44:76:02:01.  Sanitation. The facility shall be designed, constructed, maintained, and operated to minimize the sources and transmission of infectious diseases to patients, personnel, visitors, and the community at large. This requirement shall be accomplished by providing the physical resources, personnel, and technical expertise necessary to ensure good public health practices for institutional sanitation.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1).

          Law Implemented: SDCL 34-12-13(1).

          44:76:02:02.  Pets. No pet kept in or visiting a facility may negatively affect the well-being of a patient.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1).

          Law Implemented: SDCL 34-12-13(1).

          Cross-Reference: Physically disabled, blind, or deaf person's right to be accompanied by guide dog without extra charge, SDCL 20-13-23.2.

          44:76:02:03.  Cleaning methods and facilities. The facility shall have supplies, equipment, work areas, and complete written procedures for cleaning, sanitizing, disinfecting, or sterilizing all work areas, equipment, utensils, and medical devices used for patients' care. Common use equipment shall be disinfected or sterilized after each use. Facilities shall have separate clean and soiled utility rooms.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(2).

          Law Implemented: SDCL 34-12-13(2).

          44:76:02:04.  Chemicals used to sanitize, disinfect, or sterilize. The label of chemicals used to sanitize, disinfect, or sterilize shall indicate registration with the Environmental Protection Agency as effective, safe, and approved for their intended use.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(2).

          Law Implemented: SDCL 34-12-13.(2)

          44:76:02:05.  Sterilization. Instruments, supplies, utensils and equipment which are not single service shall be decontaminated before sterilization in a manner that will make them safe for handling by personnel. Supplies and equipment commercially prepared and sterilized to retain sterility indefinitely are acceptable in lieu of sterilization in the facility. Autoclaves used for steam sterilization shall be bacteriologically monitored at least weekly. Supplies and equipment sterilized and packaged in the facility shall have the processing date on the package and shall be reprocessed in accordance with any specific manufacturer's recommendation for the packaging.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(2).

          Law Implemented: SDCL 34-12-13(2).

          44:76:02:06.  Housekeeping cleaning methods and equipment. The facility shall establish written housekeeping procedures for the cleaning of all areas in the facility and copies made available to all housekeeping personnel. All parts of the facility shall be kept clean, neat, and free of visible soil, litter, and rubbish. Equipment and supplies shall be provided for cleaning of all surfaces. Such equipment shall be maintained in a safe, sanitary condition. Hazardous cleaning solutions, chemicals, poisons, and substances shall be labeled, stored in a safe place, and kept in an enclosed section separate from other cleaning materials. Cleaning of areas designed for patient use shall be performed by dustless methods that minimize the spread of pathogenic organisms in the facility's atmosphere. Each vacuum used in medical facilities shall be equipped to provide effective discharge air filtration of particles larger than 0.3 microns. Cleaning shall include all environmental surfaces within the facility that are subject to contamination from dust, direct splash, or pathogenic organisms except medical equipment, supplies, or devices that are the responsibility of other services or departments of the facility.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(2).

          Law Implemented: SDCL 34-12-13(2).

          44:76:02:07.  Food service. Food services if provided shall meet the safety and sanitation procedures for food service in §§ 44:02:07:01, 44:02:07:02, and 44:02:07:04 to 44:02:07:95, inclusive, the Food Service Code. Any food service provided from an outside food establishment shall be inspected by a local, state, or federal agency. In addition, a mechanical dishwasher shall be provided in all facilities providing food service. The facility shall have the space, equipment, supplies, and mechanical systems for efficient, safe, and sanitary food preparation if any part of the food service is provided by the facility.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(5) and (8).

          Law Implemented: SDCL 34-12-13(5) and (8).

          Note: Article 44:02, Lodging and Food Service, Administrative Rules of South Dakota, contains the Food Service Code and may be obtained from Legislative Mail, 1320 East Sioux Avenue, Pierre, South Dakota 57501, telephone (605) 773-4935, for $4.14.

          44:76:02:08.  Handwashing facilities. Handwashing facilities consisting of hot and cold running water dispensed through a mixing faucet controlled with blade handles or other hands-free controls, a towel dispenser with single-service towels or a hand-drying device, and hand cleanser shall be located in dietary areas, utility rooms, staff stations, pharmacies, laboratories, surgical suites, physical therapy rooms, restorative therapy rooms, examination and treatment rooms, laundry, and all toilet rooms. If existing faucets and controls are replaced or changed, they shall be replaced with mixing faucets controlled with blade handles or other hands-free controls.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1) and (4).

          Law Implemented: SDCL 34-12-13(1) and (4).

          Cross-Reference: Plumbing fixture devices, § 44:76:12:14.

          44:76:02:09.  Linen. The supply of linens and towels shall equal three times the number of post operative rooms. The facility shall have written procedures for the storage and handling of soiled and clean linens. The facility shall contract with a commercial laundry service or the laundry service of another licensed health care facility for all common use linens if laundry services are not provided on the premises. A facility providing laundry services shall have adequate space and equipment for the safe and effective operation of the laundry service. Commingled patients' personal clothing, common-use linen, any isolation clothing, and housekeeping items shall be processed by methods that assure disinfection. The facility shall process laundry following the laundry equipment and cleaning agent recommendations. If hot water is used for disinfection, minimum water temperatures supplied for laundry purposes shall be 160 degrees Fahrenheit (71 degrees centigrade). If chlorine bleach is added to the laundry process to provide 100 parts per million or more of free chlorine, the minimum hot water temperatures supplied for laundry purposes may be reduced to 120 degrees Fahrenheit (48.8 degrees centigrade). The facility may choose to wash common-use linen and any isolation clothing in water temperatures less than 120º F. if the following conditions are met:

          (1)  The supplier of the chemical specifies low-temperature wash formulas in writing for the machines used in the facility;

          (2)  Charts providing specific information concerning the formulas to be used for each machine are posted in an area accessible to staff;

          (3)  The facility ensures that laundry staff receives in-service training by the chemical supplier on a routine basis, regarding chemical usage and monitoring of wash operations; and

          (4)  The facility ensures that staff monitors chemical usage and wash water temperatures at least monthly to ensure conformance with the chemical supplier's instructions.

          Any clothing that is not commingled may be processed according to manufacturer's recommendations using water temperatures and detergent in quantity as recommended by the garment or detergent manufacturer. The facility shall have distinct areas for the storage and handling of clean and soiled linens. Those areas used for the storage and handling of soiled linens shall be negatively pressurized. The facility shall establish special procedures for the handling and processing of contaminated linens. Soiled linen shall be placed in closed containers prior to transportation. To safeguard clean linens from cross contamination, the linens shall be transported in containers used exclusively for clean linens, shall be kept covered with dust covers at all times while in transit or in hallways, and shall be stored in areas designated exclusively for this purpose. A written request for any modification of the requirements of this section shall be reviewed and approved by the department before any changes are made.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1) and (4).

          Law Implemented: SDCL 34-12-13(1) and (4).

          44:76:02:10.  Infection prevention and control. The infection prevention and control program shall utilize the concept of standard precautions. Bloodborne pathogen control shall be maintained according to the requirements contained in 29 C.F.R. 1910.1030, July 1, 2006. The facility shall designate a qualified professional with training in infection control to be responsible for the implementation of the infection control program including surveillance and reporting activities. There shall be written procedures that govern the use of aseptic techniques and procedures in all areas of the facility. Each facility shall develop policies and procedures for the handling and storage of potentially hazardous substances (including lab specimens). There shall be a method of control used in relation to the sterilization of supplies and a written policy requiring sterile supplies to be reprocessed. The facility shall provide orientation and continuing education to all personnel on the facility's staff on the cause, effect, transmission, prevention, and elimination of infections. Each facility shall develop a written policy for evaluation and reporting of any employee with a reportable infectious disease.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1), 34-22-9(8).

          Law Implemented: SDCL 34-12-13(1).

          44:76:02:11.  Plumbing. Facility plumbing systems shall be designed and installed in accordance with SDCL 36-25-15 and 36-25-15.1. Plumbing shall be sized, installed, and maintained to carry required quantities of water to required locations throughout the facility. Plumbing may not constitute a source of contamination of food equipment or utensils or create an unsanitary condition or nuisance.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1) and (14).

          Law Implemented: SDCL 34-12-13(1) and (14).

          44:76:02:12.  Water supply. The facility's water supply shall be obtained from a public water system or, in its absence, from a supply approved by the Department of Agriculture and Natural Resources. Each private water supply shall have a water sample bacteriologically tested at least monthly. The volume of water shall be sufficient for the needs of the facility, including fire fighting requirements. The hot water system shall be capable of supplying the work and patient areas with water at the required temperatures. Maximum hot water temperatures at plumbing fixtures used by patients may not exceed 125 degrees Fahrenheit (52 degrees centigrade). The minimum temperature of hot water for patient use shall be at least 100 degrees Fahrenheit (38 degrees centigrade).

          Each water supply system shall maintain one part per million free residual chlorine at remote point-of-use fixtures in the facility or may use another bacteriological control method, such as increasing water temperature range from 122 degrees to 125 degrees Fahrenheit (50-52 degrees centigrade), that has been demonstrated to be equivalent in control of Legionella. The facility shall document water temperatures to verify the hot water temperature is being maintained within the acceptable range. The chlorine testing shall be done daily using photocell and light source DPD (N, N, Diethyl-p-phenylenediamine) test kits, and the test results logged. If testing demonstrates that consistent chlorine levels are maintained, the frequency of testing may be reduced to a level necessary to demonstrate compliance.

          Source: 42 SDR 51, effective October 13, 2015; SL 2021, ch 1, §§ 8, 19, effective April 19, 2021.

          General Authority: SDCL 34-12-13(1).

          Law Implemented: SDCL 34-12-13(1).

          Cross-References: Standards adopted for plumbing -- Conformity to National Code, SDCL 36-25-15; Scope and objectives of plumbing standards and rules, SDCL 36-25-15.1.

          44:76:02:13.  Ventilation. Electrically powered exhaust ventilation shall be provided in all soiled areas, wet areas, toilet rooms, and storage rooms. Clean storage rooms may also be ventilated by supplying and returning air from the building's air-handling system.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1).

          Law Implemented: SDCL 34-12-13(1).

          44:76:02:14.  Lighting. Spaces occupied by people, machinery, and equipment within buildings and their approaches and parking lots shall have artificial lighting at a level for general safety. Required exits shall be equipped with continuous emergency lighting. Emergency power shall be provided if the main source of power fails.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1).

          Law Implemented: SDCL 34-12-13(1).

          44:76:02:15.  Refuse and waste disposal. Garbage, refuse, and waste shall be handled and disposed of in a safe and sanitary manner. Final disposal of all refuse and waste shall comply with articles 74:27 and 74:28. Putrescible garbage shall be removed at a frequency to contain or prevent odors, insects, and vermin.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1).

          Law Implemented: SDCL 34-12-13(1).

          44:76:02:16.  Insect and rodent control. The facility shall take effective measures to protect against the entrance into the facility and the breeding or presence on the premises of rodents, flies, roaches, and other vermin. The facility may use chemical substances of a poisonous nature in accordance with the requirements of this section to control or eliminate various types of vermin. The substances shall be properly colored and labeled to identify them as poisons, shall be used and stored in a safe manner, and may not be stored with food or drugs used for human consumption. Extreme care shall be taken to prevent any poisons from contaminating food or food products.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1).

          Law Implemented: SDCL 34-12-13(1).

          44:76:02:17.  Sewage disposal. Sewage shall be disposed of in a public sewage works system or, in its absence, in a manner approved by the department in accordance with the provisions of SDCL chapter 34A-2.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1).

          Law Implemented: SDCL 34-12-13(1).

          44:76:02:18.  Occupant protection. Each facility shall be constructed, arranged, equipped, maintained, and operated to avoid injury or danger to the occupants. The extent and complexity of occupant protection precautions is determined by the services offered and the physical needs of the patients admitted to the facility. The facility shall take at least the following precautions:

          (1)  Develop and implement a written and scheduled preventive maintenance program;

          (2)  Provide securely constructed and conveniently located grab bars in all toilet rooms and bathing areas used by patients;

          (3)  Provide a call system for each patient recovery station, preoperative and postoperative holding space, and in all toilet rooms and bathing facilities routinely used by patients. The call system shall be capable of being easily activated by the patient and shall register at a staff station serving the unit. A wireless call system may be used;

          (4)  Provide grounded or double-insulated electrical equipment or protect the equipment with ground fault circuit interrupters. Ground fault circuit interrupters shall be provided in wet areas and for outlets within six feet of sinks;

          (5)  A portable space heater, portable halogen lamp, household-type electric blanket, or house-hold heating pad may not be used in a facility;

          (6)  Any light fixture located over a patient recovery station, preoperative and postoperative holding spaces, in any bathing or treatment area, in a clean supply storage room, in any laundry clean linen storage area, or in any medication set-up area shall be equipped with a lens cover or a shatterproof lamp;

          (7)  Any clothes dryer shall have a galvanized metal vent pipe for exhaust; and

          (8)  The storage and transfilling of oxygen cylinders or containers shall meet the requirements of the NFPA 99 Standard for Health Care Occupancies, 2012 Edition.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1) and (3).

          Law Implemented: SDCL 34-12-13(1) and (3).

          Reference: NFPA 99 Health Care Facilities, 2012 edition, National Fire Protection Association. Copies may be obtained from the National Fire Protection Association, P.O. Box 9101, Quincy, MA 02269-9101. Phone: 1-800-344-3555. Cost: $93.00.

          44:76:02:19.  Area requirements. Each facility shall be constructed, equipped, and operated to maintain the privacy and dignity of all patients. In a multi-patient recovery room, each patient recovery area shall be able to be separated from the other patients by privacy curtains.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1) and (3).

          Law Implemented: SDCL 34-12-13(1) and (3).

          44:76:02:20.  Physical plant changes. A facility shall submit any proposed change by new construction, remodeling, or change of use of an area to the department. Any change shall have the approval of the department before it is made.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1) and (3).

          Law Implemented: SDCL 34-12-13(1) and (3).

          44:76:02:21.  Location. The location of facilities shall promote the health, treatment, comfort, safety, and well-being of persons accepted and retained for care. Facilities shall be served by good, passable roads. Easy accessibility for employees, visitors, and fire-fighting services shall be maintained.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1), (3), and (14).

          Law Implemented: SDCL 34-12-13(1), (3), and (14).

          44:76:02:22.  Heating and cooling. The temperature in any occupied space in the facility shall be maintained between 68 and 80 degrees Fahrenheit during business hours.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1).

          Law Implemented: SDCL 34-12-13(1).

          44:76:02:23.  Other hazardous conditions. A facility may be directed to remove or correct other hazardous conditions not covered in this chapter if the department considers the conditions to have a potential to cause injury or illness to the patients or staff.

          Source: 42 SDR 51, effective October 13, 2015.

          General Authority: SDCL 34-12-13(1).

          Law Implemented: SDCL 34-12-13(1).