Section 309A

REMOVAL OF HOSPITAL BUILDINGS FROM

GENERAL ACUTE CARE SERVICES

309A.1 General. The requirements of this section shall apply¶

when general acute care services are completely removed from SPC buildings or when buildings are removed from OSHPD jurisdiction. All buildings that remain under the OSHPD jurisdiction, after one or more SPC buildings are removed, shall satisfy the requirements of the California Building Standards Code. Approval of construction docu- ments and a building permit are required for removal of SPC Buildings from general acute care services or removal of buildings from OSHPD jurisdiction.

309A.1.1 Buildings without approved extensions. An SPC-1 hospital building without an approved delay in compliance requirements in accordance with the Califor- nia Administrative Code (CAC) Chapter 6 Section 1.5.2 or past the extension date granted in accordance with the CAC Chapter 6 Section 1.5.2 shall not be issued a build- ing permit until a project to remove the subject SPC-1 building from general acute care services has been approved, permitted, and closed in compliance by the Office.

Exception: Building permits for seismic compliance, maintenance and repair shall be permitted to be issued.

309A.2 Definitions. The following words and terms are¶

applicable to this section only:

BUILDING. The area included within surrounding exterior walls or any combination of exterior walls and fire walls (as described in California Building Code Sections 202 and 706) exclusive of vent shafts and courts. Areas of the building not provided with surrounding walls shall be included in the building area if such areas are included within the horizontal projection of the roof or floor above. A building may consist of one or more adjacent SPC buildings.

GENERAL ACUTE CARE SERVICE. Means basic and supplemental services, as defined in California Building Code Section 1224.3, provided in a general acute care build- ing, as defined in California Building Code Section 202 and the California Administrative Code, Chapter 6, Section 1.2.

STRUCTURAL SEPARATION. Means a building separa- tion in accordance with the California Building Code.

309A.3 Establishing eligibility for removal from general¶

acute care service. In order to establish that one or more SPC buildings are eligible for removal from general acute care service, the hospital owner shall submit construction documents showing that after the SPC buildings are removed from general acute care service:

1. All basic acute care services or supplemental services on the hospital’s license are provided in SPC buildings satisfying the requirements for SPC-2, SPC-3, SPC-4, SPC-4D, or SPC-5.

Exception: If the hospital includes SPC-1 buildings that are not being removed from general acute care

PROVISIONS FOR ALL COMPLIANCE METHODS

308A.1.1.1.3 Existing SPC-3 or higher hospital buildings. Means of egress for remodels of existing SPC-3 or higher hospital buildings shall only pass through hospital buildings that have approved per- formance categories of SPC-2 or higher and NPC- 4 /NPC-4D or higher.

Exception: The means of egress shall be permit- ted to pass through hospital buildings that have approved nonstructural performance categories of NPC-3, or NPC-2 if the building has an approved extension to the NPC-3 deadline. Non- structural components in the path of egress shall be braced in accordance with the new building provisions of this code.

308A.1.1.1.4 Existing SPC-1 hospital buildings. Means of egress for remodels of existing SPC-1 hos- pital buildings shall only pass through hospital buildings that have approved performance catego- ries of SPC-1 or higher and NPC-2 or higher.

Exception: Means of egress for acute care ser- vice spaces for hospitals licensed pursuant to subdivision (a) of Section 1250 of the Health and Safety Code shall comply with the requirements of Section 308A.1.1.1.2.

308A.1.1.1.5 Other hospital buildings. Hospital buildings that would not otherwise require evalua- tion for an SPC rating, which are used as a part of the means of egress for hospital buildings, shall be evaluated in accordance with the requirements of Section 1.3, Chapter 6, of the California Administra- tive Code to determine the appropriate rating, or shall meet the structural requirements of these regu- lations for conforming hospital buildings. Means of egress shall be in accordance with the requirements of Sections 308A.1.1.1.1 through 308A.1.1.1.4.

308A.1.1.1.6 Buildings removed from hospital ser- vice. The means of egress for acute care hospitals shall be permitted to pass through buildings that are removed from hospital service only if the buildings remain under the jurisdiction of OSHPD, and only until January 1, 2030, subject to the following:

1. Egress for conforming hospital buildings shall be permitted to pass through buildings that have been removed from acute care hospital service that comply with the requirements of Section 308A.1.1.1.1 or 308A.1.1.1.3.

2. Egress for nonconforming hospital buildings shall be permitted to pass through buildings that have been removed from acute care hos- pital service that comply with the require- ments of Section 308A.1.1.1.2 or 308A.1.1.1.4.

After January 1, 2030, the means of egress for acute care hospital buildings shall only pass through hospital buildings that have approved per- formance categories of SPC-3 or higher and NPC-5.

308A.1.2 Jurisdiction. Means of egress shall only pass through buildings that are under the jurisdiction of the

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service, and these SPC-1 buildings have an approved extension to the SPC-2 deadline, basic acute care services or supplemental services on the hospital’s license are permitted to remain in these SPC buildings for the duration of their extension or until these SPC-1 buildings are removed from gen- eral acute care service, whichever comes first.

2. All basic acute care services or supplemental services on the hospital’s license are provided in SPC buildings satisfying the requirements for NPC-3, NPC-4/NPC- 4D, or NPC-5.

Exception: Services shall be permitted to be located in SPC buildings satisfying the requirements of NPC-2 if the SPC buildings have an approved exten- sion to NPC-3 deadline.

3. The hospital complies with all egress requirements, including occupant load, number of required exits and travel distance to exits, and provides evidence that no egress from any acute care hospital building passes through the SPC buildings removed from general acute care service, SPC-1 buildings, or through buildings not under OSHPD jurisdiction.

Exceptions:

1. If the SPC building has an approved extension to the SPC-2 deadline, existing egress through the SPC-1 building shall be permitted for the duration of the extension or until the SPC-1 building is removed from general acute care service, whichever comes first.

2. When permitted by Section 308A.1.1.1.6.

4. No SPC building removed from general acute care ser- vice is used as a smoke compartment for any acute care hospital building. Buildings not under OSHPD juris- diction shall not be used as a smoke compartment for any acute care hospital building.

5. Structural separation, fire barriers and fire walls shall satisfy the requirements of the California Building Standards Code.

Exception: An SPC seismic separation in accor- dance with the California Administrative Code Chapter 6 Section 3.4 shall be deemed to satisfy the building structural/seismic separation requirement in this section for SPC buildings that will remain under OSHPD jurisdiction.

6. If the SPC building removed from general acute care service shares a common fire alarm system with the acute care hospital, the main fire alarm control panel shall be located in an acute care hospital building. The SPC building removed from general acute care service shall be in a separate zone monitored by the main fire alarm control panel. Flexible connections shall be pro- vided for conduits/conductors crossing structural or SPC seismic separation joints. If the intent is to place the SPC building under local jurisdiction, the building shall satisfy Section 309A.5.1.

Exception: Flexible connections for fire alarm con- duits/conductors crossing seismic separation joints

PROVISIONS FOR ALL COMPLIANCE METHODS

between an SPC building removed from general acute care service and adjacent SPC-1 or SPC-2 buildings may be omitted, provided the fire alarm in the adjacent SPC-1 and SPC-2 buildings have no connection to any SPC-3, SPC-4, SPC-4D, and SPC-5 buildings providing general acute care ser- vice.

7. If the SPC building removed from general acute care service shares the fire sprinkler system with the acute care hospital, an isolation valve with a tamper switch shall be provided to isolate the portion of the system serving the SPC building removed from acute care ser- vice. Flexible connections shall be provided in piping that crosses structural or SPC seismic separation joints. The fire sprinkler system shall not originate in the SPC building removed from general acute care ser- vice. If the intent is to place the building under local jurisdiction, the building shall satisfy Section 309A.5.1.

Exception: Flexible connections for seismic separa- tion joints and fail safe shutoff valves, and discon- nects for utilities between an SPC building removed from general acute care service and adjacent SPC-1 or SPC-2 buildings may be omitted, provided utili- ties in the adjacent SPC-1 and SPC-2 buildings have no connection to any SPC-3, SPC-4, SPC-4D, and SPC-5 buildings providing general acute care ser- vice.

8. Patient access as required by California Building Code Section 1224.4.7.5 does not pass through an SPC building removed from general acute care service or through buildings that are not under the jurisdiction of OSHPD.

9. The primary accessible entrance to the hospital is not through an SPC building removed from general acute care service or through buildings that are not under the jurisdiction of OSHPD.

10. No utilities servicing acute care hospital buildings originate in or pass through, over, or under, an SPC building removed from general acute care service, except as permitted by Section 307A.1.1.1.5, or a build- ing not under OSHPD jurisdiction.

11. If utilities originating in an acute care hospital building feed an SPC building removed from general acute care hospital service, fail safe shutoff valves and/or discon- nects shall be provided that permit isolation of the SPC building removed from general acute care service from the hospital utilities. Flexible connections shall be pro- vided for all utilities crossing structural or SPC seismic separation joints.

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cies and services were in compliance at the time they were located in the SPC building. Any hospital support services located in the building removed from general acute care service, including administrative services, central sterile supply, storage, morgue and autopsy, employee dressing rooms and lockers, janitorial and housekeeping service, and laundry, shall be in excess of the minimum require- ments for licensure and operation. Prior approval by the California Department of Public Health shall be obtained by hospital to maintain these services in the SPC building removed from acute care service.

309A.4.3 Change of licensed services under existing license. A change of service or function for all, or a por- tion, of the SPC building removed from general acute care service requires compliance with the current requirements for that service, including accessibility requirements in accordance with California Building Code Chapter 11B.

309A.4.3.1 Skilled nursing or acute psychiatric ser- vices. When general acute care services are removed from an SPC building which is intended to be used for skilled nursing or acute psychiatric services, and the new services will be licensed under the existing license of the general acute care hospital these new services shall comply with Section 307A.1.1.1.5 for a noncon- forming hospital building.

309A.4.3.2 Outpatient clinical services. When general acute care services are removed from an SPC building which is intended to be used for outpatient clinical ser- vices under the existing acute care hospital, license, the building is required to comply with the current OSHPD 3 code requirements for the new service.

309A.4.4 SPC buildings removed from general acute care service with new license. When general acute care services are removed from an SPC building, and new ser- vices provided in the SPC building are issued an initial license, as determined by the California Department of Public Health, as a skilled nursing facility or acute psychi- atric hospital, the SPC building shall comply with the new building code requirements or equivalent provisions of the California Building Standards code at the time of applica- tion.

309A.4.5 Change of building occupancy or division. When an SPC building is removed from general acute care service with or without change of license, the new occu- pancy group and division of the building, and/or new ser- vice or function, shall be established . A new certificate of occupancy shall be required for the building removed from general acute care service.

309A.5 Change in jurisdiction for buildings removed from¶

general acute care service. Except as provided by Section 309A.5.3, at the hospital’s discretion, a building removed from general acute care service shall be permitted to be placed under the jurisdiction of the local enforcement agency. To be eligible for a change in jurisdiction, the build- ing removed from general acute care service shall satisfy the requirements of Section 309A.5.1.

PROVISIONS FOR ALL COMPLIANCE METHODS

309A.4 Buildings intended to remain under OSHPD juris-¶

diction.

309A.4.1 Qualifying nonacute care services . In order for a freestanding building, as defined in the California Administrative Code, Section 7-111, that is removed from general acute care service, to remain under OSHPD juris- diction, it shall contain one or more qualifying services. Qualifying services include:

a. Services considered “Outpatient Clinical Services”

as defined in H&SC §129730(a):

i. Administrative space

ii. Central sterile supply

iii. Storage

iv. Morgue and autopsy facilities

v. Employee dressing rooms and lockers

vi. Janitorial and housekeeping facilities

vii. Laundry

b. Outpatient portions of the following services (with

no more than 25 percent in-patient use), including but not limited to:

i. Surgical

ii. Chronic dialysis

iii. Psychiatry

iv. Rehabilitation, occupational therapy, or

physical therapy

v. Maternity

vi. Dentistry

vii. Chemical dependency

c. Services that duplicate Basic Services, as defined in

H&SC §1250, or services that are provided as part of a Basic Service, but are not required for facility licensure (with no more than 25 percent in-patient use).

All hospital support services listed in Section 309A.4.1 Item a that are located in an SPC building at the time gen- eral acute care services are removed may remain, pro- vided the California Department of Public Health certifies to the Office that it has received and approved a plan that demonstrates how the health facility will continue to pro- vide all basic services in the event of any emergency when the SPC building may no longer remain functional. This certification shall be submitted by hospital to the Office prior to approval of the application to remove the SPC building from general acute care service.

309A.4.2 Maintaining existing nonacute care services under existing license . Existing approved nonacute care occupancies, or services, existing in the SPC building at the time it is removed from general acute care service shall be permitted to remain, and removal of the SPC building from general acute care service is not considered a change in occupancy. The enforcement agency shall be permitted to require evidence that the existing occupan-

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309A.5.1 Eligibility for change in jurisdiction. For a building removed from general acute care service to be eligible for a change in jurisdiction to the local enforcing agency, all the following criteria shall be satisfied:

a. The building removed from general acute care ser-

vice shall be freestanding, as defined in the Califor- nia Administrative Code, Section 7-111.

b. Any hospital support services located in the building

removed from general acute care service, including administrative services, central sterile supply, stor- age, morgue and autopsy, employee dressing rooms and lockers, janitorial and housekeeping service, and laundry, shall be in excess of the minimum requirements for licensure and operation. Prior approval by the California Department of Public Health shall be obtained by hospital to locate these services in the building removed from general acute care service.

c. Services/systems and utilities (e.g., power, emer-

gency power, communication/data/nurse-call sys- tems, space-heating systems, fire alarm system, fire- sprinkler system, medical gas & plumbing systems) shall be separate and independent from those serv- ing any buildings under OSHPD jurisdiction.

d. If the building being transferred to the jurisdiction

of the local enforcing agency is adjacent to a build- ing under OSHPD jurisdiction and fire-resistive construction separations are required, they shall be located in the building under OSHPD jurisdiction.

309A.5.2 Modification of b uildings removed from OSHPD jurisdiction. The owner of the building shall be responsible for bringing the building into compliance with all requirements of the new authority having jurisdiction. If a building requires modification to become eligible for removal from OSHPD jurisdiction, the construction proj- ect shall be closed with compliance by OSHPD prior to the change in jurisdiction. All occupancy separation, set- back, and allowable area requirements shall be enforced.

309A.5.3 Buildings not eligible for change in jurisdic- tion. The following freestanding buildings shall remain under OSHPD jurisdiction:

a. Any building in which basic and/or supplementary

services are provided for a general acute care hos- pital, acute psychiatric hospital, and general acute care hospital providing only acute medical rehabili- tation center services.

b. Any building which provides required patient

access, egress, or smoke compartment for a Build- ing under OSHPD’s jurisdiction.

c. Any building in which services under OSHPD juris-

diction are provided, including skilled nursing ser- vices, intermediate care services, acute psychiatric services, and distinct part skilled nursing or inter- mediate care services.

d. Any building providing central plant or utility ser-

vices to a building under OSHPD jurisdiction.

PROVISIONS FOR ALL COMPLIANCE METHODS

e. Any building through which utilities pass through,

over or under, to serve a building under OSHPD jurisdiction.

309A.6 Vacant space. With the removal of general acute care¶

services, the vacated space must be re-classified with an intended occupancy as required under California Building Code Section 302. If the hospital determines that the building or space in the SPC building removed from general acute care service will be vacant, the hospital shall demonstrate that unsafe conditions as described in California Building Code Section 116.1 are not created.

309A.7 Demolition: Demolition of SPC buildings to be¶

removed from general acute care services shall be permitted when buildings remaining under OSHPD’s jurisdiction, after demolition, satisfy the requirements of the California Build- ing Standards Code and demolition activity does not impair the operation and/or safety of any buildings that remain under the OSHPD’s jurisdiction. Demolition shall be in accordance with California Building Code Section 3303.