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 554.352 - Location and Site for New Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) Any conditions considered to be a fire,
					 safety, or health hazard will be grounds for disapproval of a site by HHSC. A
					 new facility may not be built in an area designated as a floodplain of 100
					 years or less.
(b) Site grades must
					 provide for positive surface water drainage so that there will be no ponding or
					 standing water on the designated site. This does not apply to local government
					 requirements for engineered controlled run-off holding ponds.
(c) A new building or addition must be set
					 back at least 10 feet from the property lines except as otherwise approved by
					 HHSC.
(d) Exit doors from the
					 building must not open directly onto a drive for vehicular traffic, but must be
					 set back at least six feet from the edge of the drive, measured from the end of
					 the building wall in the case of a recessed door, to prevent accidents due to
					 lack of visual warning.
(e) Walks
					 must be provided as required from all exits and must be of non-slip surfaces
					 free of hazards. Walks must be at least 48 inches wide except as otherwise
					 approved. Ramps must be used in lieu of steps where possible for the
					 individuals with a disability and to facilitate bed or wheelchair removal in an
					 emergency.
(f) Outdoor activity,
					 recreational, and sitting spaces must be provided and appropriately designed,
					 landscaped, and equipped. Some shaded or covered outside areas are needed.
					 These areas must be designed to accommodate residents in wheelchairs.
(g) Each facility must have
					 parking space to satisfy the needs of residents, employees, staff, and
					 visitors. In the absence of a formal parking study, each facility must provide
					 for a ratio of at least one parking space for every four beds in the facility.
					 This ratio may be reduced slightly in areas convenient to public parking
					 facilities. Space must be provided for emergency and delivery vehicles. A
					 parking space must not block or inhibit egress from the outside exit doors.
					 Parking spaces and drives must be at least ten feet away from windows in
					 bedrooms, dining areas, and living areas.
(h) Barriers must be provided for resident
					 safety from traffic or other site hazards by the use of appropriate methods
					 such as fences, hedges, retaining walls, railings, or other landscaping. These
					 barriers must not inhibit emergency egress to a safe distance away from the
					 building.
(i) Open or enclosed
					 courts with resident rooms or living areas opening upon them must not be less
					 than 20 feet in the smallest dimension unless otherwise approved by HHSC.
					 Nonparallel wings forming an acute angle may have a maximum of two windows in
					 each wing that are separated by a distance less than 20 feet, but not less than
					 ten feet, when measured between the nearest edges of the opposing openings.
(j) Auxiliary buildings located
					 within 20 feet of the main building must meet the applicable requirements in
					 NFPA 101 for separation and construction.
(k) Other buildings on the site must meet the
					 appropriate occupancy section or separation requirements in NFPA 101.
(l) Fire service and access must
					 be as follows:
(1) The facility must be
					 served by a paid or volunteer fire department. The fire department must provide
					 written assurance to HHSC that the fire department can respond to an emergency
					 at the facility within an appropriately prompt time for the travel conditions
					 involved.
(2) The facility must be
					 served by an adequate water supply that is satisfactory and accessible for fire
					 department use as determined by the fire department serving the facility and by
					 HHSC.
(3) There must be at least
					 one readily accessible fire hydrant located within 300 feet of the building.
					 The hydrant must be on a minimum six inch service line. The hydrant, its
					 location, and service line, or equivalent must be as approved by the local fire
					 department and HHSC.
(4) The
					 building must have suitable all-weather fire lanes as required by local fire
					 authorities or, if no local fire authority has jurisdiction, by HHSC. As a
					 minimum, the fire department must be able to access two sides of the building.