<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".49" citation="COMAR 10.07.02.49" title_num="10" subtitle_num="07" chapter_num="02" heading="Resident Bedroom in Nursing Home.">
  <paragraph num="A.">
    <text>Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home unless a waiver has been granted by the Office of Health Care Quality in accordance with Regulation .03G of this chapter.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Bedroom Accommodations.</text>
    <paragraph num="(1)">
      <text>Bedroom.</text>
      <paragraph num="(a)">
        <text>A resident’s room shall have direct access to an exit in accordance with the requirements applicable to nursing homes specified in NFPA 101 Life Safety Code.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A room that opens into the kitchen may not be used as a resident bedroom.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A room may not be used as a resident bedroom if it can only be reached by passing through a kitchen.</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Residents may not occupy rooms extending below the ground level.</text>
      </paragraph>
      <paragraph num="(e)">
        <text>No more than four individuals may occupy a multiple occupancy bedroom.</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Residents’ beds may not be located near radiators, registers, or sources of draft.</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Adequate storage space shall be provided in each bedroom to allow each resident to keep necessary items of clothing, including items that need to be hung.  Adequate storage space shall be provided for residents’ personal possessions, including the storage of seasonal clothing.</text>
      </paragraph>
      <paragraph num="(h)">
        <text>All occupants of any bedroom shall be of the same sex, except in the case of a two-bed room occupied by:</text>
        <paragraph num="(i)">
          <text>Siblings;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A parent and child;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A married couple; or</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Consenting residents.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Bedroom — New Construction. A nursing home shall provide cubicle curtains and tracks in multiple occupancy bedrooms between beds to ensure privacy of residents.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Bedroom — Existing Construction. In an existing nursing home, curtains or screens shall be acceptable.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Floor and Window Space.</text>
    <paragraph num="(1)">
      <text>Floors.</text>
      <paragraph num="(a)">
        <text>A distance of at least 3 feet shall be maintained between each bed. Beds are to be placed so that all sides of the bed are at least 18 inches from heating units.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The following shall be considered a minimum allowance of floor space:</text>
        <paragraph num="(i)">
          <text>100 square feet, single-bed room; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>80 square feet, per bed, for multiple-bed rooms.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>The following floor areas may not be included in the calculation of floor space:</text>
        <paragraph num="(i)">
          <text>Toilet rooms and bathing facilities;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Closets;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The floor area occupied by wardrobes, bureaus, or lockers, when permanently installed as part of walls or ceilings and as a permanent component of a bedroom;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>HVAC equipment, including any steam, water, or electrical supply or return lines that may run parallel to the floor or interrupt the floor surface;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Support columns, pipe chases, or other structures, whether free-standing or as an integral part of a wall; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>The arc of any doors that open into the room, excluding closet doors.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>The minimum horizontal dimensions of a bedroom shall be 10 feet to:</text>
        <paragraph num="(i)">
          <text>Facilitate the placement of beds as required in Regulation .44 of this chapter; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Maintain a minimum clearance of 3 feet at the foot of the bed.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(e)">
        <text>In an existing nursing home, the usable floor area for rooms having a bedroom shall have a finished ceiling height of 8 feet. For a bedroom that has sloping walls, only 50 percent of the floor area with a ceiling height between 4 feet and 7 feet, 6 inches, shall be credited, provided that at least 50 percent of the total area of the bedroom has a ceiling height of 8 feet.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Windows.</text>
      <paragraph num="(a)">
        <text>The window area within each bedroom shall be at least 10 square feet per bed. The window opening shall be at least 28 inches so that the total area equals 10 square feet per bed.  This is to allow entry of fire fighters, removal of smoke, and emergency evacuation.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The maximum height from the floor to the top of a window sill shall be 44 inches above the finished floor.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A portable window air-conditioning unit may not block window space. The installation of a portable air-conditioning unit shall be approved by the:</text>
        <paragraph num="(i)">
          <text>Local fire authorities; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Department.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>If windows cannot be opened for ventilation, a central HVAC system shall be provided and maintained.</text>
      </paragraph>
      <paragraph num="(e)">
        <text>If windows can be opened, but the nursing home has concern over the window being opened due to resident safety issues and elopement, the window sash may be restricted by hardware as approved by the Department.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Furnishings.</text>
    <paragraph num="(1)">
      <text>Furnishings.</text>
      <paragraph num="(a)">
        <text>The nursing home shall provide residents with their own bed. The bed shall be at least 36 inches wide and be substantially constructed. Rollaway type beds, cots, or folding beds may not be used.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Bed.</text>
        <paragraph num="(i)">
          <text>Each bed provided shall be in good repair, with a clean and comfortable standard size mattress and foundation.</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>To avoid injury to the resident, the mattress and foundation shall fit the bed.</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Clean linen and a clean, comfortable pillow shall be provided. Extra pillows shall be available.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Bedroom Furniture. A resident shall be provided with the following furnishings, which shall be convenient to the resident:</text>
        <paragraph num="(i)">
          <text>Bedside stand with a drawer;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Towel hanger;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A comfortable chair;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>A chest of drawers with at least one locking drawer;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Enclosed space for hanging clothing;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>A wall mirror in each room, unless contraindicated by physician’s order; and</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>A bedside lamp, over-bed lamp, or other directional light source for resident reading and bedside care.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>Resident’s Personal Furnishings.</text>
        <paragraph num="(i)">
          <text>A nursing home shall develop policies and procedures to give residents the opportunity to use the resident’s own furnishings as detailed in this chapter.</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The nursing home shall make its resident’s personal furnishing policies available for review by residents and the resident’s representative.</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>These policies shall address the condition of the personal furnishings, presence of insects or vermin, and overall safety to ensure that the use of the resident’s belongings does not create any safety or health issues.</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Personal furnishings that are allowed shall be appropriate for the resident’s use.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(e)">
        <text>Windows shall be provided with shades or draperies adequate to control glare and maintain privacy.</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Each living room for residents’ use shall be provided with a sufficient number of reading lamps, tables, and comfortable chairs or sofas.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Furnishings — New Construction. A bedroom shall be provided with a hand-washing sink with both hot and cold running water unless a toilet or bathroom facility with a sink is connected to the bedroom.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Medication Storage Cabinets.</text>
      <paragraph num="(a)">
        <text>Medication storage cabinets with locks shall be permitted for the storage of resident medications that do not require refrigeration within a resident bedroom.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Controlled medications to be stored within medication storage cabinets in a resident’s room shall be held within a separate compartment that is locked and inside of the larger medication storage cabinet in that room.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>