26 Tex. Admin. Code § 507.511 - Construction Requirements for an Existing End Stage Renal Disease Facility
(a) All buildings in which existing ESRD
facilities licensed by the department are located shall comply with this
subsection.
(1) A licensed ESRD facility which
is licensed prior to the effective date of these rules is considered to be an
existing licensed ESRD facility and shall continue, at a minimum, to meet the
licensing requirements under which it was originally licensed.
(2) Existing licensed ESRD facilities shall
meet the requirements for Existing Ambulatory Health Care Occupancies contained
in Chapter 21 of the 2000 edition of the National Fire Protection Association
101, Life Safety Code, (NFPA 101), the ESRD Standards/Rules (1996, 1999, or
2006 editions as amended), and the ESRD rules under which the buildings or
sections of buildings were constructed. All documents published by NFPA as
referenced in this section may be obtained by writing or calling the NFPA at
the following address or telephone number: National Fire Protection
Association, 1 Batterymarch Park, P.O. Box 9101, Quincy, MA 02269-9101 or (800)
344-3555.
(3) In lieu of meeting
the requirements in paragraph (1) of this subsection, an existing licensed ESRD
facility may, instead, comply with National Fire Protection Association (NFPA)
101, Life Safety Code 2003 Edition (NFPA 101) Chapter 21, Existing Ambulatory
Health Care Occupancies.
(b) All major remodeling, renovations,
additions and alterations to an existing ESRD facility shall be done in
accordance with the requirements for new construction in §
117.102 of this title (relating to
Construction Requirements for a New End Stage Renal Disease Facility). All
areas of an existing ESRD facility that are not part of a major remodel,
renovation, addition or alteration to the ESRD facility, are not required to
meet these new construction requirements as long as the existing portion of the
facility met the rules and codes that were in effect when it was originally
constructed and licensed. When existing conditions make such changes
impractical, the department may grant a conditional approval of minor
deviations from the requirements of §
117.102 of this title, if the
intent of the requirements is met and if the care, safety and welfare of
patients will not be jeopardized. The operation of the ESRD facility,
accessibility of individuals with disabilities, and safety of the patients
shall not be jeopardized by a condition(s) which is not in compliance with
§
117.102 of this title and this
section.
(1) Any alteration, modification,
replacement, or any installation of new building equipment, such as mechanical,
electrical, emergency power equipment, energy/utility management, conveying
systems, plumbing, fire protection, or other equipment with a primary function
of building service that affects life safety, infection control, changes the
functional operation, or the health, safety and welfare of patients or staff
shall comply with the requirements for new construction and shall not be
replaced, materially altered, or extended in an existing ESRD facility until
complete plans and specifications have been submitted to the department, and
the department has reviewed and approved the plans and specifications in
accordance with §
117.104 of this title (relating to
Preparation, Submittal, Review and Approval of Plans, and Retention of
Records).
(2) Minor remodeling or
alterations within an existing ESRD facility which do not involve alterations
to load bearing members and partitions, change functional operation, affect
fire safety, or involve any of the major changes listed in paragraph (1) of
this subsection are considered to be minor projects and require evaluation and
approval by the department. An ESRD facility shall submit by mail or fax a
written request and floor plan for evaluation, a brief description of the
proposed changes, and sketches of the area being remodeled. Based on such
submittal, the department shall evaluate and determine whether any additional
submittals or inspections are required. The department shall notify the ESRD
facility of its decision. 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 would not require
submission to the department for approval.
(3) All remodeling or alterations which
involve alterations to load bearing members or partitions, change functional
operation, add treatment stations, or affect fire safety are considered major
projects. An ESRD facility shall comply with this section prior to beginning
construction of major projects.
(A) Plans
shall be submitted in accordance with §
117.104 of this title for all
major remodeling or alterations.
(B) As of February 9, 2009, all new
facilities or increasing the number of in-center dialysis treatment stations in
existing facilities shall have an isolation room or be granted a waiver by
Center for Medicare and Medicaid Services. The waiver shall demonstrate that
there is sufficient capacity in the geographic area for isolation rooms for
hepatitis B positive patients. A written request for waiver shall be made
through the Texas Department of State Health Services, Health Facility
Compliance Group, Mail Code 1979, P.O. Box 149347, Austin, Texas, 78714-9347
for transmission to CMS.
(C)
Phasing of construction in existing facilities.
(i) Projects involving alterations of or
additions to existing buildings shall be programmed and phased so that on-site
construction shall minimize disruptions of existing functions.
(ii) Access, exit access, and fire protection
shall be maintained so that the safety of the occupants shall not be
jeopardized during construction.
(iii) A noncombustible or limited combustible
dust and vapor barrier shall be provided to separate areas undergoing
demolition and construction from occupied areas. When a fire retardant plastic
material is used for temporary daily usage, it shall be removed at the end of
each day.
(iv) The air inside the
construction area shall be protected by mechanical filtration that recirculates
inside the space or is exhausted directly to the exterior.
(v) The area shall be properly ventilated and
maintained. The area under construction shall have a negative air pressure
differential to the adjoining areas and shall continue to operate as long as
construction dust and odors are present.
(vi) Temporary sound barriers shall be
provided where intense prolonged construction noises will disturb patients or
staff in the occupied portions of the building during patient treatment
times.
(vii) When construction is
done after hours or on weekends, the facility shall assure that all areas of
construction are cleaned thoroughly and a clean safe environment is provided
before patients are treated. All fire safety protection and building systems
are in place and working properly.
(c) A previously licensed ESRD facility which
has been vacated or used for other purposes shall comply with all the
requirements for new construction contained in §
117.102 of this title in order to
be licensed.
Notes
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No prior version found.