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 W - CERTIFICATION OF FACILITIES FOR CARE OF PERSONS WITH ALZHEIMER'S DISEASE AND RELATED DISORDERS › Section 554.2208 - Standards for Certified Alzheimer's Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) General requirements.
(1) Residents eligible for admission to
				  Alzheimer's units will have a diagnosis of Alzheimer's disease or related
				  disorders. The need for admission to the Alzheimer's unit must be documented by
				  the attending physician.
(2)
				  Security and safety measures are provided to prevent the residents from harming
				  themselves or leaving designated indoor or outdoor areas without supervision by
				  staff members or other responsible escort. Policies will also be provided to
				  prevent abuse of the rights and property of other residents.
(3) Understanding that security measures to
				  prevent wandering may infringe on resident rights, care must be exercised in
				  the use of physical or chemical restraint. The specific purpose and
				  time-limited orders for any physical or chemical restraint must be written and
				  renewed according to facility policy. The frequency of such renewal must not
				  exceed 60 days.
(4) Activity and
				  recreational programs will be provided and utilized to the maximum extent
				  possible for all residents in order to promote physical well being and help
				  with behavior management. The program must be tailored to the individual
				  resident's needs, being appropriate for his specific impairment and stage of
				  disease.
(5) Residents are provided
				  privacy in treatment and in care for his or her personal needs.
(6) Access to outdoor areas must be provided
				  and such areas must have suitable walls or fencing that do not allow climbing
				  or present a hazard.
(A) The minimum distance
				  of the fence from the building must be:
(i)
				  8'-0" from the building if there are no window openings; or
(ii) 20'-0" from a bedroom window if the
				  fencing is solid and 15'-0" from a bedroom window if the fencing is open
				  similar to chain-link.
(B) The minimum area of enclosure must be 800
				  square feet. Exception: If the enclosed space has an area of refuge which
				  extends beyond a minimum of 20'-0" from the building and the area of refuge is
				  equal to or greater than 15 square feet per resident for the wings
				  enclosed.
(C) An exit gate from the
				  enclosure to a public way must comply with the following criteria.
(i) A minimum of two gates must be remotely
				  located from each other if only one wing or exit is enclosed. If the enclosed
				  space between the building and the fence is less than 10'-0", one of the
				  remotely located exit gates must be directly in line with the building exit
				  door.
(ii) If doors into two or
				  more smoke compartments are enclosed by the fencing and entry access can be
				  made at each door, a minimum of one gate is required.
(iii) The gates must be located to provide a
				  continuous path of travel from the building exit to a public way including
				  walkways of concrete, asphalt, or other approved materials suitable for wheeled
				  beds, chairs, and stretchers. Gates and walkways must be wide enough to
				  accommodate beds and wheelchairs.
(D) If gates are locked, the gate nearest the
				  exit from the building must be locked with an electronic lock which operates
				  the same as electronic locks on corridor control doors or exit doors and is in
				  compliance with the NFPA 70 for exterior exposure. Additional gates may also
				  have electronic locks or may have keyed locks provided staff carry the keys. A
				  gate between two enclosed wings may have a keyed lock provided access can be
				  gained into both wings from the exterior.
(E) Fencing material must comply with the
				  following:
(i) Wood--no limit on height,
				  should be constructed with posts and support members on the exterior to deter
				  residents from climbing over fence.
(ii) Wire--if chain-link type fence, provide
				  protection on top of the fence to prevent resident injury from pointed
				  wire.
(7) Any
				  security measures taken to provide for the safety of wandering patients should
				  be as unobtrusive as possible.
(8)
				  Toxic garden plantings must be prohibited.