Saving Lives, Protecting People, Guidelines for environmental infection control in health-care facilities: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee, National Center for Immunization and Respiratory Diseases, Causes, How it Spreads, & People at Increased Risk, Things to Consider: Outbreak Investigations, Things to Consider: Healthcare-associated Cases and Outbreaks, Procedures for Identifying Cooling Towers, Photos of Various Types of Cooling Towers, Special Considerations for Healthcare Facilities, Water Management in Healthcare Facilities, Considerations for Hotel Owners and Managers, Considerations for Vacation Rental Owners and Managers, Considerations for Public Hot Tub Operators, Unexplained Respiratory Disease Outbreaks (URDO), European Legionnaires Disease Surveillance Network (ELDSNet), U.S. Department of Health & Human Services. Immediately preceding text appears at serial pages (23242) and (37960). 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. (c)The nurses station shall have facilities for: (3)Medication storage and preparation, which may be within the clean workroom, if a self-contained cabinet is provided. E. Adult. Mechanical ventilation shall be provided in this workroom. Source Immediately preceding text appears at serial page (242525). The area shall have separate soiled and clean workrooms. Exemption for State Law - The LSC nor HCFC is not applicable where CMS finds that a State has in effect a fire and safety code imposed by State law that adequately protects patients in health care facilities. View CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. 2233; amended January 31, 1987, effective July 1, 1987, 17 Pa.B. %{>6cK$7%LEtC Housekeeping and food and drink services. GL 23-1001. Guidelines for environmental infection control in health-care facilities: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. The provisions of this 205.46 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. 514. The provisions of this 205.71 amended under section 803 of the Health Care Facilities Act (35 P. S. 448.803); and section 2102(g) of The Administrative Code of 1929 (71 P. S. 532(g)). The written procedure, per the Interpretive Guidance (IG), The provisions of this 205.21 amended under section 803 of the Health Care Facilities Act (35 P. S. 448.803); and section 2102(g) of The Administrative Code of 1929 (71 P. S. 532(g)). (4)A double-locked narcotic compartment within the medication area. 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. The LSC is a set of fire protection requirements designed to provide a reasonable degree of safety from fire. 3999. Beyond air temperature, air quality at nursing homes must also be maintained. hYmo7+ For the wash solution in spray-type washers that use chemicals to sanitize, less than 49oC (120oF). The provisions of this 205.28 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. (d)Single bed bedrooms shall provide minimum room area clearance, in addition to the area of closets, vestibule, wardrobes and toilet rooms, of 100 square feet. The provisions of this 205.17 amended under section 803 of the Health Care Facilities Act (35 P. S. 448.803); and section 2102(g) of The Administrative Code of 1929 (71 P. S. 532(g)). 3999. 514; reserved July 23, 1999, effective July 24, 1999, 29 Pa.B. 514. The provisions of this 205.73 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. A safe, clean, and comfortable environment. 2233; amended January 31, 1987, effective July 1, 1987, 17 Pa.B. Cable and push button housing requirement will apply to those facilities constructed after July 1, 1987. D.II. 3999. 514. Here's a look at the minimum internal cooking temperatures to know: Minimum Internal Temperature. Please direct comments or questions to. An official website of the United States government. The provisions of this 205.30 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. The provisions of this 205.67 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. Corrective Actions (some examples) Eliminate dead legs, unused branches Remove or repurpose high risk features (e.g., water features, decorative fountains) Flush taps/fixtures in vacant rooms (a)The facility shall provide a general bathing area in each nursing unit to serve residents bedrooms which do not have adjoining bathrooms with a bathtub or shower. The provisions of this 205.74 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. 2233; amended January 31, 1987, effective July 1, 1987, 17 Pa.B. For areas not listed, such as dining rooms, lounge and recreation rooms, solaria, and the like, mechanical ventilation rates are optional, but where mechanical ventilation is provided, the supply air shall be obtained from the outdoors through individual room units or from central systems. The provisions of this 205.81 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. 3999. Facilities need to consider the size of the emergency water supply (b)There may be no less than 3 1/2 feet of space from front of toilet to opposite wall or fixtures. 3999. From the January 01, 2014 Issue of McKnight's Long-Term Care News. Only one duplex receptacle is required between beds plus sufficient duplex receptacles to supply portable lights, television and motorized beds, if used, and one duplex receptacle on another wall. The provisions of this 205.2 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. . The provisions of this 205.31 amended under section 803 of the Health Care Facilities Act (35 P. S. 448.803); and section 2102(g) of The Administrative Code of 1929 (71 P. S. 532(g)). 7500 Security Boulevard, Baltimore, MD 21244, National Partnership to Improve Dementia Care in Nursing Homes. The provisions of this 205.50 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. Do other residents seem to be exhibiting discomfort from the interior temperature? (a)There may be no new construction of a facility without the Departments approval of final plans. 532(g)). (a)In toilet rooms that adjoin resident bedrooms, there shall be at least one toilet for four residents. 2233, unless otherwise noted. In toilet rooms adjacent to bedrooms, the lavatory may be omitted if provided in each bedroom. The provisions of this 205.86 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. 3999. According to F-323 PP and the federal guidelines, the water temps. Therefore, all LSC and HCFC waiver requests recommended for approval by SAs and AO,must be forwarded to the RO for adjudication. ( (g)In facilities licensed prior to January 1975, resident multibed bedrooms shall have at least 65 square feet of space per resident. Get general information, including a link to FAQs, regarding enforcement actions that CMS may take when a nursing home is not in compliance with Medicare or Medicaid requirements. (a)At least one janitor closet shall be provided in a unit. The rooms may not be more than 120 feet from the most remote room served. nursing home, nursing facility, nursing care facility or intermediate care facility or a health facility that is planned, organized, operated, and maintained to provide supportive, restorative, and preventive services . The minimum dimension of a resident toilet room containing only a toilet shall be 3 feet by 6 feet. The Secretary has delegated to CMS the authority to grant waivers of LSC and HCFC provisions for all facilities participating in Medicare and Medicaid. weather events to occur, this is an important requirement for providers to have (a)Grounds shall be adequate to provide necessary service areas and outdoor areas for residents. 514. Doors into rooms used by residents may not be locked from the outside when the resident is in the room. (f)A multibed bedroom shall provide minimum room area clearances, in addition to the area of closets, vestibule, wardrobes and toilet rooms of 80 square feet per bed. 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. Where subsection (a) requirements for outdoor air is optional, this air may be supplied directly by transfer ducts or grilles to adjacent spaces without being filtered through a central system. 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. If a medication cart is used, provisions shall be made to lock the cart or to place the cart when not in use in a safe area that can be locked. (c)Hot water outlets accessible to residents shall be controlled so that the water temperature of the outlets does not exceed 110F. Ben Crump Law Powered by. 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. Immediately preceding text appears at serial page (89924). The provisions of this 205.35 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. 696 (January 28, 2023). 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. ];J$g%q?l-Ti}J] Kg^Halx0N 2233; reserved January 31, 1987, effective July 1, 1987, 17 Pa.B. States may also require their own initial survey before permitting facilities to become operational and admit patients. The provisions of this 205.14 amended under section 803 of the Health Care Facilities Act (35 P. S. 448.803); and section 2102(g) of The Administrative Code of 1929 (71 P. S. 532(g)). 2233; reserved January 31, 1987, effective July 1, 1987, 17 Pa.B. The provisions of this 205.33 amended under section 803 of the Health Care Facilities Act (35 P. S. 448.803); and section 2102(g) of The Administrative Code of 1929 (71 P. S. 532(g)). 2003;52(RR-10):142. 2233; amended January 31, 1987, effective July 1, 1987, 17 Pa.B. Is such clothing needed inside the home? With the idea of continuous quality improvement in mind, CMSCG's interdisciplinary team ensures that all departments can achieve and maintain compliance while improving quality of care. (e)The facility shall ensure that water for baths and showers is at a safe and comfortable temperature before the resident is bathed. Immediately preceding text appears at serial page (242516). (3) For dishwashing temperatures, refer to chapter 246-215 WAC. Copyright 2023 Haymarket Media, Inc. All Rights Reserved This material may not be published, broadcast, rewritten or redistributed in any form without prior authorization. Wait a minimum of 30 seconds before adjusting. Ceiling heights may be 7 feet 6 inches except in boiler rooms where a minimum of 30 inches shall be provided above the main boiler heater and connecting piping. How Can You Help Prevent Nursing Home Abuse? Procedures that occur . The provisions of this 205.33 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. This shall be directly accessible from bedrooms without entering the general corridor. (c) A person who repairs or tests the installation or operation of backflow prevention assemblies must hold a license issued by the commission under Chapter 37, Water Code. 696 (January 28, 2023). (a)Window openings in the exterior walls that are used for ventilation shall be effectively covered by screening. (b)Floors in the kitchen, bathroom, toilet rooms, shower rooms, utility rooms, bedpan and hopper rooms shall be of nonskid, nonabsorbent materials and easily cleanable. 514; corrected June 19, 1987, 17 Pa.B. 2233; reserved January 31, 1987, effective July 1, 1987, 17 Pa.B. The provisions of this 205.14 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. Minimum Standards for Care Homes. how water will be distributed and what is the method for calculating the volume If there was truly an emergency in your facility today, 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. The unlisted room areas, if ventilated, shall contain an equal pressure relationship. The provisions of this 205.37 amended under section 803 of the Health Care Facilities Act (35 P. S. 448.803); and section 2102(g) of The Administrative Code of 1929 (71 P. S. 532(g)). (i)In each resident room there shall be grounding type receptacles as follows: one duplex receptacle on each side of the head of each bed except for parallel adjacent beds. 3999. Stuffed meat, seafood, poultry, or pasta. 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. Nursing Homes: Rules and Regulations. Is There a High Risk for Infection in Nursing Homes? 3999. The report said that in a review of CDC recommendations, "When state regulations or codes do not allow hot water temperatures above the range of 105F-120F (40.6C-49C) for hospitals or 95F-110F (35C-43.3C) for nursing care facilities or when buildings cannot be retrofitted for thermostatic mixing valves, follow either of these alternative The provisions of this 205.40 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. (e)Equipment shall be made available and accessible for residents desiring to do their personal laundry. Immediately preceding text appears at serial page (242512). d]^ukV{kX,KndQ#q (e)Floors or units with more than eight residents of both sexes shall be provided with separate toilet fixtures in a ratio of 1:4 or major fraction thereof for each sex. The provisions of this 205.19 amended under section 803 of the Health Care Facilities Act (35 P. S. 448.803); and section 2102(g) of The Administrative Code of 1929 (71 P. S. 532(g)). 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Get the legal notice of provider and supplier terminations CMS is required to post for the public. The provisions of this 205.37 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. Learn about the required standardized patient assessment data about quality measures and Standardized Patient Assessment Data Elements (SPADEs) for public reporting our Compare site. This space is required in addition to the space required for lounge and recreation rooms. Under these agreements, the designated State fire authority generally agrees to: In most cases, the SA schedules the LSC/HCFC survey to coincide with the health survey; however, the timing of the LSC/HCFC survey is left to the discretion of the SAs. The Pennsylvania Code website reflects the Pennsylvania Code Emergency Rule for Hospitals Participating in the Centers for Medicare and Medicaid Services Acute Hospital Care at Home Program During the COVID-19 Pandemic. Why Are Nursing Homes Required to Maintain a Temperature Range Between 71 and 81 degrees? In multicorridor nursing units, additional visible signal indicators shall be installed at corridor intersections. (6)One-fourth inch scale layout: main kitchen, nurses station, utility room, physical therapy room, occupational therapy room and the like. The provisions of this 205.66 amended under section 803 of the Health Care Facilities Act (35 P. S. 448.803); and section 2102(g) of The Administrative Code of 1929 (71 P. S. 532(g)). Cubicle curtains may provide this privacy. Learn about public reporting, state-based coalitions, research, training, and revised surveyor guidance focused on ways to make quality of life better for people with dementia to protect them from substandard care and promote goal-directed, person-centered care for every nursing home resident. 3999. 2233; amended January 31, 1987, effective July 1, 1987, 17 Pa.B. Routine Prevention of Waterborne Microbial Contamination Within the Distribution System. 3999. If the codes listed in this subsection conflict, the most stringent requirement shall apply. (a)Provisions shall be made for isolating a resident as necessary in a single room which is ventilated to the outside as set forth in 205.66 (relating to special ventilation requirements for new construction). (f)Toilets and lavatories other than resident facilities shall be provided for male and female visitors in facilities. 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. 3999. These rules are typically applied to nursing homes, adult day health care institutions, and state homes for veterans. Immediately preceding text appears at serial pages (242505) to (242506). CMS Blog (8/28/19) Ensuring Safety and Quality In Nursing Homes, F922 Procedures to Ensure Water Availability, Ftag of the Week F695 Respiratory/ Tracheostomy Care and Suctioning (Pt 3), Ftag of the Week F695 Respiratory/ Tracheostomy Care and Suctioning (Pt 2), Ftag of the Week F695 Respiratory/ Tracheostomy Care and Suctioning (Pt 1), CMS MDS Transition to iQIES Reference Info, CMS Rescinds QSO-20-31-ALL and Releases QSO-23-10-NH. Immediately preceding text appears at serial page (242505). For hand sinks the minimum water temperature is 100F. Care homes Schools Hotels However, free chlorine is degraded rapidly at elevated water temperatures, which is a concern for hot water chlorination (Health Protection Surveillance Centre, 2009), The rate of reaction for the conversion of chlorine to monochloramine is sensitive to pH and can also be affected by contact time and temperature. The provisions of this 205.25 amended under section 803 of the Health Care Facilities Act (35 P. S. 448.803); and section 2102(g) of The Administrative Code of 1929 (71 P. S. 532(g)). The provisions of this 205.91 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. The provisions of this 205.1 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. There is no authority for either the State or the RO to grant waivers of Board and Care Occupancy provisions. Immediately preceding text appears at serial page (37961). 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. a plan in place for. 514. Immediately preceding text appears at serial page (23254). (a)A nurses station shall be located in each nursing unit, located as centrally as practical within the nursing unit. When you visit, does the home feel either too warm or too cold? (h)Ventilation air openings which are located near floors shall be installed not less than 3 inches above the finished floor. (a)Plumbing systems shall be installed to meet the requirements of local plumbing codes and Chapter 14, Medical Care Facility Plumbing Equipment, of the PHCC National Standard Plumbing Code. Procedures to Ensure Water Availability, which is part of the Physical There shall be recreation or lounge rooms for residents on each floor. Centers for Disease Control and Prevention. (a)Ventilation for new construction shall conform to the following: (b)Central air systems shall be provided with filters having a minimum efficiency of 25% based on ASHRAE Standard No. 3999. 50.01 (3), a nursing home is a place where five or more people who are not related to the operator: Reside. Measure the pH of your water to determine whether the disinfectant used in your building will be effective. The provisions of this 205.72 amended under section 803 of the Health Care Facilities Act (35 P. S. 448.803); and section 2102(g) of The Administrative Code of 1929 (71 P. S. 532(g)). 2462; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. The system pressure shall be sufficient to operate fixture and equipment during maximum demand periods. (a)Artificial lighting shall be restricted to electric lighting. According to the National Institute on Aging, in a nursing home, senior residents receive, Nursing home abuse can take on many forms. 2233; amended January 31, 1987, effective July 1, 1987, 17 Pa.B. The regulation at F922 states that facilities must have 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. Hot water should be stored at least at 60C and distributed so that it reaches a temperature of 50C (55C in healthcare premises) within one minute at the outlets. Please see LSC/HCFC Laws, Regulations, and Compliance Information link below in the Downloads section. 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. Immediately preceding text appears at serial pages (242506) to (252507). The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. We take your privacy seriously. (e)Each bathing room shall include a toilet and lavatory. The LSC is a set of fire protection requirements designed to provide a reasonable degree of safety from fire. (a)A floor occupied by residents shall have lavatories in the ratio of 1:4 residents or major fraction thereof. (b)Tables and space shall be provided to accommodate wheelchairs with trays and other devices. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Life Safety Code & Health Care Facilities Code Requirements, Quality, Safety & Oversight - Certification & Compliance, End Stage Renal Disease Facility Providers, Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), Psychiatric Residential Treatment Facility Providers, Comprehensive Outpatient Rehabilitation Facilities, Clinical Laboratory Improvement Amendments (CLIA), Religious Nonmedical Health Care Institutions, Chapter 2 - The Certification Process (PDF), LSC Laws, Regulations, and Compliance Information (PDF), CMS 2786W - Fire Safety Survey Report - ICF-IID (Large Facilities) 2012 Life Safety Code, CMS 2786Y - Fire Safety Evaluation System - ICF-IID (Small Facilities) 2012 Life Safety Code, CMS 2567 Statement of Deficiencies and Plan of Correction, CMS 2786M - Worksheet for Determining Evacuation Capability - ICF-IID (Existing Facilities Only) 2012 Life Safety Code, CMS 2786R - Fire Safety Survey Report - Health Care 2012 Life Safety Code, CMS 2786V - Fire Safety Survey Report - ICF-IID (Small Facilities) 2012 Life Safety Code, CMS 2786X - Fire Safety Survey Report - ICF-IID (Apartment House) 2012 Life Safety Code, CMS 2786T - Fire Safety Evaluation System - Health Care 2012 Life Safety Code, CMS 2786U - Fire Safety Survey Report - ASC & ESRD 2012 Life Safety Code, Quality, Safety & Oversight - Enforcement, Life Safety Code & Health Care Facilities Code (HCFC). (c)Minimum lighting levels for long-term care nursing facilities shall conform with the following: (d)The applicable standards for lighting levels are those established by the current edition of the Illuminating Engineering Society of North America (IES) Lighting Handbook. Sign up to get the latest information about your choice of CMS topics. No part of the information on this site may be reproduced forprofit or sold for profit. The provisions of this 205.40 amended under section 803 of the Health Care Facilities Act (35 P. S. 448.803); and section 2102(g) of The Administrative Code of 1929 (71 P. S. 532(g)). Title. pursuant to 6 CCR 1011-1, Chapter II, General Licensure Standards, Part 4, waiver of regulations for health care entities. (b)Water distribution systems shall be designed and arranged to provide potable hot and cold water at hot and cold water outlets at all times. If the hot water temperature can be maintained at 124F (51C), explore engineering options (e.g., install preset thermostatic valves in point-of-use fixtures) to help minimize the risk of scalding. As part of the same Standard, and to prevent risks from scalding, pre-set valves of a type Cookies used to make website functionality more relevant to you. (3)Schedules of room finishes, door type and size, plumbing fixtures, electrical fixtures and special equipment, such as sterilizers, kitchen equipment and the like. Immediately preceding text appears at serial pages (242511) to (242512). (b)The general bathroom or shower room used by residents shall be provided with one emergency signal bell located in close proximity to the tub or shower and which registers at the nursing station. The provisions of this 205.42 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. (b)Spaces occupied by people, machinery and equipment within buildings shall have electric lighting which is operational at all times. No part of the information on this site may be reproduced for profit or sold for profit. Please call today for a free case evaluation. Receive care or treatment for their physical or mental health. 3999. Read what institutions must do to qualify to participate as a SNF in the Medicare program and as a nursing facility in the Medicaid program. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. 2233; amended January 31, 1987, effective July 1, 1987, 17 Pa.B. We would issue notices to the maintenance department, with a copy to administration, if the temps went over a certain degree. 2233; amended January 31, 1987, effective July 1, 1987, 17 Pa.B. The provisions of this 205.90 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. 514; reserved July 23, 1999, effective July 24, 1999, 29 Pa.B. When state regulations or codes do not allow hot water temperatures above the range of 105F120F (40.6C49C) for hospitals or 95F110F (35C43.3C) for nursing care facilities or when buildings cannot be retrofitted for thermostatic mixing valves, follow either of these alternative preventive measures to minimize the growth of. The provisions of this 205.25 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. For existing facilities, a nursing home must maintain a minimum temperature of 71 degrees Fahrenheit during the heating season. Temperatures that are either too high or too low can lead to the following health problems with the elderly residents of nursing homes: Beyond rules that govern temperature settings in nursing homes, there are also strict rules governing how issues are to be identified and who are to be held responsible for problems arising from temperatures that are either too high or too low. The provisions of this 205.88 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. (a)Doors into bathrooms and toilet rooms used by residents shall be at least 36 inches wide, except for an existing facility where the minimum width of toilet room doors is 32 inches. Call or text 800-712-9119 or complete a Free Case Evaluation form, In the legal context, the burden of proof plays a critical role in the success of a case. https:// The provisions of this 205.82 adopted August 29, 1975, effective September 1, 1975, 5 Pa.B. 514; amended July 23, 1999, effective July 24, 1999, 29 Pa.B. Hot Water Temperatures in Adult Family Homes, P-01942 Author: Division of Quality Assurance Subject: 1100 Keywords "dqa, division of quality assurance, bal, bureau of assisted living, adult family homes, hot water temperatures, p01942" Created Date: 8/28/2017 11:39:30 AM 2233; amended July 6, 1979, effective July 7, 1979, 9 Pa.B. The facility shall have available at all times a quantity of linens essential for proper care and comfort of residents. Other shower areas may have standard installation of shower controls. This is in addition to the emergency signal bell located at each toilet unless a single bell can be reached by the resident from both the toilet and tub or shower. (c)There shall be at least one toilet on each floor to accommodate residents in wheelchairs. There shall be indoor stairs and stairways to a basement if the stairs are to be used by personnel of the facility. 2233; amended January 31, 1987, effective July 1, 1987, 17 Pa.B. The health and wellbeing of nursing home residents can be greatly affected by temperatures that are either too high or too low. Home Frequently Asked Questions Nursing Home Abuse Why Are Nursing Homes Required to Maintain a Temperature Range Between 71 and 81 degrees?