(a) This section applies to a small house or household facility that is designed to provide a non-institutional environment to promote resident-centered care. New construction of a small house or household facility, including a conversion of an existing facility, an addition to an existing facility, or rehabilitation of an existing facility, must meet the requirements of this section.
(b) A small house or household facility must comply with this chapter, except it is not required to comply with a requirement in Division 9 of this subchapter (relating to Facilities Licensed On or After April 2, 2018) if HHSC waives the requirement in accordance with subsection (c) of this section or if the requirement is modified by subsection (g) of this section.
(c) HHSC may waive a requirement in Division 9 of this subchapter if HHSC determines a waiver of the requirement would facilitate the implementation of resident-centered care. To request a waiver of a requirement, a facility must submit plans to HHSC according to §554.344 of this subchapter (relating to Plan Review). The plans must include a statement from an architect identifying which requirements the facility is requesting to be waived and explaining how the waiver would contribute to the goals of resident-centered care.
(d) A small house or household facility must be designed and equipped to provide a homelike environment that promotes resident-centered care.
(e) A small house or a household within a facility must:
(1) have no more than 16 bedrooms as described in subsection (g)(2) of this section;
(2) have living, dining, social, and staffing areas exclusively within and for the house or household; and
(3) have a kitchen that meets the requirements in §554.354(g)(1) of this subchapter (relating to Architectural Space Planning and Utilization for New Facilities) or a food service area that meets the requirements of an auxiliary serving kitchen in §554.354(g)(3) of this subchapter, exclusively within and for the house or household.
(f) A small house or household facility must be:
(1) a single small house model, which is a single licensed building having no more than 16 residents that meets the licensing requirements for architectural spaces provided within the same licensed building;
(2) a multiple small house model, which is a single licensed group of two or more small houses located in close proximity to each other on a single contiguous property that meets the licensing requirements for architectural spaces in each house and that may include a stand-alone central building that provides social-diversional space, a treatment area, or an administrative area; or
(3) a household model, which is a single licensed building that contains one or more households having no more than 16 residents each; that may include a central area that provides social-diversional space, a treatment area, or an administrative area; and that must be arranged to avoid travel through the household by persons who are not residing in, visiting, or providing services for the household.
(g) A small house or household facility must comply with the requirements in this section and is not required to request a waiver for an exception described in this subsection.
(1) The outdoor activity, recreational, and sitting spaces required in §554.352(f) of this subchapter (relating to Location and Site for New Facilities) must include a porch area under a roof with suitable furniture for sitting and space for wheelchairs.
(2) The resident bedroom requirements in §554.354(a) of this subchapter must be met, except:
(3) The nursing service area requirements in §554.354(b) of this subchapter must be met, except:
(4) Resident bathing and toilet facility requirements in §554.354(c) of this subchapter must be met, except the door between a bathroom and a resident bedroom:
(5) The living area requirements in §554.354(e) of this subchapter and dining room requirements in §554.354(f) of this subchapter must be met, except the distance between the floor and the window sill of a window in the living or dining room must not exceed 36 inches, to allow a view to the outside from a seated position.
(6) The dietary facility requirements in §554.354(g) of this subchapter must be met, except a kitchen serving 16 or fewer non-employees per meal:
(7) The exit requirements in §554.355(3) of this subchapter (relating to Exit Provisions for New Facilities) must be met except for fixed furniture and wheeled equipment as permitted by NFPA 101.
Source Note: The provisions of this §554.345 adopted to be effective April 1, 2014, 39 TexReg 2313; amended to be effective March 22, 2018, 43 TexReg 1646; transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871; amended to be effective January 2, 2022, 46 TexReg 9037