Section 144-125-3.D - Application Procedures3.D.1. Filing of Application Any person, partnership, association or corporation desiring a license to engage in ambulatory surgical facilities shall, prior to the commencement of such operation, file an application with the Department. Applications submitted on behalf of a corporation or association shall be made by any two officers thereof or by its administrator. (All applicants shall comply with these rules and regulations.)
3.D.2. Contents of Application Each application shall contain:
a. The name by which the Ambulatory Surgical Facility is to be legally known and the name under which it shall be doing business.b. A description of all facilities utilized by the Ambulatory Surgical Facility. This will include the address(es), telephone number(s) and name(s) of owner(s) of all buildings utilized by the Ambulatory Surgical Facility.c. A listing of surgical procedures provided by the agency.3.D.3. Change in Ownership of Ambulatory Surgical Facility a. No license shall be assigned or transferred.b. At least thirty (30) days advance written notice shall be given to the Division of Program Analysis and Development, Office of Health Planning and Development and the Division of Licensing and Certification, Bureau of Medical Services, prior to the transfer of ownership of any Ambulatory Surgical Facility.c. Each application for a license from a new owner shall be accompanied by a statement from the previous owner or his duly authorized representative concerning the change of ownership. In lieu of this statement, a copy of the deed or other validating document shall be submitted. In addition, an application fee, calculated in accordance with Section 3.A. 1. of this chapter, shall be submitted to the Department. When the ownership of an Ambulatory Surgical Facility provider changes, upon receipt of a completed application and fee the Department may issue a license for a period of one year. The new owner's application must demonstrate that the agency will continue to comply with the requirements for licensure.10-144 C.M.R. ch. 125, § 3.D