#### § 59.140 Nursing home care requirements.

As a condition for receiving a grant and grant funds for a nursing home facility under this part, States must comply with the requirements of this section.

(a) Resident rooms must be designed and equipped for adequate nursing care, comfort, and privacy of residents. Resident rooms must:

(1) Accommodate no more than four residents;

(2) Have direct access to an exit corridor;

(3) Have at least one window to the outside;

(4) Be equipped with, or located near, toilet and bathing facilities (VA recommends that public toilet facilities also be located near the residents dining and recreational areas);

(5) Be at or above grade level;

(6) Be designed or equipped to ensure full visual privacy for each resident;

(7) Except in private rooms, each bed must have ceiling suspended curtains that extend around the bed to provide total visual privacy in combination with adjacent walls and curtains;

(8) Have a separate bed for each resident of proper size and height for the safety of the resident;

(9) Have a clean, comfortable mattress;

(10) Have bedding appropriate to the weather and climate;

(11) Have functional furniture appropriate to the resident's needs, and

(12) Have individual closet space with clothes racks and shelves accessible to the resident.

(b) Unless determined by VA as necessary to accommodate an increased quality of care for patients, a nursing home project may propose a deviation of no more than 10 percent (more or less) from the following net square footage for the State to be eligible for a grant of 65 percent of the total estimated cost of the project. If the project proposes building more than the following net square footage and VA makes a determination that it is not needed, the cost of the additional net square footage will not be included in the estimated total cost of construction.

Table to Paragraph (b)—Nursing Home

| I. Support facilities [allowable square feet (or metric equivalent) per facility for VA participation]: | |
| Administrator | 200 |
| Assistant administrator | 150 |
| Medical officer, director of nursing or equivalent | 150 |
| Nurse and dictation area | 120 |
| General administration (each office/person) | 120 |
| Clerical staff (each) | 80 |
| Computer area | 40 |
| Conference room (consultation area, in-service training) | 500 (for each room) |
| Lobby/waiting area. (150 minimum/600 maximum per facility) | 3 (per bed) |
| Public/resident toilets (male/female) | 25 (per fixture) |
| Pharmacy1 | |
| Dietetic service1 | |
| Dining area | 20 (per bed) |
| Canteen/retail sales | 2 (per bed) |
| Vending machines (450 max. per facility) | 1 (per bed) |
| Resident toilets (male/female) | 25 (per fixture) |
| Child day care1 | |
| Medical support (staff offices/exam/treatment room/family counseling, etc.) | 140 (for each room) |
| Barber and/or beauty shops | 140 |
| Mail room | 120 |
| Janitor's closet | 40 |
| Multipurpose room | 15 (per bed) |
| Employee lockers | 6 (per employee) |
| Employee lounge (500 max. per facility) | 120 |
| Employee toilets | 25 (per fixture) |
| Chapel | 450 |
| Physical therapy | 5 (per bed) |
| Office, if required | 120 |
| Occupational therapy | 5 (per bed). |
| Office, if required | 120 |
| Library | 1.5 (per bed) |
| Building maintenance storage | 2.5 (per bed) |
| Resident storage | 6 (per bed) |
| General warehouse storage | 6 (per bed) |
| Medical/dietary/pharmacy | 7 (per bed) |
| General laundry1 | |
| II. Bed units: | |
| One | 150 |
| Two | 245 |
| Large two-bed per unit | 305 |
| Four | 460 |
| Lounge areas (resident lounge with storage) | 8 (per bed) |
| Resident quiet room | 3 (per bed) |
| Clean utility | 120 |
| Soiled utility | 105 |
| Linen storage | 150 |
| General storage | 100 |
| Nurses station, ward secretary | 260 |
| Medication room | 75 |
| Exam/Treatment room | 140 |
| Waiting area | 50 |
| Unit supply and equipment | 50 |
| Staff toilet | 25 (per fixture) |
| Stretcher/wheelchair storage | 100 |
| Kitchenette | 150 |
| Janitor's closet | 40 |
| Resident laundry | 125 |
| Trash collection | 60 |
| III. Bathing and Toilet Facilities: | |
| (A) Private or shared facilities: | |
| Wheelchair facilities | 25 (per fixture) |
| Standard facilities | 15 (per fixture) |
| (B) Full bathroom | 75 |
| (C) Congregate bathing facilities: | |
| First tub/shower | 80 |
| Each additional fixture | 25 |
| | |
| --- | --- |
| 1 The size to be determined by the Chief Consultant, Geriatrics and Extended Care, as necessary to accommodate projected patient care needs (must be justified by State in space program analysis). | |

(Authority: [38 U.S.C. 101](https://www.govinfo.gov/link/uscode/38/101), [501](https://www.govinfo.gov/link/uscode/38/501), [1710](https://www.govinfo.gov/link/uscode/38/1710), [1742](https://www.govinfo.gov/link/uscode/38/1742), [8105](https://www.govinfo.gov/link/uscode/38/8105), [8131-8137](https://www.govinfo.gov/link/uscode/38/8131); Sections 2, 3, 4, and 4a of the Architectural Barriers Act of 1968, as amended, Public Law 90-480, [42 U.S.C. 4151-4157](https://www.govinfo.gov/link/uscode/42/4151))