.42 Physical Plant — General Requirements.

A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.

B. A nursing home shall comply with all applicable federal, State, and local governing laws, regulations, standards, ordinances, and codes.

C. A nursing home shall be constructed to comply with the provisions of the NFPA 101 Life Safety Code, as promulgated by the State Fire Prevention Commission, that are applicable to nursing homes.

D. Securely anchored handrails:

(1) Shall be provided on each side of all corridors in resident areas; and

(2) May not be more than 36 inches high as measured from the floor to the top of the handrail.

E. Elevators.

(1) New Construction. Elevators shall meet the requirements for elevators in a long-term care nursing home as set forth in the Guidelines for Design and Construction of Residential, Health, Care, and Support Facilities.

(2) Existing Facilities. An existing nursing home shall meet all local codes and standards for safety and maintenance of institutional elevators.

F. Lighting.

(1) A residentís room shall:

(a) Be lighted by outside windows; and

(b) Have artificial light adequate for reading and other uses as required.

(2) In order to prevent accidents and promote efficiency of service, the nursing home shall ensure that the following areas have sufficient artificial lighting:

(a) Entrances;

(b) Hallways;

(c) Stairways;

(d) Inclines;

(e) Ramps;

(f) Basements;

(g) Attics;

(h) Storerooms;

(i) Kitchens;

(j) Laundries; and

(k) Service units.

G. Minimally Maintained Lighting Levels. The following table lists the minimum lighting requirements in the following given areas:

Area Minimum Lighting
(1) Administrative areas 30 foot-candles
(2) Dining areas 30 foot-candles
(3) Recreation areas 100 foot-candles
(4) Residentís room 10 foot-candles
(5) Residentís reading lamps 30 foot-candles
(6) Nurses station 20 foot-candles
(7) Medicine storage and preparation area 100 foot-candles
(8) Stairways 20 foot-candles
(9) Corridors 20 foot-candles

H. Night Lights.

(1) A nursing home shall have sufficient lighting at night in the following areas:

(a) Hallways;

(b) Stairs; and

(c) Designated toilets of the nursing home for the safety of the resident who gets up during the night.

(2) There shall be at least one night light in each bedroom for residents.

(3) In new construction, the night light shall be located at the resident room door and be capable of being switched on and off.

I. Screens.

(1) A nursing home shall ensure that screened doors and windows are installed and maintained in accordance with applicable fire and safety codes and COMAR 10.15.03 Food Service Facilities.

(2) Maintenance and installation may not conflict with other applicable laws, regulations, codes, or ordinances.

(3) A nursing home shall equip all screened doors with self-closing devices, to provide for the normal flow of ingress and egress of traffic.

(4) A nursing home shall screen with wire screen or its equivalent, not less than 16 meshes per linear inch for doors and windows that provide ventilation.

J. Garbage Disposal.

(1) Garbage shall be:

(a) Stored in water-tight containers with tight-fitting covers; and

(b) Emptied at frequent intervals.

(2) Soiled containers shall be thoroughly scoured and aired before using again.

K. Garbage Storage Space. Storage space shall be provided for garbage and trash awaiting pickup.

L. Burning. A nursing home may not burn or incinerate garbage at the nursing home.

M. Special Medical Wastes. The nursing home shall meet the requirements for handling, treatment, and disposal of special medical wastes as provided in COMAR 10.06.06.

N. Smoking.

(1) Resident Smoking Requirements.

(a) A resident who smokes shall be assessed for safe smoking behaviors at admission and on significant changes in condition.

(b) A resident assessed to exhibit unsafe behaviors shall have a care plan to ensure the resident is safe when smoking.

(2) Nursing Home Smoking Requirements.

(a) Smoking areas shall be designated.

(b) Smoking shall be prohibited at the main entrance to all facilities.

(c) All tobacco products shall be extinguished and disposed of in noncombustible containers with self-closing lids in accordance with the provisions of NFPA 101 Life Safety Code.

O. A nursing home shall be protected throughout the entire building by an automatic fire extinguishing system.