(a)  All institutions shall be provided with toilet, handwashing, and bathing facilities that are conveniently located and readily accessible to residents and staff.   These facilities, and laundry facilities when provided, shall be kept clean and in good repair.

(b)  Toilet facilities shall comply with the requirements of the state agency licensing the facility.  Toilet rooms shall not be used for storage.  Fixtures and furnishings shall be kept clean and in good repair.  Durable, legible signs shall be posted or stenciled conspicuously in each toilet room for food service employees directing them to wash their hands before returning to work.

(c)  Institutions where bedpans, urinals or emesis basins are used shall provide facilities for emptying, cleaning, and disinfecting bedpans, urinals and emesis basins.  Bedpans, urinals and emesis basins shall be cleaned after each use and shall be disinfected before use by other patients. Where bedpans are cleaned in patient rooms, bedpan cleaning facilities shall consist of a water closet with bedpan lugs or spray arms.  Where facilities for cleaning bedpans are not provided in patient rooms, bedpans shall be taken to a soiled utility room and be cleaned and disinfected using an EPA registered hospital disinfectant after each use.  Where disposable bedpans are reused, they shall be labeled with the patient's name and date and shall not be used by more than one patient.  Bedside commodes shall be cleaned after each use and shall be cleaned and disinfected before use by successive patients.  Hand sinks shall not be used for cleaning bedpans or bedside commodes.

(d)  Handwashing facilities shall be accessible to all areas where personnel may be exposed to bodily excretions or secretions and in sterile supply processing areas, medication rooms, laundry areas, and soiled utility rooms.  Any area where personnel may be exposed to bodily excretions or secretions shall have handwashing facilities located in the same room or have a doorway connecting to an adjacent room or corridor containing handwashing facilities.  All lavatories shall be supplied with hot and cold running water through a mixing faucet, or with tempered warm water, soap, and sanitary towels or hand‑drying devices.  Facilities in operation prior to March 1, 2003 that do not have handwashing lavatories in all areas required shall not be required to install additional lavatories if an approved hand hygiene program is used.  Hand hygiene programs shall be approved by the Environmental Health Specialist case-by-case based on type and frequency of activities involving contamination with bodily excretions or secretions, use of gloves to reduce contamination, availability of pre-moistened detergent wipes for hand cleaning, use of alcohol rubs or other skin antiseptics, and availability of handwashing facilities on the same wing or floor of the building.  Handwashing facilities shall be provided in kitchens and any other food preparation areas in addition to any lavatories provided at employees' toilet rooms.  Sinks used for washing utensils and equipment shall not be accepted as a substitute for required handwashing facilities.  Handwash lavatories shall be used only for handwashing.  Lavatories provided for use of patients or residents shall be used only for handwashing, personal hygiene, rinsing feeding tubes and obtaining water.  Lavatories used for handwashing or personal hygiene shall not be used for disposal of body fluids or cleaning soiled linens.  Lavatories in medication rooms used primarily for handwashing can be used for other purposes, such as disposal of medications, which do not interfere with effective handwashing.

(e)  Water heating facilities shall provide hot water within the temperature range of 100 degrees F to 116 degrees F at all lavatories and bathing facilities.

(f)  Bathing facilities as required by the licensing agency shall be provided, maintained and kept clean. Bathing facilities shall be supplied with hot and cold running water and a mixing device, or tempering device.  Shared bathing equipment that has contact with patient's skin shall be cleaned with detergent and an EPA registered hospital disinfectant between patient uses.  Manufacturer's instructions shall be followed for cleaning equipment with pumps.  A supply of cleaning and disinfectant agents shall be accessible to bathing areas.  Where disinfectants are mixed on site, the concentration of the mix shall be assured by use of a metering pump, measuring device or chemical test kit.


History Note:        Authority G.S. 130A‑235;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. March 1, 2003 (see S.L. 2002-160); September 1, 1990;

Temporary Amendment Eff. June 1, 2003;

Amended Eff. February 1, 2004.