1. (1) the purpose and proposed license category of the facility;
2. (2) any services offered, including a detailed description of each service;
3. (3) any ancillary services required to support each function or program;
4. (4) the applicant or licensee's interdepartmental relationships;
5. (5) any services offered under contract by outside providers and the required in-house facilities to support those services;
6. (6) any services shared with other licensure categories or functions;
7. (7) a description of anticipated inpatient and outpatient workloads;
8. (8) the physical and mental condition of intended patients;
9. (9) the age range of the intended patients;
10. (10) the ambulatory or non-ambulatory condition of intended patients;
11. (11) the type and use of general or local anesthetics;
12. (12) any use of physical or chemical restraints;
13. (13) area requirements for each service offered, stated in net square feet;
14. (14) if provided, seclusion treatment rooms, including staff monitoring procedures;
15. (15) x-ray facilities, nurse call systems, communication systems, and other special systems;
16. (16) if a building is designed for expansion, a description of how essential core services will accommodate increased demand;
17. (17) inpatient services, treatment areas, or diagnostic facilities planned or anticipated to be housed in other buildings;
18. (18) the construction-type of any other building;
19. (19) a description of protections from the weather for patients during transport between buildings;
20. (20) an infection control risk assessment to determine the need for the number and types of isolation rooms; and

21. (21) any special requirement that could affect the building, including:

    1. (a) any exhaust system;
    2. (b) any filter on an air conditioning system;
    3. (c) any laboratory hood;
    4. (d) a list of specialized equipment that could require a special dedicated service or special structure;
    5. (e) any medical gas;
    6. (f) any special electrical requirement; and
    7. (g) any other special mechanical requirement.

The applicant or licensee shall ensure the functional program documentation includes:

KEY: health care facilities

Date of Last Change: March 14, 2025

Notice of Continuation: January 23, 2023

Authorizing, and Implemented or Interpreted Law: 26B-2-202