# Ambulatory Health Care Facility



## Rick18071 (Sep 16, 2013)

2009 IBC. B use.

Looking at a health care facilty. It has x-ray room, labs, waitingroom, treatment room, and 9 exam rooms. It is also showing a ambulace entrance. Does the ambulance entrance make this make it an Ambulatory Health Care Facility which requires sprinklers per 903.2.2?


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## jpranch (Sep 16, 2013)

trauma room???


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## Rick18071 (Sep 16, 2013)

no trauma room


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## rshuey (Sep 16, 2013)

wrong wording


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## jpranch (Sep 16, 2013)

Just wondering why the ambulance? It it outgoing going just in case? Any "procedures" being done there? What types of treatment? Med gas? Anesthesia?


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## cda (Sep 16, 2013)

So what do they say they are doing there??

Any day surgery

What do they label the place as??


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## RLGA (Sep 16, 2013)

Ambulatory means that the patients typically can walk in and walk out--not that it has an ambulance entrance.

I expect that the ambulance entrance is to provide discreet access to emergency transportion to a suitable hospital/emergency room care should a patient need it.

Taking such a patient in a gurney through the waiting/lobby area is bad for business at these types of facilities.


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## rshuey (Sep 16, 2013)

wrong wording


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## RLGA (Sep 16, 2013)

rshuey said:
			
		

> Way to spoil it. I was hoping for some more responses before someone posted the actual meaning....


I'll hold my tongue, er, fingers, next time.


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## kilitact (Sep 16, 2013)

Ambulatory is where individuals are rendered incapable of self-preservation.


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## Rick18071 (Sep 16, 2013)

Maybe it should be an ambulance exit if they are only using it to transfer patients  elsewhere. But if the patient needs to be wheeled out I would asume that they are incapable of self-preservation which would still make it an Ambulatory Health Care Facility.


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## RLGA (Sep 16, 2013)

kilitact said:
			
		

> Ambulatory is where individuals are rendered incapable of self-preservation.


Au contraire.  Ambulatory: "relating to walking: relating to or equipped for walking"

A person who is rendered incapable of self-preservation is not ambulatory.  However, the IBC definition states that individuals may be rendered incapable of self preservation while in the care of such a facility due to minor surgical procedures, dialysis, or other procedures that would not allow a patient to exit immediately.  However, they will not be housed over night in such a facility.  In other words, they *walk *in, have the procedure done (incapable of self-preservation), then *walk *out later.


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## cda (Sep 16, 2013)

So what do they say they are doing there??

Any day surgery

What do they label the place as??


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## Rick18071 (Sep 16, 2013)

What if they use a wheel chair and can't walk?


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## Rick18071 (Sep 16, 2013)

They only labled it as health care. A clinic.


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## kilitact (Sep 16, 2013)

RLGA said:
			
		

> Au contraire.  Ambulatory: "relating to walking: relating to or equipped for walking"A person who is rendered incapable of self-preservation is not ambulatory.  However, the IBC definition states that individuals may be rendered incapable of self preservation while in the care of such a facility due to minor surgical procedures, dialysis, or other procedures that would not allow a patient to exit immediately.  However, they will not be housed over night in such a facility.  In other words, they *walk *in, have the procedure done (incapable of self-preservation), then *walk *out later.


                                                           Definitions

Section 202

Ambulatory Health Care Facility. Buildings or portions thereof used to provide medical, surgical, psychiatric, nursing or similar care on a less than 24-hour basis to individuals who are rendered incapable of self-preservation.

Looks like it states "are rendered incapable" not may.


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## RLGA (Sep 16, 2013)

kilitact:

That's the definition of an "ambulatory health care facility," not "ambulatory."  Ambulatory has the definition as I stated above.  An ambulatory health care facility means that a person can walk in, receive treatment, then walk out within a 24-hour period.  If there is a chance that a person may be "rendered incapable of self-preservation" while in treatment, then it is an ambulatory health care facility.  Not all patients at the facility will be rendered as such.


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## cda (Sep 16, 2013)

Sounds like a B unless they knock out 4 people then sprinkle it

Are they showing any med gas?


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## BSSTG (Sep 16, 2013)

kilitact said:
			
		

> Ambulatory is where individuals are rendered incapable of self-preservation.


dictionary.com definition

am·bu·la·to·ry

 [am-byuh-luh-tawr-ee, -tohr-ee] Show IPA adjective, noun, plural am·bu·la·to·ries.

adjective

1. of, pertaining to, or capable of walking: an ambulatory exploration of the countryside.

2. adapted for walking, as the limbs of many animals.

3. moving about or from place to place; not stationary: an ambulatory tribe.

4. Also, ambulant. Medicine/Medical .

a. not confined to bed; able or strong enough to walk: an ambulatory patient.

b. serving patients who are able to walk: an ambulatory care center.

5. Law. not fixed; alterable or revocable: ambulatory will.

BS


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## kilitact (Sep 17, 2013)

BSSTG said:
			
		

> dictionary.com definition am·bu·la·to·ry
> 
> [am-byuh-luh-tawr-ee, -tohr-ee] Show IPA adjective, noun, plural am·bu·la·to·ries.
> 
> ...


Yes, where your ambulatory and rendered incapable of self-preservation


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## Rick18071 (Sep 17, 2013)

You could be rendered incapable of self-preservation while your there even if you can walk in and out. You could be in the middle of getting a cast on or on anesthesia.


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## cda (Sep 17, 2013)

Is this a fancy Doc in the box???


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## Msradell (Sep 17, 2013)

cda said:
			
		

> Is this a fancy Doc in the box???


That's Certainly What It Sounds like to Me!


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## kilitact (Sep 17, 2013)

Msradell said:
			
		

> That's Certainly What It Sounds like to Me!


Could be a dispensery/smoke shop,


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## Codegeek (Sep 17, 2013)

RGLA is correct, an ambulatory health care facility is where someone comes in for minor surgery and is kept less than 24-hours and dismissed.  Most ambulatory facilities do things like sinus surgery, tonsillectomies, gall bladder removal (maybe), etc.  If the point is to have minor "day" surgery and have the patient go home the same day, it's an ambulatory health care facility.

The history behind the IBC code language, which is new in the 2009, comes from facilities showing up for "day" surgery and not really meeting the definition of an I use group.  Since the code was somewhat silent on these up and coming facilities, there was a committee created after the 2006 code hearings in Orlando, to develop some code language specific for these "day" surgery facilities.


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## Mech (Sep 17, 2013)

> Is this a fancy Doc in the box???


Is this a new character on the Island of Misfit Toys?


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## Rick18071 (Sep 18, 2013)

So if they can't walk in and out but must be wheeled in and out it's not an ambulatory health care facility. What is it then?


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## RLGA (Sep 18, 2013)

Rick18071 said:
			
		

> So if they can't walk in and out but must be wheeled in and out it's not an ambulatory health care facility. What is it then?


That is not always the case.  For the most part, people walk in and out.  Some may have to be wheeled out, either by policy after certain procedures or because they just can't.  Hospitals, which also includes ambulatory and nonambulatory patitents) and ambulatory health care facilities are very similar--the primary difference is that the ambulatory health care facility does not permit stays over 24 hours in length; otherwise, it's a hospital.


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## cda (Sep 18, 2013)

Depends on why the question is asked

If to require sprinklers than all the factors have to be taken into account

If it is a one hole doctor office should not make a difference


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## Mech (Sep 18, 2013)

Back to the original post.  The definition for Ambulatory Health Care Facility does not mention how a patient arrives or leaves.

Determine if the building meets the definition of Ambulatory Health  Care Facility.  If it does, then look at 903.2.2 to determine if  sprinklers are required.


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## High Desert (Sep 18, 2013)

Section 202 - 2012 IBC

 Ambulatory Health Care Facility. Buildings or portions thereof used to provide medical, surgical, psychiatric, nursing or similar care on a less than 24-hour basis to individuals who are rendered incapable of self-preservation.

[F] 903.2.2 Ambulatory care facilities. An automatic sprinkler system shall be installed throughout the entire floor containing an ambulatory care facility where either of the following conditions exist at any time:

1. Four or more care recipients are incapable of selfpreservation, whether rendered incapable by staff or staff has accepted responsibility for care recipients already incapable.

2. One or more care recipients that are incapable of self-preservation are located at other than the level of exit discharge serving such a facility.

In buildings where ambulatory care is provided on levels other than the level of exit discharge, an automatic sprinkler system shall be installed throughout the entire floor where such care is provided as well as all floors below, and all floors between the level of ambulatory care and the nearest level of exit discharge, including the level of exit discharge.

These are typically eye surgery, oral surgeons and other such day clinics that use general anesthesia making patients incapable of self-preservation. They can also be patients that arrive incapable. They come in, go under, and then leave after the procedure all in the same day.


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