# Title 33 — State Department of Health

## Article 33-03 — Public Health Division

## Chapter 33-03-24.2 — General Standard for Construction and Equipment for Basic Care Facilities

### § 33-03-24.2-01. Definitions.

The definitions located in section 33-03-24.1-01 apply to this chapter.
History: Effective July 1, 2015.
General Authority: NDCC 23-09.3-09, 28-32-02
Law Implemented: NDCC 23-09.3-09
### § 33-03-24.2-02. Waiver provision.

The waiver provision located in section 33-03-24.1-04 applies to this chapter.
History: Effective July 1, 2015.
General Authority: NDCC 23-09.3-09, 28-32-02
Law Implemented: NDCC 23-09.3-09
### § 33-03-24.2-03. Access and surveillance by the department.

The provisions located in section 33-03-24.1-03 apply to this chapter.
History: Effective July 1, 2015.
General Authority: NDCC 23-09.3-09, 28-32-02
Law Implemented: NDCC 23-09.3-04, 23-09.3-05
### § 33-03-24.2-04. Plans of correction.

The provisions located in section 33-03-24.1-03 apply to this chapter.
History: Effective July 1, 2015.
General Authority: NDCC 23-09.3-09, 28-32-02
Law Implemented: NDCC 23-09.3-09
### § 33-03-24.2-05. Emanating services.

1. Sufficient information on the design of other types of facilities physically attached to the basic
care facility must be submitted to the department so as to determine that safety from fire and
the adequacy of the spaces and services of the facility are not compromised.
2. Occupants of other types of facilities may use service spaces, such as dining and activities in
the facility only when the size of such spaces exceeds the standards of this chapter by
providing a minimum of fifteen square feet per additional occupant using the space.

History: Effective July 1, 2015.
General Authority: NDCC 23-09.3-09, 28-32-02
Law Implemented: NDCC 23-09.3-09
### § 33-03-24.2-06. Plans and specifications.

1. A facility shall contact the department prior to any substantial changes in or alterations to any
portion of the structure to determine to what extent it is subject to review. A substantial change
includes alterations affecting the fire safety or structural integrity of the building, changes in
service areas or services provided within a service area, changes in bed capacity, or any other
change governed by the standards of this chapter. The department may request plans,
specifications, or other information as may be required and shall make the final determination
on those areas subject to review.
2. A facility shall submit plans and specifications to the department for all construction,
remodeling, and installations subject to review. The plans and specifications must be prepared
by an architect or engineer licensed in North Dakota, unless otherwise determined by the
department.
3. Start of construction prior to approval by the department of the final plans and specifications is
not permitted.
4. All construction, remodeling, and installations must be in accordance with the final plans and
specifications approved by the department. Modifications or deviations from the approved
plans and specifications must be submitted to and approved by the department.
5. The department may make inspections of construction, remodeling, or installations and
arrange conferences with the facility to ensure conformance with approved plans and
specifications.
6. The construction specifications must require the contractor to perform tests to ensure all
systems conform to the approved plans and specifications.
7. Routine maintenance does not require the submission of plans and specifications. For the
purpose of this subsection, routine maintenance means repair or replacement of existing
equipment, room finishes and furnishings, and similar activities.
History: Effective July 1, 2015.
General Authority: NDCC 23-09.3-09, 28-32-02
Law Implemented: NDCC 23-09.3-09
### § 33-03-24.2-07. Codes and standards.

1. A basic care facility must be designed, constructed, equipped, maintained, and operated in
compliance with:
a. This chapter;
b. The Guidelines for Residential Health, Care and Support Facilities, 2014 edition,
compiled by the facility guidelines institute;
c. The national fire protection association 101 Life Safety Code, 2012 edition;
d. North Dakota Century Code section 54-21.3-04.1, relating to accessibility for disabled
persons;
e. The requirements for food and beverage establishments issued by the department;

f. North Dakota Administrative Code article 62-03.1 relating to plumbing standards;
g. North Dakota Administrative Code article 24-02 relating to electrical wiring standards;
h. North Dakota Administrative Code article 45-12 relating to boiler rules and regulations;
i. North Dakota Administrative Code article 33-15 governing air pollution control, relating to
incinerators; and
j. North Dakota Administrative Code article 33-10 relating to radiological health.
2. A basic care facility must comply with all applicable building codes, ordinances, and rules of
city, county, or state jurisdictions.
3. These standards are established to bring about a desired performance result. If specific limits
are prescribed, equivalent solutions may be acceptable if approved in writing by the
department as meeting the intent of these standards.
History: Effective July 1, 2015.
General Authority: NDCC 23-09.3-09, 28-32-02
Law Implemented: NDCC 23-09.3-09
### § 33-03-24.2-08. Fire safety.

1. The basic care facility shall comply with the national fire protection association Life Safety
Code, 2012 edition, chapters 32 and 33, residential board and care occupancy, slow
evacuation capability, or a greater level of fire safety.
2. Fire drills must be held monthly with a minimum of twelve per year, alternating with all
workshifts. Residents and staff, as a group, shall either evacuate the building or relocate to an
assembly point identified in the fire evacuation plan. At least once a year, a fire drill must be
conducted during which all staff and residents evacuate the building.
3. Fire evacuation plans must be posted in a conspicuous place in the facility.
4. Written records of fire drills must be maintained. These records must include dates, times,
duration, names of staff and residents participating and those absent and why, and a brief
description of the drill, including the escape path used and evidence of simulation of a call to
the fire department.
5. Each resident shall receive an individual fire drill walk-through within five days of admission.
6. Any variation to compliance with the fire safety requirements must be approved in writing by
the department.
7. Residents of facilities meeting a greater level of fire safety must meet the fire drill
requirements of that occupancy classification.
History: Effective July 1, 2015.
General Authority: NDCC 23-09.3-09, 28-32-02
Law Implemented: NDCC 18-01-03.2, 23-09.3-09
### § 33-03-24.2-09. General building requirements.

The basic care facility must be operated in conformance with all state and local laws, rules, and
ordinances concerning fire safety and sanitation.

1. Lounge and activity space must be provided at a minimum of fifteen square feet [1.39 square
meters] per licensed bed for recreation, visiting, and an activity program. The lounge and
activity area may be used to accommodate religious services and activities. Each lounge area
for resident use must be provided with an adequate number of reading lamps, tables, and
chairs or couches. These furnishings must be well-constructed and accommodate the needs
of the residents.
2. Kitchen. Dietary areas and equipment must be designed to accommodate the requirements
for sanitary storage, processing, and handling.
3. Dining area.
a. A minimum of fifteen square feet [1.39 square meters] per licensed bed must be provided
for dining. Activity and dining areas must be separate.
b. Dining room furnishings must be well-constructed, comfortable, in good repair, and must
accommodate the needs of the residents. There must be a sufficient number of tables of
suitable design to accommodate the needs of all residents using wheelchairs.
4. Resident bedrooms.
a. All bedrooms used for residents must be dry, well-ventilated, and otherwise suitable for
occupancy. Each room must have direct access to a corridor and have an outside wall
with natural light provided by a window. Resident bedrooms licensed after the effective
date of these rules must be at or above grade level.
b. The glazed areas of the window may not be less than one-tenth of the floor area of the
room. Windows must be easily opened and must be provided with screens. Windows
may have stops to prevent full opening that could result in accidental falls or unintended
exiting from window openings.
c. Room size will vary depending on the number of beds, but minimum floor dimensions
may not be less than ten feet [3.05 meters]. In computing floor area, only usable floor
space may be included. Single rooms must provide at least one hundred square feet
[9.29 square meters]. Double rooms must provide at least eighty square feet
[7.43 square meters] per bed.
d. Each resident must be provided with a bed and mattress. Cots, rollaways, or folding beds
may not be used. Double beds may be used if requested by the resident and there is
adequate space. Each bed must be provided with springs in good repair and a clean,
firm, comfortable mattress of appropriate size for the bed, as well as a minimum of one
clean, comfortable pillow.
e. Each bedroom window must have window shades, or an equivalent, in good repair.
f. Light levels to meet the needs of residents and to allow for reading and safety must be
provided.
g. Each bedroom must be provided with a mirror unless there is a mirror in a toilet room
opening into the bedroom. Each resident lavatory must be provided with a mirror.
Bedrooms or bathrooms in a secured unit or secured facility may or may not have mirrors
based on the assessment of the resident.
h. For each bed there must be furnished a minimum of two adequately sized dresser
drawers, a chair, a bedside table or stand, an individual towel rack, and closet, locker, or
wardrobe space for hanging clothing within the room.

5. Toilet rooms and bathing facilities.
a. Separate toilets for public use must be provided.
b. Each bath and toilet room must be well-lighted.
6. The facility shall provide for adequate ventilation throughout to assure an odor-free,
comfortable environment.
7. Office spaces and other areas must be furnished with desks, chairs, lamps, cabinets,
benches, worktables, or other furnishings essential to the proper use of the area.
History: Effective July 1, 2015.
General Authority: NDCC 23-09.3-09, 28-32-02
Law Implemented: NDCC 23-09.3-04
