(1) No person,
partnership, association, corporation, or state, county or local government
unit, or any division, department, board or agency thereof, shall establish,
conduct, operate, or maintain in the State of Tennessee any ASTC without having
a license. A license shall be issued only to the applicant named and only for
the premises listed in the application for licensure. Licenses are not
transferable or assignable and shall expire and become invalid annually on the
anniversary date of their original issuance. The license shall be conspicuously
posted in the ASTC.
In order to
make application for a license:
applicant shall submit an application on a form prepared by the
(b) Each applicant for
a license shall pay an annual license fee in the amount of one thousand four
hundred and four dollars ($1,404.00). The fee must be submitted with the
application and is not refundable.
The issuance of an application form is in
no way a guarantee that the completed application will be accepted or that a
license will be issued by the department. Patients shall not be admitted to the
ASTC until a license has been issued. Applicants shall not hold themselves out
to the public as being an ASTC until the license has been issued.
A license shall not be issued until the facility is in
substantial compliance with these rules and regulations including submission of
all information required by Tennessee Code Annotated §
or as later amended, and all information required by the Commissioner.
(d) The applicant must prove the
ability to meet the financial needs of the facility.
(e) The applicant shall not use subterfuge or
other evasive means to obtain a license, such as filing for a license through a
second party when an individual has been denied a license or has had a license
disciplined or has attempted to avoid inspection and review process.
(f) The applicant shall allow the ambulatory
surgical treatment center to be inspected by a Department surveyor. In the
event that deficiencies are noted, the applicant shall submit a plan of
corrective action to the Board that must be accepted by the Board. Once the
deficiencies have been corrected, then the Board shall consider the application
ASTC, when issued a license, shall be classified according to the type of
services rendered or category of patients served. The ASTC shall confine its
services to those described in its license and shall advertise only the
services which it is licensed to perform. The classification shall be listed on
A proposed change
of ownership must be reported to the department a minimum of thirty (30) days
prior to the change. A new application and fee must be received by the
department before the license may be issued.
(a) For purposes of licensing, the licensee
of an ASTC has the ultimate responsibility for the operation of the facility,
including the final authority to make or control operational decisions and
legal responsibility for the business management. A change of ownership occurs
whenever this ultimate legal authority for the responsibility of ASTC
operations is transferred.
change of ownership occurs whenever there is a change in the legal structure by
which the facility is owned and operated and any ownership interest of the
preceding or succeeding entity changes.
Transactions constituting a change of
ownership include, but are not limited to, the following:
1. Transfer of the facility's legal
2. Lease of the facility's
3. Dissolution of any
partnership that owns, or owns a controlling interest in, the
4. One partnership is
replaced by another through the removal, addition or substitution of a
5. Merger of a facility
owner (a corporation) into another corporation where, after the merger, the
owner's shares of capital stock are canceled;
6. The consolidation of a corporate facility
owner with one or more corporations; or,
7. Transfers between levels of
Transactions which do not constitute a change of ownership include, but are not
limited to, the following:
1. Changes in the
membership of a corporate board of directors or board of trustees;
2. Two (2) or more corporations merge and the
originally-licensed corporation survives;
3. Changes in the membership of a non-profit
4. Transfers between
departments of the same level of government; or,
5. Corporate stock transfers or sales, even
when a controlling interest.
(e) Management agreements are generally not
changes of ownership if the owner continues to retain ultimate authority for
the operation of the facility. However, if the ultimate authority is
surrendered and transferred from the owner to a new manager, then a change of
ownership has occurred.
Sale/lease-back agreements shall not be treated as changes in ownership if the
lease involves the facility's entire real and personal property and if the
identity of the leasee, who shall continue the operation, retains the same
legal form as the former owner.
(a) In order to renew a license, each
ambulatory surgical treatment center shall submit to periodic inspections by
Department surveyors for compliance with these rules. If deficiencies are
noted, the licensee shall submit an acceptable plan of corrective action and
shall remedy the deficiencies. In addition, each licensee shall submit a
renewal form approved by the board and applicable renewal fee prior to the
expiration date of the license.
If a licensee fails to renew its license prior to the date of its expiration
but submits the renewal form and fee within sixty (60) days thereafter, the
licensee may renew late by paying, in addition to the renewal fee, a late
penalty of one hundred dollars ($100) per month for each month or fraction of a
month that renewal is late; provided that the late penalty shall not exceed
twice the renewal fee.
event that a licensee fails to renew its license within the sixty (60) day
grace period following the license expiration date, then the licensee shall
reapply for a license by submitting the following to the Board office:
1. A completed application for
2. The license fee
provided in rule 1200-08-10-.02(2)(b); and
3. Any other information required by the
Health Services and Development Agency.
(d) Upon reapplication, the licensee shall
submit to an inspection of the facility by Department of Health
Tenn. Comp. R. &
rule filed July 22, 1977; effective August 22, 1977. Amendment filed February
26, 1985; effective March 28, 1985. Repeal and new rule filed June 30, 1992;
effective August 14, 1992. Repeal and new rule filed March 21, 2000; effective
June 4, 2000. Amendment filed June 16, 2003; effective August 30, 2003.
Amendment filed January 19, 2007; effective April 4, 2007. Amendment filed July
18, 2007; effective October 1, 2007. Public necessity rules filed April 29,
2009; effective through October 11, 2009. Emergency rules filed October 9,
2009; effective through April 7, 2010. Amendments filed September 24, 2009;
effective December 23, 2009. Amendment filed December 16, 2013; effective March
16, 2014. Amendments filed March 21, 2018; to have been effective June 19,
2018. However, on May 24, 2018, the Government Operations Committee filed a
5-day stay; new effective date 6/24/2018.
Authority: T.C.A. §§
68-11-209(a)(1), 68-11-210, 68-11-216, and Chapter 846 of the Public Acts of