Applying SPS 382.50 to Additions and Alterations for Health Care and Health Care Related Facilities
Table 382.20-1, Item No. 1 states all plumbing, new installations, additions and alterations, regardless of the number of plumbing fixtures involved, serving hospitals, nursing homes, ambulatory surgery centers, renal dialysis centers, community−based residential facilities (CBRF), and inpatient hospice require plans and specifications to be submitted to the department for review.
The Department has received health care facilities plans in which the owner was replacing one or a series of fixtures by adding or altering the existing water distribution system. In some of these cases, the health care facility did not have an existing disinfection system meeting the provisions of Wis. Admin. Code section SPS 382.50(3)(b)6*. Wis. Admin. Code section SPS 382.22(3)(a) states when a fixture, appliance or section of pipe is replaced, the replacement fixture, appliance or pipe shall conform to the provisions of this chapter.
The Department has created this document to outline specific situations or scenarios in which the provisions within Wis. Admin. Code section SPS 382.50 and all other code sections apply to additions and alterations for health care and health care related facilities. For the purposes of this document the Department interprets additions to mean an extension or increase in the floor area or height of a building or structure. Furthermore, the Department interprets an alteration as any renovation of the plumbing system within an existing structure. Below is a table outlining the plumbing code section and instances in which they apply.
Code Section | Instances to Apply |
SPS 382.50(2)(a) Special fixtures and equipment.
| Applies to all alterations and additions involving new or relocated ice manufacture or storage; sterilizers and washer sanitizers; and, aspirators. |
SPS 382.50(2)(b) Spouts and actions. Except in psychiatric-care facilities in areas where patient safety is at risk with standard gooseneck spouts and actions, the selection of spouts and actions on plumbing fixtures shall comply with this section and Table 382.50-1.
| Applies to all alterations and additions involving new or relocated lavatories and sinks accessible to patients. |
SPS 382.50(2)(c) Floor drain prohibition.
| Applies to all alterations and additions involving new or relocated operating, delivery and cystoscopic rooms. |
SPS 382.50(3)(a) Hospital water supply systems. Water supply systems serving hospitals shall comply with all of the following:
| Does not apply unless the water service is extended to accommodate an addition or alteration of the hospital. |
SPS 382.50(3)(ag) Health care facilities. Hot and cold water shall be provided to all sinks accessible to patients and comply with all of the following:
| Does not apply to new or relocated sinks accessible to patients if the scope of the installation is only adding or relocating sinks accessible to patients and no new hot water distribution systema is installed. Requiring the entire hot water system to be at the new minimum storage temperature of 140°F has the potential to create a health hazard for the users per Wis. Admin. Code section SPS 382.10(1)(a). The existing water distribution system may or may not have been installed at a time when the proper mechanisms were required to address a temperature fail safe and scald protection. The 140°F water would serve the entire water distribution system and not just the addition or alteration. |
SPS 382.50(3)(b)1. Water supply systems serving a hospital, community-based residential facility, inpatient hospice or nursing home shall comply with all of the following: a. Except as provided in subd. 1. b., a single control valve may serve an area where 4 or fewer patient care units exist and where each unit contains not more than 2 persons. b. A water supply serving an intensive care patient care unit shall be individually valved. | Applies to all alterations and additions involving an altered or additional patient care units. Also, if there is an altered or additional intensive care patient care unit. |
SPS 382.50(3)(b)2. All water distribution piping shall be insulated in accordance with chs. SPS 361 to 366. | Applies to all alterations and additions involving a new hot water distribution system.** |
SPS 382.50(3)(b)3. Cold water shall be supplied to lavatories or sinks located in patient rooms. | Applies to all alterations and additions involving new or relocated lavatories or sinks located in patient rooms. |
SPS 382.50(3)(b)4. A hot water distribution system shall be under constant recirculation to provide continuous hot water at each hot water outlet, except that when using thermal disinfection, under subd. 6. a. uncirculated hot water distribution piping may not exceed 3 feet in developed length. | Does not apply unless a hot water recirculation system exists. |
SPS 382.50(3)(b)4m. Control valves shall automatically regulate the temperature of the water supply of the distribution system that exceeds 140°F to each fixture accessible to patients. | Applies to all alterations and additions involving a new hot water distribution system**. |
SPS 382.50(3)(b)5. Water provided to patient showers, therapeutic equipment and all types of baths shall be installed with pressure balanced and thermostatically controlled control valves which automatically regulate the temperature of the water supply to the fixture fitting outlet within a temperature range of 110°F to 115°F. Such control valves shall automatically reduce flow to 0.5 gpm or less when the water supply to the fitting outlet exceeds 115°F or when loss of cold water pressure occurs. | Applies to all alterations and additions involving new or relocated patient showers, therapeutic equipment and all types of baths.
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SPS 382.50(3)(b)6. Hot water distribution systems may not include a heat recovery system, and shall be installed and maintained to provide disinfection by one of the following methods: a. Water stored and circulation initiated at a minimum of 140°F and with a return of a minimum of 124°F. be. .5 mg/L residual chlorine. bm. Chloramine. bs. Chlorine dioxide. c. Another disinfection method approved by the department or using disinfectant provided by the municipality with an approved minimum residual disinfectant concentration at all points and individual site approval by the department. | Applies to all additions. Applies to alterations of the hot water distribution system**, which: Change the size capacity of the water heater(s); and, Change the size or material of the piping anywhere in the hot water distribution system** Does not apply to alterations of the hot water distribution systema, when any of the following apply: A repair or a replacement of a section of hot water distribution piping if the piping is the same size and material; Additional fixtures added to the existing hot water distribution system if the size capacity of the water heater is increased, size of the piping is not increased, or the material of the piping does not change; Direct replacement of the water heater(s); Direct replacement of plumbing fixtures per SPS 382.20(1)(am). |
SPS 382.50(3)(b)7. A water distribution system may not be designed, installed, or maintained so that the maximum water temperature to fixture fitting outlets accessible to patients exceeds 115°F. | Applies to all alterations and additions involving new or relocated fixture fitting outlets accessible to patients.
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SPS 382.50(3)(b)7m. The use of limit stops in faucets or shower or tub mixing valves to achieve a maximum temperature of 115°F is prohibited. | Applies to all alterations and additions involving new or relocated faucets, showers, or tub mixing valves.
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SPS 382.50(3)(b)8. Except as provided in subd. 7., a water distribution system may not be designed, installed and maintained so that the maximum temperature to fixture fitting outlets exceeds 180°F. | Applies to all alterations and additions involving new or relocated patient fixture fitting outlets. |
SPS 382.50(3)(b)9. Water outlets accessible to patients shall have laminar flow. | Applies to all alterations and additions involving new or relocated water outlets accessible to patients. |
SPS 382.50(3)(b)10. Any portion of the water distribution system terminating by means of a plug, cap, or closed fitting and dry downstream with no outlet within the water distribution system may not exceed 6 pipe diameters. | Applies to all alterations and additions involving extensions or alterations of the existing water distribution system. |
SPS 382.50(3)(b)11. Where a dialysis box is installed in a patient room or a patient toilet room, all of the following shall apply: a. The dialysis box shall be lockable. b. Hose threads located within a lockable dialysis box used exclusively for the connection of portable dialysis equipment do not require a cross connection control device. c. A receptor located within a dialysis box shall be sealed when not in use. | Applies to all alterations and additions involving new or relocated dialysis boxes. |
SPS 382.50(3)(b)12. Hot water distribution piping shall be labeled with the disinfection method used. Labeling shall be within the water heater mechanical room on the hot water distribution piping at the point of injection, within 5 feet of the injection point, and every 25 feet thereafter within the mechanical room. The interior of all doors serving the mechanical room shall be labeled with the disinfection method. All label lettering shall be at least 1/2 inch height in clearly readable letters. | Applies to all alterations and additions involving a new hot water distribution system**. |
SPS 382.50(3)(b)13. Facilities with a population exceeding 250 occupants shall have a water management plan. The management plan shall include all of the following: a. An emergency water contingency plan program on the loss or contamination of the water supply. b. A pathogen control plan. c. The emergency and routine disinfection procedures. d. The identity of the individual responsible for the water quality. e. The provisions for the periodic flushing of the water supply system. f. Balancing valve report for the hot water distribution system. | Applies to all alterations and additions involving facilities with a population exceeding 250 occupants |
SPS 382.50(3)(b)14. Expansion tanks installed in the hot water distribution system shall be of the flow-through type. | Applies to all alterations and additions involving new or relocated expansion tanks. |
SPS 382.50(3)(c) Adult day care centers. A water distribution system serving an adult day care center may not be designed, installed, or maintained so that the maximum water temperature to fixture fitting outlets accessible to participants exceeds 115°F. | Applies to all alterations and additions involving new or relocated fixture fitting outlets accessible to patients. |
All other plumbing code sections not listed above. | Applies to all additions and alterations of health care and health care related facilities. |
* Wis. Admin. Code section SPS 382.22(2)(a)1. states any existing plumbing system may remain and maintenance continue if the maintenance is in accordance with the original system design and the plumbing system was installed in accordance with the code in effect at the time of installation.
** The Department interprets “hot water distribution system” to mean that portion of the water distribution system from a water heater inlet control valve to the connection of a fixture supply connector, plumbing fixture, plumbing appliance, water-using equipment, or other piping systems to be served.