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 C - NURSING FACILITY LICENSURE APPLICATION PROCESS › Section 554.211 - Relocation

Current through Reg. 49, No. 28; July 12, 2024
(a) A license
				  holder may not relocate a facility to another location without approval from
				  the Texas Department of Human Services (DHS). The license holder must submit a
				  complete application and the fee required under § 554.216 of Title 40
				  (relating to License Fees) to DHS before the relocation.
(b) Residents may not be relocated until the
				  new building has been inspected and approved as meeting the standards of the
				  Life Safety Code as applicable to nursing facilities.
(c) Following Life Safety Code approval by
				  DHS, the license holder must notify DHS of the date residents will be
				  relocated. If the new facility meets the standards for operation based on an
				  on-site survey, a license will be issued.
(d) The effective date of the license will be
				  the date all residents are relocated.
(e) The license holder must continue to
				  maintain the license at the current location and must continue to meet all
				  requirements for operation of the facility until the date of the
				  relocation.
(f) This section
				  applies to relocation of a currently licensed facility, and does not govern the
				  relocation of Medicaid-certified beds. See § 554.2322 of Title 40
				  (relating to Medicaid Bed Allocation Requirements) for guidelines on relocation
				  of Medicaid-certified beds.
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 C - NURSING FACILITY LICENSURE APPLICATION PROCESS › Section 554.212 - Time Periods for Processing License Applications

Current through Reg. 49, No. 28; July 12, 2024
(a) The Health and Human Services Commission
				  (HHSC) will process only applications received within 60 days prior to the
				  requested date of the issuance of the license.
(b) An application is complete when all
				  requirements for licensing have been met, including compliance with standards.
				  If an inspection for compliance is required, the application is not complete
				  until the inspection has occurred, reports have been reviewed, and the
				  applicant complies with the standards.
(c) If the application is postmarked by the
				  filing deadline and received by HHSC within 15 days of the postmark, the
				  application is considered to be timely filed .
(d) HHSC notifies a facility within 30 days
				  of receipt of the application if any of the following applications are
				  incomplete:
(1) initial
				  application;
(2) change of
				  ownership;
(3) renewal;
				  and
(4) increase in
				  capacity.
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 C - NURSING FACILITY LICENSURE APPLICATION PROCESS › Section 554.215 - Opportunity to Show Compliance

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Before the institution of proceedings to revoke or suspend a license or deny an
				  application for the renewal of a license, the Texas Department of Human
				  Services (DHS) gives the license holder:
(1)
				  notice by personal service or by registered or certified mail of the facts or
				  conduct alleged to warrant the proposed action, with a copy being sent to the
				  facility; and
(2) an opportunity to
				  show compliance with all requirements of law for the retention of the license
				  by sending the director of Long Term Care-Regulatory a written request. The
				  request must:
(A) be postmarked within 10
				  days of the date of DHS's notice and be received in the state office of the
				  director of Long-Term Care-Regulatory within 10 days of the date of the
				  postmark; and
(B) contain specific
				  documentation refuting DHS's allegations.
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 C - NURSING FACILITY LICENSURE APPLICATION PROCESS › Section 554.216 - License Fees

Current through Reg. 49, No. 28; July 12, 2024
(a) Basic fees.
(1) Probationary license. The license fee is
				  $125 plus $5 for each unit of capacity or bed space for which a license is
				  sought.
(2) Initial and renewal
				  license. The license fee is $375 plus $15 for each unit of capacity or bed
				  space for which a license is sought. The fee must be paid with each initial and
				  renewal of license application.
(3)
				  Increase in bed space. An approved increase in bed space is subject to an
				  additional fee of $15 for each unit of capacity or bed space.
(4) Change of administrator. A facility must
				  report a change of administrator within 30 days of the effective date of the
				  change by submitting a change of administrator notice and a $20 fee to DADS
				  Licensing and Credentialing Section, Regulatory Services Division. If DADS
				  Licensing and Credentialing Section, Regulatory Services Division does not
				  receive the notice within 30 days of the effective date of the change, DADS may
				  impose a $500 administrative penalty. If the notice is postmarked within the
				  30-day period, 15 days will be added to the time period to receive the
				  notice.
(5) Background information
				  fee. The background information fee is $50.
(6) Late renewal fee. An applicant for
				  license renewal that submits an application during the 45-day period ending on
				  the date the current license expires must pay a late fee of an amount equal to
				  one-half of the total basic renewal fee in subsection (a)(2) of this section.
				  The late fee for a two-year renewal license issued in accordance with §
				  554.208(b)(2) of this subchapter (relating to Renewal Procedures and
				  Qualifications) is one half of the total two-year renewal fee calculated in
				  accordance with § 554.208(c) of this subchapter.
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 C - NURSING FACILITY LICENSURE APPLICATION PROCESS › Section 554.218 - Method of Payment

Current through Reg. 49, No. 28; July 12, 2024
Payment of fees must be by check or money order made
					 payable to the Texas Department of Human Services. All fees are nonrefundable
					 except as provided by the Government Code, Chapter 2005.
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 C - NURSING FACILITY LICENSURE APPLICATION PROCESS › Section 554.219 - Plan Review Fees

Current through Reg. 49, No. 28; July 12, 2024
(a) The Texas
				  Department of Human Services (DHS) charges a fee to review plans for new
				  buildings, additions, conversion of buildings not licensed by DHS, or
				  remodeling of existing licensed facilities.
(b) The fee schedule follows:
(1) Facilities--new construction:
(A) single-story facilities--$20 per bed,
				  $2,000 minimum; and
(B)
				  multiple-story facilities--$24 per bed, $2,500 minimum.
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 C - NURSING FACILITY LICENSURE APPLICATION PROCESS › Section 554.220 - Expedited Life Safety Code and Physical Plant Inspection Fees

Current through Reg. 49, No. 28; July 12, 2024
(a) DADS charges a
				  fee for expedited Life Safety Code and physical plant inspections for new
				  buildings, additions, conversion of buildings not licensed by DADS, or
				  remodeling of existing licensed facilities.
(b) Table of Expedited Life Safety Code and
				  Physical Plant Inspection Fees.
Attached
					 Graphic
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 1 - GENERAL PROVISIONS › Section 554.300 - General Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 The facility must be designed, constructed, equipped, and maintained to protect
					 the health and ensure the safety of residents, personnel, and the
					 public.
(b) If children are
					 admitted to the facility, accommodations, furnishings, and equipment
					 appropriate to children must be provided, including the following;
(1) The facility must provide indoor and
					 outdoor recreation areas designed to encourage exploration within the
					 children's capabilities.
(2) The
					 facility must provide pediatric equipment and supplies in appropriate sizes for
					 the age and development level of the children. Pediatric emergency supplies and
					 equipment must be readily available for use.
(3) The environment must be the least
					 restrictive allowable while remaining within the parameters of safety. All
					 areas of the facility accessible to children must be "child proof" for safety
					 hazards. This type of safety proofing is above the normal level of hazard
					 control maintained for adult residents and includes the addition of safety
					 covers on electrical outlets not in use that are accessible to
					 children.
(4) Pediatric resident's
					 rooms must be decorated and furnished in accordance with the age and
					 developmental level of the children and as an expression of their individual
					 preferences.
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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.302 - Applicable Codes and Standards

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 The facility must meet the provisions of the Existing Health Care Occupancies
					 chapter of NFPA 101.
(b) The
					 following codes, standards, or guidelines govern their subject areas for
					 existing construction:
(1) If the
					 municipality has a building code and a plumbing code, those codes
					 govern.
(2) In the absence of
					 municipal codes, nationally recognized codes must be used. To ensure
					 continuity, all nationally recognized codes, when used, must be publications of
					 the same group or organization.
(3)
					 Heating, ventilating, and air-conditioning systems must be designed and
					 installed in accordance with NFPA 90A and the ASHRAE Handbook, except as may be
					 modified in this subchapter.
(4)
					 Electrical and illumination systems must be designed and installed in
					 accordance with NFPA 70 and the Lighting Handbook of the Illuminating
					 Engineering Society of North America, except as may be modified in this
					 subchapter.
(5) 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 28 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) 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.
(6) 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.
(7) Each building must be classified as to
					 building construction type for fire resistance rating purposes in accordance
					 with NFPA 220 and NFPA 101.
(8)
					 Building insulation materials, unless sealed on all sides and edges in an
					 approved manner with noncombustible material, must have a flame-spread rating
					 of 25 or less when tested in accordance with ASTM E84, UL723, or ASTM E662.
(9) A facility with a boiler must
					 meet all applicable requirements of Texas Health and Safety Code, Chapter
					 755.
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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.303 - Emergency Power

Current through Reg. 49, No. 28; July 12, 2024
(a) Emergency power
					 systems must meet the requirements of NFPA 99 applicable to existing
					 facilities, for the risk category determined by the requirements of §
					 554.300(i) of this subchapter (relating to General Requirements), and the
					 requirements of this section. Rehabilitation or modernization of an existing
					 emergency power system must be based on the assessed risk category and
					 according to the requirements of NFPA 99 for new health care
					 facilities.
(b) An emergency
					 electrical power system must supply power adequate at least for lighting all
					 entrances and exits, equipment to maintain the fire detection, alarm, and
					 extinguishing systems, and any systems or equipment whose failure is likely to
					 cause major injury or death to a resident if the normal electrical supply is
					 interrupted. Emergency electrical services by generator or battery must be
					 provided to comply with the provisions of NFPA 70. Battery systems must be
					 capable of sustaining power for a duration of at least one and one-half hours.
(1) The emergency electrical power system
					 must supply the following systems :
(A)
					 illumination for means of egress, nurses' stations, medication rooms, dining
					 and living rooms, and areas immediately outside of exit doors;
(B) exit signs and exit directional signs
					 required by NFPA 101;
(C) alarm
					 systems, including fire alarms activated by manual stations, water flow alarm
					 devices of sprinkler systems, fire and smoke detecting systems, and alarms
					 required for nonflammable medical gas systems if installed;
(D) task illumination and selected
					 receptacles at any required or provided generator set location;
(E) selected duplex receptacles, including
					 receptacles in resident corridors, each resident-bed location where systems or
					 equipment is used whose failure is likely to cause major injury or death to a
					 resident, nurses' stations, medication rooms, including biological
					 refrigerator, if a generator is required or provided;
(F) nurse call systems;
(G) resident room night lights when
					 provided;
(H) elevator cab
					 lighting, control, and communication systems;
(I) all facility telephone equipment;
					 and
(J) those paging or speaker
					 systems that are necessary for the communication plan for an emergency. Radio
					 transceivers that are necessary for emergency use must be capable of operating
					 for at least one hour upon total failure of both normal and emergency
					 power.
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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.304 - Space and Equipment

Current through Reg. 49, No. 28; July 12, 2024
The facility must:
(1) provide sufficient space and equipment in
					 dining, health services, recreation, and program areas to enable staff to
					 provide residents with needed services as required by these standards and as
					 identified in each resident's plan of care; and
(2) maintain all essential mechanical,
					 electrical, and resident care equipment in safe operating 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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.305 - Resident Rooms

Current through Reg. 49, No. 28; July 12, 2024
Resident rooms must be designed and equipped for adequate
						nursing care, comfort, and privacy of residents.
(1) Bedrooms must:
(A) accommodate no more than four residents.
					 The total number of beds in ward rooms with three or more beds must not exceed
					 50% of the total facility capacity in existing facilities unless approved by
					 HHSC.
(B) measure at least 80
					 square feet per resident in multiple resident bedrooms and at least 100 square
					 feet in single resident rooms.
(C)
					 have direct access to an exit corridor.
(D) be designed or equipped to ensure full
					 visual privacy for each resident. A facility must take appropriate measures to
					 protect the privacy and dignity of the residents through the use of cubicle
					 curtains, screens, or procedures. Curtains and screens must be rendered and
					 maintained flame-retardant.
(E) in
					 facilities initially certified after March 31, 1992, except in private rooms,
					 have ceiling-suspended curtains for each bed, which extend around the bed to
					 provide total visual privacy, in combination with adjacent walls and curtain
					 (see paragraph (4) of this section).
(F) have at least one operable window to the
					 outside which can readily be opened from the inside without the use of tools.
					 The height of the window sill must not exceed 36 inches above the floor. The
					 minimum area of windows in each bedroom must equal at least 8.0% of the room
					 area. Operable window sections may be restricted to not more than six nor less
					 than four inches for security or safety reasons. Each window must be provided
					 with a flame-retardant shade, curtain, or blind.
(G) have a floor at or above grade
					 level.
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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.307 - Resident Call System

Current through Reg. 49, No. 28; July 12, 2024
(a) The nurse's
					 station must be equipped to receive resident calls through a communication
					 system from:
(1) resident rooms;
					 and
(2) toilet and bathing
					 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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.308 - Dining and Resident Activities

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Requirements. The facility must provide one or more rooms designated for
					 resident dining and activities. These rooms must be:
(1) well-lighted;
(2) well ventilated, with nonsmoking areas
					 identified;
(3) adequately
					 furnished; and
(4) sufficiently
					 spacious to accommodate all activities.
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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.309 - Other Environmental Conditions

Current through Reg. 49, No. 28; July 12, 2024
The facility must provide a safe, functional, sanitary,
						and comfortable environment for residents, staff, and the public.
(1) The facility must:
(A) establish procedures to ensure that water
					 is available to essential areas when there is a loss of normal water
					 supply;
(B) have adequate outside
					 ventilation by means of windows, mechanical ventilation, or a combination of
					 the two;
(C) maintain an effective
					 pest control program so that the facility is free of pests and rodents;
					 and
(D) equip corridors with firmly
					 secured handrails on each side on all wall segments 18 inches in length or
					 longer. These rails must be substantially anchored to withstand downward force
					 and must be mounted 33 to 36 inches from the floor.
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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.310 - Site and Grounds

Current through Reg. 49, No. 28; July 12, 2024
(a) Site grades
					 must provide for positive surface water drainage so that there will be no
					 ponding or standing water at or near the building that would present a hazard
					 to health or provide a breeding site or harborage for carriers of
					 disease.
(b) Outdoor activity,
					 recreational, and sitting spaces must be provided for residents as space
					 permits.
(c) Each facility must
					 have parking spaces to satisfy the needs of residents, employees, staff, and
					 visitors. Provisions must be made for handicapped parking and access into the
					 building.
(d) Protection 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. This protection must not inhibit the free emergency egress
					 to a safe distance away from the building.
(e) Auxiliary buildings located on the site
					 within 20 feet of the main licensed structure and which contain hazardous
					 operations or contents, such as laundries or storage buildings, must meet the
					 same code requirements for safety as the main licensed structure.
(f) Other buildings on the site must meet the
					 appropriate occupancy section or separation requirements of NFPA 101
					 .
(g) All outside areas, grounds,
					 and adjacent buildings on the site must be maintained in good condition and
					 kept free of rubbish, garbage, and untended growth that may constitute a fire
					 or health hazard.
(h) Enclosed
					 exterior spaces, such as fenced areas, that are in a means of egress to a
					 public way must meet the requirements of § 554.2208(a)(6) of this chapter
					 (relating to Standards for Certified Alzheimer's 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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.311 - Fire Service and Access

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 The facility must be served by a paid or volunteer fire department. The fire
					 department must provide written assurance to the licensing agency that the fire
					 department can respond to an emergency at the facility within an appropriately
					 prompt time for the travel conditions.
(b) 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.
(c) There must be at least
					 one approved, readily accessible fire hydrant located within 300 feet of the
					 building. The hydrant must be on a minimum six-inch service line, or else there
					 must be an approved equivalent, such as a storage tank. The hydrant, its
					 location, and service line, or equivalent must be approved by the local fire
					 department and HHSC.
(d) The
					 building must have suitable fire lanes for access as required by local fire
					 authorities and 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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.313 - Interior Finishes-Walls, Ceilings, and Floors

Current through Reg. 49, No. 28; July 12, 2024
Interior finishes of walls and ceilings must have limited
						flame-spread rating as required by NFPA 101. Where new interior finishes of
						walls, ceilings, or floors are applied to existing facilities, the new finishes
						must meet the requirements for flame-spread ratings for new construction. Fire
						retardant paints or solutions must not be applied to new materials in an effort
						to meet flame-spread requirements for new construction. This description of
						interior finishes does not apply to furniture or accessories.
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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.314 - Fire Alarms, Detection Systems, and Sprinkler Systems

Current through Reg. 49, No. 28; July 12, 2024
Fire alarms, detection systems, and sprinkler systems
						must be as required by NFPA 101, NFPA 72, and NFPA 13.
(1) Components must be compatible and
					 laboratory listed for the use intended.
(2) Wiring and circuitry for alarm systems
					 must meet the applicable requirements for NFPA standards, including NFPA 70,
					 for these systems.
(3) 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.
(4) Smoke detector sensitivity must be
					 checked within one year after installation and every alternate year thereafter
					 in accordance with NFPA 72. Documentation, including as-built installation
					 drawings, operation and maintenance manuals, and a written sequence of
					 operation for systems installed after July 1, 2000, must be available for
					 examination by HHSC.
(5) 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 will occur automatically:
(A) smoke and fire doors which are held open
					 by an approved device must be released to close;
(B) air handlers (air conditioning/heating
					 distribution fans) serving three or more rooms or any means of egress must shut
					 down immediately;
(C) smoke dampers
					 must close; and
(D) the
					 alarm-initiating 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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.315 - Portable Fire Extinguishers

Current through Reg. 49, No. 28; July 12, 2024
Portable fire extinguishers must be provided and
						maintained to comply with the provisions of NFPA 10. This includes type of
						extinguishers (A, B, or C), location and spacing, mounting heights, monthly
						inspections by staff, yearly inspections by a licensed agent, any necessary
						servicing, and hydrostatic testing as recommended by the manufacturer.
(1) Extinguishers in resident corridors must
					 be spaced so that travel distance is not more than 75 feet. The minimum size of
					 extinguishers must be either 2 1/2 gallon for water type or five pound for ABC
					 type.
(2) Extinguishers must be
					 installed on supplied hangers or brackets or be mounted in cabinets approved by
					 HHSC.
(3) Extinguishers must be
					 surface wall-mounted or recessed in cabinets where they are not subject to
					 physical damage or dislodgement.
(4) Extinguishers having a gross weight not
					 exceeding 40 pounds must be installed so that the top of the extinguisher is
					 not more than five feet above the floor. Extinguishers with a gross weight
					 greater than 40 pounds must be installed so the top of the extinguisher is not
					 more than 3-1/2 feet above the floor. The clearance between the bottom of the
					 extinguisher and the floor must not be less than four inches.
(5) Portable extinguishers provided in
					 hazardous rooms must be located as close as possible to the exit door opening
					 and on the latch (knob) side.
(6)
					 Staff must be appropriately trained in the use of each type of extinguisher in
					 the 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 D - FACILITY CONSTRUCTION › Division 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.316 - Subdivision of Building Spaces-Smoke Barriers

Current through Reg. 49, No. 28; July 12, 2024
(a) Subdivision of building spaces must be as
					 required by NFPA 101.
(b) The
					 facility must maintain the integrity of smoke barrier walls, including those
					 parts of walls in attics and other concealed spaces.
(c) The facility must maintain the integrity
					 of smoke dampers in air ducts.
(d)
					 Ducts with smoke dampers must have maintenance panels for inspection. The
					 maintenance panels must be removable without tools. Means of access must also
					 be provided in the ceiling or side wall to facilitate smoke damper inspection
					 readily and without obstruction. Location of dampers must be identified on the
					 wall or ceiling of the occupied area below.
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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.317 - Elevators and Escalators

Current through Reg. 49, No. 28; July 12, 2024
Elevators must comply with the provisions of NFPA 101 and
						ASME A17.3. Elevators are required for buildings having residents' facilities,
						such as bedrooms, dining, or recreation areas; or services, such as diagnostic
						or therapy, located on other than the main entrance floor. Passenger elevators
						and escalators must be inspected by a qualified agent at least every six
						months. Freight elevators must be inspected every 12 months.
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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.318 - Other Rooms and Areas

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Nurses' station.
(1) All resident bedroom
					 corridors must be observable by direct line of sight or by mechanical means
					 from a designated nurses' station or auxiliary station. There must be at least
					 one nurses' station per floor in multi-story buildings.
(2) If all resident bedroom corridors are
					 observable by direct line of sight from inside the nurses' station or from
					 within 24 inches of the counter or hall of the nurses' station, no auxiliary
					 stations are required, even if resident bedrooms are more than 150 feet from
					 the nurses' station.
(3) When
					 resident bedrooms are more than 150 feet from the nurses' station and the
					 adjacent corridors are not observable from the station by direct line of sight,
					 an auxiliary station must be established and used.
(4) All corridors adjacent to resident
					 bedrooms that are more than 150 feet from a designated nurses' station or
					 auxiliary station must be observable by direct line of sight from the
					 designated nurses' station or auxiliary station. Corridors located in the
					 service area of an auxiliary station must be observable, as described in
					 paragraphs (2) and (3) of this subsection, at the auxiliary station.
(5) The 150-foot limitation described in
					 paragraphs (2) - (4) of this subsection may be increased to 165 feet in
					 facilities or additions to facilities completed before August 10,
					 1983.
(6) In addition to the
					 required normal and emergency illumination, the facility must keep on hand and
					 readily available to night staff no less than one working flashlight at each
					 nurses' station.
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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.319 - Provisions for Persons with Disabilities

Current through Reg. 49, No. 28; July 12, 2024
New facilities and additions must meet the requirements
						of the Texas Department of Licensing and Regulation, Elimination of
						Architectural Barriers Section. Existing facilities must meet the requirements
						of the Americans with Disabilities Act and must, at a minimum, comply with the
						following:
(1) The facility must
					 provide and mark at least one parking space for persons with
					 disabilities.
(2) The facility must
					 provide wheelchair access into the building by use of ramps and curb breaks.
					 Ramps must not slope more than 1:12 (one unit of rise to 12 units of
					 run).
(3) Room identification signs
					 or letters must be installed four feet six inches to five feet above finished
					 floor and located on the corridor walls adjacent to the latch side of the door
					 jamb. Letters or numbers on signs must be raised or recessed at least 1/32 inch
					 minimum. Characters must be at least 5/8 inch in height and no higher than two
					 inches.
(4) Grab bars at toilet and
					 bathing units must be 1-1/4 inch to 1-1/2 inch in diameter.
(5) Toilet facilities must be available and
					 of sufficient size to accommodate wheelchairs. There must be at least one
					 public wheelchair-accessible restroom.
(6) Water closet seat height in toilet
					 facilities for persons with disabilities must be 17 to 19 inches from
					 floor.
(7) Mirrors and dispensers
					 for persons with disabilities must be no higher than 40 inches above the
					 floor.
(8) Drinking fountains or
					 coolers must meet American National Standards Institute (ANSI) A117.1 (that is,
					 up front spout and controls no more than 36 inches from floor maximum).
					 Fountains existing at the time of this publication do not have to be
					 altered.
(9) Public telephones, if
					 provided, must meet ANSI A117.1. Mounting height must not exceed 48 inches to
					 coin slot.
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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.320 - Lighting and Illumination

Current through Reg. 49, No. 28; July 12, 2024
Current recommendations of the Illumination Engineering
						Society of North America must be followed to achieve proper illumination
						characteristics and lighting levels throughout the facility. Minimum
						illumination must be ten foot candles in resident rooms and 20 foot candles in
						corridors, nurses stations, dining rooms, lobbies, toilets, bathing facilities,
						laundries, stairways, and elevators. Illumination requirements for these areas
						apply to lighting throughout the space and should be measured at approximately
						30 inches above the floor anywhere in the room. Minimum illumination for
						overbed reading lamps, medication preparation or storage areas, kitchens, and
						nurse's station desks must be 50 foot candles. Illumination requirements for
						these areas apply to the task performed and should be measured on the
						task.
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 2 - FACILITIES LICENSED BEFORE SEPTEMBER 11, 2003 › Section 554.322 - Plumbing

Current through Reg. 49, No. 28; July 12, 2024
(a) If the
					 municipality has a plumbing code, that code must be used as a basis for
					 determining the correctness of plumbing installation. In the absence of a
					 municipal code, a nationally recognized plumbing code must be used.
(b) The water supply must be of safe,
					 sanitary quality, suitable for use, and adequate in quantity and pressure. The
					 water must be obtained from a water supply system, the location, construction,
					 and operation of which are approved by TCEQ .
(c) Sewage must be discharged into a
					 state-approved sewerage system or the sewage must be collected, treated, and
					 disposed of in accordance with applicable TCEQ rules and regulations.
(d) The wastewater drainage and sewage system
					 must assure that sanitation is maintained for residents. Wastewater or sewage
					 must not be discharged on the surface of the ground. Traps must not be allowed
					 to lose their seal. Appliances must have air gaps as required for connections
					 to the sewerage system. Venting must assure a rapid flow of wastewater in the
					 sewage system.
(e) The interior
					 cold water supply system and piping must be so placed or so insulated as to
					 prevent condensation drip in habitable areas and in storage areas.
(f) Backflow preventers or vacuum breakers
					 must be installed with any water supply fixture where the outlet or attachments
					 may be submerged.
(g) Resident-use
					 hot water must be reliably controlled, such as by thermostatic or mixing
					 valves, to not exceed 110 degrees Fahrenheit and not less than 100 degrees
					 Fahrenheit at each fixture.
(h) Hot
					 water for other usages must be provided at the temperatures required for the
					 appliance or fixture or for the operation involved, such as dishwashing and
					 laundry.
(i) The supply quantity of
					 hot water must be adequate for normal peak load usage. Facilities which
					 continue to experience a shortage of hot water must remedy the situation by
					 such means as adding storage tanks, adding or increasing the size of water
					 heaters, or other approved means.
(j) Water heaters must be equipped with
					 pressure temperature relief valves.
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 3 - PROVISIONS APPLICABLE TO ALL FACILITIES › Section 554.323 - Housekeeping Services

Current through Reg. 49, No. 28; July 12, 2024
(a) The
					 facility must provide sufficient housekeeping and maintenance personnel,
					 equipment, and supplies to maintain the interior, exterior, and grounds of the
					 facility in a safe, clean, orderly, and attractive manner. In a nursing
					 facility, an employee must be designated as responsible for housekeeping
					 services.
(b) Occupied resident
					 rooms must be cleaned and put in order at least daily.
(c) Storage areas must be kept safe and free
					 from accumulations of extraneous materials such as refuse, discarded furniture,
					 and newspapers. Combustibles, such as cleaning rags and compounds, must be kept
					 in closed metal containers and labeled.
(d) Attics, mechanical rooms, boiler rooms,
					 and other similar areas must not be used for storage purposes.
(e) All bleaches, detergents, disinfectants,
					 insecticides, and other poisonous substances must be kept in a safe place
					 accessible only to employees. They must not be kept in containers previously
					 containing food or medicine. Containers must be labeled.
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 3 - PROVISIONS APPLICABLE TO ALL FACILITIES › Section 554.324 - Pest Control

Current through Reg. 49, No. 28; July 12, 2024
(a) An
					 effective, safe, and continuing pest control system against insects, rodents,
					 and vermin must be in operation in the facility. Pest control services must be
					 provided by nursing facility personnel or by contract with a licensed pest
					 control company. Care must be taken to use the least toxic and least flammable
					 effective insecticides and rodenticides. These compounds must be stored in
					 nonfood preparation and storage areas. Poisons must be under lock.
(b) The facility must protect against
					 harborages and entrances for insects, rodents, and vermin. Outside doors must
					 be self-closing to control entry of pests.
(c) Garbage and trash must be stored in
					 enclosed containers, protected against leakage, contact with disease carriers,
					 and access to animals. It must be stored in areas separate from those used for
					 the preparation and storage of food and must be removed from the premises in
					 conformity with state and local practices. Garbage and trash containers must be
					 maintained free of accumulations and coatings of garbage. Garbage storage areas
					 must be kept clean and in a state of good repair.
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 3 - PROVISIONS APPLICABLE TO ALL FACILITIES › Section 554.325 - Linen

Current through Reg. 49, No. 28; July 12, 2024
(a) The nursing
					 facility must have available at all times a quantity of linen essential for the
					 proper care and comfort of residents. Linens must be handled, stored, and
					 processed so as to control the spread of infection.
(b) Linen will be maintained in good
					 repair.
(c) Linen must be washed,
					 dried, stored, and transported in a manner which will produce hygienically
					 clean linen. The washing process must have a mechanism for soil removal and
					 bacteria kill.
(d) Clean linen must
					 be stored in a clean linen area easily accessible to the personnel.
(e) Clean towels and washcloths must be
					 provided to each resident as needed or desired. Towels and washcloths must be
					 stored in a sanitary manner between uses by the resident and must not be used
					 by more than one resident between launderings.
(f) Soiled linen and clothing must be stored
					 separately from clean linen and clothing. Soiled linen and clothing must be
					 stored in well ventilated areas, and must not be permitted to accumulate in the
					 facility. Soiled linen and clothing must be transported in accordance with
					 procedures consistent with universal precautions. Bags or containers must not
					 be reused to transport or store clean items.
(g) Soiled linen must not be sorted,
					 laundered, rinsed, or stored in bathrooms, resident rooms, corridors, kitchens,
					 or food storage areas, except soiled linen and clothing which is not
					 contaminated with blood may be rinsed in a resident's bathroom water
					 closet.
(h) Resident's personal
					 clothing that is not soiled with body wastes may be stored in a closed
					 container in the resident's closet. The clothing must be collected and cleaned
					 at least weekly.
(i) Facility staff
					 must wash their hands both after handling soiled linen and before handling
					 clean linen.
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 3 - PROVISIONS APPLICABLE TO ALL FACILITIES › Section 554.326 - Safety Operations

Current through Reg. 49, No. 28; July 12, 2024
(a) The facility
					 must have a program to inspect, test, and maintain the fire alarm system and
					 must execute the program at least once every three months.
(1) The facility must contract with a company
					 that is registered by the State Fire Marshal's Office to execute the
					 program.
(2) A person who performs
					 a service under the contract must be licensed by the State Fire Marshal's
					 Office to perform the service and must complete, sign and date an inspection
					 form similar to the inspection and testing form in NFPA 72 for a service
					 provided under the contract.
(3)
					 The facility must ensure fire alarm system components that require visual
					 inspection are visually inspected in accordance with NFPA 72.
(4) The facility must ensure fire alarm
					 system components that require testing are tested in accordance with NFPA
					 72.
(5) The facility must ensure
					 fire alarm system components that require maintenance are maintained in
					 accordance with NFPA 72.
(6) The
					 facility must ensure smoke dampers are inspected and tested in accordance with
					 NFPA 101.
(7) The facility must
					 maintain onsite documentation of compliance with 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 D - FACILITY CONSTRUCTION › Division 4 - CONSTRUCTION AND INITIAL SURVEY › Section 554.330 - Construction Procedures and Initial Survey of Completed Construction

Current through Reg. 49, No. 28; July 12, 2024
(a) Construction
					 phase.
(1) Prior to the start of construction
					 of a new facility or of building rehabilitation other than that classified as
					 repair in § 554.350 of this subchapter (relating to Building
					 Rehabilitation), a facility must notify HHSC in Austin, Texas, in
					 writing.
(2) All construction must
					 be done according to the minimum licensing requirements in this subchapter. It
					 is a facility's responsibility to employ qualified personnel to prepare the
					 contract documents for construction of a new facility or rehabilitation of an
					 existing facility. Contract documents for additions and rehabilitation other
					 than that classified as repair or renovation in § 554.350 of this
					 subchapter and for the construction of an entirely new facility must be
					 prepared by an architect licensed by the Texas Board of Architectural
					 Examiners. Drawings must bear the seal of the architect. Certain parts of
					 contract documents, including final plans, designs, and specifications, must
					 bear the seal of a licensed professional engineer approved by the Texas Board
					 of Professional Engineers to operate in Texas or, as permitted by subsections
					 (b)(12) and (15) of this section, signed by a Responsible Managing Employee or
					 Alarm Planning Superintendent licensed by the State Fire Marshal's Office.
					 These certain parts include sheets and sections covering structural,
					 electrical, mechanical, sanitary, and civil engineering.