Current through Reg. 49, No. 38; September 20, 2024
(a) This section applies to a small house or
household facility that is designed to provide a non-institutional environment
to promote resident-centered care. New construction of a small house or
household facility, including a conversion of an existing facility, an addition
to an existing facility, or rehabilitation of an existing facility, must meet
the requirements of this section.
(b) A small house or household facility must
comply with this chapter, except it is not required to comply with a
requirement in Division 9 of this subchapter (relating to Facilities Licensed
On or After April 2, 2018) if HHSC waives the requirement in accordance with
subsection (c) of this section or if the requirement is modified by subsection
(g) of this section.
(c) HHSC may
waive a requirement in Division 9 of this subchapter if HHSC determines a
waiver of the requirement would facilitate the implementation of
resident-centered care. To request a waiver of a requirement, a facility must
submit plans to HHSC according to § 554.344 of this subchapter (relating
to Plan Review). The plans must include a statement from an architect
identifying which requirements the facility is requesting to be waived and
explaining how the waiver would contribute to the goals of resident-centered
care.
(d) A small house or
household facility must be designed and equipped to provide a homelike
environment that promotes resident-centered care.
(e) A small house or a household within a
facility must:
(1) have no more than 16
bedrooms as described in subsection (g)(2) of this section;
(2) have living, dining, social, and staffing
areas exclusively within and for the house or household; and
(3) have a kitchen that meets the
requirements in § 554.354(g)(1) of this subchapter (relating to
Architectural Space Planning and Utilization for New Facilities) or a food
service area that meets the requirements of an auxiliary serving kitchen in
§ 554.354(g)(3) of this subchapter, exclusively within and for the house
or household.
(f) A
small house or household facility must be:
(1)
a single small house model, which is a single licensed building having no more
than 16 residents that meets the licensing requirements for architectural
spaces provided within the same licensed building;
(2) a multiple small house model, which is a
single licensed group of two or more small houses located in close proximity to
each other on a single contiguous property that meets the licensing
requirements for architectural spaces in each house and that may include a
stand-alone central building that provides social-diversional space, a
treatment area, or an administrative area; or
(3) a household model, which is a single
licensed building that contains one or more households having no more than 16
residents each; that may include a central area that provides
social-diversional space, a treatment area, or an administrative area; and that
must be arranged to avoid travel through the household by persons who are not
residing in, visiting, or providing services for the household.
(g) A small house or household
facility must comply with the requirements in this section and is not required
to request a waiver for an exception described in this subsection.
(1) The outdoor activity, recreational, and
sitting spaces required in § 554.352(f) of this subchapter (relating to
Location and Site for New Facilities) must include a porch area under a roof
with suitable furniture for sitting and space for wheelchairs.
(2) The resident bedroom requirements in
§ 554.354(a) of this subchapter must be met, except:
(A) a bedroom must be occupied:
(i) by only one resident; or
(ii) by two residents, if they are members of
the same family and the bedroom size, furniture, and headboard wall
requirements for double occupancy are met;
(B) the toilet requirements in §
554.354(a)(7) of this subchapter must be met, except a bathroom must serve no
more than one resident room and must include a lavatory, toilet, and a shower
or bathing unit;
(C) the night
lighting requirement in § 554.354(a)(5) of this subchapter must be met,
except it must be a recessed wall mounted fixture just inside the entry door to
the room and must not be obstructed by the door or furniture; and
(D) the electrical receptacle requirements in
§ 554.354(a)(6) of this subchapter must be met and additional receptacles
must be provided to meet the requirements for Dwelling Unit Receptacle Outlets
in NFPA 70.
(3) The
nursing service area requirements in § 554.354(b) of this subchapter must
be met, except:
(A) a nursing staff lounge is
not required in a small house facility;
(B) the nursing staff toilet room may also be
a toilet room for:
(i) kitchen
staff;
(ii) the public;
or
(iii) a general bathing room, if
the toilet room opens into the general bathing room and common areas;
and
(C) the nourishment
station may be part of the residential kitchen area.
(4) Resident bathing and toilet facility
requirements in § 554.354(c) of this subchapter must be met, except the
door between a bathroom and a resident bedroom:
(A) is not required to be a side-hinged
swinging door;
(B) may be an
externally mounted by-pass door;
(C) must have substantial hardware;
(D) must not be equipped with a bottom door
track that is a tripping hazard; and
(E) if it swings open into the bedroom, must
not interfere with the swing of any other door that opens into the
bedroom.
(5) The living
area requirements in § 554.354(e) of this subchapter and dining room
requirements in § 554.354(f) of this subchapter must be met, except the
distance between the floor and the window sill of a window in the living or
dining room must not exceed 36 inches, to allow a view to the outside from a
seated position.
(6) The dietary
facility requirements in § 554.354(g) of this subchapter must be met,
except a kitchen serving 16 or fewer non-employees per meal:
(A) may be open to the facility in compliance
with NFPA 101;
(B) must meet the
general food service needs of the residents;
(C) must provide for the storage,
refrigeration, preparation, and serving of food; for dish and utensil cleaning;
and for refuse storage and removal;
(D) must contain a multi-compartment sink,
vegetable sink, and hand washing sink;
(E) must provide a supply of hot water that,
if used for sanitizing purposes is 180 degrees Fahrenheit or at the
manufacturer's suggested temperature for chemical sanitizers;
(F) must provide a supply of cold
water;
(G) must have janitorial
facilities exclusively for the kitchen and located in close proximity to the
kitchen;
(H) must have kitchen
floors, walls, and ceilings with nonabsorbent smooth finishes or surfaces that
are capable of being routinely cleaned and sanitized to maintain a healthful
environment;
(I) must have counter
and cabinet surfaces, inside and outside, with smooth, cleanable, relatively
nonporous finishes; and
(J) must
have a toilet for the kitchen staff that is in close proximity to the kitchen
and that may also be a toilet room for the public or the general bathing
room.
(7) The exit
requirements in § 554.355(3) of this subchapter (relating to Exit
Provisions for New Facilities) must be met except for fixed furniture and
wheeled equipment as permitted by NFPA 101.
