Section 216-RICR-40-10-13.4 - Licensure Procedures13.4.1General Requirements for LicensureA. No person acting severally or jointly with any other person, shall establish, conduct or maintain a physician ambulatory surgery center in this state without a license in accordance with the requirements of R.I. Gen. Laws § 23-17-4. Physician ambulatory surgery center licensure shall not be required for the performance of exempt procedures as defined herein.B. On or after January 6, 2003, no person acting severally or jointly with any other person, shall establish, conduct or maintain a podiatry ambulatory surgery center in this state without a license in accordance with the requirements of R.I. Gen. Laws § 23-17-4. Podiatry ambulatory surgery center licensure shall not be required for the performance of exempt procedures as defined herein.C. Exemption from the requirements of certificate of need for a single-practice physician or podiatry ambulatory surgery center is pursuant to R.I. Gen. Laws § 23-15-2(4)(i).D. Initial licensure and/or changes in owner, operator or lessee of a physician ambulatory surgery center or podiatry ambulatory surgery center are subject to approval of the licensing agency.E. Surgery provided within the physician ambulatory surgery center/ podiatry ambulatory surgery center shall be provided solely by physicians or podiatrists, respectively, who are or who comprise, or are employees of, the person to whom the license is issued.13.4.2Application for LicenseA. Application for a license to conduct, maintain or operate a physician ambulatory surgery center/ podiatry ambulatory surgery center shall be made to the licensing agency upon forms provided by it one (1) month prior to expiration date of license and shall contain such information as the licensing agency reasonably requires which may include affirmative evidence of ability to comply with the provisions of R.I. Gen. Laws Chapter 23-17 and the rules and regulations herein. 1. Each application shall be accompanied by a non-refundable application fee as set forth in the rules and regulations pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title).B. A listing of names and addresses of direct and indirect owners whether individual, partnership or corporation with percentages of ownership designated shall be provided with the application for licensure and shall be updated upon any change to such ownership information. 1. The licensing agency shall be informed forthwith of any change in owner of a licensed physician ambulatory surgery center/ podiatry ambulatory surgery center.13.4.3Issuance and Renewal of LicenseA. Upon receipt of an application for a license, the licensing agency shall issue a license or renewal thereof for a period of no more than one (1) year if the applicant meets the requirements of R.I. Gen. Laws Chapter 23-17 and the rules and regulations herein. Said license, unless sooner suspended or revoked, shall expire by limitation on the 31st day of December beginning in the year 2001 (2003 for podiatry ambulatory surgery centers) and may be renewed from year to year after inspection and approval by the licensing agency. 1. All renewal applications shall be accompanied by a non-refundable application fee as set forth in the Rules and Regulations Pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title).B. A license shall be issued to a specific licensee for a specific location and shall not be transferable.C. A license issued hereunder shall be the property of the state loaned to such licensee and it shall be kept posted in a conspicuous place on the licensed premises.13.4.4CapacityA. The license for a physician ambulatory surgery center/ podiatry ambulatory surgery center shall be issued for a specified number of operating/procedure rooms.B. The post-surgical recovery area of a physician ambulatory surgery center/ podiatry ambulatory surgery center shall be adequate to meet patients' needs.13.4.5InspectionsA. The licensing agency shall make or cause to be made such inspections and investigations as it deems necessary and in accordance with R.I. Gen. Laws § 23-17-10 and the rules and regulations herein. 1. Within nine (9) months of initial licensure, the physician ambulatory surgery center/ podiatry ambulatory surgery center shall file an acceptable application with an accreditation agency, as defined herein.2. Within twenty four (24) months of initial licensure, the physician ambulatory surgery center/ podiatry ambulatory surgery center shall attain appropriate certification from an accreditation agency, as defined in herein.3. Each physician ambulatory surgery center/ podiatry ambulatory surgery center, having obtained accreditation pursuant to §13.4.5(A)(2) of this Part, shall maintain such certification as a condition of licensure.4. The physician ambulatory surgery center/ podiatry ambulatory surgery center shall provide the state agency with complete copies of all correspondence received from or mailed to any accreditation agency related to certification from the accreditation agency. Said copies shall be supplied to the state agency within three (3) days of receipt or mailing of the correspondence.B. Every physician ambulatory surgery center/ podiatry ambulatory surgery center shall be given prompt notice by the licensing agency of any deficiencies reported as a result of an inspection or investigation.C. Written reports and recommendations of inspections, including such materials from the state agency and the accreditation agency, shall be maintained on file in each physician ambulatory surgery center/ podiatry ambulatory surgery center for a period of no less than three (3) years. Physician ambulatory surgery center/ podiatry ambulatory surgery center plans for the correction of identified deficiencies shall also be maintained on file for a period of no less than three (3) years.D. All materials required pursuant to §13.4.5 of this Part shall be deemed to be public records and shall be made available by the physician ambulatory surgery center/ podiatry ambulatory surgery center to members of the public on request.13.4.6Denial, Suspension, Revocation of License or Curtailment of ActivitiesA. The licensing agency is authorized to deny, suspend or revoke the license or curtail activities of any physician ambulatory surgery center/ podiatry ambulatory surgery center which: 1. Has failed to comply with the rules and regulations pertaining to the licensing of physician ambulatory surgery center/ podiatry ambulatory surgery centers; and2. Has failed to comply with the provisions of R.I. Gen. Laws Chapter 23-17.3. Lists of deficiencies noted in inspections conducted in accordance with §13.4.5 of this Part shall be maintained on file in the licensing agency, and shall be considered by the licensing agency in rendering determinations to deny, suspend or revoke the license or to curtail activities of a physician ambulatory surgery center/ podiatry ambulatory surgery center.B. Where the licensing agency deems that operation of a physician ambulatory surgery center/ podiatry ambulatory surgery center results in undue hardship to patients as a result of deficiencies, the licensing agency is authorized to deny licensure to a physician ambulatory surgery center/ podiatry ambulatory surgery center not previously licensed, or to suspend for a stipulated period of time or revoke the license of a physician ambulatory surgery center/ podiatry ambulatory surgery center already licensed or curtail activities of the physician ambulatory surgery center/ podiatry ambulatory surgery center.C. Whenever an action shall be proposed to deny, suspend or revoke a physician ambulatory surgery center/ podiatry ambulatory surgery center license, or curtail its activities, the licensing agency shall notify the physician ambulatory surgery center/ podiatry ambulatory surgery center by certified mail, setting forth reasons for the proposed action, and the applicant or licensee shall be given an opportunity for a prompt and fair hearing in accordance with R.I. Gen. Laws §§ 23-17-8 and 42-35-9.D. However, if the licensing agency finds that public health, safety or welfare imperatively requires emergency action and incorporates a finding to that effect in its order, the licensing agency may order summary suspension of license or curtailment of activities pending proceedings for revocation or other action in accordance with R.I. Gen. Laws §§ 23-1-21 and 42-35-14(c).E. The appropriate state and federal placement and reimbursement agencies and the relevant accreditation agency(ies) shall be notified of any action taken by the licensing agency pertaining to denial, suspension or revocation of license, or curtailment of activities.216 R.I. Code R. § 216-RICR-40-10-13.4