|(a) Facility location. 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
(1) Hazardous locations.
(A) Underground and above ground hazards. New facilities
or additions to existing facilities shall not be built within 125
feet of right away/easement of hazardous locations including but not
limited to underground liquid butane or propane, liquid petroleum
or natural gas transmission lines, high pressure lines, and not
under high voltage electrical lines.
(B) Fire hazards. New facilities 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.
(2) Undesirable locations.
(A) Nuisance producing sites. New facilities shall
not be located near nuisance producing industrial sites, feed lots,
sanitary landfills, or manufacturing plants producing excessive noise
or air pollution.
(B) Cemeteries. New facilities shall not be located
near a cemetery in a manner that allows direct view of the cemetery
from patient windows.
(C) Flood plains. Construction of new facilities shall
be avoided in designated flood plains. Where such is unavoidable,
access and required functional facility components shall be constructed
above the designated flood plain. This requirement also applies to
new additions to existing facilities or portions of facilities which
have been licensed previously as facilities but which have been vacated
or used for purposes other than facilities. This requirement does
not apply to remodeling of existing licensed facilities.
(D) Airports. Construction of new facilities shall
be avoided in close proximity to airports. When facilities are proposed
to be located near airports, recommendations of the Texas Aviation
Authority and the Federal Aviation Authority shall apply. A facility
may not be constructed within a rectangular area formed by lines perpendicular
to and two miles (10,560 feet) from each end of any runway and by
lines parallel to and one-half mile (2,640 feet) from each side of
(b) Environmental considerations. Development of a
facility site and facility construction shall be governed by state
and local regulations and requirements with respect to the effect
of noise and traffic on the community and the environmental impact
on air and water.
(c) Facility site.
(1) Paved roads and walkways. Paved roads shall be
provided within the lot lines to provide access from public roads
to the main entrance, entrances serving community activities, and
to service entrances, including loading and unloading docks for delivery
trucks. Finished surface walkways shall be provided for pedestrians.
(2) Parking. 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, 1998 edition. This requirement
does not apply to freestanding parking structures. 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, P.O. Box 9101, Quincy, MA 02269-9101 or (800)
(A) Number of parking places. In the absence of a formal
parking study, one parking space shall be provided for each day shift
employee plus one space for one and one-half patient beds. This ratio
may be reduced in an area convenient to a public transportation system
or to public parking facilities on the basis of a formal parking study.
Parking shall be increased accordingly when the size of an existing
facility is increased.
(B) Additional parking. Additional parking shall be
required to accommodate medical staff, outpatient and other services
when such services are provided.
(C) Delivery parking. Separate parking facilities shall
be provided for delivery vehicles.
(D) Handicapped parking. Parking spaces for handicapped
persons shall be provided in accordance 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.
(d) Building design and construction requirements.
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, one of the following
codes shall be adhered to: Uniform Building Code, 1999 edition, published
by the International Conference of Building Officials, 5360 Workman
Mill Road, Whittier, California 90601, telephone (562) 699-0541; or
the Standard Building Code, 1997 edition, published by the Southern
Building Code Congress International, Inc., 900 Montclair Road, Birmingham,
Alabama 35213-1206, telephone (205) 591-1853.
(1) General architectural requirements. All new construction,
including conversion of an existing building to a facility, establishing
a separately licensed facility in a building with an existing licensed
health care occupancy, and establishing a licensed facility in a
nonhealth care occupancy shall comply with Chapter 18 of the National
Fire Protection Association 101, Code for Safety to Life from Fire
in Buildings and Structures, 2000 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). The
facility shall comply with the requirements of this paragraph and
any specific architectural requirements for the particular unit or
suite of the facility in accordance with §134.123 of this title
(relating to Spatial Requirements for New Construction).
(A) Special design provisions. Special provisions shall
be made in the design of a facility in regions where local experience
shows loss of life or extensive damage to buildings resulting from
hurricanes, tornadoes, or floods.
(B) Foundations. Foundations shall rest on natural
solid bearing if satisfactory bearing is available. Proper soil-bearing
values shall be established in accordance with recognized requirements.
If solid bearing is not encountered at practical depths, the structure
shall be supported on driven piles or drilled piers designed to support
the intended load without detrimental settlement, except that one-story
buildings may rest on a fill designed by a soils engineer. When engineered
fill is used, site preparation and placement of fill shall be done
under the direct full-time supervision of the soils engineer. The
soils engineer shall issue a final report on the compacted fill operation
and certification of compliance with the job specifications. All
footings shall extend to a depth not less than one foot below the
estimated maximum frost line.
(C) Physical environment. A physical environment that
protects the health and safety of patients, personnel, and the public
shall be provided in each facility. The physical premises of the facility
and those areas of the facility's physical structure that are used
by the patients (including all stairwells, corridors, and passageways)
shall meet the local building and fire safety codes and subchapters
F and G of this chapter.
(D) Construction type. A facility may occupy an entire
building or a portion of a building, provided the facility portion
of the building is separated from the rest of the building in accordance
with subparagraph (E) of this paragraph and the entire building or
the facility portion of the building complies with new construction
requirements (type of construction permitted for facilities by NFPA
101, §18-1.6.2), and the entire building is protected with a
fire sprinkler system conforming with requirements of National Fire
Protection Association 13, Standard for the Installation of Sprinkler
Systems, 1999 Edition (NFPA 13).
(E) Separate buildings. Portions of a building divided
horizontally with two-hour fire rated walls which are continuous (without
offsets) from the foundation to above the roof shall be considered
as a separate building. Communicating openings in the two-hour wall
shall be limited to public spaces such as lobbies and corridors.
All such openings shall be protected with self-closing one and one-half
hour, Class B fire door assemblies.
(F) Design for the handicapped. Special considerations
benefiting handicapped 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.
(G) Other regulations. Certain projects may be subject
to other regulations, including those of federal, state, and local
authorities. The more stringent standard or requirement shall apply
when a difference in requirements for construction exists.
(H) Exceeding minimum requirements. 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.
(I) Equivalency. 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,
and safety to those prescribed by this subchapter, providing technical
documentation which demonstrates equivalency is submitted to the department
(J) Freestanding buildings (not for patient use). Separate
freestanding buildings for nonpatient use such as the heating plant,
boiler plant, laundry, repair workshops, or general storage may be
of unprotected non-combustible construction, protected non-combustible
construction, or fire-resistive construction and be designed in accordance
with other occupancy classifications requirements listed in NFPA 101.
(K) Freestanding buildings (for patient use other than
sleeping). Buildings containing areas for patient use which do not
contain patient sleeping areas and in which care or treatment is rendered
to ambulatory inpatients who are capable of judgment and appropriate
physical action for self-preservation under emergency conditions,
may be classified as ambulatory health care occupancies or business
occupancies as listed in NFPA 101, Chapters 20 and 38, respectively,
instead of facility occupancy. Such buildings shall be located at
least 20 feet from the facility unless protected by an approved automatic
(L) Energy conservation. In new construction and in
major alterations and additions to existing buildings and in new buildings,
electrical and mechanical components shall be selected for efficient
utilization of energy.
(2) General detail and finish requirements. Details
and finishes in new construction projects, including additions and
alterations, shall be in compliance with this paragraph, with NFPA
101, Chapter 18, with local building codes, and with any specific
detail and finish requirements for the particular unit or suite as
contained in §134.123 of this title.
(A) General detail requirements.
(i) Fire safety. Fire safety features, including compartmentation,
means of egress, automatic extinguishing systems, inspections, smoking
regulations, and other details relating to fire prevention and fire
protection shall comply with §134.121 of this title (relating
to Requirements for Buildings in which Existing Licensed Facilities
are Located), and NFPA 101, Chapter 18 requirements for facilities.
The Fire Safety Evaluation System for Health Care Occupancies contained
in the National Fire Protection Association 101A, Alternative Approaches
to Life Safety, 1998 edition, Chapter 3, shall not be used in new
building construction, renovations or additions to existing facilities.
(ii) Access to exits. Corridors providing access to
all patient, diagnostic, treatment, and sleeping rooms and exits shall
be at least six feet in clear and unobstructed width (except as allowed
by NFPA 101, §18-2.3.3, Exceptions 1 and 2), not less than 7
feet 6 inches in height, and constructed in accordance with requirements
listed in NFPA 101, §18-3.6.
(iii) Corridors in other occupancies. Public corridors
in outpatient, administrative, and service areas which are designed
to other than facility requirements and are the required means of
egress from the facility shall be not less than five feet in width.