(a) License required.
  (1) Except as provided in §509.22 of this subchapter (related to Exemptions from Licensure), a person may not establish or operate a freestanding emergency medical care facility in this state without a license issued by the Texas Health and Human Services Commission (HHSC).
  (2) A facility or person shall not hold itself out to the public as a freestanding emergency medical care facility or advertise, market, or otherwise promote the services using the terms "emergency," "ER," or any similar term that would give the impression that the facility or person is providing emergency care.
  (3) An applicant shall submit a license application in accordance with §509.24 of this subchapter (relating to Application and Issuance of Initial License). The applicant shall retain copies of all application documents submitted to HHSC.
(b) Compliance requirements. A facility shall comply with the provisions of the Act and this chapter during the licensing period.
(c) Scope of facility license.
  (1) Each separate facility location shall have a separate license.
  (2) HHSC issues a facility license for the premises and person or governmental unit named in the application.
  (3) A facility shall not have more than one health facility license for the same physical address. The premises of a facility license shall be separated from any other occupancy or licensed health facility by a minimum of a one-hour fire rated wall.
  (4) A facility license authorizes only emergency care services and procedures that are related to providing emergency care.
(d) License display requirements. A facility shall prominently and conspicuously display the facility license in a public area of the licensed premises that is readily visible to patients, employees, and visitors.
(e) License alterations prohibited. A facility license shall not be altered.
(f) License transfer prohibited. A facility license shall not be transferred or assigned. The facility shall comply with the provisions of §509.27 of this subchapter (relating to Change of Ownership) in the event of a change in the ownership of a facility.
(g) Changes that affect the license.
  (1) A facility shall notify HHSC in writing before:
    (A) any construction, renovation, or modification of the facility buildings as described in 25 TAC Chapter 131, Subchapter G (relating to Physical Plant and Construction Requirements); or
    (B) facility operations cease.
  (2) A facility shall notify HHSC in writing not later than the third calendar day after:
    (A) a facility modifies its evacuation or smoke compartment relocation plans in accordance with the requirements of NFPA 101: Life Safety Code (2018); or
    (B) a facility's fire alarm system or sprinkler system becomes non-operational.
  (3) A facility shall notify HHSC in writing not later than the 10th calendar day after the effective date of:
    (A) a change in certification or accreditation status; or
    (B) a change in facility name, mailing address, telephone number, or administrator.
  (4) A facility that becomes inactive or closes shall meet the requirements in §509.26 of this subchapter (relating to Inactive Status and Closure).

Source Note: The provisions of this §509.21 adopted to be effective December 4, 2023, 48 TexReg 7064