| (a) This section applies to a small house or household
facility that is designed to provide a non-institutional environment
to promote resident-centered care. New construction of a small house
or household facility, including a conversion of an existing facility,
an addition to an existing facility, or rehabilitation of an existing
facility, must meet the requirements of this section.
(b) A small house or household facility must comply
with this chapter, except it is not required to comply with a requirement
in Division 9 of this subchapter (relating to Facilities Licensed
On or After April 2, 2018) if HHSC waives the requirement in accordance
with subsection (c) of this section or if the requirement is modified
by subsection (g) of this section.
(c) HHSC may waive a requirement in Division 9 of this
subchapter if HHSC determines a waiver of the requirement would facilitate
the implementation of resident-centered care. To request a waiver
of a requirement, a facility must submit plans to HHSC according to §554.344
of this subchapter (relating to Plan Review). The plans must include
a statement from an architect identifying which requirements the facility
is requesting to be waived and explaining how the waiver would contribute
to the goals of resident-centered care.
(d) A small house or household facility must be designed
and equipped to provide a homelike environment that promotes resident-centered
care.
(e) A small house or a household within a facility
must:
(1) have no more than 16 bedrooms as described in subsection
(g)(2) of this section;
(2) have living, dining, social, and staffing areas
exclusively within and for the house or household; and
(3) have a kitchen that meets the requirements in §554.354(g)(1)
of this subchapter (relating to Architectural Space Planning and Utilization
for New Facilities) or a food service area that meets the requirements
of an auxiliary serving kitchen in §554.354(g)(3) of this subchapter,
exclusively within and for the house or household.
(f) A small house or household facility must be:
(1) a single small house model, which is a single licensed
building having no more than 16 residents that meets the licensing
requirements for architectural spaces provided within the same licensed
building;
(2) a multiple small house model, which is a single
licensed group of two or more small houses located in close proximity
to each other on a single contiguous property that meets the licensing
requirements for architectural spaces in each house and that may include
a stand-alone central building that provides social-diversional space,
a treatment area, or an administrative area; or
(3) a household model, which is a single licensed building
that contains one or more households having no more than 16 residents
each; that may include a central area that provides social-diversional
space, a treatment area, or an administrative area; and that must
be arranged to avoid travel through the household by persons who are
not residing in, visiting, or providing services for the household.
(g) A small house or household facility must comply
with the requirements in this section and is not required to request
a waiver for an exception described in this subsection.
(1) The outdoor activity, recreational, and sitting
spaces required in §554.352(f) of this subchapter (relating to
Location and Site for New Facilities) must include a porch area under
a roof with suitable furniture for sitting and space for wheelchairs.
(2) The resident bedroom requirements in §554.354(a)
of this subchapter must be met, except:
(A) a bedroom must be occupied:
(i) by only one resident; or
(ii) by two residents, if they are members of the same
family and the bedroom size, furniture, and headboard wall requirements
for double occupancy are met;
(B) the toilet requirements in §554.354(a)(7)
of this subchapter must be met, except a bathroom must serve no more
than one resident room and must include a lavatory, toilet, and a
shower or bathing unit;
(C) the night lighting requirement in §554.354(a)(5)
of this subchapter must be met, except it must be a recessed wall
mounted fixture just inside the entry door to the room and must not
be obstructed by the door or furniture; and
(D) the electrical receptacle requirements in §554.354(a)(6)
of this subchapter must be met and additional receptacles must be
provided to meet the requirements for Dwelling Unit Receptacle Outlets
in NFPA 70.
(3) The nursing service area requirements in §554.354(b)
of this subchapter must be met, except:
(A) a nursing staff lounge is not required in a small
house facility;
(B) the nursing staff toilet room may also be a toilet
room for:
(i) kitchen staff;
(ii) the public; or
(iii) a general bathing room, if the toilet room opens
into the general bathing room and common areas; and
(C) the nourishment station may be part of the residential
kitchen area.
(4) Resident bathing and toilet facility requirements
in §554.354(c) of this subchapter must be met, except the door
between a bathroom and a resident bedroom:
(A) is not required to be a side-hinged swinging door;
(B) may be an externally mounted by-pass door;
(C) must have substantial hardware;
(D) must not be equipped with a bottom door track that
is a tripping hazard; and
(E) if it swings open into the bedroom, must not interfere
with the swing of any other door that opens into the bedroom.
(5) The living area requirements in §554.354(e)
of this subchapter and dining room requirements in §554.354(f)
of this subchapter must be met, except the distance between the floor
and the window sill of a window in the living or dining room must
not exceed 36 inches, to allow a view to the outside from a seated
position.
(6) The dietary facility requirements in §554.354(g)
of this subchapter must be met, except a kitchen serving 16 or fewer
non-employees per meal:
(A) may be open to the facility in compliance with
NFPA 101;
(B) must meet the general food service needs of the
residents;
(C) must provide for the storage, refrigeration, preparation,
and serving of food; for dish and utensil cleaning; and for refuse
storage and removal;
(D) must contain a multi-compartment sink, vegetable
sink, and hand washing sink;
(E) must provide a supply of hot water that, if used
for sanitizing purposes is 180 degrees Fahrenheit or at the manufacturer's
suggested temperature for chemical sanitizers;
(F) must provide a supply of cold water;
(G) must have janitorial facilities exclusively for
the kitchen and located in close proximity to the kitchen;
(H) must have kitchen floors, walls, and ceilings with
nonabsorbent smooth finishes or surfaces that are capable of being
routinely cleaned and sanitized to maintain a healthful environment;
(I) must have counter and cabinet surfaces, inside
and outside, with smooth, cleanable, relatively nonporous finishes;
and
(J) must have a toilet for the kitchen staff that is
in close proximity to the kitchen and that may also be a toilet room
for the public or the general bathing room.
(7) The exit requirements in §554.355(3) of this
subchapter (relating to Exit Provisions for New Facilities) must be
met except for fixed furniture and wheeled equipment as permitted
by NFPA 101.
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| Source Note: The provisions of this §554.345 adopted to be effective April 1, 2014, 39 TexReg 2313; amended to be effective March 22, 2018, 43 TexReg 1646; transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871; amended to be effective January 2, 2022, 46 TexReg 9037 |
