411-087-0310 Toilet, Handwashing, and Bathing Areas (1) General Requirements: (a) Temperature. Hot water at shower, bathing and handwash sink areas shall not exceed 120 degrees Fahrenheit (49 degrees Celsius) or be lower than 105 degrees Fahrenheit (41.5 degrees Celsius); (b) Grab Bars. Grab bars shall be provided at all residents’ toilets, showers, tubs and sitz baths. The bars shall have 1-1/2 inch (3.8 cm) clearance to walls and shall have sufficient strength and anchorage to sustain a concentrated load of 250 pounds (113.4 kilograms). Grab bars shall be returned to the wall or otherwise be constructed to prevent snagging clothes; (c) Emergency Access. All rooms containing bathtubs, sitz baths, showers, and toilets shall be equipped with doors and hardware which will permit access from the outside in any emergency. When such rooms have only one opening or are smaller than 25 square feet, the doors shall be capable of opening outward or are smaller than 25 square feet, the doors shall be capable of opening outward or be otherwise designed to be opened without need to push against a resident who may have collapsed within the room; (d) Accessibility. Toilets, handwash sinks, and baths shall be provided in accordance with the American National Standards Institute’s “Providing Accessibility and Usability for Physically Handicapped People,” effective February 5, 1986, and Title III of the Americans with Disabilities Act of 1990; (e) Nurse Call System. See OAR 411-087-0440. (2) Toilet Facilities: (a) Resident toilets: (A) Access. Each resident room shall have direct access to a toilet room without entering the general corridor area; (B) Number. One toilet room shall serve no more than four beds and no more than two resident rooms; (C) Handwash sink. Each toilet room shall contain a toilet and a handwash sink. The handwash sink may be omitted from a toilet room serving only one resident room if the room is a single-bed room and contains a handwash sink; (D) Dimensions. The dimensions of a resident toilet room shall be sufficient to allow access and self transfer by a resident in a wheelchair or with the assistance of an attendant. The distance from the toilet plumbing wall to the opposite wall shall be no less than six feet; (E) Privacy. Partitions between toilet shall be provided. These partitions shall be at least six feet in height and provide for privacy. Privacy curtains may be used in bathing areas in lieu of fixed partitions. (b) Employee/Visitor Toilets. In addition to the toilet rooms for residents, there shall be at least one toilet room on each floor with handwash sink available for facility employees and visitors. Such toilets shall be clearly identified for public use and shall be directly accessible from the corridor, public lounge or waiting area. (3) Handwashing Facilities: (a) Sinks, Water Supply Spouts, Faucet Handles: (A) Each resident room shall have a handwash sink. The handwash sink may be omitted from a single-bed room if the adjacent toilet room serves only one resident room; (B) Handwash sinks shall be securely anchored to withstand an applied vertical load of not less than 250 pounds (113.4 kilograms) on the front of the fixture; (C) Handwash sinks shall be wheelchair accessible; (D) Sink faucets shall have a single spout (outlet) which discharges both hot and cold water; (E) All handwash sinks shall be trimmed with single-lever or write-blade faucet handles which are operable without the use of hands. (b) Mirrors: (A) Mirrors shall be arranged for convenient use by residents in wheelchairs and in a standing position. Mirrors are not required in rooms exclusively serving residents whose care plans indicate mirrors are contraindicated; (B) Mirrors shall not be installed at handwash sinks in food preparation areas. (c) Hand Drying. Provisions for hand drying shall be included at all handwash sinks except scrub sinks. These shall be single use separate individual paper or cloth units enclosed in such a way as to provide protection against dust or soil and insure single unit dispensing. (4) Bathtubs and Showers: (a) Number. Bathtubs or showers shall be provided at the rate of one for every 25 beds which are not otherwise served by bathing facilities within the residents’ rooms; (b) Whirlpool Tubs. In addition to the requirements listed in subsection (4)(a) of this rule, at least one therapeutic whirlpool tub designed for disabled assist shall be provided on each floor. The facility shall have at least one therapeutic whirlpool-type tub for every 60 beds; (c) Privacy. Each tub or shower shall be in an individual room or enclosure which provides space for the private use of the bathing fixture, for drying and dressing, and for a wheelchair and an attendant; (d) Shower Dimensions: (A) Each facility shall have at least one shower that is a minimum of four feet square, without curbs, and designed to permit use by a wheelchair resident with an assisting attendant; (B) Showers for ambulatory residents shall be not less than four feet by three feet. (e) Non-Slip Surface. Shower bases and tubs shall provide non-slip surfaces; (f) Toilet/Sink Access. A toilet and handwash sink shall be accessible to each bathtub/shower without going through the central corridor. (5) Exceptions: (a) Whirlpool Tubs. The number of whirlpool tubs in facilities which have been continuously licensed since January 1, 1992 without modification of number or type of bathtubs/showers shall be considered to be in compliance with subsection (4)(b) of this rule unless otherwise provided by OAR 411-087-0010. Facilities which lack the required number of therapeutic tubs shall have a hospital-type tub on each floor which does not have a therapeutic whirlpool tub. As of January 1, 2000, all facilities shall have at least one therapeutic whirlpool tub (waivers may be provided on a case-by-case basis); (b) Showers. Facilities which have been continuously licensed since January 1, 1992 shall not be required to meet the dimensions or design criteria defined in subsection (4)(d) of this rule or requirements for dressing and drying areas adjacent showers and tubs; (c) Toilets. Facilities continuously licensed since January 1, 1992 shall be exempt from section (2) of this rule unless otherwise provided by OAR 411-087-0010; (d) Handwash Sinks. In facilities with rooms continuously licensed since January 1,1992, without meeting subsection (3)(a) of this rule, such rooms shall be exempt from this requirement unless otherwise provided by OAR 411-087-0010; (e) Spouts, Faucet Handles. Facilities continuously licensed since January 1, 1992 without meeting paragraph (3)(a)(E) of this rule shall be exempt from such paragraph unless the spouts/faucets are replaced or otherwise provided by OAR 411-087-0010; (f) Accessibility. Facilities continuously licensed since January 1, 1992 without meeting subsection (3)(a) of this rule shall be exempted from such subsection unless the spouts/faucets are replaced or otherwise provided by OAR 411-087-0010. [Publications: Publications referenced are available from the agency.] Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 22-1991, f. 12-31-91, cert. ef. 1-1-92