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RULE §554.305Resident Rooms

Resident rooms must be designed and equipped for adequate nursing care, comfort, and privacy of residents.

  (1) Bedrooms must:

    (A) accommodate no more than four residents. The total number of beds in ward rooms with three or more beds must not exceed 50% of the total facility capacity in existing facilities unless approved by HHSC.

    (B) measure at least 80 square feet per resident in multiple resident bedrooms and at least 100 square feet in single resident rooms.

    (C) have direct access to an exit corridor.

    (D) be designed or equipped to ensure full visual privacy for each resident. A facility must take appropriate measures to protect the privacy and dignity of the residents through the use of cubicle curtains, screens, or procedures. Curtains and screens must be rendered and maintained flame-retardant.

    (E) 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 (see paragraph (4) of this section).

    (F) have at least one operable window to the outside which can readily be opened from the inside without the use of tools. The height of the window sill must not exceed 36 inches above the floor. The minimum area of windows in each bedroom must equal at least 8.0% of the room area. Operable window sections may be restricted to not more than six nor less than four inches for security or safety reasons. Each window must be provided with a flame-retardant shade, curtain, or blind.

    (G) have a floor at or above grade level.

  (2) The facility must provide each resident with:

    (A) a separate bed of proper size and height for the convenience of the resident. The bed will be a minimum of 36 inches wide with a headboard of sturdy construction. The facility must provide each bed with suitable bedspreads and blankets to ensure the comfort and warmth of each resident, and must not pass bedspreads and blankets from resident to resident without first being laundered. The bed of each resident with physician's orders for bedrails must have bedrails affixed to both sides of the bed:

    (B) a clean, comfortable mattress with a moisture-proof cover, and a comfortable pillow;

    (C) bedding appropriate to the weather and climate; and

    (D) functional furniture appropriate to the resident's needs including a comfortable chair, bedside cabinet, and individual closet space in the resident bedroom with at least 16 inches of hanging space, shelves for personal belongings accessible to the resident, and closeable doors. Each bedroom must be provided with at least one noncombustible wastebasket.

  (3) 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:

    (A) are required by the special needs of the residents; and

    (B) will not adversely affect residents' health and safety.

  (4) The width and length of bedrooms and the arrangement of furniture must ensure appropriate resident circulation, especially in relation to emergency evacuation and to usual wheelchair movement. Bedrooms should not be less than 10 feet in the smallest dimension. There must be at least 36 inches between beds and should be at least 18 inches between any bed and the adjacent parallel wall that restricts access by the resident, that is, bed sides should not have to be placed against a wall to meet other spacing requirements. Beds must not extend into the bedroom door opening, nor must any other piece of furnishing or equipment be located where it might preclude or inhibit the removal of any bed or closing and latching of the bedroom door in an emergency.

  (5) Each bed must have access to a nurse call device that is part of an electrical nurse call system.

  (6) Each bed must be provided with an appropriate, safe, durable, non-glare, permanently bed-mounted or wall-mounted reading-light fixture. The fixture must be wired in accordance with NFPA 70. These fixtures should be mounted at least five feet, six inches above the floor. The switch must be within reach of a resident in the bed.

  (7) At least one duplex receptacle must be provided for each bed. Other duplex receptacles must be provided as needed or as required by NFPA 70.

  (8) Each bedroom must be ensured of having general lighting, either by means of appropriate combination reading light or by means of separate fixture.

  (9) For emergency separation from fire and smoke, bedroom doors must be maintained to close completely without dragging or binding, to latch securely, and to fit reasonably tight in the frame. The gap between the floor and the bottom of the closed door must not exceed 3/4 inch.

  (10) Vacant bedrooms may not be used for hazardous activities or hazardous storage, unless specifically approved by HHSC in writing.

  (11) Bedrooms must be identified with a raised or recessed unique number placed on or near the door. Refer to §19.319(c) of this title (relating to Provisions for Persons with Disabilities) and §19.302(b)(5) of this title (relating to Applicable Codes and Standards).

  (12) Residents must be permitted and encouraged to have personal possessions in their rooms that do not interfere with their care, treatment, or well-being, or that of other residents.

  (13) Locks on bedroom doors are permitted when they meet definite resident needs, including the following situations:

    (A) married couples whose rights of privacy could be infringed upon unless bedroom door locks are permitted; and

    (B) residents for whom the attending physician wants bedroom door locks to enhance their sense of security.

  (14) In situations such as those listed in paragraph (13) of this section, the following guidelines must be met:

    (A) bedroom door locks must be of the type which the occupant can unlock at will from inside the room;

    (B) all bedroom door locks must be of the type which can be unlocked from the corridor side;

    (C) attendants must carry keys which will permit ready accessibility to the locked bedrooms when entrance becomes necessary; and

    (D) locking of bedroom doors by residents for privacy or security will not be permitted except when specifically included in the attending physician's written orders or authorized by the nursing facility administrator.

Source Note: The provisions of this §554.305 adopted to be effective July 1, 1996, 21 TexReg 4408; 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

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