Ambulatory Surgical Center

Ambulatory Surgical Center

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 24 hours.

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 state licensure, but may choose to be Medicare certified and may choose to be accredited.

Notices/Updates

None at this time

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. Renew Online - All renewal applicants must apply online by submitting the online licensure application, fees, and supporting documents electronically through the Agency's Online Portal.

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, or recovery beds requires a change application. Applications must be submitted 60 days prior to the change or will be subject to a $500 late fine per 59A-35.040(3), F.A.C. 

Any information regarding changes to personnel or controlling interest (that do not constitute a change of ownership) are required to be reported to the agency, and must be submitted within 21 calendar days from the effective date of the change, as required by s. 408.810(3), Florida Statutes. Changes must be reported by submitting a completed application.  Applications not received within 21 calendar days will be subject to a $500 late fine.

Online Licensure - Providers can now make changes to the fictitious name, personnel, management company, address, licensed beds, and hours of operation by going to the online portal and creating a new application. Contact the licensure unit for additional information.

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.

Accreditation Requirements

Accreditation is voluntary. Accredited ASCs meeting Rule 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 and/or recertification surveys, although periodic Life Safety Code inspections are still required. Facilities must provide a complete copy of the most recent survey report indicating continuation as an accredited facility in lieu of inspections. The survey report should include correspondence from the accrediting organization containing:

• The dates of the survey,
• Any citations to which the accreditation organization requires a response,
• A response to each citation,
• The effective date of accreditation,
• Any follow-up reports, and
• Verification of Medicare (CMS) deemed status, if applicable.

Pursuant to section 395.0162, Florida Statutes, this report will become part of the facility file maintained by our office and therefore will be considered public record.  Facilities no longer accredited or granted accreditation status other than accredited or fail to submit the requested documentation will be scheduled for annual licensure and/or recertification surveys to be conducted by Agency field office staff.

Statutory Authority: Section 408.811(2), 395.002(1), 395.0161(2), 395.003(2)(c), 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:

• Medicare Administrative Contractor Choice Form [ 189.7 kB ]
• Health Insurance Benefits Agreement
  (Form CMS 370)[ ]
• Request for certification in Medicare/Medicaid program (Form CMS 377)[ ]

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

Additional Requirements and Forms

Background Screening Unit

Center administrators and financial officers must have a level 2 background screen. For information about completing a background screen, accessing the background screening clearinghouse, and maintaining the clearinghouse roster, please visit the Agency’s

Background Screening web pages

State and Federal Regulations

Federal Certification
Title 42 Code of Federal Regulations (CFR)	To search all of Title 42
Part 416	Ambulatory Surgical Services
CMS State Operations Manual[ ]	Resource for program requirements and interpretive guidelines

Applications and Supporting Forms

All applications are available on the following website: http://ahca.myflorida.com/MCHQ/HQALicensureForms/index.shtml

Form Number	Name	For	Description
AHCA Form 3130-2001	Online Licensure Health Care Licensing Application - Ambulatory Surgical Center [ 122.6 kB ]	All application types	Standard ambulatory surgical center application required to apply for or modify a license. Providers can use online licensure to submit renewal and change during licensure applications.
AHCA Form 3130-2001CL	Application Checklist Ambulatory Surgical Center [ 56.5 kB ]	For informational purposes only	A guide for applicants to use when completing the Health Care Licensing Application for Ambulatory Surgical Centers.
AHCA Form 3110-1024	Health Care Licensing Addendum	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 [ 42.9 kB ]	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.

Other Documents and Supporting Forms

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