Current through Reg. 49, No. 38; September 20, 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.
(c) HHSC
may grant a waiver for certain provisions regarding the physical plant and
environment that, in the opinion of HHSC, would be impractical for the facility
to meet. In granting the waiver, HHSC must determine that granting the waiver
has no adverse effect on resident health and safety and the requirement, if not
waived, would impose an unreasonable hardship on the facility. HHSC may require
offsetting or equivalent provisions in granting a waiver.
(d) The requirements of this subchapter are
applicable to nursing facilities as follows:
(1) All nursing facilities must comply with
division 3 of this subchapter (relating to Provisions Applicable to All
Facilities).
(2) A nursing facility
or a portion of a nursing facility licensed before September 11, 2003, and
continually operated as a licensed nursing facility, must comply with division
2 of this subchapter (relating to Facilities Licensed Before September 11,
2003).
(3) A nursing facility or a
portion of a nursing facility licensed or constructed, on or after September
11, 2003, but before April 2, 2018, and continuously operated as a licensed
nursing facility, must comply with division 5 of this subchapter (relating to
Facilities Licensed On or After September 11, 2003 and Before April 2,
2018).
(4) A nursing facility or a
portion of a nursing facility licensed or constructed on or after April 2,
2018, must comply with division 9 of this subchapter (relating to Facilities
Licensed On or After April 2, 2018).
(5) A small house or household facility is a
facility that is designed to provide a non-institutional environment to promote
resident-centered care and that meets the requirements of § 554.345 of
this subchapter (relating to Small House and Household Facilities). New
construction of a small house or household facility must meet the requirements
of § 554.345 of this subchapter.
(e) A facility must comply with NFPA 101;
NFPA 99, except Chapters 7, 8, 12, and 13; and a Tentative Interim Amendment
(TIA) issued by NFPA, including the TIAs listed in paragraphs (1) and (2) of
this subsection. A facility must also comply with other NFPA publications
referenced in NFPA 101 or in this chapter, unless otherwise approved by HHSC.
(1) The following TIAs have been issued for
NFPA 101:
(A) TIA 12-1, issued August 11,
2011;
(B) TIA 12-2, issued October
30, 2012;
(C) TIA 12-3, issued
October 22, 2013; and
(D) TIA 12-4,
issued October 22, 2013.
(2) The following TIAs have been issued for
NFPA 99:
(A) TIA 12-2, issued August 11,
2011;
(B) TIA 12-3, issued August
9, 2012;
(C) TIA 12-4, issued March
7, 2013;
(D) TIA 12-5, issued
August 1, 2013;
(E) TIA 12-6,
issued March 3, 2014;
(F) TIA 12-7,
issued December 1, 2016; and
(G)
TIA 12-8, issued April 10, 2018.
(f) Building rehabilitation on existing
buildings shall be classified in accordance with NFPA 101 and shall comply with
NFPA 101 and § 554.350 of this subchapter (relating to Building
Rehabilitation).
(g) Buildings, or
portions of buildings, may be occupied during construction, repair,
alterations, or additions only when required means of egress and required fire
protection features are in place and continuously maintained for the portion
occupied, or when alternative life safety measures acceptable to HHSC are in
place.
(h) No existing life safety
feature shall be removed or reduced when the feature is a requirement for new
construction. Life safety features and equipment that have been installed in
existing buildings, if not required by NFPA 101, must continue to be maintained
or may be completely removed if prior approval is obtained from HHSC.
(i) The facility must perform a risk
assessment in accordance with NFPA 99.
(1) The
risk assessment must follow and document the defined risk assessment procedure
used.
(2) The results of the
assessment procedure must be documented and records retained.
(3) A building system required by NFPA 99
shall be designed to meet the risk categories determined for each system as
part of this assessment. At a minimum, any new systems or equipment must be
designed to meet the requirements for Category 2 risk, as defined in NFPA
99.
(4) The assessment must be
reviewed and a new assessment performed, if necessary, on an annual basis and
when the facility identifies changes in resident care needs that cannot be met
by the currently installed systems and equipment.
(5) In addition to the requirements of NFPA
99 based on the risk assessment, a facility must also meet all applicable
requirements of this subchapter.
(j) A wing or area that is separated from the
rest of the facility by locked doors, or a facility that is locked in its
entirety, for the purpose of securing residents must meet the requirements of
§554.2208(a)(6) and (c)(1) - (10) of this chapter (relating to Standards
for Certified Alzheimer's Facilities).
