Hospitals must follow building codes, fire codes, life safety codes, federal mandated acts, and specific state and local regulations. Hospitals in California are overseen by a number of agencies and organizations. Some of these are specific to California; others have influence nationwide.
The following is a partial listing of the organizations that have influence over the hospitals in California.
OSHPOD - Office of Statewide Health Planning & Development
In California, OSHPOD is the state government organization that reviews and inspects “patient overnight stay” facility construction projects. These include hospitals, skilled nursing facilities, licensed clinics and correctional treatment centers. OSHPOD enforces building standards including IBC and Title 24 as they relate to construction.
CMS - Centers for Medicare & Medicaid Services
This federal agency administers Medicare, Medicaid, State Children’s Health Insurance Program, and Health Insurance Portability and Accountability Act standards in long term care facilities and hospitals using survey and certification process.
TJC - The Joint Commission (previously known as JCAHO)
This nationwide, private, not-for-profit organization accredits and certifies health care organizations. Joint Commission accreditation includes hospitals; doctor’s offices, nursing homes, office-based surgery centers, behavioral health treatment facilities, and providers of home care services. Certifications and inspections are voluntary.
ADA - Americans with Disabilities Act
This act prohibits discrimination on the basis of disability. A disabled person is defined as having a physical or mental impairment that substantially limits one or more major life activities. The ADA does not specifically name all of the impairments that are covered. The ADA applies to the United States Congress.
Title 24 - California Code of Regulations (CCR)
California instituted Title 24, starting in 1989. Title 24, the California Building Standards Code, is a compilation of three building standards: building standards adopted by state agencies, the national model code standards adapted to meet California condition, and building standards authorized by the California legislature that are not covered by building codes. Although not limited to hospitals, Title 24 access requirements go beyond ADA.
LAHJ - Local Authority Having Jurisdiction
This individual has statutory jurisdiction, having the right and power to interpret and apply laws, codes, regulations, etc. The LAHJ works with OSHPOD, CMS and TJC.
Each of the above agencies and organizations has their specific rules and regulations. For example, the TJC requires under-sink cabinets must remain empty and be locked at all times. The use of keyed spring latch cabinet locks where the key can only be removed in the locked position ensures that if the door is closed, the cabinet is locked. The operating key cannot be on a master key system.
The ADA requires the bottom latch of a surface vertical rod exit device have a guard plate to stop walkers, wheel chairs or gurney wheels from becoming trapped.
Hospitals have additional regulatory oversight because this is where people go when they are ill. Hospitals are particularly conscious of patient health and safety. They attempt to provide services that place patients’ and family members’ needs in high priority.
One of the ways of limiting possible transmission is to provide contact protection or to limit the amount of contact of door hardware. Many hospitals are purchasing locks and door hardware that have an anti-microbial coating or film that resists the growth of microbes. The use of anti-microbial technology has expanded beyond door hardware. For example, door manufacturers offer doors and doorjambs with anti-microbial coating.
Power Door Operators
More and more hospitals are installing power door openers, both low energy and automatic door operators. Door operators simplify the movement of patients in gurneys, wheel chairs and walkers by providing barrier free movement. They can also help prevent damage to doors that results from carts, gurneys, hand trucks, etc.