(a) Resident bedrooms. Each resident bedroom must meet the following requirements:
  (1) The maximum room capacity must be four residents.
  (2) No more than 25% of the total licensed beds may be in bedrooms with more than two beds each.
  (3) Minimum bedroom area, excluding toilet rooms, closets, lockers, wardrobes, alcoves, or vestibules, must be 100 square feet in single occupancy rooms and 80 square feet per bed in multi-bed rooms.
  (4) The minimum allowable room dimension is ten feet. The room must be designed to provide at least 36 inches between beds and 24 inches between any bed and the adjacent wall.
  (5) Each room must have at least one operable outside window arranged and located so that it can be easily opened from the inside without the use of tools or keys. The maximum allowable sill height must not exceed 36 inches above the floor. All operable windows must have insect screens. The minimum area of a window in each bedroom must equal at least 16 square feet or 8.0% of the room area, whichever is larger. Operable window sections may be restricted to not more than six nor less than four inches for security or safety reasons.
  (6) Each room must have general lighting, wall-mounted bed reading lights, and night lighting. The night light must be switched just inside the entrance to each resident room with a silent type switch unless otherwise approved by HHSC. The light providing general illumination must be switchable at the door of the resident room for use of staff and residents. A durable non-glare reading light with an opaque front panel securely anchored to the wall, integrally wired, must be provided for each resident bed. The switch must be within reach of a resident in the bed.
  (7) Two duplex or a fourplex grounding type receptacles must be provided beside the head of each bed. Other walls must have duplex receptacles to accommodate items such as TV, radio, razors, hairdryers, clocks, and as required by NFPA 70.
  (8) Each resident must have access to a toilet room without entering the general corridor area. One toilet room must serve no more than two resident rooms. The toilet room must contain a water closet and a lavatory. The lavatory may be omitted from a toilet room which serves two bedrooms if each resident room contains a lavatory.
  (9) Each resident must have a bed with a comfortable mattress, a bedside stand with at least two enclosed storage spaces, a dresser, and closet or wardrobe space providing privacy for clothing and personal belongings. Clothes storage space must provide at least 22 inches of lineal hanging space per bed and have closable doors. Chairs and space must be provided for use by residents and visitors.
  (10) Each room must open onto an exit corridor and must be arranged for convenient resident access to dining, living, and bathing areas.
  (11) Visual privacy such as cubicle curtains must be available for each resident in multi-bed rooms. Design for privacy must not restrict resident access to entry, lavatory, or toilet, nor may it restrict bed evacuation or obstruct sprinkler flow coverage.
  (12) At least one noncombustible wastebasket must be provided in each bedroom.
  (13) See the requirements in §19.341(d)(4) of this subchapter (relating to Electrical Requirements) for nurse call systems.
  (14) Bedrooms must be identified with a raised or recessed unique number placed on or near the door. Refer to §19.333(g) of this subchapter (relating to General Considerations).
  (15) Locks on bedroom doors are permitted when they meet definite resident needs.
    (A) Situations in which locking may be necessary include the following:
      (i) married couples whose rights of privacy could be infringed upon unless bedroom door locks are permitted; and
      (ii) residents for whom the attending physician wants bedroom door locks to enhance the residents’ sense of security.
    (B) In situations such as those listed in subparagraph (A) of this paragraph, the following guidelines must be met:
      (i) bedroom door locks must be of the type which the occupant can unlock at will from inside the room;
      (ii) all bedroom door locks must be of the type which can be unlocked from the corridor side;
      (iii) attendants must carry keys which will permit ready access to the locked bedrooms when entrance becomes necessary; and
      (iv) locking of bedroom doors by residents for privacy or security will not be permitted except when specifically included in the attending physician's written orders or authorized by the nursing facility administrator.
  (16) Vacant bedrooms must not be used for hazardous activities or hazardous storage, unless specifically approved by HHSC in writing.
(b) Nursing service areas. The service areas described in this subsection must be located in or readily available to each nursing unit. The size and disposition of each service area will depend upon the number and types of beds to be served. Each service area may be arranged and located to serve more than one nursing unit, but at least one service area must be provided on each nursing floor. The maximum allowable distance from a resident room door to a nurses' station is 150 feet. The following requirements are applicable to services areas:
  (1) Nurses' stations must be provided with space for nurses' charting, doctors' charting, and storage for administrative supplies. Nurses' stations must be located to provide a direct view of resident corridors. A direct view of resident corridors is acceptable if a person can see down the corridors from a point within 24 inches of the outside of the nurses' station counter or wall. When a nurses’ station does not provide a direct view of resident corridors, an auxiliary station complying with the following guidelines must be provided.
    (A) The auxiliary station must be staffed by nursing personnel during all shifts.
      (i) More than one auxiliary station may be assigned to a designated nurses’ station, regardless of the distance between stations.
      (ii) The nurse call system for resident corridors monitored by the auxiliary station must report to the auxiliary station.
      (iii) Each auxiliary station must meet the emergency electrical requirements for a nurses’ station, including electrical receptacles and emergency lighting.
      (iv) If a required auxiliary station does not already exist and the facility must establish a new auxiliary station, all applicable standards, particularly those pertaining to the physical plant and NFPA 101, must be observed.
    (B) In addition to the required normal and emergency illumination, the facility must keep on hand and readily available to night staff no less than one working flashlight at each nurses’ station.
  (2) Lounge and toilet room must be provided for nursing staff.
  (3) Lockers or security compartments must be provided for the safekeeping of personal effects of staff. These must be located convenient to the duty station of personnel or in a central location.
  (4) Clean utility room must contain a work counter, sink with high-neck faucet with lever controls, and storage facilities and must be part of a system for storage and distribution of clean and sterile supply materials.
  (5) Soiled utility room must contain a water closet or equivalent flushing rim fixture, a sink large enough to submerge a bedpan with spray hose and high-neck faucet with lever controls, work counter, waste receptacle, and linen receptacle. These utility rooms must be part of a system for collection and cleaning or disposal of soiled utensils or materials. A separate hand-wash sink must be provided if the bedpan disinfecting sink cannot normally be used for hand-washing.
  (6) Provision must be made for convenient and prompt 24-hour distribution of medication to residents. The medication preparation room must be under the nursing staff's visual control and contain a work counter, refrigerator, sink with hot and cold water, and locked storage for biologicals and drugs and must have a minimum area of 50 square feet. The minimum dimension allowed is five feet six inches. An appropriate air supply must be provided to maintain adequate temperature and ventilation for safe storage of medications. For purposes of storage of unrefrigerated medications, the room temperature must be maintained between 59 degrees and 86 degrees Fahrenheit.
  (7) Provision must be made for separate closets or room for clean linens. Corridors must not be used for folding or cart storage. Storage rooms must be located and distributed in the building for efficient access to bedrooms.
  (8) Soiled linen rooms must be provided as required in subsection (l) of this section.
Cont'd...