Current through Reg. 49, No. 38; September 20, 2024
The facility must be designed, constructed, equipped, and
maintained to protect the health and ensure the safety of residents, personnel,
and the public.
(1) Life safety from
fire.
(A) The facility must meet the
applicable provisions of NFPA 101 as designated by the federal law and
regulations.
(B) After
consideration of the findings of HHSC, CMS may waive specific provisions of
NFPA 101 which, if rigidly applied, would result in unreasonable hardship on
the facility, but only if the waiver does not adversely affect the health and
safety of residents or personnel.
(2) Emergency power.
(A) An emergency electrical power system must
supply power adequate at least for lighting all entrances and exits; equipment
to maintain the fire detection, alarm, and extinguishing systems; and any
systems or equipment whose failure is likely to cause major injury or death to
a resident if the normal electrical supply is interrupted.
(B) When systems or equipment whose failure
is likely to cause major injury or death to a resident are used, the facility
must provide emergency electrical power with an emergency generator defined in
NFPA 99 located on the premises.
(3) Space and equipment. The facility must:
(A) provide sufficient space and equipment in
dining, health services, recreation, living, and program areas to enable staff
to provide residents with needed services as required by these standards and as
identified in each resident's assessment and plan of care;
(B) maintain all essential mechanical,
electrical, and patient care equipment in safe operating condition;
and
(C) conduct regular inspections
of all bed frames, mattresses, and bed rails, if any, as part of a regular
maintenance program to identify areas of possible entrapment. When bed rails
and mattresses are used and purchased separately from the bed frame, the
facility must ensure that the bed rails, mattress, and bed frame are
compatible.
(4) Resident
rooms. Resident rooms must be designed and equipped for adequate nursing care,
comfort, and privacy of residents.
(A)
Bedrooms must:
(i) accommodate no more than
four residents for a facility that receives approval of construction or
reconstruction plans by state and local authorities or are newly certified
before November 28, 2016;
(ii)
accommodate no more than two residents for a facility that receives approval of
construction or reconstruction plans by state and local authorities or are
newly certified on or after November 28, 2016;
(iii) measure at least 80 square feet per
resident in multiple resident bedrooms and at least 100 square feet in single
resident rooms;
(iv) have direct
access to an exit corridor;
(v) be
designed or equipped to ensure full visual privacy for each resident;
(vi) in facilities initially certified after
March 31, 1992, except in private rooms, have ceiling-suspended curtains for
each bed, which extend around the bed to provide total visual privacy, in
combination with adjacent walls and curtain;
(vii) have at least one window to the
outside; and
(viii) have a floor at
or above grade level.
(B)
The facility must provide each resident with:
(i) a separate bed of proper size and height
for the safety and convenience of the resident;
(ii) a clean, comfortable mattress;
(iii) bedding appropriate to the weather and
climate; and
(iv) functional
furniture appropriate to the resident's needs and individual private closet
space in the resident's bedroom with clothes racks and shelves accessible to
the resident.
(C) HHSC
may permit variations in requirements specified in paragraph (1)(A) and (B) of
this section relating to rooms in individual cases when the facility
demonstrates in writing that the variations:
(i) are required by the special needs of the
residents; and
(ii) will not
adversely affect residents' health and safety.
(5) Bathroom. Each resident room must be
equipped with or located near toilet and bathing facilities. For a facility
that receives approval of construction from state and local authorities or are
newly certified on or after November 28, 2016, each resident room must have its
own bathroom equipped with at least a commode and sink.
(6) Nurse call system. The facility must be
adequately equipped to allow residents to call for staff assistance through a
communication system which relays the call directly to a staff member or to a
centralized staff work area :
(A) before
November 28, 2019, from each resident's room;
(B) beginning November 28, 2019, from each
resident's beside ; and
(C) from
toilet and bathing facilities.
(7) Dining and resident activities. The
facility must provide one or more rooms designated for resident dining and
activities. These rooms must be:
(A)
well-lighted;
(B) well ventilated,
with nonsmoking areas identified;
(C) adequately furnished; and
(D) sufficiently spacious to accommodate all
activities.
(8) Other
environmental conditions. The facility must provide a safe, functional,
sanitary, and comfortable environment for residents, staff, and the public. The
facility must:
(A) establish procedures to
ensure that water is available to essential areas when there is a loss of
normal water supply;
(B) have
adequate outside ventilation by means of windows, mechanical ventilation, or a
combination of the two;
(C) equip
corridors with firmly secured handrails on each side; and
(D) maintain an effective pest control
program so that the facility is free of pests and rodents.
(E) establish policies, according to
applicable federal, state, and local laws and regulations, regarding smoking,
smoking areas, and smoking safety that also take into account non-smoking
residents.
