1. (a) The physical environment shall be maintained, inside and outside, so as to provide for the health, safety, well-being, and comfort of patients and personnel, which shall include accommodations for patients and personnel with disabilities.

2. (b) The birthing center shall:

   1. (1) Have all entrances and exits accessible at all times;
   2. (2) Be maintained in good repair and kept free of hazards to personnel and patients, including, but not limited to, hazards from falls, burns, or electrical shocks;
   3. (3) Be free from environmental nuisances, including excessive noise and odors;
   4. (4) Keep all corridors free from obstructions; and

   5. (5) Take measures to prevent the presence of rodents, insects, and vermin, including but not limited to:

      1. a. Having tightly fitting screens on all doors, windows, or other openings to the outside unless the door is self closing and remains closed unless in use;
      2. b. Repairing holes and caulking of pipe channels; and
      3. c. Extermination by a pesticide applicator licensed under RSA 430.

3. (c) Equipment providing heat within a birthing center, including but not limited to, gas furnace or boiler, oil furnace or boiler, wood stove, or pellet stove shall:

   1. (1) Maintain a temperature as follows, except where patients have control of the thermostat in their own room:

      1. a. Be at least 65 degrees Fahrenheit at night; and
      2. b. Be at least 70 degrees Fahrenheit during the day if there are patients present; and
   2. (2) Be serviced once a year or as recommended by the manufacturer with written documentation of such service retained for at least 4 years.
4. (d) Electric heating systems shall be exempt from (c)(2) above.

5. (e) Portable space heating devices shall be prohibited, unless the following are met:

   1. (1) Such devices are used only in employee areas where personnel are present and awake at all times; and
   2. (2) The heating elements of such devices do not exceed 212 degrees Fahrenheit.
6. (f) Unvented fuel-fired heaters shall not be used in any birthing center.
7. (g) Plumbing shall be sized, installed, and maintained in accordance with the state plumbing code pursuant to RSA 155-A.
8. (h) Delivery rooms shall have general lighting in addition to examination lighting at each birthing bed. Portable examination lights shall be permitted, but must be immediately accessible.
9. (i) Ventilation shall be provided throughout the entire building whenever necessary, including but not limited to, fans to remove excessive heat, moisture, smoke, objectionable odors, dust, and explosive or toxic gases.
10. (j) There shall be a reception and waiting area that includes chairs, tables, and lighting adequate to read materials and complete forms as required.
11. (k) Pursuant to RSA 155:66, I, smoking shall be prohibited in the birthing center.
12. (l) There shall be public access to a telephone and toilet facilities for the patient and the patient’s visitors.

13. (m) The licensee shall ensure the birthing center has properly maintained equipment including, but not limited to:

    1. (1) A heat source for the newborn;
    2. (2) Portable lighting;
    3. (3) Sterilizer or demonstration of sterilizing capability;
    4. (4) Blood pressure equipment, thermometers, fetoscope, or doptone;
    5. (5) Oxygen;
    6. (6) Neonatal resuscitation bag; and
    7. (7) Intravenous equipment.
14. (n) The birthing center shall provide patients with continuous access to a device or means that will signal personnel when the patient(s) are in need of assistance.

15. (o) The number of sinks and toilets in the birthing center shall be as follows:

    1. (1) Sinks and toilets in a ratio of one to every 6 patients; and

    2. (2) Personnel and visitors shall either have:

       1. a. Separate sinks and toilets; or
       2. b. Be counted along with patients in the ratios in (1) above.
16. (p) All patients shall have access to a bathroom with a toilet, tub or shower, a hand washing sink, soap dispensers, and paper towels or a hand-drying device providing hot air.
17. (q) All showers and tubs shall have slip resistant floors and surfaces which are intact, easily cleanable, and impervious to water.
18. (r) All bathroom and closet door locks or latches shall be designed so that the door can be easily unlocked and opened from the inside and outside in an emergency.
19. (s) Each patient bedroom shall have natural lighting provided by at least one operable window with a screen to the outside, which is of a size equivalent to or greater than 8% of the room’s gross square footage.

20. (t) Each patient bedroom shall provide at least 100 square feet per room, exclusive of space required for closets, wardrobes, and bathrooms and contain the following:

    1. (1) A bed with a mattress that complies with the state fire code;
    2. (2) Clean pillow, linens, and blankets;
    3. (3) A lamp for the bed; and
    4. (4) Window blinds or curtains that provide privacy.
21. (u) Only one patient shall be admitted to each bedroom in the birthing center.
22. (v) Each bedroom shall have a door that shall be of the side hinge type and not a folding door or a curtain.
23. (w) Each bedroom shall have its own separate entry to permit the patient to reach their room without passing through the room of another person.
24. (x) All mattresses and new upholstered furniture or draperies shall comply with the state fire code.
25. (y) Each birthing center may be licensed for more than one licensing classification, but if the licensee has overnight beds for more than one licensing classification, physically separate and distinct units shall be required for each classification.
26. (z) All handwashing facilities shall be provided with hot and cold running water.

Source. #11161, eff 8-20-16; ss by #14074, eff 9-20-24, EXPIRES: 9-20-34 (formerly He-P 810.22)