| (a) Compliance. All buildings in which existing hospitals
licensed by the Texas Health and Human Services Commission (HHSC)
are located shall comply with this subsection. This chapter shall
not be applied retroactively to an operating hospital holding an active
HHSC facility license before the effective date of this chapter that
complies with the occupancy requirements in National Fire Protection
Association 101, Life Safety Code, (NFPA 101), the Hospital Licensing
Standards/Rules (1969, 1985, or 1998 editions as amended), and the
hospital licensing rules under which the buildings or sections of
buildings were constructed.
(1) Minimum fire safety and construction requirements.
(A) Code requirements. A limited services rural hospital
(LSRH) shall meet the requirements for health care occupancies contained
in the 1967, 1973, 1981, 1985, 1991, 1997, 2000, 2003, or 2010 editions
of the NFPA 101, Life Safety Code, the Hospital Licensing Standards/Rules
(1969, 1985, or 1998 editions as amended), and the hospital licensing
rules under which the buildings or sections of buildings were constructed.
(B) Existing construction requirements. Existing LSRHs
or portions of existing LSRHs constructed before the adoption of any
of the editions of NFPA 101, the Hospital Licensing Standards, and
the hospital licensing rules listed in subparagraph (A) of this paragraph,
shall comply with this section and Chapter 19, NFPA 101, 2012 edition.
(2) Remodeling. All requirements listed in this chapter
are applicable to renovations, additions and alterations unless stated
otherwise.
(A) Alteration or installation of new equipment. Any
alteration or any installation of new equipment shall be accomplished
as nearly as practicable with the subchapter requirements, except
that when existing conditions make changes impractical to accomplish,
minor deviations from functional requirements may be permitted if
the intent of the requirements is met and if the care and safety of
patients will not be jeopardized.
(B) Installation, alteration, or extension approval.
No new system of mechanical, electrical, plumbing, fire protection,
or piped medical gas system may be installed or any such existing
system may be replaced, materially altered or extended, until complete
plans and specifications for the replacement, installation, alteration,
or extension have been submitted to HHSC, reviewed and approved in
accordance with §511.167 of this subchapter (relating to Preparation,
Submittal, Review, and Approval of Plans, and Retention of Records).
(C) Minor remodeling or alterations. All remodeling
or alterations that do not involve alterations to load bearing members
or partitions, change functional operation, affect fire safety (e.g.,
modifications to the fire, smoke, and corridor walls), add or subtract
services for which the LSRH is licensed, and do not involve changes
listed in subparagraph (B) of this paragraph, shall be submitted for
approval without submitting contract documents. Such approval shall
be requested in writing, with a brief description of the proposed
changes in accordance with §511.167(f)(3) of this subchapter.
(D) Major remodeling or alterations. Plans shall be
submitted in accordance with §511.167 of this subchapter for
all major remodeling or alterations. All remodeling or alterations
that involve alterations to load bearing members or partitions, change
functional operation, affect fire safety (e.g., modifications to the
fire, smoke, and corridor walls), or add services over those for which
the LSRH is licensed are considered as major remodeling and alterations.
(E) Phasing of construction in existing facilities.
(i) Projects involving alterations of and additions
to existing buildings shall be programmed and phased so that on-site
construction will minimize disruptions of existing functions.
(ii) Access, exit access, and fire protection shall
be maintained so that the safety of the occupants will not be jeopardized
during construction.
(iii) A noncombustible or limited combustible dust
and vapor barrier shall be provided to separate areas undergoing demolition
and construction from occupied areas. When a fire retardant plastic
material is used for temporary daily usage, it shall be removed at
the end of each day.
(iv) The air inside the construction area shall be
protected by mechanical filtration that recirculates inside the space
or is exhausted directly to the exterior.
(v) The area shall be properly ventilated and maintained.
The area under construction shall have a negative air pressure differential
to the adjoining areas and shall continue to operate as long as construction
dust and odors are present.
(vi) Temporary sound barriers shall be provided where
intense prolonged construction noises will disturb patients or staff
in the occupied portions of the building.
(F) Nonconforming conditions. When doing renovation
work, if it is found to be infeasible to correct all of the nonconforming
conditions in the existing LSRH in accordance with these rules, HHSC
may grant a conditional approval if the operation of the LSRH, Americans
with Disabilities Act accessibility requirements, and safety of the
patients are not jeopardized by the nonconforming condition.
(b) Previously licensed hospitals. Buildings that have
been licensed previously as general hospitals, special hospitals,
or LSRHs but have been vacated or used for purposes other than as
general hospitals, special hospitals, or LSRHs and that are not in
compliance with the 1967, 1973, 1981, 1985, 1991, 1997, 2000, 2003,
or 2010 editions of the NFPA 101, the Hospital Licensing Standards/Rules
(1969, 1985, or 1998 editions as amended), and hospital licensing
rules under which the building or sections of buildings were constructed
shall comply with the requirements of §511.162 of this subchapter
(relating to General Construction Requirements), §511.163 of
this subchapter (relating to Spatial Requirements), §511.165
of this subchapter (relating to Building with Multiple Occupancies), §511.167
of this subchapter, and §511.168 of this subchapter (relating
to Construction, Inspections, and Approval of Project).
(c) Service removal. Where removal of a patient care
service occurs in a patient care bedroom, patient treatment room,
patient diagnostic room, patient therapy room, or any other similar
location where patient services are provided and the area does not
hold an Architectural Review Unit application number, the following
systems and furnishing shall be removed from that room, rooms, or
unit affected:
(1) access to the nurse call system equipment, including
nurse call activation devises, and dome lights;
(2) access to the medical gases;
(3) access to cubicle curtains and cubicle curtain
tracks; and
(4) access to patient reading lights.
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