Facility Planning Legal & Regulatory Issues Week 3.
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Transcript of Facility Planning Legal & Regulatory Issues Week 3.
Facility PlanningLegal & Regulatory Issues
Week 3
Objectives for Week 3Legal & Regulatory Issues
Examine local, state, and federal legal and regulatory requirements.
Develop a plan for waste management, fire and safety, and disaster management
Examine Local, State, & Federal legal and regulatory
requirementsRegulatory considerations
FederalInternational Building CodeNational Electrical CodeAmericans with Disabilities Act (ADA)
Governs accessibility requirements Details required sizes of patient rooms, bathrooms, etc., for wheelchair accessibilityIncludes signage requirementsRequires and determines grab bar placementStipulates handicap parking requirements
Examine Local, State, & Federal legal and regulatory
requirementsFederal (con’t)
National Fire Protection Association (NFPA) 101 Life Safety Code for Healthcare Occupancies
Requirements for fire alarms, emergency lighting, and fire suppression equipmentStipulates distances to exits, fire pull stations, fire extinguishers, etc.Determines fire and smoke ratings required for most aspects of the building and some furnishings, such as wall and floor coverings and some fabrics Governs smoke barrier requirementsDining room elevator requirementsSome states, like California, have requirements that are stricter than the federal government
Examine Local, State, & Federal legal and regulatory
requirementsHealth Insurance Portability And Accountability Act (HIPAA) governs patient privacy concerns and information security
OSHA Requires worker safeguards (may affect equipment selection or design of work areas) Specific policies and procedures must be in place by opening date related to
Bloodborne pathogensConfined spaces (elevators)Material Safety Data Sheets (MSDS) – Hazard Communication PlanElectrical safety (lock-out, tag-out)Other worker safety issues
Examine Local, State, & Federal legal and regulatory
requirementsFederal (continued):
Clinical Laboratory Improvement Amendments (CLIA) governs clinical laboratoriesMedicare and Medicaid Conditions of Participation
Examine Local, State, & Federal legal and regulatory
requirementsState
State health planning; Certificate of Need (CON) laws still apply in some statesState licensing agency (Department of Health, Aging or Senior Services)
Must approve architectural/detailed construction plans before construction startsConducts onsite inspections of the construction in progress
State fire codes enforced by the state fire marshallState building codes
Examine Local, State, & Federal legal and regulatory
requirementsLocal
Planning and zoning lawsLocal building codesLocal fire department and city-specific fire requirementsArchitectural/detailed construction plans must be approved and a building permit issued before construction beginsConduct periodic surveys of the construction in progress
Examine Local, State, & Federal legal and regulatory
requirements
If the completed project will be accredited (by JCAHO, CARF/CCAC, other), architectural plans should be reviewed to assure compliance with applicable standards.
Examine Local, State, & Federal legal and regulatory
requirementsLicenses and permits required for operating the facility
Must be in place before the facility opensOccupancy permit (issued by local authority)License from the state licensing agency (Department of Health, Aging or Senior Services)A local business license may be required
Examine Local, State, & Federal legal and regulatory
requirementsLicenses and permits required for operating the facility
Separate business or operating licenses may be required for:
Food service departments, restaurants, and cafeteriasBarber and beauty shopsGift shop
Drug Enforcement Agency permits (for storing and dispensing medications). If selling medications to outpatients, a retail pharmacy license will be required.Clinical Laboratory Improvements Act (CLIA) for clinical laboratory services. LTC facilities will require a CLIA waiver
Examine Local, State, & Federal legal and regulatory
requirementsLicensing, certifying, and opening the new facility:
The state licensing agency will conduct a survey of the completed facility. If all requirements are met, the license to operate will be issuedRequirements for passing the licensure survey
Building and grounds 100% completeAll building systems working properlyAll furnishings, equipment, and supplies in placeRequired staff hired, trained and some on duty during the licensure survey
Examine Local, State, & Federal legal and regulatory
requirementsLicensing, certifying, and opening the new facility:
All policies and procedures finalizedDisaster plan complete Waste management plan completeAll contracts for any contracted services negotiated and in effect
After state operating license has been issued and the first patients have been admitted, Medicare/Medicaid surveyors will arrive to check for compliance with the Medicare and Medicaid Conditions of Participation. If the facility is in substantial compliance, the facility will be certified to receive payment for Medicare and Medicaid patients.
Plans for Waste Management, Fire and Safety, and Disaster
ManagementWaste management
Regulatory standards for waste management originated with the World Health Organization (WHO)
Occupational Safety and Health Administration (OSHA) and the Environmental Protection Agency (EPA) govern many of the U. S. waste management requirements
Plans for Waste Management, Fire and Safety, and Disaster
ManagementWaste managementThe waste management plan must address:
Sorting of waste (where it is generated is best)Handling (as little as possible)Interim storage—short term (1 to 2 days) before final disposalFinal disposal
Solid medical wasteLiquid medical wasteContaminated sharpsWaste anesthesia gasesRadioactive materials
Required recordkeeping
Plans for Waste Management, Fire and Safety, and Disaster
ManagementGuidelines for disaster planning or emergency management defined by the Department of Homeland Security
Sample disaster or emergency management plans and guidance for developing plans are available from many states. An example from Kansas for long-term care facilities is located at: http://www.jocoem.org/documents/Plan_Templates/Adult_Care_Homes_Disaster_Plan_Template.pdfShould address business continuity planning as well as specific disaster conditions that might occur
Plans for Waste Management, Fire and Safety, and Disaster
ManagementHealth care facilities should also address their role for providing assistance when disasters occur elsewhere in their community
Disaster plan should include a section on responding to firesKey points in business continuity planning
Carefully assess how your organization functions and create a business flow chart if none existsIdentify operations critical to survivalInclude emergency payroll, expedited financial decision making, and accounting systemsDetermine management successionIdentify your suppliers, resources, and other business partners
Disaster Management
Develop additional professional relationships in case primary suppliers are unable to service needsCreate a contact list to use in emergencies and keep with emergency supplies at an off-site locationPlan what you will do if your building is not accessiblePlan for payroll continuityDefine crisis management procedures and individual responsibilities in advanceReview and update the plan annuallyDevelop a plan for maintaining communication with employees
Disaster Management
Keep important records like building plans, insurance policies, employee contact and identification information in a safe off-site location
Ensure you have employees able to workSupplies
Focus first on the basics of fresh water, food, clean air, and warmth. Create a plan for having essential medical supplies on hand or available
Create evacuation plansDevelop policies and procedures about deciding whether to stay or evacuateEnsure all employees are well trained in the procedures
Questions?Next week……..
Individual – Toolwire Model
(alternate assignment is a powerpoint –you need a PHOTO of every key element)
Team Summary