| (a) The facility must be designed, constructed, equipped,
and maintained to protect the health and ensure the safety of residents,
personnel, and the public.
(b) If children are admitted to the facility, accommodations,
furnishings, and equipment appropriate to children must be provided,
including the following;
(1) The facility must provide indoor and outdoor recreation
areas designed to encourage exploration within the children's capabilities.
(2) The facility must provide pediatric equipment and
supplies in appropriate sizes for the age and development level of
the children. Pediatric emergency supplies and equipment must be readily
available for use.
(3) The environment must be the least restrictive allowable
while remaining within the parameters of safety. All areas of the
facility accessible to children must be "child proof" for safety hazards.
This type of safety proofing is above the normal level of hazard control
maintained for adult residents and includes the addition of safety
covers on electrical outlets not in use that are accessible to children.
(4) Pediatric resident's rooms must be decorated and
furnished in accordance with the age and developmental level of the
children and as an expression of their individual preferences.
(c) HHSC may grant a waiver for certain provisions
regarding the physical plant and environment that, in the opinion
of HHSC, would be impractical for the facility to meet. In granting
the waiver, HHSC must determine that granting the waiver has no adverse
effect on resident health and safety and the requirement, if not waived,
would impose an unreasonable hardship on the facility. HHSC may require
offsetting or equivalent provisions in granting a waiver.
(d) The requirements of this subchapter are applicable
to nursing facilities as follows:
(1) All nursing facilities must comply with division
3 of this subchapter (relating to Provisions Applicable to All Facilities).
(2) A nursing facility or a portion of a nursing facility
licensed before September 11, 2003, and continually operated as a
licensed nursing facility, must comply with division 2 of this subchapter
(relating to Facilities Licensed Before September 11, 2003).
(3) A nursing facility or a portion of a nursing facility
licensed or constructed, on or after September 11, 2003, but before
April 2, 2018, and continuously operated as a licensed nursing facility,
must comply with division 5 of this subchapter (relating to Facilities
Licensed On or After September 11, 2003 and Before April 2, 2018).
(4) A nursing facility or a portion of a nursing facility
licensed or constructed on or after April 2, 2018, must comply with
division 9 of this subchapter (relating to Facilities Licensed On
or After April 2, 2018).
(5) A small house or household facility is a facility
that is designed to provide a non-institutional environment to promote
resident-centered care and that meets the requirements of §554.345
of this subchapter (relating to Small House and Household Facilities).
New construction of a small house or household facility must meet
the requirements of §554.345 of this subchapter.
(e) A facility must comply with NFPA 101; NFPA 99,
except Chapters 7, 8, 12, and 13; and a Tentative Interim Amendment
(TIA) issued by NFPA, including the TIAs listed in paragraphs (1)
and (2) of this subsection. A facility must also comply with other
NFPA publications referenced in NFPA 101 or in this chapter, unless
otherwise approved by HHSC.
(1) The following TIAs have been issued for NFPA 101:
(A) TIA 12-1, issued August 11, 2011;
(B) TIA 12-2, issued October 30, 2012;
(C) TIA 12-3, issued October 22, 2013; and
(D) TIA 12-4, issued October 22, 2013.
(2) The following TIAs have been issued for NFPA 99:
(A) TIA 12-2, issued August 11, 2011;
(B) TIA 12-3, issued August 9, 2012;
(C) TIA 12-4, issued March 7, 2013;
(D) TIA 12-5, issued August 1, 2013;
(E) TIA 12-6, issued March 3, 2014;
(F) TIA 12-7, issued December 1, 2016; and
(G) TIA 12-8, issued April 10, 2018.
(f) Building rehabilitation on existing buildings shall
be classified in accordance with NFPA 101 and shall comply with NFPA
101 and §554.350 of this subchapter (relating to Building Rehabilitation).
(g) Buildings, or portions of buildings, may be occupied
during construction, repair, alterations, or additions only when required
means of egress and required fire protection features are in place
and continuously maintained for the portion occupied, or when alternative
life safety measures acceptable to HHSC are in place.
(h) No existing life safety feature shall be removed
or reduced when the feature is a requirement for new construction.
Life safety features and equipment that have been installed in existing
buildings, if not required by NFPA 101, must continue to be maintained
or may be completely removed if prior approval is obtained from HHSC.
(i) The facility must perform a risk assessment in
accordance with NFPA 99.
(1) The risk assessment must follow and document the
defined risk assessment procedure used.
(2) The results of the assessment procedure must be
documented and records retained.
(3) A building system required by NFPA 99 shall be
designed to meet the risk categories determined for each system as
part of this assessment. At a minimum, any new systems or equipment
must be designed to meet the requirements for Category 2 risk, as
defined in NFPA 99.
(4) The assessment must be reviewed and a new assessment
performed, if necessary, on an annual basis and when the facility
identifies changes in resident care needs that cannot be met by the
currently installed systems and equipment.
(5) In addition to the requirements of NFPA 99 based
on the risk assessment, a facility must also meet all applicable requirements
of this subchapter.
(j) A wing or area that is separated from the rest
of the facility by locked doors, or a facility that is locked in its
entirety, for the purpose of securing residents must meet the requirements
of §554.2208(a)(6) and (c)(1) - (10) of this chapter (relating
to Standards for Certified Alzheimer's Facilities).
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