CMS SOM App. PP, Tag F918

Each resident room must be equipped with or located near toilet and bathing

facilities. For facilities that receive approval of construction plans from State and

local authorities or are newly certified after November 28, 2016, each residential

room must have its own bathroom equipped with at least a commode and sink.

GUIDANCE: §483.90(f)

“Bathing Facilities” is defined as a space that contains either a shower(s) or a tub(s) for

resident use. See definition of “toilet facilities” for definition of “located near.”

“Toilet facilities” is defined as a space that contains a lavatory and a toilet/commode.

CMS is also using the term “commode” to mean the same as a “toilet” when referring to

a plumbing fixture. If the resident’s room is not equipped with an adjoining toilet

facility, then “located near” means residents who are independent in the use of a

toilet/commode, including chair bound residents, can routinely use a toilet/commode in

the unit that they can access quickly.

Facilities that meet any of the below criteria must meet the requirement for having in

each resident bedroom its own bathroom consisting of at least a sink and commode/toilet:

• A facility that received approval for construction from the state or local authority

after November 28, 2016;

• A facility that is newly certified after November 28, 2016;

• A facility that completes a change of ownership under §489.18 and the new owner

does not accept assignment of the existing provider agreement resulting in a “new

initial certification” for a new provider agreement that is effective after November

28, 2016; or

• A facility whose provider agreement was terminated by CMS, and a new provider

is working to reenroll in the Medicare program as a newly certified facility

effective after November 28, 2016.

Facilities that meet any of the above criteria also must meet the requirements in

§483.90(e)(1)(i), which requires accommodation of no more than two residents per

bedroom. We note that two conjoined private bedrooms (i.e., single occupancy in each

room) with a shared bathroom equipped with at least a commode and a sink (i.e., “Jack &

Jill bathroom”) are in compliance with §483.90(e)(1)(i) and §483.90 (f). However, if

more than one resident resides in either conjoined bedroom, this would no longer be

compliant with CMS regulations.

In the case where the Secretary has declared a public health emergency and the President

declares a national emergency, the Secretary is authorized at section 1135 of the Act to

waive or modify certain specified requirements under Titles XVIII, XIX, XXI, and XI

under certain conditions. The waiver of specific requirements under section 1135 for

affected facilities requesting a waiver would depend on many factors, including, for

example, the extent of damage to the facility. New construction or reconstruction of

facilities affected by a public health emergency should be discussed with the appropriate

CMS Location.

PROCEDURES: §483.90(f)

If a facility meets any of the criteria above and does not have each resident rooms

equipped with or located near toilet and bathing facilities, then noncompliance exists.