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 554.360 - Mechanical Requirements for New Facilities

Universal Citation: 26 TX Admin Code § 554.360

Current through Reg. 49, No. 38; September 20, 2024

(a) The design of the mechanical systems must be done by or under the direction of a licensed professional mechanical engineer approved by the Texas Board of Professional Engineers to operate in Texas, and the parts of the plans and specifications covering mechanical design must bear the legible seal of the engineer.

(1) Building services pertaining to utilities; heating, ventilating, and air-conditioning systems; vertical conveyors; and chutes must be according to NFPA 101.

(2) Required plumbing fixtures must be according to NFPA 101 and §554.354 of this division (relating to Architectural Space Planning and Utilization for New Facilities) in specific use areas.

(b) Plumbing.

(1) All plumbing systems must be designed and installed according to the requirements of the locally adopted plumbing code. In the absence of a locally-adopted plumbing code, a nationally recognized model plumbing code must be used. Any discrepancy between an applicable code and the requirements of this section must be called to the attention of HHSC for resolution.

(2) Supply systems must ensure adequate hot and cold water. In addition to hot water for kitchen and laundry use, a rule-of-thumb for hot water for resident use at 110 degrees Fahrenheit is to provide 6-1/2 gallons per hour per resident.

(3) Water must be supplied from a system approved by the Water Supply Division of TCEQ, or from a system regulated by an entity responsible for water quality in that jurisdiction as approved by the Water Supply Division of TCEQ.

(4) The sewage system must connect to a system permitted by the Water Quality Division of TCEQ, or to a system regulated by an entity responsible for water quality in that jurisdiction as approved by the Water Quality Division of TCEQ.

(5) The minimum ratio of fixtures to residents shall be as required in §554.354(c) of this division.

(6) For design calculation purposes, resident-use hot water must not exceed 110 degrees Fahrenheit at the fixture. For purposes of conforming to licensure requirements, an operating system providing water from 100 degrees Fahrenheit to 115 degrees Fahrenheit is acceptable. Hot water for laundry and kitchen use must be normally 140 degrees Fahrenheit. Hot water for dish sanitizing must be 180 degrees Fahrenheit.

(7) A facility must provide water closets with a seat height 17 inches to 19 inches from the floor for persons with disabilities.

(8) Showers for wheelchair residents must not have curbs. Tub and shower bottoms must have a slip-resistant surface. Shower and tub enclosures, other than curtains, must be of tempered glass, plastic, or other safe material.

(9) Drinking fountains must not extend into exit corridors.

(10) A facility must provide fixture controls easily operable by residents, such as lever-type controls.

(11) Plumbing fixtures for residents must be vitreous china or porcelain finished cast iron or steel unless otherwise approved by HHSC. Fiberglass bathing units are acceptable if they have a Class B flame spread rating when tested according to ASTM E84.

(12) Hand-washing sinks for staff use must be according to §554.354 of this division. A facility must provide lavatories adjacent to all water closets.

(13) A soiled utility room must be provided with a flushing device, such as a water closet with bedpan lugs; a spray hose with a siphon breaker or similar device, such as a high neck faucet with lever controls; and a deep sink that is large enough to submerse a bedpan. A sterilizer may be used for sanitizing in place of a deep sink.

(14) A facility must install a siphon breaker or back-flow preventer with any water supply fixture if the outlet or attachments may be submerged.

(15) A facility must provide clean-outs for waste piping lines located so there is the least physical and sanitary hazard to residents. To avoid contamination, clean-outs must open to the exterior, where possible.

(16) A facility with a boiler must meet all applicable requirements of Texas Health and Safety Code Chapter 755.

(1) General Requirements.

(A) HVAC systems must be designed and installed in accordance with ASHRAE standards, except as may be modified by this section.

(B) HVAC systems serving spaces or providing health functions covered by NFPA 99 must be commissioned as required by NFPA 99.

(D) Mechanical plans must bear a statement verifying that the systems are designed according to NFPA 90A and NFPA 99.

(E) All air-supply and air-exhaust systems must be mechanically-operated.

(F) Ducts must be of metal or other approved noncombustible material. Cooling ducts must be insulated against condensation.

(G) Static pressures of systems must be within limits recommended by ASHRAE and the equipment manufacturer, both upstream and downstream.

(2) Heating and Cooling.

(A) A facility must provide heating and cooling by a central air conditioning system, or a substantially similar air conditioning system. Air conditioning systems must be designed, installed and functioning to maintain temperatures suitable for resident comfort within all areas used by residents.

(B) Design temperatures for heating and cooling must be as required by NFPA 99.

(C) A heating system must be able to maintain a temperature of at least 75 degrees Fahrenheit for all areas occupied by residents. For all other occupied areas, a heating system must be able to maintain a temperature of at least 72 degrees Fahrenheit.

(D) A cooling system must be able to maintain a temperature of not more than 78 degrees Fahrenheit.

(E) Occupied areas generating high heat, such as kitchens, must be provided with a sufficient cool air supply to maintain a temperature not exceeding 85 degrees Fahrenheit at the five-foot level. Supply air volume must be approximately equal to the air volume exhausted to the exterior for these areas.

(F) The location and design of air diffusers, registers, and return air grilles must ensure that residents are not in harmful or excessive drafts in their normal usage of the room.

(G) In geographic locations or interior room areas where extreme humidity levels are likely to occur for extended periods of time, apparatus for controlling humidity levels with automatic humidistat controls, preferably at 40-60% relative humidity, are recommended as part of central systems.

(H) Unvented space heaters and portable heating units must not be used. Heating devices or appliances must not be a burn hazard to residents.

(I) Gas-fired Heating Equipment.

(i) Systems using liquefied petroleum gas fuel must meet the requirements of the Railroad Commission of Texas and NFPA 58.

(ii) A combustion fresh air inlet must be provided to all gas or fossil fuel operated equipment in steel ducts or passages from outside the building according to NFPA 54. Combustion air must be provided through two permanent openings, one commencing within 12 inches of the floor and one commencing within 12 inches of the ceiling.

(iii) A room where gas-fired heating equipment is located must be vented to the exterior to exhaust heated ambient air in the room.

(3) Ventilation.

(A) Air systems must provide for mixing at least 10% outside air for the supply distribution. Blowers for central heating and cooling systems must be designed so that they may run continuously.

(B) A facility must locate an outdoor air intake according to NFPA 99 and as far as practical, but not less than 10 feet, from exhaust outlets or ventilating systems, combustion equipment stacks, medical vacuum systems, plumbing vent stacks, or areas which may collect vehicular exhaust and other noxious fumes.

(C) Fresh air inlets must be appropriately screened to prevent entry of debris, rodents, and animals. A facility must provide access to such screens for periodic inspection and cleaning to eliminate clogging or air stoppage.

(D) A facility must incorporate natural ventilation using windows or louvers, if possible and practical. Windows or louvers must have insect screens.

(E) The design of ventilation systems must provide air movement that is from clean to less clean areas. The ventilation systems must be designed and balanced to provide the pressure relationships to adjacent spaces as required by NFPA 99. The installer must furnish and certify a final engineered system air balance report for the completed system. The report must demonstrate the pressure relationships required by NFPA 99.

(F) Air supply to food preparation areas must not be from air that has circulated through places such as resident bedrooms and baths.

(G) Ventilation rates for all areas of a facility must be as required by NFPA 99. These rates are the minimum acceptable rates, but do not preclude the use of higher ventilation rates.

(H) The bottoms of ventilation openings must be at least three inches above the floor of any room.

(I) A door protecting a corridor or way of egress must not include an air transfer grille or louver. A corridor must not be used to supply air to or exhaust air from any room except that air from a corridor may be used as make-up air to ventilate a small toilet room, a janitor's closet, or a small electrical or telephone closet opening directly on a corridor, provided the ventilation can be accomplished by door undercuts not exceeding 3/4 inches.

(4) Exhaust.

(A) A facility must provide forced air exhaust of all room air directly to the outdoors according to NFPA 99.

(i) Areas such as laundries, kitchens, and dishwashing areas must exhaust all room air to the outdoors to remove excess heat and moisture and to maintain air flow in the direction of clean to soiled areas.

(ii) Unsanitary areas, including janitor's closets, soiled linen areas, soiled workroom and utility areas, and soiled areas of laundry rooms, must exhaust all room air outdoors.

(B) All exhaust must be continuously ducted to the exterior. Exhausting air into attics or other spaces is not permitted. Exhaust duct material must be metal.

(C) Exhaust hoods, ducts, and automatic extinguishers for kitchen cooking equipment must be according to NFPA 96, when required by NFPA 101.

(5) Integration with Building Construction.

(A) Smoke compartmentation must meet the requirements of §554.356 of this division (relating to Smoke Compartments (Subdivision of Building Spaces) for New Facilities).

(B) An air system must be designed as much as possible to avoid having ducts passing through fire walls or smoke barrier walls. All openings or duct penetrations in these walls must be according to NFPA 101.

(C) A smoke damper at a smoke barrier must close automatically upon activation of the fire alarm system to prevent the flow of air or smoke in either direction, when required by NFPA 101.

(D) A duct with a smoke damper must have maintenance panels for inspection. A maintenance panel must be removable without tools. A facility must provide access in the ceiling or side wall to facilitate smoke damper inspection. A facility must identify the location of dampers on the wall or ceiling of the occupied area below.

(E) A central air supply system or a system serving a means of egress must automatically and immediately shut down upon activation of the fire alarm system, except when such a system is part of an engineered smoke-removal system approved by HHSC.

(6) All ventilation or air-conditioning systems must be equipped with filters as required by NFPA 99. Filters must be of sufficient efficiency to minimize dust and lint accumulations throughout the system and building, including in supply and return plenums and ductwork. Filters must be easily accessible for routine changing or cleaning.

(d) Sprinkler systems. The following requirements are applicable to sprinkler systems:

(1) Sprinkler systems must be according to NFPA 13 and this subchapter.

(2) The design and installation of sprinkler systems must meet any applicable state laws pertaining to these systems and one of the following criteria:

(A) A sprinkler system must be designed by a qualified licensed professional engineer approved by the Texas Board of Professional Engineers to operate in Texas. The engineer must supervise the installation and provide written approval of the completed installation.

(B) A sprinkler system must be planned and installed according to NFPA 13 by a firm with a certificate of registration issued by the State Fire Marshal's Office. The RME's license number and signature must be included on the prepared sprinkler drawings.

(3) A facility must ensure all sprinkler piping is protected against freezing. The design of freeze protection must minimize the need for dependence on staff action or intervention to provide protection.

(e) Piped gas and vacuum systems. A piped medical gas or medical vacuum system, including a piped oxygen system, a vacuum system, or a drive gas system such as a compressed air system, must be designed, installed, operated and managed according to the requirements of NFPA 99 for new health care facilities, and based on the risk category determined by the assessment required by § 554.300(i) of this subchapter (relating to General Requirements).

Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.

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