In a rehabilitation center does a patient sleeping room become a patient care area once a dialysis machine is introduced?

I would say yes for the receptacle that the machine plugs into.

We ran new bedside circuits with backup power for the machines using hospital wiring methods. The AHJ now wants the lighting to be wired with hospital wiring methods as well. Some of the lighting is existing and some is being added (remodel. We wired the new lighting with regular MC, he wants it changed to hospital grade MC. The original lighting is piped using the emt as the only equipment grounding conductor.

If the fixtures are located more than 7-1/2-feet above the floor and switched from an area outside the patient care are, they don’t need to have the redundant ground so, if that's the case, regular MC should be okay there. As I understand it, if the wall switch is located more than 6-feet away from the edge of the bed, it would generally be considered as outside the patient care area.
IMO, 517.13,B exception #2 in the 2011 NEC is improperly worded and misleading. The way it references 517.13,A makes it sound like you have to have the redundant ground, which would make no sense, since it negates the purpose of the exception even being in article.

Do they have permanent fixed water and drain connections for the dialysis unit, like in a clinic?
I guess technically the area would become a patient care area, but in the hospitals, those portable hemodialysis units just roll into the room and they run long flexible lines to hook up to the sink faucet for water supply and drain them into the toilet of the patient bathroom. They have all the filtration tanks mounted on the back of the cart.
The peritoneal units just look like bags hanging from a pole with a cycler unit and a drain line or bag.

KJay,

There are no water or drain connections, the units are portable and will be wheeled in as needed. Prior to the installation of the bedside circuits for the machines the rooms were only patient sleeping rooms. It looks like the installation of the circuits changed them to patient care areas.

Did you look at the cord cap on the machine? Green dot??

Greg & Kjay have it 100%

I often wondered why they didn't have a different configuration on "hospital" plugs (maybe 4 pin with an extra ground), to help enforce 517 but I bet that would result in an adapter cable.

Greg:
Like the IG pool filter pumps with the factory twistlock?

I came accross quite a few ingenius homeowners this summer up here.

I would like to think that in a controlled setting like a health care facility the abuses would be limited but the more I think about it I do wonder why we go to all the trouble to bring a redundant ground to a receptacle and do not continue it to the equipment that actually connects to the patient.
The main problem would be getting it implemented. There are probably a million health care facilities and a 100 million pieces of equipment out there.

If I was king and able to design the new HCF receptacle it would be a 5-15 with a second ground hole in the middle so it would be backward compatible with old equipment and the new plug getting installed on new equipment.
Think of the "stimulus", all of those new receptacles we would have to install.

Greg:
A small side note to this subject. Our local hospital only 'stocks' HCF devices. Period, that's all they order and have in stock. Office areas, hallways, restrooms, waiting areas, etc. They 'failed' one inspection a few years back for non HCF receptacles in a few new patient rooms, due to what I refer to as 'hurry up fatigue', and were not happy campers. They used to have 'spec' grade in non HCF areas.

Guess the extra $ solves the problem.

The problem is, if you see an HCF receptacle you might assume HCF wiring methods feeding it and it sounds like you could be wrong if that is all they have in their bag. They could start using waiting rooms as patient treatment areas, assuming green dot receptacles mean it is compliant.
If you can believe all the hype, there are going to be more patients from all of this "reform"

The receptacles for the machines was never the question. We already ran reduntant grounding and green dot receps for the machines.
The question was about the rest of the room, mainly the lighting, and if it is now a patient care area because of the machines. That question has not been answered, perhaps because there is so much gray area involved.

I'd be open and shut for me...

Those are patient care machines if they've got redundant grounding.

Again, that was never in question. What is in question is are the sleeping rooms now patient care areas because they can now power the machines?

If they are only using something like a portable dialysis machine and it is on a HFC compliant circuit, I think you have met the intent of the code and you would be good to go in my patch.

Ditto to Gregs comment above.

Okay, I’ve been thinking this over for a while and I’m just wondering what difference it makes if the cord caps of the equipment have a green dot? The hospital grade receptacles they plug into are just higher quality heavy-duty, 3-wire, general purpose grounded receptacles. They don’t have any special provision for additional redundant grounding connection on the yoke.
I’ve installed hemodialysis equipment in a home before and the only requirement from the manufacturer is for a 3-wire grounded 20-amp individual branch circuit with GFCI protection. The water supply and drain lines for these can be set up either with temporary connections like in the situation the OP described or permanently connected.
Granted the NEC has much more stringent requirements for health care facilities, but I still not sure that this makes a difference in this particular situation.

Just some info for reference:
If the hemodialysis equipment for some reason stops mid cycle, say from equipment failure or a power outage, it is not life threatening because there is only about 300 ml or a coffee cup full of blood in the system at any time, even though it looks like a lot more. Normally a built in alarm sounds and the staff generally have up to two-minutes to perform a manual rinseback using the saline bag hanging above. If left for longer than that, the blood can clot in the lines, balance chambers or UF cartridge and the treatment is terminated and also the blood that remains in the system is discarded. The amount of blood lost is normally not critical even for patients with severe anemia.

Kjay:
Yes, a HCF device is a higher quality device, based on the mfg literature & UL testing spec.

The 'green dot' IMHO is only an indicator, as the 'triangle' indicates IG devices.

I just threw my 'green dot' on the cord cap in the discussion, as that is the easiest way to determine IF a device requires an HCF receptacle.

We had the discussion a while ago about the legality of IG receptacles on non-IG circuits. Wouldn't the same thing apply to HFC receptacles?

Well, I think if the inspector determines the patient bed area is now patient care area, which I believe it technically is based on the definition in [NEC 2011] 517.2, then the facility will likely end up having only certain dedicated patient bed locations that are also considered general patient care areas where they can administer the dialysis treatments, unless they want to make the changes to every patient bed location to make them into patient care areas.
I think that could be an issue for a rehabilitation center where there may be a need for several of these locations to be operating at once, but the code says what it says and I think it’s going to be the inspectors call as to which way things go and what will be required.

I don’t really see that the wiring method had any bearing on this, since the requirements for the branch circuit wiring methods and receptacle type appear to be the same for both locations, with the major differences being things like number of branch circuits, number of receptacles, emergency system circuits, etc.

I see where 517.16 restricts the use of IG receptacles in these areas anyway, but I don’t know where there is a restriction elsewhere in the code for using hospital grade receptacles in locations other than health care facilities, since as far as I can tell, all the green dot, hospital grade rating indicates is that they are an extra heavy-duty receptacle that meets the NEMA and/or UL standards for use in health care facilities. Any redundant grounding would seem to take place ahead of the receptacle itself, so IMO anyway, it shouldn’t have any effect on the use of the receptacle. I guess if someone wants to spend that kind of dough for their receptacles, they can put them just about anywhere they want.

Greg,

Was that part of the discussion I had with a dental chair needing redundant grounding?

This was more of a reaction to a comment that some health care facility maintenance department was using HFC receptacles everywhere. Wouldn't that create a situation where you would not be sure what was an HFC compliant circuit and what wasn't without opening up the box? (similar to the IG situation)

It might be easy to assume that if all the receptacles in a room were HFC, the room was built to HFC standards.

Greg:

I should have responded to your post sooner than this. Yes, it does give a 'false' impression that the circuitry is HCF compliant, when in some locations it is not. However, as the renovations continue any area that is being renovated is being wired with HCF cable or conduit. This reasoning is for future possibility of using 'any' of the renovated areas for patient care areas in an emergency, or 'over capacity' situation.

I suppose the problem is when you have a rock soup renovation. A room just starts creeping from office space to patient care a little at a time and might be done without any permits.

Greg:

That is not an issue at the hospital!

A few nearby office buildings that are constantly 'revolving door' space for various 'medical professionals' is where the unprofessionsl, and sometimes "scary" work happens. I even had a so called EC attempt to correct violations by actually green spray painting the NMC, to show me 'it's hospital grade'.