| (a) Multiple hospitals located within one building.
(1) Identifiable location. Each hospital shall conform
with all the requirements contained in Chapter 18 of the National
Fire Protection Association 101, Life Safety Code, 2012 edition (NFPA
101), relating to New Health Care Occupancies.
(A) The guest hospital shall be in one separately contiguous
location.
(B) In no case may a person leave the guest hospital,
traverse the host hospital, and then reenter the guest hospital to
access the remaining portion of the guest hospital.
(C) A connecting stair within the host hospital may
be used to connect the vertical contiguous areas of the guest hospital.
(D) A guest hospital may not occupy two or more noncontiguous
areas of a host hospital that contain intervening space of the host
hospital even if on the same floor.
(E) Construction of the host hospital building shall
conform to the requirements of NFPA 101 Chapter 18, and the building
shall be fully sprinklered.
(2) Separate facilities. Each limited services rural
hospital (LSRH) shall provide the following separate facilities:
(A) a nursing unit in accordance with the requirements
of §511.163(q) of this subchapter (relating to Spatial Requirements);
(B) an administration office with an adjacent waiting
room or waiting area;
(C) a medical records room that conforms with the requirements
of §511.163(m) of this subchapter;
(D) a pharmacy suite that complies with §511.163(s)
of this subchapter;
(E) employee locker facilities that comply with requirements
of §511.163(f)(1) of this subchapter;
(F) a housekeeping room that complies with the requirements
of §511.162(d)(2)(A)(xxviii) of this subchapter (relating to
Construction Requirements);
(G) emergency facilities as required by §511.163(e)(1)(A)
of this subchapter;
(H) imaging and other diagnostic services and facilities,
in accordance with §511.46 of this chapter (relating to Radiologic
Services) and §511.163(j) of this subchapter respectively;
(I) laboratory services and a laboratory suite that
comply with §511.163(k) of this subchapter, and §511.45
of this chapter (relating to Laboratory Services) of this chapter
respectively;
(J) where surgical services are provided, a surgical
suite in accordance with §511.163(x) of this subchapter;
(K) dietary services and dietary suite, including staff
dining facilities, which comply with §511.53 of this chapter
(relating to Dietary Services) and §511.163(d) of this subchapter
respectively;
(L) external signage at the building entrance that
identifies each hospital; and
(M) internal signage that provides directions to each
hospital.
(3) Means of egress. Means of egress from the host
or guest hospital shall not be through a psychiatric hospital or a
crisis stabilization unit or other area subject to locking. Means
of egress may traverse through a hospital that conforms with the requirements
of §511.161 of this subchapter (relating to Requirements for
Buildings in Which Existing Licensed Hospitals are Located) or §511.162
of this subchapter. Stairs must have guardrails from the floor of
the guest hospital to the level of exit discharge in accordance with
NFPA 101 §7.2.2.4.5.
(4) Additional services and facilities. Additional
services and facilities when required in each licensed hospital may
be provided by contractual agreement with the other hospital when
the services and facilities comply with the specific requirements
of Subchapter C of this chapter (relating to Operational Requirements)
and §511.163 of this subchapter. Some services may be provided
by contractual agreement with a commercial contractor; however, the
following minimal facilities shall be provided on site by the host
hospital and be located in one of the hospitals. If the host hospital
fails to provide the facilities and services, the guest hospital shall
describe to the Texas Health and Human Services Commission (HHSC)
how it plans to provide services:
(A) cart cleaning and sanitizing services and facilities
that comply with §511.163(b) of this subchapter;
(B) general storage services and facilities that comply
with §511.163(h) of this subchapter;
(C) housekeeping rooms as required in §511.162(d)(2)(A)(xxviii)
of this subchapter;
(D) parking facilities, in accordance with §511.162(c)(2)
of this subchapter;
(E) physical therapy, occupational therapy services
and facilities, or both in accordance with §511.57 of this chapter
(relating to Therapy Services), and §511.163(u) of this subchapter
respectively;
(F) patient activity facilities shall comply with the
requirements for the specific service in accordance with §511.163
of this subchapter as follows: mental health and chemical dependency
nursing units §511.163(n)(1) and rehabilitation therapy suite §511.163(u)(1)(A)(i)
and (ii) of this subchapter;
(G) respiratory care services and respiratory therapy
suite that comply with §511.70 of this chapter (relating to Respiratory
Care Services) and §511.163(v) of this subchapter respectively;
(H) body-holding room that complies with §511.163(o)(1)(D)
of this subchapter;
(I) central sterile supply that complies with §511.163(c)
of this subchapter respectively;
(J) waste and waste disposal services and waste processing
and storage units shall comply with §511.71 of this chapter (relating
to Waste and Waste Disposal); and
(K) emergency water storage requirement in Texas Administrative
Code Title 25 §133.162(d)(4)(A)(i)(VIII) shall be required for
the LSRH and the hospital and be located in either the LSRH or other
hospital.
(5) Building systems and equipment.
(A) The following systems shall be provided separately
in each hospital at a 24-hour staffed location.
(i) Nurses calling systems shall be provided separately
in each hospital in accordance with §511.162(d)(5)(L) and Table
7 in §511.169(g) of this subchapter (relating to Tables).
(ii) Medical gas alarms shall be provided in each hospital.
(iii) Fire alarm annunciator panels shall be provided
in each hospital so that each hospital can monitor the other.
(iv) An emergency generator annunciator panel shall
be provided in each hospital.
(B) Where applicable, the following systems may serve
more than one hospital provided the systems meet the new construction
requirements of §511.162 of this subchapter.
(i) Air conditioning, heating, and ventilating systems.
(ii) Drainage systems.
(iii) Elevators.
(iv) Fire sprinkler systems. The guest hospital may
not be constructed in a host hospital when the host hospital is not
fully sprinklered. The host and guest hospitals shall be fully sprinklered.
(v) Medical piping systems.
(vi) Stand pipe systems.
(vii) Steam systems.
(viii) Water supply systems, hot and cold (including
emergency water storage).
(ix) Electrical service and equipment.
(I) Where applicable, the building electrical service,
lighting, essential electrical system, and fire alarm system may be
a part of or extension of those in the existing hospital, provided
the existing systems meet these requirements. The host hospital shall
be responsible for maintenance, testing and upkeep of the essential
electrical system. Power and lighting distribution panels shall be
within each hospital served and comply with the requirements of §511.162(d)(5)(E)
of this subchapter. Electrical installation details shall conform
with all requirements contained in §511.162(d)(5)(A) of this
subchapter.
(II) When the existing essential electrical system
is nonconforming, the following options are available:
(-a-) a separate conforming essential electrical system
shall be provided in the guest hospital; or
(-b-) separate transfer switches connected to the existing
on-site generator(s) shall be provided when adequate capacity is available
and the host hospital existing nonconforming system shall be corrected.
Corrections shall be made in accordance with a plan of correction
approved by HHSC.
(b) LSRHs located in buildings with licensed health
care facilities other than hospitals.
(1) Before an LSRH is licensed in a building containing
other licensed health care facilities, all the requirements of this
chapter and the following requirements shall be met.
Cont'd... |
