(a) Wastewater and water supply.
  (1) Wastewater. An existing large Type A assisted living facility must ensure wastewater and sewage are discharged into a sewerage system or an onsite sewerage facility approved by the Water Quality Division of the Texas Commission on Environmental Quality (TCEQ), or to a system regulated by an entity responsible for water quality in that jurisdiction as approved by the Water Quality Division of TCEQ.
  (2) Water supply. An existing large Type A assisted living facility must ensure the water supply is of safe, sanitary quality, suitable for use, adequate in quantity and pressure, and obtained from a public or private water supply system or a private well.
(b) Resident-use plumbing fixtures.
  (1) Water closets and lavatories.
    (A) An existing large Type A assisted living facility must provide at least one water closet and one lavatory for every six residents and for each additional resident fewer than six. Multiple toilets in a single space must comply with paragraph (2)(B) of this subsection.
    (B) An existing large Type A assisted living facility must ensure a lavatory is readily accessible to each water closet.
    (C) An existing large Type A assisted living facility must provide at least one water closet, lavatory, and bathing unit, that are accessible to residents, on each floor containing resident sleeping rooms.
  (2) Bathing units.
    (A) An existing large Type A assisted living facility must provide one tub or shower for every 10 residents, and for any fraction thereof.
    (B) Where multiple water closets or bathing units are provided in a single space, an existing large Type A assisted living facility must provide partitions or curtains to separate plumbing fixtures for resident privacy.
    (C) An existing large Type A assisted living facility must ensure tubs and showers have non-slip bottoms or floor surfaces, either built-in or applied to the surfaces.
  (3) Hot water supply. An existing large Type A assisted living facility must provide a supply of hot water for resident-use. Hot water for lavatories and bathing units accessible to residents must be maintained between 100 and 120 degrees Fahrenheit.
  (4) Supplies. An existing large Type A assisted living facility must supply towels, soap, and toilet tissue for individual resident use.
(c) Public and staff-use plumbing fixtures. In addition to the staff toilets required for the dietary staff according to §553.132(j) of this division (relating to Space Planning and Utilization Requirements for an Existing Large Type A Assisted Living Facility), an existing large Type A assisted living facility must provide toilets, including water closets and lavatories, for use by the public and by facility staff as follows:
  (1) if licensed for 60 or fewer residents, a toilet for use by the public and by facility staff; or
  (2) if licensed for more than 60 residents, a toilet for use by the public and a separate toilet for use by facility staff.
(d) Gas. An existing large Type A assisted living facility must ensure equipment using natural gas or propane and related gas piping meets the requirements of 9.1.1, Gas, in NFPA 101, Chapter 9, Building Service and Fire Protection Equipment.
(e) Heating, ventilation, and air-conditioning (HVAC) and exhaust systems.
  (1) General requirements. An existing large Type A assisted living facility must ensure HVAC equipment meets the requirements of 33.3.6.2, Heating, Ventilating, and Air-Conditioning, in NFPA 101, Chapter 33, Existing Residential Board and Care Occupancies.
  (2) Heating and cooling. An existing large Type A assisted living facility must provide heating and cooling for resident comfort.
    (A) An existing large Type A assisted living facility must ensure air conditioning systems can maintain and do maintain the comfort range of 68 to 82 degrees Fahrenheit in resident-use areas.
    (B) An existing large Type A assisted living facility constructed or licensed after August 1, 2004, must have a central air-conditioning system, or a substantially similar air conditioning system, that can maintain and does maintain a temperature range required under subparagraph (A) of this paragraph within areas used by residents.
    (C) An existing large Type A assisted living facility may not use an open flame heating device in the facility, except as permitted by subparagraphs (D) - (E) of this section.
    (D) An existing large Type A assisted living facility must ensure a fuel-fired heating device, other than a working fireplace, meets the following requirements.
      (i) A fuel-fired heating device must be connected to a chimney or vent.
      (ii) A fuel-fired heating device must take air for combustion directly from outside.
      (iii) A fuel-fired heating device must be designed and installed to provide for complete separation of the combustion system from the atmosphere of the occupied area.
      (iv) A fuel-fired heating device must have safety features to immediately stop the flow of fuel and shut down the equipment in case of either excessive temperatures or ignition failure.
      (v) A fuel-fired heating device not meeting the requirements of clauses (i) - (iv) of this subparagraph may be continued in service, subject to approval by HHSC.
    (E) An existing large Type A assisted living facility must ensure a working fireplace meets the following requirements.
      (i) A building containing a working fireplace must be protected by an approved, supervised automatic sprinkler system with listed quick response or listed residential sprinklers.
      (ii) A new working fireplace must be installed, maintained and used according to NFPA 54 and NFPA 211.
      (iii) A working fireplace may not be located in a resident sleeping room.
      (iv) The room where a working fireplace is located must be provided with electrically supervised carbon monoxide detection connected to the fire alarm system according to NFPA 720.
      (v) A direct-vent gas fireplace, as defined in NFPA 54, must meet the following requirements.
        (I) A direct-vent gas fireplace must include a sealed glass front with a wire mesh panel or screen.
        (II) The controls for a direct-vent gas fireplace must be locked or located in a restricted location.
      (vi) A solid-fuel burning fireplace must be equipped with:
        (I) a raised hearth at least four inches above the surrounding finished floor; and,
        (II) a fireplace enclosure that is guaranteed against breakage up to a temperature of 650 degrees Fahrenheit and constructed of heat-tempered glass or other approved material;
      (vii) An existing working fireplace not meeting the requirements of clauses (i) - (vi) of this subparagraph may be continued in service, subject to approval by HHSC.
  (3) Ventilation.
    (A) An existing large Type A assisted living facility must be ventilated using windows, mechanical ventilation, or a combination of both.
    (B) An existing large Type A assisted living facility with interior areas designated for smoking within the building must provide mechanical ventilation directed to the exterior to remove smoke at the rate of 10 air changes per hour.
  (4) Exhaust. An existing large Type A assisted living facility must ensure bathrooms, toilet rooms, janitorial facilities, and other odor-producing rooms or areas for soiled or unsanitary operations are exhausted with operable windows or powered exhaust vented to the exterior for odor control.

Source Note: The provisions of this §553.137 adopted to be effective August 31, 2021, 46 TexReg 5189