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 554.354 - Architectural Space Planning and Utilization for New Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) Resident
					 bedrooms. Each resident bedroom must meet the following requirements:
(1) The maximum room capacity must be two
					 residents.
(2) Minimum bedroom
					 area, excluding toilet rooms, closets, lockers, wardrobes, alcoves, or
					 vestibules, must be 100 square feet in single occupancy rooms and 80 square
					 feet per bed in multi-bed rooms.
(3) The minimum allowable room dimension is
					 ten feet. The room must be designed to provide at least 36 inches between beds
					 and 24 inches between any bed and the adjacent wall.
(4) Each room must have at least one operable
					 outside window arranged and located so that it can be easily opened from the
					 inside without the use of tools or keys. The maximum allowable sill height must
					 not exceed 36 inches above the floor. All operable windows must have insect
					 screens. The minimum area of window in each bedroom must equal at least 16
					 square feet or 8.0% of the gross floor area of the room, whichever is larger.
					 Operable window sections may be restricted to not more than six nor less than
					 four inches for security or safety reasons.
(5) Each room must have general lighting,
					 wall-mounted bed reading lights, and night lighting. The night light must be
					 switched just inside the entrance to each resident room with a silent type
					 switch, must be a recessed wall mounted fixture just inside the entry door to
					 the room and must not be obstructed by the door or furniture, unless otherwise
					 approved by HHSC. The light providing general illumination must be switchable
					 at the door of the resident room for use of staff and residents. A durable
					 non-glare reading light with an opaque front panel securely anchored to the
					 wall, integrally wired, must be provided above each resident bed. The switch
					 for this reading light must be within reach of a resident in the bed.
(6) The minimum number of power receptacles
					 at a resident bed location shall be determined based on the risk assessment
					 required by NFPA 99 and § 554.300(i) of this subchapter (relating to
					 General Requirements), as follows:
(A) All
					 receptacles must be listed and identified as "hospital grade";
(B) Four of the required receptacles must be
					 provided beside the head of each bed;
(C) No fewer than eight receptacles must be
					 provided within the patient care vicinity, as defined in NFPA 99;
(D) If the failure of patient-care-related
					 electrical equipment is likely to cause major injury or death to a resident, no
					 fewer than fourteen receptacles must be provided within the patient care
					 vicinity.
(E) Additional
					 receptacles, beyond the minimum quantities above, must be provided to ensure
					 the electrical needs of all residents living in the bedroom are met, including
					 power for TV, radio, razors, hairdryers, clocks, or as required by NFPA 99 and
					 NFPA 70.
(7) Each
					 resident bedroom must have direct access to a bathroom without entering the
					 general corridor area. The bathroom must serve no more than one resident room
					 and must include, at least, a lavatory and toilet.
(8) Each resident must have a bed with a
					 comfortable mattress, a bedside stand with at least two enclosed storage
					 spaces, a dresser, and closet or wardrobe space providing privacy for clothing
					 and personal belongings. Private clothes storage space must provide at least 22
					 inches of lineal hanging space per bed and have closable doors. Chairs and
					 space must be provided for use by residents and visitors.
(9) Each room must open onto an exit corridor
					 and must be arranged for convenient resident access to dining, living, and
					 bathing areas. To ensure a direct view from nurses' stations, resident room
					 doors must not be recessed into the corridor wall more than four feet. Alcoves
					 must meet applicable accessibility standards for a front approach to the door,
					 and handrails must be provided in the alcove. If an alcove exceeds four feet in
					 depth, it is a corridor and must meet all requirements for corridors, including
					 direct view from a nurses' station, minimum width of the corridor, and
					 provisions for handrails.
(10)
					 Visual privacy, such as cubicle curtains, must be available for each resident
					 in multi-bed bedrooms. Design for privacy must not restrict resident access to
					 the entry, lavatory, or toilet, nor may it restrict bed evacuation or obstruct
					 sprinkler flow coverage.
(11) At
					 least one noncombustible wastebasket must be provided in each
					 bedroom.
(12) See the requirements
					 in § 554.361(d)(4) of this subchapter (relating to Electrical Requirements
					 for New Facilities) for nurse call systems.
(13) Bedrooms must be identified with a
					 raised or recessed unique number placed on or near the door. Refer to TAS for
					 information about signs.
(14) Locks
					 on bedroom doors are permitted when they meet definite resident needs.
(A) Situations in which locks may be
					 necessary include the following:
(i) married
					 couples whose rights of privacy could be infringed upon unless bedroom door
					 locks are permitted; and
(ii)
					 residents for whom the attending physician wants bedroom door locks to enhance
					 the residents' sense of security.
(B) In situations such as those listed in
					 subparagraph (A) of this paragraph, the following guidelines must be met:
(i) bedroom door locks must be of the type
					 which the occupant can unlock at will from inside the room;
(ii) all bedroom door locks must be of the
					 type which can be unlocked from the corridor side;
(iii) attendants must carry keys which will
					 permit ready access to the locked bedrooms when entrance becomes
					 necessary;
(iv) locking of bedroom
					 doors by residents for privacy or security will not be permitted except when
					 specifically included in the attending physician's written orders or authorized
					 by the nursing facility administrator.
(15) Vacant bedrooms must not be used for
					 hazardous activities or hazardous storage, unless specifically approved by HHSC
					 in writing.