June 1999

Information Bulletin 99-10
NH-27

• REPEALER.
• Minnesota Rules Chapter 4660

State Licensure Requirements for the Physical Plant of a Nursing Home

Purpose

The purpose of this Information Bulletin is to clarify what State licensure rules are applicable to nursing homes. This is not new information, nor is it new regulatory language, but rather further clarification/guidance.

History

The Minnesota Rules, Chapter 4660 were adopted in 1972 and generally address the physical plant of a nursing home. This chapter divides facilities into two categories, addressing requirements for both existing facilities and new construction. Buildings and additions to those buildings that were built prior to the 1972 adoption of the chapter are considered "existing" facilities and facilities (or parts thereof) built after the adoption date of 1972 are considered "new construction".

In 1995 and 1996, MN Rules Chapter 4658 were adopted. Most of the physical plant requirements of chapter 4658 are applicable only to new construction, i.e., construction commenced after November 13, 1995 (MN Rule 4658.3000 to 4658.4690).

In order to maintain requirements for all nursing homes that were operating at the time of the adoption of Chapter 4658, Minnesota Rule 4658.0010, subpart 4, was included in this chapter.

Minnesota Rule 4658.0010, subpart 4, states: "Existing facilities must, at a minimum, maintain compliance with the rules applicable at the time of their construction". For clarification MN. Chapter 4658 defines an existing facility as a licensed nursing home or nursing home space that was in place before November 13, 1995.

What does all this mean?

When reviewing what physical plant requirements pertain to your facility, it is important that you have knowledge of when the facility was built, in addition to when any additions or major reconstruction took place. This knowledge will assist you in determining what requirements are applicable to your facility and/or parts thereof. If your facility was built prior to November 13, 1995, Chapter 4660 is applicable to your facility. You will need to determine whether your facility is considered "existing" or "new construction" as defined by this Chapter 4660 and apply those physical plant regulations to your facility.

Waivers

If you had been granted a waiver by the Minnesota Department of Health of a rule part under Chapter 4660, this waiver is still valid as long as the stipulations in the waiver are being followed. You do not have to reapply for a waiver under the MN Rule Chapter 4658.

General Information

If you would like a copy of the Minnesota Rule Chapter 4660, you may access it via our MDH Website at Information Bulletins Copies of the tables not included with the web site document, 4660.9930 (nursing homes) and 4660.9940 (boarding care homes) Ventilation Pressure Relationships and Ventilation for Certain Areas, may be obtained by calling the Minnesota Department of Health, Health Regulation Division at (651) 201-4101..

If you would like a hard copy of the Minnesota Rules Chapter 4658, they are available at the Minnesota Bookstore at 117 University Avenue, St. Paul, MN 55155 or by calling (651) 297-3000, Minnesota Toll Free: 1-800-657-3757.

If you have any questions related to this Information Bulletin, please contact the Engineering Section at the Minnesota Department of Health, Health Regulation Division, 85 East Seventh Place, Suite 300, St. Paul, Minnesota 55164-0900 or call 651-201-4200.

REPEALER.Minnesota Rules, parts 4655.0100, subparts 4, 8, and 10; 4655.7500; 4655.8000; 4655.9070; 4655.9300; 4655.9320; 4655.9321; 4655.9322; 4655.9323; 4655.9324; 4655.9325; 4655.9326; 4655.9327; 4655.9328; 4655.9329; 4655.9330; 4655.9331; 4655.9332; 4655.9333; 4655.9334; 4655.9335; 4655.9336; 4655.9337; 4655.9338; 4655.9339; 4655.9341; 4660.1300; 4660.1400; 4660.1410; 4660.1420; 4660.1430; 4660.1440; 4660.1450; 4660.1460; 4660.1470; 4660.1480; 4660.1500; 4660.1600; 4660.1700; 4660.1800; 4660.1900; 4660.2000; 4660.2100; 4660.2200; 4660.2300; 4660.2400; 4660.2500; 4660.2600; 4660.2610; 4660.2620; 4660.2630; 4660.2640; 4660.2700; 4660.2800; 4660.2900; 4660.3000; 4660.3100; 4660.3200; 4660.3300; 4660.5700; 4660.5800; 4660.5810; 4660.7600; 4660.8010; 4660.8300; 4660.8380; 4660.8410; 4660.8500; 4660.8510; 4660.8520; 4660.8530; 4660.8540; 4660.8550; 4660.8560; 4660.8700; 4660.9910; 4660.9920; and 4660.9930, are repealed.

History

21 SR 196, effective 11/10/96

 

MINNESOTA RULES CHAPTER 4660
DEPARTMENT OF HEALTH
NURSING; BOARDING CARE HOMES; PHYSICAL PLANT

4660.0090 SCOPE.

The rules in chapter 4660 apply to both nursing homes and boarding care homes unless otherwise indicated.

STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.0100 DEFINITIONS.

Subpart 1. Existing facility. An existing facility is defined in part 4655.0100, subpart 5. The term "existing" or "existing construction" as used in parts 4660.0100 to 4660.9940 of these rules shall be considered synonymous with "existing facility," as defined in part 4655.0100, subpart 5.
Subp. 2. New construction. New construction involves all construction planned and commenced after the effective date of these rules. The term "new" or "new construction" as used in parts 4660.0100 to 4660.9940 of these rules means the erection of new facilities, expansion of or additions to existing facilities, modernization or major remodeling involving substantial changes in space or arrangement, and any building planned for conversion to be licensed under the provisions of these rules.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.0200 LICENSURE.

As a condition of licensure, a certificate of need shall be obtained for "construction or modification" as defined in the Minnesota Certificate of Need Act, Laws of Minnesota 1971, chapter 628.
On matters affecting licensure which are not regulated by the Certificate of Need Act, the commissioner of health shall be notified directly in writing relative to proposed planning for all new construction as defined herein, remodeling, changes in existing service, function or bed capacity, addition of new services, sale, and change of ownership.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08
HIST: L 1977 c 305 s 39

4660.0300 COMPLIANCE WITH REGULATIONS.

Subpart 1. Compliance. The physical plant of all facilities shall be in compliance with these rules as follows.
Subp. 2. New construction. All new construction shall be in accordance with the requirements for new construction as outlined in these rules.
Subp. 3. Existing facilities. All existing facilities shall be deemed to be in substantial compliance with the physical plant requirements for new construction, except as noted in these regulations. When additional beds are added to existing facilities the required dayroom and dining room areas shall be based on the bed capacity of the entire facility. Compliance with the standards for new construction for existing facilities shall be for the areas involved and to the extent that the existing structure will permit. Selected improvements or correction of minor deficiencies in existing facilities shall not be a requirement for compliance with new construction criteria.
Subp. 4. Reclassification. As a condition for reclassification of a boarding care home to a nursing home, the physical plant shall be in compliance with all new construction requirements for nursing homes.
Subp. 5. State fire marshal. Fire protection shall be provided in accordance with the requirements of the state fire marshal and of these rules. The state fire marshal's approval of plans for new construction and of the fire protection of the completed facility shall be prerequisite for licensure. Facilities shall maintain a clearance by the state fire marshal in order to qualify for continued licensure.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

PLANS

4660.0400 PREPARATION OF PLANS.

Architectural and engineering plans and specifications for new construction shall be prepared and signed by architects and engineers who are registered in the state of Minnesota and in accordance with the requirements by the Board of Architecture, Engineering, Land Surveying, and Landscape Architecture.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.0500 APPROVAL OF PLANS.

Preliminary plans and final working drawings and specifications for proposed construction shall be submitted to the commissioner of health for review and approval. Preliminary plans shall be approved before the preparation of final working drawings is undertaken. Final working drawings and specifications shall be approved before construction is begun.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08
HIST: L 1977 c 305 s 39

4660.0600 PRELIMINARY PLANS.

Preliminary plans shall be drawn to scale, show basic dimensions, and indicate the general layout and space arrangement of the proposed building or area and shall include a site plan when applicable. Plans shall indicate assignments of rooms and areas, and shall show bed capacities and fixed equipment.
The planning should include consideration for future expansion of a facility. This includes the site, orientation of the structure on the site, parking areas as well as patient, dietary, and laundry areas. If a laundry is not contemplated initially, provision should be made for its possible future location.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.0700 FINAL PLANS.

Final architectural plans and specifications shall include elevations and sections through the building showing types of construction, and shall indicate dimensions and assignments of rooms and areas, room finishes, door types and hardware, elevations and details of nurses' stations, utility rooms, toilets and bathing areas, and large-scale layouts of dietary and laundry areas. Plans shall show location of fixed equipment and sections and details of elevators, chutes, and other conveying systems. Fire walls and smoke partitions shall be indicated. The roof plan shall show all mechanical installations. The site plan, if applicable, shall indicate the proposed and existing buildings, topography, roadways, walks, and utility service lines.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.0800 FINAL MECHANICAL AND ELECTRICAL PLANS.

Final mechanical and electrical plans and specifications shall cover the complete layout and type of all installations, systems and equipment to be provided in accordance with the requirements of these rules. Heating plans shall include heating elements, piping, thermostatic controls, pumps, tanks, heat exchangers, boilers, breeching, and accessories. Ventilation plans shall include room air quantities, ducts, fire and smoke dampers, exhaust fans, humidifiers, and air handling units. Plumbing plans shall include fixtures and equipment fixture schedule, water supply and circulating piping, pumps, tanks, riser diagrams, building drains, the size, location and elevation of water and sewer services, and the building fire protection systems. Electrical plans shall include fixtures and equipment, receptacles, switches, power outlets, circuits, power and light panels, transformers, and service feeders. Plans shall show location of nurse call signals, telephones, fire alarm stations and detectors, and emergency lighting.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.0900 START OF CONSTRUCTION.

The department shall be notified in writing of the date of start of construction not less than seven days after commencement. Unless construction is commenced within one year after approval of final working drawings and specifications, the drawings shall be resubmitted for renewal of review and approval.
All construction shall be executed in accordance with the approved final plans and specifications. Subsequent construction changes which involve these rules shall be approved by the department before such changes are made.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1000 FINAL INSPECTION.

The department shall be notified at least 30 days prior to the completion of construction so that arrangements can be made for a final inspection by the department and by the state fire marshal. Completion involves the entire construction, equipment, staffing patterns and services. Mechanical and electrical systems shall be completed and tested for performance and safety in accordance with specifications and state requirements before new construction can be licensed and patients or residents admitted.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1100 PLAN SAFEKEEPING.

At least one set of complete plans of the entire facility, including changes resulting from remodeling or alterations, shall be kept on file in the licensed facility.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1200 NEW CONSTRUCTION SITE.

A care facility shall be so located as to promote at all times the health, comfort, and safety of patients and residents. The factors included in selecting the site for a new facility shall be as follows:

1. Public utilities shall be available and such services provided for power and light.

2. The water supply shall be obtained from an approved public water supply system where such is available; otherwise, water shall be obtained from a water supply system, the location, construction, and operation of which is approved by the commissioner of health. Plans and specifications for a private water supply system shall be approved before construction of the system or the facility is started.

3. Sewage and other liquid wastes shall be discharged into an approved public sewerage system where such a system is available; otherwise, the sewage shall be collected, treated, and disposed of in a sewage disposal system which is approved by the commissioner of health and the Minnesota Pollution Control Agency. Plans and specifications for a private sewage disposal system shall be approved before construction of the system or the facility is started.

4. The site shall be away from insect-breeding swamps and shall be no closer than 300 feet to the right-of-way of a railroad main line or to the property line of industrial developments which are nuisance-producing or hazardous to health. The site shall not be contiguous to or in immediate view of a cemetery or a funeral home.

5. The site shall be located within five miles of a municipality and in an area which has a written contract with the municipality providing fire department service, or a written contract with the municipality to provide the services of an approved organized fire department to which an alarm can be sent by telephone or other suitable alarm sending device.

6. The site shall not be located within 85 feet of underground or 300 feet of above-ground storage tanks or warehouses containing flammable liquids used in connection with a service station, garage, bulk plant, or marine terminal or bottling plant of liquefied petroleum gas installation.

7. The topography shall be such that good natural drainage is available, and that the site is not subject to flooding.

8. Adequate all-weather roads and walks shall be provided within the lot lines to the main entrance and the service entrance, including employees' and visitors' parking at the site.

9. Grading to one primary entrance shall allow for access for the elderly and the physically handicapped.

10. The site shall include space for outdoor activities.

11. Community activities shall be accessible, and there shall be a maintained public access to the site.

12. Medical services shall be readily available, and the location shall be such that employees can be recruited.

STAT AUTH: MS s 144.56; 144A.02 to 144A.08
HIST: L 1977 c 305 s 39

PATIENT OR RESIDENT AREAS

4660.1300 APPLICABILITY.

Parts 4660.1400 to 4660.3200 apply to nursing homes only.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1400 PATIENTS' BEDROOM REQUIREMENTS, BEDROOM CAPACITIES,
NEW CONSTRUCTION.

At least five percent of the rooms shall be designed for single person occupancy (one bed), and shall have private toilet rooms. At least 75 percent of the beds shall be located in rooms designed for one or two beds. No room shall have more than four beds.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1410 BEDROOM LOCATION EXISTING AND NEW.

Bedrooms for patients shall be outside rooms; they shall be dry, well ventilated, naturally lighted, and otherwise suitable for occupancy. Each bedroom shall have direct access to an exit corridor. In existing facilities, the floor in existing bedrooms shall not be more than three feet below the outside grade level. All bedrooms for patients which are licensed on or after the effective date of these rules shall be at or above grade. In all new construction, the floor shall be located at or above the outside grade level or outside surface.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1420 PLACEMENT OF BEDROOMS IN NEW CONSTRUCTION.

Patient bedrooms shall be located not more than 120 feet from the nurses' station and a clean utility room; and the location of the soiled utility room shall be not more than 80 feet from a patient bedroom or from the nurses' station.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1430 USABLE FLOOR AREA IN BEDROOM.

Subpart 1. Existing and new. The usable floor area and the arrangement and shape of the bedroom shall provide space for furnishings, for the free movement of patients with physical handicaps and for nursing procedures. The usable floor area does not include spaces occupied by toilet rooms, vestibules, lockers or closets, or heating units.
Subp. 2. Existing facilities. The usable floor area per bed shall not be less than: 100 square feet for single rooms, 80 square feet for two-bed rooms, and 70 square feet for three- or four-bed rooms, when thus licensed prior to the effective date of these rules.
Subp. 3. New construction. In new construction the usable floor area per bed shall not be less than: 100 square feet for single rooms, and 80 square feet for two-, three-, or four-bed rooms.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1440 BED ARRANGEMENT.

Subpart 1. Existing and new. Beds shall be located so as to avoid drafts, excessive heat, or other discomforts to patients. All single and multibed rooms shall allow for a bed arrangement which provides at least three feet of floor space at both sides and the foot end of each bed.
Subp. 2. New construction. Multibed rooms shall be arranged to permit not more than two beds side by side parallel to the window wall.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1450 BEDROOM WINDOWS IN NEW CONSTRUCTION.

The window area shall not be less than one-eighth of the usable floor area, and the window sill shall not be higher than two feet, six inches above the floor. The window shall face an open outside space not less than 30 feet deep, and shall provide an unobstructed angle of vision within this space of not less than 65 degrees. This angle may be read along the exterior wall.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1460 BEDROOM DOORS.

Subpart 1. Existing and new. For existing and new construction:

1. The nursing home shall develop a written policy regarding the use of locks on patient bedroom doors. The policy shall address whether or not doors can be locked while the patient is in the room.

2. All such locks shall permit exit from the room by a simple operation without the use of a key. All locks shall be openable with a master key which is located at each nursing station.

Subp. 2. New construction. The door to the corridor shall be of fire-resistive construction in accordance with chapters 1300 to 1365, the State Building Code, 1971 edition, open into the bedroom, and provide a clear opening of 44 inches. Bedroom doors shall not open directly to a dayroom, dining area, or any other common use area.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1470 CLOTHES CLOSET.

Subpart 1. New construction. A separate built-in closet or storage space for clothing and personal belongings shall be provided within the room for each patient. It shall be provided with shelving, at least one drawer unless included in the bedroom, and a full-length hanging space sized to accommodate clothes on hangers. The interior closet area shall be at least 22 inches deep and 36 inches wide.
Locks may be provided, with keys for the patients when a pass key is provided for the nurse.
Subp. 2. Existing facilities. See part 4655.7000, subpart 1, item C.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1480 CUBICLE CURTAINS, EXISTING AND NEW.

Cubicle curtains shall be installed for complete privacy for each patient in multibed rooms. Decorative types recommended.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1500 CORRIDORS.

Subpart 1. Existing and new. Securely anchored handrails shall be provided on both sides of corridors used by patients.
Subp. 2. New construction. The unobstructed width of all corridors in patient areas shall be eight feet, and all exits shall comply with chapters 1300 to 1365, the State Building Code, 1971 edition. The handrails shall be mounted at a height of 32 inches to the top of rail. The handrail shall be a round or oval section, 1-3/4 to two inches in diameter, and the clear distance between the handrail and wall shall be 1-1/2 inches. Wall bracket supports shall be provided at least six feet on center, and the brackets shall be capable of supporting a load of not less than 200 pounds.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1600 NURSES' STATION.

Subpart 1. Existing and new. One or more nurses' stations shall be provided, and there shall be at least one nurses' station per patient floor. A nurses' station may serve more than one nursing area on the same floor, when adequately sized and staffed, and the maximum travel distances are not exceeded. The station area shall include a nurse call register panel and counter space for nurses' and doctors' charting, and space for storage of charts and supplies.
Subp. 2. New construction. Each nursing station shall be located at the main corridor for better control and for observation of patients and signals.
Subp. 3. Recommended room. An examination and treatment room is recommended. The room should be provided with a lavatory with institutional fittings, a single-service towel dispenser, storage cabinets, a treatment table, and a high-intensity examining light.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1700 MEDICATION ROOM, EXISTING AND NEW.

The medicine preparation area (see parts 4655.7730 and 4655.7740) shall be provided in a location which is quiet and convenient for the nursing staff, and separated from all soiled activities. It can be a designated area within the nurses' station or the clean utility room. The area shall contain a work counter, a sink with institutional fittings, a single-service towel dispenser, a refrigerator for medications with a reliable thermometer, and medicine and narcotics cabinets.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1800 CLEAN UTILITY ROOM.

Subpart 1. Existing and new. A separate clean utility room shall be provided, conveniently located within each nursing area.
Subp. 2. New construction. The clean utility room shall contain a work counter, a sink with institutional fittings, a single-service towel dispenser, and adequate storage cabinets and shelving for clean items and supplies.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.1900 STERILIZING FACILITIES, EXISTING AND NEW.

An autoclave for instrument sterilizing if provided in the nursing home shall be located in the clean utility room or in a separate sterilizing room. See part 4655.7500, item C.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2000 CLEAN LINEN STORAGE, EXISTING AND NEW.

Rooms, closets, or enclosed carts shall be provided for the storage of clean linen.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2100 STAFF TOILET ROOMS, NEW CONSTRUCTION.

A separate nurses' toilet room shall be provided near the nurses' station. It shall include a water closet, a lavatory with institutional fittings, a mirror, and a single-service towel dispenser.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2200 SOILED UTILITY ROOM.

Subpart 1. Existing and new. A separate soiled utility room shall be provided which is conveniently located within each nursing area. It shall contain a flushing rim service sink with bedpan flushing equipment, hand-washing facilities, and a single-service towel dispenser. Cabinets and shelving shall be provided for the storage of materials and supplies. The washer-sanitizer for bedpans shall be located here.
Subp. 2. New construction. The soiled utility room shall be provided with a work counter and a deep counter sink with institutional fittings for cleanup and for hand washing.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2300 NOURISHMENT AREA, NEW CONSTRUCTION.

A nourishment area or room shall be provided for serving between-meal refreshments; it may serve more than one nursing area, and can be located contiguous with a dayroom. The nourishment area shall be provided with work counter and sink, storage cabinets, and a refrigerator. Ice storage or an ice maker-dispenser, if provided in the patient areas, shall be located here.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2400 SANITARY FIXTURES.

Subpart 1. Existing facilities. The number of sanitary fixtures shall not be less than: one water closet and one lavatory for eight beds, and one shower or tub for 20 beds.
When the licensed capacity is increased, the requirements under subpart 2 shall apply to the new addition. In patient toilets where grab bars or towel bars are not provided, such bars shall be installed in accordance with part 4660.2600 to the extent that the room arrangements will permit.
Subp. 2. New construction. The number of sanitary fixtures shall not be less than: one water closet and one lavatory for four beds, and one shower or tub for 15 beds.
Toilets in central bathing, other service areas, or for personnel, or the public shall not be counted in the above requirement. If urinals are provided, they shall be floor mounted. No toilet room shall be without a lavatory and all lavatories shall be provided with hot and cold water. Lavatories and sinks used by nurses or doctors shall be provided with institutional fittings in accordance with part 4660.8010, subpart 2, and shall include the provision of single-service hand-drying facilities. A single-service towel dispenser can use single or roll towels, either disposable or washable.
Subp. 3. Existing and new. Water closets shall be located in separate toilet rooms, in stalls or within bathing areas only. Portable commodes, chemical toilets, or water closets with moving parts in the bowl or waste line assembly shall not be considered as substitutes for the required number of water closets.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2500 PROVISION OF PATIENT TOILET ROOMS, NEW CONSTRUCTION.

Each toilet room shall be directly accessible from the bedroom, except as noted; it may serve two bedrooms if patients are of the same sex, but not more than four beds. Hinged doors shall swing out, or they shall be double acting and be provided with an emergency type release stop. Privacy door locks shall be of a type which can be opened from the outside without the use of a separate device. Sliding doors shall be surface mounted. Folding doors shall be limited to toilet rooms with a single door access, and shall be capable of easy and positive latching when being closed, and of staying folded in the open position; the required width of door opening shall be increased to allow for the door when folded. Toilet rooms shall be designed for the elderly, disabled, and infirm and special toilet rooms accessible to wheelchair users shall be provided for at least 25 percent of the patients. At least one such special toilet room shall be provided which has access from the corridor side for general use; the toilet required in central bathing can service this function when properly designed and arranged.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2600 TOILET ROOM LAYOUT, NEW CONSTRUCTION.

Layout:

1. The door opening shall be at least two feet, eight inches wide.

2. The center of the water closet shall be located 18 to 21 inches from the side wall and there shall be at least three feet of unobstructed space in front of the bowl. No basic interior room dimension shall be less than three feet, six inches.

3. The water closet shall be mounted at a height of not less than 16 inches nor more than 19 inches above the floor, measured to the top of seat. The bowl shall be elongated with an open front seat. It is recommended that individual bedpan flushing equipment and lugs be included with all patient water closets serving bedrooms.

4. The paper holder shall be securely anchored on the side wall near the water closet, six inches above the seat, and six to 12 inches in front of the seat with both dimensions measured to the center of the holder.

5. A vertical grab bar, at least 18 inches long, shall be provided on the side wall near the water closet. The low end shall be mounted at a height of ten inches above the toilet seat and at a distance of 12 inches in front of the seat. A grab bar on each side of the water closet is recommended.

6. Grab bars shall have an outside diameter of one and one-half inches, and shall provide a clearance of one and one-half inches between the bar and the wall. Bars shall be securely anchored to sustain a load of 250 pounds for five minutes.

7. The lavatory, with or without a counter top, shall be mounted at a height of 32 inches above the floor, measured to the top edge.

8. A towel bar for patients shall be provided at a height of 42 inches above the floor. It shall be a horizontal grab bar, securely anchored.

9. A mirror shall be provided.

10. A small shelf for personal toilet accessories shall be provided, unless such space is provided by a suitable lavatory or a counter.

STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2610 SPECIAL TOILET ROOMS, NEW CONSTRUCTION.

Special toilet rooms:

1. Toilet rooms for wheelchair users shall be arranged to allow wheelchair movement for both the frontal and the oblique angle approach. It is recommended that the room also be designed for lateral transfer of wheelchair users.

2. The door opening shall be at least two feet, eight inches wide, and shall be located within an area in front of the water closet.

3. The center of the water closet shall be located 18 inches from the side wall, and there shall be at least four feet of unobstructed space in front of the bowl. No basic interior room dimension shall be less than five feet, six inches.

4. D. The water closet shall be mounted at a height of 18 to 19 inches above the floor measured to the top of the seat. The bowl shall be elongated with an open front seat.

5. E. The paper holder shall be securely anchored on the side wall near the water closet, six inches above the seat, and six to 12 inches in front of the seat with both dimensions measured to the center of the holder.

6. An L-shape grab bar, each leg at least 18 inches long, shall be provided, securely anchored, on the side wall near the water closet. The low end of the vertical leg shall be mounted at a height of ten inches above the toilet seat and at a distance of 12 inches in front of the seat, and the horizontal bar shall extend toward the back wall.

7. A horizontal grab bar, braced for vertical and lateral loads, and projecting 16 inches out from the back wall, shall be located at the open, opposite side of the water closet. It shall be without floor supports and shall be mounted at a height of ten inches above the toilet seat and at a distance of four to six inches away from the edge of the toilet seat.

8. Grab bars shall have an outside diameter of one and one-half inches, and shall provide a clearance of one and one-half inches between the bar and the wall. Bars shall be securely anchored to sustain a load of 250 pounds for five minutes.

9. The lavatory, with or without countertop, shall be accessible and shall not interfere with general wheelchair movements. It shall be mounted at a height of 32 inches above the floor, measured to the top edge, and shall provide a vertical free clearance of at least 26 inches for knee space. A standard type lavatory which meets these conditions is acceptable.

10. A towel bar for patients shall be provided at a height of 42 inches. It shall be a horizontal grab bar, securely anchored.

11. The bottom of the mirror shall be placed at a height of 36 inches and the top at a height of at least 66 inches.

12. A small shelf for personal toilet accessories shall be provided at a height of 32 to 36 inches, unless such space is provided by a suitable lavatory or a counter.

STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2620 PATIENT TOILET BATH COMBINATIONS.

Subpart 1. Existing and new; shared rooms. In a room used by more than one patient, the bathtub or shower area shall be provided with a draw curtain for privacy.
Subp. 2. Existing and new; nonslip surfaces; grab bars. Bathtubs and showers shall be provided with a nonslip bottom or floor surface, and the areas shall be provided with grab bars.
Subp. 3. New construction. The toilet area shall comply with part 4660.2600. The shower or bathtub area shall comply with the provisions for the physically handicapped in chapters 1300 to 1365, the State Building Code, 1971 edition. In addition to the above, shower and bathtub areas shall be provided with recessed soap holders without handles.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2630 CENTRAL BATHING AREA.

Subpart 1. Fixtures. Bathing fixtures shall be provided in accordance with part 4660.2400.
Subp. 2. Existing and new. Bathing areas:

1. In bathing areas with more than one fixture, each bathtub or shower area shall be provided with privacy curtains and/or wall dividers.

2. Bathtubs and showers shall be provided with a nonslip bottom or floor surface, and at least one grab bar, securely anchored, shall be provided at each fixture.

3. There shall be convenient access to toilet facilities. If a water closet is located within an open area with multiple bathing fixtures, the toilet area shall be provided with privacy curtains or stall partitions. Such a toilet facility shall not be for general use by patients outside the bathing area.

Subp. 3. New construction. Bathing areas:

1. All bathtub and shower areas shall be designed for assisted bathing.

2. The bathing area shall have direct access to a toilet room without going through the general corridor, and the toilet room shall allow space for assistance of patients; see part 4660.2600 or 4660.2610.

3. If towel bars are provided, they shall be horizontal grab bars, securely anchored.

4. Central showers shall not be less than four feet by four feet or four feet, six inches by three feet, six inches with the long side open, without a curb, and with a 32-inch-high splash protection.

5. The shower area shall have the controls located near the splash protection for easy reach by both patient and attendant, and the floor drain shall be located near the rear wall.

6. A flexible hose hand shower shall be provided, and soap holders shall be without handles and be recessed.

7. A vertical, nonslip grab bar, 24 inches long, shall be provided at the shower and at the shower entrance location. The low end of the grab bar shall be three feet above the floor. Horizontal grab bars inside wet areas shall be mounted at a height of four feet, six inches above the floor.

8. A folding shower seat, 16 inches deep and 19 inches above the floor, is recommended for use by ambulatory patients.

9. The elevated tub shall be free-standing not more than 32 inches high and shall provide at least three feet of working space for the attendant on one side, and at least four feet at the end and on the opposite side for a chair lift.

10. A pedestal being used to elevate a standard type bath tub shall be provided with a finished cleanable surface, and include a toe space.

11. A flexible hose hand shower shall be provided, and the soap holder shall be without handle and be recessed.

12. A vertical, nonslip grab bar, 24 inches long, shall be provided on each side of the tub at the head end. The low end of the grab bar shall be three feet above the floor or four inches above the rim of the tub.

STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2640 TOILET TRAINING ROOM.

Subpart 1. Existing and new. A room shall be provided for toilet training, and may serve the central bathing area. The toilet seat shall be provided with removable or hinged side rails.
Subp. 2. New construction. Toilet training room:

1. The toilet training room shall be accessible from the general corridor. The space shall provide for a three-foot, six-inch clearance at the sides of the water closet, four feet at the front.

2. The water closet shall be mounted at a height of 18 to 19 inches, measured to the top of the seat. A lavatory with institutional fittings shall be provided, but shall be located outside the wheelchair clearance limits.

STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2700 STORAGE ROOM, NEW CONSTRUCTION.

A room or space for the storage of wheelchairs, walkers and other bulky equipment on the basis of one square foot per bed shall be provided in each patient area.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2800 JANITOR'S CLOSET, NEW CONSTRUCTION.

A janitor's closet shall be provided for each patient floor or area. It shall contain a floor receptor or service sink, storage for housekeeping supplies, and equipment.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.2900 DRINKING FOUNTAINS, NEW CONSTRUCTION.

Refrigerated drinking fountains shall be provided in patient areas and in the recreational or activities area. The fountain shall be of a type and installation which is accessible to, and usable by the physically handicapped.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.3000 ROOM NUMBERING, EXISTING AND NEW.

All bedrooms and service rooms shall be labeled utilizing a system of numbers. The numbers of rooms in multistory facilities shall be prefixed by the number of the corresponding floor level.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.3100 STAFF HOUSING, EXISTING AND NEW.

When living quarters for staff or administration are provided within the facility, they shall be separated from the patients' areas.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.3200 MECHANICAL AND ELECTRICAL SYSTEMS, EXISTING AND NEW.

The requirements for plumbing, heating, ventilation, and electrical systems are covered in parts 4660.7800 to 4660.8610 and 4660.9900 to 4660.9940.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.3300 APPLICABILITY.

Parts 4660.3400 to 4660.4700, residents' bedroom and service areas, apply to boarding care homes only.
STAT AUTH: MS s 144.56

4660.3400 BEDROOM CAPACITIES, NEW CONSTRUCTION.

At least five percent of the rooms shall be designed for single-person occupancy (one bed), and shall have private toilet rooms. At least 75 percent of the beds shall be located in rooms designed for one or two beds. No room shall have more than four beds.
STAT AUTH: MS s 144.56

4660.3410 LOCATION OF BEDROOMS, EXISTING AND NEW.

Bedrooms for residents shall be outside rooms; they shall be dry, well ventilated, naturally lighted, and otherwise suitable for occupancy. Each bedroom shall have direct access to an exit corridor. In existing facilities, the floor in existing bedrooms shall not be more than three feet below the outside grade level. All bedrooms for residents which are licensed on or after the effective date of these rules shall be at or above grade. In all new construction, the floor shall be located at or above the outside grade level or outside surface.
STAT AUTH: MS s 144.56

4660.3420 USABLE FLOOR AREA.

Subpart 1. Existing and new. The usable floor area and the arrangement and shape of the room shall provide space for furnishings and for the free movement of residents. The usable floor area does not include spaces occupied by toilet rooms, vestibules, lockers or closets, or heating units.
Subp. 2. Existing facilities. The usable floor area per bed shall not be less than: 100 square feet for single rooms; 80 square feet for two-bed rooms; and 70 square feet for three- or four-bedrooms, when thus licensed prior to the effective date of these rules.
Subp. 3. New construction. In new construction the usable floor area per bed shall not be less than: 100 square feet for single rooms, and 80 square feet for two-, three-, or four-bed rooms.
STAT AUTH: MS s 144.56

4660.3430 BED ARRANGEMENT.

Subpart 1. Existing and new. Beds shall be located so as to avoid drafts, excessive heat, or other discomforts to residents. All single and multibed rooms shall allow for a bed arrangement which can provide at least three feet of floor space at both sides and the foot end of each bed.
Subp. 2. New construction. Multibed rooms shall be arranged to permit not more than two beds side by side parallel to the window wall.
STAT AUTH: MS s 144.56

4660.3440 WINDOWS, NEW CONSTRUCTION.

The window area shall not be less than one-eighth of the usable floor area, and the window sill shall not be higher than two feet, six inches above the floor. The window shall face an open outside space not less than 30 feet deep, and shall provide an unobstructed angle of vision within this space of not less than 65 degrees. This angle may be read along the exterior wall.
STAT AUTH: MS s 144.56

4660.3450 BEDROOM DOORS, NEW CONSTRUCTION.

The door to the corridor shall be of fire-resistive construction in accordance with chapters 1300 to 1365, the State Building Code, 1971 edition, open into the bedroom, and provide a clear opening of 36 inches. Bedroom doors shall not open directly to a dayroom, dining area, or any other common use area. Privacy locks on doors to residents' bedrooms shall be of a type which can be opened with a master key from the corridor side at all times.
STAT AUTH: MS s 144.56

4660.3460 CLOTHES CLOSET.

Subpart 1. New construction. A separate built-in closet or storage space for clothing and personal belongings shall be provided within the room for each resident. It shall be provided with shelving, at least one drawer, unless included in the bedroom, and a full-length hanging space sized to accommodate clothes on hangers. The interior closet area shall be at least 22 inches deep and 36 inches wide. Locks may be provided, if openable with a master key.
Subp. 2. Existing facilities. See part 4655.7000, subpart 1, item C.
STAT AUTH: MS s 144.56

4660.3470 CUBICLE CURTAINS, EXISTING AND NEW.

Cubicle curtains shall be installed for complete privacy for each resident in multibed rooms. Decorative types recommended.
STAT AUTH: MS s 144.56

4660.3500 CORRIDORS, NEW CONSTRUCTION.

The unobstructed width of all corridors in resident areas shall be at least six feet, and all exits shall comply with chapters 1300 to 1365, the State Building Code, 1971 edition.
It is recommended that the planning of a new boarding care home include provisions for ease of compliance with nursing home requirements in order to accommodate a future higher level of care.
STAT AUTH: MS s 144.56

4660.3600 ATTENDANTS' STATION.

Subpart 1. Existing facilities. An attendants' station shall be provided with space for the residents' records and a medicine cabinet.
Subp. 2. New construction. An attendants' station or stations shall be provided on each resident area or floor with space for the residents' records and a medicine cabinet.
STAT AUTH: MS s 144.56

4660.3700 CLEAN LINEN STORAGE, EXISTING AND NEW.

One or more rooms, closets, or enclosed carts shall be provided for the storage of clean linen.
STAT AUTH: MS s 144.56

4660.3800 NOURISHMENT AREA, NEW CONSTRUCTION.

A nourishment area or room shall be provided for between-meal refreshments; it may serve more than one resident area, and can be located contiguous with a dayroom. The nourishment area shall be provided with work counter and sink, storage cabinets, and a refrigerator. Ice storage or an ice maker-dispenser, if provided in the resident areas, shall be located here.
STAT AUTH: MS s 144.56

4660.3900 SANITARY FIXTURES.

Subpart 1. Existing facilities. The number of sanitary fixtures shall not be less than: one water closet and one lavatory for eight beds, and one shower or tub for 20 beds.
When the licensed capacity is increased, the requirement under subpart 2 shall apply to the new addition. In resident toilets where grab bars or towel bars are not provided, such bars shall be installed in accordance with part 4660.2600 to the extent that the room arrangements will permit.
Subp. 2. New construction. The number of sanitary fixtures shall not be less than one water closet and one lavatory for four beds, and one shower or tub for 15 beds.
Toilets in central bathing, other service areas, or for personnel or the public shall not be counted in the above requirement. If urinals are provided, they shall be floor mounted. No toilet room shall be without a lavatory and all lavatories shall be provided with hot and cold water. A single-service towel dispenser can use single or roll towels, either disposable or washable.
Subp. 3. Existing and new. Water closets shall be located in separate toilet rooms, in stalls or within bathing areas only. Portable commodes, chemical toilets, or water closets with moving parts in the bowl or waste line assembly shall not be considered as substitutes for the required number of water closets.
STAT AUTH: MS s 144.56

4660.4000 PROVISION OF RESIDENT TOILET ROOMS, NEW CONSTRUCTION.

Each toilet room shall be directly accessible from the bedroom, except as noted; it may serve two bedrooms if residents are of the same sex, but not more than four beds. Hinged doors shall swing out, or they shall be double acting and be provided with an emergency type release stop. Privacy door locks shall be of a type which can be opened from the outside without the use of a separate device. Sliding doors shall be surface mounted. Folding doors shall be limited to toilet rooms with a single door access, and shall be capable of easy and positive latching when being closed, and of staying folded in the open position; the required width of door opening shall be increased to allow for the door when folded. Toilet rooms shall be designed for the elderly and infirm.
STAT AUTH: MS s 144.56

4660.4100 TOILET ROOM LAYOUT, NEW CONSTRUCTION.

The door opening shall be at least two feet, eight inches wide.
The center of the water closet shall be located 18 to 21 inches from the side wall and there shall be at least three feet of unobstructed space in front of the bowl. No basic interior room dimension shall be less than three feet, six inches.
The water closet shall be mounted at a height of not less than 16 inches nor more than 19 inches above the floor, measured to the top of seat. The bowl shall be elongated with an open front seat.
The paper holder shall be securely anchored on the side wall near the water closet, six inches above the seat, and six to 12 inches in front of the seat with both dimensions measured to the center of the holder.
A vertical grab bar, at least 18 inches long, shall be provided on the side wall near the water closet. The low end shall be mounted at a height of ten inches above the toilet seat and at a distance of 12 inches in front of the seat. A grab bar on each side of the water closet is recommended.
Grab bars shall have an outside diameter of one and one-half inches, and shall provide a clearance of one and one-half inches between the bar and the wall. Bars shall be securely anchored to sustain a load of 250 pounds for five minutes. The lavatory, with or without a counter top, shall be mounted at a height of 32 inches above the floor, measured to the top edge. A towel bar shall be provided at a height of 42 inches above the floor. It shall be a horizontal grab bar, securely anchored. A mirror shall be provided. A small shelf for personal toilet accessories shall be provided, unless such space is provided by a suitable lavatory or a counter.
STAT AUTH: MS s 144.56

4660.4110 RESIDENT TOILET-BATH COMBINATIONS.

Subpart 1. Existing and new. In a room used by more than one resident the bathtub or shower area shall be provided with a draw curtain for privacy. Bathtubs and showers shall be provided with a nonslip bottom or floor surface, and the areas shall be provided with grab bars.
Subp. 2. New construction. The toilet area shall comply with part 4660.4100. The shower or bathtub area shall comply with the requirements in part 4660.4120, subpart 3, and with the requirements for the physically handicapped in chapters 1300 to 1365, the State Building Code, 1971 edition. In addition to the above, shower and bathtub areas shall be provided with recessed soap holders without handles.
STAT AUTH: MS s 144.56

4660.4120 CENTRAL BATHING AREA.

Subpart 1. Fixtures. Bathing fixtures shall be provided in accordance with part 4660.3900.
Subp. 2. Existing and new. In bathing areas with more than one fixture, each bathtub or shower area shall be provided with privacy curtains and/or wall dividers. Bathtubs and showers shall be provided with a nonslip bottom or floor surface, and at least one grab bar, securely anchored, shall be provided at each fixture. There shall be convenient access to toilet facilities. If a water closet is located within an open area with multiple bathing fixtures, the toilet area shall be provided with privacy curtains or stall partitions. Such a toilet facility shall not be for general use by residents outside the bathing area.
Subp. 3. New construction. All bathtub or shower areas shall be designed for the elderly and infirm. At least one special bathtub or shower area, designed for assisted bathing, shall be available for general use. Shower stalls shall be at least two feet, six inches by two feet, six inches inside dimension, and be without curbs. Bathtubs shall be at least 18 inches, but not more than 20 inches above the floor. Soap holders shall be without handles and be recessed. The special bathtub or shower facilities shall be provided in accordance with the provisions for the physically handicapped in chapters 1300 to 1365, the State Building Code, 1971 edition. A shower for assisted bathing shall not be less than four feet by four feet or four feet, six inches by three feet, six inches with the long side open without a curb, and with a 32-inch-high splash protection. The shower area shall have the controls located near the splash protection for easy reach by both resident and attendant, and the floor drain shall be located near the rear wall. A flexible hose hand shower shall be provided, and the soap holder shall be without handle and be recessed. A vertical, nonslip grab bar, 24 inches long, shall be provided at the shower and at the shower entrance location. The low end of the grab bar shall be three feet above the floor. Horizontal grab bars inside wet areas shall be mounted at a height of four feet, six inches above the floor. A folding shower seat, 16 inches deep and 19 inches above the floor, is recommended.
A bathtub area for assisted bathing shall provide at least three feet of working space for the attendant on at least two sides of the tub. A flexible hose hand shower shall be provided, and the soap holder shall be without handle and be recessed. A vertical, nonslip grab bar, 36 inches long, shall be provided at the point of access at each side or end of the tub. The low end of the grab bar shall be four inches above the rim. A horizontal grab bar, 36 inches long, shall be installed four inches above the inside rim, if the bathtub is installed with the long side toward the wall.
STAT AUTH: MS s 144.56

4660.4200 STORAGE ROOM, NEW CONSTRUCTION.

A room or space for storage of bulky equipment shall be provided.
STAT AUTH: MS s 144.56

4660.4300 JANITOR'S CLOSET, NEW CONSTRUCTION.

A janitor's closet shall be provided for each floor or resident area. It shall contain a floor receptor or service sink, storage for housekeeping supplies, and equipment.
STAT AUTH: MS s 144.56

4660.4400 DRINKING FOUNTAINS, NEW CONSTRUCTION.

Refrigerated drinking fountains shall be provided in resident areas and in the recreational or activities area.
STAT AUTH: MS s 144.56

4660.4500 ROOM NUMBERING, EXISTING AND NEW.

All bedrooms and service rooms shall be labeled utilizing a system of numbers. The numbers of rooms in multistory facilities shall be prefixed by the number of the corresponding floor level.
STAT AUTH: MS s 144.56

4660.4600 STAFF HOUSING, EXISTING AND NEW.

When living quarters for staff or administration are provided within the facility, they shall be separated from the residents' areas.
STAT AUTH: MS s 144.56

4660.4700 MECHANICAL AND ELECTRICAL SYSTEMS, EXISTING AND NEW.

The requirements for plumbing, heating, ventilation, and electrical systems are covered in parts 4660.7800 to 4660.8610 and 4660.9900 to 4660.9940.
STAT AUTH: MS s 144.56

SUPPORTIVE SERVICE AREAS

4660.4810 DINING AND ACTIVITY AREAS, REQUIRED FLOOR AREA.

Subpart 1. New construction. The total areas set aside for dining, dayroom and activities shall not be less than 30 square feet per bed. It is recommended that an additional, separate activities area be provided.
Subp. 2. Existing and new. Additional space shall be provided for the above if the facility is offering a day care program.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.4820 DAYROOMS, NEW CONSTRUCTION.

The minimum dayroom and activities area shall be 20 square feet per bed. Areas used for corridor traffic or chapels with fixed pews shall not count as dayroom space. Dayrooms shall be located convenient to the bedroom areas and there shall be at least one on each bedroom floor in multistory construction. Dayrooms shall have outside windows, and the sill shall not be higher than two feet, six inches above the floor. It is recommended that an additional, separate activities area be provided.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.4830 DINING AREA, NEW CONSTRUCTION.

The minimum dining area shall be ten square feet per bed. The dining room area shall be separate from the kitchen.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.4840 ACTIVITIES AREA, NEW CONSTRUCTION.

Subpart 1. In general. The area for social and recreational activities or therapeutic treatment shall provide space, arrangement, and equipment to accommodate the activities program.
Subp. 2. Space arrangement. Special consideration shall be given to space arrangement for obtaining maximum flexibility in divisions or separations of activities areas according to the type of function. Dirty and dusty activities shall be separate from clean activities, and noisy activities shall be completely separate and enclosed.
Subp. 3. Storage. Storage for supplies and equipment, including storage accommodations and display space for individual participants' projects shall be provided.
Subp. 4. Sanitary facilities. A counter with a sink or a lavatory and a single-service towel dispenser shall be provided within the area. A toilet room shall be available nearby.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

DIETARY FACILITIES

4660.4900 KITCHEN AREA, NEW CONSTRUCTION.

Subpart 1. In general. The kitchen shall be located convenient to the service entrance, the food storage areas, and the dining area. Door openings to food preparation areas shall be located away from entrances to soiled linen or utility rooms, trash rooms, or a laundry. The kitchen area shall be arranged for efficient operation and shall contain sufficient space and equipment for the type of food service selected. If a commercial food service is utilized, or if meals are provided by another facility, the dietary areas and equipment shall be designed to provide for the sanitary storage, processing, and handling of such food. The kitchen area shall be subjected only to that traffic which is directly related to the functions of the food service; food storage areas shall be located to avoid delivery traffic through the kitchen area.
A dietary area designed for limited food preparation should be arranged for possible future expansion in the case that a facility reverts to a standard type food service at a later date. It is recommended that doors with locks be provided to secure the kitchen and food storage areas during off-hours.
Subp. 2. Storage for nonperishable food. A well-ventilated storeroom shall be provided for day storage, and for the reserve food supply. The supply room shall have storage capacity for at least one week's supplies. Shelving shall be finished with a washable surface, and the bottom shelf shall be at least eight inches above the floor. Floor drains shall not be provided.
Subp. 3. Storage for perishable food. Refrigerated storage for perishable foods shall be provided for a minimum three-day supply, and refrigerators, freezers, and refrigerated storerooms shall each be equipped with a reliable thermometer. Walk-in coolers and freezers shall be equipped with open-grid, corrosion-resistant metal shelving with the lowest shelf at least eight inches above the floor; be provided with inside lighting and inside safety lock releases; and the floors shall be flush with the kitchen floor to accommodate movable equipment. Floor drains, directly connected to the building sewer system, shall not be provided inside the room. The required temperatures are covered under part 4655.8670, subpart 4.
Subp. 4. Storage for dishes and utensils. Enclosed storage shall be provided for all china, glasses, flatware and other food service utensils, including cooking utensils, pots and pans. Dishes and utensils shall not be stored in the dishwashing area.
Subp. 5. Supervisor's office. An office or separate desk space for the dietary supervisor shall be provided within or adjacent to the kitchen. The area shall include space for reference books and files. Dietary office space may be provided in the administrative area in a facility with 30 beds or less.
Subp. 6. Janitor's closet. The dietary department shall be provided with its own janitor's closet with a floor receptor or service sink, and storage for housekeeping supplies and equipment.
Subp. 7. Lavatories. At least one lavatory with a single-service towel dispenser, shall be provided in the food preparation area and in the clean end of the dishwashing area. A single lavatory may be provided for a smaller dietary department; it shall be located near the clean end of the dishwashing area. Mirrors shall not be installed in food preparation areas.
Subp. 8. Toilet room. A toilet room shall be conveniently accessible for the dietary staff. It shall not open directly into any food service area. It shall contain a water closet, lavatory, mirror, and a single-service towel dispenser.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.4910 FOOD SERVICE EQUIPMENT.

Subpart 1. In general, new construction. All food service equipment, including icemakers, drinking fountains and dishwashers, shall be of a type equal to the standards established by the National Sanitation Foundation (NSF); see part 4660.8610. Sufficient separation shall be provided between each piece of equipment and between equipment and walls to permit easy and effective cleaning, or the equipment shall be placed with a tight fit and the joints sealed. Equipment which is not sealed at the floor shall be installed on sanitary legs providing at least six inches clearance between the equipment and the floor, or it shall be provided with casters. Aisles between equipment shall have a minimum width of four feet to allow room for traffic in work areas and to permit movement of mobile equipment.
Subp. 2. Food carts, new construction. Food carts shall be enclosed when used for the transport of uncovered food trays or containers through nondietary areas. Floor storage shall be provided for the storage of all carts.
Subp. 3. Cutting boards, new construction. Cutting boards or similar use table tops shall be constructed of hard rubber, high-pressure laminate, or of similar nonporous, smooth, and cleanable material, and be free of cracks, crevices, and open seams.
Subp. 4. Scullery sink, new construction. A three-compartment scullery sink shall be provided for the complete hand washing of pots and pans. A drainboard, at least 30 inches long, shall be provided on each end of the sink. Each compartment shall be of a size and depth which will accommodate utensils, pots, and pans. The sanitizing compartment shall be at least 14 inches deep, permit the introduction of long-handled wire baskets for small utensils, and shall be equipped with a unit heater capable of maintaining a water temperature of at least 170 degrees Fahrenheit. If the mechanical dishwasher or a mechanical utensil washer is used for the sanitizing of pots and pans, a sanitizing compartment may not be required and a two-compartment scullery sink may be acceptable.
Subp. 5. Existing facilities. All food service equipment when it is being replaced shall be of a type equal to the standards established by the National Sanitation Foundation (NSF), see part 4660.8610.
STAT AUTH: MS s 144.56; 144A.02 to 144A.08

4660.4920 DISHWASHING AREA, NEW CONSTRUCTION.

The dishwashing area shall be separate and away from the kitchen food preparation area, and shall be arranged and equipped as follows:

1. Soiled dishes shall arrive at the soiled dish counter without passing through the clean dish side of the dishwashing area or through the food preparation area of the kitchen. The soiled dish counter shall include provisions for prerinse of dishes and disposal of garbage.

2. Facilities with more than 30 beds shall be provided with a commercial hood type or conveyor dishwasher. The area containing the dishwasher and the soiled dish spray rinse shall be separated from the food preparation area and the clean dish storage area by a wall protection.

3. In facilities with 30 beds or less, a commercial type under-counter type dishwasher shall be a minimum requirement.

4. Clean dishes shall be returned directly from the clean dish counter to a clean area for storage. The clean dish counter shall not be less than four feet long in facilities with pass-through type dishwashers. If necessary, provision shall be made for the return of empty dish racks to the dishwasher area.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.4930 WASHING OF FOOD CARTS, NEW CONSTRUCTION.

   A separate area shall be provided for the cleaning of food carts.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.4940 WASHING OF GARBAGE CANS, NEW CONSTRUCTION.

   An area, separated from the dietary area, shall be provided for the washing of garbage cans.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5000 THE LAUNDRY, SIZE AND LOCATION.

   Subpart 1. Existing and new. The laundry, if provided in the facility, shall be sized and equipped to handle the laundering of all linen and personal clothing to be processed in the facility.
   Subp. 2. New construction. The entrance to a soiled linen collection room or to a laundry processing room shall be located away from patient or resident living areas and the entrance to the kitchen. Door widths to laundry areas shall allow for movement of equipment and linen carts.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5010 SOILED LINEN COLLECTION ROOM.

   Subpart 1. Existing and new. A separate, enclosed soiled linen room shall be provided for the collection, storage, and sorting of soiled linen to be processed in the laundry processing room or by an outside laundry service.
   Subp. 2. New construction. The soiled linen collection room shall be located at the soiled side of the laundry processing room. A soiled linen collection room for facilities with outside laundry service shall be located near the service entrance.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5020 LAUNDRY PROCESSING ROOM, NEW CONSTRUCTION.

   The laundry processing room shall be arranged to allow for the orderly, progressive flow of work from the soiled to the clean area. Equipment shall be arranged to minimize linen transportation, provide the necessary floor area between operations, and avoid cross-traffic between clean and soiled operations. The room shall provide space for storage of laundry supplies, cleaning equipment, and for parking of laundry trucks used in the operation. Hand-washing facilities shall be available for the area. A two-compartment laundry tub shall be provided and shall be of a material with a nonabsorbent, smooth, permanent finish. The laundry tub may be provided with fittings for the required hand-washing facilities.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5030 LAUNDRY EQUIPMENT, EXISTING AND NEW.

   The equipment shall be of commercial type and shall consist of one or more washers, extractors, tumblers, or combinations of these, as well as ironers and presses, depending on the size of the facility. The washer installation shall be capable of meeting the operating requirements in parts 4655.8000, subpart 6, and 4655.8300, subpart 4. The washers and extractors should each have a combined rated capacity of not less than 12 pounds of dry laundry per patient, when operating not more than 40 hours per week. The tumbler and flat work ironer should each have a rated capacity of 15 percent and 70 percent respectively of the washers when operating 40 hours per week.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5040 CLEAN LINEN ROOM, EXISTING AND NEW.

   A separate, enclosed clean linen storage room shall be provided.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5050 LAUNDRY FOR PERSONAL CLOTHING, EXISTING AND NEW.

   Provision shall be made for the washing of personal clothing either within or outside the facility.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5100 CENTRAL STORAGE, NEW CONSTRUCTION.

   Central storage shall be provided in all facilities for the storage of bulk supplies and equipment. At least ten square feet per bed shall be provided.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5200 REFUSE AREA, EXISTING AND NEW.

   An outside, fenced area or a separate room shall be provided for holding trash and garbage prior to disposal. It shall be located convenient to the service entrance and be sized to accommodate the refuse volume and the chosen type of disposal system. An incinerator, if provided, shall be in a separate room, or in a designated area within the boiler or heater room, or outdoors.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5300 YARD EQUIPMENT, NEW CONSTRUCTION.

   Separate storage for yard maintenance equipment and supplies shall be provided outside the facility.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5400 MAIN ENTRANCE AREA, NEW CONSTRUCTION.

   A lobby area appropriate to the size of the facility shall be provided. It shall be located near the main control area, with easy access to elevators, if provided. Public toilet facilities shall be provided in this area.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5500 ADMINISTRATION, NEW CONSTRUCTION.

   Space shall be provided for administrative functions involving business records and for the safekeeping of patients' and residents' valuables.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5600 FACILITIES FOR PERSONNEL, EXISTING AND NEW.

   Locker and toilet facilities shall be provided in accordance with the requirements of the Minnesota Department of Labor and Industry; see part 4660.8610.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5700 PLUMBING, VENTILATION, AND LIGHTING, EXISTING AND NEW.

   The requirements for mechanical and electrical systems are covered in parts 4660.7800 to 4660.8610 and 4660.9900 to 4660.9940.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5800 PHYSICAL THERAPY AREA.

   Subpart 1. Application. Subparts 2 and 3 apply to nursing homes only.
   Subp. 2. Existing and new. The physical therapy service, if provided, shall contain space and equipment for exercise and treatment which meets the needs of a medically directed therapy program. It is recommended that this area be utilized for in-service training in restorative nursing procedures. Each treatment area shall be provided with cubicle curtains for patients' privacy. Storage space shall be provided for supplies and equipment, and the area shall be provided with a lavatory or sink with institutional fittings and a single-service towel dispenser. A desk and file space for the supervisor shall be provided which also may serve an adjacent activities area. A toilet room shall be convenient to the area. The toilet room may also serve an adjacent activities area.
   Subp. 3. New construction. The toilet room shall comply with the requirements for special toilets, part 4660.2610.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.5810 BARBER AND BEAUTY SHOP SERVICES.

   Subpart 1. Application. Subpart 2 applies to nursing homes only.
   Subp. 2. New construction. A room shall be provided for barber and beauty shop services with a shampoo sink, a lavatory, and storage space.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   CONSTRUCTION DETAILS, CHUTES AND ELEVATORS

   4660.6000 ACCESS TO FACILITY, NEW CONSTRUCTION

   Accessibility to the facility by patients, residents, and the handicapped shall include at least one primary entrance without obstructions such as steps or curbs on walkways. Ramp slope shall not exceed one foot rise in 12 feet.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.6100 AREA HEAT PROTECTION, EXISTING AND NEW.

   Floors and walls for patient or resident living areas which are overheated due to adjoining heat sources shall be insulated or otherwise protected to prevent the surface from exceeding a temperature of 85 degrees Fahrenheit.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.6200 CEILINGS.

   Subpart 1. Existing and new. All ceiling finishes in living and service areas for patient and resident areas shall be washable and/or cleanable. Ceilings in high humidity areas shall be provided with a smooth and water resistant finish.
   Subp. 2. New construction. Ceilings shall be acoustically treated in corridors and in patient or resident living areas. Materials which flake or dust shall not be used.
   Subp. 3. Ceiling heights, new construction. Minimum ceiling heights shall be provided as follows:

   1. Boiler room ceilings shall be at least five feet higher than the top of the boiler unit and at least two feet, six inches above the main boiler header and connecting piping with a minimum total height of nine feet.

   2. Ceilings in corridors, storage rooms, patients' toilet rooms, and other minor rooms shall not be less than seven feet, six inches.

   3. Ceilings in all other rooms shall not be less than eight feet.

   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.6300 CLEAN AIR, EXISTING AND NEW.

   All air supplied to the facility shall be free from harmful particulate matter, any type of combustion products or contaminants, obnoxious odors, or exhausted air from the building or adjoining property.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.6400 DOOR HANDLES, NEW CONSTRUCTION.

   Lever type door handles shall be provided on all doors to bedrooms, toilet rooms, dayroom, dining room, and activities areas.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.6500 DUMBWAITERS AND CONVEYORS, NEW CONSTRUCTION.

   Shaft enclosure and installation requirements for dumbwaiters or conveyors shall be in accordance with the provisions in chapters 1300 to 1365, the State Building Code, 1971 edition. Enclosed dumbwaiter pits and conveyor spaces shall be provided with access for cleaning.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.6600 ELEVATORS, NEW CONSTRUCTION.

   Shaft enclosures and elevator installations shall be provided in accordance with the requirements in chapters 1300 to 1365, the State Building Code, 1971 edition. Elevators shall be provided in all facilities where patients or residents occupy or use more than the entrance or first floor level. The elevator cab shall be at least five feet in each direction and the car door shall have a clear opening of at least three feet.
   Number of elevators: one elevator for one to 59 persons above the first floor, two elevators for 60 to 200 persons above the first floor, and three elevators for 201 to 350 persons above the first floor. One additional elevator shall be added for each 150 persons in facilities with more than 350 persons above first floor.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.6700 ELECTRICAL SAFETY, EXISTING AND NEW.

   Major appliances such as washers and dryers shall be grounded. Electrical items such as radios, television sets, or lamps shall not be placed next to sanitary fixtures.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.6800 EXTERIOR MECHANICAL SHAFTS, NEW CONSTRUCTION.

   Exterior shafts serving equipment for patient or resident areas shall be constructed to prevent accumulation of dirt, leaves, or snow.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.6900 FLOORS, EXISTING AND NEW.

   Subpart 1. General requirements. All floors in living and service areas for patients and residents shall be washable and/or cleanable.
   Subp. 2. Dietary areas, wet areas. Floors in areas subject to local wetting shall be finished with a smooth, hard, nonslip, nonabsorbent surface. In dietary areas, such floor surfaces shall be grease resistant.
   Subp. 3. Carpeting requirements. Carpeting, including padding or adhesives, shall conform with the required smoke and flamespread ratings in chapters 1300 to 1365, the State Building Code, 1971 edition; each square yard of the product, or the container, shall be marked for identification of its flamespread rating. Carpeting in patient or resident areas shall be of stain-resistant, high-density, low-pile construction which is cleanable and facilitates wheeled traffic. It shall be stretched and securely fastened to avoid looseness and bunching.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.6910 FLOOR JOINTS, NEW CONSTRUCTION.

   Thresholds and expansion joint covers shall be flush with the floor, except at exterior doors. Adjacent dissimilar floor materials shall be flush with each other to provide an unbroken surface.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.6920 NONSKID SURFACES, EXISTING AND NEW.

   Stairways, ramps, bathtubs, and showers shall be provided with nonslip surfaces. Rubber nonskid mats in bath and shower stalls, and loose scatter rugs in patient or resident areas shall not be used.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.7000 GLASS PROTECTION.

   Subpart 1. Existing facilities. All full height windows, glass partitions, or glass doors shall be provided with decals or markings.
   Subp. 2. New construction. Any full height window or glass partition of clear glass which has the sill placed at or near floor level and is located in areas accessible to patients or residents shall be provided with a railing or some other structural safety barrier at a height of at least 30 inches above the floor. Glass doors shall be provided with a push bar or with decals or markings.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.7100 THE INCINERATOR, NEW CONSTRUCTION.

   An incinerator, if provided, shall comply with the requirements of the Minnesota Pollution Control Agency.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.7200 LINEN AND TRASH CHUTES, NEW CONSTRUCTION.

   Chute enclosures, service openings, and general installation shall be provided in accordance with the requirements of chapters 1300 to 1365, the State Building Code, 1971 edition. Minimum diameter of a gravity type chute shall be two feet.
   The valve for the chute flushing equipment shall be located for convenient use. The ceiling space between shaft walls and the discharge end of the chute shall be sealed to prevent odors from leaking into the enclosing shaft space.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.7300 OVERHEAD PIPING, NEW CONSTRUCTION.

   Overhead piping shall not be exposed in dietary areas, clean supply and clean linen areas. Overhead sanitary waste lines in these areas shall be avoided.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.7400 PROTECTION RAILINGS, NEW CONSTRUCTION.

   Protection railings, 42 inches high, shall be provided in accordance with the requirements for guardrails in chapters 1300 to 1365, the State Building Code, 1971 edition. The provision shall include railings for top landings of stairs, and window wells and open air shafts in areas accessible to patients or residents.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.7500 WALLS.

   Subpart 1. Existing and new. Wall finishes in living and service areas for patients and residents shall be smooth, washable and/or cleanable. Colors shall be light and cheerful. Walls in areas subject to local wetting shall be provided with a hard, nonabsorbent surface in accordance with chapters 1300 to 1365, the State Building Code, 1971 edition. Walls in high humidity areas shall be provided with a water resistant finish. The juncture at floors and walls in dietary areas shall be sealed or coved.
   Subp. 2. New construction. The juncture at floors and walls shall be coved in all areas used for food preparation and storage of prepared foods.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.7600 ELEVATORS IN NEW CONSTRUCTION.

   The following applies to nursing homes only. At least one elevator shall be a hospital-size elevator. The inside cab dimension shall be at least five feet wide and seven feet deep. The car doors shall have a clear opening of at least three feet, eight inches.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   MECHANICAL AND ELECTRICAL SYSTEMS

   4660.7800 PLANT OPERATION AND MAINTENANCE FOR EXISTING AND NEW
         CONSTRUCTION.

   Subpart 1. General requirements. The physical plant shall be kept in a continuous state of good repair and operation with regard to the health, comfort, safety and well-being of the occupants in accordance with an established routine maintenance and repair program.
   Subp. 2. Walls, floors, and ceilings. Walls, floors, and ceilings shall be kept in good and acceptable repair at all times. They shall be of a type or finish to permit good maintenance including frequent washing, cleaning, or painting.
   Subp. 3. Illumination. Lighting shall be provided and maintained throughout the facility in accordance with parts 4660.8410 to 4660.8560.
   Subp. 4. Emergency electrical service. If an emergency electrical service is provided it shall be maintained in working condition. An emergency generator shall be operated and tested at frequent intervals.
   Subp. 5. Electrical wiring and appliances. Electrical wiring, appliances, fixtures, equipment, and cords shall be maintained in a serviceable and safe condition. Light and power panels shall be properly indexed and locked when necessary. Radios, televisions, lamps, or clocks shall not be placed within reach of sanitary fixtures.
   Subp. 6. Heating, air conditioning, and ventilation. The mechanical systems shall be operated to maintain the necessary temperatures and air changes. Convectors, registers, ducts, and equipment shall be cleaned at regular intervals, and filters exchanged, when required. The heating system shall be capable of maintaining a minimum temperature of 75 degrees Fahrenheit in all living areas.
   Subp. 7. Descaling of equipment. Caution shall be taken that acid or other chemical solutions do not enter the potable water supply during the descaling operation of mechanical equipment.
   Subp. 8. Boiler water additives. Precautions shall be taken to assure that the type and concentration of boiler water additives is not harmful if steam is used for humidification or comes into direct contact with food.
   Subp. 9. Brine Tanks. All brine tanks shall be provided with tight fitting, overlapping covers.
   Subp. 10. Elevators and other machinery. Elevators, dumbwaiters, conveyor systems, and other machinery shall be maintained so as to comply with the rules of the Minnesota Department of Labor and Industry. All dangerous areas and equipment shall be provided with proper safeguards and appropriate devices to prevent accidents.
   Subp. 11. Periods of construction. Special precautions shall be taken to protect patients or residents from dust, harmful and obnoxious odors, dangers, and excessive noise during construction periods.
   Subp. 12. Testing of fire safety system. The total fire alarm system and the fire fighting equipment shall be tested at regular intervals as required by the state fire marshal.
   Subp. 13. Storage of hazardous materials. The storage of gasoline containers, gasoline powered equipment, liquid petroleum gas, fuel oil, paints and other flammable items shall be in accordance with the requirements of the state fire marshal.
   Subp. 14. Grounds. The surrounding grounds within lot lines shall be maintained in an acceptable manner and be kept free of accumulations of refuse and debris. Driveways, walks, and outside steps or ramps shall be maintained in good condition for access and safe use at all times, including the winter months.
   Subp. 15. Hot water temperature. Hot water supplied to lavatories and bathing fixtures shall not exceed 110 degrees Fahrenheit at the fixtures.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.7900 BUILDING CONSTRUCTION, NEW CONSTRUCTION.

   All new construction shall be in accordance with the requirements for Group D Occupancy in chapters 1300 to 1365, the State Building Code, 1971 edition.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8000 PLUMBING, NEW CONSTRUCTION.

   Subpart 1. Installation. All plumbing systems shall be installed and tested in accordance with the requirements of chapter 4715, the Minnesota Plumbing Code, 1969 edition, and with these rules.
   Subp. 2. Area drainage. Roofs, basements, tunnels, pits, shafts, areaways, courts, yards, and drives shall be properly drained to eliminate intrusion of rain water or ground water into the building. Floor drains in exterior areaways and similar installations shall be provided with a running trap located inside the building to prevent freeze-up in the winter.
   Subp. 3. Sanitary fixtures. The numbers and special types of sanitary fixtures required in the various areas are covered under parts 4660.1300 to 4660.5810. The material used for sanitary fixtures shall be smooth and nonabsorbent with a nonslip bottom surface in bathtubs and showers. Flush valves in living areas shall be of a quiet operating type.
   Subp. 4. Waste line interceptors. Interceptors for sand, plaster, rags, buttons, and other solids shall be provided on the waste line for sinks used for ceramics in activity areas and for washers in the laundry. Grease interceptors are not recommended.
   Subp. 5. Valves. Each water service main, branch main, riser, and branch to a group of fixtures shall be valved. Stop valves shall be provided at each fixture. There shall be easy access to all valves, and if concealed, their location shall be marked.
   Subp. 6. Booster heater. If the water system provides only 110 degrees Fahrenheit hot water, a booster heater shall be provided for the dishwasher and for the washer(s) in the laundry. It shall be located and sized to maintain the required temperature at the point of use. A pressure and temperature relief valve and a conductor pipe which discharges within ten inches off the floor shall be provided. It is recommended that separate hot water heaters for 110 degrees Fahrenheit and 180 degrees Fahrenheit be provided.
   Subp. 7. Pipe insulation. Sufficient insulation shall be provided for all water and steam piping to assure proper functioning of the systems, provide safety against burns, and to prevent undesirable condensation or heat transfer in areas for patients or residents.
   Subp. 8. Hot water supply. Circulating hot water shall be provided in all hot water mains and in risers more than three stories high to assure hot water at the fixtures. The hot water heating equipment shall have sufficient capacity and recovery to supply water at temperatures at the point of use as follows:

   A. patient and resident areas, 110 degrees Fahrenheit;
   B. mechanical dishwashing, 180 degrees Fahrenheit;
   C. washers in the laundry, 180 degrees Fahrenheit.

   If a thermostatically controlled mixing valve is used, it shall be of the "fail safe" type, which prevents flow of hot water in case the cold water supply fails. Heaters shall be insulated and provided with a thermometer.
   Subp. 9. Dishwashing machine. The dishwashing machine shall be of a commercial type equal to the standards established by Standard No. 3 of the National Sanitation Foundation (NSF), April, 1965 and shall be of a size that can accommodate food trays. The water supply line at the machine shall be provided with a pressure reducing valve, a pressure gauge, and a vacuum breaker. The rinse water flow pressure shall be maintained between 15 and 25 pounds per square inch (psi) at the machine by the use of a pressure reducing valve. A pressure gauge shall be installed following the reducing valve. A recirculation system and pump shall be provided if the final rinse water heater is located more than five feet from the dishwasher. The drain shall be an indirect waste connection to a trapped floor drain, or it shall be a trapped connection to a branch with a floor drain without a backwater valve in the horizontal branch.
   Subp. 10. Waste and vent piping restrictions. Waste lines over food preparation areas, food storage areas, clean storage areas, and electrical panels shall be avoided. Precautions shall be taken to protect these areas from possible leakage or condensation from overhead lines. Plumbing waste lines and vents shall not be located within ventilation plenums.
   Subp. 11. Floor drains. Floor drains shall not be installed in areas for food storage nor shall they be directly connected to ventilation equipment or air supply plenums.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8010 PLUMBING, NEW CONSTRUCTION FOR NURSING HOMES.

   Subpart 1. Application. Subparts 2 to 4 apply to nursing homes only.
   Subp. 2. Institutional fittings. Institutional fittings shall include: a mixing faucet, a gooseneck spout or other approved spout, wrist-action controls, and an open grid strainer on the waste in the lavatories.
   The spout shall provide a minimum vertical distance of five inches from its discharge point to the rim of the fixture, and a minimum horizontal bowl clearance of seven inches between the discharge point and the inside face of the rim.
   The blades on wrist-action controls shall not exceed four and one-half inches in length, except that handles on clinical sinks shall not be less than six inches long.
   Subp. 3. Clinical sinks. Flushing rim service sinks or clinical sinks shall have an integral trap in which the upper portion of a visible trap seal provides a water surface. A bedpan-cleaning device shall be included at the clinical sink in soiled utility rooms.
   Subp. 4. Sterilizer vent systems. All sterilizers requiring vapor vents shall be connected with a vapor venting system extending up through the roof independent of the plumbing fixture vent system. The vertical riser pipe shall be provided with a drip line which discharges into the drainage system through an air gap or open waste fixture. The connection between the fixture and the vertical vent riser pipe shall be made by means of a horizontal offset. Vent material shall be erosion and corrosion resistant.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8200 HEATING AND COOLING, NEW CONSTRUCTION.

   Subpart 1. Design and installation. All heating and/or cooling systems shall be designed and installed in accordance with the requirements of chapters 1300 to 1365, the State Building Code, 1971 edition. The heating system shall be capable of maintaining a temperature of 75 degrees Fahrenheit in all patient and resident areas. Areas shall be zoned according to use and exposure, and be provided with thermostatic temperature controls. Provision is recommended for humidification of up to 25 percent relative humidity.
   Subp. 2. Isolation of major components. A means of isolating major sections or components in the heating system shall be provided. Supply and return mains, and risers of space heating systems shall be valved to isolate the various sections of each system. Each piece of equipment shall be valved at the supply and return ends. Any pump on which the heating system is dependent should be installed in duplicate for standby service in a nursing home.
   Subp. 3. Controls and gauges. All valves and controls shall be placed for convenient access and use, and thermometers and gauges shall be mounted for easy observation.
   Subp. 4. Heating elements. Heating elements shall be located so as not to interfere with beds in patients' or residents' rooms. Tubing and casing of gravity type heating convectors shall be mounted at least four inches above the floor and be provided with removable sturdy covers in order to facilitate cleaning.
   Subp. 5. Forced flow room units. Cabinets for forced flow heating/cooling units shall be sturdy and shall be mounted either continuously along the floor with a tight fit or at least four inches above the floor. Outside air shall be filtered. The interior air grill for recirculation shall be located not less than four inches above the floor on floor mounted units. Fans or blowers shall be of a quiet operating type, and the fan or blower housing shall not be directly connected to the metal of the unit cabinet. It is recommended that recirculated air also be passed through the filter, and that the filter be replaceable from within the room.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   VENTILATION

   4660.8300 DESIGN AND INSTALLATION, NEW CONSTRUCTION.

   All ventilation systems shall be designed and installed in accordance with the requirements of chapters 1300 to 1365, the State Building Code, 1971 edition, and with these rules.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8310 VENTILATION REQUIREMENTS.

   Subpart 1. Existing construction. Ventilation in existing facilities shall include mechanical exhaust ventilation in the following areas: kitchen; laundry; soiled linen collection room; soiled utility rooms; and toilets, except when private or semiprivate and provided with window ventilation. Ventilation is recommended for janitors' closets.
   Subp. 2. New construction. Mechanical supply and exhaust ventilation shall be provided for all areas as indicated in part 4660.9930 or 4660.9940. Areas not covered in this table shall be ventilated in accordance with the requirements in chapters 1300 to 1365, the State Building Code, 1971 edition. Areas indicated with equal or positive pressure relationship to adjacent areas shall be provided with tempered makeup air.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8320 FRESH AIR INTAKES, NEW CONSTRUCTION.

   Fresh air intakes for ventilation systems shall be located not less than 25 feet away from a ventilation exhaust, combustion exhaust, driveway or parking area. The bottom of fresh air intakes serving central air systems shall be located as high as possible, but not less than four feet above grade, or, if installed through the roof, not less than two feet above roof level. Air intakes for individual room units shall not be less than one foot, six inches above outside grade. Any exhaust system or waste chute vent shall terminate not less than 25 feet away from windows that can be opened.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8330 HEIGHT OF REGISTERS, NEW CONSTRUCTION.

   Registers for air supply or return shall be located not less than four inches above the floor.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8340 FILTERS, NEW CONSTRUCTION.

   All outside air introduced into living and service areas of a facility shall be filtered. Return air to central ventilation systems shall be filtered.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8350 DIETARY AREA, NEW CONSTRUCTION.

   The dietary area shall be ventilated separately. Ventilation hoods shall be provided for ranges and other heat-producing equipment in addition to the general ventilation. Grease extractors or filters shall be provided. Filters and grease drip pans shall be easily removable for cleaning and replacement. A separate exhaust from the mechanical dishwasher shall not satisfy the requirement for general ventilation of the dishwashing area. Exhaust ducts shall be provided with access panels for cleaning.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8360 LAUNDRY AREA, NEW CONSTRUCTION.

   Air in the laundry shall be vented away from the finishing and ironing area and toward the extracting and washing area. The general air movement shall be from the clean area to the soiled area, and shall be of sufficient volume to remove steam, odors and excessive heat. Dryers shall be provided with a lint collector. Horizontal exhaust ducts shall be provided with access panels for cleaning. Spot ventilation for large heat-producing equipment such as dryers and ironers should be provided.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8370 MECHANICAL ROOMS, NEW CONSTRUCTION.

   Mechanical rooms below grade with equipment utilizing liquefied petroleum gas shall be provided with continuous mechanical ventilation providing a pressure which is equal or greater than atmospheric.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8380 VENTILATION REQUIREMENTS FOR NURSING HOMES.

   Subpart 1. Application. Subparts 2 and 3 apply to nursing homes only.
   Subp. 2. Filters, new construction. When central air systems are installed, outside air for use in patient areas shall pass through filters rated at a minimum efficiency of 30 percent based on the National Bureau of Standards Dust Spot Test Method with Atmospheric Dust. Filter frames shall be durable and carefully dimensioned and shall provide an airtight fit with the enclosing ductwork.
   Subp. 3. Sterilizer room, new construction. A separate room with a large autoclave shall be provided with supply and exhaust ventilation. If an autoclave is built into a separate equipment room, the equipment room shall be provided with exhaust ventilation.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   ELECTRICAL SYSTEMS

   4660.8410 ELECTRICAL SYSTEMS, INSTALLATION AND EQUIPMENT FOR NEW CONSTRUCTION.

   All electrical installations and equipment shall be in accordance with the requirements of chapters 1300 to 1365, the State Building Code, 1971 edition, and with these rules.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8420 DISTRIBUTION PANEL BOARDS.

   Subpart 1. Existing and new. All circuits in light and power panels shall be identified with a typewritten index. It is recommended that doors on electrical panel boards accessible to patients or residents be equipped with a lock.
   Subp. 2. New construction. Lighting and appliance panel boards shall be provided for the circuits on each floor, except for emergency system circuits.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8430 CORRIDOR RECEPTACLES, NEW CONSTRUCTION.

   Single receptacles on a separate circuit for equipment such as floor cleaning machines shall be installed approximately 50 feet apart in all corridors and within 25 feet of ends of corridors.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8440 SWITCHES AND RECEPTACLES, NEW CONSTRUCTION.

   Switches shall not be placed higher than 42 inches above the floor. Convenience outlets for electrical appliances shall be located to avoid danger in wet areas.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8450 INTERIOR LIGHTING.

   Subpart 1. Existing facilities. Each bedroom shall be provided with general illumination and a reading light for each occupant. General lighting levels measured 30 inches above the floor and special illumination at work surfaces shall not be less than:

   1. 30 footcandles for all reading surfaces or locations
   2. 20 footcandles at work or activity surfaces in kitchen and laundry;

   3. Ten footcandles for all other areas, such as bedrooms, dining areas, dayrooms, bathrooms, toilets, corridors, and service stairways; and

   4. five footcandles for exit stairways, mechanical equipment rooms, and storage areas.

   Subp. 2. New construction. Interior lighting for living and service areas for patients and residents shall be provided in accordance with the minimum levels of illumination listed in part 4660.9900. Each bedroom shall be provided with general illumination and a separate reading light for each occupant. The required illumination levels are given in footcandle power. General illumination shall be measured 30 inches above the floor and special illumination at the height of the work or reading surface, or location.
   Subp. 3. Recommended lighting levels. It is recommended that lighting levels for areas not covered in the regulations be provided in accordance with Illuminating Engineering Society Recommended Levels of Illumination, 1966 edition.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8460 FIRE ALARM SYSTEMS, EXISTING AND NEW.

   Fire alarm systems and sprinkler systems shall be provided in accordance with the requirements by the state fire marshal. New construction shall be in accordance with chapters 1300 to 1365, the State Building Code, 1971 edition.
   STAT AUTH: MS s 144.56; 144A.02 to 144A.08

   4660.8500 APPLICABILITY.

   Parts 4660.8510 to 4660.8560 apply to nursing homes only.
   STAT AUTH: MS s 144A.02 to 144A.08

   4660.8510 INTERIOR LIGHTING.

   Subpart 1. Existing facilities. In addition to the lighting requirements in part 4660.8450, subpart 1, nursing and treatment areas shall be provided with the following illumination levels:

   1. 30 footcandles at the charting desk and at the medicine preparation surface; and

   2. 20 footcandles at work surfaces in the medicine storage room, utility rooms, physical therapy, and examination room.

   Subp. 2. New construction. In addition to the lighting requirement in part 4660.9900, nursing and treatment areas shall be provided with the minimum levels of illumination listed in part 4660.9910. The required illumination levels are given in footcandle power. General illumination shall be measured 30 inches above the floor, and special illumination measured at the height of the work surface.
   STAT AUTH: MS s 144A.02 to 144A.08

   4660.8520 BEDROOM RECEPTACLES, NEW CONSTRUCTION.

   Each patient bedroom shall have duplex receptacles on each side of the head of each bed. Receptacles on other walls shall be provided as required by chapters 1300 to 1365, the State Building Code, 1971 edition.
   STAT AUTH: MS s 144A.02 to 144A.08

   4660.8530 NIGHT LIGHTS, NEW CONSTRUCTION.

   Each patient bedroom shall be provided with a night light.
   STAT AUTH: MS s 144A.02 to 144A.08

   4660.8540 NURSE CALL SYSTEM.

   Subpart 1. Existing and new. An electrical nurse call system shall be provided in a nursing home. It shall register a call from the patient at the nursing station and activate a signal light by the bedroom door.
   Subp. 2. New construction. A nurse call system shall cover patient and nursing service areas where indicated in part 4660.9920. Nurse calls or emergency calls shall be capable of being inactivated only at the points of origin. A central annunciator shall be provided where the door signal lights are not visible from the nurses' station.
   A nurse call shall be provided at the head end of each patient's bed. It shall register a call from the patient at the nurses' station and activate a visual signal light in the corridor at the patient's door and a duty signal in all required service areas for nursing. In multicorridor nursing units, additional visible signal lights shall be provided at corridor intersections.
   An emergency call shall be provided in each patient toilet and in all areas used for patient bathing. If a pull cord is provided it shall extend to within six inches above the floor. A push-button type emergency call shall be installed at a height of 24 inches. An emergency call shall register a call from a patient at the nurses' station, and activate a duty signal in all required service areas for nursing. The emergency duty signal shall provide a visual signal light and an audible alarm.
   If a nurse call system provides two-way voice communication, it shall be equipped with an indicator light at each call station which lights and remains lighted as long as the voice circuit is operating. Nurse calls of this type may be capable of being inactivated at the nurses' station.
   STAT AUTH: MS s 144A.02 to 144A.08

   4660.8550 PATIENTS' SECURITY SIGNAL, EXISTING AND NEW.

   Exit doors leading directly to the outside which are not under observation from the nurses' station shall be provided with an automatic audible alarm system. Where a local alarm is not audible at the nurses' station, an electric exit alarm system shall register at the nurses' station or other assigned control area.
   STAT AUTH: MS s 144A.02 to 144A.08

   4660.8560 EMERGENCY ELECTRIC SERVICE, EXISTING AND NEW.

   To provide electricity during an interruption of the normal electric supply that affects medical care, or safety of the occupants, an emergency source of electricity shall be provided and connected to certain circuits for lighting. The emergency system shall provide lighting for the nurses' stations, the telephone switchboard, the patient corridors, the exits, the boiler or heater room, the emergency generator, if provided; and it shall assure functioning of the fire alarm system. Emergency electrical service shall be provided by one of the following methods:

   1. a battery-operated system with automatic controls and recharging if effective for four or more hours; or

   2. an on-site emergency generator.

   It is recommended that the emergency generator system include all items necessary for the functioning of the heating system. An automatic transfer switch is recommended.
   STAT AUTH: MS s 144A.02 to 144A.08

   4660.8610 CODES AND REGULATIONS, NEW CONSTRUCTION.

   All construction, installations, and equipment shall conform to the following codes and standards, provided that the requirements of such codes or standards are not inconsistent with the requirements of these regulations.

   1. State Building Code, chapters 1300 to 1365, 1971 edition. Available from the Print Communications Division, 117 University Avenue, Saint Paul, Minnesota 55155.
      
   2. Minnesota Plumbing Code, 1969 edition. Available from the Print Communications Division, 117 University Avenue, Saint Paul, Minnesota 55155.
      
   3. Equipment Standards by the National Sanitation Foundation:

   1. Standard No. 2, Food Service Equipment, April 1965;
   2. Standard No. 3, Spray-Type Dishwashing Machines, April 1965;
   3. Standard No. 4, Commercial Cooking & Warming Equipment, April 1970;
   4. Standard No. 5, Commercial Hot Water Generating Equipment, January 1959;
   5. Standard No. 6, Dispensing Freezers, July 1970;
   6. Standard No. 7, Food Service Refrigerators & Storage Freezers, April 1966;
   7. Standard No. 8, Commercial Powdered Food Preparation Equipment, April 1965;
   8. Standard No. 12, Automatic Ice-Making Equipment, June 1964;
   9. Standard No. 25, Vending Machines for Food & Beverages, August 1968;
   10. Standard No. 26, Pot, Pan, and Utensil Washers, July 1970;
   11. Standard No. 29, Detergent and; Chemical Feeders for Commercial Spray-Type Dishwashing Machines, September 1969;

    D. Vending Machines, State Health Department Regulation No. 10950, November, 1966.

    E. "Illuminating Engineering Society, Lighting Handbook, 1966."

    F. Nonflammable Medical Gas Systems, National Fire Protection Association, NFPA No. 56F, 1970 edition.

    G. State of Minnesota rules of the Department of Labor and Industry, Occupational Safety and Health Rules, January 1971. Available from the Print Communications Division, 117 University Avenue, Saint Paul, Minnesota 55155.

    H. Air Pollution Control Rules, Regulations, and Air Quality Standards, 1969 edition. Available from the Print Communications Division, 117 University Avenue, Saint Paul, Minnesota 55155.

   STAT AUTH: MS s 144A.02 to 144A.08

   4660.8700 DEFINITION OF INTERMEDIATE CARE FACILITY.

   For the purposes of Laws of Minnesota 1969, chapter 387, there are hereby established two classifications of intermediate care facilities, Class I and Class II.
   A Class I facility is a nursing home, as licensed by the commissioner of health, which meets the requirements set forth in the Federal Register, volume 34, page 9782, June 24, 1969, to be codified as Code of Federal Regulations, title 45, section 234.130.
   A Class II facility is a boarding care home, as licensed by the commissioner of health, which meets the requirements set forth in the Federal Register, volume 34, page 9782, June 24, 1969, to be codified as Code of Federal Regulations, title 45, section 234.130.
   STAT AUTH: MS s 144A.02 to 144A.08
   HIST: L 1977 c 305 s 39

   4660.9900 MINIMUM ILLUMINATION LEVELS.

   AREA	GENERAL ILLUMINATION	SPECIAL ILLUMINATION
   Exit stairways, central storage, mechanical equipment room	5
   Bedrooms	10	30 (reading)
   Corridors, stairways, janitor's closet, dietary storage, clean linen closet	10
   Dayroom, Dining Room	20	30 (reading)
   Activity Area	30	100 (work Tables)
   Toilet, bathing, dietary area, laundry processing room, soiled linen collection room	30
   Barber and beauty room	50

   STAT AUTH: MS s 144A.02 to 144A.08

    

   4660.9910 MINIMUM ILLUMINATION LEVELS.

   AREA	GENERAL ILLUMINATION	SPECIAL ILLUMINATION
   Nurse Station	20 (night) 50 (day	70 (desk)
   Medication area, clean utility room, Sterilizer room	30	100 (cabinet) 100 (counter)
   Soiled utility room	20
   Physical therapy area	20	30 (treatment area)
   Examination and treatment room	50	100 (examination table)

   STAT AUTH: MS s 144A.02 to 144A.08

    

   4660.9920 NURSE CALL SYSTEM.

   TYPE OF SIGNAL	ROOM OR AREA
   Nurse Call	Patient Rooms
   Emergency Call	Patient's toilets, patient's bathing and training toilet room
   Duty Signal	Medication room, nourishment area, clean utility room, soiled utility room, sterilizing room

   Note: An emergency call is recommended for the following areas:

   Day rooms without visual control from nurses' station;
   Physical therapy and activity areas.
   STAT AUTH: MS s 144A.02 to 144A.08