reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 5 - FACILITIES LICENSED ON OR AFTER SEPTEMBER 11, 2003 AND BEFORE APRIL 2, 2018 › Section 554.331 - Construction Standards

Current through Reg. 49, No. 28; July 12, 2024
(a) This
					 section applies to a facility constructed or licensed on or after September 11,
					 2003, but before April 2, 2018. The requirements of NFPA 101 and other
					 applicable NFPA codes and standards referenced in NFPA 101 will apply unless
					 otherwise noted or modified in this section:
(1) Buildings that were constructed or that
					 received design approval or building permits before July 5, 2016, must comply
					 with the Existing Health Care Occupancies chapter of NFPA 101. All other
					 buildings covered by this section must comply with the New Health Care
					 Occupancies chapter of NFPA 101.
(2) In addition to NFPA 101 and the standards
					 referenced therein, a facility covered by this division is subject to the
					 codes, standards, and requirements established by the following: UL; ASHRAE;
					 and ASTM.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 5 - FACILITIES LICENSED ON OR AFTER SEPTEMBER 11, 2003 AND BEFORE APRIL 2, 2018 › Section 554.333 - General Considerations

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Services. Nursing facilities must either contain the elements described in this
					 section or the facility must indicate the manner in which the needed services
					 are to be made available. Appropriate modifications or deletions in space
					 requirements may be made when services are shared or purchased.
(b) Sizes. The sizes of the various
					 departments will depend upon program requirements and organization of services
					 within the facility. Some functions requiring separate spaces or rooms in these
					 minimum requirements may be combined provided that the resulting plan will not
					 compromise the best standards of safety and of medical and nursing
					 practices.
(c) Shared or combined
					 services. Nursing facilities may be operated together with hospitals and may
					 share administration, food service, recreation, janitor service, and physical
					 therapy facilities, but must have clearly identifiable physical separations
					 such as a separate wing or floor. Nursing facilities with different levels of
					 care will require identifiable physical separations. Combined attendant or
					 nurses' stations and medication room areas will require some separating
					 construction features.
(d) Exterior
					 finishes. Unless otherwise approved by HHSC, the exterior finish material of
					 buildings classified as fire resistive or protected noncombustible
					 construction, per NFPA 220, must have a flame spread index no greater than 25
					 and a smoke developed index no greater than 450, when tested in accordance with
					 ASTM E84 or UL 723. All other exterior materials must have a flame spread index
					 no greater than 75 and a smoke developed index no greater than 450. Items of
					 trim may be of combustible material subject to approval by HHSC. Roof covering
					 assemblies must have a Class A or Class B rating, when tested in accordance
					 with ASTM E108 or UL 790.
(e)
					 Accessibility for individuals with disabilities. The facility must comply with
					 accessibility requirements for individuals with disabilities in the revised
					 regulations for Title II and III of the Americans with Disabilities Act at CFR
					 Part 35 and Part 36, also known as the 2010 ADA Standards for Accessible Design
					 and the TAS adopted by the Texas Department of Licensing and Regulation (TDLR)
					 rules at 16 TAC Chapter 68. A facility must register plans for new
					 construction, substantial renovations, modifications, and alterations with
					 TDLR, Attn: Elimination of Architectural Barriers Program, and comply with
					 TAS.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 5 - FACILITIES LICENSED ON OR AFTER SEPTEMBER 11, 2003 AND BEFORE APRIL 2, 2018 › Section 554.336 - Smoke Compartmentation (Subdivision of Building Spaces)

Current through Reg. 49, No. 28; July 12, 2024
(a) Smoke
					 compartmentation must be as described in NFPA 101 and in this
					 section.
(b) An exit sign must be
					 provided on each side of corridor smoke doors unless otherwise directed by HHSC
					 .
(c) The metal frames for the wire
					 glass view panels in smoke doors must be steel, unless otherwise approved by
					 HHSC. The bottom of the view panel must not be higher than 54 inches above the
					 floor. Pairs of opposite (double egress) swinging smoke doors in corridors must
					 have push/pull hardware. The door leaves must align in the closed
					 position.
(d) Smoke barrier walls
					 in concealed spaces such as attics, must have prominent signs on each side that
					 read: "Warning: Smoke/fire barrier. Properly seal all openings."
(e) Provisions must be made for reasonable
					 access to concealed smoke barrier walls for maintaining smoke dampers and so
					 that walls and dampers can be visually checked periodically for conformance by
					 facility staff, service persons, and inspectors. Access must provide for visual
					 inspection of both sides of the wall, and of all parts (end-to-end and
					 top-to-bottom). Ceiling access panels must be prefabricated metal panel, or its
					 equivalent, and be at least 20 inches by 20 inches with no obstructions above
					 (such as ducts) to hamper entrance, and it must be fire rated if required to
					 maintain ceiling-roof or ceiling-floor fire rating. Access must be provided for
					 both sides of the wall.
(f) Air
					 systems should be designed to avoid having ducts which penetrate smoke barrier
					 walls, thus eliminating the need for smoke dampers which are often a problem to
					 maintain in proper working condition.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 5 - FACILITIES LICENSED ON OR AFTER SEPTEMBER 11, 2003 AND BEFORE APRIL 2, 2018 › Section 554.337 - Fire Protection Systems

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Fire protection systems include detection, alarm, and communication systems;
					 fixed automatic extinguishment systems; and portable extinguishers. These
					 systems must meet the requirements of NFPA 101, and of this section. Components
					 must be compatible and laboratory listed for the use intended.
(b) Fire protection systems must meet the
					 requirements of all applicable NFPA standards, such as NFPA 72 for alarm
					 systems, as referenced in NFPA 101. Wiring and circuitry for alarm systems must
					 meet the applicable requirements of NFPA standards including the NFPA 70 for
					 these systems.
(c) Requirements of
					 emergency electrical systems must be in accordance with § 554.341 of this
					 chapter (relating to Electrical Requirements). Requirements for sprinkler
					 systems must be in accordance with § 554.340(4) of this chapter (relating
					 to Mechanical Requirements).
(d)
					 Partial sprinkler systems (those provided only for hazardous areas) must be
					 interconnected with the fire alarm and comply with NFPA 101. Each partial
					 system must have a valve with a supervisory switch to sound a trouble signal,
					 water flow switch to activate the fire alarm, and an end-of-line test
					 drain.
(e) Fire alarm systems must
					 be installed, maintained, and repaired by an agent having a current certificate
					 of registration with the State Fire Marshal's office, in accordance with state
					 law. A fire alarm installation certificate must be provided as required by the
					 Office of the State Fire Marshal.
(f) The fire alarm system must be designed so
					 that whenever the general alarm is sounded by activation of any device (such as
					 manual pull, smoke sensor, sprinkler, or kitchen range hood extinguisher), the
					 following must occur automatically:
(1) smoke
					 and fire doors which are held open by approved devices must be released to
					 close;
(2) air handlers (air
					 conditioning or heating distribution fans) serving three or more rooms or any
					 means of egress must shut down immediately;
(3) smoke dampers must close; and
(4) the alarm-initiating-device location must
					 be clearly indicated on the fire alarm control panel(s) and all auxiliary
					 panels.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 5 - FACILITIES LICENSED ON OR AFTER SEPTEMBER 11, 2003 AND BEFORE APRIL 2, 2018 › Section 554.338 - Hazardous Areas

Current through Reg. 49, No. 28; July 12, 2024
(a) Protection from
					 hazardous areas must be as required in NFPA 101, except as required or modified
					 in this section. Gas-fired equipment must not be located in attic spaces,
					 except under the following conditions:
(1)
					 the area around the units must be constructed to be one-hour fire
					 rated;
(2) the enclosure must have
					 sprinkler protection; and
(3)
					 combustion and venting air must be ducted from the exterior in properly sized
					 metal ducts.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 5 - FACILITIES LICENSED ON OR AFTER SEPTEMBER 11, 2003 AND BEFORE APRIL 2, 2018 › Section 554.339 - Structural Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Every building and every portion thereof must be designed and constructed to
					 sustain all dead and live loads in accordance with accepted engineering
					 practices and standards.
(b)
					 Special provisions must be made in the design of buildings in regions where
					 local experience shows loss of life or extensive damage to buildings resulting
					 from hurricanes, tornadoes, earthquakes, or floods.
(c) The sponsor is responsible for employing
					 qualified personnel in the preparation of plan designs and engineering and in
					 the construction of the facility to assure that all structural components are
					 adequate, safe, and meet the applicable construction requirements.
(d) The design of the structural system must
					 be done by or under the direction of a professional structural engineer who is
					 currently registered by the Texas Board of Professional Engineers and Land
					 Surveyors in accordance with state law.
(e) The parts of the plans, details, and
					 specifications covering the structural design must bear the legible seal of the
					 engineer on the original drawings from which the prints are made.
(f) If the municipality has a building code,
					 that code must govern the building requirements for the construction involved.
					 NFPA 101 must be used for fire safety requirements. Should discrepancies
					 between the codes arise, they must be called to the attention of
					 HHSC.
(g) In the absence of a local
					 building code, a nationally recognized building code must be used with regard
					 to the construction integrity of the building. NFPA 101 must be used for fire
					 safety requirements.
(h) Each
					 building must be classified as to building construction type for fire
					 resistance rating purposes in accordance with NFPA 220 and NFPA 101.
(i) Enclosures of vertical openings between
					 floors must meet NFPA 101.
(j) All
					 interior walls, partitions, and roof structure in buildings of fire resistive
					 and noncombustible construction must be of noncombustible or limited
					 combustible materials.
(k) Building
					 insulation materials, unless sealed on all sides and edges in an approved
					 manner, must have a flame spread rating of 25 or less when tested in accordance
					 with NFPA 255 and NFPA 258.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 5 - FACILITIES LICENSED ON OR AFTER SEPTEMBER 11, 2003 AND BEFORE APRIL 2, 2018 › Section 554.342 - Miscellaneous Details

Current through Reg. 49, No. 28; July 12, 2024
(a) Safety
					 related details. A high degree of safety for the occupants is needed to
					 minimize accidents more apt to occur with the elderly and/or infirm residents
					 in a nursing facility. Consideration must be given to the fact that many have
					 impaired vision, hearing, spatial perception, and ambulation.
(1) Hazards such as sharp corners and edges
					 and unexpected steps must be avoided.
(2) Items such as drinking fountains,
					 telephone booths, vending machines, and portable equipment must be located so
					 as not to restrict corridor traffic or reduce corridor width.
(3) Windows must be designed to prevent
					 residents from accidentally falling through the windows.
(4) Doors that normally stay open or are
					 frequently used must not swing out into the corridor unless otherwise needed or
					 required. Alcoves may be provided for doors that must swing outward toward a
					 corridor or way of egress.
(5) The
					 proper use of safety glass must be adhered to in applicable locations and
					 conditions.
(6) Thresholds and
					 expansion joint covers must be made essentially flush with the floor surface to
					 facilitate use of wheelchairs and carts. See § 554.340(a)(8) of Title 40
					 (relating to Mechanical Requirements) for requirements for such items as shower
					 curbs, surfaces, and doors.
(7)
					 Grab bars must be provided at all residents' toilets, showers, tubs, and sitz
					 baths. The bars must be 1-1/4 to 1-1/2 inches in diameter and must have 1-1/2
					 inch clearance to walls. Bars must have sufficient strength and anchorage to
					 sustain a concentrated load of 250 pounds. Grab bar standards must comply with
					 standards adopted under the Americans with Disabilities Act of 1990.
(8) Handrails must be provided on both sides
					 of corridors used by residents. A clear distance of 1-1/2 inches must be
					 provided between the handrail and the wall. Handrails must be securely mounted
					 to withstand downward forces of 250 pounds. Handrails may be omitted on wall
					 segments less than 18 inches. Handrails must be mounted 33 inches to 36 inches
					 above the floor, and must comply with standards adopted under the Americans
					 with Disabilities Act and the Texas Accessibility Standards.
(9) Ends of handrails and grab bars must be
					 constructed to prevent snagging the clothes of residents (that is, return ends
					 to wall).
(10) Ceiling fan blades
					 must be at least seven feet above the floor and be located so as not to
					 interfere with the operation of any ceiling-mounted smoke detectors.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 5 - FACILITIES LICENSED ON OR AFTER SEPTEMBER 11, 2003 AND BEFORE APRIL 2, 2018 › Section 554.343 - Elevators

Current through Reg. 49, No. 28; July 12, 2024
All buildings having residents' facilities (such as
						bedrooms, dining rooms, or recreation areas) or resident services (such as
						diagnostic or therapy) located on other than the main entrance floor must have
						at least one electric or electrohydraulic elevator and must comply with
						standards adopted under the American National Standards Institute (ANSI) Code,
						§A17.1.
(1) Number of elevators.
(A) At least one hospital-type elevator must
					 be installed where one to 60 resident beds are located on any floor other than
					 the main entrance floor.
(B) At
					 least two (one of which must be hospital-type) elevators must be installed
					 where 61 to 200 resident beds are located on floors other than the main
					 entrance floor, or where the major inpatient services are located on a floor
					 other than those containing resident beds. Elevator service may be reduced for
					 those floors which provide only partial inpatient services.
(C) At least three (one of which must be
					 hospital-type) elevators must be installed where 201 to 350 resident beds are
					 located on floors other than the main entrance floor or where the major
					 inpatient services are located on a floor other than those containing resident
					 beds. Elevator service may be reduced for those floors which provide only
					 partial inpatient services.
(D) For
					 facilities with more than 350 resident beds, the number of elevators must be
					 determined from a study of the facility plan and the estimated vertical
					 transportation requirements.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 7 - SMALL HOUSE AND HOUSEHOLD FACILITIES › Section 554.345 - Small House and Household Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) This section applies to a small house or
					 household facility that is designed to provide a non-institutional environment
					 to promote resident-centered care. New construction of a small house or
					 household facility, including a conversion of an existing facility, an addition
					 to an existing facility, or rehabilitation of an existing facility, must meet
					 the requirements of this section.
(b) A small house or household facility must
					 comply with this chapter, except it is not required to comply with a
					 requirement in Division 9 of this subchapter (relating to Facilities Licensed
					 On or After April 2, 2018) if HHSC waives the requirement in accordance with
					 subsection (c) of this section or if the requirement is modified by subsection
					 (g) of this section.
(c) HHSC may
					 waive a requirement in Division 9 of this subchapter if HHSC determines a
					 waiver of the requirement would facilitate the implementation of
					 resident-centered care. To request a waiver of a requirement, a facility must
					 submit plans to HHSC according to § 554.344 of this subchapter (relating
					 to Plan Review). The plans must include a statement from an architect
					 identifying which requirements the facility is requesting to be waived and
					 explaining how the waiver would contribute to the goals of resident-centered
					 care.
(d) A small house or
					 household facility must be designed and equipped to provide a homelike
					 environment that promotes resident-centered care.
(e) A small house or a household within a
					 facility must:
(1) have no more than 16
					 bedrooms as described in subsection (g)(2) of this section;
(2) have living, dining, social, and staffing
					 areas exclusively within and for the house or household; and
(3) have a kitchen that meets the
					 requirements in § 554.354(g)(1) of this subchapter (relating to
					 Architectural Space Planning and Utilization for New Facilities) or a food
					 service area that meets the requirements of an auxiliary serving kitchen in
					 § 554.354(g)(3) of this subchapter, exclusively within and for the house
					 or household.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 8 - BUILDING REHABILITATION › Section 554.350 - Building Rehabilitation

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 This section applies to facilities undergoing rehabilitation.
(b) Rehabilitation work is classified as
					 follows:
(1) The patching, restoration, or
					 painting of materials, elements, equipment, or fixtures for the purpose of
					 maintaining such materials, elements, equipment, or fixtures in good or sound
					 condition must be classified as repair and must meet the following
					 requirements:
(A) A repair must meet the
					 applicable requirements of § 554.300(d) of this subchapter (relating to
					 General Requirements);
(B) A repair
					 must be done using like materials, unless such materials are prohibited by NFPA
					 101; and
(C) A repair must not make
					 a building less conforming with NFPA 101 or the applicable sections of this
					 subchapter, or with any alternative arrangements previously approved by HHSC,
					 than it was before the repair was undertaken, unless approved by
					 HHSC.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 9 - FACILITIES LICENSED ON OR AFTER APRIL 2, 2018 › Section 554.351 - Construction Standards for New Nursing Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) This section applies to a facility
					 licensed on or after April 2, 2018. The requirements of NFPA 101 and other
					 applicable NFPA codes and standards referenced in NFPA 101 will apply unless
					 otherwise noted or modified in this section:
(1) Buildings covered by this section must
					 comply with the New Health Care Occupancies chapter of NFPA 101.
(2) In addition to NFPA 101 and the standards
					 referenced therein, a facility covered by this division is subject to the
					 codes, standards, and requirements established by the following: UL; ASHRAE;
					 and ASTM.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 9 - FACILITIES LICENSED ON OR AFTER APRIL 2, 2018 › Section 554.356 - Smoke Compartments (Subdivision of Building Spaces) for New Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) Smoke
					 compartments must be as described in NFPA 101 and in this section.
(b) A facility must provide an exit sign on
					 each side of corridor smoke barrier doors, unless otherwise directed by HHSC.
(c) The metal frame for a vision
					 panel in a smoke barrier door must be steel, unless otherwise approved by HHSC.
					 The bottom of a vision panel must be located no more than 43 inches above the
					 floor. A facility must provide push or pull hardware on pairs of opposite
					 swinging, double egress smoke barrier doors in corridors. Door leaves must
					 align in the closed position.
(d) A
					 facility must provide prominent signs on each side of smoke barrier walls in
					 concealed spaces such as attics. The signs must state: "Warning: Smoke/fire
					 barrier. Properly seal all openings."
(e) A facility must provide reasonable access
					 to concealed smoke barrier walls for maintaining smoke dampers, where provided,
					 so that walls and dampers can periodically be visually checked for conformance
					 by facility staff, service personnel, and inspectors. A facility must provide
					 access to both sides of the wall, and to all parts, end-to-end and
					 top-to-bottom. A facility must provide prefabricated metal ceiling access
					 panels, or their equivalent, that are at least 20 inches wide by 20 inches
					 long. Ceiling access panels must be fire resistance-rated if required to
					 maintain the fire resistance rating of a roof-ceiling or floor-ceiling
					 assembly.
(f) A facility should
					 design air systems to avoid ducts that penetrate smoke barrier walls, thus
					 eliminating the need for smoke dampers which are often a problem to maintain in
					 proper working condition.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 9 - FACILITIES LICENSED ON OR AFTER APRIL 2, 2018 › Section 554.357 - Fire Protection Systems for New Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) Fire protection systems include
					 detection, alarm, and communication systems; fixed automatic extinguishment
					 systems; and portable extinguishers. These systems must meet the requirements
					 of NFPA 101, and of this section. Components must be compatible and listed by a
					 nationally recognized testing laboratory for the intended use.
(b) Fire protection systems must meet the
					 requirements of all applicable NFPA standards, such as NFPA 72 for alarm
					 systems, as referenced in NFPA 101. Wiring and circuitry for alarm systems must
					 meet the applicable requirements of NFPA standards, including NFPA
					 70.
(c) Emergency electrical
					 systems must meet the requirements of this division.
(d) A fire alarm system must be installed,
					 maintained, and repaired by an agent having a current certificate of
					 registration from the State Fire Marshal's Office, according to state law. The
					 agent must provide a Fire Alarm Installation Certificate to the facility as
					 required by the State Fire Marshal's Office.
(e) A fire alarm system must be designed so
					 that whenever a general alarm is sounded by activation of any device, such as a
					 manual pull, smoke detector, fire sprinkler, or kitchen range hood
					 extinguisher, the following must occur automatically:
(1) smoke and fire doors which are held open
					 by approved devices must be released to close;
(2) air conditioning or heating distribution
					 fans serving three or more rooms, or any means of egress, must shut down
					 immediately;
(3) smoke dampers must
					 close; and
(4) the location of an
					 alarm-initiating device must be clearly indicated on the fire alarm control
					 panel and all auxiliary panels.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 9 - FACILITIES LICENSED ON OR AFTER APRIL 2, 2018 › Section 554.358 - Hazardous Areas for New Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) Protection from hazardous areas must be
					 as required in NFPA 101, except as required or modified in this section.
					 Gas-fired equipment must not be located in attic spaces, except under the
					 following conditions:
(1) the area around the
					 units must have a one-hour fire resistance rating;
(2) the enclosure must have sprinkler
					 protection; and
(3) combustion and
					 venting air must be ducted from the exterior in properly sized metal
					 ducts.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 9 - FACILITIES LICENSED ON OR AFTER APRIL 2, 2018 › Section 554.359 - Structural Requirements for New Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) Every building and portion of a building
					 must be capable of sustaining all dead and live loads in accordance with
					 accepted engineering practices and standards.
(b) Special provisions must be made in the
					 design of buildings in regions where local experience shows loss of life or
					 extensive damage to buildings resulting from hurricanes, tornadoes,
					 earthquakes, or floods.
(c) The
					 facility is responsible for employing qualified personnel in the preparation of
					 plan designs and engineering and in the construction of the facility to ensure
					 that all structural components are adequate, safe, and meet the applicable
					 construction requirements.
(d) The
					 design of the structural system must be done by or under the direction of a
					 professional structural engineer who is currently licensed by the Texas Board
					 of Professional Engineers according to state law.
(e) The parts of the plans, details, and
					 specifications covering the structural design must bear the legible seal of the
					 engineer on the original drawings from which the prints are made.
(f) A building must be constructed according
					 to the locally adopted building code. NFPA 101 must be used for fire safety
					 requirements. Discrepancies between the codes must be called to the attention
					 of HHSC for resolution.
(g) In the
					 absence of a locally-adopted building code, a building must meet the
					 requirements of a nationally recognized model building code. NFPA 101 must be
					 used for fire safety requirements.
(h) Each building must be classified as to
					 building construction type for fire resistance rating purposes according to
					 NFPA 220 and NFPA 101.
(i)
					 Enclosures of vertical openings between floors must meet NFPA 101.
(j) All interior walls, partitions, and roof
					 structure in buildings of fire resistive and noncombustible construction must
					 be according to NFPA 101.
(k)
					 Building insulation materials, unless sealed on all sides and edges in an
					 approved manner, must have a flame spread rating of 25 or less when tested
					 according to ASTM E84 or UL 723.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 9 - FACILITIES LICENSED ON OR AFTER APRIL 2, 2018 › Section 554.360 - Mechanical Requirements for New Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) The design of the mechanical systems must
					 be done by or under the direction of a licensed professional mechanical
					 engineer approved by the Texas Board of Professional Engineers to operate in
					 Texas, and the parts of the plans and specifications covering mechanical design
					 must bear the legible seal of the engineer.
(1) Building services pertaining to
					 utilities; heating, ventilating, and air-conditioning systems; vertical
					 conveyors; and chutes must be according to NFPA 101.
(2) Required plumbing fixtures must be
					 according to NFPA 101 and §554.354 of this division (relating to
					 Architectural Space Planning and Utilization for New Facilities) in specific
					 use areas.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 9 - FACILITIES LICENSED ON OR AFTER APRIL 2, 2018 › Section 554.361 - Electrical Requirements for New Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) The design of the electrical systems must
					 be done by or under the direction of a licensed professional electrical
					 engineer approved by the Texas Board of Professional Engineers and Land
					 Surveyors to operate in Texas, and the parts of the plans and specifications
					 covering electrical design must bear the legible seal of the engineer.
(1) Utilities; heating, ventilating, and
					 air-conditioning systems; vertical conveyors; and chutes must meet the
					 requirements of NFPA 101, Chapter 9, Building Service and Fire Protection
					 Equipment.
(2) Fire protection
					 systems, including fire alarms, must meet the requirements of §554.357 of
					 this division (relating to Fire Protection Systems for New
					 Facilities).
(3) Lighting and
					 outlets at resident bedrooms must meet the requirements of §554.354 of
					 this division (relating to Architectural Space Planning and Utilization for New
					 Facilities).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter D - FACILITY CONSTRUCTION › Division 9 - FACILITIES LICENSED ON OR AFTER APRIL 2, 2018 › Section 554.363 - Elevators for New Facilities

Current through Reg. 49, No. 28; July 12, 2024
A facility providing resident-use areas, such as
						bedrooms, dining rooms, or recreation areas, or resident services, such as
						diagnostic services or therapy services, located on other than the main
						entrance floor must provide at least one elevator that complies with the
						requirements of ASME A17.1.
(1) Number
					 of elevators.
(A) When one to 60 resident
					 beds are located on any floor other than the main entrance floor, a facility
					 must provide at least one hospital-type elevator.
(B) When 61 to 200 resident beds are located
					 on any floor other than the main entrance floor or when major inpatient
					 services are located on a floor other than those containing resident beds, a
					 facility must provide at least two elevators, one of which must be
					 hospital-type.
(C) When 201 to 350
					 resident beds are located on any floor other than the main entrance floor, or
					 when major inpatient services are located on a floor other than those
					 containing resident beds, a facility must provide at least three elevators, one
					 of which must be hospital-type.
(D)
					 A facility with a capacity of more than 350 resident beds must determine the
					 number of elevators required from a study of the facility plan and the
					 estimated vertical transportation requirements.
(E) Elevator service may be reduced, with the
					 approval of HHSC, for those floors that provide only partial inpatient
					 services.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter E - RESIDENT RIGHTS › Section 554.401 - Introduction

Current through Reg. 49, No. 28; July 12, 2024
(a) The resident
				  has a right to a dignified existence, self-determination, and communication
				  with and access to persons and services inside and outside the facility. A
				  facility must protect and promote the rights of each resident.
(b) HHSC adopts by reference as a requirement
				  for obtaining a license under Texas Health and Safety Code Chapter 242 the
				  Centers for Medicare and Medicaid Services rule regarding resident rights,
				  42 CFR §
											483.10, adopted to be effective November 28,
				  2016. The adopted rule was published in the October 4, 2016, issue of the
				  Federal Register (81 Fed. Reg. 68688, 68849).
(c) HHSC has developed the following
				  statement of the rights of a resident.
Attached Graphic
(d) The facility must give
				  a copy of the Statement of Resident Rights to each resident, next of kin or
				  guardian, and facility staff member. The facility must maintain a copy of the
				  statement, signed by the resident or the resident's next of kin or guardian, in
				  the facility records.
(e) The
				  Statement of Resident Rights must be posted in accordance with § 554.1921
				  of this chapter (relating to General Requirements for a Nursing
				  Facility).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter E - RESIDENT RIGHTS › Section 554.402 - Exercise of Rights

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  resident has the right to exercise the resident's rights as a resident at the
				  facility and as a citizen or resident of the United States.
(b) The resident has the right to be free of
				  interference, coercion, discrimination, or reprisal from the facility in
				  exercising the resident's rights.
(c) In the case of a resident found to lack
				  capacity under the laws of the State of Texas by a court of competent
				  jurisdiction, the rights of the resident are exercised by the resident
				  representative appointed under Texas law to act on the resident's
				  behalf.
(d) The facility must
				  comply with all applicable provisions of the Texas Human Resources Code, Title
				  6, Chapter 102. An individual may not be denied appropriate care on the basis
				  of the individual's race, religion, color, national origin, sex, age,
				  disability, marital status, or source of payment.
(e) The facility must allow the resident the
				  right to observe the resident's religious beliefs. The facility must respect
				  the religious beliefs of the resident in accordance with
				  42 United States Code §
											1396f.
(f) Competent adults may issue directives or
				  durable powers of attorney for health care, subject to the requirements of
				  § 554.419 of this subchapter (relating to Advance Directives ).
(g) In the case of a resident who has not
				  been found to lack capacity by a state court, any legal surrogate designated in
				  accordance with state law may exercise the resident's rights to the extent
				  provided by state law.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter E - RESIDENT RIGHTS › Section 554.403 - Notice of Rights and Services

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility
				  must inform the resident, both orally and in writing, in a language that the
				  resident understands, of the resident's rights and all rules and regulations
				  governing resident conduct and responsibilities during the stay in the
				  facility. This notification must be made prior to or upon admission and during
				  the resident's stay if changed.
(b)
				  The facility must also inform the resident, upon admission and during the stay,
				  in a language the resident understands, of the following:
(1) facility admission policies;
(2) a description of the protection of
				  personal funds as described in § 554.404 of this subchapter (relating to
				  Protection of Resident Funds);
(3)
				  the Texas Human Resources Code, Title 6, Chapter 102; or a written list of the
				  rights and responsibilities contained in the Texas Human Resources Code, Title
				  6, Chapter 102;
(4) a written
				  description of the services available through the Ombudsman Program. This
				  information must be made available to each facility by the ombudsman program.
				  Facilities are responsible for reproducing this information and making it
				  available to residents, their families, and resident representatives;
(5) a written statement to the resident, the
				  resident's next of kin, or guardian describing the facility's policy for:
(A) the drug testing of employees who have
				  direct contact with residents; and
(B) the criminal history checks of employees
				  and applicants for employment;
(6) HHSC rules and the facility's policies
				  related to the use of restraint and involuntary seclusion. This information
				  must also be given to the resident's legally authorized representative, if the
				  resident has one; and
(7) facility
				  essential caregiver policies and procedures during a public health emergency or
				  disaster, and this information must also be given to the resident’s
				  legally authorized representative, if the resident has one.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter E - RESIDENT RIGHTS › Section 554.404 - Protection of Resident Funds

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Management of financial affairs. The resident has the right to manage the
				  resident's financial affairs and the facility may not require a resident to
				  deposit their personal funds with the facility. A resident may designate
				  another person to manage the resident's financial affairs.
(b) Management of personal funds.
(1) Licensed-only facilities. Upon written
				  authorization of a resident, the facility may hold, safeguard, manage, and
				  account for the personal funds of the resident deposited with the facility. The
				  facility will act as a fiduciary agent if the facility holds, safeguards, and
				  accounts for the resident's personal funds.
(2) Medicaid-certified facilities. Upon
				  written authorization of a resident, the facility must hold, safeguard, manage,
				  and account for the personal funds of the resident deposited with the facility,
				  as described in § 554.405 of this subchapter (relating to Additional
				  Requirements for Trust Funds in Medicaid-certified Facilities). The facility
				  will act as a fiduciary agent if the facility holds, safeguards, and accounts
				  for the resident's personal funds.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter E - RESIDENT RIGHTS › Section 554.405 - Additional Requirements for Trust Funds in Medicaid-Certified Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) Deposit of
				  funds. The facility must keep funds received from a resident for holding,
				  safeguarding, and accounting, separate from the facility's funds.
(1) This separate account must be identified
				  " (Name of Facility), Resident's Trust Fund Account," or by a similar title
				  that shows a fiduciary relationship exists between a resident and the
				  facility.
(2) A facility may
				  commingle the trust funds of Medicaid residents and private-pay
				  residents.
(3) If the funds are
				  commingled, the facility must provide, upon request, the following records to
				  HHSC, the Texas Office of the Attorney General Medicaid Fraud Control Unit, and
				  the U.S. Department of Health and Human Services:
(A) copies of release forms signed and dated
				  by each private-pay resident or resident representative whose funds are
				  commingled; and
(B) legible copies
				  of the trust fund records of private-pay residents whose funds are
				  commingled.
(4) The
				  facility must maintain the forms and records described in paragraph (3) of this
				  subsection in the same manner as the financial records of Medicaid residents as
				  specified in this section.
(5) A
				  facility must ensure that a release form described in paragraph (3)(A) of this
				  subsection:
(A) includes permission for the
				  facility to maintain trust fund records of private-pay residents in the same
				  manner as those of Medicaid residents;
(B) is obtained from a private-pay resident
				  upon admission or at the time of request for trust fund services; and
(C) includes a provision allowing inspection
				  of the private-pay resident's trust fund records by the agencies described in
				  paragraph (3) of this subsection.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter E - RESIDENT RIGHTS › Section 554.406 - Free Choice

Current through Reg. 49, No. 28; July 12, 2024
(a) Resident
				  rights. The resident has the right to:
(1)
				  choose and retain a personal attending physician, subject to that physician's
				  compliance with the facility's standard operating procedures for physician
				  practices in the facility;
(2) be
				  fully informed in advance about care and treatment and of any changes in that
				  care or treatment that may affect the resident's well-being; and
(3) participate in planning care and
				  treatment or changes in care and treatment, to the extent practicable. See
				  § 554.419 of Title 40 (relating to Advance Directives).
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter E - RESIDENT RIGHTS › Section 554.407 - Privacy and Confidentiality

Current through Reg. 49, No. 28; July 12, 2024
The resident has the right to personal privacy and
					 confidentiality of the resident's personal and clinical records.
(1) Personal privacy includes accommodations,
				  medical treatment, written and telephone communications, personal care, visits,
				  and meetings of family and resident groups, but this does not require the
				  facility to provide a private room for each resident.
(2) Except as provided in paragraph (3)(B) of
				  this section, the resident may approve or refuse the release of personal and
				  clinical records to any individual outside of the facility.
(3) The resident's right to refuse release of
				  personal and clinical records does not apply:
(A) when the resident is transferred to
				  another health care institution;
(B) when the record release is required by
				  law or permitted under § 554.1910(d) of this chapter (relating to Clinical
				  Records); or
(C) during
				  surveys.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter E - RESIDENT RIGHTS › Section 554.408 - Grievances

Current through Reg. 49, No. 28; July 12, 2024
(a) A resident has
				  the right to:
(1) voice grievances without
				  discrimination or reprisal including grievances regarding treatment that has
				  been furnished as well as treatment that has not been furnished;
(2) prompt efforts by the facility to resolve
				  grievances the resident may have, including those with respect to the behavior
				  of other residents; and
(3) notify
				  state agencies of complaints against a facility. Complaints will be
				  acknowledged by the staff of the agency that receives the complaint. All
				  complaints will be investigated, whether oral or written.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter E - RESIDENT RIGHTS › Section 554.409 - Examination of Survey Results

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  The resident has the right to:
(1) examine
				  the results of the most recent survey of the facility conducted by federal or
				  state surveyors and any plan of correction in effect with respect to the
				  facility; and
(2) receive
				  information from agencies acting as client advocates, and be afforded the
				  opportunity to contact these agencies.
Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION › Subchapter E - RESIDENT RIGHTS › Section 554.410 - Refunds in Medicaid-Certified Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) The nursing facility must refund private
				  funds paid to the facility for periods covered by Medicaid, including
				  retroactive periods of Medicaid coverage, when:
(1) the Medicaid vendor payment has been
				  accepted by the nursing facility; or
(2) the nursing facility has been notified by
				  HHSC about an individual's eligibility for Medicaid.