Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.45 - Physical Plant - Ventilation

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Unless otherwise indicated, all general requirements apply to both new
				  construction and an existing nursing home.
B. An existing nursing home shall provide for
				  adequate ventilation through windows or mechanical means or a combination of
				  both.
C. A new nursing home shall
				  adhere to the requirements of this chapter.
D. Ventilation System Details.
(1) All air-supply and air-exhaust systems
				  shall be mechanically operated.
(2)
				  The ventilation rates shown in Table 1 under §D(10) of this regulation
				  shall be considered the minimum acceptable rates and may not be construed as
				  precluding the use of higher ventilation rates.
(3) All fans serving exhaust systems shall be
				  located at the discharge end of the system.
(4) Outdoor air intakes shall be located:
(a) As far as practical but not less than 25
				  feet from:
(i) Exhaust outlets of ventilating
				  systems;
(ii) Combustion equipment
				  stacks;
(iii) Medical-surgical
				  vacuum systems;
(iv) Plumbing vent
				  stacks; or
(v) Areas that may
				  collect vehicular exhaust and other noxious fumes; and
(b) As high as practical, so that the bottom
				  of the outdoor air intake is:
(i) At least 6
				  feet above ground level; or
(ii) At
				  least 3 feet above roof level.
(5) The ventilation systems shall be designed
				  and balanced to provide the pressure relationships as shown in Table 1 under
				  §D(10) of this regulation.
(6)
				  The bottoms of ventilation openings may not be not less than 3 inches above the
				  floor of any room.
(7) Corridors
				  may not be used to supply air to or exhaust air from any room, except that air
				  from corridors may be used to ventilate bathrooms, toilet rooms, janitors'
				  closets, and small electrical or telephone closets opening directly on
				  corridors.
(8) Filters.
(a) A central ventilation or air conditioning
				  system shall be equipped with filters having efficiencies no less than those
				  specified in Table 2 under §D(11) of this regulation.
(b) The filter bed shall be located upstream
				  of the air conditioning equipment, unless a prefilter is employed.
(c) If a prefilter is employed, the prefilter
				  shall be upstream of the equipment and the main filter bed may be located
				  further downstream.
(d) A filter or
				  filter efficiency shall comply with the standards of the Guidelines for Design
				  and Construction of Residential Health, Care, and Support Facilities.
(e) A filter frame shall be durable and
				  carefully dimensioned and shall have an airtight fit with the enclosing duct
				  work.
(f) A joint between filter
				  segments and the enclosing duct work shall be gasketed or sealed to provide a
				  positive seal against air leakage.
(g) A manometer shall be installed across
				  each filter bed serving central air systems.
(9) Air Ducts.
(a) Air-handling duct systems shall meet the
				  requirements applicable to nursing homes cited in NFPA 99 Health Care
				  Facilities Code.
(b) Fire and smoke
				  dampers shall be constructed, located, and installed in accordance with the
				  requirements of NFPA 101 Life Safety Code.
(c) Air ducts that pass through a required
				  smoke barrier shall be provided with a smoke damper at the barrier.
(d) Smoke dampers shall activate by smoke
				  detectors located in the ducts at the smoke barrier, or by the smoke detectors
				  used to close smoke barrier doors.
(e) Smoke dampers shall be controlled to
				  close automatically to prevent flow of smoke-laden air in either
				  direction.
(f) Smoke dampers shall
				  be equipped with automatic remote control reset devices, except that manual
				  reopening will be permitted if smoke dampers are accessible.
(g) All devices shall be interlocked with the
				  fire alarm system.
(10)
				  Table 1. This table refers to the pressure relationships and ventilation of
				  certain areas of a nursing home other than chronic disease hospitals.
Area Designation
Pressure Relationship To Adjacent Areas
Minimum Air Changes
of Outdoor Air per
Hour Supplied to Room
Minimum Total Air
Changes per Hour
Supplied to Room
All Air Exhausted
Directly to
							 Outdoors
Recirculated Within
Room Units
(a) Resident Room
E
2
2
Optional
Optional
(b) Resident Area Corridor
E
2
4
Optional
Optional
(c) Examination and Treatment Room
E
2
6
Optional
Optional
(d) Physical Therapy
N
2
6
Optional
Optional
(e) Occupational Therapy
N
2
6
Optional
Optional
(f) Soiled Workroom or Soiled Holding
N
2
10
Yes
No
(g) Clean Workroom or Clean Holding
P
2
4
Optional
Optional
(h) Toilet Room
N
Optional
10
Yes
No
(i) Bathroom
N
Optional
10
Yes
No
(j) Janitor Closet(s)
N
Optional
10
Yes
No
(k) Sterilizer Equipment Room
N
Optional
10
Yes
No
(l) Linen and Trash Chute Room
N
Optional
10
Yes
No
(m) Food Preparation Center
E
2
10
Yes
No
(n) Warewashing Room
N
Optional
10
Yes
No
(o) Dietary Day Storage
E
Optional
10
Yes
No
(p) Laundry, General
E
2
10
Yes
No
(q) Soiled Linen Sorting and Storage
N
Optional
10
Yes
No
(r) Clean Linen Storage
P
2
2
Optional
Optional
Key: P = Positive, N = Negative, E =
							 Equal
(11) Table 2. This table refers to the filter
				  efficiencies for central ventilation and air conditioning systems in a nursing
				  home other than chronic disease hospitals.
Area Designation
Minimum Number
of Filter Beds
Filter Efficiencies (Percent)
Main Filter
							 Bed
(a) Resident Care, Treatment, Diagnostic, and Related
							 Areas. These areas may be reduced to 35 percent for all-outdoor air
							 systems.
1
80
(b) Food Preparation Areas and Laundries.
1
80
(c) Administrative, Bulk Storage and Soiled Holding
							 Areas.
1
25
(12) Exhaust Hoods. All hoods over cooking
				  surfaces shall comply with the requirements as provided in COMAR
				  10.15.03.