NEC 2011 (NFPA 70-2011)Article 517 - Health Care Facilities517.15 General Requirements. Patient care areas shall contain a grounding system that complies with the following

(B) Redundant Grounding.

Grounding shall be provided to electrical systems in patient care areas by more than one grounding conductor. These grounding conductors shall be installed in separate raceways or by other approved means.517.16 Panelboards for patient care areas shall



(A) Grounding. Have an equipment grounding bus sized in accordance with 250.122.(B) Isolated Grounding Receptacle and Isolated Power Circuit. Be provided with an isolated grounding receptacle and isolated power circuit as required by 517.18 for each patient bed location served.517.17 (D) Grounding. All grounded circuits in patient care areas shall be grounded so that there is no intentional impedance in the grounding circuit path.517.18 Isolated Power Systems. In patient care areas, an isolated power system shall supply each isolated grounding receptacle and isolated power circuit associated with a patient bed location.

Exception: Isolated grounding receptacles and isolated power circuits are not required in areas where isolated patient beds are not required by other articles in this Code.517.19 Ground-Fault Circuit Interrupters (GFCIs).(D) Patient Care Vicinity. Receptacles and luminaires used in the patient care vicinity shall be protected by GFCIs as required in Part III of Article 517 and by 210.8. Patient proximity shall be determined by accessibility, not by the use of the space.210.8 Ground-Fault Circuit-Interrupter Protection for Personnel.(B) Dwelling Units. All 125-volt, single-phase, 15- and 20-ampere receptacles installed in the locations specified in (B)(1) through (B)(4) shall have GFCI protection.(1) Bathrooms(2) Kitchens(3) Garages(4) Outdoors517.25 Wiring and Equipment in Patient Care Vicinity.(A) Lighting Fixtures. Lighting fixtures shall not be installed over patient beds in critical care areas, emergency rooms, or other similar locations. They shall be installed over 6 ft 6 in (1.98 m) above the floor in other patient care areas as measured from the top of the finished floor to the bottom of the fixture.(B) Switches and Receptacles. Switches and receptacles shall not be installed within patient reach. They shall be located outside the patient care vicinity and away from all sinks and lavatories.

Based on the information provided and the applicable NEC 2011 requirements: The lighting circuit in the exam room in a dialysis center must have redundant grounding even though the switch is not in the patient care vicinity and the light is over 6'6" from the floor. This is because the patient care area must have a grounding system with redundant grounding conductors and all grounded circuits in patient care areas must be grounded without intentional impedance in the grounding circuit path. The lighting fixture cannot be installed over the patient bed but must be installed over 6'6" above the floor in other patient care areas. Switches and receptacles must not be installed within patient reach and must be located outside the patient care vicinity and away from all sinks and lavatories. Flag for review