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.
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| 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 |
