(a) Application submittal. The applicant shall submit the following documents to the Department of State Health Services (department) no earlier than 60 calendar days prior to the projected opening date of the hospital:
  (1) an accurate and complete application form;
  (2) a copy of the hospital's patient transfer policy which is developed in accordance with §133.44 of this title (relating to Hospital Patient Transfer Policy) and is signed by both the chairman and secretary of the governing body attesting to the date the policy was adopted by the governing body and the effective date of the policy;
  (3) a copy of the hospital's memorandum of transfer form which contains at a minimum the information described in §133.44(c)(10)(B) of this title;
  (4) if the application is for a special hospital license, a copy of a written agreement the special hospital has entered into with a general hospital which provides for the prompt transfer to and the admission by the general hospital of any patient when special services are needed but are unavailable at the special hospital. This agreement is required and is separate from any voluntary patient transfer agreements the hospital may enter into in accordance with §133.61 of this title (relating to Hospital Patient Transfer Agreements);
  (5) copies of any patient transfer agreements entered into between the hospital and another hospital in accordance with §133.61 of this title;
  (6) for existing facilities, a copy of a hospital fire safety survey 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 hospital opening date. For new construction, addition, and renovation projects, written approval by the local building department and local fire authority shall be submitted during the final construction inspection by the department;
  (7) the appropriate license fee as required in §133.26 of this title (relating to Fees); and
  (8) the following ownership information:
    (A) the name and social security number of the sole proprietor, if the applicant is a sole proprietor;
    (B) the name and social security number of each general partner who is an individual, if the applicant is a partnership;
    (C) the name and social security number of any individual who has an ownership interest of more than 25% in the corporation, if the applicant is a corporation; and
    (D) if the applicant is a niche hospital, the names and license numbers of any physicians licensed by the Texas Medical Board who have a financial interest in the applicant or any entity which has an ownership interest in the applicant.
(b) Additional documentation for new hospitals or conversions from nonhospital buildings. In addition to the document submittal requirements in subsection (a) of this section, the following shall be completed prior to the issuance of a hospital license to newly constructed hospitals or hospitals from conversions of nonhospital buildings.
  (1) Final construction documents shall be reviewed and approved by the department in accordance with §133.167 of this title (relating to Preparation, Submittal, Review and Approval of Plans and Retention of Records).
  (2) For new construction, necessary intermediate inspections and final construction inspections shall be conducted by the department in accordance with §133.168(b) of this title (relating to Construction, Inspections, and Approval of Project) to determine that the hospital was constructed or remodeled in accordance with this chapter.
  (3) When an applicant intends to reopen and relicense a building formerly licensed as a hospital, an on-site inspection shall be conducted by the department in accordance with §133.168 of this title to determine compliance with applicable construction and fire safety requirements.
  (4) All plan review and construction inspection fees shall be paid to the department.
  (5) A certificate of occupancy approved by the local fire authority, and issued by the city building inspector, if applicable, shall be obtained and a copy submitted to the department.
  (6) A complete and accurate Final Construction Approval form shall be submitted to the department.
(c) Presurvey conference. The applicant or the applicant's representative shall attend a presurvey conference at the office designated by the department. The designated survey office may waive the presurvey conference requirement. (d) Issuance of license. When it is determined that the hospital has complied with subsections (a) - (c) of this section, the department shall issue the license to the applicant.
  (1) Effective date. The license shall be effective on the date the hospital is determined to be in compliance with subsections (a) - (c) of this section. The effective date shall not be prior to the date of the final construction inspection conducted by the department.
  (2) Expiration date.
    (A) If the effective date of the license is the first day of a month, the license expires on the last day of the 23rd month after issuance.
    (B) If the effective date of the license is the second or any subsequent day of a month, the license expires on the last day of the 24th month after issuance.
(e) Withdrawal of application. If an applicant decides not to continue the application process for a license or renewal of a license, the application may be withdrawn. If a license has been issued, the applicant shall return the license to the department with its written request to withdraw. The department shall acknowledge receipt of the request to withdraw.
(f) Denial of a license. Denial of a license shall be governed by §133.121 of this title (relating to Enforcement Action).
(g) Inspection. During the licensing period, the department shall conduct an inspection of the hospital to ascertain compliance with the provisions of the Act and this chapter.
  (1) If a hospital has applied to participate in the federal Medicare program, the inspection may be conducted in conjunction with the inspection to determine compliance with 42 Code of Federal Regulations, Part 482 (relating to Conditions of Participation for Hospitals).
  (2) A hospital shall have admitted and be providing services to at least one inpatient in the hospital at the time of the inspection.

Source Note: The provisions of this §133.22 adopted to be effective June 21, 2007, 32 TexReg 3587