{"data":{"id":"us/38-cfr-59.160","jurisdiction":"us","citation":"38 CFR 59.160","heading":"Adult day health care requirements.","body":"As a condition for receiving a grant and grant funds under this part for an adult day health care facility, States must meet the requirements of this section.\n(a) Each adult day health care program, when it is co-located in a nursing home, domiciliary, or other care facility, must have its own separate designated space during operational hours.\n(b) The indoor space for an adult day health care program must be at least 100 square feet per participant including office space for staff, and must be 60 square feet per participant excluding office space for staff.\n(c) Each program will need to design and partition its space to meet its own needs, but the following functional areas must be available:\n(1) A dividable multipurpose room or area for group activities, including dining, with adequate table setting space.\n(2) Rehabilitation rooms or an area for individual and group treatments for occupational therapy, physical therapy, and other treatment modalities.\n(3) A kitchen area for refrigerated food storage, the preparation of meals and/or training participants in activities of daily living.\n(4) An examination and/or medication room.\n(5) A quiet room (with at least one bed), which functions to isolate participants who become ill or disruptive, or who require rest, privacy, or observation. It should be separate from activity areas, near a restroom, and supervised.\n(6) Bathing facilities adequate to facilitate bathing of participants with functional impairments.\n(7) Toilet facilities and bathrooms easily accessible to people with mobility problems, including participants in wheelchairs. There must be at least one toilet for every eight participants. The toilets must be equipped for use by persons with limited mobility, easily accessible from all programs areas, i.e., preferably within 40 feet from that area, designed to allow assistance from one or two staff, and barrier free.\n(8) Adequate storage space. There should be space to store arts and crafts materials, personal clothing and belongings, wheelchairs, chairs, individual handiwork, and general supplies. Locked cabinets must be provided for files, records, supplies, and medications.\n(9) An individual room for counseling and interviewing participants and family members.\n(10) A reception area.\n(11) An outside space that is used for outdoor activities that is safe, accessible to indoor areas, and accessible to those with a disability. This space may include recreational space and a garden area. It should be easily supervised by staff.\n(d) Furnishings must be available for all participants. This must include functional furniture appropriate to the participants' needs.\n(e) Unless determined by VA as necessary to accommodate an increased quality of care for patients, an adult day health care facility project may propose a deviation of no more than 10 percent (more or less) from the following net square footage for the State to be eligible for a grant of 65 percent of the total estimated cost of the project. If the project proposes building more than the following net square footage and VA makes a determination that it is not needed, the cost of the additional net square footage will not be included in the estimated total cost of construction.\nTable to Paragraph (e)—Adult Day Health Care\nI. Support facilities [allowable square feet (or metric equivalent) per facility for VA participation]:\nProgram Director 200\nAssistant administrator 150\nMedical officer, director of nursing or equivalent 150\nNurse and dictation area 120\nGeneral administration (each office/person) 120\nClerical staff (each) 80\nComputer area 40\nConference room (consultation area, in-service training) 500 (for each room).\nLobby/receiving/waiting area (150 minimum) 3 (per participant)\nPublic/resident toilets (male/female) 25 (per fixture).\nDining area (may be included in the multipurpose room) 20 (per participant).\nVending machines 1 (per participant).\nParticipant toilets (male/female) 25 (per fixture).\nMedical support (staff offices/family counseling, etc.) 140 (for each room).\nJanitor's closet 40\nDividable multipurpose room 15 (per participant).\nEmployee lockers 6 (per employee)\nEmployee lounge 120\nEmployee toilets 25 (per fixture).\nPhysical therapy 5 (per participant).\nOffice, if required 120\nOccupational therapy 5 (per participant).\nOffice, if required 120\nBuilding maintenance storage 2.5 (per participant).\nResident storage 6 (per participant).\nGeneral warehouse storage 6 (per participant).\nMedical/dietary 7 (per participant).\nGeneral laundry 1\nII. Other Areas:\nParticipant quiet room 3 (per participant).\nClean utility 120\nSoiled utility 105\nGeneral storage 100\nNurses station, ward secretary 260\nMedication/exam/treatment rooms 75\nWaiting area 50\nProgram supply and equipment 50\nStaff toilet 25 (per fixture).\nWheelchair storage 100\nKitchen 120\nJanitor's closet 40\nResident laundry 125\nTrash collection 60\nIII. Bathing and Toilet Facilities:\n(A) Private or shared facilities:\nWheelchair facilities 25 (per fixture).\nStandard facilities 15 (per fixture).\n(B) Full bathroom 75\n1 The size to be determined by the Chief Consultant, Geriatrics and Extended Care, as necessary to accommodate projected patient care needs (must be justified by State in space program analysis).","path":["Title 38—Pensions, Bonuses, and Veterans' Relief","CHAPTER I—DEPARTMENT OF VETERANS AFFAIRS","PART 59—GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-38.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:25:50Z","sha256":"eddb311518bdf3b49ed094f2b58bb509e4fdff3a73bd3171654d8c6b616a2a71","source_id":"us-cfr","stale":true,"prev":"us/38-cfr-59.150","next":"us/38-cfr-59.170"},"notice":"GroundRules: Original legal text. Not legal advice."}