(a) Any conditions considered to be a fire, safety, or health hazard will be grounds for disapproval of a site by HHSC. A new facility may not be built in an area designated as a floodplain of 100 years or less.
(b) Site grades must provide for positive surface water drainage so that there will be no ponding or standing water on the designated site. This does not apply to local government requirements for engineered controlled run-off holding ponds.
(c) A new building or addition must be set back at least 10 feet from the property lines except as otherwise approved by HHSC.
(d) Exit doors from the building must not open directly onto a drive for vehicular traffic, but must be set back at least six feet from the edge of the drive, measured from the end of the building wall in the case of a recessed door, to prevent accidents due to lack of visual warning.
(e) Walks must be provided as required from all exits and must be of non-slip surfaces free of hazards. Walks must be at least 48 inches wide except as otherwise approved. Ramps must be used in lieu of steps where possible for the individuals with a disability and to facilitate bed or wheelchair removal in an emergency.
(f) Outdoor activity, recreational, and sitting spaces must be provided and appropriately designed, landscaped, and equipped. Some shaded or covered outside areas are needed. These areas must be designed to accommodate residents in wheelchairs.
(g) Each facility must have parking space to satisfy the needs of residents, employees, staff, and visitors. In the absence of a formal parking study, each facility must provide for a ratio of at least one parking space for every four beds in the facility. This ratio may be reduced slightly in areas convenient to public parking facilities. Space must be provided for emergency and delivery vehicles. A parking space must not block or inhibit egress from the outside exit doors. Parking spaces and drives must be at least ten feet away from windows in bedrooms, dining areas, and living areas.
(h) Barriers must be provided for resident safety from traffic or other site hazards by the use of appropriate methods such as fences, hedges, retaining walls, railings, or other landscaping. These barriers must not inhibit emergency egress to a safe distance away from the building.
(i) Open or enclosed courts with resident rooms or living areas opening upon them must not be less than 20 feet in the smallest dimension unless otherwise approved by HHSC. Nonparallel wings forming an acute angle may have a maximum of two windows in each wing that are separated by a distance less than 20 feet, but not less than ten feet, when measured between the nearest edges of the opposing openings.
(j) Auxiliary buildings located within 20 feet of the main building must meet the applicable requirements in NFPA 101 for separation and construction.
(k) Other buildings on the site must meet the appropriate occupancy section or separation requirements in NFPA 101.
(l) Fire service and access must be as follows:
  (1) The facility must be served by a paid or volunteer fire department. The fire department must provide written assurance to HHSC that the fire department can respond to an emergency at the facility within an appropriately prompt time for the travel conditions involved.
  (2) The facility must be served by an adequate water supply that is satisfactory and accessible for fire department use as determined by the fire department serving the facility and by HHSC.
  (3) There must be at least one readily accessible fire hydrant located within 300 feet of the building. The hydrant must be on a minimum six inch service line. The hydrant, its location, and service line, or equivalent must be as approved by the local fire department and HHSC.
  (4) The building must have suitable all-weather fire lanes as required by local fire authorities or, if no local fire authority has jurisdiction, by HHSC. As a minimum, the fire department must be able to access two sides of the building.
(m) Enclosed exterior spaces, such as fenced areas, that are in a means of egress to a public way must meet the requirements of §19.2208(a)(6) of this chapter (relating to Standards for Certified Alzheimer's Facilities).

Source Note: The provisions of this §554.352 adopted 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