electrical wiring/ outlets for optometry exam lanes

[mduggerod]

Hi all, I am an Optometrist and there is quite a bit of discrepancy between Optometrists regarding the electrical wiring requirements for our exam lanes. We are considered medical care facilities; however, have no continuous patient care, patient beds or 24 hour care. Most offices generally have a "lift" chair that moves up and down (electrical) and a glorified microscope to help us look at the front of the eye (with a light, so electrical needed) I don't quite understand how the profession can be 50/50 regarding whether hospital grade plugs/ electrical are needed or not? If there was a solid code regarding this, wouldn't it make sense that all would say "We have to have xxxx electrical in our office." ?? I hope this makes sense and someone can help. Thank you for your time.

 

[david]

reach down and look at the cord end, is there a green dot on the end where the blades stick out.

is there a tag affixed to the cord from the manufacture stating it must be plug into a system of assured grounding or equivalent or it must be plug into a hospital grade receptacle.

did the manufactures instruction state something like that.

if so you have your answer.

Its rather complicated to explain why there are differences of interpretation on this issue from an NEC perspective electrical code or from NFPA standard for health care facilities. But it comes down to a statement about a patient bed location.

and how it is defined in the NEC. and how used in the section dealing with general care areas and critical care areas in health care facilities.

when applying the term patient bed locations to the exceptions the definition doesn't make sense, and on top of that the commentary for NFPA health care facilities, makes the comment that it is the standard intention that areas that a patient is being examined is to be considered a patient bed location

And older commentary that i had even went further to make the statement that it was understood that examine areas in general care was patient care areas and the definition was given to make it understood that examine tables in critical care where to be included as patient bed locations.

Now all this may give you just a taste of why there are different views on this. It may go away as health care facilities are being broken down into different levels of care depending on a patient exposure to a level of risk

 

[tkb]

Hi all, I am an Optometrist and there is quite a bit of discrepancy between Optometrists regarding the electrical wiring requirements for our exam lanes. We are considered medical care facilities; however, have no continuous patient care, patient beds or 24 hour care. Most offices generally have a "lift" chair that moves up and down (electrical) and a glorified microscope to help us look at the front of the eye (with a light, so electrical needed) I don't quite understand how the profession can be 50/50 regarding whether hospital grade plugs/ electrical are needed or not? If there was a solid code regarding this, wouldn't it make sense that all would say "We have to have xxxx electrical in our office." ?? I hope this makes sense and someone can help. Thank you for your time.

You are describing a patient care area, and hospital grade devices and a redundant grounding wiring method needs to be used.

You want to be called a doctor, but don’t want your patient care area to be classified as such. :happysad:

 

[kwired]

From what I can tell "hospital grade" receptacles are only required at "patient bed locations" which is defined in 517.2.

The exam rooms at OP's facility are patient care areas, but most optometry clinics (and many other places that mostly only perform examinations and relatively minor procedures) wouldn't have a "patient bed location", just basic care spaces or general care spaces.

 

[david]

From what I can tell "hospital grade" receptacles are only required at "patient bed locations" which is defined in 517.2.

The exam rooms at OP's facility are patient care areas, but most optometry clinics (and many other places that mostly only perform examinations and relatively minor procedures) wouldn't have a "patient bed location", just basic care spaces or general care spaces.

And your speaking from a building electrical system prospective and the definition of a patient bed location and not from the equipment prospective. the OP ask from the doctors prospective, which should include the equipment and instructions

 

[mduggerod]

You are describing a patient care area, and hospital grade devices and a redundant grounding wiring method needs to be used.

You want to be called a doctor, but don’t want your patient care area to be classified as such. :happysad:

That's not the case, Tim. I personally don't care, but don't understand how there can be so much discrepancy on the issue??? Seems like something needs cleared up or people need properly educated. Example. Doctor A down the road has no requirement for this, Dr B. 5 miles away has to have them? Why when I post this thread on Optometry websites it is about 50/50 regarding the hospital vs. non hospital grade?

 

[jumper]

It usually comes down to the definition of what is an optometrist.

Many optometrist are not MDs. Ophthalmologists are MDs.

Same difference between chiropractors and D.O. One is a MD and one is not.

Psychology and Psychiatry. Only one can write a prescription.

Every exam room is not a patient care area.

 

[mduggerod]

Thanks to all for the responses!

 

[hbiss]

No different than a doctors office (GP). Most don't require hospital grade receptacles and wiring for exam rooms. Consider that some offices can be in private residences.

-Hal

 

[kwired]

It usually comes down to the definition of what is an optometrist.

Many optometrist are not MDs. Ophthalmologists are MDs.

Same difference between chiropractors and D.O. One is a MD and one is not.

Psychology and Psychiatry. Only one can write a prescription.

Every exam room is not a patient care area.

In all those cases I'd say it has to do more with what medical procedures are intended to be performed in the space in question. In same facility you could have rooms that are just "exam rooms" and other rooms where more advanced procedures are performed.

 

[hbiss]

517.1 Scope
The provisions of this article shall apply to electrical construction
and installation criteria in health care facilities that
provide services to human beings.
The requirements in Parts II and III not only apply to
single-function buildings but are also intended to be individually
applied to their respective forms of occupancy
within a multifunction building (e.g., a doctor’s examining
room located within a limited care facility would be required
to meet the provisions of 517.10).

517.10 Applicability
(A) Applicability. Part II shall apply to patient care areas
of all health care facilities.

(B) Not Covered. Part II shall not apply to the following:
(1) Business offices, corridors, waiting rooms, and the like
in clinics, medical and dental offices, and outpatient facilities

From the NEC Handbook, informational note:

The requirements of Article 517 apply to all types of health
care facilities, yet each type of health care facility is intended
to apply the article provisions in a very specific manner.
For example, in a suite of doctors’ offices within an
office building, a doctor’s business office is treated as an ordinary
occupancy and the electrical installation is required
to comply with the applicable requirements of Chapters 1
through 4. However, the wiring and electrical equipment in
the examining rooms and any other patient care areas within
the office suite are required to be installed per the applicable
rules of Article 517.

Then there is this:

Formal Interpretation 99-1
Reference: Article 517, Part II
Question: Does Part II of Article 517 of the NEC apply to patient
sleeping rooms of nursing homes or limited care facilities
where patient care activities do not involve the use of electrical
or electronic life support systems; or invasive procedures
where patients are electrically connected to line connected
electromedical devices?
Answer: No
Issue Edition: 1999
Reference: Article 517
Issue Date: August 1, 2000
Effective Date: August 21, 2000

Even this is ambiguously written. Is it patient sleeping rooms within limited care facilities or is it patient sleeping rooms and limited care facilities? I interpret it as the latter.

-Hal

 

[mduggerod]

Thanks so much Hal, This is the wording I am looking for. Really appreciate it.

 

[hbiss]

We both can see why there is so much confusion.

-Hal

 

[david]

Let me tell you a real story, real life story. Than we will get to why there is confusion on this.

My friend Debbie who I lived with for 25 years now deceased had muscular dystrophy. Was a very involved advocate even blocking buses in Washington DC over accessibility issues. Enough back ground on her.

Through her lifelong work she involved herself in outreach to woman in nursing homes. One young woman 17 years old became particularly close to Debbie. We meaning Debbie, I and a nurse that was assigned to this young lady after Debbie helping this young Lady sign herself out of the nursing home for the day took her to an accessible cabin we rented at a state park on the lake.
We walked the trails they in there wheel chairs, we even had a big buck jump the trail just in front of Debbie and her young friend. The day turned into eight hours and her young friend began to tire, we headed back.

The nurse’s shift was up Debbie and I went with her to the door watched her go down the hall as we have so many times before, she made contact with the charge Nurse at the nurses station turned to us gave a small wave with her fingers smiled and went into a shower room just off to the left of the nurses station to wait for the nurse to send someone in to attend to her trake. Two doors down from that shower room was her room

I had been in her room many times and from my perspective and the perspective of the NEC what was required in her room. It was a nursing home, it was the room the young lady called hers, she had equipment that her life dependent on. And something went wrong, we were informed after that wonderful outing, that huge smile as she turned away to wait for her nurse, she smothered that night, something failed something went wrong.

You guys are well aware of the definition patient sleeping bed. So let’s look at the sections exceptions and why the definition doesn’t make any sense.

517.18 General Care Areas. 2008 NEC
(A) Patient Bed Location. Each patient bed location shall be supplied by at least two branch circuits, one from the emergency system and one from the normal system. All branch circuits from the normal system shall originate in the same panelboard.

Exception No. 2: Requirements of 517.18(A) shall not apply to patient bed locations in clinics, medical and dental offices, and outpatient facilities; psychiatric, substance abuse, and rehabilitation hospitals; sleeping rooms of nursing homes and limited care facilities meeting the requirements of 517.10(B)(2).

Exception #2 excludes the requirement in 517.18 (A) 2008 NEC
From patient bed locations in outpatient facilities, from patient bed locations in clinics, from patient bed locations in doctors office buildings, from patient bed locations in dentist offices, patient bed locations psychiatric hospitals, from patient bed locations in rehabilitation hospitals, patient bed locations used exclusively as patient sleeping in nursing homes and limited care facilities.

The NEC is not exempting something that does not exist, so by making the list of exemptions above is a clear indication that it is the standards intention that patient sleeping beds exist in each of the medical faculties that were listed in the exception 2 to 517.18 (A) 2018

Now we go to 517.18 (B) 2008 NEC Exception No. 1: The requirements of 517.18(B) shall not apply to psychiatric, substance abuse, and rehabilitation hospitals meeting the requirements of 517.10(B)(2).

The exception 2 to 517.18 (A) already gave you a partial list of the standard intent that patient bed location are found in clinics, medical and dental offices, and outpatient facilities; psychiatric, substance abuse, and rehabilitation hospitals; sleeping rooms of nursing homes and limited care facilities meeting the requirements of 517.10(B)(2).

517.18 (B) does not specifically exempt the requirement for receptacles or those required receptacles to be hospital grade in clinics, medical and dental offices, and outpatient facilities

Now try and apply the definition of a patient bed location to each of the medical facilities listed above especially an outpatient facility.
If you do insist that an outpatient facilities by definition of a patient bed location has no requirement for Rec no requirement for the number of rec and no requirement for hospital grade rec.

than you have no choice than to except that hospital emergency rooms are not required any rec, no number of rec. and no hospital grade rec. patients in emergency rooms that are not admitted if it is classified an outpatient area of a hospital

Now try and apply the definition of a patient bed location to each of the medical facilities listed above.
The definition of a patient bed location does not make any sense in application to these exceptions.

(B) Patient Bed Location Receptacles. Each patient bed location shall be provided with a minimum of four receptacles. They shall be permitted to be of the single or duplex types or a combination of both. All receptacles, whether four or more, shall be listed “hospital grade” and so identified. The grounding terminal of each receptacle shall be connected to an insulated copper equipment grounding conductor sized in accordance with Table 250.122.
Patient Bed Location. The location of a patient sleeping bed, or the bed or procedure table of a critical care area. [99:3.3.137]


I think you asked why is there confusions, i hinted to it early on, i tried to explain it , and many will disagree!!

 

[david]

Let me tell you a real story, real life story. Than we will get to why there is confusion on this.

My friend Debbie who I lived with for 25 years now deceased had muscular dystrophy. Was a very involved advocate even blocking buses in Washington DC over accessibility issues. Enough back ground on her.

Through her lifelong work she involved herself in outreach to woman in nursing homes. One young woman 17 years old became particularly close to Debbie. We meaning Debbie, I and a nurse that was assigned to this young lady after Debbie helping this young Lady sign herself out of the nursing home for the day took her to an accessible cabin we rented at a state park on the lake.
We walked the trails they in there wheel chairs, we even had a big buck jump the trail just in front of Debbie and her young friend. The day turned into eight hours and her young friend began to tire, we headed back.

The nurse’s shift was up Debbie and I went with her to the door watched her go down the hall as we have so many times before, she made contact with the charge Nurse at the nurses station turned to us gave a small wave with her fingers smiled and went into a shower room just off to the left of the nurses station to wait for the nurse to send someone in to attend to her trake. Two doors down from that shower room was her room

I had been in her room many times and from my perspective and the perspective of the NEC what was required in her room. It was a nursing home, it was the room the young lady called hers, she had equipment that her life dependent on. And something went wrong, we were informed after that wonderful outing, that huge smile as she turned away to wait for her nurse, she smothered that night, something failed something went wrong.

You guys are well aware of the definition patient sleeping bed. So let’s look at the sections exceptions and why the definition doesn’t make any sense.

517.18 General Care Areas. 2008 NEC
(A) Patient Bed Location. Each patient bed location shall be supplied by at least two branch circuits, one from the emergency system and one from the normal system. All branch circuits from the normal system shall originate in the same panelboard.

Exception No. 2: Requirements of 517.18(A) shall not apply to patient bed locations in clinics, medical and dental offices, and outpatient facilities; psychiatric, substance abuse, and rehabilitation hospitals; sleeping rooms of nursing homes and limited care facilities meeting the requirements of 517.10(B)(2).

Exception #2 excludes the requirement in 517.18 (A) 2008 NEC
From patient bed locations in outpatient facilities, from patient bed locations in clinics, from patient bed locations in doctors office buildings, from patient bed locations in dentist offices, patient bed locations psychiatric hospitals, from patient bed locations in rehabilitation hospitals, patient bed locations used exclusively as patient sleeping in nursing homes and limited care facilities.

The NEC is not exempting something that does not exist, so by making the list of exemptions above is a clear indication that it is the standards intention that patient sleeping beds exist in each of the medical faculties that were listed in the exception 2 to 517.18 (A) 2018

Now we go to 517.18 (B) 2008 NEC Exception No. 1: The requirements of 517.18(B) shall not apply to psychiatric, substance abuse, and rehabilitation hospitals meeting the requirements of 517.10(B)(2).

The exception 2 to 517.18 (A) already gave you a partial list of the standard intent that patient bed location are found in clinics, medical and dental offices, and outpatient facilities; psychiatric, substance abuse, and rehabilitation hospitals; sleeping rooms of nursing homes and limited care facilities meeting the requirements of 517.10(B)(2).

517.18 (B) does not specifically exempt the requirement for receptacles or those required receptacles to be hospital grade in clinics, medical and dental offices, and outpatient facilities

Now try and apply the definition of a patient bed location to each of the medical facilities listed above especially an outpatient facility.
If you do insist that an outpatient facilities by definition of a patient bed location has no requirement for Rec no requirement for the number of rec and no requirement for hospital grade rec.

than you have no choice than to except that hospital emergency rooms are not required any rec, no number of rec. and no hospital grade rec. patients in emergency rooms that are not admitted if it is classified an outpatient area of a hospital

Now try and apply the definition of a patient bed location to each of the medical facilities listed above.
The definition of a patient bed location does not make any sense in application to these exceptions.

(B) Patient Bed Location Receptacles. Each patient bed location shall be provided with a minimum of four receptacles. They shall be permitted to be of the single or duplex types or a combination of both. All receptacles, whether four or more, shall be listed “hospital grade” and so identified. The grounding terminal of each receptacle shall be connected to an insulated copper equipment grounding conductor sized in accordance with Table 250.122.
Patient Bed Location. The location of a patient sleeping bed, or the bed or procedure table of a critical care area. [99:3.3.137]


I think you asked why is there confusions, i hinted to it early on, i tried to explain it , and many will disagree!!

Sorry all references where from the 2008 NEC i miss typed and made reference to 2018

 

[david]

Let me tell you a real story, real life story. Than we will get to why there is confusion on this.

something went wrong, we were informed after that wonderful outing, that huge smile as she turned away to wait for her nurse, she smothered that night, something failed something went wrong.

Her suction machine went to battery power the battery drained the suction stopped and she passed away

From the perspective of the NEC what was required in her room. It was a nursing home, it was the room the young lady called hers, she had equipment that her life dependent on.

517.18 General Care Areas. 2008 NEC
(A) Patient Bed Location. Each patient bed location shall be supplied by at least two branch circuits, one from the emergency system and one from the normal system. All branch circuits from the normal system shall originate in the same panelboard.

Exception #2 excludes the requirement in 517.18 (A) 2008 NEC
From patient bed locations in outpatient facilities, from patient bed locations in clinics, from patient bed locations in doctors office buildings, from patient bed locations in dentist offices, patient bed locations psychiatric hospitals, from patient bed locations in rehabilitation hospitals, patient bed locations used exclusively as patient sleeping in nursing homes and limited care facilities.

Now we go to 517.18 (B) 2008 NEC Exception No. 1: The requirements of 517.18(B) shall not apply to psychiatric, substance abuse, and rehabilitation hospitals meeting the requirements of 517.10(B)(2).

Patient Bed Location. “The location of a patient sleeping bed”

517.18 (B) does not specifically exempt the requirement for receptacles or those required receptacles to be hospital grade in clinics, medical and dental offices, and outpatient facilities and limited care facilities and nursing homes

“Except nursing home sleeping beds used exclusively for sleeping”

From the perspective of the NEC what was required in her room.

what was required in her room?

 

[GoldDigger]

I might be open to the argument that a sleeping bed of a patient who requires constant suction is in fact a treatment bed, not one used "only" for sleeping.

 

[david]

I might be open to the argument that a sleeping bed of a patient who requires constant suction is in fact a treatment bed, not one used "only" for sleeping.

Yes not that hard of an argument to make, and there should be two branch circuits to depend on and her suction machine
should have never went to its battery and it should have been plug into a hospital grade rec.

now it gets harder to explain why the NEC calls out "patient bed locations" in "out patient" facilities

these where not FPN these where exceptions stating "patient bed locations" in out patient facilities are exempt, and how that is explained also explains the confusion in applying the requirement for hospital grade rec, and that leads to each of the medical facilities calling out "patient bed location" i.e. doctors office, dental office

I never new a dental office to provide a place intended for a patients comfort to sleep (Rest)

 

[david]

I hope this has been helpful

 

[GoldDigger]

I hope this has been helpful

Resolution is too low to read....

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