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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 554NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER DFACILITY CONSTRUCTION
DIVISION 8BUILDING REHABILITATION
RULE §554.350Building Rehabilitation

(a) This section applies to facilities undergoing rehabilitation.

(b) Rehabilitation work is classified as follows:

  (1) The patching, restoration, or painting of materials, elements, equipment, or fixtures for the purpose of maintaining such materials, elements, equipment, or fixtures in good or sound condition must be classified as repair and must meet the following requirements:

    (A) A repair must meet the applicable requirements of §19.300(d) of this subchapter (relating to General Requirements);

    (B) A repair must be done using like materials, unless such materials are prohibited by NFPA 101; and

    (C) A repair must not make a building less conforming with NFPA 101 or the applicable sections of this subchapter, or with any alternative arrangements previously approved by HHSC, than it was before the repair was undertaken, unless approved by HHSC.

  (2) The replacement in kind, strengthening, or upgrading of building elements, materials, equipment, or fixtures, that does not result in a reconfiguration of the building spaces within, must be classified as renovation and must meet the following requirements:

    (A) Any new work that is part of a renovation must comply with the applicable requirements of §19.300(d) of this subchapter;

    (B) Any new interior or exterior finishes must meet the requirements of division 9 of this subchapter (relating to Facilities Licensed On or After April 2, 2018).

    (C) A renovation must not make a building less conforming with NFPA 101 or the applicable sections of this subchapter, or with any alternative arrangements previously approved by HHSC, than it was before the renovation was undertaken, unless approved by HHSC; and

    (D) The reconfiguration or extension of any system, or the installation of any additional equipment, must be classified as modification according to paragraph (3) of this subsection.

  (3) The reconfiguration of any space; the addition, relocation, or elimination of any door or window; the addition or elimination of load-bearing elements; the reconfiguration or extension of any system; or the installation of any additional equipment, must be classified as modification and must meet the following requirements:

    (A) A newly constructed element, component, or system must comply with division 9 of this subchapter;

    (B) All other work in a modification must meet, at a minimum, the requirements for a renovation according to paragraph (2) of this subsection; and,

    (C) If the total rehabilitation work area classified as modification exceeds 50 percent of the total building area, the work must be classified as reconstruction according to paragraph (4) of this subsection.

  (4) The reconfiguration of a space that affects an exit or a corridor shared by more than one occupant space; or the reconfiguration of a space such that the rehabilitation work area is not permitted to be occupied because existing means of egress and fire protection systems, or their equivalent, are not in place or continuously maintained, must be classified as reconstruction and must meet the following requirements:

    (A) Any reconstruction of components of the means of egress must comply with the applicable requirements of §19.300(d) of this subchapter, except for the following components, which must comply with division 9 of this subchapter.

      (i) illumination of means of egress;

      (ii) emergency lighting of means of egress; or

      (iii) marking of means of egress, including exit signs.

    (B) If the total rehabilitation work area classified as reconstruction on any one floor exceeds 50 percent of the total area of the floor, all means of egress components on that floor identified in paragraph (4)(A)(i) - (iii) of this subsection must comply with division 9 of this subchapter.

    (C) If the total rehabilitation work area classified as reconstruction exceeds 50 percent of the total building area, all means of egress components in the building identified in paragraph (4)(A)(i) - (iii) of this subsection must comply with division 9 of this subchapter.

    (D) All other work classified as reconstruction must meet, at a minimum, the requirements for modification according to paragraph (3) of this subsection and renovation according to paragraph (2) of this subsection.

  (5) A change in the purpose or level of activity within a facility that involves a change in application of the requirements of this subchapter must be classified as a change of use and must comply with division 9 of this subchapter.

  (6) A change in the use of a structure or portion of a structure must comply with division 9 of this subchapter.

  (7) An increase in the building area, aggregate floor area, building height, or number of stories of a structure must be classified as an addition and must comply with division 9 of this subchapter.

(c) If an existing licensed facility plans a building rehabilitation that includes a change in the facility capacity, HHSC must reevaluate the ratio of bathing units to meet minimum standards and the square footage of dining and living areas to meet a minimum of 19 square feet per bed. Conversion of existing living, dining, or activity areas to resident bedrooms must not reduce these functions to a total area of less than 19 square feet per bed. The facility's registered or licensed dietitian or architect having knowledge in the design of food service operations must reevaluate the dietary department. This reevaluation must be provided to HHSC.

(d) A rehabilitation to an occupied building that involves exit-ways or exit doors must be accomplished without compromising the exits or creating a dead end situation at any time. HHSC may approve temporary exits, or the facility must relocate residents until construction blocking the exit is completed. The facility must maintain other basic safety features such as fire alarms, sprinkler systems, and emergency power.


Source Note: The provisions of this §554.350 adopted 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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