1. (a) The total number of operating rooms shall be determined by the surgical workload. The minimum size of each operating room shall be 15 feet by 18 feet, and there shall be at least one operating room in any facility of 75 or fewer certified beds.
2. (b) A cystoscopy room is required in a facility of over one 150 beds. There shall be a toilet with a lavatory immediately adjacent to the cystoscopy room.

3. (c) A separate recovery room, with charting space, medication storage and preparation space, and a clinical sink is required.

   1. (1) The recovery room shall contain at least one bed per operating room plus an additional bed.
   2. (2) The location of the recovery room shall provide convenient access to elevators, nursing units and the operating rooms.
   3. (3) The floor area of the recovery room shall provide adequate space around each bed for circulation and equipment.
   4. (4) One blood pressure machine or portable blood pressure equipment shall be provided for each bed.
   5. (5) An audible signal device for summoning additional personnel from the operating room supervisors' office, anesthesiologist's office and nurses workrooms or areas within the surgical suite shall be provided.
   6. (6) Oxygen and suction facilities shall be provided for each bed.

4. (d) In each surgical suite, the size of each service area will depend on the surgical workload and such service areas shall include:

   1. (1) A surgical supervisor station.
   2. (2) Sterilizing facilities near operating room with high-speed autoclave.
   3. (3) Facilities for storage and preparation or medication.
   4. (4) Scrub-up facilities adjacent to operating rooms.
   5. (5) Soiled workroom containing counter, clinical sink, waste receptacle, and soiled linen receptacles.
   6. (6) Storage for sterile and unsterile supplies, which may be in the clean workroom.

5. (e) Anesthesia services shall be properly organized, and integrated with other related departments. The anesthesia service area shall include:

   1. (1) An anesthesia workroom for cleaning and storage of resuscitative equipment.
   2. (2) A storage room or rooms for anesthetic agents.

6. (f) Additional service areas relating to the anesthesia and operating rooms shall be provided and shall include, but not be limited to, the following:

   1. (1) Nitrous oxide and oxygen facilities when such services are not piped in.
   2. (2) A clean workroom for storage and assembly of supplies with a counter and sink.
   3. (3) Equipment storage room for surgical and monitoring equipment.
   4. (4) A janitor's closet.
   5. (5) Separate male and female clothing change areas, lockers, and at least one toilet for each sex, for use by doctors, nurses, orderlies, and other personnel.
   6. (6) A holding area for patients in facilities with two or more operating rooms.
   7. (7) A stretcher alcove or area that is not in the line of traffic or part of a required exitway.

7. (g) In medical facilities maintaining specialized cardiac surgical centers, additional supportive service areas and equipment shall be provided on the hospital premises, including, but not limited to the following:

   1. (1) A special procedure (catheterization) x-ray room, with a minimum net area of 400 square feet.
   2. (2) An office and conference room for use of staff and for use as a viewing room.
   3. (3) A film storage and darkroom when required for proper processing of film.

   4. (4) Equipment necessary for the operation of the special procedure (catheterization x-ray room), including the following:

      1. (i) X-ray equipment with capability either in biplane cineangiocardiography or in rapid film techniques or both.
      2. (ii) Image intensifier.
      3. (iii) Medical television system.
      4. (iv) Automatic injector.
      5. (v) Diagnostic x-ray examination table for special procedures.
      6. (vi) Rapid film changer for rapid serial and standard full size radiography.
      7. (vii) Film developing and viewing equipment for all types of film utilized (cine, cut-film, etc.).
      8. (viii) External defibrillator.
      9. (ix) Biological recorder, including one electrocardiograph and two pressures.

   5. (5) For facilities serving pediatric patients:

      1. (i) x-ray equipment with biplane capabilities either in cineangio-cardiography or in rapid film techniques or both; and
      2. (ii) equipment for blood gas analysis and pH, with micro-techniques.
   6. (6) A pulmonary function unit.
   7. (7) Special surgery rooms for open heart procedures adjacent to the general surgical unit of the hospital. If the operating rooms in the surgical suite are used interchangeably for different types of surgery, the room or rooms assigned for cardiac surgery must be large enough to accommodate the larger operating staff and special equipment required for open heart surgery.
   8. (8) Surgical instruments and monitoring equipment especially designed for intra-thoracic and cardiac surgery.
   9. (9) Defibrillating apparatus, which shall at all times be available to the surgery room(s).
   10. (10) A blood bank approved by the department.
   11. (11) Special plumbing installations, which shall be installed for connection of the pump oxygenator. Pump oxygenator storage space shall be provided, in a pump room in the clean area of the surgical suite.
   12. (12) A post-operative care area, exclusively for cardiac surgical patients, adjacent to, but separate from a general post-operative care area; and a coronary care unit, which shall provide for the direct visual observation of all patients from a central vantage point. A lavatory for handwashing shall be available in close proximity to each bed. All necessary special equipment including, but not limited to, monitoring devices, respirators, pacemakers, defibrillators, for cardiac resuscitation shall be provided.

8. (h) In medical facilities maintaining specialized cardiac diagnostic centers, additional supportive service areas and equipment shall be provided either in the area of the cardiac center or in the radiology department. The supportive services shall include, but not be limited to the following:

   1. (1) A special procedure (catheterization) x-ray room, with a minimum net area of 400 square feet.
   2. (2) An office and conference room for use of staff and for use as a viewing room, may be multi-purpose, and used by other departments.
   3. (3) A film storage and darkroom when required, for proper processing of film.

   4. (4) Equipment necessary for the operation of the special procedure (catheterization) x-ray room, including the following:

      1. (i) X-ray equipment with capability either in cineangiocardiography or in rapid film techniques or both.
      2. (ii) Image intensifier.
      3. (iii) Medical television system.
      4. (iv) Automatic injector.
      5. (v) Diagnostic x-ray examination table for special procedures.
      6. (vi) Rapid film changer for rapid serial and standard full size radiography.
      7. (vii) Film developing and viewing equipment for all types of film utilized (cine, cut-film, etc.).
      8. (viii) External defibrillator.
      9. (ix) Biological recorder, including one electrocardiograph and two pressures.

   5. (5) For facilities serving pediatric patients:

      1. (i) x-ray equipment with biplane capabilities either in cineangiocardiography or in rapid film techniques or both; and
      2. (ii) equipment for blood gas analysis and pH, with microtechniques.

Each inpatient surgical suite shall be located to prevent through traffic and shall comply with the following: