(a) Compliance. All
buildings in which existing hospitals licensed by the Texas Health and Human
Services Commission (HHSC) are located shall comply with this subsection. This
chapter shall not be applied retroactively to an operating hospital holding an
active HHSC facility license before the effective date of this chapter that
complies with the occupancy requirements in National Fire Protection
Association 101, Life Safety Code, (NFPA 101), the Hospital Licensing
Standards/Rules (1969, 1985, or 1998 editions as amended), and the hospital
licensing rules under which the buildings or sections of buildings were
constructed.
(1) Minimum fire safety and
construction requirements.
(A) Code
requirements. A limited services rural hospital (LSRH) shall meet the
requirements for health care occupancies contained in the 1967, 1973, 1981,
1985, 1991, 1997, 2000, 2003, or 2010 editions of the NFPA 101, Life Safety
Code, the Hospital Licensing Standards/Rules (1969, 1985, or 1998 editions as
amended), and the hospital licensing rules under which the buildings or
sections of buildings were constructed.
(B) Existing construction requirements.
Existing LSRHs or portions of existing LSRHs constructed before the adoption of
any of the editions of NFPA 101, the Hospital Licensing Standards, and the
hospital licensing rules listed in subparagraph (A) of this paragraph, shall
comply with this section and Chapter 19, NFPA 101, 2012
edition.
(2) Remodeling.
All requirements listed in this chapter are applicable to renovations,
additions and alterations unless stated otherwise.
(A) Alteration or installation of new
equipment. Any alteration or any installation of new equipment shall be
accomplished as nearly as practicable with the subchapter requirements, except
that when existing conditions make changes impractical to accomplish, minor
deviations from functional requirements may be permitted if the intent of the
requirements is met and if the care and safety of patients will not be
jeopardized.
(B) Installation,
alteration, or extension approval. No new system of mechanical, electrical,
plumbing, fire protection, or piped medical gas system may be installed or any
such existing system may be replaced, materially altered or extended, until
complete plans and specifications for the replacement, installation,
alteration, or extension have been submitted to HHSC, reviewed and approved in
accordance with §
511.167 of this subchapter
(relating to Preparation, Submittal, Review, and Approval of Plans, and
Retention of Records).
(C) Minor
remodeling or alterations. All remodeling or alterations that do not involve
alterations to load bearing members or partitions, change functional operation,
affect fire safety (e.g., modifications to the fire, smoke, and corridor
walls), add or subtract services for which the LSRH is licensed, and do not
involve changes listed in subparagraph (B) of this paragraph, shall be
submitted for approval without submitting contract documents. Such approval
shall be requested in writing, with a brief description of the proposed changes
in accordance with §
511.167(f)(3) of
this subchapter.
(D) Major
remodeling or alterations. Plans shall be submitted in accordance with §
511.167 of this subchapter for all
major remodeling or alterations. All remodeling or alterations that involve
alterations to load bearing members or partitions, change functional operation,
affect fire safety (e.g., modifications to the fire, smoke, and corridor
walls), or add services over those for which the LSRH is licensed are
considered as major remodeling and alterations.
(E) Phasing of construction in existing
facilities.
(i) Projects involving alterations
of and additions to existing buildings shall be programmed and phased so that
on-site construction will minimize disruptions of existing functions.
(ii) Access, exit access, and fire protection
shall be maintained so that the safety of the occupants will not be jeopardized
during construction.
(iii) A
noncombustible or limited combustible dust and vapor barrier shall be provided
to separate areas undergoing demolition and construction from occupied areas.
When a fire retardant plastic material is used for temporary daily usage, it
shall be removed at the end of each day.
(iv) The air inside the construction area
shall be protected by mechanical filtration that recirculates inside the space
or is exhausted directly to the exterior.
(v) The area shall be properly ventilated and
maintained. The area under construction shall have a negative air pressure
differential to the adjoining areas and shall continue to operate as long as
construction dust and odors are present.
(vi) Temporary sound barriers shall be
provided where intense prolonged construction noises will disturb patients or
staff in the occupied portions of the building.
(F) Nonconforming conditions. When doing
renovation work, if it is found to be infeasible to correct all of the
nonconforming conditions in the existing LSRH in accordance with these rules,
HHSC may grant a conditional approval if the operation of the LSRH, Americans
with Disabilities Act accessibility requirements, and safety of the patients
are not jeopardized by the nonconforming condition.
