An application package is required for any person, facility or corporation modifying or building a physical plant for the following types of healthcare facilities, which are regulated by the HHSC Architectural Review Unit,
- Ambulatory Surgical Centers (ASC)
- End Stage Renal Disease Facilities (ESRD)
- Freestanding Emergency Medical Care Facilities (FEMC)
- Hospitals (both General and Special)
- Private Psychiatric Hospitals and Crisis Stabilization Units (CSU)
- Special Care Facilities (SCF)
Approval of an application package in writing by the ARU is required before any of the following steps are taken or construction begins,
- Construction of a facility for an initial license, including relocation, re-opening a closed facility or a conversion of a licensed or previously licensed healthcare facility to a different licensed designation
- Renovation consisting of construction, additions, alterations, renovations, remodeling, equipment and finish upgrades, repairs, building system upgrades, removal of a function, demolition, change of service(s) or retrofitting a function such as but not limited to changing of licensed bed designations or ESRD treatment and training designations, or a change of invasive procedural services
- Where a currently licensed facility is affected by a disaster and will be undergoing repairs
The ARU’s application and inspection process is necessary to receive license approval from HHSC.
After the application has been approved, construction can begin. The ARU will inspect the facility during construction. As needed, they may conduct a final inspection for each phase. The Final Architectural Inspection Form is required before patients can occupy the facility. Staff occupancy may be granted under certain circumstances. Construction does not include excavation or site preparation.
Email Inquiries: AskARU@hhs.texas.gov
- Email Application to: ApplicationARU@hhs.texas.gov
- Email Inspection Request to: InspectionARU@hhs.texas.gov
- Subject Line: Inspection Request App# (enter Application Number)
- Email Plan of Correction from Inspection to: AskARU@hhs.texas.gov
- Subject Line: POC (Application Number) for (Inspector’s Name)
- Email Final Construction Approval Form to: AskARU@hhs.texas.gov
- Subject Line: POC# (Application Number) for (Inspector’s Name)
- Email Plan of Correction-Life Safety to: LifeSafetyARU@hhs.texas.gov
Mail Fees. Make check payable to HHSC. Mail check and copy of application/inspection form only to either address below.
HHSC AR MC 1470
1100 West 49th Street
Austin, TX 78756
Regular (USPS) Mail:
HHSC AR MC 1470
PO Box 149055
Austin, TX 78714-9055
Operating hours, including Inspection hours: 8:00 am – 5:00 pm CST, excluding state holidays
The Architectural Review Process
- Design the project. Refer to this webpage for Applicable Laws & Rules.
- Feasibility Conference, which is optional but highly recommended.
- Submit the application package. Refer to the Application Package Instructions, ARU-21 (PDF). Download the application, FM ARU-01 (PDF) from this website.
- Obtain the ARU's written Notice to Start of Construction. Construction shall NOT commence until ARU issues a written approval to begin construction.
- Construction starts.
- Submit an inspection request, FM ARU-02, obtained from the ARU. Refer to Inspection Instructions, ARU-22 (PDF).
- ARU conducts a final architectual inspection on each phase of the project. ARU may also conduct an intermediate inspection of the phases of the project before a final architectural inspection occurs.
- Obtain ARU's inspection approval on construction project. Refer to Inspection Instructions, ARU-22 (PDF).
- Submit the Plan of Corrections for every inspection conducted. Refer to Inspection Instructions, ARU-22 (PDF).
- Obtain ARU's approval for project closeout. Refer to Project Closeout Instructions, ARU-25 (PDF).
Application, Forms and Instructions
- Application Form, FM ARU-01 (PDF)
- Application Package Instructions, ARU-21 (PDF)
- Inspection Instructions, ARU-22 (PDF)
- Project Closeout Instructions, ARU-25 (PDF)
Applicable Laws & Rules
- Texas Health and Human Services Commission: Title 25 Texas Administrative Code.
- Texas Health and Human Services Commission: Title 26 Texas Administrative Code.
- Ambulatory Surgical Centers Licensing Rules: 25 TAC Chapter 135
- End Stage Renal Disease Facilities Licensing Rules: 25 TAC Chapter 117
- Freestanding Emergency Medical Care Facility: 25 TAC Chapter 131
- Hospital Licensing Rules: 25 TAC Chapter 133
- Private Psychiatric Hospitals and Crisis Stabilization Units Licensing Rules: 26 TAC Chapter 510
- Special Care Facilities Licensing Rules: 26 TAC Chapter 506
NFPA 101, 2012 edition and NFPA 99, 2012 edition for General and Special Hospital, Private Psychiatric Hospital and Crisis Stabilization Unit, Ambulatory Surgical Center who receive Medicare reimbursements.
NFPA 101, 2003 edition and NFPA 99, 2002 edition for each End Stage Renal Disease Facility, each Freestanding Emergency Medical Care Facility, each Special Care Facility and any Ambulatory Surgical Center or any hospital or CSU who does not receive Medicare reimbursements.
Frequently Asked Questions
When is an application required?
An application is required for construction, erection, repair, remodeling, renovations, modifications, additions, alterations, removal, conversion, change of service(s), change of function, change of licensed beds or ESRD stations, change of licensed facility type, large/stationary equipment replacement, building system equipment upgrade, demolition, initial facility license or re-opening a closed General or Special Hospital, Private Psychiatric Hospital or Crisis Stabilization Unit, Ambulatory Surgical Center, End Stage Renal Disease Facility, Freestanding Emergency Medical Care Facility, or Special Care Facility. If a facility type is not mentioned above, do not submit project to the ARU. Refer to the Application Package Instructions, ARU-21 (PDF), and the Application Form, ARU-01 (PDF), from this website.
When can construction, remodel, etc. (items mentioned in above paragraph) begin?
Construction can only commence after ARU's written approval is obtained, which is based on an approved application package. The term construction shall not be construed to include excavation or site preparation.
When can patients occupy?
Upon obtaining the Final Architectural Review Form issued by ARU, FM ARU-03, the facility may occupy the newly constructed space with staff only when a facility receives a new or modified license from the Facility Licensing Unit. Under no circumstance shall patients be admitted, transferred in, or procedures performed until the facility receives their new or modified license. Inspection Instructions, ARU-22 (PDF).
Upon obtaining the Final Architectural Review Form, FM ARU-03, the facility may occupy the newly constructed space if a construction project does not require changes in the facility's license. With the Final Architectural Review Form, staff may occupy the design space and services may be provided to patients (e.g. construction of an operating room, catheterization lab, or imaging suite). Inspection Instructions, ARU-22 (PDF).
Is a plan review required before construction or change of service/function?
Written approval from ARU is required before any work or change of function can occur and is obtained either by approval of self-certification request or approval of plan review comments. Written approval shall provide the type of inspections required.
In lieu of a plan review, the facility can opt for self-certification. If a plan review is requested by the facility, indicate this request in the project narrative. The review time is approximately 120 business days, depending on the size of the project. If the facility opts out of the plan review, they may request the self-certification process. Self-certification is a process where registered architects and professional engineers may bypass a full review of a building project by filling out the third page of the application form. With this streamlined approval process, registered architects and professional engineers may self-certify that their project complies with all applicable laws and codes, and requests the project be approved without a full review or any oversight by ARU.
When are fees required?
Application fees can be found in Chapter 8.3 and 8.4 of the Application Package Instructions, ARU-21 (PDF).
Inspection fee can be found in Chapter 10-11 of the Inspection Instructions, ARU-22 (PDF).
Do applications expire?
Incomplete application package submittals remain in ARU's office for 30 calendar days, and then are discarded.
Application packages with application numbers remain active for 360 calendar days but will expire on the 361st calendar day if the project has not received an inspection, or after the date of the last inspection that shows progress towards completion of the project. An expired application must be resubmitted before any inspection is conducted. Refer to the Application Package Instructions, ARU-21 (PDF).
Is professional staff available for consultation prior to application?
Code questions and answers can be obtained via three options.
- Call in-office Inspector at 512-834-6649.
- Email Inspector at AskARU@hhs.texas.gov.
- Schedule a feasibility conference by calling 512-834-4577.
Feasibility conferences are held at our office on Tuesday, Wednesday and Thursday at 10 a.m., 1 p.m. and 3 p.m. on first scheduled basis. Conferences determine the feasibility of a project, provide consultation regarding project questions, and establish understanding of compliance with the rules and codes. This is not a plan review.
Feasibility conferences can be held at any stage of initial design through final design. Feasibility conferences are a maximum of 90 minutes and multiple projects can be discussed during this time frame. Only a sketch of the plan(s) is required for the meeting. Stakeholders shall keep the meeting minutes and submit them to the Inspector, who conducted the conference for their approval.
What type of work is exempt from an application package?
Maintenance work does not require notification to ARU. Replacing a building system and interior or exterior finish upgrade is not maintenance work and does require an application package to ARU. Refer to maintenance definition in Application Package Instructions, ARU-21 (PDF).
What happens after the work has been completed?
Once the work is completed, a final architectural inspection shall be required. Upon approval of the final architectural inspection, the Final Architectural Inspection Form, FM ARU-03, shall be issued by the ARU. Refer to Project Closeout Instructions, ARU-25 (PDF).
How is a license obtained? How are licensed beds or ESRD stations modified?
An architectural review is one of the processes that are necessary in order to receive license approval/modification from the Facility Licensing Unit. Refer to the Facility Licensing Unit webpage or call 512-834-6648 for further information.
What documents are required at a final inspection?
Refer to Inspection Instructions, ARU-22 (PDF). Chapters 8 and 9. Chapter 9 contains a list when a previously licensed facility is opening as an initial application. Chapter 8 address any other final inspection's required documents.
What is the application or inspection or project closeout process?
Other Helpful Resources
- Fee Schedule in the Application Package Instructions, ARU-21 (PDF), under chapter 8, Application Definitions
- Architectural definitions in Application Package Instructions, ARU-21 (PDF), under chapter 8, Application Definitions
- For scheduling a feasibility conference, refer to "Is professional staff available for consultation prior to application?.
- Required Documents for Final Inspection, other than re-opening a closed licensed facility, in the Inspection Instructions, ARU-22 (PDF), in chapter 8
- Required Documents for Final Inspection for re-opening a closed licensed facility in the Inspection Instructions, ARU-22 (PDF), in chapter 9
- How to write a Plan of Correction to the intermediate and the final inspection reports in the Inspection Instructions, ARU-22 (PDF), chapter 7