Freestanding Emergency Medical Care Facilities

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The Texas Freestanding Emergency Medical Care Facility Licensing Act was first enacted in 2009 by the 81st Legislature. A freestanding emergency medical care facility is a facility that is structurally separate and distinct from a hospital and which receives an individual and provides emergency care. Emergency care is defined as health care services provided in a freestanding emergency medical care facility to evaluate and stabilize a medical condition of a recent onset and severity, including severe pain, psychiatric disturbances, or symptoms of substance abuse, that would lead a prudent layperson possessing an average knowledge of medicine and health to believe that the person's condition, sickness, or injury is of such a nature that failure to get immediate medical care could result in:

  • placing the person's health in serious jeopardy
  • serious impairment to bodily functions
  • serious dysfunction of a bodily organ or part
  • serious disfigurement
  • or in the case of a pregnant woman, serious jeopardy to the health of the woman or fetus

HHSC develops rules that establish minimum standards for licensing procedures; for granting, denying, suspending, and revoking a license; for licensing fees; for operation; and for requirements concerning design, construction.

Find or Verify a Licensee

Licensing

The staff of the Facility Licensing Group is responsible for licensing FECs. The Architectural Review Group is responsible for conducting plan reviews and construction inspections of new and existing freestanding emergency medical care facilities.

Contact information for the zone offices is available by finding your zone (PDF) and then locating the contact info for zone offices. The list also contains phone numbers, fax numbers and email addresses.

The following documents, fees, and actions shall be completed and approved before a license will be issued:

Initial Application

  • A license application form (PDF) shall be submitted no earlier than 90 calendar days prior to the projected opening date of the facility.
  • A license fee of $14,820.00 shall be submitted. License fees are not refundable.
  • Patient Transfer Documents:
    • A copy of the facility's Patient Transfer Policy that is in accordance with §131.66 Patient Transfer Policy, and signed by the Chairman and Secretary of the Governing Body shall be submitted.
    • A copy of the facility's Memorandum of Transfer form that is in accordance with §131.66(b)(9) shall be submitted.
    • A copy of the facility's Patient Transfer Agreement with a General Hospital that is in accordance with §131.67 Patient Transfer Agreements shall be submitted.
    • Please submit transfer documents to Lisa Peers, RN, BSN, Nurse Consultant, at lisa.peers@dshs.state.tx.us or fax to 512-834-4514 for approval. Ms. Peers may also be contacted by telephone at 512-834-6600, extension 2615.
  • A completed Fire Safety Survey Report form shall be submitted. Annual fire safety inspections are required for continued licensure status. Please include a copy of a fire inspection report conducted within the last 12 months indicating approval by the local fire authority.
  • Approval for occupancy shall be obtained from the Department of State Health Services, Architectural Review Group.
  • The applicant or the applicant's representative shall attend a pre-survey conference at the zone office designated by the department. Please contact the designated zone office (PDF) to schedule the pre-survey conference

Relocation Application

  • A license application form (PDF) shall be submitted no earlier than 90 calendar days prior to the projected opening date of the facility.
  • A license fee of $14,820.00 shall be submitted. License fees are not refundable.
  • Patient Transfer Documents:
    • A copy of the facility's Patient Transfer Policy that is in accordance with §131.66 Patient Transfer Policy, and signed by the Chairman and Secretary of the Governing Body shall be submitted.
    • A copy of the facility's Memorandum of Transfer form that is in accordance with §131.66(b)(9) shall be submitted.
    • A copy of the facility's Patient Transfer Agreement with a General Hospital that is in accordance with §131.67 Patient Transfer Agreements shall be submitted.
    • Please submit transfer documents to Lisa Peers, RN, BSN, Nurse Consultant, at lisa.peers@dshs.state.tx.us or fax to 512-834-4514 for approval. Ms. Peers may also be contacted by telephone at 512-834-6600, extension 2615.
  • A copy of the letter of accreditation by the Joint Commission or another accrediting organization verifying accreditation and the effective date of accreditation.
  • A completed Fire Safety Survey Report form shall be submitted. Annual fire safety inspections are required for continued licensure status. Please include a copy of a fire inspection report conducted within the last 12 months indicating approval by the local fire authority.
  • Approval for occupancy shall be obtained from the Department of State Health Services, Architectural Review Group.

Change of Ownership Application

  • A license application form (PDF) shall be submitted at least 30 calendar days before the date of the change of ownership.
  • A license fee of $14,820.00 shall be submitted. License fees are not refundable.
  • Patient Transfer Documents:
    • A copy of the facility's Patient Transfer Policy that is in accordance with §131.66 Patient Transfer Policy, and signed by the Chairman and Secretary of the Governing Body shall be submitted.
    • A copy of the facility's Memorandum of Transfer form that is in accordance with §131.66(b)(9) shall be submitted.
    • A copy of the facility's Patient Transfer Agreement with a General Hospital that is in accordance with §131.67 Patient Transfer Agreements shall be submitted.
    • Please submit transfer documents to Lisa Peers, RN, BSN, Nurse Consultant, at lisa.peers@dshs.state.tx.us or fax to 512-834-4514 for approval. Ms. Peers may also be contacted by telephone at 512-834-6600, extension 2615.
  • A copy of the letter of accreditation by the Joint Commission or another accrediting organization verifying accreditation and the effective date of accreditation.
  • A copy of two completed Fire Safety Survey Report forms shall be submitted. Annual fire safety inspections are required for continued licensure status. Please include a copy of a fire inspection report dated within the last 12 months and a second report dated within the last 13 to 24 months indicating approval by the local fire authority.
  • The applicant or the applicant's representative shall attend a pre-survey conference at the zone office designated by the department. The designated zone office may waive the pre-survey conference requirement for a Change of Ownership. Please contact the designated zone office (PDF) to schedule the pre-survey conference or to request a waiver.
  • In addition to the documents required in §131.25 Application and Issuance of Initial License, the applicant shall include evidence (bill of sale, lease agreement, or legal court document) of the change of ownership.

License Applications

Supporting Forms and Documents

Survey Components

During the initial licensing period, department zone office staff will conduct an on-site survey to ascertain compliance with the provisions of the Health and Safety Code and associated rules. An entrance conference will be held with key facility personnel. Zone office staff will explain the survey process and answer questions. During the survey, zone office staff will:

  • Review clinical records
  • Review facility policies and procedure
  • Review quality assurance activities
  • Review personnel records
  • Interview staff
  • Conduct an exit conference with key facility personnel
  • Discuss survey findings

CLIA Information

Visit the CLIA information website. For more information, please contact the zone office (PDF) for your location.

Laws and Rules

Enforcement Actions

Free Standing Emergency Medical Care Facility Enforcement Actions, June 2018 – June 2019 (PDF)

Contact Information

The Facility Licensing Group is dedicated to assist you through this process and is available to answer your questions. If you have any questions, please contact the Facility Licensing Group:

Phone: 512-834-6648
Fax: 512-834-4514
Email: pamela.adams@dshs.state.tx.us, angela.arthur@dshs.state.tx.us or infohflc@hhsc.state.tx.us

Mailing Address for Applications with Fees:
Facility Licensing Group
Texas Health and Human Services
P.O. Box 149347 (MC 2835)
Austin, Texas 78714-9347

Enforcement Unit

Toll-Free: 888-973-0022
Phone: 512-834-6634
Fax: 512-834-6623
Email: enforcement@hhsc.state.tx.us

Mailing Address:
Texas Health and Human Services
Regulatory Services Division, Enforcement Unit
P.O. Box 149347
Austin, Texas 78714-9347