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<regulation prefix="Regulation" num=".42" citation="COMAR 10.07.02.42" title_num="10" subtitle_num="07" chapter_num="02" heading="Physical Plant — General Requirements.">
  <paragraph num="A.">
    <text>Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.</text>
  </paragraph>
  <paragraph num="B.">
    <text>A nursing home shall comply with all applicable federal, State, and local governing laws, regulations, standards, ordinances, and codes.</text>
  </paragraph>
  <paragraph num="C.">
    <text>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.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Securely anchored handrails:</text>
    <paragraph num="(1)">
      <text>Shall be provided on each side of all corridors in resident areas; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>May not be more than 36 inches high as measured from the floor to the top of the handrail.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Elevators.</text>
    <paragraph num="(1)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Existing Facilities. An existing nursing home shall meet all local codes and standards for safety and maintenance of institutional elevators.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Lighting.</text>
    <paragraph num="(1)">
      <text>A resident’s room shall:</text>
      <paragraph num="(a)">
        <text>Be lighted by outside windows; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Have artificial light adequate for reading and other uses as required.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>In order to prevent accidents and promote efficiency of service, the nursing home shall ensure that the following areas have sufficient artificial lighting:</text>
      <paragraph num="(a)">
        <text>Entrances;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Hallways;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Stairways;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Inclines;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Ramps;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Basements;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Attics;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Storerooms;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Kitchens;</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Laundries; and</text>
      </paragraph>
      <paragraph num="(k)">
        <text>Service units.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Minimally Maintained Lighting Levels. The following table lists the minimum lighting requirements in the following given areas:</text>
  </paragraph>
  <paragraph num="H.">
    <text>Night Lights.</text>
    <paragraph num="(1)">
      <text>A nursing home shall have sufficient lighting at night in the following areas:</text>
      <paragraph num="(a)">
        <text>Hallways;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Stairs; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Designated toilets of the nursing home for the safety of the resident who gets up during the night.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>There shall be at least one night light in each bedroom for residents.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>In new construction, the night light shall be located at the resident room door and be capable of being switched on and off.</text>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>Screens.</text>
    <paragraph num="(1)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Maintenance and installation may not conflict with other applicable laws, regulations, codes, or ordinances.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A nursing home shall equip all screened doors with self-closing devices, to provide for the normal flow of ingress and egress of traffic.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>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.</text>
    </paragraph>
  </paragraph>
  <paragraph num="J.">
    <text>Garbage Disposal.</text>
    <paragraph num="(1)">
      <text>Garbage shall be:</text>
      <paragraph num="(a)">
        <text>Stored in water-tight containers with tight-fitting covers; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Emptied at frequent intervals.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Soiled containers shall be thoroughly scoured and aired before using again.</text>
    </paragraph>
  </paragraph>
  <paragraph num="K.">
    <text>Garbage Storage Space. Storage space shall be provided for garbage and trash awaiting pickup.</text>
  </paragraph>
  <paragraph num="L.">
    <text>Burning. A nursing home may not burn or incinerate garbage at the nursing home.</text>
  </paragraph>
  <paragraph num="M.">
    <text>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.</text>
  </paragraph>
  <paragraph num="N.">
    <text>Smoking.</text>
    <paragraph num="(1)">
      <text>Resident Smoking Requirements.</text>
      <paragraph num="(a)">
        <text>A resident who smokes shall be assessed for safe smoking behaviors at admission and on significant changes in condition.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A resident assessed to exhibit unsafe behaviors shall have a care plan to ensure the resident is safe when smoking.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Nursing Home Smoking Requirements.</text>
      <paragraph num="(a)">
        <text>Smoking areas shall be designated.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Smoking shall be prohibited at the main entrance to all facilities.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>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.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="O.">
    <text>A nursing home shall be protected throughout the entire building by an automatic fire extinguishing system.</text>
  </paragraph>
</regulation>