10A NCAC 13F .1304       SPECIAL CARE UNIT Physical environment REQUIREMENTS

In addition to meeting all applicable building codes and licensure regulations for adult care homes, the special care unit shall meet the following building requirements:

(1)           For facilities licensed prior to April 1, 2025, the following shall apply:

(a)           Plans for new or renovated construction or conversion of existing building areas shall be submitted to the Construction Section of the Division of Health Service Regulation for review and approval.

(b)           If the special care unit is a portion of a facility, it shall be separated from the rest of the building by closed doors.

(c)           Unit exit doors may be locked only if the locking devices meet the requirements outlined in the N.C. State Building Code for special locking devices.

(d)           Where exit doors are not locked, a system of security monitoring shall be provided.

(e)           The unit shall be located so that other residents, staff and visitors do not have to routinely pass through the unit to reach other areas of the building.

(f)            At a minimum the following service and storage areas shall be provided within the special care unit: staff work area, nourishment station for the preparation and provision of snacks, lockable space for medication storage, and storage area for the residents' records.

(g)           Living and dining space shall be provided within the unit at a total rate of 30 square feet per resident and may be used as an activity area.

(h)           Direct access from the facility to a secured outside area shall be provided.

(i)            A toilet and hand lavatory shall be provided within the unit for every five residents.

(j)            A tub and shower for bathing of residents shall be provided within the unit.

(k)           Use of potentially distracting mechanical noises such as loud ice machines, window air conditioners, intercoms and alarm systems shall be minimized or avoided.

(2)           For facilities licensed on or after April 1, 2025, the following shall apply:

(a)           A special care unit that is part of an adult care home shall meet licensure rules for adult care homes contained in Rules .0301-.0311 of this Subchapter with the following exceptions: .0305(e)(3), .0305(f)(1), .0305(f)(4), .0305(h)(3), .0305(k), and .0305(l).

(b)           The unit, if part of an adult care home, shall be separated from the rest of the facility by walls and closed doors.

(c)           The unit, if part of an adult care home, shall be located so that other residents, staff, and visitors will not have to pass through the unit to reach other areas of the facility.

(d)           Unit exit doors shall be locked with locking devices meeting the requirements outlined in the North Carolina State Building Code for special locking arrangements.

(e)           Unit exit doors shall have a sounding device that is activated when the door is opened per Rule .0305(h)(4) of this Subchapter.

(f)            Operable exterior windows shall be equipped with mechanisms to limit window openings to no less than four inches and no greater than six inches to minimize the chance of elopement.

(g)           There shall be direct access from the unit to a secured outside area located on the same level as the unit.

(h)           Fences used to enclose the secured outside area shall be at least six feet high and shall be constructed to prevent residents' ability to climb over the fence.

(i)            The following service and storage areas shall be provided within the special care unit:

(i)            a staff work area;

(ii)           a staff bathroom;

(iii)          a nourishment station for the preparation and provision of snacks. The nourishment station shall be provided with a sink trimmed with valves that can be operated without hands. If the sink is equipped with blade handles, the blade handles shall not be less than four and one half inches in length. If the sink faucet depends on the building electrical service for operation, the faucet must have an emergency power source or battery backup capability. If the faucet has battery operated sensors, the facility shall have a maintenance policy to keep extra rechargeable or non-rechargeable batteries on premises for the faucets;

(iv)          lockable space for medication storage;

(v)           storage area for the residents' records;

(vi)          separate storage room or area shall be provided for the storage of soiled linens; and

(vii)         a housekeeping closet, with mop sink or mop floor receptor.

(j)            The living room and dining room/dining area may be sized per Rules .0305(b) and .0305(c) of this Subchapter or may be combined for a minimum of 30 square feet per resident. The combined space may be used as an activity area.

(k)           The unit shall have a central bathing area meeting the following:

(i)            a door of three feet minimum width;

(ii)           a roll-in shower designed to allow the staff to assist a resident in taking a shower without the staff getting wet. The roll-in shower shall be designed and equipped for unobstructed ease of shower chair entry and use. If a bathroom with a roll-in shower designed and equipped for unobstructed ease of shower chair entry adjoins each resident bedroom in the facility, the central bathing area is not required to have a roll-in shower;

(iii)          a bathtub, a manufactured walk-in tub or a similar manufactured bathtub designed for easy transfer of residents into the tub. Bathtubs shall be accessible on three sides. Manufactured walk-in tubs or a similar manufactured bathtub shall be accessible on at least two sides. Staff shall not be required to reach over or through the tub faucets and other fixture fittings to assist the resident in the tub;

(iv)          a toilet and a lavatory trimmed with valves that can be operated without hands. If the lavatory is equipped with blade handles, the blade handles shall not be less than four and one half inches in length. If the lavatory faucet depends on the building electrical service for operation, the faucet must have an emergency power source or battery backup capability. If the faucet has battery operated sensors, the facility shall have a maintenance policy to keep extra rechargeable or non-rechargeable batteries on premises for the faucets; and

(v)           individual cubicle curtains shall enclose each toilet, bathtub, manufactured walk-in tub or similar manufactured bathtub, and shower.

(l)            If each resident bedroom has direct access to a bathroom equipped with a shower meeting the requirements of Rule .0305(e)(7)(B) of this Subchapter, the shower required by this rule is not required to be provided in the unit.

(m)          Fire extinguishers required by Rule .0308(a) of this Subchapter shall be secured in a manner acceptable to the local Fire Marshal to prevent access by residents.

History Note:        Authority G.S. 131D-2.16; 131D-4.5; 131D-4.6; 131D-8; 143B-165;

Temporary Adoption Eff. December 1, 1999;

Eff. July 1, 2000;

Readopted Eff. April 1, 2025.