(a) All first-time applications for licensing, including those from unlicensed operating ambulatory surgical centers (ASCs) and licensed ASCs for which a change of ownership or relocation is anticipated, are applications for an initial license.
(b) Upon written or verbal request, the department shall furnish a person with an application form for an ASC license. The applicant shall submit to the department a completed original application and the nonrefundable license fee.
  (1) The applicant shall provide:
    (A) the name and address of the owner of the ASC, or a list of names and addresses of persons who own an interest in the ASC;
    (B) the name, Texas license number, and license expiration date of the medical chief of staff;
    (C) the number of physicians, dentists, podiatrists and advanced practice registered nurses on staff at the ASC;
    (D) the name, Texas license number, and license expiration date of the director of nursing of the ASC;
    (E) whether the ASC has applied for certification under Title XVIII of the Social Security Act; and
    (F) number of surgery suites.
    (G) the following data concerning the applicant, the applicant's affiliates, and the managers of the applicant:
      (i) denial, suspension, probation, or revocation of an ambulatory surgical center license in any state, a license for any health care facility or a license for a home and community support services agency (agency) in any state; or any other enforcement action, such as (but not limited to) court civil or criminal action in any state;
      (ii) denial, suspension, probation, or revocation of or other enforcement action against an ambulatory surgical center license in any state, a license for any health care facility in any state, or a license for an agency in any state which is or was proposed by the licensing agency and the status of the proposal;
      (iii) surrendering a license before expiration of the license or allowing a license to expire in lieu of the department proceeding with enforcement action;
      (iv) federal or state (any state) criminal felony arrests or convictions;
      (v) Medicare or Medicaid sanctions or penalties relating to the operation of a health care facility or agency;
      (vi) operation of a health care facility or agency that has been decertified or terminated from participation in any state under Medicare or Medicaid; or
      (vii) debarment, exclusion, or contract cancellation in any state from Medicare or Medicaid; and
    (H) for the two-year period preceding the application date, the following data concerning the applicant, the applicant's affiliates, and the managers of the applicant:
      (i) federal or state (any state) criminal misdemeanor arrests or convictions;
      (ii) federal or state (any state) tax liens;
      (iii) unsatisfied final judgments;
      (iv) eviction involving any property or space used as an ambulatory surgical center or health care facility in any state;
      (v) injunctive orders from any court; or
      (vi) unresolved final federal or state (any state) Medicare or Medicaid audit exceptions.
  (2) Upon receipt of the application, the department shall review the application to determine whether it is complete. All documents submitted to the department shall be originals. The address provided on the application shall be the address at which the ASC is operating.
  (3) If the department determines that the application for an unlicensed ASC is complete and correct, a representative of the department shall schedule a pre-survey conference with the applicant in order to inform the applicant of the standards for the operation of the ASC. A pre-survey conference may, at the department's discretion, be waived for an applicant of a licensed ASC for which a change of ownership is anticipated.
  (4) After a pre-survey conference has been held or waived at the department's discretion and the facility has received an approved architectural inspection conducted by the department, the department may issue a license to an ASC to provide ambulatory surgical services in accordance with these sections.
(c) When it is determined that the facility is in compliance with subsection (b) of this section, the department shall issue the license to the applicant.
  (1) Effective date. The license shall be effective on the date the facility is determined to be in compliance with subsection (b) of this section.
  (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.
(d) If an applicant decides not to continue the application process for a license, the application may be withdrawn. The applicant shall submit a written request to withdraw to the department. The department shall acknowledge receipt of the request to withdraw.
(e) During the initial licensing period, the department shall conduct a survey of the ASC to ascertain compliance with the provisions of the Health and Safety Code, Chapter 243, and this chapter.
  (1) The ASC shall request that an on-site survey be conducted after the ASC has provided services to a minimum of one patient.
  (2) The ASC shall be providing services at the time of the survey.
  (3) If the ASC has applied to participate in the federal Medicare program, the Medicare survey may be conducted in conjunction with the licensing survey.
  (4) The initial licensing survey may be waived if the ASC provides documented evidence of accreditation by the Joint Commission, the Accreditation Association for Ambulatory Health Care, or the American Association for Accreditation of Ambulatory Surgery Facilities and Medicare deemed status.

Source Note: The provisions of this §135.20 adopted to be effective June 18, 2009, 34 TexReg 3948