Item 9B - Texas Administrative Code<<Prev Rule Texas Administrative Code Next Rule>>
TITLE 25 HEALTH SERVICES
PART 1 DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 133 HOSPITAL LICENSING
SUBCHAPTER I PHYSICAL PLANT AND CONSTRUCTION REQUIREMENTS
RULE § 133.163 Spatial Requirements for New Construction
(A) Exhaust hoods shall have an indicator light indicating that the exhaust fan is in operation.
(B) The electrical circuit(s) to equipment in wet areas shall be provided with five milliampere
GFCI.
(f) Emergency suite. This subsection applies to all hospitals (general or special) included under
the hospital license, including those licensed as a multiple -location hospital.
(1) Architectural requirements.
(A) Emergency treatment area.
(i) Emergency treatment room. As a minimum requirement, all hospitals shall provide at least
one emergency treatment room and facilities to handle emergencies. The room(s) and facilities
shall meet the following requirements.
(I) The emergency treatment room for a single patient shall have a minimum clear area of
120 square feet clear floor area exclusive of fixed and movable cabinets and shelves. The
minimum clear room dimension exclusive of fixed cabinets and built-in shelves shall be 10 feet.
The emergency treatment room shall contain cabinets, medication storage, work counter,
examination light, and a hand washing fixture with hands-free operable controls.
(II) When a multiple -bed emergency treatment room is provided, the clearance between the
side of a bed/gurney and a wall/partition shall be a minimum of four feet. The clearance between
the sides of beds/gurneys shall be a minimum of six feet. The minimum distance at the foot of
the bed/gurney shall not be less than seven feet for single load area/room or ten feet for double
load area/room. Four feet of the passage space at the foot of the bed may be shared between two
beds/gurneys. The multiple -bed emergency treatment room shall contain cabinets, medication
storage, work counter, examination light, and a hand washing fixture with hands-free operable
controls. The fixed and movable cabinets and shelves shall not encroach upon the bed/gurney
clear floor space/area. The requirements of this subclause are illustrated in Table 8, Diagram C
of §133.169(h) of this title.
(III) One hand washing fixture with hands-free operable controls shall be provided for each
bed/gurney location. One hand washing fixture may serve two beds/gurneys if distributed
appropriately between the two.
(IV) Storage space shall be provided within the room or suite and be under staff control for
general medical -surgical emergency supplies and medications. Adequate space shall be provided
for emergency equipment such as emergency treatment trays, ventilator, defibrillator, splints,
cardiac monitor, etc.
(V) Locked storage space shall be provided for drugs and an area for preparation of
medication with a work counter, refrigerator, and hand washing fixture with hands-free operable
controls.
(VI) An alcove shall be provided for stretcher and wheelchair storage. The storage shall be
located out of the line of traffic.
(VII) Patient toilet room(s) shall be provided and shall be convenient to treatment rooms,
examination rooms, and holding rooms, and a hand washing fixture with hands-free operable
controls.
(VIII) In a special hospital, comprehensive medical rehabilitation hospital, or pediatric and
adolescent hospital, the emergency treatment room and facilities may be located anywhere in the
hospital.
(ii) Additional requirements for a general hospital. Except for comprehensive medical
rehabilitation hospitals and pediatric and adolescent hospitals that generally provide care that is
not administered for or in expectation of compensation, a general hospital shall also meet the
following requirements.
(I) Emergency entry signage. An emergency sign shall be provided at the entry from the
public road(s) or street(s) serving the site. The emergency sign at the entry to the site shall be
illuminated and connected to the emergency essential electrical system. Additional sign(s) on-
site may be required to direct patients to the emergency treatment area entrance when the
emergency treatment area is not visible from the site entry. The letters on the entry sign shall be
red with a contrasting background, all capitalized, at least eight inches in height, and an arrow
indicating direction.
(II) Entrances. Separate ambulance and pedestrian entrances at grade level shall be well -
illuminated, identified by signs, and protected from inclement weather. The ambulance entry
shall have a drive under canopy for protection from inclement weather. The emergency access to
permit discharge of patients from automobile and ambulances shall be paved. Parking shall be
provided near and convenient to the pedestrian entrance.
(III) Control station. A registration, reception, discharge or control station shall be located
to permit staff observation and control of access to treatment room(s), pedestrian and ambulance
entrances, and public waiting area(s). When a dedicated triage space is provided, it shall include
a counter with a hand washing fixture with hands-free operable controls.
(IV) Public waiting room. A public waiting room shall be provided.
(V) Public facilities. Toilet facilities, public telephone(s), and drinking fountain(s) shall be
provided for the exclusive use of the waiting room.
(VI) Diagnostic radiographic (X-ray) room. Imaging facilities for diagnostic services shall
be readily available to the emergency suite. If a separate radiographic (X-ray) room is installed
within the emergency suite, it shall comply with the requirements in subsection (1)(1)(A) of this
section. When the diagnostic X-ray room is exclusively used for the emergency treatment area,
the dressing rooms may be omitted.
(VII) Laboratory unit. Laboratory services shall be made available to the emergency suite.
If a separate laboratory workroom is installed within the emergency suite, it shall comply with
the requirements in subsection (n)(1)(C)(i) of this section. All laboratory services provided on
site or by contractual arrangement shall comply with § 133.41(h) of this title (relating to Hospital
Functions and Services).
(VIII) Medical staff work area and charting area(s). A medical staff work area and charting
area(s) shall be provided. The area may be combined with the reception and control area.
(IX) Clean storage room. A clean storage room shall be provided for clean supplies, linens
and medications as needed. A hand washing fixture shall be provided with hands-free operable
controls.
(X) Soiled workroom. The workroom shall contain a work counter, a clinical sink or
equivalent flushing type fixture, hand washing fixture with hands-free operable controls, waste