(a) A facility that is operating before the effective date of this chapter is considered to be a pre-existing facility and shall meet the physical plant and construction requirements under this chapter.(b) A pre-existing facility shall complete all major remodeling, renovations, additions, and alterations in accordance with the requirements for new construction in §131.143 of this title (relating to Construction Requirements for a New Facility). All areas of a pre-existing facility that are not part of a major remodel, renovation, addition or alteration to the facility, are not required to meet these new construction requirements as long as the existing portion met the codes that were in effect when it was originally constructed and licensed. When existing conditions make such changes impractical, the department may grant a conditional approval of minor deviations from the requirements of §131.143 of this title, if the intent of the requirements is met and if the care, safety and welfare of patients will not be jeopardized. The operation of the facility, accessibility of individuals with disabilities, and safety of the patients shall not be jeopardized by a condition(s) which is not in compliance with this subchapter.(1) Any alteration, modification, replacement, or installation of new building equipment (such as mechanical, electrical, emergency power equipment, energy/utility management, conveying systems, plumbing, fire protection, or other equipment), with a primary function of building service that affects life safety, infection control, functional operation, or the health, safety, and welfare of patients and staff shall comply with the requirements for new construction and shall not be replaced, materially altered, or extended in a pre-existing licensed facility until complete plans and specifications have been submitted to the department, and the department has reviewed and approved the plans and specifications in accordance with §131.146 of this title (relating to Preparation, Submittal, Review and Approval of Plans, and Retention of Records).(2) Minor remodeling or alterations within an existing facility which do not involve alterations to load-bearing members and partitions, change functional operation, affect fire safety, or involve any of the major changes listed in paragraph (1) of this subsection are considered to be minor projects and require evaluation and approval by the department. A pre-existing licensed facility shall submit by mail or fax a written request and floor plan for evaluation, a brief description of the proposed changes, floor plan, and sketches of the area being remodeled. Based on such submittal, the department shall evaluate and determine whether any additional submittals or inspections are required. The department shall notify the facility of its decision. The patching, restoration, or painting of materials, elements, equipment, or fixtures for the purpose of maintaining such materials, elements, equipment, or fixtures in good or sound condition would not require submission to the department for approval.(3) All remodeling or alterations which involve alterations to load-bearing members or partitions, change functional operation, or affect fire safety are considered major projects. A facility shall comply with this section before beginning construction of major projects.(A) Plans shall be submitted in accordance with this section for all major remodeling or alterations.(B) Construction projects involving alterations of or additions to existing buildings shall be programmed and phased so that on-site construction shall minimize disruptions of existing functions.(i) Access, exit access, and fire protection shall be maintained so that the safety of the occupants shall not be jeopardized during construction.(ii) A noncombustible or limited combustible dust and vapor barrier shall be provided to separate areas undergoing demolition and construction from occupied areas. When a fire retardant plastic material is used for temporary daily usage, it shall be removed at the end of each day.(iii) The air inside the construction area shall be protected by mechanical filtration that recirculates inside the space or is exhausted directly to the exterior.(iv) The area shall be properly ventilated and maintained. The area under construction shall have a negative air pressure differential to the adjoining areas and shall continue to operate as long as construction dust and odors are present.(v) Temporary sound barriers shall be provided where intense prolonged construction noises will disturb patients or staff in the occupied portions of the building during patient treatment times.(vi) When construction occurs after hours or on weekends, the facility shall thoroughly clean all areas of construction and provide a clean safe environment before treating patients. The facility shall ensure that all fire safety protection and building systems are in place and working properly.(c) Pre-existing facilities shall be easily accessible to the community and to service vehicles such as delivery trucks, ambulances, and fire protection apparatus.(1) The facility site shall include paved roads, walkways, and parking in accordance with local building codes and ordinances.(2) Pre-existing licensed facilities shall comply with the Americans with Disabilities Act (ADA) of 1990, Public Law 101 - 336, 42 United States Code, Chapter 126, and