902 KAR 20:031. Facility specifications; personal care homes.


      RELATES TO: KRS 216B.010-216B.130, 216B.990(1), (2)

      STATUTORY AUTHORITY: KRS 216B.042, 216B.105

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 216B.042 and 216B.105 mandate that the Kentucky Cabinet for Human Resources regulate health facilities and health services. This administrative regulation provides for the licensure requirements for the facility specifications for the construction, alteration and maintenance of personal care homes.


      Section 1. Definitions. (1) "Board" means the Commission for Health Economics Control in Kentucky.

      (2) "License" means an authorization issued by the board for the purpose of operating a personal care home and offering personal care service.

      (3) "Licensure agency" means the Division for Licensing and Regulation in the Office of the Inspector General, Human Resources Cabinet.


      Section 2. Preparation and Approval of Plans and Specifications. After receiving certificate of need from the board, the following procedures shall be followed:

      (1) Before construction is begun for the erection of new buildings or alterations to existing buildings or any changes in facilities, for a personal care facility, the licensee or applicant shall submit plans in the detail specified in Section 3 of this administrative regulation to the licensure agency for approval.

      (2) All architectural, mechanical and electrical drawings shall bear either the seal of an architect registered in the Commonwealth of Kentucky or the seal of a professional engineer registered in the Commonwealth of Kentucky, or both.

      (3) Drawings shall not exceed thirty-six (36) inches by forty-six (46) inches when trimmed.

      (4) All such plans and specifications must be approved by the licensure agency prior to commencement of construction of new buildings or alterations of existing buildings.

      (5) Plans and specifications in specific detail as required by the Kentucky Building Code shall be submitted together with architectural and/or engineering stamps as required by KRS Chapters 322 and 323, to the Department of Housing, Buildings and Construction for determining compliance with the Kentucky Building Code. All such plans and specifications must be approved by the Department of Housing, Buildings and Construction, and appropriate local building permits shall be obtained prior to commencement of construction.


      Section 3. Submission of Plans and Specifications. (1) First stage; schematic plans (required only if facility exceeds 100 beds).

      (a) Single line drawings of each floor shall show the relationship of the various departments or services to each other and the room arrangement in each department. The name of each room shall be noted. Drawings shall include typical resident room layouts (scaled one-fourth (1/4) inch = one (1) foot) with dimensions noted. The proposed roads and walks, service and entrance courts, parking and orientation shall be shown in a plot plan.

      (b) If the project is an addition, or is otherwise related to existing buildings on the site, the plans shall show the facilities and general arrangements of those buildings.

      (2) Second stage; preliminary plans. Preliminary sketch plans shall include the following:

      (a) Architectural: plans of basement and floors.

      (b) Outline specifications.

      1. General description of the construction, including interior finishes, types and locations of acoustical material, and special floor covering;

      2. Description of the air-conditioning, heating, and ventilation systems and their controls, duct and piping systems; and dietary, laundry, and other special equipment;

      3. General description of electrical service including voltage, number of feeders, and whether feeders are overhead or underground.

      (3) Third stage; contract documents.

      (a) Working drawings. Working drawings shall be complete and adequate for bid, contract, and construction purposes. Drawings shall be prepared for each of the following branches of the work: architectural, structural, mechanical, and electrical. They shall include the following:

      1. Architectural drawings.

      a. Approach plan showing all new topography, newly established levels and grades, existing structures on the site (if any), new building structures, roadways, walks, and parking areas;

      b. Plan of each basement, floor and roof;

      c. Elevations of each facade;

      d. Sections through building;

      e. Required scale and full-size details;

      f. Schedule of doors, windows, and room finishes;

      g. Equipment. Location of all fixed equipment. Layout of typical and special rooms indicating all fixed equipment and major items of movable equipment. Equipment not included in contract shall be so indicated;

      h. Conveying systems. Details of construction, machine and control spaces necessary, size and type of equipment, and utility requirements for the following: dumbwaiters: electric, hand, hydraulic; elevators: freight, passenger, patient; loading dock devices; pneumatic tube systems.

      2. Structural drawings.

      a. Plans for foundations, floors, roofs, and all intermediate levels with sizes, sections, and the relative location of the various structural members;

      b. Dimensions of special openings;

      c. Details of all special connections, assemblies, and expansion joints.

      3. Mechanical drawings.

      a. Heating, steam piping, and air-conditioning systems: radiators and steam heated equipment, such as warmers and steam tables; heating and steam mains and branches with pipe sizes; diagram of heating and steam risers with pipe sizes; sizes, types, and capacities of boilers, furnaces, hot water heaters with stokers, oil burners, or gas burners; pumps, tanks, boiler breeching, and piping, and boiler room accessories; air-conditioning systems with required equipment, water and refrigerant piping and ducts; supply and exhaust ventilation systems with heating/cooling connections and piping; air quantities for all room supply and exhaust ventilating duct openings.

      b. Plumbing, drainage, and standpipe systems. Size and elevation of: street sewer, house sewer, house drains, street water main, and water service into the building. Location and size of soil, waste, and water service with connections to house drains, clean-outs, fixtures, and equipment. Size and location of hot, cold, and circulating branches, and risers from the service entrance, and tanks; riser diagram of all plumbing stacks with vents, water risers, and fixture connections. Standpipe and sprinkler systems where required; all fixtures and equipment that require water and drain connections.

      4. Electrical drawings.

      a. Electric service entrance with switches and feeders to the public service feeders, characteristics of the light and power current, transformers and their connections if located in the building;

      b. Location of main switchboard, power panels, light panels, and equipment. Diagram of feeders and conduits with schedule of feeder breakers or switches;

      c. Light outlets, receptacles, switches, power outlets, and circuits;

      d. Telephone layout showing service entrance, telephone switchboard, strip boxes, telephone outlets, and branch conduits;

      e. Nurses' call systems with outlets for residents' beds and rest rooms; duty station, door signal light and wiring diagrams (this is optional but required in all higher levels of care);

      f. Emergency electrical system with outlets, transfer switch, sources of supply, feeders, and circuits;

      g. All other electrically operated systems and equipment.

      (b) Specifications. Specifications shall supplement the drawings to fully describe types, sizes, capacities, workmanship, finishes and other characteristics of all materials and equipment and shall include:

      1. Cover or title sheet;

      2. Index;

      3. Sections describing materials and workmanship in detail for each class of work;

      4. General conditions, which must contain the following requirements: Access to the work. Representatives of the appropriate state agencies will have access at all reasonable times to the work wherever it is in preparation or progress, and the contractor shall provide proper facilities for such access and inspection.


      Section 4. Compliance with Building Codes, Ordinances and Administrative Regulations. (1) This section may be administered independently from other sections of this administrative regulation.

      (2) General. Nothing stated herein shall relieve the sponsor from compliance with building codes, ordinances, and administrative regulations which are enforced by city, county, or state jurisdictions.

      (3) The following requirements shall apply where applicable and as adopted by the respective agency authority:

      (a) Requirements for safety pursuant to 815 KAR 10:020, as amended.

      (b) Requirements for plumbing pursuant to 815 KAR 20:010-190, as amended.

      (c) Requirements for air contaminants for incinerators pursuant to 401 KAR 59:020 and 401 KAR 61:010.

      (d) Requirements for elevators pursuant to 815 KAR 4:010.

      (e) Requirements for making buildings and facilities accessible to and usable by the physically handicapped, pursuant to KRS 198B.260 and administrative regulations promulgated thereunder.

      (4) Prior to occupancy, the facility shall have final approval from appropriate agencies.

      (5) All facilities shall be currently approved by the Fire Marshal's Office in accordance with the Life Safety Code before relicensure is granted by the licensure agency.


      Section 5. Facility Requirements and Special Conditions. (1) Facilities shall be available to the public, staff, and residents who may be physically handicapped with special attention given to ramps, drinking fountain height, mirrors, etc.

      (2) At least sixty-six (66) percent of the beds in the facility shall be located in rooms designed for one (1) or two (2) beds.

      (3) Access to the facility shall be by means of a paved or gravel roadway which shall be available for use by traffic prior to a license being issued to a facility for occupancy.


      Section 6. Resident Unit. The following shall be included:

      (1) Resident rooms. Each room shall meet the following requirements:

      (a) Maximum room capacity: four (4) residents.

      (b) Resident rooms shall be designed to permit not less than a three (3) foot space between beds, and at least a three (3) foot space between the side of the bed and the nearest wall, fixed cabinet, or heating/cooling unit. Beds shall be at least thirty-six (36) inches wide. A minimum of three (3) feet is required between the foot of the bed and opposite wall or foot of opposite bed in multibed rooms.

      (c) Windows. All resident rooms shall have windows opening to the outside. The sill shall not be higher than three (3) feet above the floor and shall be above grade. Window area shall be at least eight (8) percent of resident room floor area.

      (d) Lavatory. In single and two (2) bed rooms with a private toilet room, the lavatory may be located in the toilet room. Where two (2) residents' rooms share a common toilet, a lavatory shall be provided in each resident room.

      (e) Wardrobe or closet for each resident. Minimum clear dimensions: one (1) foot and ten (10) inches deep by one (1) foot and eight (8) inches wide with full length hanging space; provide clothes rod and shelf.

      (f) In multibed rooms a method of assuring visual privacy for each resident shall be provided.

      (2) Resident toilet and bathing areas for existing facilities.

      (a) Where a centralized bathing area is used, the facility shall provide for each sex on every floor the following: one (1) shower stall or one (1) bathtub for each twelve (12) residents or major fraction thereof is required. One (1) shower stall shall be designed for wheelchair use.

      (b) Where a centralized toilet area is used, the facility shall provide for each sex on every floor the following: one (1) toilet for each eight (8) residents or fraction thereof and one (1) lavatory for each sixteen (16) residents or fraction thereof is required. Toilets must be separated by a permanent partition and at least one (1) toilet for each sex must be designed for wheelchair use.

      (c) The centralized bathing and centralized toilet area may be combined into one (1) location provided provision is made for the privacy of sexes.

      (d) Grab bars or patient lift with a safety device shall be provided at all tubs. Grab bars shall be provided at all shower stalls and toilets.

      (3) Service areas for each floor. The size and location of each service area will depend on the maximum number of residents the floor was designed for and shall include:

      (a) Duty station. An adequate centralized area must be provided for charting and other required administrative functions.

      (b) Staff lounge area. The area shall have personal storage space and a toilet room for staff.

      (c) Visitors toilet room. The home shall provide a toilet room for visitors. The staff toilet room may serve as the visitors toilet room if marked and accessible.

      (d) Medication area, with sink, refrigerator, locked storage and facilities for preparation of medication. Controlled substances locker must be under double lock.

      (e) Clean linen storage. Enclosed storage area.

      (f) Janitor's closet. Storage of housekeeping supplies and equipment. Floor receptor or service sink.

      (4) Residents' dining, TV viewing, and recreation areas.

      (a) The total areas set aside for these purposes shall be not less than thirty (30) square feet per bed for the first fifty (50) beds and twenty (20) square feet per bed for all beds in excess of fifty (50).

      (b) Storage shall be provided for recreational equipment and supplies (such as wall cabinets or closets).


      Section 7. Dietary Department. If a commercial service will be used or meals will be provided by an adjacent hospital, dietary areas and equipment shall be designed to accommodate the requirements for sanitary, efficient and safe storage, processing, and handling, otherwise the following shall be provided:

      (1) Food preparation center. Provide a lavatory but do not provide a mirror.

      (2) Food serving facilities to accommodate residents and staff.

      (3) Dishwashing and pot-washing facilities. Dish and utensil washing equipment will be used that will result in sanitized serviceware and will prevent recontamination.

      (4) Refrigerated storage shall accommodate a three (3) day supply minimum.

      (5) Dry storage shall accommodate a three (3) day supply minimum.

      (6) Food carts. If the home uses food carts, space shall be provided in the kitchen or in a separate storage area for the cleaning and storage of food carts.

      (7) Janitor's closet. Storage for housekeeping supplies and equipment; floor receptor or service sink.

      (8) A toilet room conveniently accessible to the dietary department. If a toilet room is built in this department, it must have two (2) door separation from food preparation area or dining areas.


      Section 8. Administration Department. Sufficient space shall be allotted for administrative operations. The areas may include: an administrator's office, business office, information center, admitting and medical records.


      Section 9. Laundry. The following shall be included:

      (1) Soiled linen room.

      (2) Clean linen room.

      (3) Lavatory. Accessible from soiled, clean, and processing rooms.

      (4) Laundry processing room and storage for laundry supplies (need not be provided if laundry is processed outside the facility).


      Section 10. Storage and Service Areas. The following shall be included:

      (1) Sufficient storage space shall be provided.

      (2) Engineering service and equipment areas. The following shall be provided where applicable:

      (a) Boiler room;

      (b) Mechanical and electrical equipment room(s) (can be combined with boiler room);

      (c) Storage room for housekeeping equipment (need not be provided if space is available in janitor's closets or elsewhere);

      (d) Refuse area, for holding trash prior to disposal, shall be located convenient to service entrance.


      Section 11. Details and Finishes. A high degree of safety for the occupants in minimizing the incidence of accidents shall be provided. Hazards such as sharp corners shall be avoided. All details and finishes shall meet the following requirements:

      (1) Details.

      (a) Handrails shall be provided on both sides of corridors used by residents in personal care with a clear distance of one and one-half (1 1/2) inches between handrail and wall.

      (b) All doors opening onto corridors shall be swing-type except elevator doors. Alcoves and similar spaces which generally do not require doors are excluded from this requirement.

      (c) All doors to resident room toilet rooms shall swing outward or shall be equipped with hardware which will permit access in any emergency.

      (d) Thresholds and expansion joint covers, if used, shall be flush with the floor.

      (e) Grab bars and accessories in toilet, shower, and bathrooms shall have sufficient strength and anchorage to sustain a load of 250 pounds for five (5) minutes.

      (f) Lavatories intended for use by residents shall be installed to permit wheelchairs to slide under.

      (g) Mirrors shall be arranged for convenient use by residents in wheelchairs as well as by residents in standing position.

      (h) Towel rack or dispensers shall be provided at all lavatories and sinks used for hand-washing.

      (i) Ceiling heights.

      1. Boiler room. Not less than two (2) feet and six (6) inches above the main boiler header and connecting piping with adequate headroom under piping for maintenance and access;

      2. Corridors, storage rooms, residents' toilet room, and other minor rooms. Not less than seven (7) feet and six (6) inches;

      3. All other rooms. Not less than eight (8) feet.

      (k) Boiler room, food preparation centers, and laundries shall be insulated and ventilated to prevent any floor surface above from exceeding a temperature of eighty-five (85) degrees Fahrenheit.

      (l) Noise reduction criteria. The ceilings of the following areas shall be designed to reduce noise transmission:

      1. Corridors in resident areas;

      2. Work areas such as utility rooms;

      3. Lobbies and recreation areas.

      (m) Special attention shall be given to sound transmission from boiler rooms, mechanical rooms, and kitchen, to resident bedroom areas.

      (2) Finishes.

      (a) Floors generally shall be easily cleanable and shall have the wear resistance appropriate for the location involved. Floors in kitchen and related spaces shall be waterproof and grease-proof. In all areas where floors are subject to wetting, they shall have a nonslip finish.

      (b) Adjacent dissimilar floor materials shall be flush with each other to provide an unbroken surface.

      (c) Walls generally shall be washable and in the immediate area of plumbing fixtures, the finish shall be moisture-proof. Wall bases in dietary areas shall be free of spaces that can harbor insects.

      (d) Ceilings generally shall be washable or easily cleanable. This requirement does not apply to boiler rooms, mechanical and building equipment rooms, shops and similar spaces.


      Section 12. Elevators. Elevators shall conform with 815 KAR 4:010. Elevators, where required. All facilities where either resident beds or residential facilities such as recreation, resident dining or therapy rooms are located on other than the first floor, shall have electric or electrohydraulic elevators as follows:

      (1) Number of elevators. All homes with resident beds or residential facilities located on any floor other than the first floor shall have at least one (1) hospital-type elevator and such additional elevators as determined by the licensure agency from a study of the facility plan and the estimated vertical transportation requirements.

      (2) Cars and platforms. Cars of hospital-type elevators shall have inside dimensions that will accommodate a resident's bed and attendants and shall be at least five (5) feet wide by seven (7) feet and six (6) inches deep; car doors shall have a clear opening of not less than three (3) feet and eight (8) inches. Cars of all other required elevators shall have a clear opening of not less than three (3) feet.

      (3) Leveling. Elevators shall have automatic leveling of the two (2) way automatic maintaining type with accuracy within plus or minus one-half (1/2) inch.


      Section 13. Construction. Foundations shall rest on natural solid ground if a satisfactory soil is available at reasonable depths. Proper soil bearing values shall be established in accordance with recognized standards. If solid ground is not encountered at practical depths, the structure shall be supported on driven piles or drilled piers designed to support the intended load without detrimental settlement.


      Section 14. Mechanical Requirements. (1) Steam and hot water systems.

      (a) Boilers. If boilers are used, a minimum of two (2) must be provided; the combined capacity of the boilers, based upon the published Steel Boiler Institute or Institute of Boiler and Radiator Manufacturer's net rating, must be able to supply 150 percent of the normal requirements of all systems and equipment.

      (b) The design and installation of boilers in personal care homes shall comply with 815 KAR 15:010 through 060.

      (2) Temperature and ventilating systems.

      (a) Temperature. A minimum temperature of seventy-two (72) degrees Fahrenheit shall be provided for in occupied areas in winter conditions. A maximum temperature of eighty-five (85) degrees Fahrenheit shall be provided for in occupied areas in summer conditions.

      (b) Ventilation systems details. All air-supply and air-exhaust systems shall be mechanically operated. All fans serving exhaust systems shall be located at or near the point of discharge from the building. The ventilation rates shown in Table 1, Section 16 of this administrative regulation, shall not be considered as precluding the use of higher ventilation rates if they are required to meet design conditions.

      1. Outdoor ventilation air-intakes, other than for individual room units, shall be located as far away as practicable but not less than twenty-five (25) feet from the exhausts from any ventilating system or combustion equipment. The bottom of outdoor intakes serving central air systems shall be located as high as possible but not less than eight (8) feet above the ground level or, if installed through the roof, three (3) feet above roof level.

      2. The ventilation systems shall be designed and balanced to provide the general pressure relationship to adjacent areas shown in Table 1, Section 16 of this administrative regulation.

      3. Room supply air inlets, recirculation, and exhaust air outlets shall be located not less than three (3) inches above the floor.

      4. Corridors shall not be used to supply air to or exhaust air from any room, except that exhaust air from corridors may be used to ventilate rooms such as bathrooms, toilet rooms, or janitor's closets which open directly on corridors.

      (3) Plumbing and other piping systems. Lavatories in resident rooms shall have the water supply spout mounted so that its discharge point is a minimum distance of five (5) inches above the rim of the fixture. Fixtures used in the dietary area, soiled workroom and clean workroom shall be trimmed with valves which can be operated without the use of hands. Where blade handles are used for this purpose, they shall be at a distance from the centerline of the sink to be operational.

      (4) Water supply systems.

      (a) System shall be designed to supply water to the fixtures and equipment on the upper floors at a minimum pressure of fifteen (15) pounds per square inch during maximum demand periods.

      (b) Each water service main, branch main, riser and branch to a group of fixtures shall be valved. Stop valves shall be provided at each fixture.

      (c) Hot, cold and chilled water piping and waste piping on which condensation may occur shall be insulated. Insulation of cold and chilled water lines shall include an exterior barrier.

      (d) Backflow preventers (vacuum breakers) shall be installed on hose bibbs and on all fixtures to which hoses or tubing can be attached such as janitor's sinks and bedpan flushing attachments.

      (e) Hot water distribution systems shall be arranged to provide hot water at each fixture at all times.

      (f) Piping over food preparation centers, food serving facilities, food storage areas, and other critical areas shall be kept to a minimum and shall not be exposed. Special precautions shall be taken to protect these areas from possible leakage of, or condensation from necessary overhead piping systems.

      (5) Hot water heaters and tanks.

      (a) The hot water heating equipment shall have sufficient capacity to supply the water at the temperature and amounts indicated below:








6 1/2


4 1/2

Temp. F.




 *Temperature may be reduced to 140 if chloritizer is used.

**If the temperature used is below 180 the home shall utilize detergents and other additives to insure that the linens be adequately cleaned.


      (b) Storage tank(s) shall be provided and shall be fabricated of corrosion-resistant metal, or have noncorrosive lining.

      (6) Plumbing approval. Prior to final approval of the plans and specifications by the licensure agency, the plumbing plans and specifications must be approved by the Division of Plumbing, Department of Housing, Buildings and Construction.


      Section 15. Electrical Requirements. (1) General. Electrical requirements of the Kentucky Building Code shall apply where applicable.

      (2) The wiring in each home shall be inspected by a certified electrical inspector and a certificate of approval shall be issued, to the facility, prior to occupancy; however, the wiring in existing buildings shall be approved by a certified electrical inspector only when the building has not been previously so approved for health care occupancy or where the State Fire Marshal finds that a hazardous condition exists.

      (3) Switchboard and power panels. All breakers and switches shall be indexed.

      (4) Lighting.

      (a) All spaces occupied by people, machinery, and equipment within buildings, and the approaches thereto, and parking lots shall have electric lighting.

      (b) Residents' bedrooms shall have general lighting. A reading light shall be provided for each resident when appropriate. Residents' reading lights and other fixed lights not switched at the door shall have switch controls convenient for use at the luminaire. Night lights shall be provided in each resident's room.

      (c) Lighting levels for the facility shall comply with the requirements in Table 2, Section 16 of this administrative regulation.

      (5) Receptacles (convenience outlets).

      (a) Bedroom. Each resident bedroom shall have duplex receptacles as follows: one (1) each side of the head of each bed (for parallel adjacent beds, only one (1) receptacle is required between beds); receptacles for luminairies, television and motorized beds, if used, and one (1) receptacle on another wall.

      (b) Corridors. Duplex receptacles for general use shall be installed approximately fifty (50) feet apart in all corridors and within twenty-five (25) feet of ends of corridors.

      (6) Emergency electric service.

      (a) General.

      1. To provide electricity during an interruption of the normal electric supply that could affect the care or safety of the occupants, an emergency generating set shall be provided and connected to certain circuits for lighting and power for a continuous period up to four (4) hours.

      2. When the home is supplied by at least two (2) dedicated and separate utility service feeders, an emergency generating set is not required.

      (b) Emergency electrical connections. Emergency electric service shall be provided to circuits as follows:

      1. Lighting.

      a. Exitways and all necessary ways of approach thereto, including exit signs and exit direction signs, exterior of exits, exit doorways, stairways, and corridors;

      b. Medication preparation areas;

      c. Switch-gear location and boiler room;

      d. Elevator (if required for emergency).

      2. Equipment, essential to life safety and for protection of important or vital materials: sewage or sump lift pump, if installed.

      (c) Details. The emergency system shall be so controlled that after interruption of the normal electric power supply, the electric source is brought to full voltage and frequency and connected to all emergency lighting, all alarms, and equipment.


      Section 16. Appendix: Table 1 - Pressure Relationships and Ventilation of Certain Personal Care Areas. Table 2 - Lighting Levels for Personal Care.



Area Designation


Relationship to Adjacent Areas

All Supply

Air From Outdoors

Minimum Air

Changes of Outdoor Air Per Hour

Minimum Total Air Changes Per Hour

All Air Exhausted to Outdoors

Resident room






Resident area corridor






Treatment room






Physical therapy and hydrotherapy, if applicable






Dining and recreation areas






Soiled workroom






Clean workroom






Toilet room






Bedpan room if applicable












Janitor's closet






Linen and trash chute room






Food preparation center






Dishwashing area






Dietary dry storage






Laundry, general






Soiled linen sorting and storage






Clean linen storage






P = Positive   N = Negative   O = Equal   -- = Optional





Administrative and lobby areas, day


Administrative and lobby areas, night


Corridors and interior ramps


Corridor night lighting


Dining area and kitchen




Exit stairways and landings


Janitor's closet


Staff lounge, general, day


Staff lounge, general, night


Medicine cabinet


Resident care unit (or room), general


Resident care room, reading


Recreation area (floor level)


Stairways other than exits


Toilet and bathing facilities


Utility room, general


*Minimum on task at anytime

      (8 Ky.R. 222; eff. 11-5-81; Am. 16 Ky.R. 966; eff. 1-12-90.)