SECTION 551.68. Architectural Space Planning

(a) Large facilities.

(1) Ancillary resident space. The minimum total ancillary resident-use space must be not less than 35 square feet per resident. Ancillary space includes areas for living, dining, recreation, therapy, training, and other such program areas. It does not include bedrooms, passageways, offices, kitchens, or laundries (more than 35 square feet per resident is usually needed in facilities with less than 60 residents). A facility which has large proportions (approximately 65 percent or greater) of nonambulatory or bedfast residents must provide at least 50 square feet of ancillary space per resident unless otherwise approved by HHSC. An area providing less space than called for in this paragraph cannot be approved except on an individual basis where clearly justified.

(2) Resident bedrooms.

(A) A bedroom must be arranged and equipped for adequate personal care and for comfort and privacy. A bedroom must have full height walls that extend from floor to ceiling with doors. (Partial partitions or furnishings are not a substitute.) An exception is that an existing facility constructed prior to October 3, 1988, that has partial partitions in lieu of full-height walls, need not install the full-height walls unless there are major renovations or conversions.

(B) A bedroom must provide at least 80 square feet for a single occupancy (one resident) and 60 square feet per resident for multiple occupancy. (Note: room configuration and usability are taken into consideration and there may be instances where the minimum square footage will not be acceptable.) The minimum room dimension must be at least eight feet for a single resident room and at least ten feet for a multiple-resident room, unless otherwise approved by HHSC. An exception is that a multi-occupancy bedroom for persons in wheelchairs must have 70 square feet per resident.

(C) No more than four residents may be in any one bedroom. An exception is HHSC may grant a variance from the limit of four residents per room only if a physician who is a member of the IDT and who is a qualified intellectual disability professional (QIDP):

(i) certifies that each resident to be placed in a bedroom accommodating more than four residents is so severely medically impaired as to require direct and continuous monitoring during sleeping hours; and

(ii) documents the reasons why accommodating in a room of only four or fewer residents would not be medically feasible.

(D) In the bedroom and for each resident there must be a bed with a comfortable mattress and appropriate bedding, functional furniture appropriate to residents' needs, and closet space providing security and privacy for clothing and personal belongings. Closet space must provide at least 24 inches of lineal hanging space per resident (in certain cases, such as for infants, exceptions may be made). Married couples may share a bed.

(E) Each bedroom must have at least one outside wall with an operable window giving outside exposure. Unless approved otherwise by the HHSC, the window sill of the required window must be no higher than 44 inches from the floor and must be at or above outside grade level. Other window requirements must be as called for in NFPA 101. The window area for a bedroom must be equal to at least 10 percent of the total room floor area.

(F) If a bedroom is below grade level, it must have a window that is usable as a second means of escape by a resident occupying the room. The window must be no more than 44 inches (measured to the window sill) above the floor.

(G) A resident bedroom must open onto an exit corridor, living area, or public area and must be arranged for convenient resident access to dining, living, and bathing areas.

(3) Social-diversional spaces.

(A) A living room, a day room, a lounge, or other social-diversional space, must be provided on a sliding scale as follows (as part of the minimum required ancillary space):

Attached Graphic

(B) Where a required way of exit is through a living area, a pathway equal to the corridor width will normally be deducted from that area. Such exit pathways must be kept clear of obstructions.

(C) Each living room and dining room must have at least one outside window. Normally, a resident classroom and a training area must also have an outside window unless otherwise approved by HHSC.

(4) Dining space. Dining space must provide at least 15 square feet per resident for single-shift feeding. If procedure is approved for feeding in two shifts, at least eight square feet per resident must be provided.

(5) Training spaces including academic, behavioral, occupational, physical, and speech therapy spaces. Classroom type space is anticipated for most training activities. The number and size of such spaces will be evaluated on an individual facility basis and according to program policies and procedures. Generally, a training room must provide at least 20 square feet per resident trainee within the room except that no training room may be less than 80 square feet. For purposes of calculation, space must be provided for at least one-third of the total population at any one time (i.e., plan space for 33 residents in a 100-resident facility).

(6) Kitchens (main/dietary).

(A) A kitchen must be evaluated based on its performance in the sanitary and efficient preparation and serving of meals to residents. Consideration must be given to planning for the type of meals served, the overall building design, the food service equipment, arrangement, and the work flow involved in the preparation and delivery of food. Plans for construction of new facilities must contain a detailed kitchen layout prepared by, or under the direction of, a registered or licensed dietitian.

(B) A kitchen must be designed so that room temperature, at peak load, must not exceed an average temperature of 85 degrees Fahrenheit measured over the room at the five-foot level. The amount of supply air must take into account the large quantities of air exhausted at the range hood and dishwashing area.

(C) A kitchen must be provided with operational equipment as planned and scheduled by the facility's consultants for preparing and serving meals and for refrigerating and freezing perishable foods, as well as equipment in, or adjacent to, the kitchen or dining area for producing ice.

(D) A kitchen must be provided with facilities for washing and sanitizing dishes and cooking utensils. Such facilities will be provided for the number of meals served and the method of serving (permanent or disposable dishes, etc.). The kitchen must contain a compartmented sink large enough to immerse pots and pans. Separation of soiled and clean dish areas must be maintained, including air flow.

(i) A mechanical dishwasher must be used to sanitize dishes and utensils and must meet the requirements specified under 25 TAC Chapter 228; or

(ii) Dishes and utensils must be manually sanitized in accordance with 25 TAC Chapter 228 prior to placement in the dishwasher.

(E) A kitchen must be provided with a supply of hot and cold water. Hot water for sanitizing purposes must be 180 degrees Fahrenheit or the manufacturer's suggested temperature for chemical sanitizers, as specified for the system in use. For a mechanical dishwasher, the temperature measurement is at the manifold.

(F) A kitchen must be provided with at least one hand-washing lavatory or hand-sanitizing device. A hand-washing lavatory must be provided with hot and cold running water, soap, and individual towels, preferably paper towels; common use towels must not be used.

(G) In new construction, a staff restroom facility with a lavatory must be accessible to kitchen staff without traversing resident use areas. The restroom door must not open directly into the kitchen, e.g., provide a vestibule.

(H) In new construction, a janitorial facility must be provided exclusively for the kitchen and must be located in and entered from the kitchen.

(I) Nonabsorbent smooth finishes or surfaces must be used on kitchen floors, walls, and ceilings. Such surfaces must be capable of being sanitized to maintain a healthful environment.

(J) All operable window openings must be screened. A door opening to the outside of the building must have self-closing devices.

(7) Food storage areas (main/kitchen).

(A) In new construction, a food storage area must be planned based on the number and type of resident meals to be served. The size and layout of dry foods storage must be prepared by or designed under the direction of a licensed or registered dietitian.

(B) Food storage areas must provide for storage of a four-day minimum supply of nonperishable foods at all times.

(C) Shelves must be movable metal or sealed lumber, and walls must be finished with a nonabsorbent finish to provide a cleanable surface.

(D) Dry food storage must have an approved venting system to provide for positive air circulation.

(E) The maximum room temperature for food storage must not exceed 85 degrees Fahrenheit at all times. The measurement must be taken at the five-foot level.

(F) Food storage areas may be located apart from the food preparation area as long as there is space adjacent to the kitchen for necessary daily stores.

(8) Food services areas.

(A) Where a service area other than the kitchen is used to dispense foods, this must be designated as a food service area and must have equipment for maintaining required food temperatures while serving.

(B) A separate food service area must have hand-washing facilities as a part of the food service area. An employee toilet must be provided.

(C) Finishes of all surfaces except ceilings must be the same as those required for dietary kitchens.

(9) Other spaces.

(A) A bathing unit (tubs or showers) must be provided at a minimum ratio of one per 15 residents. Toilets and sinks must be provided at a minimum ratio of one per eight residents. Bathing and toilet facilities must be of a type appropriate to the resident's varying needs and disabilities and designed for privacy within the bathroom.

(B) Adequate storage space must be provided for equipment, carts, wheelchairs, etc., to eliminate the problem of such items being left or stored in corridors, or overcrowding bedroom space.

(b) Small facilities.

(1) Bedrooms.

(A) A bedroom must be arranged and equipped for adequate personal care and for comfort and privacy. A bedroom must have full height walls that extend from floor to ceiling with doors. (Partial partitions or furnishings are not a substitute.)

(B) A bedroom must provide at least 80 square feet for a single occupancy (one resident) and 60 square feet per resident for multiple occupancy. (Note: room configuration and usability are taken into consideration and there may be instances where the minimum square footage will not be acceptable.) The minimum room dimension must be at least eight feet for a single resident room and at least ten feet for a multiple-resident room, unless otherwise approved by the HHSC. An exception is that a multi-occupancy bedroom for residents in wheelchairs must have 70 square feet per resident.

(C) No more than four residents may be in any one bedroom. An exception is that HHSC may grant a variance from the limit of four residents per room only if a physician who is a member of the IDT and who is a QIDP:

(i) certifies that each resident to be placed in a bedroom accommodating more than four residents is so severely medically impaired as to require direct and continuous monitoring during sleeping hours; and

(ii) documents the reasons why accommodating in a room of only four or fewer residents would not be medically feasible.

(D) In the bedrooms and for each resident there must be a bed with a comfortable mattress and appropriate bedding, functional furniture appropriate to residents' needs, and closet space providing security for personal clothing and belongings. Closet space must provide at least 24 inches of lineal hanging space per resident (in certain cases, such as for infants, exceptions may be made). Married couples may share a bed.

(E) Every bedroom must have at least one outside window that can be readily opened from the inside and provides a clear opening of at least 5.7 square feet (minimum width of 20 inches; minimum height of 24 inches). The bottom of the opening must be not more than 44 inches above the floor. Minimum dimensions for operable window section are 20 inches wide by 41.2 inches in height, or 24 inches in height by 34.2 inches wide to provide the minimum 5.7 feet of opening. If a bedroom has a second means of escape independent and remote from the primary means of escape, the bedroom must have a window with clear glass of area not less than 8 percent of the bedroom floor area. When opened, the window must have an open space of not less than 4 percent of the bedroom floor area.

(F) A bedroom door must be 20-minute fire rated or 1 3/4-inch solid bonded core wood. This door must have automatic closures and latch in their frames. Exceptions are as follows.

(i) A bedroom door only needs to be smoke resistant and does not need automatic closure if the building has an approved sprinkler system throughout.

(ii) A bedroom door only needs to only be smoke resistant with automatic closures if the facility is classified "prompt" level of evacuation difficulty.

(G) Each small facility must have at least two remotely located means of escape that do not involve windows. The arrangement must be such that there is a primary means of escape from each sleeping room that provides a path of travel to the outside without traversing any corridor or other space exposed to unprotected vertical openings or common living spaces, such as living rooms and kitchens. Exceptions are as follows:

(i) A second means of escape or alternate protection is not required:

(I) if the bedroom has a door leading directly to the outside of the building, at or to grade level; or

(II) if the building is protected with an approved sprinkler system meeting NFPA 13, NFPA 13R, or NFPA 13D.

(ii) Separated primary means of escape is not necessary if the building is single story; has 1 3/4-inch solid bonded core doors to bedrooms or smoke resistant doors with closures; 20-minute fire protection for the structure; Class A or B interior finish; bedroom windows of proper size; total smoke detection coverage of habitable spaces, including loft areas that are tied into the manual fire alarm system; and two remote means of escape.

(2) Living room space. Living room space must provide at least 15 square feet per resident (with a minimum of 120 square feet regardless of number of residents). Living room space can include one or more rooms or areas provided that the first such area is at least 80 square feet each.

(3) Dining space. Dining space must be large enough to accommodate all residents at one sitting and must provide at least 15 square feet per resident. Living and dining space may be in one room or area providing a combined total of 30 square feet per resident (15 square feet living plus 15 square feet dining per resident).

(4) Bathrooms. Bathrooms must provide for individual privacy. Water closets and lavatories must be provided at a minimum ratio of one for each five residents. There must be at least one tub or shower for each eight residents. At least one bathroom (with water closets, lavatory, and tub or shower) must be provided on each sleeping floor accessible to the residents of that floor.

(5) Kitchen. The facility must have a kitchen to meet the general food service needs of the residents. It must include provisions for the storage, refrigeration, preparation, and serving of food; for dish and utensil cleaning; and for refuse storage and removal. A mechanical dishwasher must be provided.

(6) Office. An office or other space must be available for private individual counseling and for the safekeeping of files and records.

(7) Stairs. Buildings of two or more stories require at least two separate approved exit stairs from the upper floors. Usable space under the stairs is not allowed unless fire separated or protected in accordance with NFPA 101. Open interior stairways which constitute an "unprotected vertical opening" to a required exit passageway on the upper floor must be provided with a barrier (wall and door) at either the lower or upper level to prevent the rapid rise of fire or smoke originating on the lower level from rendering the upstairs passageway to the second stair impassable.

(8) Fire rating. Interior wall and ceiling surfaces must have, as the finished surface or a substrate or sheathing, a fire resistance of not less than 20 minutes, similar to that provided by 3/8-inch gypsum board.

Source Note: The provisions of this §551.68 adopted to be effective July 1, 1996, 21 TexReg 5328; amended to be effective May 1, 1998, 23 TexReg 4060; amended to be effective May 1, 2004, 29 TexReg 3237; transferred effective May 1, 2019, as published in the Texas Register April 12, 2019, 44 TexReg 1883; amended to be effective February 24, 2022, 47 TexReg 787