Health Care Facilities Construction Standards Update

1. Health Care Facilities Construction Standards Update New York State Hospital Review & Planning Council Codes & Regulations Subcommittee Ms. Sandra Haff New York State Department of Health Division of Health Facility Planning Thomas M. Jung, R.A

2. New York State Hospital CodeStandards of Construction • Part 711: General Standards of Construction • Part 712:New Hospitals • Part 713 Nursing Homes • 713-1: Nursing Homes between 1968 and 1990 • 713-2: Nursing Homes from 1990 to present • Part 714: VACANT • Part 715: Diagnostic & Treatment Centers • Part 716: Rehabilitation Facilities

3. New York State Hospital CodeTitle 10 - Article 28 • Part 711 General Standards of Construction • Applicable to all Facility Types • Adoption by reference of applicable national standards

4. Nationally Recognized Standards • National Fire Protection Association (NFPA) • NFPA 101 Life Safety Code • Fire & Life Safety (protection and exiting) • Other NFPA standards referenced by NFPA 101 • Mandated by CMS • Guidelines for Design & Construction of Health Care Facilities • 1947 General Standards: regulations for Hill-Burton program • 1984 Guidelines: removed from regulation by DHHS • 1987 Guidelines: first revision & publication by others with federal support • 1996-97 Guidelines: selected sections adopted by NYSDOH • Subsequently revised 2001, 2006 and 2010

5. State Hospital Code(continued) • Part 712 Standards of Construction for Hospitals • Applicable to all Acute Care Facilities • Originally based on Hill-Burton Hospital standard (origin of the Guidelines) • NYSDOH written and revised prior to 1998

6. State Hospital Code(continued) • Part 713 Standards of Construction for Nursing Homes • Applicable to all Nursing Homes • Originally based on Hospital standards • Includes Adult Day Health Care • NYSDOH written and revised • Part 714 Standards of Construction for Health Related Facilities • Deleted due to elimination of facility category

7. State Hospital Code(continued) • Part 715 Standards of Construction for Diagnostic & Treatment Centers • Applicable to all Outpatient Facilities • Freestanding & In-hospital (no inpatients) • NYSDOH written and revised prior to 1998 • Part 716 Standards of Construction for Rehabilitation Facilities • Applicable to inpatient and outpatient facilities with rehabilitation focus • Originally based on Hospital standards • NYSDOH written and revised prior to 1998

8. 1998 State Hospital Code Last Major Revision • Largest SHC Update ever • First significant update since late 1970’s • Construction Standards Advisory Group - Comprised of80+ NYS health care design & construction stakeholders • Architects (American Institute of Architects) • Engineers and Construction Managers • NH owners and Hospital facility representatives • NH and Hospital association representatives • NYSDOH and GORR staff • CMS Staff

9. 1998 State Hospital Code Revision(continued) • Part 711: General Standards • Adopted 1997 Life Safety Code (formerly 1985) • Limited adoption of 1997 Guidelines • Updated all referenced standards • Part 712: New Hospitals • Adopted 1997 Guidelinesin lieu of writing standard • Part 713: New Nursing Homes • Updated NYSDOH standards

10. 1998 State Hospital Code Revision(continued) • Part 714: Health Related Facilities • Deleted - No longer applicable • Part 715: New D&TC’s • Complete re-write of NYSDOH standard to a Performance Based model • Part 716: New Rehabilitation Facilities • Adopted 1997 Guidelines in lieu of writing standard

11. Current Update ProposalJustification • NFPA 101 Life Safety Code consistency with Centers for Medicare & Medicaid Services (CMS) • Pre-1998: Both CMS and NYSDOH adopt 1985 edition of Life Safety Code • 1998: NYSDOH adopts 1997 edition of Life Safety Code (CMS Delayed) • 2003: CMS adopts 2000 edition of Life Safety Code

12. Justification for Update(continued) • Guidelines for Design and Construction of Health Care Facilities • Status growing as U.S. consensus standard for health care design & construction • U.S. Department of Health & Human Services/CMS • HUD mortgage program • JCAHO • 42+ states have adopted all or in part • NYSDOH adopted in 1998 for Hospitals & Rehabilitation Facilities • NYS experience post-1998 has been positive • Effort to revise dedicated NYSDOH regulations significant & not timely

13. Proposals Under Review • Part 711: General Standards • Adopt 2000 Life Safety Code (supercedes 1997) • Consistent with CMS and JCAHO • Part 712: New Hospitals • Update to 20062010Guidelines (supercedes 1997) • Part 713: New Nursing Homes • Adopt 20062010Guidelines in lieu of writing own standard

14. Proposals Under Review(continued) • Part 714: Re-activate for Adult Day Health Care Facilities (Relocate from Part 713) • Adopt 20062010Guidelines in lieu of writing standard • Part 715: New D&TC’s • Adopt 20062010Guidelines in lieu of writing standard • Part 716: New Rehabilitation Facilities • Update to 20062010Guidelines(1997)

15. Summary of Current Proposal

16. Format Changes

17. Goals of Current Proposal • Consistency with CMS (Life Safety Code) • 2000 Edition • Consistency across U.S. • 42+ States have adopted Guidelines • Ease of future updates • Guidelines are consensus document • 140+ national representatives (including NYS) • Public Proposals & Comments • Design, Construction & Clinical expertise • 28+ DOH representatives from other states

18. Thank you….Questions ? Thomas M. Jung, R.A. Division of Health Facilities Planning Bureau of Architectural & Engineering Facility Planning (518) 402-0967 tmj02@health.state.ny.us