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

(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.

(1) Site plan documents must include grade contours; streets, with names; a north arrow; fire hydrant locations; fire lanes; utilities, public or private; fences; unusual site conditions, such as ditches, low water levels, and other buildings on-site; and indications of buildings located five feet or less beyond site property lines. Site plan documents for nursing facilities may include the developed landscaping plan for resident use.

(2) Foundation plan documents must include the general foundation design and details.

(3) Floor plan documents must include room names, numbers, and usages; resident care areas; numbered doors, including swing; windows; a legend or clarification of wall types; dimensions; fixed equipment; plumbing fixtures; kitchen basic layout; and identification of all smoke barrier walls and fire walls, outside wall to outside wall.

(4) For new construction, additions to or rehabilitation of an existing building, an overall plan of the entire building must be drawn or reduced to fit on an 8 1/2-inch by 11-inch sheet.

(5) Schedules must include door materials, sizes, and types; window materials, sizes, and types; room finishes; and special hardware.

(6) Elevations must include exterior elevations with material note indications, and interior elevations, where needed for special conditions.

(7) Roof plans must include any roof top equipment, roof slopes, drain locations, and gas piping.

(8) Details must include wall sections as needed, especially for special conditions; cabinets and built-in work, basic design only; cross sections through buildings as needed; and miscellaneous details and enlargements as needed.

(9) Building structure documents must include structural framing layout and details, primarily for columns, beams, joists, and structural frames; roof framing layout, when this cannot be adequately shown on cross section; cross sections in quantity and detail to show sufficient structural design; and structural details as necessary to ensure adequate structural design.

(10) Electrical documents must include electrical layout, including lights, convenience outlets, equipment outlets, switches, and other electrical outlets and devices; service, circuiting, distribution, and panel diagrams; exit signs and emergency egress lighting; emergency electrical provisions, such as generators and panelboards; fire alarms and similar systems, such as control panels, devices, and alarms; staff communication systems, including a nurse call system; and sizes and details sufficient to ensure safe and properly operating systems.

(11) Plumbing documents must include plumbing layout with pipe sizes and details sufficient to ensure safe and properly operating systems, water systems, sanitary systems, gas systems, other systems normally considered under the scope of plumbing, fixtures, and provisions for combustion air supply.

(12) Heating, ventilation, and air-conditioning (HVAC) documents must include sufficient details of HVAC systems and components to ensure a safe and properly operating installation including, heating, ventilating, and air-conditioning layout; ducts; protection of duct inlets and outlets; combustion air; piping; exhausts; duct smoke detectors; fire dampers; and equipment types, sizes, and locations.

(13) Fire sprinkler system plans and hydraulic calculations must be designed in accordance with the applicable sections of NFPA 13, and signed by a Responsible Managing Employee, licensed by the State Fire Marshal's Office, or sealed by a licensed professional engineer.

(14) Other layouts, plans, or details that are necessary to convey a clear understanding of the design and scope of the project, including plans covering private water or sewer systems, which must be reviewed by the local health or wastewater authority having jurisdiction.

(15) Specifications must include installation techniques, quality standards, manufacturers, references to specific codes and standards, design criteria, special equipment, hardware, finishes, and any other information needed to amplify drawings and notes.

(16) Fire detection and alarm system working plans must be designed according to the applicable sections of NFPA 72 and NFPA 70 and signed by an Alarm Planning Superintendent licensed by the State Fire Marshal's Office, or sealed by a licensed professional engineer.

(1) Upon completion of construction of a new facility, or building rehabilitation other than that classified as repair or renovation in § 554.350 of this subchapter, a final construction inspection of the facility, including grounds, basic equipment and furnishings, must be performed by HHSC prior to occupancy. The completed construction must have the written approval of the local authorities having jurisdiction, including the fire marshal and building official. When construction or building rehabilitation does not alter the licensed capacity of a facility, based on submitted documentation and the scope of the performed building rehabilitation, HHSC may permit a facility to use the rehabilitated portion of a facility pending a final construction inspection or may determine a final construction inspection is not required.

(2) An applicant may obtain the inspection described in paragraph (1) of this subsection on an expedited basis. An applicant may obtain a Life Safety Code inspection within 15 business days after HHSC receives a written request if the applicant submits:

(3) After the completed construction is surveyed and found acceptable by HHSC, this information is conveyed to the licensing officer as part of the information needed to issue a license to the facility. Additions to or rehabilitation of existing facilities may require a revision or modification to an existing license. The building, including basic furnishings and operational needs, grades, drives, parking, and grounds must be 100 percent complete at the time of this initial survey visit for HHSC to approve occupancy and licensing. A facility may accept up to three residents between the time it receives initial approval from HHSC and the time the license is issued.

(4) A copy of the following documents must be provided to HHSC at the time of the survey of the completed building. HHSC may request some or all of these documents prior to scheduling the initial survey:

(1) If, during the survey of completed construction, the surveyor finds basic requirements not met, HHSC will not license the facility or approve it for occupancy. Such basic items may include the following:

(2) If the surveyor encounters deficiencies that do not affect the health and safety of the residents, licensure may be recommended based on an approved written plan of correction by the facility's administrator.