Types of Receptacles for Psychiatric Wards

Q. We had an inspection on our psychiatric ward and the question came up about what type of receptacles are approved in this type of environment... In the patient rooms we installed a special cover with a tamper proof screw over the receptacle which was accepted. They are asking for is GFCI receptacles in the hallways of this ward. To my understanding, GFCI receptacles are for wet locations and devices exposed to the elements. My question is what type if any receptacles are accepted in this type of area. As I said before the receptacles that are in the patient rooms are covered. The hallways are monitored by staff but the patients still have access to them.

A. The first part of the answer is: "What does your state require that is different than what is required by NFPA Codes?

The second part of the answer has to be: "When was your facility constructed and what codes did they use at that time? Has it been renovated in that specific area since then?"

In my opinion - having maintained inpatient care areas for all age groups of patients who have psychiatric, mental health issues and/or behavioral problems, I have found that the best approach when providing electrical receptacles in these areas is to provide outlets that provide both tamper resistance and GFCI protection. Patients can and will find ways to harm themselves given the opportunity to do so. I have never found tamper resistant covers to provide much protection. It has been my thoughts that the cost of the outlets that provided both tamper and GFCI were far less than the cost associated with handling an event if a patient hurts themselves.

OK now we can provide some general code answers!

Let's start with Psychiatric Hospital - A building used exclusively for the psychiatric care, on a 24-hour basis, of four or more inpatients.

The 2008 edition of the NEC states the following:

517.18 General Care Areas.
(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. 1: Branch circuits serving only special-purpose outlets or receptacles, such as portable X-ray outlets, shall not be required to be served from the same distribution panel or panels.

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 No. 3: A general care patient bed location served from two separate transfer switches on the emergency system shall not be required to have circuits from the normal system.

(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.

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).

Exception No. 2: Psychiatric security rooms shall not be required to have receptacle outlets installed in the room.

FPN: It is not intended that there be a total, immediate replacement of existing non–hospital grade receptacles. It is intended, however, that non–hospital grade receptacles be replaced with hospital grade receptacles upon modification of use, renovation, or as existing receptacles need replacement.

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OK so we now know that psychiatric rooms do not have to have receptacles per the 2008 edition of the NEC but if they are installed they need to be hospital grade devices. The requirement that stated the outlets or covers had to be tamper resistant is no longer in this code section, nor was it in the 2005 edition - but may well exist in a state code.

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NFPA 99 states the following:

4.3.2.2.6.2 Minimum Number of Receptacles. The number of receptacles shall be determined by the intended use of the patient care areas in accordance with 4.3.2.2.6.2(A) through 4.3.2.2.6.2(D).

(A) Receptacles for Patient Bed Locations in General Care Areas. Each patient bed location shall be provided with a minimum of four receptacles (or two duplex receptacles).

(B) Receptacles for Patient Bed Locations in Critical Care Areas. Each patient bed location shall be provided with a minimum of six receptacles (or three duplex receptacles).

(C) Receptacles for Bathrooms or Toilets. Receptacles shall not be required in bathrooms or toilet rooms.

(D) Receptacles for Special Areas. Receptacles shall not be required in areas where medical requirements mandate otherwise (e.g., certain psychiatric, pediatric, or hydrotherapy areas).

II. Wiring and Protection

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

Selected Receptacles. A minimum number of electrical receptacles to accommodate appliances ordinarily required for local tasks or likely to be used in patient care emergencies.

Psychiatric Hospital. A building used exclusively for the psychiatric care, on a 24-hour basis, of four or more inpatients.

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I find no requirements for having GFCI outlets for corridors. This may be a state requirement.

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Wet Procedure Locations. Those spaces within patient care areas where a procedure is performed and that are normally subject to wet conditions while patients are present. These include standing fluids on the floor or drenching of the work area, either of which condition is intimate to the patient or staff. Routine housekeeping procedures and incidental spillage of liquids do not define a wet location.

517.20 Wet Procedure Locations.

(A) Receptacles and Fixed Equipment. All receptacles and fixed equipment within the area of the wet procedure location shall have ground-fault circuit-interrupter protection for personnel if interruption of power under fault conditions can be tolerated, or be served by an isolated power system if such interruption cannot be tolerated.

Exception: Branch circuits supplying only listed, fixed, therapeutic and diagnostic equipment shall be permitted to be supplied from a grounded service, single- or 3-phase system, provided that

(a) Wiring for grounded and isolated circuits does not occupy the same raceway, and

(b) All conductive surfaces of the equipment are connected to an equipment grounding conductor.

(B) Isolated Power Systems. Where an isolated power system is utilized, the isolated power equipment shall be listed as isolated power equipment, and the isolated power system shall be designed and installed in accordance with 517.160.

FPN: For requirements for installation of therapeutic pools and tubs, see Part VI of Article 680.

517.21 Ground-Fault Circuit-Interrupter Protection for Personnel.

Ground-fault circuit-interrupter protection for personnel shall not be required for receptacles installed in those critical care areas where the toilet and basin are installed within the patient room.

Patient Care Area. Any portion of a health care facility wherein patients are intended to be examined or treated. Areas of a health care facility in which patient care is administered are classified as general care areas or critical care areas. The governing body of the facility designates these areas in accordance with the type of patient care anticipated and with the following definitions of the area classification.

FPN: Business offices, corridors, lounges, day rooms, dining rooms, or similar areas typically are not classified as patient care areas.