(a) License required.
  (1) A hospital shall obtain a license prior to admitting patients.
  (2) Upon written request, the Department of State Health Services (department) shall furnish a person with an application for a hospital license.
  (3) The license application shall be submitted in accordance with §133.22 of this title (relating to Application and Issuance of Initial License). The applicant shall retain copies of all application documents submitted to the department.
(b) Compliance. A hospital shall comply with the provisions of the Act and this chapter during the licensing period.
(c) Scope of hospital license.
  (1) A hospital license is issued for the premises and person or governmental unit named in the application.
  (2) A hospital license shall not include off-site outpatient facilities.
  (3) Multiple hospitals may share one building.
    (A) Each hospital shall be licensed separately.
    (B) No part of the building may be dually licensed by more than one hospital; and
    (C) Each hospital in the building shall comply with the requirements of §133.165 of this title (relating to Building with Multiple Occupancies).
  (4) Multiple hospitals may be licensed under one license provided the following conditions are met.
    (A) The hospitals must comply with the requirements for multiple hospitals under a single license as specified under §133.2(41) of this title (relating to Definitions).
    (B) Each hospital location under the hospital license must;
      (i) provide emergency services in compliance with §133.41(e) of this title (relating to Hospital Functions and Services); and
      (ii) meet the requirements as an existing hospital in accordance with §133.161 of this title (relating to Requirements for Buildings in Which Existing Licensed Hospitals are Located) as determined by the department; or
      (iii) meet the requirements of a new hospital in accordance with §133.162 of this title (relating to New Construction Requirements) as determined by the department.
    (C) The administration of the primary hospital location must submit to the department the following:
      (i) a complete and accurate multiple-location application;
      (ii) a licensing fee for the number of design beds at the multiple-location hospital in accordance with §133.26(b) of this title (relating to Fees);
      (iii) a copy of a hospital fire safety survey of the multiple-location hospital indicating approval by the local fire authority in whose jurisdiction the hospital is based that is dated no earlier than one year prior to the multiple-location application; and
      (iv) if the main hospital is accredited by a Centers for Medicare and Medicaid Services-approved organization, a letter extending the accreditation of the main hospital to the multiple location.
    (D) If a change of ownership is concurrent with the request for a hospital to become a multiple location of another, the department will require the new owners to submit the documents in subparagraph (C) of this paragraph and a signed copy of the bill of sale or lease agreement that reflects the effective date of the sale or lease. No change of ownership application will be required.
  (5) A hospital license and an ambulatory surgical center license shall not be issued for the same premises.
(d) Display. A hospital shall prominently and conspicuously display the hospital license in a public area of the licensed premises that is readily visible to patients, employees, and visitors.
(e) Alteration. A hospital license shall not be altered.
(f) Transfer or assignment prohibited. A hospital license shall not be transferred or assigned. The hospital shall comply with the provisions of §133.24 of this title (relating to Change of Ownership) in the event of a change in the ownership of a hospital.
(g) Changes which affect the license.
  (1) A hospital shall notify the department in writing prior to the occurrence of any of the following:
    (A) addition or deletion of those services indicated on the license application;
    (B) changes in design bed capacity as the phrase is used in §133.26(b)(1)(A) - (C) of this title;
    (C) request to change license classification; and
    (D) any construction, renovation, or modification of the hospital buildings.
  (2) A hospital shall notify the department in writing at the time of the occurrence of any of the following:
    (A) cessation of operation of the hospital. The hospital shall include in the written notice the location where the medical records will be stored and the identity and telephone number of the custodian of the medical records;
    (B) change in certification or accreditation status;
    (C) change in hospital name, telephone number or administrator; and
    (D) change in the emergency contact name and phone number.

Source Note: The provisions of this §133.21 adopted to be effective June 21, 2007, 32 TexReg 3587