26 Tex. Admin. Code § 510.122 - New Construction Requirements
(a) Facility
location. Any proposed new facility shall be easily accessible to the community
and to service vehicles such as delivery trucks, ambulances, and fire
protection apparatus. No building may be converted for use as a facility which,
because of its location, physical condition, state of repair, or arrangement of
facilities, would be hazardous to the health and safety of the patients.
(1) Hazardous locations.
(A) Underground and above ground hazards. New
facilities or additions to existing facilities shall not be built within 125
feet of right away/easement of hazardous locations including underground liquid
butane or propane, liquid petroleum or natural gas transmission lines, high
pressure lines, and not under high voltage electrical lines.
(B) Fire hazards. New facilities shall not be
built within 300 feet of above ground or underground storage tanks containing
liquid petroleum or other flammable liquids used in connection with a bulk
plant, marine terminal, aircraft refueling, bottling plant of a liquefied
petroleum gas installation, or near other hazardous or hazard producing
plants.
(2) Undesirable
locations.
(A) Nuisance producing sites. New
facilities shall not be located near nuisance producing industrial sites, feed
lots, sanitary landfills, or manufacturing plants producing excessive noise or
air pollution.
(B) Cemeteries. New
facilities shall not be located near a cemetery in a manner that allows direct
view of the cemetery from patient windows.
(C) Flood plains. Construction of new
facilities shall be avoided in designated flood plains. Where such is
unavoidable, access and required functional facility components shall be
constructed above the designated flood plain. This requirement also applies to
new additions to existing facilities or portions of facilities which have been
licensed previously as facilities but which have been vacated or used for
purposes other than facilities. This requirement does not apply to remodeling
of existing licensed facilities.
(D) Airports. Construction of new facilities
shall be avoided in close proximity to airports. When facilities are proposed
to be located near airports, recommendations of the Texas Aviation Authority
and the Federal Aviation Authority shall apply. A facility may not be
constructed within a rectangular area formed by lines perpendicular to and two
miles (10,560 feet) from each end of any runway and by lines parallel to and
one-half mile (2,640 feet) from each side of any runway.
(b) Environmental considerations.
Development of a facility site and facility construction shall be governed by
state and local regulations and requirements with respect to the effect of
noise and traffic on the community and the environmental impact on air and
water.
(c) Facility site.
(1) Paved roads and walkways. Paved roads
shall be provided within the lot lines to provide access from public roads to
the main entrance, entrances serving community activities, and to service
entrances, including loading and unloading docks for delivery trucks. Finished
surface walkways shall be provided for pedestrians.
(2) Parking. Off-street parking shall be
available for visitors, employees, and staff. Parking structures directly
accessible from a facility shall be separated with two-hour fire rated
noncombustible construction. When used as required means of egress for facility
occupants, parking structures shall comply with National Fire Protection
Association 88A, Standard for Parking Structures, 1998 edition. This
requirement does not apply to freestanding parking structures.
(A) Number of parking places. In the absence
of a formal parking study, one parking space shall be provided for each day
shift employee plus one space for one and one-half patient beds. This ratio may
be reduced in an area convenient to a public transportation system or to public
parking facilities on the basis of a formal parking study. Parking shall be
increased accordingly when the size of an existing facility is
increased.
(B) Additional parking.
Additional parking shall be required to accommodate medical staff, outpatient
and other services when such services are provided.
(C) Delivery parking. Separate parking
facilities shall be provided for delivery vehicles.
(D) Accessible parking. Parking spaces for
persons with disabilities shall be provided in accordance with the Americans
with Disabilities Act (ADA) of 1990,
Public Law
101-336 , 42 United States Code, Chapter 126, and
Title 36 Code of Federal Regulations, Part 1191, Appendix A, Accessibility
Guidelines for Buildings and Facilities.
(d) Building design and construction
requirements. Every building and every portion thereof shall be designed and
constructed to sustain all dead and live loads in accordance with accepted
engineering practices and standards and the local governing building codes.
Where there is no local governing building code, one of the following codes
shall be adhered to: Uniform Building Code, 1999 edition, published by the
International Conference of Building Officials.
(1) General architectural requirements. All
new construction, including conversion of an existing building to a facility,
establishing a separately licensed facility in a building with an existing
licensed health care occupancy, and establishing a licensed facility in a
non-health care occupancy shall comply with Chapter 18 of the National Fire
Protection Association 101, Code for Safety to Life from Fire in Buildings and
Structures, 2000 edition (NFPA 101), and Subchapters F and G of this chapter
(relating to Fire Prevention and Safety Requirements and Physical Plant and
Construction Requirements, respectively). The facility shall comply with the
requirements of this paragraph and any specific architectural requirements for
the particular unit or suite of the facility in accordance with §
510.123 of this subchapter
(relating to Spatial Requirements for New Construction).
(A) Special design provisions. Special
provisions shall be made in the design of a facility in regions where local
experience shows loss of life or extensive damage to buildings resulting from
hurricanes, tornadoes, or floods.
(B) Foundations. Foundations shall rest on
natural solid bearing if satisfactory bearing is available. Proper soil-bearing
values shall be established in accordance with recognized requirements. If
solid bearing is not encountered at practical depths, the structure shall be
supported on driven piles or drilled piers designed to support the intended
load without detrimental settlement, except that one-story buildings may rest
on a fill designed by a soils engineer. When engineered fill is used, site
preparation and placement of fill shall be done under the direct full-time
supervision of the soils engineer. The soils engineer shall issue a final
report on the compacted fill operation and certification of compliance with the
job specifications. All footings shall extend to a depth not less than one foot
below the estimated maximum frost line.
(C) Physical environment. A physical
environment that protects the health and safety of patients, personnel, and the
public shall be provided in each facility. The physical premises of the
facility and those areas of the facility's physical structure that are used by
the patients (including all stairwells, corridors, and passageways) shall meet
the local building and fire safety codes and subchapters F and G of this
chapter.
(D) Construction type. A
facility may occupy an entire building or a portion of a building, provided the
facility portion of the building is separated from the rest of the building in
accordance with subparagraph (E) of this paragraph and the entire building or
the facility portion of the building complies with new construction
requirements (type of construction permitted for facilities by NFPA 101,
§18-1.6.2), and the entire building is protected with a fire sprinkler
system conforming with requirements of National Fire Protection Association 13,
Standard for the Installation of Sprinkler Systems, 1999 Edition (NFPA
13).
(E) Separate buildings.
Portions of a building divided horizontally with two-hour fire rated walls
which are continuous (without offsets) from the foundation to above the roof
shall be considered as a separate building. Communicating openings in the
two-hour wall shall be limited to public spaces such as lobbies and corridors.
All such openings shall be protected with self-closing one and one-half hour,
Class B fire door assemblies.
(F)
Design for people with disabilities. Special considerations benefiting staff,
visitors, and patients with disabilities shall be provided. Each facility shall
comply with the Americans with Disabilities Act (ADA) of 1990,
Public Law
101-336 , 42 United States Code, Chapter 126, and
Title 36 Code of Federal Regulations, Part 1191, Appendix A, Accessibility
Guidelines for Buildings and Facilities.
(G) Other regulations. Certain projects may
be subject to other regulations, including those of federal, state, and local
authorities. The more stringent standard or requirement shall apply when a
difference in requirements for construction exists.
(H) Exceeding minimum requirements. Nothing
in this subchapter shall be construed to prohibit a better type of building
construction, more exits, or otherwise safer conditions than the minimum
requirements specified in this subchapter.
(I) Equivalency. Nothing in this subchapter
is intended to prevent the use of systems, methods, or devices of equivalent or
superior quality, strength, fire resistance, effectiveness, durability, and
safety to those prescribed by this subchapter, providing technical
documentation which demonstrates equivalency is submitted to the department for
approval.
(J) Freestanding
buildings (not for patient use). Separate freestanding buildings for nonpatient
use such as the heating plant, boiler plant, laundry, repair workshops, or
general storage may be of unprotected non-combustible construction, protected
non-combustible construction, or fire-resistive construction and be designed in
accordance with other occupancy classifications requirements listed in NFPA
101.
(K) Freestanding buildings
(for patient use other than sleeping). Buildings containing areas for patient
use which do not contain patient sleeping areas and in which care or treatment
is rendered to ambulatory inpatients who are capable of judgment and
appropriate physical action for self-preservation under emergency conditions,
may be classified as ambulatory health care occupancies or business occupancies
as listed in NFPA 101 Chapters 20 and 38, respectively, instead of facility
occupancy. Such buildings shall be located at least 20 feet from the facility
unless protected by an approved automatic sprinkler system.
(L) Energy conservation. In new construction
and in major alterations and additions to existing buildings and in new
buildings, electrical and mechanical components shall be selected for efficient
utilization of energy.
(2) General detail and finish requirements.
Details and finishes in new construction projects, including additions and
alterations, shall be in compliance with this paragraph, with NFPA 101, Chapter
18, with local building codes, and with any specific detail and finish
requirements for the particular unit or suite as contained in §
510.123 of this subchapter.
(A) General detail requirements.
(i) Fire safety. Fire safety features,
including compartmentation, means of egress, automatic extinguishing systems,
inspections, smoking regulations, and other details relating to fire prevention
and fire protection shall comply with §
510.121 of this subchapter
(relating to Requirements for Buildings in which Existing Licensed Facilities
are Located), and NFPA 101 Chapter 18 requirements for facilities. The Fire
Safety Evaluation System for Health Care Occupancies contained in the National
Fire Protection Association 101A, Alternative Approaches to Life Safety, 1998
edition, Chapter 3, shall not be used in new building construction,
renovations, or additions to existing facilities.
(ii) Access to exits. Corridors providing
access to all patient, diagnostic, treatment, and sleeping rooms and exits
shall be at least six feet in clear and unobstructed width (except as allowed
by NFPA 101, §18-2.3.3, Exceptions 1 and 2), not less than 7 feet 6 inches
in height, and constructed in accordance with requirements listed in NFPA 101
§18-3.6.
(iii) Corridors in
other occupancies. Public corridors in outpatient, administrative, and service
areas which are designed to other than facility requirements and are the
required means of egress from the facility shall be not less than five feet in
width.
(iv) Encroachment into the
means of egress. Items such as drinking fountains, telephone booths or
stations, and vending machines shall be so located as to not project into and
restrict exit corridor traffic or reduce the exit corridor width below the
required minimum. Portable equipment shall not be stored so as to project into
and restrict exit corridor traffic or reduce the exit corridor width below the
required minimum.
(v) Doors in
means of egress. All door leaves in the means of egress shall be not less than
36 inches wide or as otherwise permitted for facilities by NFPA 101
§18-2.3.5.
(vi) Sliding doors.
When sliding doors are provided to a means of egress corridor, the sliding
doors shall have break-away provisions, positive latching devices, and shall be
installed to resist passage of smoke.
(vii) Control doors. Designs that include
cross-corridor control doors should be avoided. When unavoidable,
cross-corridor control doors shall consist of two 32-inch wide leaves which
swing in a direction opposite from the other, or of the double acting type, and
be provided with view panels.
(viii) Emergency access. Rooms containing
bathtubs, showers, or water closets, intended for patient use shall be provided
with at least one outswinging door or special frame and hardware which will
permit the door to swing out for staff access to a patient who may have
collapsed against the door. The width of such doors shall not be less than 36
inches.
(ix) Obstruction of
corridors. All doors which swing towards the corridor must be recessed.
Corridor doors to rooms not subject to occupancy (any room that you can walk
into and close the door behind you is considered occupiable) may swing into the
corridor, provided that such doors comply with the requirements of NFPA 101
§7-2.1.4.3.
(x) Stair landing.
Doors shall not open immediately onto a stair without a landing. The landing
shall be 44 inches deep or have a depth at least equal to the door width,
whichever is greater.
(xi) Doors to
rooms subject to occupancy. All doors to rooms subject to occupancy shall be of
the swing type except that horizontal sliding doors complying with the
requirements of NFPA 101 §18-2.2.2.9 are permitted. Door leaves to rooms
subject to occupancy shall not be less than 36 inches wide unless noted
otherwise.
(xii) Operable windows
and exterior doors. Windows that can be opened without tools or keys and outer
doors without automatic closing devices shall be provided with insect
screens.
(xiii) Glazing. Glass
doors, lights, sidelights, borrowed lights, and windows located within 12
inches of a door jamb or with a bottom-frame height of less than 18 inches and
a top-frame height of more than 36 inches above the finished floor which may be
broken accidentally by pedestrian traffic shall be glazed with safety glass or
plastic glazing material that will resist breaking and will not create
dangerous cutting edges when broken. Similar materials shall be used for wall
openings in activity areas such as recreation and exercise rooms, unless
otherwise required for fire safety. Safety glass, tempered or plastic glazing
materials shall be used for shower doors and bath enclosures, interior windows
and doors. Plastic and similar materials used for glazing shall comply with the
flame-spread ratings of NFPA 101 §18-3.3.
(xiv) Fire doors. All fire doors shall be
listed by an independent testing laboratory and shall meet the construction
requirements for fire doors in National Fire Protection Association 80,
Standard for Fire Doors and Fire Windows, 1999 edition. Reference to a labeled
door shall be construed to include labeled frame and hardware.
(xv) Elevator doors. Elevator shaft openings
shall be protected with a B labeled one-hour fire protection rated doors in
buildings less than four stories; and one and one-half hour fire protection
rated doors in buildings four or more stories.
(xvi) Elevator lobbies. Elevator lobbies
shall have at least 10 feet of clear floor space in front of the elevator
doors.
(xvii) Grab bars. Grab bars
shall be provided at patient toilets, showers and tubs. The bars shall have
sufficient strength and anchorage to sustain a concentrated vertical or
horizontal load of 250 pounds. Grab bars are not permitted at bathing and
toilet fixtures unless designed and installed to eliminate the possibility of
patients harming themselves. Grab bars intended for use by persons with a
disability shall also comply with ADA requirements.
(xviii) Soap dishes. Recessed soap dishes
shall be provided at all showers and bathtubs.
(xix) Hand washing facilities. Location and
arrangement of fittings for hand washing facilities shall permit their proper
use and operation. Hand washing fixtures with hands-free operable controls
shall be provided within each procedure room, workroom, examination and
treatment room and all toilet rooms unless noted otherwise. Hands-free includes
blade-type handles, and foot, knee, or sensor operated controls. Particular
care shall be given to the clearances required for blade-type operating
handles. Lavatories and hand washing facilities shall be securely anchored to
withstand an applied vertical load of not less than 250 pounds on the front of
the fixture. In addition to the specific areas noted, hand washing facilities
shall be provided and conveniently located for staff use throughout the
facility where patient care and services are provided.
(xx) Hand drying. Provisions for hand drying
shall be included at all hand washing facilities except scrub sinks. There
shall be hot air dryers or individual paper or cloth units enclosed in such a
way as to provide protection against dust or soil and ensure single unit
dispensing.
(xxi) Mirrors. Mirrors
shall not be installed at hand washing fixtures where asepsis control and
sanitation requirements would be lessened by hair combing.
(xxii) Ceiling heights. The minimum ceiling
height shall be eight feet with the following exceptions.
(I) Minor rooms. Ceilings in storage rooms,
toilet rooms, and other minor rooms shall be not less than 7 feet 6
inches.
(II) Boiler rooms. Boiler
rooms shall have ceiling clearances not less than 2 feet 6 inches above the
main boiler header and connecting piping.
(III) Overhead clearance. Suspended tracks,
rails, pipes, signs, lights, door closers, exit signs, and other fixtures that
protrude into the path of normal traffic shall not be less than 6 feet 8 inches
above the finished floor.
(xxiii) Areas producing impact noises.
Recreation rooms, exercise rooms, and similar spaces where impact noises may be
generated shall not be located directly over patient bed area unless special
provisions are made to minimize noise.
(xxiv) Noise reduction. Noise reduction
criteria in accordance with the Table 1 in §
510.131(a) of
this subchapter (relating to Tables) shall apply to partitions, floor, and
ceiling construction in patient areas.
(xxv) Rooms with heat producing equipment.
Rooms containing heat-producing equipment such as heater rooms, laundries, etc.
shall be insulated and ventilated to prevent any occupied floor surface above
from exceeding a temperature differential of 10 degrees Fahrenheit above the
ambient room temperature.
(xxvi)
Chutes. Linen and refuse chutes shall comply with the requirements of National
Fire Protection Association 82, Standard on Incinerators and Waste and Linen
Handling Systems and Equipment, 1999 edition, and NFPA 101
§18-5.4.
(xxvii) Thresholds
and expansion joint covers. Thresholds and expansion joint covers shall be
flush with the floor surface to facilitate the use of wheelchairs and carts.
Expansion and seismic joints shall be constructed to restrict the passage of
smoke and fire and shall be listed by a nationally recognized testing
laboratory.
(xxviii) Housekeeping
room.
(I) In addition to the housekeeping
rooms required in certain suites, sufficient housekeeping rooms shall be
provided throughout the facility as required to maintain a clean and sanitary
environment.
(II) Each housekeeping
room shall contain a floor receptor or service sink and storage space for
housekeeping equipment and supplies.
(xxix) Public toilets. In addition to the
public toilets required for the main lobby, a public toilet shall be provided
convenient to each public and visitor waiting area. This may be a single unisex
toilet for small waiting areas.
(B) General finish requirements.
(i) Cubicle curtains and draperies.
(I) Cubicle curtains, draperies and other
hanging fabrics shall be noncombustible or flame retardant and shall pass both
the small scale and the large scale tests of National Fire Protection
Association 701, Standard Methods of Fire Tests for Flame-Resistant Textiles
and Films, 1999 edition. Copies of laboratory test reports for installed
materials shall be submitted to the Texas Health and Human Services Commission
at the time of the final construction inspection.
(II) Cubicle curtains shall be provided to
assure patient privacy.
(ii) Flame spread, smoke development and
noxious gases. Flame spread and smoke developed limitations of interior
finishes shall comply with Table 2 of §
510.131(b) of
this subchapter and NFPA 101 §10-2.1. The use of materials known to
produce large or concentrated amounts of noxious or toxic gases shall not be
used in exit accesses or in patient areas. Copies of laboratory test reports
for installed materials tested in accordance with National Fire Protection
Association 255, Standard Method of Test of Surface Burning Characteristics of
Building Materials, 2000 edition, and National Fire Protection Association 258,
Standard Research Test Method for Determining Smoke Generation of Solid
Materials, 1997 edition, shall be provided.
(iii) Floor finishes. Flooring shall be easy
to clean and have wear resistance appropriate for the location involved. Floors
that are subject to traffic while wet (such as shower and bath areas, kitchens,
and similar work areas) shall have a nonslip surface. In all areas frequently
subject to wet cleaning methods, floor materials shall not be physically
affected by germicidal and cleaning solutions. The following are acceptable
floor finishes:
(I) painted
concrete;
(II) vinyl and vinyl
composition tiles and sheets;
(III)
monolithic or seamless flooring:
(-a-) where
required, seamless flooring shall be impervious to water, coved, and installed
integral with the base, tightly sealed to the wall, and without voids that can
harbor insects or retain dirt particles; and
(-b-) welded joint flooring is
acceptable;
(IV) ceramic
and quarry tile;
(V) wood
floors;
(VI) carpet flooring, which
if installed in patient rooms and similar patient care areas, shall be treated
to prevent bacterial and fungal growth;
(VII) terrazzo; and
(VIII) poured in place floors.
(iv) Wall finishes. Wall finishes
shall be smooth, washable, moisture resistant, and cleanable by standard
housekeeping practices. Wall finishes shall comply with requirements contained
in Table 2 of §
510.131(b) of
this subchapter and NFPA 101 §18-3.3.
(I)
Wall finishes shall be water resistant in the immediate area of plumbing
fixtures.
(II) Wall finishes in
areas subject to frequent wet cleaning methods shall be impervious to water,
tightly sealed and without voids.
(v) Floor, wall and ceiling penetrations.
Floor, wall, and ceiling penetrations by pipes, ducts, and conduits shall be
tightly sealed to minimize entry of dirt particles, rodents, and insects.
Joints of structural elements shall be similarly sealed.
(vi) Ceiling types. All occupied rooms and
spaces shall be provided with finished ceilings. Ceilings which are a part of a
rated roof or ceiling assembly or a floor or ceiling assembly shall be
constructed of listed components and installed in accordance with the listing.
Three types of ceilings that are required in various areas of the facility are
the following.
(I) Ordinary ceilings. Ceilings
such as acoustical tiles installed in a metal grid which are dry cleanable with
equipment used in daily housekeeping activities such as dusters and vacuum
cleaners.
(II) Washable ceilings.
Ceilings that are made of washable, smooth, moisture impervious materials such
as painted lay-in gypsum wallboard or vinyl faced acoustic tile in a metal
grid.
(III) Monolithic ceilings.
Ceilings which are monolithic from wall to wall (painted solid gypsum
wallboard), smooth and without fissures, open joints, or crevices and with a
washable and moisture impervious finish.
(vii) Special construction. Special
conditions may require special wall and ceiling construction for security in
areas such as storage of controlled substances and areas where patients are
likely to attempt suicide or escape.
(viii) Materials finishes. Materials known to
produce noxious gases when burned shall not be used for mattresses, upholstery,
and wall finishes.
(3) General mechanical requirements. This
paragraph contains common requirements for mechanical systems; steam and hot
and cold water systems; air-conditioning, heating and ventilating systems;
plumbing fixtures; piping systems; and thermal and acoustical insulation. The
facility shall comply with the requirements of this paragraph and any specific
mechanical requirements for the particular unit or suite of the facility in
accordance with §
510.123 of this subchapter.
(A) Cost. All mechanical systems shall be
designed for overall efficiency and life cycle costing, including operational
costs. Recognized engineering procedures shall be followed to achieve the most
economical and effective results. In no case shall patient care or safety be
sacrificed for conservation.
(B)
Equipment location. Mechanical equipment may be located indoors or outdoors
(when in a weatherproof enclosure), or in separate buildings.
(C) Vibration isolation. Mechanical equipment
shall be mounted on vibration isolators as required to prevent unacceptable
structure-borne vibration. Ducts, pipes, etc. connected to mechanical equipment
which is a source of vibration shall be isolated from the equipment with
vibration isolators.
(D)
Performance and acceptance. Prior to completion and acceptance of the facility,
all mechanical systems shall be tested, balanced, and operated to demonstrate
to the design engineer or the design engineer's representative that the
installation and performance of these systems conform to the requirements of
the plans and specifications.
(i) Material
lists. Upon completion of the contract, the owner shall be provided with parts
lists and procurement information with numbers and description for each piece
of equipment.
(ii) Instructions.
Upon completion of the contract, the owner shall be provided with instructions
in the operational use of systems and equipment as required.
(E) Heating, ventilating and air
conditioning (HVAC) systems. All HVAC systems shall comply with and shall be
installed in accordance with the requirements of National Fire Protection
Association 90A, Standard for the Installation of Air Conditioning and
Ventilating Systems, 1999 edition, (NFPA 90A), NFPA 99, Chapter 5, the
requirements contained in this subparagraph, and the specific requirements for
a particular unit in accordance with §
510.123 of this subchapter.
(i) General ventilation requirements. All
rooms and areas in the facility listed in Table 3 of §
510.131(c) of
this subchapter shall have provision for positive ventilation. Fans serving
exhaust systems shall be located at the discharge end and shall be conveniently
accessible for service. Exhaust systems may be combined, unless otherwise
noted, for efficient use of recovery devices required for energy conservation.
The ventilation rates shown in Table 3 of §
510.131(c) of
this subchapter shall be used only as minimum requirements since they do not
preclude the use of higher rates that may be appropriate. Supply air to the
building and exhaust air from the building shall be regulated to provide a
positive pressure within the building with respect to the exterior.
(I) Cost reduction methods. To reduce utility
costs, the building design and systems proposed shall utilize energy conserving
procedures including recovery devices, variable air volume, load shedding,
systems shut down or reduction of ventilation rates (when specifically
permitted) in certain areas when unoccupied, insofar as patient care is not
jeopardized.
(II) Economizer cycle.
Mechanical ventilation shall be arranged to take advantage of outside air
supply by using an economizer cycle when appropriate to reduce heating and
cooling systems loads. Innovative design that provides for additional energy
conservation while meeting the intent of this section for acceptable patient
care will be considered.
(III)
Outside air intake locations. Outside air intakes shall be located at least 25
feet from exhaust outlets of ventilating systems, combustion equipment stacks,
medical-surgical vacuum systems, plumbing vents, or areas which may collect
vehicular exhaust or other noxious fumes. (Prevailing winds and proximity to
other structures may require other arrangements.) Plumbing and vacuum vents
that terminate five feet above the level of the top of the air intake may be
located as close as 10 feet.
(IV)
Low air intake location limit. The bottom of outside air intakes serving
central systems shall be located as high as practical but at least six feet
above ground level, or if installed above the roof, three feet above the roof
level.
(V) Contaminated air exhaust
outlets. Exhaust outlets from areas (kitchen hoods, ethylene oxide sterilizers,
etc.) that exhaust contaminated air shall be above the roof level and arranged
to exhaust upward.
(VI) Directional
air flow. Ventilation systems shall be designed and balanced to provide
directional flow as shown in Table 3 of §
510.131(c) of
this subchapter. For reductions and shut down of ventilation systems when a
room is unoccupied, the provisions in Note 4 of Table 3 of §
510.131(c) of
this subchapter shall be followed.
(VII) Areas requiring fully ducted systems.
Fully ducted supply, return and exhaust air for HVAC systems shall be provided
for all general patient care areas and where required for fire safety purposes.
Combination systems, utilizing both ducts and plenums for movement of air in
these areas shall not be permitted. Such areas include isolation rooms and food
preparation areas.
(VIII)
Ventilation start-up requirements. Air handling systems shall not be started up
and operated without the filters installed in place. This includes the 90%
efficiency filters where required. Ducts shall be cleaned thoroughly by an air
duct cleaning contractor when the air handling systems have been operating
without the required filters in place.
(IX) Humidifier location. When duct
humidifiers are located upstream of the final filters, they shall be located at
least 15 feet from the filters. Ductwork with duct-mounted humidifiers shall be
provided with a means of removing water accumulation. An adjustable high-limit
humidistat shall be located downstream of the humidifier to reduce the
potential of condensation inside the duct. All duct take-offs should be
sufficiently downstream of the humidifier to ensure complete moisture
absorption. Reservoir-type water spray or evaporative pan humidifiers shall not
be used.
(ii) Filtration
requirements. All central air handling systems serving patient care areas,
including nursing unit corridors, shall be equipped with filters having
efficiencies equal to, or greater than, those specified for those types of
areas in Table 4 of §
510.131(d) of
this subchapter. Filter efficiencies shall be average efficiencies tested in
accordance with American Society of Heating, Refrigerating, and
Air-conditioning Engineers (ASHRAE), Inc., Standard 52, 1999 edition. All
joints between filter segments and between filter segments and the enclosing
ductwork, shall have gaskets and seals to provide a positive seal against air
leakage. Air handlers serving more than one room shall be considered as central
air handlers.
(I) Filtration requirements for
air handling units serving single rooms requiring asepsis control. Dedicated
air handlers serving only one room where asepsis control is required, including
operating rooms, delivery rooms, special procedure rooms, and nurseries shall
be equipped with filters having efficiencies equal to, or greater than, those
specified for patient care areas in Table 4 of §
510.131(d) of
this subchapter.
(II) Filtration
requirements for air handling units serving other single rooms. Dedicated air
handlers serving all other single rooms shall be equipped with nominal filters
installed at the return air grille.
(III) Location of multiple filters. Where two
filter beds are required by Table 4 of §
510.131(d) of
this subchapter, filter bed number one shall be located upstream of the
air-conditioning equipment and filter bed number two shall be downstream of the
supply fan or blowers.
(IV)
Location of single filters. Where only one filter bed is required by Table 4 of
§
510.131(d) of
this subchapter, it shall be located upstream of the supply fan. Filter frames
shall be durable and constructed to provide an airtight fit with the enclosing
ductwork.
(V) Pressure monitoring
devices. A manometer or draft gauge shall be installed across each filter bed
having a required efficiency of 75% or more including hoods requiring high
efficiency particulate air (HEPA) filters.
(iii) Thermal and acoustical insulation for
air handling systems. Asbestos insulation shall not be used.
(I) Thermal duct insulation. Air ducts and
casings with outside surface temperature below ambient dew point or temperature
above 80 degrees Fahrenheit shall be provided with thermal
insulation.
(II) Insulation in air
plenums and ducts. Linings in air ducts and equipment shall meet the Erosion
Test Method described in Underwriters Laboratories, Inc., Standard Number
181.
(III) Insulation flame spread
and smoke developed ratings. Interior and exterior insulation, including
finishes and adhesives on the exterior surfaces of ducts and equipment, shall
have a flame spread rating of 25 or less and a smoke developed rating of 50 or
less as required by NFPA 90A Chapters 2 and 3.
(IV) Linings and acoustical traps. Duct
lining and acoustical traps exposed to air movement shall not be used in ducts
serving critical care areas. This requirement shall not apply to mixing boxes
and acoustical traps that have approved nonabrasive coverings over such
linings.
(V) Frangible insulation.
Insulation of soft and spray-on types shall not be used where it is subject to
air currents or mechanical erosion or where loose particles may create a
maintenance problem.
(VI) Existing
duct linings. Internal linings shall not be used in ducts, terminal boxes, or
other air system components supplying operating rooms, delivery rooms, birthing
rooms, labor rooms, recovery rooms, nurseries, trauma rooms, isolation rooms,
and intensive care units unless terminal filters of at least 90% efficiency are
installed downstream of linings.
(iv) Fire damper requirements. Fire dampers
shall be located and installed in all ducts at the point of penetration of a
two-hour or higher fire rated wall or floor in accordance with the requirements
of NFPA 101 §18-5.2.
(v) Smoke
damper requirements. Smoke dampers shall be located and installed in accordance
with the requirements of NFPA 101 §18-3.7.3, and NFPA 90A Chapter 3.
(I) Fail-safe installation. Smoke dampers
shall close on activation of the fire alarm system by smoke detectors installed
and located as required by National Fire Protection Association 72, National
Fire Alarm Code, 1999 edition (NFPA 72), Chapter 5; NFPA 90A, Chapter 4; and
NFPA 101, §18-3.7; the fire sprinkler system; and upon loss of power.
Smoke dampers shall not close by fan shut-down alone.
(II) Interconnection of air handling fans and
smoke dampers. Air handling fans and smoke damper controls may be
interconnected so that closing of smoke dampers will not damage the
ducts.
(III) Frangible devices. Use
of frangible devices for shutting smoke dampers is not permitted.
(vi) Acceptable damper assemblies.
Only fire damper and smoke damper assemblies integral with sleeves and listed
for the intended purpose shall be acceptable.
(vii) Duct access doors. Unobstructed access
to duct openings in accordance with NFPA 90A §2-3.4, shall be provided in
ducts within reach and sight of every fire damper, smoke damper and smoke
detector. Each opening shall be protected by an internally insulated door which
shall be labeled externally to indicate the fire protection device located
within.
(viii) Restarting controls.
Controls for restarting fans may be installed for convenient fire department
use to assist in evacuation of smoke after a fire is controlled, provided that
provisions are made to avoid possible damage to the system because of closed
dampers. To accomplish this, smoke dampers shall be equipped with remote
control devices.
(ix) Make-up air.
If air supply requirements in Table 3 of §
510.131(c) of
this subchapter do not provide sufficient air for use by exhaust hoods and
safety cabinets, filtered make-up air shall be ducted to maintain the required
air flow direction in that room. Make-up systems for hoods shall be arranged to
minimize short circuiting of air and to avoid reduction in air velocity at the
point of contaminant capture.
(4) General piping systems and plumbing
fixture requirements. All piping systems and plumbing fixtures shall be
designed and installed in accordance with the requirements of the National
Standard Plumbing Code, published by the International Association of Plumbing
and Mechanical Officials, 2000 edition, and this paragraph.
(A) Piping systems.
(i) Water supply systems. Water service pipe
to point of entrance to the building shall be brass pipe, copper tube (not less
than type M when buried directly), copper pipe, cast iron water pipe,
galvanized steel pipe, or approved plastic pipe. Water distribution system
piping within buildings shall be brass pipe, copper pipe, copper tube, or
galvanized steel pipe. Piping systems shall be designed to supply water at
sufficient pressure to operate all fixtures and equipment during maximum
demand.
(I) Valves. Each water service main,
branch main, riser, and branch to a group of fixtures shall be valved. Stop
valves shall be provided at each fixture.
(II) Backflow preventers. Backflow preventers
(vacuum breakers) shall be installed on hose bibbs, laboratory sinks, janitor
sinks, bedpan flushing attachments, and on all other fixtures to which hoses or
tubing can be attached.
(III)
Flushing valves. Flush valves installed on plumbing fixtures shall be of a
quiet operating type, equipped with silencers.
(IV) Capacity of water heating equipment.
Water heating equipment shall have sufficient capacity to supply water for
clinical, dietary and laundry use at the temperatures and amounts specified in
Table 5 of §
510.131(e) of
this subchapter.
(V) Water
temperature measurements. Water temperatures shall be measured at hot water
point of use or at the inlet to processing equipment.
(VI) Water storage tanks. Water storage tanks
shall be fabricated of corrosion-resistant metal or lined with noncorrosive
material.
(VII) Hot water
distribution. Water distribution systems shall be arranged to provide hot water
at each hot water outlet at all times.
(VIII) Emergency water supply. Emergency
potable water storage shall be provided. The storage capacity shall not be less
than 500 gallons or 12 gallons per patient bed, whichever is greater. Capacity
of hot water storage tanks may be included as part of the required emergency
water capacity when valves and piping systems are arranged to make this water
available at all times.
(ii) Fire sprinkler systems. Fire sprinkler
systems shall be provided in facilities as required by NFPA 101, §18-3.5.
All fire sprinkler systems shall be designed, installed, and maintained in
accordance with the requirements of NFPA13, and shall be certified as required
by §
510.127(d)(3)(C)
of this subchapter (relating to Preparation, Submittal, Review and Approval of
Plans).
(iii) Nonflammable medical
gas and clinical vacuum systems. Nonflammable medical gas and clinical vacuum
system installations shall be designed, installed and certified in accordance
with the requirements of NFPA 99, §4-3 for Level I systems and the
requirements of this clause.
(I) Outlets.
Nonflammable medical gas and clinical vacuum outlets shall be provided in
accordance with Table 6 of §
510.131(f) of
this subchapter.
(II) Installer
qualifications. All installations of the medical gas piping systems shall be
done only by, or under the direct supervision of a holder of a master plumber
license or a journeyman plumber license with a medical gas piping installation
endorsement issued by the Texas State Board of Plumbing Examiners.
(III) Installer tests. Prior to closing of
walls, the installer shall perform an initial pressure test, a blowdown test, a
secondary pressure test, a cross-connection test, and a purge of the piping
system as required by NFPA 99.
(IV)
Qualifications for conducting verification tests and inspections. Verification
tests and inspections by a party, other than the installer, shall be conducted
by individuals who are technically competent and experienced in the field of
piped medical gas systems.
(V)
Verification tests. Upon completion of the installer inspections and tests and
after closing of walls, verification tests of the medical gas piping systems,
the warning system, and the gas supply source shall be conducted. The
verification tests shall include a cross-connection test, valve test, flow
test, piping purge test, piping purity test, final tie-in test, operational
pressure tests, and medical gas concentration test.
(VI) Verification test requirements.
Verification tests of the medical gas piping system, the warning system, shall
be performed on all new piped medical gas systems, additions, renovations, or
repaired portions of an existing system. All systems that are breached and
components that are added, renovated, or replaced shall be inspected and
appropriately tested. The breached portions of the systems subject to
inspection and testing shall be all of the new and existing components in the
immediate zone or area located upstream of the point or area of intrusion and
downstream to the end of the system or a properly installed isolation
valve.
(VII) Warning system
verification tests. Verification tests of piped medical gas systems shall
include tests of the source alarms and monitoring safeguards, master alarm
systems, and the area alarm systems.
(VIII) Source equipment verification tests.
Source equipment verification tests shall include medical gas supply sources
(bulk and manifold) and the compressed air source systems (compressors, dryers,
filters, and regulators).
(IX)
Written certification. Upon successful completion of all verification tests,
written certification for affected piped medical gas systems and piped medical
vacuum systems including the supply sources and warning systems shall be
provided by a party technically competent and experienced in the field of
medical gas pipeline testing stating that the provisions of NFPA 99 have been
adhered to and systems integrity has been achieved. The written certification
shall be submitted directly to the facility and the installer. A copy shall be
forwarded to HHSC by the facility.
(X) Facility responsibility. Before new piped
medical gas systems, additions, renovations, or repaired portions of an
existing system are put into use, the facility shall be responsible for
ensuring that the gas delivered at the outlet is the gas shown on the outlet
label and that the proper connecting fittings are checked against their
labels.
(XI) Documentation of
medical gas and clinical vacuum outlets. Documentation of the installed,
modified, extended, or repaired medical gas piping system shall be submitted to
HHSC by the same party certifying the piped medical gas systems. The number and
type of medical gas outlets (oxygen, vacuum, medical air, nitrogen, nitrous
oxide, etc.) shall be documented and arranged tabularly by room numbers and
room types.
(iv) Steam
and hot water systems.
(I) Boilers. Boilers
shall have the capacity, based upon the net ratings as published in The I-B-R
Ratings Book for Boilers, Baseboard Radiation and Finned Tube (commercial) by
the Hydronics Institute Division of GAMA, to supply the normal requirements of
all systems and equipment. The number and arrangement of boilers shall be such
that, when one boiler breaks down or routine maintenance requires that one
boiler be temporarily taken out of service, the capacity of the remaining
boilers shall be sufficient to provide hot water service for clinical, dietary,
and patient use, steam for sterilization and dietary purposes, and heating for
emergency, recovery, treatment, and general patient rooms. However, reserve
capacity for space heating of noncritical care areas (e.g. general patient
rooms and administrative areas) is not required in geographical areas where a
design dry bulb temperature equals 25 degrees Fahrenheit or higher as based on
the 99% design value shown in the Handbook of Fundamentals, 1999 edition,
published by ASHRAE, Inc.
(II)
Boiler accessories. Boiler feed pumps, heating circulating pumps, condensate
return pumps, and fuel oil pumps shall be connected and installed to provide
normal and standby service.
(III)
Valves. Supply and return mains and risers of cooling, heating, and process
steam systems shall be valved to isolate the various sections of each system.
Each piece of equipment shall be valved at the supply and return ends except
that vacuum condensate returns need not be valved at each piece of
equipment.
(v) Drainage
systems.
(I) Above ground piping. Soil stacks,
drains, vents, waste lines, and leaders installed above ground within buildings
shall be drain-waste-vent (DWV) weight or heavier and shall be copper pipe,
copper tube, cast iron pipe, or galvanized iron pipe.
(II) Underground piping. All underground
building drains shall be cast iron soil pipe, hard temper copper tube (DWV or
heavier), acrylonitrile-butodiene-styrene (ABS) plastic pipe (DWV Schedule 40
or heavier), polyvinyl chloride (PVC) plastic pipe (DWV Schedule 40 or
heavier), or extra strength vitrified clay pipe (VCP) with compression joints
or couplings with at least 12 inches of earth cover.
(III) Drains for chemical wastes. Separate
drainage systems for chemical wastes (acids and other corrosive materials)
shall be provided. Materials acceptable for chemical waste drainage systems
shall include chemically resistant glass pipe, high silicone content cast iron
pipe, VCP, plastic pipe, or plastic lined pipe.
(IV) Drains above sensitive areas. Drainage
pipes shall not be located above sensitive clean or sterile areas such as
sterile processing, storage of food or of food preparation and serving areas,
etc. unless protected from leaks or condensation by an approved method such as
drip pans.
(V) Sewers. Building
sewers shall discharge into a community sewerage system. Where such a system is
not available, a facility providing sewage treatment must conform to applicable
local and state regulations.
(vi) Thermal insulation for piping systems
and equipment. Insulation shall be provided for the following:
(I) boilers, smoke breeching, and
stacks;
(II) steam supply and
condensate return piping;
(III) hot
water piping and all hot water heaters, generators, converters, and storage
tanks;
(IV) chilled water,
refrigerant, other process piping, equipment operating with fluid temperatures
below ambient dew point, and water supply and drainage piping on which
condensation may occur and insulation on cold surfaces shall include an
exterior vapor barrier; and
(V)
other piping, ducts, and equipment as necessary to maintain the efficiency of
the system.
(vii) Pipe
and equipment insulation rating. Flame spread shall not exceed 25 and smoke
development rating shall not exceed 150 for pipe insulation as determined by an
independent testing laboratory in accordance with National Fire Protection
Association 255, Standard Method of Test of Surface Burning Characteristics of
Building Materials, 2000 edition. Smoke development rating for pipe insulation
located in environmental air areas shall not exceed 50.
(viii) Identification. All piping including
heating, ventilating, air-conditioning (HVAC) shall be color coded or otherwise
marked for easy identification.
(ix) Asbestos insulation. Asbestos insulation
shall not be used.
(B)
Plumbing fixtures. Plumbing fixtures shall be made of nonabsorptive
acid-resistant materials and shall comply with the recommendations of the
National Standard Plumbing Code, and this paragraph.
(i) Sink and lavatory controls. All fixtures
used by medical and nursing staff and all lavatories used by patients and food
handlers shall be trimmed with valves which can be operated without the use of
hands. Blade handles used for this purpose shall not be less than four inches
in length. Single lever or wrist blade devices may be used.
(ii) Clinical sink traps. Clinical sinks
shall have an integral trap in which the upper portion of a visible trap seal
provides a water surface.
(iii)
Back flow or siphoning. All plumbing fixtures and equipment shall be designed
and installed to prevent the back-flow or back-siphonage of any material into
the water supply. The over-the-rim type water inlet shall be used wherever
possible. Vacuum-breaking devices shall be properly installed when an
over-the-rim type water inlet cannot be utilized.
(iv) Drinking fountain. Each drinking
fountain shall be designed so that the water issues at an angle from the
vertical, the end of the water orifice is above the rim of the bowl, and a
guard is located over the orifice to protect it from lip
contamination.
(v) Sterilizing
equipment. All sterilizing equipment shall be designed and installed to prevent
not only the contamination of the water supply but also the entrance of
contaminating materials into the sterilizing units.
(vi) Hose attachment. No hose shall be
affixed to any faucet if the end of the hose can become submerged in
contaminated liquid unless the faucet is equipped with an approved, properly
installed vacuum-breaker.
(vii)
Bedpan washers and sterilizers. Bedpan washers and sterilizers shall be
designed and installed so that both hot and cold water inlets shall be
protected against back-siphonage at maximum water level.
(viii) Flood level rim clearance. The water
supply spout for lavatories and sinks required in patient care areas shall be
mounted so that its discharge point is a minimum of five inches above the rim
of the fixture.
(ix) Floor drains
or floor sinks. Where floor drains or floor sinks are installed, they shall be
of a type that can be easily cleaned by removal of the cover. Removable
stainless steel mesh shall be provided in addition to grilled drain cover to
prevent entry of large particles of waste which might cause
stoppages.
(x) Under counter
piping. Under counter piping and above floor drains shall be arranged (raised)
so as not to interfere with cleaning of floor below the equipment.
(xi) Ice machines. All ice making machines
shall be of the self-dispensing type, unless otherwise specified.
(5) General electrical
requirements. This paragraph contains common electrical requirements. The
facility shall comply with the requirements of this paragraph and with any
specific electrical requirements for the particular unit or suite of the
facility in accordance with §
510.123 of this subchapter.
Electrical systems shall comply with NFPA 99 Chapter 3.
(A) Electrical installations. All new
electrical material and equipment, including conductors, controls, and
signaling devices, shall be installed in compliance with applicable sections of
the National Fire Protection Association 70, National Electrical Code, 1999
edition (NFPA 70), and NFPA 99 and as necessary to provide a complete
electrical system. Electrical systems and components shall be listed by
nationally recognized listing agencies as complying with available standards
and shall be installed in accordance with the listings and manufacturers'
instructions.
(i) All fixtures, switches,
sockets, and other pieces of apparatus shall be maintained in a safe and
working condition.
(ii) Extension
cords and cables shall not be used for permanent wiring.
(iii) All electrical heating devices shall be
equipped with a pilot light to indicate when the device is in service, unless
equipped with a temperature limiting device integral with the heater.
(iv) All equipment, fixtures, and appliances
shall be properly grounded in accordance with NFPA 70.
(v) Under-counter receptacles and conduits
shall be arranged (raised) to not interfere with cleaning of floor below the
equipment.
(B)
Installation testing and certification.
(i)
Installation testing. The electrical installations, including alarm, nurses
calling system and communication systems, shall be tested to demonstrate that
equipment installation and operation is appropriate and functional.
(I) Grounding continuity shall be tested as
described in NFPA 99 for new or existing work.
(II) A written record of performance tests on
special electrical systems and equipment shall show compliance with applicable
codes and standards.
(ii)
Installation certification. Certifications in affidavit form signed by a
registered electrical engineer attesting that the electrical service,
electrical equipment, and electrical appliances have been installed in
compliance with the approved plans, applicable standards, or both shall be
submitted to HHSC when requested.
(C) Electrical safeguards. Shielded isolation
transformers, voltage regulators, filters, surge suppressors, and other
safeguards shall be provided as required where power line disturbances are
likely to affect fire alarm components, data processing, equipment used for
treatment, and automated laboratory diagnostic equipment.
(D) Services and switchboards. Main
switchboards shall be located in separate rooms, separated from adjacent areas
with one-hour fire rated enclosures containing only electrical switchgear and
distribution panels and shall be accessible to authorized persons only. These
rooms shall be ventilated to provide an environment free of corrosive or
explosive fumes and gases, or any flammable and combustible materials.
Switchboards shall be located convenient for use and readily accessible for
maintenance as required by NFPA 70, Article 384. Overload protective devices
shall operate properly in ambient temperatures.
(E) Panelboards. Panelboards serving normal
lighting and appliance circuits shall be located on the same floor as the
circuits they serve. Panelboards serving critical branch emergency circuits may
serve three floors, the floor where the panelboard is located, the floor above
and the floor below. Panelboards serving life safety branch circuits may serve
three floors, the floor where the panelboard is located, and the floors above
and below.
(i) Circuiting shall minimize the
number of receptacles on a single branch circuit, in order to limit the effects
of a branch circuit outage, caused by one faulted device. Any life-support
equipment on that circuit would be lost.
(ii) Loading of branch circuits is limited by
NFPA 70, Articles 210, 220, and 384.
(F) Wiring. All conductors for controls,
equipment, lighting and power operating at 100 volts or higher shall be
installed in accordance with the requirements of NFPA 70, Article 517. All
surface mounted wiring operating at less than 100 volts shall be protected from
mechanical injury with metal raceways to a height of seven feet above the
floor. Conduits and cables shall be supported in accordance with NFPA 70,
Article 300.
(G) Lighting.
(i) Lighting intensity for staff and patient
needs shall comply with Chapter 17, Institution and Public Building Lighting,
Health Care Facilities, of the Illuminating Engineering Society of North
America (IES) Lighting Handbook, published by the IES.
(I) Consideration should be given to
controlling intensity and wavelength to prevent harm to the patient's eyes
(i.e., cataracts due to ultraviolet light).
(II) Approaches to buildings and parking
lots, and all spaces within buildings shall have fixtures that can be
illuminated as necessary. All rooms including storerooms, electrical and
mechanical equipment rooms, and all attics shall have sufficient artificial
lighting so that all parts of these spaces shall be clearly visible.
(III) Consideration should be given to the
special needs of the elderly. Excessive contrast in lighting levels that makes
effective sight adaptation difficult shall be minimized.
(ii) Means of egress and exit sign lighting
intensity shall comply with NFPA 101 §§7-8, 7-9 and 7-10.
(iii) Electric lamps which may be subject to
breakage or which are installed in fixtures in confined locations when near
woodwork, paper, clothing, or other combustible materials, shall be protected
by wire guards, or plastic shields.
(iv) Ceiling mounted examination light
fixtures shall be suspended from rigid support structures mounted above the
ceiling.
(H) Receptacles.
Only listed "hospital" grade single-grounding or duplex-grounding receptacles
shall be used in all patient care areas. This does not apply to special purpose
receptacles.
(i) Installations of multiple
ganged receptacles shall be permitted in patient care areas.
(ii) Electrical outlets powered from the
critical branch shall be provided in all patient care, procedure and treatment
locations in accordance with NFPA 99 §3-4.2.2.2(c). At least one
receptacle at each patient treatment or procedure location shall be powered
from the normal power panel.
(iii)
Replacement of malfunctioning receptacles and installation of new receptacles
powered from the critical branch in existing facilities shall be accomplished
with receptacles of the same distinct color as the existing
receptacles.
(iv) In locations
where mobile X-ray or other equipment requiring special electrical
configuration is used, the additional receptacles shall be distinctively marked
for the special use.
(v) Each
receptacle shall be grounded to the reference grounding point by means of a
green insulated copper equipment grounding conductor.
(I) Equipment.
(i) Equipment required for safe operation of
the facility shall be powered from the equipment system in accordance with the
requirements contained in NFPA 99 §3-4.2.2.3.
(ii) Boiler accessories including feed pumps,
heat-circulating pumps, condensate return pumps, fuel oil pumps, and waste heat
boilers shall be connected and installed to provide both normal and standby
service.
(J) Ground fault
circuit interrupters (GFCI). GFCIs shall comply with NFPA 70. When GFCIs are
used in critical areas, provisions shall be made to ensure that other essential
equipment is not affected by activation of one interrupter.
(K) Nurses calling systems. Three different
types of nurses calling systems are required to be installed in a facility: a
nurses regular calling system; a nurses emergency calling system; and a staff
emergency assistance calling system. The facility shall comply with the
requirements of this paragraph and any specific requirements for nurses calling
systems for the particular unit of the facility in accordance with §
510.123 of this subchapter.
(i) A nurses regular calling system is
intended for routine communication between each patient and the nursing staff.
Activation of the system at a patient's regular calling station will sound a
repeating (every 20 seconds) audible signal at the nurse station, indicate type
and location of call on the system monitor, and activate a distinct visible
signal in the corridor at the patient suites door. In multi-corridor nursing
units, additional visible signals shall be installed at corridor intersections.
The audible signal shall be canceled and two-way voice communication between
the patient room and the nursing staff shall be established at the unit's
nursing station when the call is answered by the nursing staff. The visible
signals in the corridor shall be canceled upon termination of the call. An
alarm shall activate at the nurses station when the call cable is
unplugged.
(ii) A nurses emergency
calling system shall be installed in all toilets used by all patients to summon
nursing staff in an emergency. Activation of the system shall sound a repeating
(every 5 seconds) audible signal at the nurse station, indicate type and
location of call on the system monitor, and activate a distinct visible signal
in the corridor at the patient suites door. In multi-corridor nursing units,
additional visible signals shall be installed at corridor intersections. The
visible and audible signals shall be cancelable only at the patient calling
station. Activation of the system shall also activate distinct visible signals
in the clean workroom, in the soiled workroom, medication, charting, clean
linen storage, nourishment, nurse lounge and equipment storage. When
conveniently located and accessible from both the bathing and toilet fixtures,
one emergency call station may serve one bathroom. A nurses emergency call
system shall be accessible to a collapsed patient lying on the floor.
(iii) A staff emergency assistance calling
system (code blue) is intended to be used by staff to summon additional help in
an emergency. In open suites, an emergency assistant call system device shall
be located at the head of each bed and in each individual room. The emergency
assistance calling device can be shared between two beds if conveniently
located. Activation of the system will sound an audible signal at the nursing
unit's nurses station, indicate type and location of call on the system monitor
and activate a distinct visible signal in the corridor at the patient suites
door. In multi-corridor nursing units, additional visible signals shall be
installed at corridor intersections. Activation of the system shall also
activate visible and audible signals in the clean workroom, in the soiled
workroom, medication, charting, clean linen storage, nourishment, equipment
storage, and examination or treatment rooms with back up to a continuously
staffed area (other than the nurse station or an administrative center) from
which assistance can be summoned. The system shall have voice communication
capabilities so that the type of emergency or help required may be
specified.
(L) Emergency
electric service. A Type I essential electrical system shall be provided in
each facility in accordance with requirements of NFPA 99, NFPA 101, and
National Fire Protection Association 110, Standard for Emergency and Standby
Power Systems, 1999 edition. Exception: Crisis stabilization units have the
option of providing a Type II essential electrical system in accordance with
the requirements of NFPA 99 and NFPA 101.
(i)
The number of transfer switches to be used shall be based on reliability,
design and load considerations.
(ii) All wiring installation of the emergency
system of the essential electrical system shall be mechanically protected in
nonflexible metal raceways in compliance with NFPA 70
§517-30(c)(3).
(iii) The
stored fuel capacity for emergency generators shall be sufficient to permit
continuous operation for at least 24 hours at full load.
(M) Fire alarm system. A fire alarm system
which complies with NFPA 101 §18-3.4, and with NFPA 72 Chapter 3
requirements, shall be provided in each facility. The required fire alarm
system components are as follows.
(i) A fire
alarm control panel (FACP) shall be installed at a continuously attended (24
hour) location. A remote fire alarm annunciator listed for fire alarm service
and installed at a continuously attended location and is capable of indicating
both visual and audible alarm, trouble and supervisory signals in accordance
with the requirements of NFPA 72 may be substituted for the FACP.
(ii) Manual fire alarm pull stations shall be
installed in accordance with NFPA 101 §18-3.4.
(iii) Smoke detectors for door release
service shall be installed on the ceiling at each door opening in the smoke
partition in accordance with NFPA 72 §2-10.6, where the doors are held
open with electromagnetic devices conforming with NFPA 101
§18-2.2.6.
(iv) Ceiling
mounted smoke detectors shall be installed in room containing the FACP when
this room is not attended continuously by staff as required by NFPA 72
§1-5.6.
(v) Smoke detectors
shall be installed in supply air ducts in accordance with NFPA 72
§2-10.4.2 and §2-10.5, and with NFPA 90A §4-4.2.
(vi) Smoke detectors shall be installed in
return air ducts in accordance with requirements of NFPA 72 §2-10.4.2.2
and §2-10.5, and NFPA 90A §4-4.2(2).
(vii) Fire sprinkler system water flow
switches shall be installed in accordance with requirements of NFPA 101
§9-6.2; NFPA 13 §3-10; and NFPA 72 §3-8.5.
(viii) Sprinkler system valve supervisory
switches shall be installed in accordance with the requirements of NFPA 72
§3-8.6.
(ix) Audible alarm
indicating devices shall be installed in accordance with the requirements of
NFPA 101, §18-3.4., and NFPA 72 §6-3.
(x) Visual fire alarm indicating devices
which comply with the requirements of §
510.122(d)(1)(F)
of this subchapter (relating to New Construction Requirements) and NFPA 72
§6-4 shall be provided.
(xi)
Devices for transmitting alarm for alerting the local fire brigade or municipal
fire department of fire or other emergency shall be provided. The devices shall
be listed for the fire alarm service by a nationally recognized laboratory and
be installed in accordance with such listing and the requirements of NFPA
72.
(xii) A smoke detection system
for spaces open to corridor(s) shall be provided when required by NFPA 101
§18-3.6.1.
(xiii) A fire alarm
signal notification which complies with NFPA 101 §9-6.3, shall be provided
to alert occupants of fire or other emergency.
(xiv) Wiring for fire alarm detection
circuits and fire alarm notification circuits shall comply with requirements of
NFPA 70, Article 760.
(xv) A smoke
detection system for elevator recall shall be located in elevator lobbies,
elevator machine rooms and at the top of elevator hoist ways as required by
NFPA 72 §3-9.3.7.
(I) The elevator recall
smoke detection system in new construction shall comply with requirements of
American Society of Mechanical Engineers/American National Standards Institute
(ASME/ANSI) A17.1, Safety Code for Elevators and Escalators, 1996
edition.
(II) The elevator recall
smoke detection system in existing facilities shall comply with requirements of
ASME/ANSI A17.3, Safety Code for Existing Elevators and Escalators, 1995
edition.
(xvi) A smoke
detection system for initiating smoke removal from atriums shall be located
above the highest floor level of the atrium and at return intakes from the
atrium in accordance with National Fire Protection Association 92B, Guide for
Smoke Management Systems in Malls, Atria, and Large Areas, 1995
edition.
(xvii) Smoke detectors for
shut-down of air handling units shall be provided. The detectors shall be
installed in accordance with NFPA 90A §4-4.2.
(xviii) New or modified fire alarm systems
shall be certified as meeting applicable NFPA standards such as NFPA 101, 72A,
72E, etc. on form FML-009 040392 of the Office of the State Fire Marshal. A
copy of the fire alarm system certification shall be submitted to
HHSC.
(N)
Telecommunications and information systems. Telecommunications and information
systems central equipment shall be installed in a separate location designed
for the intended purpose. Special air conditioning and voltage regulation shall
be provided as recommended by the manufacturer.
(O) Lightning protection systems. When
installed, lightning protection systems shall comply with National Fire
Protection Association 780, Standard for the Installation of Lightning
Protection Systems, 1997 edition.
Notes
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No prior version found.