<<Prev Rule

Texas Administrative Code

Next Rule>>
TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 131FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER GPHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS
RULE §131.143Construction Requirements for a New Facility

(a) Any proposed new facility shall be easily accessible to the community and to service vehicles such as delivery trucks, ambulances, and fire protection apparatus. No building may be converted for use as a facility which, because of its location, physical condition, state of repair, or arrangement of facilities, would be hazardous to the health and safety of the patients.

  (1) A facility shall have at least two exits remotely located in accordance with National Fire Protection Association (NFPA) 101, Life Safety Code, 2003 Edition (NFPA 101), §20.2.4.1. When a required means of egress from the facility is through another portion of the building, that means of egress shall comply with the requirements of NFPA 101 which are applicable to the occupancy of that other building. Such means of egress shall be open, available, unlocked, unrestricted, and lighted at all times during the facility hours of operation. All documents published by National Fire Protection Association (NFPA) as referenced in this section may be obtained by writing or calling the NFPA at the following address or telephone number: National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02269-9101 or (800) 344-3555. NFPA documents are also available for public inspection during regular working hours at the offices of Architectural Review Group, Texas Department of State Health Services, 1100 West 49th Street, Austin, Texas 78756-3199.

  (2) Hazardous locations.

    (A) A new facility or an addition to an existing facility shall not be constructed within 150 feet of easement boundaries or setbacks of hazardous underground locations including but not limited to liquid butane or propane, liquid petroleum or natural gas transmission lines, high pressure lines, and not within the easement of high voltage electrical lines. Municipality's main natural gas lines in right-of ways serving dwellings and gas lines on property servicing gas meter(s) under this provision are not consider natural high pressure lines.

    (B) A new facility and an addition to an existing facility shall not be built within 300 feet of above ground or underground storage tanks containing liquid petroleum or other flammable liquids used in connection with a bulk plant, marine terminal, aircraft refueling, bottling plant of a liquefied petroleum gas installation, or near other hazardous or hazard producing plants.

  (3) Undesirable locations.

    (A) In lieu of local codes, a new facility shall not be located closer than 1500 feet to nuisance producing industrial sites, feed lots, sanitary landfills, or manufacturing plants producing excessive noise or air pollution.

    (B) Flood plains.

      (i) When a new facility is constructed in a designated 100-year flood plain, the building finished floor elevation shall be one foot above the set base flood plain elevation. The building shall meet all local flood code ordinances and local flood control requirements.

      (ii) To obtain a license as a facility, a previously licensed facility and an existing building or a portion of an existing building located in a designated 100-year flood plain shall meet the requirement of clause (i) of this subparagraph.

      (iii) Facility required functional components shall be constructed above the designated flood plain in a new addition to an existing facility located in a designated 100-year flood plain. The new addition shall meet the requirement of clause (i) of this subparagraph.

      (iv) Currently licensed facilities located within a designated 100-year flood plain are exempted from these requirements for renovations and repairs.

(b) The facility site shall include paved roads, walkways, and parking in accordance with the requirements set out in this subsection.

  (1) Paved roads and walkways.

    (A) Paved roads shall be provided within lot lines for access from public roads to the main entrance and to service entrances.

    (B) Finished surface walkways shall be provided for pedestrians. When public transportation or walkways serve the site, finished surface walkways or paved roads shall extend from the public conveyance to the building entrance.

  (2) Parking and disability requirements.

    (A) Off-street parking shall be available for visitors, employees, and staff. Parking structures directly accessible from a facility shall be separated with two-hour fire rated noncombustible construction. When used as required means of egress for facility occupants, parking structures shall comply with National Fire Protection Association 88A, Standard for Parking Structures, 2002 edition. This requirement does not apply to freestanding parking structures.

    (B) In the absence of local code, one parking space shall be provided for each staff member on duty, plus one space for each three treatment or examination stations, one space for each three diagnostic rooms and one visitor's space for every five treatment/exam/diagnostic stations/rooms. Parking facilities shall be increased accordingly when the size of existing facilities is increased.

    (C) When on-street parking is available and acceptable to the local authorities having jurisdiction, the numbers of parking spaces may be reduced accordingly and shall meet the requirement of subparagraph (B) of this paragraph.

    (D) Special considerations benefiting disabled staff, visitors, and patients shall be provided. Each facility shall comply with the Americans with Disabilities Act (ADA) of 1990, Public Law 101-336, 42 United States Code, Chapter 126, and Title 36 Code of Federal Regulations, Part 1191, Appendix A, Accessibility Guidelines for Buildings and Facilities or 16 TAC, §68.20 (relating to Buildings and Facilities Subject to Compliance with the Texas Accessibility Standards), Texas Accessibility Standards (TAS), April 1, 1994 edition, issued by the Texas Department of Licensing and Regulation, under the Texas Architectural Barriers Act, Government Code, Chapter 469.

(c) Every building and every portion thereof shall be designed and constructed to sustain all dead and live loads in accordance with accepted engineering practices and standards and the local governing building codes. Where there is no local governing building code, the facility shall be constructed in accordance with the International Building Code, 2003 edition, published by the International Code Council, 500 New Jersey Avenue, Northwest, 6th Floor, Washington, District of Columbia 20001-2070, (888) 422-7233.

  (1) All new construction, including conversion of an existing building to a facility or establishing a separately licensed facility within another existing building, shall comply with NFPA 101, Chapter 20, New Ambulatory Health Care Occupancies, of the National Fire Protection Association 101, Life Safety Code, 2003 edition (NFPA 101), and Subchapters F and G of this chapter (relating to Fire Prevention and Safety Requirements, and Physical Plant and Construction Requirements, respectively). Construction documents shall be submitted to the department in accordance with §131.146 of this title (relating to Preparation, Submittal, Review and Approval of Plans, and Retention of Records).

    (A) Construction types for multiple building occupancy.

      (i) When a facility is part of a larger building which complies with NFPA 101, §20.1.6, Minimum Construction Requirements for (fire resistance) construction type, the designated facility shall be separated from the remainder of the building with a minimum of one-hour fire rated construction.

      (ii) When a facility is located in a multistory building of two or more stories, the entire building shall meet the construction requirements of NFPA 101, §20.1.6.3. A facility shall not be located in a multistory building which does not comply with the minimum construction requirements of NFPA 101, §20.1.6.3.

      (iii) When a facility is part of a one-story building that does not comply with the construction requirements of NFPA 101, §20.1.6.2, the facility shall be separated from the remainder of the building with a 2-hour fire rated construction. The designated facility portion shall have the construction type upgraded to comply with NFPA 101, §20.1.6.2.

    (B) Special provisions shall be made in the design of a facility if located in a region where local experience shows loss of life or extensive damage to buildings resulting from hurricanes, tornadoes, or floods.

  (2) A facility shall provide a physical environment that protects the health, safety, and welfare of patients, personnel, and the public.

  (3) The more stringent standard, code or requirement shall apply when a difference in requirements for construction exists.

  (4) Nothing in this subchapter shall be construed to prohibit a better type of building construction, more exits, or otherwise safer conditions than the minimum requirements specified in this subchapter.

  (5) Nothing in this subchapter is intended to prevent the use of systems, methods, or devices of equivalent or superior quality, strength, fire resistance, effectiveness, durability, safety to health and welfare of individuals, and safety to those prescribed by this subchapter, provided technical documentation which demonstrates equivalency is submitted to the department for approval.

  (6) Separate freestanding buildings for non-patient use such as the heating plant, boiler plant, laundry, repair workshops, or general storage may be of unprotected noncombustible construction, protected noncombustible construction, or fire-resistive construction and be designed and constructed in accordance with other occupancy classifications requirements listed in NFPA 101.

(d) Spatial requirements.

  (1) Administration and public areas.

    (A) A primary entrance shall be located at grade level and be accessible to individuals with disabilities, and protected against inclement weather with a canopy from the point of passenger loading and unloading to the building entrance. The canopy shall at least extend over the passenger side of the vehicle to minimally protect the patient from inclement weather.

    (B) A main lobby shall be located at the primary entrance and shall include a reception and information counter or desk, waiting space(s), private interview space/alcove, public toilet facilities located convenient to the lobby/waiting area, public telephones, drinking fountain(s), bottled water or water cooler, and storage room or alcove for wheelchairs. Private interview space/alcove may be omitted if all interviews are conducted in treatment or exam rooms.

    (C) General office(s) space shall be provided for business transactions, medical and financial records, and administrative and professional staff on site or off site.

    (D) Storage. Storage room or closet for office equipment and supplies shall be provided and located outside of the patient treatment areas.

    (E) When a facility is fully digitalized, an IT closet shall be provided for computer servers. When the facility is not fully digitalized, the facility shall provide an area for storage of clinical records which is separate from patient treatment and diagnostic areas, and shall be secured from unauthorized access.

  (2) Emergency entrance and signage.

    (A) A separate ambulance entrance at grade level shall be well-illuminated, identified by sign(s), and protected from inclement weather. The ambulance entry shall have a drive under canopy for protection from inclement weather. The primary and ambulance entry to permit discharge of patients from automobiles and ambulances shall be paved. Parking shall be provided near and convenient to the pedestrian primary entrance.

    (B) Emergency entry signage. An emergency sign shall be provided at the entry from the public road(s) or street(s) serving the site. The emergency sign at the entry to the site shall be illuminated and connected to the emergency essential electrical system. Additional sign(s) on-site may be required to direct patients to the emergency treatment area entrance when the emergency treatment area is not visible from the site entry. The letters on the entry sign shall be red or white with a contrasting background, all capitalized, at least eight inches in height, and include an arrow indicating direction.

    (C) A facility that is not in continuous operation 24 hours per day and 7 days per week shall display clearly visible signage at the main entry and ambulance entry points of the facility. The signage letter size shall be readable and not smaller than half an inch in height. The signage shall provide the information required under §131.22(c) of this title (relating to Classifications of Facilities).

    (D) A facility that is not in continuous operation shall comply with the requirements under §133.22(d) of this title.

  (3) Emergency suite.

    (A) Control station/nurse station shall be located to permit staff observation and control of access to treatment room(s), exam rooms, pedestrian and ambulance entrances, and public waiting area(s). Video cameras may be substituted for direct visual observation for pedestrian and ambulance entrances, and public waiting area(s). The nurse station shall contain cabinets, work counter, and a hand washing fixture with hands-free operable controls. The counter height shall not exceed 42 inches. The nurse station may be combined with or include centers for reception and communication.

    (B) When a dedicated triage space/room is provided, it shall include a counter with a hand washing fixture with hands-free operable controls.

    (C) Charting and dictation space for physician's space may be in a separate room or alcove or control station/nurse station. Suitable space shall be provided when computers are used for the clinical records.

Cont'd...

Next Page

Link to Texas Secretary of State Home Page | link to Texas Register home page | link to Texas Administrative Code home page | link to Open Meetings home page