Ambulatory Surgical Center

 

Jack Plagge, Manager
Hospital & Outpatient Services Unit

Bureau of Health Facility Regulation
2727 Mahan Drive, Mail Stop #31
Tallahassee, Florida 32308
Telephone: (850) 412-4549
Florida Relay Service (TDD): (800) 955-8771
Fax: (850) 488-5897
Email: hospitals@ahca.myflorida.com

An ambulatory surgery center (ASC) is a licensed facility not part of a hospital with the primary purpose of providing elective surgical care. The patient is admitted to and discharged from the facility within the same working day. Overnight stays are not permitted.

A license issued by the Agency for Health Care Administration is required in order to operate an ambulatory surgical facility. It is unlawful for a person to use or advertise to the public, in any way or by any medium whatsoever, any facility as an "ambulatory surgical facility" unless such facility has first secured a license under the provisions of Chapter 395, Part I, Florida Statutes and Chapter 408, Part II, Florida Statutes. This licensure does not apply to veterinary facilities or to commercial business establishments using the word "hospital" as a part of a trade name if no treatment of human beings is performed on the premises of such establishments.

Ambulatory surgical centers must maintain current state licensure, but may choose to be Medicare certified and may choose to be accredited. Accredited ambulatory surgical centers meeting Chapter 59A-5.004(3), Florida Administrative Code may be "deemed" to be in compliance with the licensure and certification requirements. Deemed ASCs are not scheduled for routine on-site licensure surveys. All ASCs are subject to periodic Life-Safety Code inspections.

Notices/Updates

Online Applications – In addition to submitting license renewal applications online, licensees may also submit changes during the licensure period. Changes to the fictitious name, address, operating rooms, recovery beds, and personnel can be submitted by going to the online portal and creating a new application.  Contact the licensure unit for additional information.

Transparency in Health Care Legislation Effective July 1, 2016 (House Bill 1175)[88KB, PDF]

Transparency in Health Care Legislation, Additional Questions July 5, 2016[353KB, PDF]

A Statement of Estimated Regulatory Costs (SERC) regarding Proposed Rule 59A-5.032, F.A.C. was drafted in response to the receipt of a Lower Cost Regulatory Alternative. A copy of the SERC is available here: Statement of Estimated Regulatory Costs [6.67MB, PDF]

Accrediting Organizations for Ambulatory Surgical Centers
Accrediting Organization Web Address Deemed for State Licensure Deemed Option for Medicare Certification
Accreditation Association for Ambulatory Health Care (AAAHC) http://www.aaahc.org/ Yes Yes
American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) http://www.aaaasf.org/ Yes Yes
American Osteopathic Association/Healthcare Facilities Accreditation Program (AOA/HFAP) http://www.hfap.org/ Yes Yes
The Joint Commission (TJC) http://www.jointcommission.org/ Yes

Yes

Institute for Medical Quality (IMQ) http://www.imq.org/ No

Yes

Licensure Requirements

Initial

Initial applicants must have a current project under review with the Agency’s Office of Plans and Construction (850) 412-4477 for compliance with appropriate building code before applying for licensure.  Any application for licensure submitted prior to having a project review will be returned. Applications and supporting forms (see application for checklist) must be submitted at least 60 days but no more than 120 days prior to the anticipated opening date.  As a general rule, an appropriate time to submit a licensure application is when the 100% physical plant inspection is scheduled by the Agency's Office of Plans and Construction. The licensure application fee is $1,679.82 and the survey/inspection fee is $400. Applications submitted without the appropriate fees will not be accepted. Possession of a license is required prior to providing patient care.

Renewal

The licensure application, renewal fee and supporting documents must be submitted to the Agency 120 to 60 days prior to the expiration date. A late fee of $50 per day, up to 50% of the licensure fee or $500 (whichever is less) will be assessed for any application not received 60 days prior to expiration. A renewal application will not be accepted if the license is expired. An initial license application must be filed if the license has expired. 

Change of Ownership (CHOW)

Chapter 408.803, Florida Statutes defines a change of ownership as...(a)  An event in which the licensee sells or otherwise transfers its ownership to a different individual or entity as evidenced by a change in federal employer identification number or taxpayer identification number; or (b)  An event in which 51 percent or more of the ownership, shares, membership, or controlling interest of a licensee is in any manner transferred or otherwise assigned. This paragraph does not apply to a licensee that is publicly traded on a recognized stock exchange. A change solely in the management company or board of directors is not a change of ownership.

A licensure application, fee, and supporting forms (see application checklist) must be submitted at least 60 days prior to the change of ownership.  The change of ownership application fee is $1,679.82. Application requirements are similar to initial licensure requirements with addition of statements from the buyer affirming any physical plant deficiencies will be corrected. In addition, an affirmation from the buyer and seller that any outstanding fees owed the State (owed by either party), will be paid, identifying who will pay and when. Documentation signed by the buyer and seller that will substantiate the change of ownership has occurred must be submitted before the application can be approved and license issued in the name of the new licensee.

Other Change During the Licensure Period

Changes to the name, address, number of operating rooms, procedure rooms, recovery beds or select personnel (chief executive officer, financial officer, patient safety officer, risk manager requires an AHCA Form 3130-2001, Health Care Licensing Application Ambulatory Surgical Center. The $25 license reprint fee will apply if the change affects the face of the license.

Voluntary Termination of a License

A licensee must inform the agency not less than 30 days prior to the discontinuance of operation and comply with the requirements listed in Chapter 408.810(4), Florida Statutes.

Medicare Certification Requirements

Medicare certification for initial enrollment or change of ownership is achieved by adherence to requirements in 42 Code of Federal Regulations, Part 416.  This includes submission of the following to the Agency for Health Care Administration, Hospital and Outpatient Services Unit:

In addition, a CMS Form 855B must be submitted to the Florida Medicare Administrative Contractor.

Licensure Requirements, Forms and Additional Information

Background Screening Unit

State and Federal Regulations

State Licensure
Chapter 395, Part 1, Florida Statutes ASC & Hospital Licensure Requirements
Chapter 59A-5, Florida Administrative Code ASC Licensure Rules
Chapter 59A-10, Florida Administrative Code Internal Risk Management Program
Chapter 408, Part II, Florida Statutes Agency General Licensure Requirements
Chapter 59A-35, Florida Administrative Code Agency General Licensure Rules
Federal Certification
Title 42 Code of Federal Regulations (CFR) To search all of Title 42
Part 416 Ambulatory Surgical Services

CMS State Operations Manual [1.75MB, PDF]

Resource for program requirements and interpretive guidelines

Applications and Supporting Forms

Renew Online – Providers can now renew their licenses through the Agency’s Online Licensing application.

Form Number Name For Description

AHCA Form 3130-2001

Health Care Licensing Application - Ambulatory Surgical Center [137KB, DOCX]

All application types

Standard ambulatory surgical center application required to apply for or modify a license.

AHCA Form 3110-1024

Health Care Licensing Addendum [126KB, DOCX]

Initial
Change of Ownership
Renewal

Collects the confidential information to comply with the reporting requirements pursuant to Chapter 408, Part II, Florida Statutes.
AHCA Form 3130-2003

Emergency Management Planning Criteria for Ambulatory Surgical Centers [42KB, PDF]

Initial
Change of Ownership

Provides an outline to develop an emergency management plan. The plan must be approved by the county emergency operations center annually.
AHCA Form 3170-2004

Clinical Laboratory Applications

Initial
Change of Ownership
Renewal
Miscellaneous

For non-waived clinical laboratory testing. Clinical laboratory licenses under the same ownership/control as the ambulatory surgical center must concurrently submit a clinical laboratory application.

Other Documents and Supporting Forms

Name For Description
Bed Memo

Initial
Any bed changes

Internal AHCA memo signifying compliance with Florida Building Code and which lists the beds (Class C operating rooms and recovery beds) eligible for licensure.
Business Articles

Initial
Change of Ownership

Articles of incorporation or similarly titled document as filed with the Florida Department of State
Compliance with zoning requirements

Initial
Change of Ownership

Any documentation from a local government identifying the facility is in compliance with local zoning requirements
Certificate of Occupancy Initial Specific documentation from a local government granting the right to occupy a facility.
Management Agreement

Initial
Change of Ownership

Contract between the licensee and a management company for management services
Closing Document Change of Ownership Bill of Sale or similar document signed by the buyer and seller indicating the date of transfer of ownership.
Statement of outstanding deficiencies Change of Ownership Statement from the buyer assuring any uncorrected life-safety code deficiencies will be corrected timely.
Statement of outstanding payments due Change of Ownership Statement from the buyer identifying any outstanding balance owed AHCA (buyer or seller), and indicating who will pay and when.
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