(a) These dedicated and discrete units shall be either neurobehavioral units, or neurobehavioral step-down units. When provided, these separate units shall comply with section 4.2-2.2, "Resident unit," of part 4, "Residential Health Care Facilities," of the Guidelines for Design and Construction of Health Care Facilities, 2010 edition, as described in more detail in section 711.2(b)(7) of this Title, and with the following variations and additional requirements:

1. (1) Each neurobehavioral unit shall be designed for a minimum of 15 residents and a maximum of 20 residents and shall be planned as a secure unit. All resident bedrooms in neurobehavioral units shall be single occupancy.
2. (2) Each neurobehavioral step-down unit shall be limited to a maximum of 20 certified beds, and shall not be a secure unit. This unit shall be monitored for elopement however, with a delayed egress system on all unit doors. Neurobehavioral step-down units shall provide single occupancy resident rooms for at least 10 percent of the unit capacity. For the balance of the unit, the maximum number of beds in a resident room shall be two.
3. (3) Doors to resident bedrooms shall open outward.
4. (4) A private toilet room shall be provided for each resident bedroom.
5. (5) An exercise room shall be located on the unit and provide a minimum of 25 net square feet per resident. Additional space shall be provided for storage. Adjacent dedicated resident toilet and showers shall be provided.
6. (6) An activity room shall be located on the unit and provide a minimum of 38 net square feet per resident. Additional space shall be provided for equipment storage. Adjacent resident toilet and bathing facilities shall be provided.
7. (7) Each neurobehavioral step-down unit shall be provided at least one separate enclosed room providing a distraction-free treatment environment with visual and auditory separation from adjacent spaces and functions. This space shall accommodate a maximum of eight persons, for activities for functional living skills or cognitive skill development.
8. (8) Conference/counseling rooms sufficient for private family meetings with facility personnel and for meetings of facility staff shall be provided on the nursing unit. At least one room shall accommodate up to eight persons.
9. (9) Adequate on-unit offices shall be provided for staff use.
10. (10) Resident bathing facilities shall be provided at a ratio of one fixture per seven residents.

11. (11) Details and finishes shall be designed to provide a high degree of safety and security for both residents and staff.

    1. (i) Doors to all resident rooms shall be located so as to negate a possible resident hiding space behind the door.
    2. (ii) Doors, which separate the neurobehavioral units from adjacent functional areas of the facility shall be secure. Delayed egress doors shall be sufficient for neurobehavioral step-down units.
    3. (iii) The walls of resident use rooms shall be constructed so as to resist damage.
    4. (iv) The ceilings of resident use rooms shall be constructed to resist damage. The ceiling surface shall be monolithic from wall to wall.
    5. (v) Light switches and electric convenience outlets shall be tamper proof.
    6. (vi) Major room furnishings such as desks, dressers, night tables, and shelving shall be designed and/or installed to minimize the danger of injury to residents and staff.
    7. (vii) Shower heads in resident bathing rooms shall be of a recessed type.
    8. (viii) Operable windows shall be provided with devices, which will prevent the possibility of accidental falls. The operable sash opening shall be limited to six inches, however, alternate window opening protection may be acceptable, i.e., security screens. Window bars are not permitted.
    9. (ix) An emergency call system for staff use shall be provided in all resident use spaces to permit staff communications in an emergency.
    10. (x) Secure outside activity areas shall be provided. Resident access to the areas shall be directly from the unit.