Guideline text:
(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.41(b)(9) Buildings must have an outside window or outside door in every sleeping room, and for any building constructed after July 5, 2016 the sill height must not exceed 36 inches above the floor. Windows in atrium walls are considered outside windows for the purposes of this requirement.

(i) The sill height requirement does not apply to newborn nurseries and rooms intended for occupancy for less than 24 hours.

(ii) The sill height in special nursing care areas of new occupancies must not exceed 60 inches.

Interpretive Guidelines §482.41(b)(9):

Guidance is pending and will be updated in future release.

A-0720

(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.41(c) Standard:  Building Safety

Except as otherwise provided in this section, the hospital must meet the applicable provisions and must proceed in accordance with the Health Care Facilities Code (NFPA 99 and Tentative Interim Amendments TIA 12-2, TIA 12-3, TIA 12-4, TIA 12-5 and TIA 12-6).

(1) Chapters 7, 8, 12, and 13 of the adopted Health Care Facilities Code do not apply to a hospital.

(2) If application of the Health Care Facilities Code required under paragraph (c) of this section would result in unreasonable hardship for the hospital, CMS may waive specific provisions of the Health Care Facilities Code, but only if the waiver does not adversely affect the health and safety of patients.

Interpretive Guidelines §482.41(c)(1) and (2):

Guidance is pending and will be updated in future release.

A-0722

(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.41(d) Standard:  Facilities

The hospital must maintain adequate facilities for its services.

Interpretive Guidelines §482.41(d)

Adequate facilities means the hospital has facilities that are:

- Designed and maintained in accordance with Federal, State and local laws, regulations and guidelines; and
- Designed and maintained to reflect the scope and complexity of the services it offers in accordance with accepted standards of practice.

## Survey Procedures §482.41(d)

- Observe the facility layout and determine if the patient's needs are met.  Toilets, sinks, specialized equipment, etc. should be accessible.
- Review the facility's water supply and distribution system to ensure that the water quality is acceptable for its intended use (drinking water, irrigation water, lab water, etc.).  Review the facility water quality monitoring and, as appropriate, treatment system.

A-0723

(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.41(d)(1) - Diagnostic and therapeutic facilities must be located for the safety of patients.

Interpretive Guidelines §482.41(d)(1)

Guidance is pending and will be updated in future release.

A-0724

(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.41(d)(2) - Facilities, supplies, and equipment must be maintained to ensure an acceptable level of safety and quality.

Interpretive Guidelines §482.41(d)(2)

Guidance is pending and will be updated in future release.

A-0725

(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.41(d)(3) - The extent and complexity of facilities must be determined by the services offered.

## Interpretive Guidelines §482.41(d)(3)

Physical facilities must be large enough, numerous enough, appropriately designed and equipped, and of appropriate complexity to provide the services offered in accordance with

Federal and State laws, regulations and guidelines and accepted standards of practice for that location or service.

## Survey Procedures §482.41(d)(3)

Verify through observation that the physical facilities are large enough and properly equipped for the scope of services provided and the number of patients served.

Structured rule (JSON):
{"intent_tags": ["safety", "compliance"], "logic_config": {"location_scope": "every sleeping room", "required_artifact": "outside window or outside door"}, "rule_type": "existence", "scope_tags": ["facility", "legal"]}