7.1 All new construction, extensive remodeling or conversions to a nursing facility shall comply with the standards
and guidelines set forth under the “Nursing Facilities” section of the current edition of Guidelines for Design
and Construction of Health Care Facilities, a publication of the American Institute of Architects Committee on
Architecture for Health with assistance of the U.S. Department of Health and Human Services.

7.2 The facility shall be handicapped accessible and meet applicable American National Standards Institute
(A.N.S.I.) standards.

7.3 Facility Systems Requirements
7.3.1 Water Supply and Sewage Disposal
7.3.1.1 The facility water supply and sewage disposal system shall comply with Division of Public Health
and Department of Natural Resources and Environmental Control standards, respectively.
7.3.1.2 The water system shall supply hot and cold water under sufficient pressure to satisfy facility needs
at peak demand.
7.3.1.3 Hot water accessible to residents shall not exceed 110° F.
7.3.2 Heating, Ventilation, Air Conditioning. The HVAC system for all areas used by residents shall be safe and
easily controlled.
7.3.3 Facility lighting shall meet current standards of the Guidelines for Design and Construction of Health Care
Facilities.
7.3.4 The facility shall be equipped with a resident call system which meets the current standards of the
Guidelines for Design and Construction of Health Care Facilities. An intermediate care facility serving only
developmentally disabled residents shall be exempt from this regulation.

7.4 Physical Environment Requirements
7.4.1 Safety Requirements
7.4.1.1 Stairs shall have stair treads and handrails.
7.4.1.2 Hallways shall have handrails on both sides of corridors. An intermediate care facility serving only
developmentally disabled residents shall be exempt from this regulation.
7.4.1.3 Non-skid flooring materials shall be used and maintained in good condition.
7.4.2 Bedrooms
7.4.2.1 Each resident shall be provided with a reading light. At least one bedroom light shall be controlled
by a switch at the bedroom entrance.
7.4.2.2 The facility shall provide at least one room with private toilet and hand washing sink for residents
who require isolation.
7.4.3 Bathrooms
7.4.3.1 Bathroom walls and floors shall be impervious to water. Bathrooms shall have at least one window
or mechanical ventilation exhausted to the outside.
7.4.3.2 A minimum of one bathtub or shower shall be provided for every 20 residents not otherwise served
by bathing facilities within residents’ rooms. Each nursing unit shall have at least one bathtub.
7.4.3.3 Each tub or shower in a central bathing facility shall be in an individual room or enclosure with
space for the private use of the tub or shower, for drying and dressing, and for a wheelchair and
attendant. Showers shall be at least four feet square without curbs. Toilets in central bathing
facilities shall have provisions for privacy.
7.4.3.4 Each resident’s room shall have direct access to a hand washing sink and a toilet.
7.4.3.5 A wall-mounted hand grip shall be provided at each resident toilet, bath tub and shower.
7.4.3.6 Separate bathroom and hand washing sinks shall be provided for the staff.
7.4.4 Resident Common Areas
7.4.4.1 Areas for resident recreational and social activities shall provide at least 30 square feet per bed for
the first 100 beds and 27 square feet per bed for beds in excess of 100.
7.4.4.2 The dining areas shall accommodate all residents.
7.4.4.3 Facilities for resident hair care and grooming shall be separate from resident rooms.
7.4.4.4 Equipment and materials for resident hair care and grooming shall comply with facility infection
control policies and procedures.

7.5 Kitchen and Food Storage Areas. Facilities shall comply with the Delaware Food Code.

7.6 Sanitation and Laundry
7.6.1 The facility shall provide for the safe storage of cleaning materials, pesticides and other potentially toxic
materials.
7.6.2 Each facility shall have a janitor’s closet containing a service sink.
7.6.3 For on-site laundry processing, the facility shall:
7.6.3.1 Provide a room under negative air pressure for receiving, sorting, and washing soiled linen.
7.6.3.1.1 If hot water is used for destroying micro-organisms, washers must be supplied with water
heated to a minimum of 160º F.
7.6.3.1.2 If low temperature laundry cycles are used, a total available chlorine residual of 50-150 ppm
must be present and monitored during the wash cycle.
7.6.3.2 Provide a room under positive air pressure for drying and folding clean linen, equipped with a hand
washing sink.
7.6.4 For off-site laundry processing, the facility shall:
7.6.4.1 Contract with a commercial laundry.
7.6.4.2 Provide a soiled linen holding room (or a designated area in the soiled utility room) under negative
air pressure for the storage of soiled linen.
7.6.4.3 Provide a clean linen storage area.
7.6.5 The facility shall have a soiled utility room under negative pressure for storage of infectious waste and for
disposal of body fluids. The room shall have a work counter, hand washing sink, and clinical sink or other
bed pan cleaning device.

7.7 Equipment and Supplies
7.7.1 The facility shall supply sufficient equipment and supplies for nursing care to meet the needs of each
resident. The facility shall obtain specific items when indicated for individual residents and approved by the
attending physician or director of nursing.
7.7.2 The facility shall provide each resident with:
7.7.2.1 A hospital bed of appropriate size with a mattress covered with non-porous material. Modifications
or attachments to the bed shall conform to manufacturer’s specifications.
7.7.2.2 A bedside stand with a drawer and storage space for a bedpan, urinal, emesis basin and
washbasin.
7.7.2.3 A minimum of two drawers in a dresser or chest of drawers.
7.7.2.4 A closet or wardrobe.
7.7.2.5 A chair suitable for resident relaxation.
7.7.2.6 An over-bed table.
7.7.3 The facility shall provide cubicle curtains around each bed in bedrooms occupied by more than one
resident.
7.7.4 The facility shall provide sufficient storage space on each nursing unit for nursing supplies and equipment.
7.7.5 The facility shall provide safe storage for residents’ valuables.
7.7.6 The facility shall maintain a functioning scale, calibrated quarterly, capable of accurately weighing each
resident.

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