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«2 Peachtree Street, NW GEORGIA DEPARTMENT OF Suite 31-447 COMMUNITY HEALTH Atlanta, GA 30303-3142 David Cook, Commissioner Nathan ...»

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2 Peachtree Street, NW


Suite 31-447


Atlanta, GA 30303-3142


David Cook, Commissioner Nathan Deal, Governor


State Licensure for Ambulatory Surgical Centers

This letter will provide information regarding the State Licensure Requirements for Ambulatory Surgical Centers (ASC) in Georgia. This Section is responsible for licensing ASCs under State Law and assisting the Centers for Medicare and Medicaid Services in performing the certification function for those providers wishing to participate in the Medicare program.


Before this Section can survey your facility for a license to operate an ASC, you must submit

the following documents:

1. A completed application to operate an ASC, mailed to the Acute Care Section, Healthcare Facility Regulation Division, Department of Community Health, 2 Peachtree St., NW, Suite 31-447, Atlanta, GA 30303-3142.

2. A copy of the Certificate of Need (CON) or Letter of Non-Reviewability (LNR) issued by the Division of Health Planning (DHP). You can contact DHP at 404-656Peachtree Street, 5th Floor, Atlanta, Georgia 30303-3159.

3. Notarized Identity Affidavits for ALL owners

4. A completed Application and Initial License Fee Coupon with payment as directed on

the coupon. The coupon may be found at (blanks are underscores):

http://dch.georgia.gov/vgn/images/portal/cit_1210/32/27/163015381Licensing_Initial_16_Save.pdf or go to www.dch.georgia.gov, click on the third icon down on the left (Healthcare Facility Regulation), click on Forms and Applications from the menu on the left, click on the left box in red that has “Click here to download APPLICATION & INITIAL LICENSE FEE PAYMENT COUPON”.

5. A copy of the construction plan approval and final inspection letters issued by the state architect.

6. A copy of the local (city, county, or state) fire safety authority/fire marshal inspection report which states an inspection has been made of the premises and that state and local fire safety requirements have been met.

7. Copy of the certificate of occupancy for the ASC.

8. Evidence that X-Ray facilities in the ASC meet the Rules and Regulations promulgated by DHR. You can contact the Diagnostic Services Unit at 404-657-5450.

Equal Oppor

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9. Evidence that any Laboratory Services offered at the ASC meet Federal and State requirements. You can contact the Diagnostic Services Unit at 404-657-5450.


Once you have an estimated date that the ASC will be ready for survey, please fax or mail a request for an initial licensure survey and include the estimated ready date. The fax number for the Acute Care Section is 404-657-8934. You will be contacted by a staff person from this Section to answer any questions you may have regarding the licensure process and to make arrangements for your initial licensure survey. The survey process consists of review of policies and procedures, staff personnel files, physician credential files, staff interviews and a tour of your facility. We have enclosed a survey preparation checklist for your convenience. However the checklist is not all inclusive. You are advised to read all the Rules and Regulations for ASCs, Chapter 290-5-33, and prepare to show surveyors how your facility will comply with all the rules.


If at the conclusion of the survey your facility is found to be in full compliance with the Rules and Regulations for Ambulatory Surgical Treatment Centers (Chapter 290-5-33), your permit will be issued effective the last day of the survey. If deficiencies are cited, your permit will be issued effective the date this Section receives an acceptable plan of correction.

A permit will not be issued until the Section has proof that the Application & Initial License Fee has been made and the check has cleared the bank.

Under State law and regulations, you must notify this Section at least 30 days in advance of any change in ownership. The State Permit is not transferable.

If we can be of further assistance to you, please contact the Acute Care Section Director at (404) 657-5440.


State Regulations License Application Checklist for Initial Application Checklist for Initial Licensure Survey

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290-5-33-.01 Definitions. Amended. Unless a different meaning is required by the context, the following terms as used in these rules and regulations shall have the meaning hereinafter respectively

ascribed to them:

(a) "Ambulatory Surgical Treatment Centers" means any institution, building, or facility, or part thereof, devoted primarily to the provision of surgical treatment to patients not requiring hospitalization, as provided under provisions of Georgia Code Section 88-1901. Such facilities do not admit patients for treatment which normally requires overnight stay, nor provide accommodations for treatment of patients for period of twenty-four (24) hours or longer;

(b) "Governing Body" and/or "Management" means the Board of Directors and/or Trustees, the partnership, the corporation, the association, or the person or group of persons who maintain and control the operation of the ambulatory surgical treatment center and who are legally responsible for its operation;

(c) "Center" means an ambulatory surgical treatment center as defined in these rules and regulations;

(d) "Board," unless otherwise indicated, shall mean the Georgia Board of Human Resources;

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(e) "Commissioner" means the Commissioner of the Georgia Department of Human Resources or his designee;

(f) "Department" means the Georgia Department of Human Resources;

(g) "General Anesthesia" means any drug, element or other material administered to eliminate all sensation and which, when administered, is accompanied by a state of unconsciousness;

(h) "Licensee" means the person or body to whom the license or permit is issued and who is held responsible for compliance with all required rules, regulations, and minimum standards;

(i) "Permit" or "license" means an authorization granted by the Department to an applicant to operate an ambulatory surgical treatment center providing one or more types or classifications of services;

(j) "Provisional Permit" means an authorization granted by the Department to an applicant to operate an ambulatory surgical treatment center on a conditional basis to allow a newly established center a reasonable but limited period of time to demonstrate that operational procedures are in satisfactory compliance with these rules and regulations, or to allow an established and operating center a specified length of time to comply with these rules and regulations, provided said center shall first present a plan of improvement which is acceptable to the Department;

(k) "Plan of Improvement" means a written plan submitted to the Department by the person or persons responsible for the center, and acceptable to the Department. The plan shall identify the existing areas of noncompliance of the facility, together with the proposed procedures, methods and period of time to correct the areas of noncompliance;

(l) "Professional Staff" means the group of persons or body appointed by the Governing Body to provide patient services, and who require special licensure or registration. Normally, the professional staff will be restricted to currently licensed medical, dental, and podiatrist practitioners. Other personnel, for example, registered nurses, may be appointed to the professional staff to assist the practitioners in the development, interpretation, and enforcement of patient care policies;

(m) "Practitioner" means a physician, dentist, or podiatrist;

(n) "Physician" means an individual who is currently licensed to practice medicine, surgery or osteopathy in the State of Georgia, under the Georgia Medical Practice Act, Chapter 84-9, Georgia Laws, Ann.;

(o) "Dentist" means any person who is currently licensed to practice dentistry in the State of Georgia, under provisions of the Georgia Dentist and Dental Hygienists Act, Chapter 84-7, Georgia Laws, Ann.;

(p) "Podiatrist" (Chiropodist) means any person who is currently licensed to practice podiatry (chiropody) in the State of Georgia, under provisions of the Georgia Podiatry Act, Chapter 84-6, Georgia Laws, Ann.;

(q) "Registered Nurse," "Registered Professional Nurse," or "R.N." means a person who is currently licensed to practice as a licensed registered nurse under provisions of Chapter 84-10, Georgia Laws, Ann.;

(r) "Licensed Practical Nurse" or "L.P.N." means a person currently licensed to practice as a licensed practical nurse under provisions of Chapter 84-68, Georgia Laws, Ann.;

(s) "Private Office(s)," "Office(s)," and/or "Treatment Rooms" means any area or place established and maintained by a currently licensed individual practitioner, professional association, or group practice of such practitioners, in his/her/their private individual or private group practice, in which he/she/they

Ambulatory Surgical Treatment Centers Chapter 290-5-33

primarily see(s), consult(s) with, examine(s), and/or treats private patients on a regular and on-going basis, and in the operation of which such currently licensed practitioners have full control of all financial, administrative, and professional arrangements with said patients;

(t) "Hospital" means any facility which meets the requirements of and is currently licensed as a hospital under Georgia Laws and rules and regulations pertaining thereto;

(u) "Procedure Room" means any room or area of the ambulatory surgical treatment center in which surgical procedures are performed;

(v) "Patient" means any individual who receives medical/surgical treatment in facilities governed by these regulations;

(w) "Qualified Counselor" means a person who assists the professional staff by talking with and informing patients regarding expectations and probable outcomes associated with services in an ambulatory surgical treatment center, and who possesses the following minimum qualifications: at least a bachelor's degree from an accredited college or university in nursing, psychology or social work, or in some related field, or who has special training in counseling which is deemed acceptable by the Department; provided, however, that any such counselor shall function only under the direct supervision of the responsible practitioner.

Authority Ga. L. 1964, pp. 499, 507, 522, 565, 611, 612, 613; Ga. L. 1964, p. 338, as amended; Ga. L. 1966, pp. 310, 311, 312; Ga. L. 1972, pp.

1069, 1070, 1072; Ga. L. 1973, p. 635 et seq.; Ga. L. 1978, pp. 1757, 1758; Ga. L. 1978. p. 941 et seq.; and Ga. L. 1979, p. 1109 et seq.

Administrative History. Original Rule entitled "Definitions" was filed on January 23, 1976; effective February 12, 1976. Amended: Rule repealed. Filed October 31, 1979; effective November 20, 1979. Amended: Rule of the same title has been adopted. Filed January 22, 1980;

effective March 1, 1980, as specified by the Agency.

290-5-33-.02 Exemptions. Amended. The following types of health care facilities are exempt from the

requirements of these regulations:

(a) currently licensed hospitals, or a facility as specified in 290-5-33-.03 (12);

(b) a practitioner's private offices or treatment rooms in which a practitioner primarily sees, consults with, and treats patients;

(c) facilities owned and operated by the Federal Government.

Authority Ga. L. 1964, pp. 499, 507, 522, 565, 611, 612, 613; Ga. L. 1964, p. 338, as amended; Ga. L. 1966, pp. 310, 311, 312; Ga. L. 1972, pp.

1069, 1070, 1071, 1072 ; Ga. L. 1973, p. 635 et seq.; Ga. L. 1978, pp. 1757, 1758; Ga. L. 1978, p. 941 et seq.; and Ga. L. 1979, p. 1109 et seq.

Administrative History. Original Rule entitled "Application" was filed on January 23, 1976; effective February 12, 1976. Amended: Rule repealed. Filed October 31, 1979; effective November 20, 1979. Amended: Rule entitled "Exemptions" adopted. Filed January 22, 1980;

effective March 1, 1980, as specified by the Agency.

290-5-33-.03 Organization and Administration. Amended.

(1) Each ambulatory surgical treatment center shall be organized with an identifiable governing body that establishes the objectives, sets the policies and assumes full legal responsibilities for the overall conduct of the center and for compliance with all applicable laws and regulations pertaining to the center. The membership of the governing body shall be identified in the application to the Department for licensure.

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(3) The governing body of the center shall be responsible for appointing the professional staff and shall establish effective mechanisms for quality assurance and to ensure the accountability of the center's medical and/or dental staff and other professional personnel.

(4) The organizational objectives of the ambulatory surgical treatment center shall be clearly stated in the procedures and policies of the governing body and on the application for licensure.

(5) The governing body shall inform the Department of the name(s) of the administrator(s) to whom the responsibility for the day-to-day management of the center is delegated, including the implementation of rules and policies adopted by the governing body.

(6) Each center shall be at all times under the immediate personal and daily supervision and control of the administrator or his designated representative, whose authority, duties and responsibilities shall be defined in writing and which shall be available to the Department upon request.

(7) The Department shall be notified with a new application, or written amendment to the current application, when there are changes in location, ownership, management or operational objectives.

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