Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 30 - Division of Regulation and Licensure › Chapter 30 - Ambulatory Surgical Centers and Abortion Facilities › Section 19 CSR 30-30.070 - Physical Standards for Abortion Facilities

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment changes the regulation to
				  reflect that it does not apply to abortion facilities that do not perform
				  surgical abortions or surgical intervention for abortion complications. This
				  amendment also updates outdated references to statutes and the Department of
				  Health and Senior Services' name.
PURPOSE: Section
				  197.225,
				  RSMo authorizes the Department of Health and Senior Services to establish
				  physical standards for abortion facilities in order to provide acceptable care
				  in a safe environment. Abortion facilities are defined in section
				  197.200(1),
				  RSMo and are subject to licensure under section
				  197.205,
				  RSMo.
(1) This regulation
				does not apply to abortion facilities that do not perform surgical abortions or
				surgical intervention for abortion complications.
(2) Requests for
				deviations from requirements on physical facilities shall be in writing to the
				Department of Health and Senior Services. Approvals for deviations shall be in
				writing and both requests and approvals shall be made a part of the permanent
				Department of Health and Senior Services records for the abortion
				facility.
(3) Any abortion facility constructed or renovated
				after October 25, 1987 shall have plans prepared by an architect or engineer
				registered in Missouri. These plans shall be submitted to the department for
				review and approval prior to construction. New abortion facilities shall have
				the following:
(A) At least two (2) remote
				exits shall be provided for each floor directly to the outside or through an
				enclosed stairway or passageway to the outside;
(B) Corridors serving patients shall be at
				least six feet (6') wide;
(C) All
				doors through which patients pass shall be at least forty-four inches (44")
				wide and of solid-core construction;
(D) One- (1-) story buildings shall be at
				least of Type II (111) protected noncombustible construction as described in
				Standard on Types of Building Construction 1979 published by the National Fire
				Protection Association;
(E)
				Multistory buildings shall be constructed of at least Type II (222)
				fire-resistive construction as described in Standard on Types of Building
				Construction published by the NFPA, or shall be protected throughout by an
				approved automatic sprinkler system;
(F) Multistory buildings shall have at least
				one (1) elevator. The elevator cab shall be at least five feet by seven feet
				(5' x 7') clear inside. The car door shall have a clear opening of not less
				than forty-four inches (44");
(G)
				Trickle-charge battery pack units shall be located to provide emergency
				lighting in the procedure room, recovery room, exit corridors, and exit stairs
				to grade;
(H) A manual fire alarm
				break station shall be located near each exit and connected to a local audible
				alarm which can be heard throughout the facility;
(I) At least two (2) ABC-type fire
				extinguishers are to be located in the facility, one (1) in the clinical
				area;
(J) Illuminated exit signs
				shall be located above each exit and illuminated directional exit signs shall
				be located where needed to direct patients and personnel to exits in event of
				an emergency;
(K) Ceiling, wall,
				and floor finishes in the clinical area including the procedure rooms, recovery
				room, personnel change rooms, central sterile and supply, janitor's closet, and
				laboratory shall be smooth and easily cleanable;
(L) Scrub-up facilities shall be knee- or
				foot-operated and provided at the rate of one (1) per procedure room. Scrub-up
				facilities shall be located outside but immediately available to the procedure
				room;
(M) Procedure rooms shall
				have the following:
1. A minimum length and
				width of twelve feet (12');
2. A
				minimum ceiling height of nine feet (9');
3. A door with a minimum width of forty-four
				inches (44"); and
4. There shall be
				no windows in the room except there may be a fixed-view window in the wall
				between the procedure room and the adjacent corridor;
(N) The recovery room shall be separated from
				the procedure room and be of sufficient size to accommodate at least four (4)
				recovery beds or recliners for each procedure room. There shall be three feet
				(3') of clear space on both sides and at the foot of each recovery bed or
				recliner;
(O) The procedure room
				and recovery room shall be provided with a minimum of six (6) air changes per
				hour. Air supplied to all areas shall be filtered through a filter with at
				least a twenty-five percent (25%) efficiency rating;
(P) Personnel change rooms shall be provided
				for each sex and located convenient to the procedure room. Each change room
				shall be equipped with a toilet and lavatory;
(Q) The laboratory shall be equipped with a
				counter, sink, and refrigerator;
(R) The procedure room shall be equipped with
				a ceiling-mounted surgical light, operating table or a conventional
				gynecological examining table with accessories, closed cabinets for equipment,
				and sufficient tables to hold an emergency tray and other necessary
				equipment;
(S) There shall be one
				(1) electrical outlet in the procedure room for the emergency light and at
				least one (1) duplex outlet on each wall;
(T) There shall be one (1) electrical outlet
				in the recovery room for the emergency light and at least one (1) duplex outlet
				for each two (2) recovery beds or recliners;
(U) Piped-in or portable oxygen and suction
				equipment shall be located in the recovery room;
(V) The sterilizing room shall be equipped
				with a steam sterilizer, counter and sink, and storage space for clean
				supplies. Air pressure in this room shall be positive in relation to adjacent
				areas;
(W) The
				soiled/decontamination room shall be equipped with a counter and sink. This
				room shall be equipped with a constant running exhaust;
(X) A patient toilet with lavatory shall be
				located convenient to the recovery room. This room shall be equipped with a
				constant running exhaust;
(Y) At
				least two (2) patient change rooms with secure storage for personal effects
				shall be provided; and
(Z) Office
				space, waiting room, record storage space, and counseling rooms shall be
				provided. Counseling rooms shall be separate and not smaller than ten feet by
				ten feet (10' x 10').