CMS SOM App. U, Tag R203

following:]

(2) Proper ventilation and temperature control and appropriate lighting levels to

ensure a safe and secure environment.

Interpretive Guidelines: §403.742(a)(2)

“Proper ventilation” is represented by characteristics such as good air circulation,

consistent air temperature, and adequate smoke exhaust removal. Air temperatures in

the facility should be comfortable in most circumstances. In extremely hot or cold

weather, precautions are taken by the facility to protect individuals from ill-effects of

temperature.

“Appropriate lighting levels” are light levels which meet patient needs, as well as meet

the needs of caregivers providing services and visitors/staff within the RNCHI.

Please also refer to Appendix Z for Emergency Preparedness Tag E-0015,

§403.748(b)(1)(ii)(A) and (B)—which requires the facility to have policies and

procedures in place to ensure that alternate sources of energy are available to maintain

temperatures to protect patient health and safety and to ensure emergency lighting is

available in the event that staff and residents need to evacuate or shelter in place—and

determine which citation would be most appropriate. If concerns arise, contact your

Physical Environment subject expert or the CMS Location for additional guidance.

Survey Procedures:

• During the building tour, observe lighting as well as temperatures and airflow.

• Verify documentation to determine:

o How does the RNHCI regulate temperature, ventilation, and lighting?

• Verify during the building tour:

o Is there good air movement?

o Are patient areas ventilated?

• What does the facility do to accommodate temperature, lighting, and ventilation

to meet patient needs?