---
kind: "section"
citation: "42 C.F.R. § 403.742"
title: "42"
number: "403.742"
heading: "Condition of participation: Physical environment."
url: "https://uscodex.org/cfr/42/403.742"
---

# §403.742. Condition of participation: Physical environment.


A RNHCI must be designed, constructed, and maintained to ensure the safety of the patients, staff, and the public.

- (a) **Standard: Buildings.** The physical plant and the overall environment must be maintained in a manner that ensures the safety and well-being of the patients. The RNHCI must have the following:
  - (1) **Procedures for the proper storage and disposal of trash.**
  - (2) Proper ventilation and temperature control and appropriate lighting levels to ensure a safe and secure environment.
  - (3) **An effective pest control program.**
  - (4) A preventive maintenance program to maintain essential mechanical, electrical, and fire protection equipment operating in an efficient and safe manner.
  - (5) **A working call system for patients to summon aid or assistance.**
- (b) **Standard: Patient rooms.** Patient rooms must be designed and equipped for adequate care, comfort, and privacy of the patient.
  - (1) Patient rooms must meet the following conditions:
    - (i) **Accommodate no more than four patients.**
    - (ii) Measure at least 80 square feet per patient in multiple patient rooms and at least 100 square feet in single patient rooms.
    - (iii) **Have direct access to an exit corridor.**
    - (iv) **Be designed or equipped to assure full visual privacy for each patient.**
    - (v) **Have at least one window to the outside.**
    - (vi) **Have a floor at or above grade level.**
  - (2) The RNHCI must furnish each patient with the following:
    - (i) **A separate bed of proper size and height for the convenience of the patient.**
    - (ii) **A clean, comfortable mattress.**
    - (iii) **Bedding appropriate to the weather and climate.**
    - (iv) Functional furniture appropriate to the patient's needs and individual closet space with clothes racks and shelves accessible to the patient.
  - (3) CMS may permit variances in requirements specified in paragraphs [(b)(1)(i)](#b-1-i) and [(ii)](#b-1-ii) of this section relating to rooms on an individual basis when the RNHCI adequately demonstrates in writing that the variances meet the following:
    - (i) **Are in accordance with the special needs of the patients.**
    - (ii) **Will not adversely affect patients' health and safety.**

## Notes

### Amendments

[64 FR 67047, Nov. 30, 1999, as amended at 81 FR 64021, Sept. 16, 2016]

### Source

Source: 64 FR 67047, Nov. 30, 1999, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302 and 1395hh.

### Amendments

[64 FR 67047, Nov. 30, 1999, as amended at 81 FR 64021, Sept. 16, 2016]