Section 403.742 - Condition of participation: Physical environmentA RNHCI must be designed, constructed, and maintained to ensure the safety of the patients, staff, and the public.
(a)Standard: Buildings. The physical plant and the overall environment must be maintained in a manner that ensures the safety and well-being of the patients. The RNHCI must have the following:(1) Procedures for the proper storage and disposal of trash.(2) Proper ventilation and temperature control and appropriate lighting levels to ensure a safe and secure environment.(3) An effective pest control program.(4) A preventive maintenance program to maintain essential mechanical, electrical, and fire protection equipment operating in an efficient and safe manner.(5) A working call system for patients to summon aid or assistance.(b)Standard: Patient rooms. Patient rooms must be designed and equipped for adequate care, comfort, and privacy of the patient.(1) Patient rooms must meet the following conditions:(i) Accommodate no more than four patients.(ii) Measure at least 80 square feet per patient in multiple patient rooms and at least 100 square feet in single patient rooms.(iii) Have direct access to an exit corridor.(iv) Be designed or equipped to assure full visual privacy for each patient.(v) Have at least one window to the outside.(vi) Have a floor at or above grade level.(2) The RNHCI must furnish each patient with the following: (i) A separate bed of proper size and height for the convenience of the patient.(ii) A clean, comfortable mattress.(iii) Bedding appropriate to the weather and climate.(iv) Functional furniture appropriate to the patient's needs and individual closet space with clothes racks and shelves accessible to the patient.(3) CMS may permit variances in requirements specified in paragraphs (b)(1)(i) and (ii) of this section relating to rooms on an individual basis when the RNHCI adequately demonstrates in writing that the variances meet the following:(i) Are in accordance with the special needs of the patients.(ii) Will not adversely affect patients' health and safety.64 FR 67047, Nov. 30, 1999, as amended at 81 FR 64021 , Sept. 16, 2016