Article 1 — DEFINITIONS AND REQUIREMENTS

The regulations in this article shall apply to the administrative procedures necessary to implement the seismic retrofit requirements of the Alfred E. Alquist Hospital Facilities Seismic Safety Act of 1983.

The regulations shall apply to all general acute care hospital facilities as defined in Section 1.2 of these regulations.

Unless otherwise stated, the words and phrases defined in this section shall have the meaning stated therein throughout Chapter 6, Part 1, Title 24.

ALTERNATIVE ANALYSIS means a complete seismic analysis using methodology approved in advance by the Office and meeting the criteria of Article 2, Section 2.7 of these regulations.

BULK MEDICAL GAS SYSTEM means an assembly of fixed equipment such as storage containers, pressure regulators, pressure relief devices, vaporizers, manifolds and interconnecting piping that has a capacity of more than 20,000 cubic feet (NTP) of cryogenic medical gas.

COMMUNICATIONS SYSTEM means the assembly of equipment such as telephone switchgear, computers, batteries, radios, microwave communications systems, towers and antennas that provide essential internal and external communication links.

COMPLETE STRUCTURAL DAMAGE means a significant portion of the structural elements have exceeded their ultimate capacities for some critical structural elements or connections have failed, resulting in dangerous permanent lateral displacement, partial collapse or collapse of the entire building. A Complete Structural Damage would be a loss of 100% of the building’s replacement cost.

CONFORMING BUILDING means a building originally constructed in compliance with the requirements of the 1973 or subsequent edition of the California Building Code or classified as SPC-4D, as defined in this section.

CRITICAL ACCESS HOSPITAL means a hospital designated by the State Department of Public Health as a critical access hospital, and certified as such by the Secretary of the United States Department of Health and Human Services under the federal Medicare Rural Hospital Flexibility Program.

CRITICAL CARE AREA means those special care units, intensive care units, coronary care units, angiography laboratories, cardiac catheterization laboratories, delivery rooms, emergency rooms, operating rooms, postoperative recovery rooms and similar areas in which patients are intended to be subjected to invasive procedures and connected to line-operated, electromedical devices.

DAMAGE CONTROL STRUCTURAL PERFORMANCE CATEGORY is a performance category that has been demonstrated either by analysis or retrofit to satisfy the requirements of Section 1.4.5.1.3 and the California Existing Building Code (CEBC) Section 304A.3.4.5, 501A.3.1, or 501A.3.2. Buildings satisfying this structural performance standard shall be deemed to satisfy the requirements of the Structural Performance Category SPC-4D.

DEPARTMENT means the Department of Health Care Access and Information (HCAI).

DISTRESSED HOSPITAL LOAN PROGRAM RECIPIENT is a hospital that received a loan pursuant to Chapter 4 (commencing with Section 129380) of Part 6 of Division 107 of the Health and Safety Code. This may also include a future program recipient, should the Legislature appropriate additional state funding to the program and extend the date identified in Section 129387.

EMERGENCY POWER SUPPLY (EPS) means the source of electric power including all related electrical and mechanical components of the proper size or capacity, or both, required for the generation of the required electrical power at the EPS output terminals. For rotary energy converters, components of an EPS include the prime mover, cooling system, generator, excitation system, starting system, control system, fuel system and lube system (if required).

ESSENTIAL ELECTRICAL SYSTEMS means a system as defined in the California Electrical Code, Article 517 “Health Care Facilities,” Chapter 5, Part 3 of Title 24.

FIRE ALARM SYSTEM means a system or portion of a combination system consisting of components and circuits arranged to monitor and annunciate the status of fire alarm or supervisory signal initiating devices and to initiate appropriate response to those signals.

FUNCTIONAL CONTIGUOUS GROUPING means a group of hospital buildings, each of which contains the primary source of one or more basic service that are operationally interconnected in a manner acceptable to the Department of Health Services.

GENERAL ACUTE CARE HOSPITAL as used in Chapter 6, Part 1 means a hospital building as defined in Section 129725 of the Health and Safety Code and that is also licensed pursuant to subdivision (a) of Section 1250 of the Health and Safety Code, but does not include these buildings if the beds licensed pursuant to subdivision (a) of Section 1250 of the Health and Safety Code, as of January 1, 1995, comprise 10 percent or less of the total licensed beds of the total physical plant, and does not include facilities owned or operated, or both, by the Department of Corrections. It also precludes hospital buildings that are licensed under the above-mentioned code sections but provide skilled nursing or acute psychiatric services only.

HEALTH CARE DISTRICT HOSPITAL is a hospital authorized pursuant to Division 23 of the Health and Safety Code.

HOSPITAL EQUIPMENT means equipment permanently attached to the building utility services such as surgical, morgue, and recovery room fixtures, radiology equipment, medical gas containers, food service fixtures, essential laboratory equipment, TV supports, etc.

HYBRID STRUCTURE means a structure consisting of an original and one or more additions, constructed at different times, and with lateral-force-resisting systems of different types, or constructed with differing materials or a different design approach. The original building and additions are interconnected and not seismically isolated.

INTEGRATED REVIEW as applied in this chapter is the process by which the Office may engage early in the project design through the development and submission of documents during the design phases of conceptualization, criteria design, detailed design, implementation documents, office review, and final plan approval of a seismic retrofit project.

NONCONFORMING BUILDING means any building that is not a conforming building.

NONSTRUCTURAL PERFORMANCE CATEGORY (NPC) means a measure of the probable seismic performance of building contents and nonstructural systems critical to providing basic services to inpatients and the public following an earthquake, as defined in Article 11, Table 11.1 of these regulations.

NONSTRUCTURAL PERFORMANCE CATEGORY NPC-4D is a performance category assigned to existing hospital buildings not designed and constructed under a building permit issued by OSHPD that have been evaluated and or retrofitted to satisfy the requirements of NPC 4D for one of the Levels defined in Article 11, Table 11.1 Nonstructural Performance Categories. Level 1 being the minimum level of seismic compliance and Level 3 being the highest level of compliance required for continued operation beyond 2030.

PATIENT ORIGIN REGION is a geographic area bounded by the same U.S. Postal Service five-digit Zip Code. For the purposes of determining the hospital service area the patient origin region may be referred to as “region.”

PRIMARY SOURCE means that building or portion of a building identified by the hospital as housing the main or principal source of a basic hospital service, serving the greatest number of patients, providing the greatest number of patient beds, or having the largest/greatest floor space of the specified basic service. The hospital may submit data to substantiate the primary source through alternative criteria if different than above.

PRINCIPAL HORIZONTAL DIRECTIONS means the two predominant orthogonal translational modes of vibration with the lowest frequency.

PROBABILITY OF COLLAPSE means the fraction of building that is expected to collapse given that the ground motions defined in Section 1.8.1 occur at the building site.

REBUILD PLAN means a plan to meet seismic standards primarily by constructing a new conforming SPC-5 building for use in lieu of an SPC-1 building.

REGION see definition for “patient origin region.”

REMOVAL PLAN means a plan to meet seismic standards primarily by removing acute care services or beds from the hospital’s license.

REPLACEMENT PLAN means a plan to meet seismic standards primarily by relocating acute care services or beds from nonconforming buildings into a conforming building.

RETROFIT PLAN means a plan to meet seismic standards primarily by modifying the building in a manner that brings the building up to SPC-2, SPC-4D, or SPC-5 standards.

RURAL HOSPITAL means a “rural general acute care hospital” as set forth in subdivision (a) of Section 1250 of the Health and Safety Code or a hospital located in a rural or frontier medical study service area, as defined by the California Healthcare Workforce Policy Commission.

SIGNIFICANT STRUCTURAL DEFICIENCY means an attribute of the structure considered to be significant with respect to Probability of Collapse.

SLENDER SEISMIC RESISTING SYSTEM means any vertical system for resisting lateral forces, such as walls, braced frames or moment frames, with a height to width ratio greater than four for the minimum horizontal dimension at any height.

SMALL AND RURAL HOSPITAL RELIEF PROGRAM is established under the administration of the Office of Health Facility Loan Insurance (OHFLI) within the Department of Health Care Access and Information (HCAI) for the purpose of funding seismic safety compliance with respect to small hospitals, rural hospitals, and critical access hospitals in the state.

SMALL HOSPITAL is a hospital with 50 beds or fewer.

STATE GRANT PROGRAM means a program established by the state to provide grant funding for seismic improvement projects for buildings used to provide general acute care services.

STRUCTURAL PERFORMANCE CATEGORY (SPC) means a measure of the probable seismic performance of building structural systems and risk to life posed by a building subject to an earthquake, as defined in Article 2, Table 2.5.3 of these regulations.

STRUCTURAL PERFORMANCE CATEGORY SPC-4D is a performance category assigned to previously nonconforming hospital buildings that have been demonstrated either by analysis or retrofit to be equivalent to the minimum prescriptive requirements of the 1979 Uniform Building Code (UBC 1979) including the California amendments, hereafter called the 1980 CBC, in accordance with Section 1.4.5.1.3 or the California Existing Building Code Sections 304A.3.3 and 304A.3.4.5, 501A.3.1, or 501A.3.2.

All general acute care hospital owners shall perform a seismic evaluation on each hospital building in accordance with the Seismic Evaluation Procedures as specified in Articles 2 through 11 of these regulations. By January 1, 2001, hospital owners shall submit the results of the seismic evaluation to the Office for review and approval. By completing this seismic evaluation, a hospital facility can determine its respective seismic performance categories for both the Structural Performance Category (SPC) and the Nonstructural Performance Category (NPC) in accordance with Articles 2 and 11 of these regulations.

Exception: The Structural Performance Category of SPC-4D shall be established in accordance with Section 1.4.5.1.3 and the California Existing Building Code (CEBC) Sections 304A.3.3 and 304A.3.4.5, 501A.3.1, or 501A.3.2.

1.3.1 Seismic evaluation submittal. Hospital owners shall submit the seismic evaluation report to the Office by January 1, 2001. There are no provisions for submittal of the evaluation report after this date, except as provided in Section 1.4.5.1.2. The hospital owners shall submit the evaluation report in accordance with Section 7-113, “Application for Plan Report or Seismic Compliance Extension Review” and Section 7-133, “Fees” of Article 3, Chapter 7, Part 1, Title 24.

Exceptions:

  1. Any hospital facility owner whose building is exempted from the structural evaluation in accordance with Section 2.0.1.2 shall not be required to submit a structural evaluation report as specified in Section 1.3.3. In lieu of the structural evaluation report, hospital owners shall submit the matrix of construction information for the specified building(s) as noted in Section 1.3.4.6 to the Office by January 1, 2001; 

  2. Any hospital facility owner whose building is exempted from the nonstructural seismic evaluation in accordance with Section 11.0.1.2 shall not be required to submit a nonstructural evaluation report as specified in Section 1.3.4. In lieu of the nonstructural evaluation report, hospital owners shall submit the matrix of construction information for the specified building(s) as noted in Section 1.3.4.6 to the Office by January 1, 2001. 

• 1.3.2 Seismic evaluation format. The evaluation shall consist of the Structural Evaluation and the Nonstructural Evaluation Reports. The reports shall be prepared in conformance with Part 1, Chapter 7, Title 24 and these regulations and prepared as follows: 1. Reports shall be submitted in an 8[1] /2 x 11 format;

  2. All site, architectural, and engineering plans shall be formatted on 11- by 17-inch sheets (folded to 8[1] /2 by 11 inches);

  3. Larger sheets, if required to clearly describe the requested information, shall be appended to the reports; and

  4. Other supporting documents in addition to those meeting the minimum requirements of Sections 1.3.3 and 1.3.4 may be appended to the reports.

• 1.3.3 Structural evaluation report. The structural evaluation report shall include the following elements:

  1. A description of the building, including photographs of the building, and sketches of the lateral force resisting system;

  2. The “General Sets of Evaluation Statements” from the Appendix;

  3. A synopsis of the investigation and supporting calculations that were made;

  4. A list of the deficiencies requiring remediation to change statement responses from false to true; and

  5. The SPC for the building, with comments on the relative importance of the deficiencies.

• 1.3.4 Nonstructural evaluation report. The nonstructural evaluation report shall include the following elements:

  1. A written description of the evaluation methods and procedures conducted in conformance with Article 11 of these regulations for the determination of the facilities existing compliance. The description shall include the systems and components required for the planned level of nonstructural performance as identified in Table 11.1;

Exceptions:

1. Additional evaluations as in accordance with Section 11.01.3 will be required for any hospital owner electing to obtain a higher NPC at a future date consistent with an approved compliance plan;

2. A complete nonstructural evaluation up to NPC 5 is required prior to the hospital owner selling or leasing the hospital to another party.

3. Provide single line diagrammatic plans (site plan and floor plans) of the following:

   • 2.1. Location of the following areas/spaces:

     • (a) Central supply areas;

     • (b) Clinical laboratory service spaces;

     • (c) Critical care areas;

     • (d) Pharmaceutical service spaces;

     • (e) Radiological service spaces; and

     • (f) Sterile supply areas.

   • 2.2. Diagrammatic or narrative descriptions of the following major building systems where deficiencies are identified that are within the scope of the evaluation, including primary source location or point(s) of entry into the building and major distribution routes of each utility or system.

     • (a) Mechanical systems including:

       • i. Air supply equipment, piping, controls and ducting;

       • ii. Air exhaust equipment and ducting;

     • iii. Steam and hot water piping systems, including boilers, piping systems, valving and components; and

     • iv. Elevators selected to provide service to patient, surgical, obstetrical and ground floors.

   • (b) Plumbing systems including:

     • i. Domestic water supply system, including heating equipment, valving, storage facilities and piping;

     • ii. Medical gas supply system, including storage facilities, manifolding and piping;

     • iii. Fire protection system, including sprinkler systems, wet and dry standpipes, piping systems and other fire suppression systems; and

     • iv. Sanitary drainage system, including storage facilities and piping.

   • (c) Electrical systems, including:

     • i. Essential electrical system, including emergency fuel storage;

     • ii. Internal communication systems;

     • iii. External communication systems;

• iv. Fire alarm systems; and

  - v. Elevators selected to provide service to patient, surgical, obstetrical and ground floors.
  

3. A synopsis of the evaluation and all the calculations used in the course of the evaluation for the planned level of nonstructural performance;

4. A list of the deficiencies identified in the course of the evaluation for the planned level of nonstructural performance;

5. Provide an 11- by 17-inch scaled Site Plan which identifies the boundaries of the facility property, locates all buildings, roadways, parking and other significant site features and improvements. Identify boundaries between buildings which were constructed at different times. For all buildings, note the names of the buildings and date of each related building permit. Provide the SPC and NPC for all buildings.

6. Provide the following matrix (given in Section 1.4.4.5) of construction information for each building of the facility under the acute care license, include the Structural Performance Category (SPC) and Nonstructural Performance Category (NPC) for all hospital buildings (see Tables 2.5.3 and 11.1). Identify each building addition separately. For buildings constructed, reconstructed or remodeled under a building permit issued by the Office, provide the OSHPD application number and the date of the initial submittal.

A compliance plan shall be prepared and submitted for each building subject to these regulations. All general acute care hospital owners shall formulate a compliance plan which shall indicate the facility’s intent to do any of the following:

1. Building retrofit for compliance with these regulations for continued acute care operation beyond 2030;

2. Partial retrofit for initial compliance, with closure or replacement expected by 2002, 2008, 2013 or 2030;

3. Removal from acute care service with conversion to nonacute care health facility use; or

4. No action, building to be closed, demolished or replaced.

• This plan shall clearly indicate the actions to be taken by the facility and shall be in accordance with the timeframes set forth in

• Article 2 (Structural Performance Category-“SPC”) and Article 11 (Nonstructural Performance Category-“NPC”) of the Seismic Evaluation Procedure regulations.

1.4.1 Preparation of the compliance plan. The Compliance Plan shall be prepared and submitted in conformance with these regulations in the following format:

1. Compliance Plans shall be submitted in an 8[1] /2- by 11-inch format;

2. All site, architectural, and engineering plans shall be formatted on 11- by 17-inch sheets (folded to 8[1] /2 by 11 inches);

3. Larger sheets, if required to clearly describe the requested information, shall be appended to the compliance plan; and

4. Other supporting documents in addition to those meeting the minimum requirements of Section 1.4.4 may be appended to the compliance plan.

1.4.2 Compliance plan submittal. Hospital owners shall submit the compliance plan to the Office by January 1, 2001, unless the owner requests an extension pursuant to Section 1.4.3. The hospital owners shall submit the compliance plan in accordance with Section 7-113, “Application for Plan or Report Review” and Section 7-133, “Fees” of Article 3, Chapter 7, Part 1, Title 24.

1.4.3 Compliance plan submittal extension. Hospital owners may request an extension from the Office for submission of the compliance plan. Any hospital owner requesting an extension for submittal of the compliance plan shall make such request in writing to the Office up to 180 days prior to, but no later than January 1, 2001. The compliance plan must be submitted no later than January 1, 2002. All hospital owners requesting an extension for submittal of the compliance plan shall certify to OSHPD that all hospital buildings continuing acute care operation beyond January 1, 2002 meet the standards of NPC 2 by January 1, 2002.

1.4.4 Compliance plan requirements. Each compliance plan shall contain the following elements:

1. An Existing Site/Campus Description;

2. A Compliance Plan Description;

3. A Compliance Site Plan;

4. A Compliance Plan Schedule; and

5. An Existing and Planned Buildings Matrix.

1.4.4.1 Existing site/campus description. If the compliance plan is submitted separately from the seismic evaluation, it will be necessary to resubmit the information as specified in Section 1.3.4.5, of the Nonstructural Evaluation Report.

1.4.4.2 Compliance plan description. Provide a comprehensive narrative description of the Compliance Plan, including the projected schedule for compliance.

1.4.4.3 Compliance site plan. Provide Compliance Site Plans, indicating the configuration of the facility at the 2008 and 2030 milestones. The plans shall indicate conforming and nonconforming buildings and identify the final configuration of the facility at each milestone, after completion of compliance measures.

1.4.4.4 Compliance plan schedule. Provide a bar graph schedule which describes the schedule for compliance with the SPC and NPC seismic performance categories, indicating the schedule of the following major phases of the plan:

1. Obtain a geotechnical report (if necessary);

2. Architecture and engineering design/construction document preparation;

3. Local approvals;

4. Office review, approval and permitting;

5. Approval of California Department of Public Health (CDPH) Licensing and Certification, and any other required licensing;

6. Permanent relocation of acute care services to other buildings or facilities (identify services affected);

7. Temporary/interim relocation of acute care services to other buildings including the duration of the approved program flexibility plan pursuant to Health and Safety Code Section 1276.05;

8. Construction period; and

9. Beneficial occupancy.

1.4.4.5 Existing and planned buildings matrix. Provide the following matrix of construction information for each building of the facility under the acute care license, include the Structural Performance Category (SPC) and Nonstructural Performance Category (NPC) for all hospital buildings (see Tables 2.5.3 and 11.1). Identify each building addition separately.

1.4.5 Compliance plan update/change notification. A change to an approved Compliance Plan shall be submitted by a hospital owner when the method or schedule to achieve compliance changes.

An owner of a hospital building not in compliance with Health and Safety Code Section 130065 shall submit for review and approval a revised compliance plan to the Department no later than January 1, 2026.

A revised Compliance Plan shall contain the following information at a minimum:

1. Facility name, address and five-digit facility identification number;

2. List of all hospital buildings in use by the facility for general acute care that are not in full compliance with Section 130065 of the Health and Safety Code, with an inventory of services in each affected building;

3. Proposed Method of Compliance for each building:

• a. Retrofit – modify the building in a manner that qualifies for a performance rating of SPC-4D or SPC-5 and NPC-5; If retrofit is the proposed method of compliance, describe the method of improvement for each affected building’s structural (SPC) and non-structural (NPC) performance rating.

  - b. Replace – relocation of general acute care services to an existing conforming building; 
  
  - c. Rebuild – relocation of general acute care services to a new SPC-5/NPC-5 building. 
  

  4. Compliance program schedule. Schedule provides anticipated dates for submission of the following activities:

     • a. Pre-design scopes of work including geotechnical studies, materials testing sampling and reports and retrofit concept review.

     • b. Design-phase activity, to include timing for plan submission and approval.

     • c. Construction-phase activity, to include permit date, construction commencement and completion.

  5. List of approved OSHPD project numbers and titles related to the seismic compliance improvement plan for each building, including building evaluations, materials testing project and test reports, and compliance construction projects.

• 1.4.5.1 Change in seismic performance category. The SPC or NPC for a hospital building shall be permitted to be changed by the Office from the initial determination in Section 1.3.3 or 1.3.4, provided the building has been modified to comply with the require-

ments of the California Existing Building Code (Part 10 of Title 24) for the specified SPC or NPC. The SPC of a hospital building shall also be permitted to be changed based on the following:

1. Collapse probability assessments in accordance with Section 1.4.5.1.2; or

2. Analysis or retrofit in accordance with Section 1.4.5.1.3.

• 1.4.5.1.1 The SPC or NPC for a hospital building may be in accordance with by the Office from the initial determination made per Sections 2.0.1.2.3 or 11.0.1.2.1 upon the following:

  1. A Seismic Evaluation Report shall be submitted and approved which shall include either or both of the following:

     • 1.1. A structural evaluation report in accordance with Section 1.3.3;

     • 1.2. A nonstructural evaluation report in accordance with Section 1.3.4.

       • Exception: To change an NPC 1 hospital building to an NPC 2 under this section, the nonstructural evaluation may be limited in scope to the systems and equipment specified in Section 11.2.1.

  2. The building has been modified to comply with the requirements of the California Existing Building Code (Part 10 of Title 24) for the specified SPC or NPC.

1.4.5.1.2 Hospital buildings with an SPC 1 rating, may be reclassified to SPC 2 by the Office, pursuant to Table 2.5.3, on the basis of a collapse probability assessment in accordance with Section 1.4.5.1.2 Item 1 provided the hospital buildings received an extension to the January 1, 2008, compliance deadline in accordance with Section 1.5.2.

• Exception: Hospital buildings with the potential for surface fault rupture and surface displacement at the building site (Section 9.3.3) are not eligible for reclassification.

1. Hospital buildings with SPC 1 rating may be reclassified as follows:

     - a) The Office shall issue a written notice to the hospital owners informing them that they may be eligible for reclassification of their SPC 1 buildings as permitted by this section. 
   
     - b) For an SPC-1 building to be considered for reclassification to the SPC-2 rating, the hospital owner shall request a collapse probability assessment. The request shall include at a minimum the information and documents specified in Section 1.8.
   

• 1.4.5.1.2.1 Upon assessment of the collapse probability of the SPC-1 building, the Office shall notify the hospital owner in writing the final SPC rating of the subject building.

Every building with collapse probability more than 0.75 percent, but less than or equal to 1.20 percent, shall be altered, repaired or seismically retrofitted to mitigate any deficiencies identified in accordance with Article 10 Sections 10.1.1.1, 10.1.2.2, 10.1.6 and 10.1.7 of this chapter (as part of the complete seismic evaluation in accordance with Section 1.3.3) by January 1, 2015. Hospitals not meeting the deadline set by this section shall not be issued a building permit for any noncompliant building except those required for seismic compliance in accordance with the California Administrative Code (Chapter 6), maintenance, and emergency repairs until the building permit required by this section is issued.

• 1.4.5.1.2.2 When the collapse probability assessment by the Office results in the building remaining in SPC 1, further evaluation may be provided by the hospital owner in accordance with Section 2.7 in order to substantiate a higher SPC rating.

• 1.4.5.1.3 Nonconforming hospital buildings shall be permitted to be reclassified to SPC-4D, pursuant to Table 2.5.3, in accordance with the CEBC Sections 304A.3.3 and 304A.3.4.5, 501A.3.1, or 501A.3.2.

Exceptions: Hospital buildings with the following deficiencies are not eligible for reclassification to SPC-4D:

1. Hospital buildings with the potential for surface fault rupture and surface displacement at the building site (Section 9.3.3).

2. Unreinforced Masonry shear wall buildings (Section 5.4), and

3. Precast Concrete buildings (Sections 4.4, 5.2 & 7.4).

1.4.5.1.4 Except as provided in Section 1.4.5.1.5, a nonconforming hospital building that does not meet the structural and nonstructural requirements of Table 2.5.3 and Table 11-1 shall not provide acute care services or beds after the compliance deadlines set forth in Section 1.5.1. After these deadlines, the following shall apply.

1. A nonconforming hospital building used as a hospital outpatient clinical services building shall not be classified as a hospital building. It shall comply with the provisions of Health and Safety Code Section 129725. It shall not be subject to the requirements of Title 24, Part 1, Chapter 6.

2. A nonconforming hospital building used as an acute psychiatric hospital or multistory skilled nursing facility or intermediate care facility shall be classified as a hospital building. However, it shall not be subject to the requirements of Title 24, Part 1, Chapter 6.

3. A nonconforming hospital building used as a single-story wood frame or light steel frame skilled nursing facility or intermediate care facility shall not be classified as a hospital building, and shall not be subject to the requirements of Title 24, Part 1, Chapter 6.

4. A nonconforming hospital building used for purposes other than those listed above shall not be classified as a hospital building; shall not be licensed pursuant to Health and Safety Code Section 1250(a); shall not be subject to the requirements of Title 24, Part 1, Chapter 6; and shall not be under the jurisdiction of the Office.

1.4.5.1.5 A hospital building from which acute care services and beds have been removed or a nonconforming hospital building without SPC or NPC rating shall not provide general acute care services unless it has been modified to comply with the requirements of SPC-4D or SPC 5 and NPC 4, NPC 4D or NPC 5. Prior to use for acute care service, the SPC and/or NPC of the hospital building shall be changed in accordance with Section 1.4.5.1.1 or 1.4.5.1.3.

All general acute care hospital owners shall comply with the seismic performance categories, both SPCs and NPCs, established in the seismic evaluation procedures, Articles 2 and 11 and set forth in Tables 2.5.3 and 11.1, respectively.

1.5.1 Compliance deadlines.

1. Before January 1, 2020, the owner of an acute care inpatient hospital where buildings are rated SPC 1 or SPC 2; or where the NPC rating is less than 5, shall submit to the Office an attestation that the board of directors of that hospital is aware that the hospital building is required to meet the January 1, 2030, deadline for substantial compliance with those regulations and standards.

2. After January 1, 2020, any general acute care hospital building which continues acute care operation must, at a minimum, meet the nonstructural requirements of NPC 2, as defined in Article 11, Table 11.1 or shall no longer be granted a building permit for construction work in such building except those required for seismic compliance in accordance with the California Administrative Code (Chapter 6), maintenance, and emergency repairs.

3. After January 1, 2030, any general acute care hospital building which continues acute care operation must, at a minimum, meet the structural requirements of SPC 3, 4, 4D or 5, as defined in Article 2, Table 2.5.3 and the nonstructural requirements of NPC 5, as defined in Article 11, Table 11.1 or shall no longer provide acute care services.

1.5.2 Delay in compliance.

1. Requirements for NPC. For any general acute care hospital building, the following shall apply:

   • 1.1. By January 1, 2024, the hospital owner shall submit to the Office a complete nonstructural evaluation up to NPC 4 or 4D and NPC 5, for each building.

   • 1.2. By March 1, 2026, the hospital owner shall submit to the Office construction documents for NPC 4 or 4D and NPC 5 compliance that are deemed ready for review by the Office, for each building that will continue to provide acute care services beyond January 1, 2030.

     • Exception: Buildings that have been removed from general acute care service, or have projects to remove the building from acute care services by January 1, 2030.

   • 1.3. By March 1, 2028, the hospital owner shall obtain a building permit to begin construction, for NPC 4 or 4D and NPC 5 compliance of each building that the owner intends to use as a general acute care hospital building after January 1, 2030. Hospitals not meeting the March 1, 2028 deadline set by this section shall not be issued a building permit for any noncompliant building except those required for seismic compliance in accordance with the California Administrative Code (Chapter 6), maintenance, and emergency repairs until the building permit required by this section is issued.

acute care hospital building after January 1, 2030. Hospitals not meeting the March 1, 2028 deadline set by this section shall not be issued a building permit for any noncompliant building except those required for seismic compliance in accordance with the California Administrative Code (Chapter 6), maintenance, and emergency repairs until the building permit required by this section is issued.

  - **Exception:** If the hospital has obtained an extension for SPC compliance, the NPC compliance deadlines shall coincide with the approved SPC extension deadlines and the requirements of Sections 1.5.2 shall be deemed to be satisfied. 

• 1.4. After March 1, 2028, for buildings with an NPC 3 or lower rating, all remodels/renovations, or other construction work, shall include anchorage and/or bracing of all equipment and services within the boundary of the scope of work that is not in compliance with NPC 4 or NPC 4D.

  • Exception 1: Remodels/renovations, or other construction work, that remove a room or space from service use or occupancy for less than 24 hours.

Exception 2: Where 20 percent or less of the affected existing construction, such as ceilings, walls, and ducts, but independent of finishes, is removed to access equipment and services for anchorage/bracing may be reinstalled as it pre-existed prior to the NPC work, as long as it was in compliance with the code at the time it was installed/constructed.

Exception 3: Buildings that have been removed from general acute care service, or have projects to remove the building from acute care services by 2030.

• 1.5. Any general acute care hospital building (located in Seismic Design Category D or F) granted an extension up to January 1, 2020 or beyond is deemed to comply with the terms of the extension if all of the following conditions are met:

  • 1.5.1. The hospital meets the anchorage and bracing requirements for NPC 2.

  • 1.5.2. The building is upgraded to NPC 3 in accordance with the compliance timeframes specified in Table 11.1. Exception: The building is SPC-2, the method of compliance is to remove the building from general acute care service by 2030, and no SPC-4D projects have been submitted to the Office.

2. Requirements for SPC.

   1. Extensions beyond January 1, 2020.

      • 1.1. The Office may grant the hospital owner an additional extension to the January 1, 2020 seismic compliance deadline for each SPC 1 building where all the following conditions are met:

        • (a) An extension was previously granted pursuant to California Health and Safety Code, Section 130060(g) or Section 130061.5(b).

        • (b) A prior compliance plan corresponding to a replacement, retrofit or rebuild project was submitted to the Office by January 1, 2018.

        • (c) The application for an extension is submitted by the owner on a form provided by the Office, and received by the Office no later than April 1, 2019.

• (d) The application, one per building, shall identify the seismic compliance method chosen based on a replacement, retrofit or rebuild plan as defined in definitions Section 1.2 of this chapter, for addressing the acute care functions in the SPC-1 building.

     - (e) Documentation of facts necessary in determining the maximum length of the extension that may be granted in accordance with subsection 2.1.1 shall be submitted with the application. 
  
        - 1.1.1. Maximum Length of Extension. The Office shall not grant an extension that exceeds the amount of time needed by the owner to come into compliance. The length of the extension to be granted shall be based upon a showing by the owner of the facts necessitating the additional time. It shall include a review of the plan and all the documentation submitted in the application for the extension, and shall permit only that additional time necessary to allow the owner to deal with compliance plan issues that cannot be fully met without the extension. 
  
        - 1.1.2. Extension for Replacement or Retrofit Plan Where Construction Has Not Started. For an extension request based on a replacement plan or retrofit plan, final seismic compliance shall be achieved, a certificate of occupancy or construction final shall be obtained by July 1, 2022 and the following conditions shall apply: 
  
           1. Application submitted shall contain an extension schedule that identifies: 
  
              - a. The maximum extension time requested, but no later than July 1, 2022. 
  
              - b. Date when building permit will be obtained. 
  
              - c. Date the hospital will begin construction. 
  
           2. A construction schedule shall be submitted within 15 calendar days of obtaining a building permit. The construction schedule shall identify a minimum of two major milestones acceptable to the office that will be used as a basis for determining whether the hospital is making adequate progress. Major milestones identified in the construction schedule shall be chosen such that they are easily verifiable by the Office. 
  
           3. Obtain a building permit. 
  
           4. Start construction.
  

Compliance with the requirements in (1 through 4) above shall be achieved no later than April 1, 2020.

• 1.1.3. Extension for Rebuild Plan Where Construction Has Not Started. For an extension requested based on a rebuild plan, final seismic compliance shall be achieved, a certificate of occupancy shall be obtained by January 1, 2025 and the following shall apply:

  1. Application submitted, shall contain an extension schedule that identifies:

     • a. The maximum time request for the extension, but no later than January 1, 2025.

     • b. Date of submission of the rebuild project deemed ready for review to the Office, but no later than July 1, 2020.

     • c. Date when building permit will be obtained.

     • d. Date the hospital will begin construction.

  2. Submission of the rebuild project deemed ready for review to the Office shall occur no later than July 1, 2020.

3. A construction schedule submitted within 15 calendar days of obtaining a building permit. The construction schedule shall identify a minimum of two major milestones acceptable to the office that will be used as a basis for determining whether the hospital is making adequate progress. Major milestones identified in the construction schedule shall be chosen such that they are easily verifiable by the Office.

4. Obtain a building permit.

5. Start construction.

Compliance with the requirements in Items 3 through 5 above shall be achieved no later than January 1, 2022.

           - 1.1.4. Extension where Construction has Started. For a hospital building that has previously submitted to the Office a retrofit, replace or rebuild project for which a retrofit, replace or rebuild project was previously submitted to the Office and is under construction, the application for an extension shall contain all the following: 

              1. The method of compliance with the requested extension which shall be no later than July 1, 2022 for retrofit or replace plan and January 1, 2025 for rebuild plan. The application shall include the facts necessitating the additional time. 

              2. The project number under which the construction has commenced and is continuing. 

              3. A revised construction schedule to reflect the extension being requested and at least two major milestones shall be identified. Major milestones shall be chosen such that they are easily verifiable by the Office. 

  - 1.2. Quarterly Status Reports. A hospital granted an extension pursuant to this section shall provide a quarterly status report in a form required by the Office, consistent with their extension/construction schedule. The first report is due on July 1, 2019, and subsequent status reports shall be due every October 1, January 1, April 1, and July 1 until seismic compliance is achieved. Each quarterly report shall contain the cumulative progress made towards meeting the dates in the extension and the construction schedules, current to 15 calendar days before the report is due. The report may be submitted to the Office no more than 15 calendar days before the due date. 

  - 1.3. Fines for Failure to Comply. Failure to comply with the dates for plan submission, construction schedule submission, obtain a building permit, to begin construction identified and accepted by the Office in the extension schedule or the major milestone dates identified and accepted by the Office in the construction schedule shall result in the assessment of a fine of five thousand dollars ($5,000) per calendar day until the requirements or milestones, respectively, are met. The Office shall not issue a construction final or certificate of occupancy for the building until all assessed penalties accrued pursuant to this section have been paid in full or, if an appeal is pending, have been posted subject to resolution of the appeal.

n the assessment of a fine of five thousand dollars ($5,000) per calendar day until the requirements or milestones, respectively, are met. The Office shall not issue a construction final or certificate of occupancy for the building until all assessed penalties accrued pursuant to this section have been paid in full or, if an appeal is pending, have been posted subject to resolution of the appeal.

  - 1.4. Adjustments to Schedules. The Office may grant an adjustment as necessary to deal with contractor, labor, material delays, with acts of God, or with governmental entitlements, experienced by the hospital. The hospital shall submit the reason for the delay along with substantiating documents, a revised construction schedule and identify at least two new major milestones consistent with the adjustment. Requests for adjustments shall be made with the Office as soon as the reasons for the delay are known but no less than 30 calendar days before any upcoming affected extension schedule or construction milestone date. 

        - Failure to comply with the revised construction schedule or meet any of the major milestones shall result in 

        - penalties as specified in subsection 2.3. The adjustment shall not exceed the corresponding final seismic compliance date of July 1, 2022 for a replacement plan or retrofit plan and January 1, 2025 for a rebuild plan. 

3. Extensions beyond the January 1, 2030 deadline. For both the structural and nonstructural requirements for qualifying hospitals under Item (a) or (b) and which satisfy the requirements in Item (c) of this section are eligible for extensions beyond the January 1, 2030 deadline, subject to the additional requirements in Items (d) through (g).

   • This section does not apply to Structural Performance Category-1 buildings.

   • (a) A Distressed Hospital Loan Program recipient, a small hospital, a rural hospital, a critical access hospital, or a health care district hospital, except as otherwise provided in this section, may seek approval from the Department for a delay to the January 1, 2030 compliance deadline of up to three years with the submission and departmental approval of a seismic compliance plan, submitted in accordance with Section 1.4 of Article 1 of Chapter 6 of Title 24 of the California Administrative Code by January 1, 2026, and a Nonstructural Performance Category-5 evaluation report, submitted in accordance with Article 11 of Chapter 6 of Title 24 of the California Administrative Code to the Department by January 1, 2025.

   • (b) Hospitals that belong to integrated health care systems with two or more separately licensed hospital facilities shall be ineligible for a delay under Item (a), including a health care district hospital that has a contractual agreement with a health system that imposes upon the health system any financial responsibility for the health care district’s infrastructure costs for compliance with Health and Safety Code Section 130065, unless the entire integrated health care system is determined by the Department to be in financial distress.

     • Exception: Item (b) does not apply to any of the following:

• (1) A rural hospital with fewer than 80 general acute care beds and general acute care hospital revenue of seventy-five million dollars ($75,000,000) or less, as reported to the Department pursuant to Health and Safety Code Section 128740 in 2020.

  • (2) A hospital that is part of an integrated health care system that is operated by a health care district or a nonprofit corporation that is affiliated with the health care district hospital owner by means of the district’s status as the nonprofit corporation’s sole corporate member.

• (3) A health care district hospital that does not have a contractual, management, lease, or operating agreement with a health system that imposes upon the health system any financial responsibility for the health care district’s infrastructure cost for compliance with Health and Safety Code Section 130065.

• (c) The hospital owner requesting an extension in accordance with this section must submit to the Department, the following:

  • (1) A Nonstructural Performance Category-5 evaluation report in compliance with Article 11 of Chapter 6 of Title 24 of the California Administrative Code for each building, if necessary, by no later than January 1, 2025.

  • (2) The hospital’s seismic compliance plan in accordance with Section 1.4 of Article 1 of Chapter 6 of Title 24 of the California Administrative Code and related regulations by January 1, 2026. The seismic compliance plan shall outline steps, including milestones, to achieve compliance with seismic safety standards at the earliest reasonable date, but by no later than January 1, 2033. The seismic compliance plan shall be approved by the Department subject to the following:

    • (i) The subject hospital shall identify at least two major milestones relating to the seismic compliance plan that will be used as the basis for determining whether the hospital is making adequate progress toward meeting the subject hospital’s seismic compliance deadline.

    • (ii) If the seismic compliance plan includes a compliance schedule that is delayed beyond the 2030 seismic compliance deadline, the hospital shall submit any documentation requested by the Department to assist the Department in its review of the reasonableness of the compliance schedule.

    • (iii) The Department shall within 120 days of the submittal deadline approve or deny the hospital’s seismic compliance plan and any delay to the seismic compliance deadline submitted in accordance with Section 1.4. If the Department determines the compliance schedule is unreasonable based on the information submitted, the Department shall notify the hospital and provide the Departmental rationale for its determination. The hospital shall be given the opportunity to address the identified concerns or to provide additional information to substantiate the compliance schedule.

ed in accordance with Section 1.4. If the Department determines the compliance schedule is unreasonable based on the information submitted, the Department shall notify the hospital and provide the Departmental rationale for its determination. The hospital shall be given the opportunity to address the identified concerns or to provide additional information to substantiate the compliance schedule.

• (d) The Department may additionally delay the amount of time for hospitals that qualify for the extension under Items (a) or (b) by two years, up to a maximum of January 1, 2035. This delay may be authorized as necessary for hospitals that continue to experience financial distress or that need to deal with contractor, labor, or material delays, acts of God, governmental entitlements, or other circumstances beyond the hospital’s control. If up to an additional two-year delay is granted, the hospital shall submit a revised construction schedule and associated milestones to the Department.

The hospital requesting the extension shall provide the Department with information that the Department deems necessary, including information to assess whether the hospital is in financial distress or continues to be in financial distress.

The Department will make a determination of financial distress using financial criteria, including, days cash on hand, current ratio, access to working capital, operating margin, cash burn rate, the financial impact of mandatory seismic compliance costs on the hospital or integrated health care system, and other methodologies developed pursuant to Chapter 4 (commencing with Health and Safety Code Section 129380) of Part 6 of Division 107 of the Health and Safety Code.

If the Department determines that an eligible hospital or integrated health care system is no longer in financial distress and is not likely to return to financial distress due to complying with seismic safety standards, the hospital or integrated health care system shall submit a revised seismic compliance plan to the Department for review and approval one month after being informed of the Department’s determination that the hospital or integrated health care system is no longer in financial distress. Notwithstanding any delay of the January 1, 2030, seismic requirements granted to the hospital or integrated health care system pursuant to Item (a), the Department may adjust compliance deadlines to reflect the fact that the hospital or integrated system is no longer in financial distress.

• (e) Adjustments to Schedules. The Department may grant an adjustment as necessary to deal with contractor, labor, material delays, with acts of God, or with governmental entitlements, experienced by the hospital. The hospital shall submit the reason for the delay along with substantiating documents, a revised construction schedule and identify new milestones consistent with the adjustment. Requests for adjustments shall be made with the Department as soon as the reasons for the delay are known but no less than 30 calendar days before any upcoming affected extension schedule or construction milestone date.

The hospital shall submit the reason for the delay along with substantiating documents, a revised construction schedule and identify new milestones consistent with the adjustment. Requests for adjustments shall be made with the Department as soon as the reasons for the delay are known but no less than 30 calendar days before any upcoming affected extension schedule or construction milestone date.

Failure to comply with the revised construction schedule or meet any of the major milestones shall result in penalties as specified in Items (f) and (g) The adjustment shall not exceed the corresponding final seismic compliance date of January 1, 2033, under Item (a) or January 1, 2035, under Item (d).

• (f) Failure to comply with the construction schedule or meet any milestone established by the Department and the hospital shall result in the assessment of a fine of five thousand dollars ($5,000) per calendar day until the requirements or milestones, respectively, are met.

• (g) Hospitals that fail to meet any milestone or seismic compliance deadline approved in its compliance plan shall not be issued a building permit for any building in the facility except those required for seismic compliance, maintenance, and emergency repairs until the milestone is met and the hospital is adequately progressing toward meeting the subject hospital’s seismic compliance, as determined by the Department.

Dispute resolution and appeals shall be in conformance with Article 5, Chapter 7, Part 1 of Title 24.

1.7 Notification from OSHPD.

1. The Office shall issue written notices of compliance to all hospital owners that have attained the minimum required SPC and NPC performance levels by the required seismic compliance dates or extension dates granted by the Office;

2. The Office shall issue written notices of violation to all hospital owners that are not in compliance with the minimum SPC and NPC performance levels by the required seismic compliance dates or extension dates granted by the Office; and

3. The Office shall notify the State Department of Health Services of the hospital owners which have received a written notice of violation for failure to comply with these regulations.

Hospital owners may request a collapse probability assessment to reclassify buildings with an SPC-1 rating to SPC-2 in accordance with Section 1.4.5.1.2, or be used to determine eligibility for an extension in accordance with Section 1.5.2 Item 8.

1.8.1 The collapse probability assessment by the Office shall be determined using the following:

1. Multi-Hazard Loss Estimation Methodology, Earthquake Module (HAZUS-MH) developed by the Federal Emergency Management Agency (FEMA)/National Institute of Building Sciences (NIBS).

2. Building specific input parameters required by the Advanced Engineering Building Module (AEBM) of the HAZUS methodology shall be obtained from Appendix H to Chapter 6.

3. Modifications by the Office to the AEBM input parameters are hereby adopted as shown in Appendix H to Chapter 6, which are based on the following:

   • a) Building type

   • b) Building height and number of stories

   • c) Building age

   • d) Significant Structural Deficiencies listed in Section 1.8.2 Item 2.

4. Site seismicity parameters adjusted for soil type, as determined by the Office, shall be the lesser of:

   • a) Deterministic ground motion due to the maximum magnitude earthquake event on the controlling fault system.

   • b) Probabilistic ground motion having 10 percent probability of being exceeded in 50 years.

1.8.2 The collapse probability assessment for SPC-1 buildings shall be based on the following building information, parameters and documents:

1. A complete seismic evaluation of the building pursuant to Section 1.3.3.

   • Exception: Hospital owners who had submitted a complete structural evaluation report in compliance with Section 1.3.3, that is deemed to be complete by the Office, need not resubmit.

2. A supplemental evaluation report prepared by a California registered structural engineer that identifies the existence or absence of the building structural Lateral Force Resisting System (LFRS) properties and Significant Structural Deficiencies listed below:

   • a. Age: Year of the California Building Code (CBC) used for the original building design. Exception: For pre-1933 buildings, the design year shall be reported.

   • b. Materials Tests: Office approved materials test results based on test plan preapproved by the Office (Section 2.1.2). c. Load path (Section 3.1).

   • d. Mass irregularity (Section 3.3.4).

   • e. Vertical discontinuity (Section 3.3.5).

   • f. Adjacent buildings (Section 3.4).

   • g. Short captive column (Section 3.6).

   • h. Material deterioration (Section 3.7).

   • i. Weak columns (Sections 4.2.8 and 4.3.6).

   • j. Wall anchorage (Section 8.2).

   • k. Redundancy (Section 3.2).

   • l. Weak story irregularity (Section 3.3.1).

   • m. Soft story irregularity (Section 3.3.2).

   • n. Torsional irregularity (Section 3.3.6).

• o. Deflection incompatibility (Section 3.5).

• p. Cripple walls (Section 5.6.4).

• q. Openings (in diaphragm) at shear walls (Section 7.1.4).

• r. Topping slab missing (Sections 7.3 and 7.4) or the building type (structural system) is of lift slab construction.

• s. URM wall height to thickness ratio (Section 5.4.3).

• t. URM Parapets (Section 10.1.6).

This supplemental evaluation report shall include supporting documentation including existing construction drawings or reconstructed as-builts (Section 2.1.2) relating to the existence or absence of the Significant Structural Deficiencies listed above including calculations, where required, for review and acceptance by the Office, unless they are included in the complete structural evaluation.

3. Building systems shall be classified as to their Model Building Type in accordance with Table 1.8. For buildings with multiple building types, all types shall be listed. The building type resulting in the maximum collapse probability will be utilized by the Office to determine eligibility for reclassification.

4. Building height and number of stories above and below the seismic base shall be specified.

5. For SPC-1 buildings where the potential for surface fault rupture and surface displacement at the building site is present as determined by Section 9.3, a supplemental geologic hazards report prepared by a California registered engineering geologist/seismologist is required to address the following:

   • a. A site plan showing diagrammatically the location of the building footprint, the surface trace or traces of potential surface fault rapture.

   • b. The expected surface displacement during a rupture event.

1.9 Small and Rural Hospital Relief Program is established in statute for the purpose of providing funding for improvement of a building’s seismic performance rating. The program is administered by HCAI, who is responsible for issuing grants to facilities for seismic improvement projects. A grant provided under this program may be used only for funding seismic safety compliance.

1.9.1 Eligibility. HCAI determines eligibility of a hospital to participate in this program in accordance with the following criteria:

• a. Small hospital.

• b. Rural hospital.

• c. Critical access hospital.

• d. Distressed Hospital Loan Program recipient that seeks delay under Section 1.5.2, Item 3, beyond the January 1, 2030 deadline.

• e. Health care district hospital that seeks delay under Section 1.5.2, Item 3, beyond the January 1, 2030 deadline. The eligible hospitals shall meet both of the following criteria:

  1. Compliance imposes a financial burden on the applicant that may result in hospital closure.

2. The hospital closure would substantially impact the accessibility of health care in the communities surrounding the hospital.

1.9.2 Grant Requirements .

1. Grants shall provide a general acute care hospital with funds to secure an SPC-4D assessment for purposes of planning for, and estimating the costs of, complying with Health and Safety Code Section 130065.

2. A general acute care hospital receiving a grant for an assessment shall provide the estimated cost of SPC-4D compliance to the Department.

3. A general acute care hospital that has received a grant for an assessment may apply for a grant for purposes of complying with Health and Safety Code Section 130065.

4. For a general acute care hospital that already has an SPC-4D assessment approved by the Department, the Department may award the general acute care hospital grant money for purposes of complying with Health and Safety Code Section 130065.

5. If state funds are appropriated to the Small and Rural Hospital Relief Fund for the purpose of complying with Health and Safety Code Section 130065, before being awarded state funds, a hospital that qualifies for assessment grants shall submit financial information to HCAI, on a form as required by HCAI, related to all of the following:

   • a) Whether the hospital has attempted to secure other methods of funding for SPC-4D compliance, including federal funding, and if not, the reason why.

   • b) The accuracy of the hospital’s SPC-4D cost estimates and confirmation that the estimated costs are only for purposes of SPC-4D compliance.

   • c) The hospital’s need for assistance due to financial hardship and lack of ability to finance the required improvements, in order to access state funds.

6. In awarding grants, HCAI shall have the authority to deny any costs from the completed assessment that the Department determines are not necessary to comply with SPC-4D requirements.

1.10 Integrated Review for seismic compliance projects.

1. Purpose. The purpose of integrated review is to provide technical assistance to a hospital’s project team in the development of a cost-efficient structural or non-structural seismic retrofit program. A cost-efficient retrofit program is one that achieves a compliant condition for SPC-4D/SPC-5 and NPC-3/NPC-4/NPC-4D and NPC-5 with no more work than is necessary to attain the rating while limiting impact to operations from project delivery.

2. Voluntary requests. The Department, at its sole discretion, may enter into a written agreement with the hospital governing board or authority for an Integrated Review. A hospital may request Integrated Review to aid in the planning and implementation of a seismic retrofit project for a general acute care hospital building. The fee for Integrated Review shall be on a Time and Materials Basis.

1.11 Public notices.

1. On or after January 1, 2023, a hospital building that is classified as SPC-2 shall be labeled with the words, “These buildings do not significantly jeopardize life, but may not be repairable or functional following an earthquake” on the department’s internet website and in the following documents. A hospital building that is classified as both SPC-5 and NPC-5 may be labeled “earthquake resilient” on the department’s internet website and in the following documents:

Documents required to include building labeling:

• a. On the title sheet of construction drawings and title sheet of specifications. The following documents and/or forms are excluded: Amended Construction Documents (ACD), Calculations, and Testing, Inspection & Observation (TIO).

• b. On the title sheet of seismic compliance evaluation reports.

2. Before January 1, 2024, the owner of an acute care inpatient hospital shall post a notice in a public space, designated as any lobby or waiting area, for each general acute care building, except for buildings with SPC-3/NPC-5, SPC-4D/NPC-5, SPC-4/NPC-5, or SPC-5/NPC-5 ratings. A project shall be submitted to the Office for the proposed location and the content of the notice. The notice sign shall be in accordance with the California Building Code , California Code of Regulations, Title 24, Part 2, Volume 1, Chapter 11B, DIVISION 7, Section 11B-703.5 Visual characters . For all notice types, the SPC and NPC rating of the building shall be included. The required format of the notice is published on the OSHPD website.

   • For each general acute care hospital building, the type of notices shown in Table 1.11 are required.

Notice Type A:

“The State of California has determined that this hospital building does not meet seismic safety standards. This building may jeopardize life and is a danger to the public in an earthquake.”

Notice Type B:

“The State of California has determined that this building does not significantly jeopardize life, but may not be repairable or functional following an earthquake.”

Notice Type C:

“The State of California has determined that the hospital building is at risk of not being functional to provide care to its patients or the community after an earthquake.”

Notice Type D:

“The State of California has determined that the hospital building meets seismic safety standards, but the hospital building may not be functional to provide care to its patients or the community after an earthquake.”

Notice Type E:

“The State of California has determined that the hospital building meets seismic safety standards and designated this building as an Earthquake Resilient Building.”

On or before January 1, 2024, and annually thereafter, the owner of an acute care inpatient hospital that includes a general acute care building that is not SPC-3/NPC-5, SPC-4D/NPC-5, SPC-4/NPC-5, or SPC-5/NPC-5 shall provide an annual status update on the Structural Performance Category ratings of the buildings and the services provided in each hospital building on the hospital campus to all of the following entities:

1. The county board of supervisors in whose jurisdiction the hospital building is located.

2. The city council in whose jurisdiction the hospital building is located, if applicable.

3. Any labor union representing workers who work in a general acute care building that is not SPC-3/NPC-5, SPC-4D/NPC-5, SPC-4/NPC-5, or SPC-5/NPC-5.

4. The board of directors of the special district or joint powers agency that provides fire and emergency medical services in the jurisdiction in which the hospital building is located, if applicable.

5. The department.

6. The board of directors of the hospital.

7. The local office of emergency services or the equivalent agency.

8. The Office of Emergency Services.

9. The medical health operational area coordinator.