dermatology clinic - 517

[malachi constant]

I'm an engineer foraying into article 517 for the first time. Working on a dermatology clinic being fit out into a strip mall shell space. Tell me if I'm missing something:

1. 517 applies to a dermatology clinic per 517.1 Scope and 517.2 definition of a Health Care Facility.
2. Provide effective ground-fault current path per 517.13(A). Can be conduit or flex as allowed by 250.118. (I saw something in another post about "hospital-grade MC cable" - what is that, and does it apply here?)
3. 517.13(B) requires an insulated equipment grounding conductor be pulled to each receptacle, metal box, and the surface of fixed electrical equipment blah blah blah.
4. 517.14 Panelboard Bonding. I don't think we have "normal" and "essential" branch-circuit panels so do not believe this applies. I basically will pull one or two 208V/3P/200A panels off the spare meter sockets. No generator, no UPS. So as long as I run the grounding conductors to the ground bar within each panel, and then connect each of the ground bars back to the service ground, I'm good - right?
5. 517.17 Ground-fault Protection does not apply - no life-support equipment (plus the service entrance is 120V to phase, so no ground fault breaker to coordinate with).
6. 517.18(A) Patient Bed Location - does not apply to clinic per exception #2. Also there are no "patient beds" as defined in 517.2.
7. 517.18(B) Patient Bed Location Receptacles - again, there are no "patient beds" as defined in 517.2, so this does not apply.
8. 517.18(C) Pediatric Locations - anyone care to guess what (if anything) is considered a pediatric location in a dermatology clinic? I do not believe "pediatric" is defined in the NEC. I will run this one by the Owner, I have a feeling they will know the answer.
9. 517.19 - Critical Care Areas - I do not believe this applies. Anyone have any reason to believe a small (four exam rooms, two procedure rooms) pediatric clinic would have critical care areas? I will also run this one by the Owner as I believe the "general/critical" distinction ultimately comes from them.
10. Part III, Essential Electrical System. This applies per 517.25 Scope. I am assuming this just means emergency lighting - this is where the article gets a little harder to follow. 517.30-35 is for hospitals, 517.40-44 is for nursing homes...so that leaves 517.45(A) and (D), which don't say much. I assume I should have battery emergency lights in the corridors, exam rooms, procedure rooms, lobby, etc. I assume no UPS or generator is required.
11517.60 Anesthetizing locations - I assume none of this applies, but will send a few questions into the Owner regarding anesthesia.

Eh, crap, I still have a number of sections to go through (low-voltage equipment, diagnostic equipment, therapeutic equipment, guarding and grounding, communications & fire alarm and isolated power systems) but need to get out of the office. I'll check in tomorrow and see how far off track you all say I am. FWIW my boss has a little experience in this, but isn't available the early part of this week as I'm trying to get it off the ground - but will have someone in-house looking over my shoulder. Thanks in advance!

 

[steve66]

Just doing a quick scan through what you wrote, it looks right to me.

You probably don't need to worry about much of 517 except the redundant grounding in 517.13.

I would ask the owner about critical care just to be safe, but if there aren't any Anesthetizing locations, then there probably won't be any critical care.

I would say you don't have any pediatric locations. Those are normally patient beds intended for children (i.e. - usually at beds intended for kids to stay in overnight.) However, I like to go above the code and put tamper proof outlets in waiting rooms. You would be supprised how many people bring small kids into a doctors office and just leave them in the waiting room.

Sounds right on the battery powered exit and emergency lights - just like any other office building would have. But it might be good to add an emergency light in the procedure room.

 

[kwired]

Just doing a quick scan through what you wrote, it looks right to me.

You probably don't need to worry about much of 517 except the redundant grounding in 517.13.

I would ask the owner about critical care just to be safe, but if there aren't any Anesthetizing locations, then there probably won't be any critical care.

I would say you don't have any pediatric locations. Those are normally patient beds intended for children (i.e. - usually at beds intended for kids to stay in overnight.) However, I like to go above the code and put tamper proof outlets in waiting rooms. You would be supprised how many people bring small kids into a doctors office and just leave them in the waiting room.

Sounds right on the battery powered exit and emergency lights - just like any other office building would have. But it might be good to add an emergency light in the procedure room.

That last sentence brings up something to consider "procedure room".

I think the kind of care being given (procedures performed) will dictate the kind of care as it relates to medical codes, licensing, etc. and can make a difference in how a room is classified. Most of what we refer to as "clinics" are intended to be nothing more than exam rooms with only "minor" procedures performed, but that is not always the case.

 

[Microwatt]

You may want to check with the local inspector in regards to #7. I have one that is requiring all receptacles to be Hospital Grade in exam rooms of clinics.

 

[steve66]

That last sentence brings up something to consider "procedure room".

I think the kind of care being given (procedures performed) will dictate the kind of care as it relates to medical codes, licensing, etc. and can make a difference in how a room is classified. Most of what we refer to as "clinics" are intended to be nothing more than exam rooms with only "minor" procedures performed, but that is not always the case.

Yes, i agree. I'm assuming its a "minor procedure" room- what we normally call a "bumps and bruises" room, although the uses for these rooms vary quite a lot. I'm getting that impression from the comment about "no anesthesia" and "no generator", but I'm assuming the OP will verify this isn't anything more. For a dermatology clinic, there is a good chance the procedure room will be a laser room.

You may want to check with the local inspector in regards to #7. I have one that is requiring all receptacles to be Hospital Grade in exam rooms of clinics.

I think hospital grade receptacles are a good idea, but they are not required for this type of facility. It doesn't sound like that inspector understands the definition of a "patient bed location."

 

[malachi constant]

For a dermatology clinic, there is a good chance the procedure room will be a laser room.

From what the architect tells me there will be 230V lasers in each large exam room and procedure room. (Two of each room = four lasers.)

And yes, that concerns me. I have asked the Owner for clarification regarding "general" vs "critical", and then followed that up questioning if there are procedures that cannot be interrupted or require sedation - i.e. "doc, what happens if the power and lights go out?".

That's the most critical part of a 30-question list I sent the Arch & Owner yesterday. I'll follow up with a phone call this morning and make sure they understand the questions and that I get good answers.

Thank you all for your comments. You're thinking like I'm thinking. You start out thinking it's probably pretty low-key, but then "procedure room" and "lasers" really gets one's attention.