(a) All first-time applications for licensing are applications for an initial license, including applications from unlicensed operational facilities and licensed facilities for which a change of ownership or relocation is anticipated.
(b) The applicant shall submit the completed application, the information required in subsection (d) of this section, and the nonrefundable license fee to the Texas Health and Human Services Commission (HHSC) 90 days before the projected opening date of the facility.
(c) The applicant shall disclose to HHSC, if applicable:
  (1) the name, address, and social security number of the owner or sole proprietor, if the owner of the facility is a sole proprietor;
  (2) the name, address, and social security number of each general partner who is an individual, if the facility is a partnership;
  (3) the name, address, and social security number of any individual who has an ownership interest of more than 25 percent in the corporation, if the facility is a corporation;
  (4) the name, medical license number, and medical license expiration date of any physician licensed by the Texas Medical Board who has a financial interest in the facility or in any entity that has an ownership interest in the facility;
  (5) the name, medical license number, and medical license expiration date of the medical chief of staff;
  (6) the name, nursing license number, and nursing license expiration date of the director of nursing;
  (7) affirmation that at least one physician licensed in the state of Texas and at least one registered nurse licensed in the state of Texas will be on site during all hours of operation;
  (8) information concerning the applicant and the applicant's affiliates and managers, as applicable:
    (A) denial, suspension, probation, or revocation of a facility license in any state or any other enforcement action, such as court civil or criminal action in any state;
    (B) surrendering a license before expiration of the license or allowing a license to expire in lieu of HHSC proceeding with enforcement action;
    (C) federal or state (any state) criminal felony arrests or convictions;
    (D) Medicare or Medicaid sanctions or penalties relating to operation of a health care facility or home and community support services agency;
    (E) operation of a health care facility or home and community support services agency that has been decertified or terminated from participation in any state under Medicare or Medicaid; or
    (F) debarment, exclusion, or contract cancellation in any state from Medicare or Medicaid;
  (9) for the two-year period preceding the application date, information concerning the applicant and the applicant's affiliates and managers, as applicable:
    (A) federal or state (any state) criminal misdemeanor arrests or convictions;
    (B) federal, state (any state), or local tax liens;
    (C) unsatisfied final judgments;
    (D) eviction involving any property or space used as a health care facility in any state;
    (E) injunctive orders from any court; or
    (F) unresolved final federal or state (any state) Medicare or Medicaid audit exceptions;
  (10) the number of emergency treatment stations;
  (11) a copy of the facility's patient transfer policy and procedure for the immediate transfer to a hospital of patients requiring emergency care beyond the capabilities of the facility developed in accordance with §509.65 of this chapter (relating to Patient Transfer Policy) and signed by the chairman and the secretary of the governing body that attests the date the policy was adopted by the governing body and its effective date;
  (12) a copy of the facility's memorandum of transfer form, which contains at a minimum the information described in §509.65 of this chapter;
  (13) a copy of a written agreement the facility has with a hospital, which provides for the prompt transfer to and the admission by the hospital of any patient when services are needed but are unavailable or beyond the capabilities of the facility in accordance with §509.66 of this chapter (relating to Patient Transfer Agreements); and
  (14) a copy of a passing fire inspection report indicating approval by the local fire authority in whose jurisdiction the facility is based that is dated no earlier than one year before the opening date of the facility.
(d) The address provided on the application shall be the physical location at which the facility is or will be operating.
(e) Upon receipt of the application, HHSC shall review the application to determine whether it is complete. If HHSC determines that the application is not complete, HHSC shall notify the facility in writing.
(f) The applicant or the applicant's representative shall attend a prelicensure conference at the office designated by HHSC. HHSC may waive the prelicensure conference requirement.
(g) After the facility has participated in a prelicensure conference or the prelicensure conference has been waived at HHSC's discretion, the facility has received an approved architectural inspection conducted by HHSC, and HHSC has determined the facility is in compliance with subsections (c) - (e) of this section, HHSC shall issue a license to the facility to provide freestanding emergency medical care services in accordance with this chapter.
(h) The license shall be effective on the date the facility is determined to be in compliance with subsections (c) - (g) of this section.
(i) The license expires on the last day of the 24th month after issuance.
(j) If an applicant decides not to continue the application process for a license, the applicant may withdraw its application. The applicant shall submit to HHSC a written request to withdraw. HHSC shall acknowledge receipt of the request to withdraw.
(k) If the applicant does not complete all requirements of subsections (b) - (d) and (f) of this section within six months after the date HHSC's health care facility licensing unit receives confirmation that HHSC received the application and payment, HHSC will consider the application to be withdrawn. Any fee paid for a withdrawn application is nonrefundable, as indicated by §509.30(d) of this subchapter (relating to Fees).
(l) During the initial licensing period, HHSC shall conduct an inspection of the facility to ascertain compliance with the provisions of the Act and this chapter.
  (1) The facility shall request HHSC conduct an on-site inspection after the facility provides services to at least one patient.
  (2) The facility shall be providing services at the time of the inspection.

Source Note: The provisions of this §509.24 adopted to be effective December 4, 2023, 48 TexReg 7064