately at the client room door or wireless page, and activate a visual and audible signal in the staff work areas or mobile nurse station receiver and the master station of the client unit. If a mobile nurse station receiver is utilized to receive the client call it will be worn by all staff who are assigned to the client unit and must identify the specific client and or room from which the call was placed;
3. The nurse call master station must not block incoming client calls. The master station control settings must not prevent the activation of the incoming audible and visual signals. In wireless systems, all orphaned calls to mobile nurse station receivers will register at the nurse call master station;
4. In multi-client rooms, activation of an emergency call shall not cancel a normal call from the same room; and,
5. A corridor dome light must be located directly outside of any client care area that is equipped with a wired nurse call station.
(i) Emergency electrical system.
1. A Type 1 essential electrical system must be provided in all ICF/DD facilities as described in NFPA 99, “Health Care Facilities.”
2. In new construction, the normal main service equipment must be separated from the emergency distribution equipment by locating it in a separate room. Transfer switches must be considered emergency distribution equipment for this purpose.
3. Switches for critical branch lighting must be completely separate from normal switching. The devices or cover plates must be of a distinctive color. Critical branch switches may be adjacent to normal switches. Switches for life safety lighting are not permitted except as required for dusk-to-dawn automatic control of exterior lighting fixtures.
4. There must be selected life safety lighting provided at a minimum of one footcandle and designed for automatic dusk-to-dawn operation along the travel paths from the exits to the public way or to safe areas located a minimum of 30 feet (9.14 meters) from the building.
5. If a day tank is provided, then it must be equipped with a dedicated low level fuel alarm and a manual pump. The alarm must be located at the generator derangement panel.
6. Transfer switch contacts must be of the open type and must be accessible for inspection and replacement.
7. If required by the facility’s emergency food plan, then there must be power connected to the equipment branch of the essential electrical system for kitchen refrigerators, freezers and range hood exhaust fans. Selected lighting within the kitchen and dry storage areas must be connected to the critical branch of the essential electrical system.
(6) Other general requirements.
(7) Physical Plant Requirements for Disaster Resistance of ICF/DD Construction.
(a) Definitions. The following definitions apply specifically to this subsection:
1. Existing Facility means a facility that prior to December 1, 2015:
a. Is licensed and certified; or
b. Has received a Stage II preliminary plan approval from the Agency for a new facility.
2. New Facility means:
a. An ICF/DD licensed after December 1, 2015; or
b. A facility that receives a Stage II Preliminary Plan approval after December 1, 2015; or
c. An addition of a wing or floor to an existing ICF/DD, which has not received a Stage II Preliminary Plan approval pursuant to this section.
3. Net Square Footage means the clear floor space of an area excluding cabinetry and other fixed furniture or equipment.
4. During and Immediately Following means a period of 72 hours following the loss of normal support utilities to the facility.
5. Occupied Client Area(s) means the location of clients inside the new facility or in the addition of a wing or floor to an existing facility during and immediately following a disaster. If clients are to be relocated into an area of the existing facility during and immediately following a disaster, then for these purposes that location will be defined as the “occupied client area.”
6. Client Support Area(s) means the area(s) required to ensure the health, safety and well-being of clients during and immediately following a disaster, such as a staff work area, clean and soiled utility areas, food preparation area and other areas as determined by the licensee to be kept operational during and immediately following a disaster.
7. On-site means either in, immediately adjacent to, or on the campus of the facility, or addition of a wing or floor to an existing facility.
8. Client(s) Served means the number of clients as determined by the licensee that will be served in the occupied client area(s) during and immediately following a disaster, including clients from other facilities, if applicable.
(b) New Facility Construction Standards. The following construction standards are in addition to the physical plant requirements described in this rule. These minimum standards are intended to increase the ability of the new facility to be structurally capable of serving as a shelter for clients, staff and the family of clients and staff and equipped to be self-supporting during and immediately following a disaster.
1. Space standards.
a. Each new facility must provide a minimum of 30 net square feet (2.79 square meters) per client served in the occupied client area(s). The number of clients served is to be determined by the facility.
b. Each licensee must have space for administrative and support activities and space for use by facility staff to allow for care of clients in the occupied client area(s).
c. Each licensee must have space for all staff and family members of clients and staff.
2. Site standards.
a. The lowest floor of all new facilities shall be elevated to the "Base flood elevation" plus 2 feet (61 cm), or to the height of hurricane Category 3 (Saffir-Simpson scale) surge inundation elevation, as described by the Sea, Lake, and Overland Surge (SLOSH) from Hurricanes model developed by the Federal Emergency Management Agency (FEMA), United States Army Corps of Engineers (USACE), and the National Weather Service (NWS), whichever elevation requirement is more stringent. The Base flood elevation shall be defined as the elevation of an area having a 1 percent chance of being equaled or exceeded by flood waters in any given year.
b. For all existing facilities, the lowest floor elevations of all additions, and all resident support areas including food service, and all resident support utilities, including mechanical, and electrical (except fuel storage as noted in sub-subparagraph 59A-26.019(7)(b)9.e., F.A.C.) for the additions shall be at or above the elevation of the existing building, if the existing building was designed and constructed to comply with either the site standards of this rule or local flood resistant requirements in effect at the time of construction, whichever requires the higher elevation. If the existing building was constructed prior to the adoption of either the site standards of this rule or local flood resistant requirements, then substantial improvements as described in this section shall either be designed and constructed to meet the requirements of this rule or be designed and constructed to meet the dry flood proofing requirements of Florida Building Code.
c. Substantial improvement shall include any repairs, reconstruction(s), rehabilitation(s), additions(s) or improvement(s) to the building over a five year period, the cost of which cumulatively exceeds the market value of the building prior to the start of work.
d. Where an off-site public access route is available to the new facility at or above the 100-year flood plain, a minimum of one on-site emergency access route must be provided that is located at the same elevation as the public access route.
4. Roofing standards.
a. Loose-laid ballasted roofs are not permitted.
b. All new roof appendages such as ducts, tanks, ventilators, receivers, condensing units and decorative mansard roofs and their attachment systems must be structurally engineered to meet the wind load requirements of the FBC. All of these attachment systems must be connected directly to the underlying roof structure or roof support structure.
5. Exterior unit standards.
a. All exterior window units, skylights, exterior louvers and exterior door units, including vision panels and their anchoring systems shall be impact resistant or protected with an impact resistant covering meeting the requirements of the Testing Application Standards (TAS) 201, 202, and 203 of Florida Building Code – Test Protocols for High-Velocity Hurricane Zones and in accordance with the requirements of Sections 1626.2 through 1626.4 of the Florida Building Code. The impact resistant coverings may be either permanently attached or may be removable if stored on site of the facility.
b. The location or application of exterior impact protective systems shall not prevent required exit egress from the building.
c. When not being utilized to protect the windows, the protective system shall not restrict the operability (if provided) of the windows to the occupied client bedrooms.
d. When not being utilized to protect the windows, the protective system shall not reduce the percentage of the clear window opening below that which is required by the FBC for client bedrooms.
e. The glazed openings inside or outside of the protective systems must meet the cyclical loading requirements as required by Sections 1626.2-1626.4 of the FBC.
f. All of the exterior impact protective systems must be designed and installed so that they do not come in contact with the glazing under uniform, impact or cyclic pressure loading. The location or application of exterior impact protective systems must not prevent required exit/egress from the building.
6. Heating, Ventilation and Air Conditioning (HVAC) Standards.
a. All new air moving-equipment, dx condensing units, through-wall units and other HVAC equipment located outside of, partially outside of, or on the roof of the facility and providing services to the new facility shall be permitted only when either of the following are met:
I. They are located inside a penthouse designed to meet the wind load requirements of the Florida Building Code, Building; or
II. Their fastening systems are designed to meet the wind load requirements of the Florida Building Code, Building and they and all associated equipment are protected as required by TAS 201, 202, and 203 in accordance with the requirements of Sections 1626.2 through 1626.4 of the Florida Building Code from damage by horizontal impact by a separate and independent structure that allows access to all parts of the equipment at all times; or
III. They are completely protected by the equipment shrouding that meets the requirements of TAS 201, 202, and 203 in accordance with the requirements of Sections 1626.2 through 1626.4 of the Florida Building Code.
b. All occupied client areas and client support areas must be supplied with sufficient HVAC as determined by the facility to ensure the health, safety and well-being of all clients and staff during and immediately following a disaster.
c. As determined by the licensee, these selected HVAC systems and their associated support equipment, such as a control air compressor essential to the maintenance of the occupied client and client support area(s), must receive their power from the emergency power supply system(s).
d. Ventilation air change rates in occupied client areas must be maintained as specified in this section during and immediately following a disaster.
e. Auxiliary equipment and specialties such as hydronic supply piping and pneumatic control piping must be located, routed and protected in such a manner as determined by the licensee to ensure the equipment receiving the services will not be interrupted.
7. Plumbing standards.
a. There must be an independent on-site supply such as a water well, or on-site storage capability such as empty water storage containers or bladders, of potable water at a minimum quantity of three gallons per client served per day during and immediately following a disaster. Hot water in boilers or tanks must not be counted to meet this requirement.
b. There must be an independent on-site supply or storage capability of potable water at a minimum quantity of one gallon per facility staff, and other personnel in the facility per day during and immediately following a disaster. For planning purposes, the number of these personnel must be estimated by the licensee.
c. The licensee must determine what amount of water will be sufficient to provide for client services, and must maintain an on-site supply or on-site storage of the determined amount.
d. When used to meet the minimum requirements of this rule, selected system appurtenances such as water pressure maintenance house pumps and emergency water supply well pumps must take power from the emergency power supply system.
8. Medical gas systems standards. The storage, distribution piping system and appurtenances serving the occupied client area(s) and client support area(s) shall be contained within a protected area(s) designed and constructed to meet the structural requirements of the building code and debris impact requirements as required by Sections 1626.2 through 1626.4 of the Florida Building Code.
9. Emergency electrical generator and essential electrical system standards. There must be an on-site emergency electrical generator system designed to support occupied client areas and client support areas with the following support services:
a. Ice making equipment to produce ice for the clients or freezer storage equipment for the storage of ice for the clients.
b. Refrigerator units and food service equipment as required by the emergency food plan.
c. There must be one clothes washer and one clothes dryer for laundry service.
d. An emergency generator system must be fueled by a fuel supply stored on-site sized to fuel the generator for 100 percent load for 64 hours, or 72 hours for actual demand load of the occupied client areas and client support areas and client support utilities, during and immediately following a disaster, whichever is greater.
e. The fuel supply shall either be located below ground or contained within a protected area that is designed and constructed to meet the structural requirements as required by the Florida Building Code and debris impact requirements as specified by Sections 1626.2 through 1626.4 of the Florida Building Code. If an underground system is utilized, it shall be designed so as to exclude the entrance of any foreign solids or liquids.
f. All fuel lines supporting the generator system(s) for the occupied client area(s) and client support area(s) shall be protected also with a method designed and constructed to meet the structural requirements as required by the Florida Building Code and debris impact requirements as specified by Sections 1626.2 through 1626.4 of the Florida Building Code.
g. All panel boards, transfer switches, disconnect switches, enclosed circuit breakers or emergency system raceway systems required to support the occupied client area(s), client support area(s) or support utilities shall be contained within a protected area(s) designed and constructed to meet the structural requirements as required by the Florida Building Code and debris impact requirements as specified by Sections 1626.2 through 1626.4 of the Florida Building Code, and shall not rely on systems or devices outside of this protected area(s) for their reliability or continuation of service.
h. The emergency generator(s) shall be air or self-contained liquid cooled and it and other essential electrical equipment shall be installed in a protected area(s) designed and constructed to meet the structural requirements as required by the Florida Building Code and debris impact requirements as specified by Sections 1626.2 through 1626.4 of the Florida Building Code.
i. If the facility does not have a permanent on-site optional standby generator to operate the normal branch electrical system, then there shall be a permanently installed pre-designed electrical service entry for the normal branch electrical system that will allow a quick connection to a temporary electrical generator. This quick connection shall be installed inside of a permanent metal enclosure rated for this purpose and may be located on the exterior of the building.
10. Fire protection standards. If the facility requires fire sprinklers as part of its fire protection, one of the following must be met:
a. On-site water storage capacity to continue sprinkler coverage in accordance with the fire codes adopted by the state fire marshal or a fire watch must be conducted.
b. If the facility provides a fire watch in lieu of water storage to continue sprinkler coverage, then one 4-A type fire extinguisher or equivalent must be provided for every three or less 2-A fire extinguishers. These additional extinguishers must be equally distributed throughout the area they are protecting.
11. External Emergency Communication. Each new facility must provide for an external electronic communication not dependent on terrestrial telephone lines, cellular, radio or microwave towers, such as on-site radio transmitter, satellite communication systems or a written agreement with an amateur radio operator volunteer group(s). This agreement must provide for a facility volunteer operator and communication equipment to be re-located into the facility in the event of a disaster until communications are restored. Other methods that can be shown to maintain uninterrupted electronic communications not dependent on land-based transmission must be pre-approved by the Agency’s Office of Plans and Construction.
Rulemaking Authority 400.967 FS. Law Implemented 400.967(2)(a) FS. History–New 12-21-15.