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 554.353 - General Considerations for New Facilities

Current through Reg. 49, No. 28; July 12, 2024
(a) Services. A nursing facility 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.
(b) Sizes. The sizes of the various
					 departments will depend upon program requirements and the 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. A nursing facility may be operated together with a hospital 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. A nursing facility 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. An assisted living facility may be operated together
					 with a nursing facility and may share food and laundry service, but must have
					 clearly identifiable physical separations such as a separate wing, or floor,
					 and each facility must independently meet all other requirements within their
					 licensed areas.
(d) Exterior
					 finishes. Unless otherwise approved by HHSC, the exterior finish material of a
					 building 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 according to ASTM E84 or UL
					 723. All others 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 according to ASTM E108 or UL
					 790.
(e) Accessibility
					 requirements. 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 of 1990 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 the TAS.