Courtemanche & Associates

By James Ballard
May 7, 2019

A-0701 Interpretive Guidelines §482.41(a) The hospital must ensure that the condition of the physical plant and overall hospital environment is developed and maintained in a manner to ensure the safety and well-being of patients.
The language in the standard has not changed but the survey process and the guidance for surveyors has significantly changed. Ensure that the Environment of Care committee is familiar with the following:
Accessibility: The hospital must ensure all buildings at all locations of the certified hospital meet State and Federal accessibility standards (e.g. Office of Civil Rights requirements). The requirements apply to the interior and exterior of all buildings.
Age-related safety features: Hospitals are expected to address safety hazards and risks related to age-related factors. Healthcare provided to neonatal, pediatric, and geriatric patients must be in accordance with nationally recognized standards. Age-related risks may include items such as security of inpatient and outpatient locations, access to medications, cleaning supplies and other hazardous materials, furniture and other medical equipment, and increased chance of falls.
Security: To minimize the risk of unauthorized access to or inappropriate departure from secured healthcare units, hospitals must demonstrate security features in accordance with nationally recognized standards to ensure the safety of vulnerable patients.
Ligature risk: The presence of unmitigated ligature risks in a psychiatric hospital or psychiatric unit of a hospital is an immediate jeopardy situation. Additionally, this also includes any location where patients at risk of suicide are identified. Ligature risk findings must be referred to the health and safety surveyors for further evaluation and possible citation under Patients’ Rights.
Weather-related exterior issues: Although hospitals cannot address all weather-related issues, they are expected to address potential safety hazards specific to weather on both the exterior and interior locations in accordance of nationally recognized standards.
Life Safety Code: surveyors assess the use of power strips in healthcare facilities. However, the following guidance is provided as reference for healthcare surveyors as they survey physical environment along with other CoP requirements.
If line-operated medical equipment is used in a patient care room/area, inside the patient care vicinity:
UL power strips would have to be a permanent component of a rack-, table-, pedestal-, or cart-mounted & tested medical equipment assembly
Power strips providing power to medical equipment in a patient care room/area must be UL 1363A or UL 60601-1
Power strips cannot be used for non-medical equipment
If line-operated medical equipment is used in a patient care room/area, outside the patient care vicinity:
UL power strips could be used for medical & non-medical equipment with precautions as described in the memo
Power strips providing power to medical equipment in a patient care room/area must be UL 1363A or UL 60601-1
Power strips providing power to non-medical equipment in a patient care room/area must be UL 1363
If line-operated medical equipment is not used in a patient care room/area, inside and outside the patient care vicinity:
UL power strips could be used with precautions Power strips providing power to non-medical equipment in a patient care room/area must be UL 1363. In non-patient care areas/rooms, other UL strips could be used with the general precautions.
The focus should be the statements made in the guidance related to nationally recognized standards. What are these standards, where to they come from and how do we obtain them? All great questions that should be being discussed in the Environment of Care Committee and amongst leadership. These standards come from various government agencies (FEMA, CDC, CMS, JC, OSHA, NWS) and professional associations (ASHRM, IAHSS, AHA, NFPA, ASHE). Remember, surveyors have new direction – be ready.