CMS SOM App. M, Tag L832

The hospice must—

(1) Have an adequate supply of hot water at all times; and

(2) Have plumbing fixtures with control valves that automatically regulate the

temperature of the hot water used by patients.

Interpretive Guidelines §418.110(i)

The intent of this regulation is that the temperature of water at fixtures and in showers

and tubs used by patients shall be automatically regulated by control valves and delivered

for use at the appropriate temperature.

There is a risk that patients or staff may be scalded by excessively hot water discharged

by plumbing fixtures. Water that is too hot may scald individuals who are exposed to it.

This danger is particularly significant for patients who may have circulatory or other

neurological deficits that prevent the instantaneous recoil from water that is too hot.

The chart below shows the estimated time for persons to receive second and third degree

burns at various temperatures.

Water Temperature Time to Receive Second

Degree Burn

Time to Receive Third

Degree Burn

120 degrees 8 minutes 10 minutes

124 degrees 2 minutes 4 minutes

131 degrees 17 seconds 30 seconds

140 degrees 3 seconds 5 seconds

150 degrees <1 second 1 second

The recommended water temperatures at the plumbing fixtures should be maintained at

or below 110 degrees.