Texas Administrative Code (Last Updated: March 27,2024) |
TITLE 26. HEALTH AND HUMAN SERVICES |
PART 1. HEALTH AND HUMAN SERVICES COMMISSION |
CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION |
SUBCHAPTER D. FACILITY CONSTRUCTION |
DIVISION 4. CONSTRUCTION AND INITIAL SURVEY |
SECTION 554.330. Construction Procedures and Initial Survey of Completed Construction
Latest version.
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(a) Construction phase. (1) Prior to the start of construction of a new facility or of building rehabilitation other than that classified as repair in §554.350 of this subchapter (relating to Building Rehabilitation), a facility must notify HHSC in Austin, Texas, in writing. (2) All construction must be done according to the minimum licensing requirements in this subchapter. It is a facility's responsibility to employ qualified personnel to prepare the contract documents for construction of a new facility or rehabilitation of an existing facility. Contract documents for additions and rehabilitation other than that classified as repair or renovation in §554.350 of this subchapter and for the construction of an entirely new facility must be prepared by an architect licensed by the Texas Board of Architectural Examiners. Drawings must bear the seal of the architect. Certain parts of contract documents, including final plans, designs, and specifications, must bear the seal of a licensed professional engineer approved by the Texas Board of Professional Engineers to operate in Texas or, as permitted by subsections (b)(12) and (15) of this section, signed by a Responsible Managing Employee or Alarm Planning Superintendent licensed by the State Fire Marshal's Office. These certain parts include sheets and sections covering structural, electrical, mechanical, sanitary, and civil engineering. (b) Contract documents. (1) Site plan documents must include grade contours; streets, with names; a north arrow; fire hydrant locations; fire lanes; utilities, public or private; fences; unusual site conditions, such as ditches, low water levels, and other buildings on-site; and indications of buildings located five feet or less beyond site property lines. Site plan documents for nursing facilities may include the developed landscaping plan for resident use. (2) Foundation plan documents must include the general foundation design and details. (3) Floor plan documents must include room names, numbers, and usages; resident care areas; numbered doors, including swing; windows; a legend or clarification of wall types; dimensions; fixed equipment; plumbing fixtures; kitchen basic layout; and identification of all smoke barrier walls and fire walls, outside wall to outside wall. (4) For new construction, additions to or rehabilitation of an existing building, an overall plan of the entire building must be drawn or reduced to fit on an 8 1/2-inch by 11-inch sheet. (5) Schedules must include door materials, sizes, and types; window materials, sizes, and types; room finishes; and special hardware. (6) Elevations must include exterior elevations with material note indications, and interior elevations, where needed for special conditions. (7) Roof plans must include any roof top equipment, roof slopes, drain locations, and gas piping. (8) Details must include wall sections as needed, especially for special conditions; cabinets and built-in work, basic design only; cross sections through buildings as needed; and miscellaneous details and enlargements as needed. (9) Building structure documents must include structural framing layout and details, primarily for columns, beams, joists, and structural frames; roof framing layout, when this cannot be adequately shown on cross section; cross sections in quantity and detail to show sufficient structural design; and structural details as necessary to ensure adequate structural design. (10) Electrical documents must include electrical layout, including lights, convenience outlets, equipment outlets, switches, and other electrical outlets and devices; service, circuiting, distribution, and panel diagrams; exit signs and emergency egress lighting; emergency electrical provisions, such as generators and panelboards; fire alarms and similar systems, such as control panels, devices, and alarms; staff communication systems, including a nurse call system; and sizes and details sufficient to ensure safe and properly operating systems. (11) Plumbing documents must include plumbing layout with pipe sizes and details sufficient to ensure safe and properly operating systems, water systems, sanitary systems, gas systems, other systems normally considered under the scope of plumbing, fixtures, and provisions for combustion air supply. (12) Heating, ventilation, and air-conditioning (HVAC) documents must include sufficient details of HVAC systems and components to ensure a safe and properly operating installation including, heating, ventilating, and air-conditioning layout; ducts; protection of duct inlets and outlets; combustion air; piping; exhausts; duct smoke detectors; fire dampers; and equipment types, sizes, and locations. (13) Fire sprinkler system plans and hydraulic calculations must be designed in accordance with the applicable sections of NFPA 13, and signed by a Responsible Managing Employee, licensed by the State Fire Marshal's Office, or sealed by a licensed professional engineer. (14) Other layouts, plans, or details that are necessary to convey a clear understanding of the design and scope of the project, including plans covering private water or sewer systems, which must be reviewed by the local health or wastewater authority having jurisdiction. (15) Specifications must include installation techniques, quality standards, manufacturers, references to specific codes and standards, design criteria, special equipment, hardware, finishes, and any other information needed to amplify drawings and notes. (16) Fire detection and alarm system working plans must be designed according to the applicable sections of NFPA 72 and NFPA 70 and signed by an Alarm Planning Superintendent licensed by the State Fire Marshal's Office, or sealed by a licensed professional engineer. (c) Initial survey of completed construction. (1) Upon completion of construction of a new facility, or building rehabilitation other than that classified as repair or renovation in §554.350 of this subchapter, a final construction inspection of the facility, including grounds, basic equipment and furnishings, must be performed by HHSC prior to occupancy. The completed construction must have the written approval of the local authorities having jurisdiction, including the fire marshal and building official. When construction or building rehabilitation does not alter the licensed capacity of a facility, based on submitted documentation and the scope of the performed building rehabilitation, HHSC may permit a facility to use the rehabilitated portion of a facility pending a final construction inspection or may determine a final construction inspection is not required. (2) An applicant may obtain the inspection described in paragraph (1) of this subsection on an expedited basis. An applicant may obtain a Life Safety Code inspection within 15 business days after HHSC receives a written request if the applicant submits: (A) a complete application as required in §554.201(b) of this chapter (relating to Criteria for Licensing) and §554.204 of this chapter (relating to Application Requirements); and (B) the appropriate Life Safety Code fee listed in §554.220 of this chapter (relating to Expedited Life Safety Code and Physical Plant Inspection Fees). (3) After the completed construction is surveyed and found acceptable by HHSC, this information is conveyed to the licensing officer as part of the information needed to issue a license to the facility. Additions to or rehabilitation of existing facilities may require a revision or modification to an existing license. The building, including basic furnishings and operational needs, grades, drives, parking, and grounds must be 100 percent complete at the time of this initial survey visit for HHSC to approve occupancy and licensing. A facility may accept up to three residents between the time it receives initial approval from HHSC and the time the license is issued. (4) A copy of the following documents must be provided to HHSC at the time of the survey of the completed building. HHSC may request some or all of these documents prior to scheduling the initial survey: (A) written approval of local authorities as called for in paragraph (1) of this subsection; (B) record drawings of the fire detection and alarm system as installed, signed by an Alarm Planning Superintendent licensed by the State Fire Marshal's Office or sealed by a licensed professional engineer, including a sequence of operation, the owner's manuals and the manufacturer's published instructions covering all system equipment, a signed copy of the State Fire Marshal's Office Fire Alarm Installation Certificate, and, for software-based systems, a record copy of the site-specific software, excluding the system executive software or external programmer software, in a non-volatile, non-erasable, non-rewritable memory; (C) documentation of materials used in the building that are required to have a specific limited fire resistance or flame spread rating, including special wall finishes or floor coverings; flame retardant curtains, including cubicle curtains; and fire resistance-rated ceilings. This documentation must include a signed letter from the installer verifying the material installed, such as carpeting, is the same material named in the documented fire test; (D) record drawings of the fire sprinkler system as installed, signed by a Responsible Managing Employee licensed by the State Fire Marshal's Office, or sealed by a licensed professional engineer, including the hydraulic calculations, alarm configuration, Contractor's Material and Test Certificates for Aboveground and Underground Piping, and all literature and instructions provided by the manufacturer describing the proper operation and maintenance of all equipment and devices in accordance with NFPA 25; (E) service contracts for maintenance and testing of systems, including alarm systems and sprinkler systems; (F) a copy of gas pressure test results of all facility gas lines from the meter to gas-fired equipment and appliances; (G) a written statement from an architect or engineer certifying the building was constructed to meet NFPA 101 all locally applicable codes, and that the facility substantially conforms to the minimum licensing requirements; (H) the contract documents specified in subsection (b) of this section; and (I) copies of reduced size floor plans on 8 1/2 by 11 inch sheets for record and file use by HHSC and for the facility to use in evacuation planning and fire alarm zone identification containing basic legible information such as overall dimensions, room usage names, actual bedroom numbers, doors, windows, and any other pertinent information. (d) Non-approval of new construction. (1) If, during the survey of completed construction, the surveyor finds basic requirements not met, HHSC will not license the facility or approve it for occupancy. Such basic items may include the following: (A) construction that does not meet minimum code or licensure standards for basic requirements such as corridor widths that are less than eight feet clear width, ceilings installed at less than the minimum seven feet six inches height above the floor, resident bedroom dimensions less than the required minimum dimensions, and other similar features that would disrupt or otherwise adversely affect the residents and staff if corrected after occupancy; (B) absence of written approval by local authorities; (C) fire protection systems that are not completely installed or not functioning properly, including fire alarm systems, emergency power and lighting, and sprinkler systems; (D) required exits that are not usable according to NFPA 101 requirements; (E) telephones that are not installed or not working properly; (F) sufficient basic furnishings, essential appliances and equipment that are not installed or are not functioning; and (G) any other basic operational or safety feature that the surveyor, as the authority having jurisdiction, encounters that in his judgment would preclude safe and normal occupancy by residents on that day. (2) If the surveyor encounters deficiencies that do not affect the health and safety of the residents, licensure may be recommended based on an approved written plan of correction by the facility's administrator. Source Note: The provisions of this §554.330 adopted to be effective July 1, 1996, 21 TexReg 4408; amended to be effective June 1, 2010, 35 TexReg 4465; 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; amended to be effective January 2, 2022, 46 TexReg 9037