59A-5021. Plan submission requirements and fees, 59A-5. Ambulatory Surgery Center License, 59A. Licensing of Healthcare Institutions and Agencies, 59. Agency for Healthcare Administration, Florida Administrative Code (2023)

  • 1(1) Construction work, including demolition, may begin only with prior written approval from the Office of Design and Construction. This includes the construction of new facilities, as well as any additions, alterations, renovations or renovations to the site, building, equipment or systems of any existing facilities.51Permission to start construction is granted by the Agency if the project complies with all applicable regulations and standards, as demonstrated by a thorough review of documents submitted to the Agency, which are required for Stage III construction documents.

    91(2) The permit to start building work, which is limited to demolition work, site work, foundation construction and building structure, may be obtained before the permit114Level III Construction Documents 118when the following are submitted for review and approval:

    127(ONE)128ONE129Stage II Preliminary Letter of Approval from the Design and Construction Office141granted by the Agency if the design complies with applicable life safety regulations and flood requirements and the layout takes into account all necessary functional spaces, as demonstrated by a thorough examination of the documents required by the Agency in accordance with this Rule on Interim Designs Tier II.

    189(b) Construction documents, specifications and construction details for all work to be performed.

    202(c) Letter from the entity releasing the Agency from any liability that may arise as a result of the final review of the project construction documents.

    230(d) Demolition or construction must be accompanied by an Infection Control Risk Assessment (ICRA) and Life Safety Plan detailing the temporary abandonment, as well as detailed phasing plans showing how the areas to be demolished or constructed are to be segregated from any residential areas and buildings to be implemented around residential areas.282Submissions that do not contain ICRA or demonstrate the security measures required by ICRA will not be approved.

    302(3) Construction must begin within 12 months of receiving approval from the Design and Construction Office. Once construction begins, construction activities must continue until the project is complete. If construction does not begin within 12 months of plan approval, or if construction activity is dormant for more than 12 months after construction begins, the project will be abandoned. Resumption of an abandoned project requires resubmission of construction documentation along with a new request for design review and is subject to all fees provided in section393395.0163, F.S. 395Projects that have not received planning permission will be considered abandoned after 12 months of inactivity and the project will be terminated.

    419(4) When any construction work is proposed, whether for new buildings or for additions, alterations or renovations to existing buildings, plans and specifications must be prepared and submitted to the Office of Plans and Construction for approval by the appropriate registered Florida professional planners , if required by Florida Building Code Chapters 471 and 481, F.S. Any architectural or engineering firm that is not a sole proprietor must also register as an architectural or engineering firm with the Florida Department of Business and Professional Regulation.

    502(5) The initial submission of plans to the Office of Design and Construction for any new project must include a completed Request for Plan Review, Form AHCA 3500-0011, June 2014, which is incorporated by reference and available at538 https://www.flrules.org/Gateway/reference.asp?No=Ref-05456,540and a valid certificate of need, if required by the Organization. This information must be included in the initial submission.558. 559Projects requiring a Certificate of Claim will not be able to commence construction without a valid Certificate of Claim. 578Plan review requests are available from the Agency for Health Care Administration, Office of Plans and Construction, 2727 Mahan Drive,599Mail Stop #24, Tallahassee, Florida 32308, or on the web at:611http://ahca.myflorida.com/MCHQ/HQALicensureForms/index.shtml

    612(6) Plans and specifications submitted for review are subject to the plan review fees specified in Sec629395.0163, F.S. 631All fees must be paid to the Health Management Agency and must be noted in the Designs and Construction Office and facility registration number. Fees are non-refundable.

    661(7) Plans and specifications may be submitted for review at any of the three stages of development described in this rule.

    682(8) A program or scope of work must be submitted for each level of submission. It should consist of a detailed written description of all planned work and all necessary steps and specify the types of medical services to be provided.

    724(9) For projects involving only equipment modifications or system renovations, only Level III construction documents will be accepted. These documents must include:

    748(a) Life safety plans showing fire/smoke compartments in renovation area.

    761(b) Detailed phase plans showing how the new works will be separated from any residential areas.

    777(c) engineering drawings and specifications for each work required.

    788(10) Phase I, schematics.

    793(a) The following shall be included in the schematic drawings:

    8031. One-line plans of each floor showing the relationship of different activities or services to each other and the layout of space on each floor.

    8282. The function of each room or rooms shall be noted in or near the room or rooms.

    8463. Proposed roads and sidewalks, access and service yards, parking areas and orientation are shown on a small area plan or first floor plan.

    8724. A simple cross-sectional diagram showing the intended construction.

    8815. A schematic life safety plan showing smoke and fire compartments, exits, exit passages and gross areas of required smoke and fire compartments.

    9046. Indicate which areas will be sprayed, new and existing.

    914(b) Where the proposed structure is an addition to or otherwise associated with existing buildings on the site, schematic plans shall show the facilities and general layout of such buildings.

    945(c) If the project involves an increase, decrease, reallocation, or transfer of licensed beds, a table detailing the total number of beds, room types, and adjacent room types must be provided.

    976(11) Phase II, preliminary designs.

    981The following should be included in the preliminary design.

    990(a) Map of the environment. For the construction of a new ambulatory surgery center, provide a map of the area with the main junctions of the local roads.

    1010(b) Land Development Plans.

    1014(c) plans showing existing properties and proposed improvements.

    1022(d) Site dimensions.

    1026(e) Location of the fire service water source for the building.

    1038(f) Architectural Works.

    10411. Plans to a scale of at least 1/8 inch, showing door and window panels, frames and frames, light fixtures and plumbing. Give the function of each space.

    10672. Typical long sections of interior and exterior walls with typical fire and fire/smoke partitions and a typical corridor partition.

    10883. All external aspects of the building.

    1093(g) Devices not included in the construction contract that require mechanical or electrical connections or construction modifications must be identified to ensure coordination with the architectural, mechanical, and electrical phases of construction.

    1128(h) If the project is located in a residential area, preliminary phase plans showing how the project will be separated from all residential areas.

    1153(i) Life Insurance Plans.

    11571. Life insurance plans must include:

    1165A. Single-sheet floor plans showing required fire and smoke compartments, all escape routes and all emergency signals. If smoke separation is required, dimension the longest run through each smoke compartment to the doors leading to the next adjacent smoke compartment, calculate the total area of ​​the smoke chamber in square feet and the tab outlet in inches.

    1227B. All areas are sprayed.

    1231C. All fire extinguishers.

    1235D. All fire alarm devices and location of railway stations.

    12442. If the project is an addition or renovation to an existing building, fully developed life safety plans must be submitted.

    12653. If the project is the rehabilitation of an existing building, safety plans must be submitted for the floor to be renovated and the required egress level(s).

    12934. In case of demolition or construction work in and around occupied buildings, a safety plan should be provided detailing temporary abandonment and detailed phased plans showing how the areas to be demolished or constructed will be separated from all occupied areas.

    1336(j) engineering drawings.

    13401. Single-sheet floor plans with a single-line diagram of the ventilation system with relative pressures for each room. Provide a written description and drawings of the proposed passive or active smoke control system and a sequence of operation linked to the life safety plans.

    13842. The general location of all fire and smoke extinguishers, all smoke vent detectors and fire statistics.

    14013. If the building has sprinkler systems, indicate the location of the sprinkler risers and the connection point for the sprinkler system. Provide design methodology for new and existing sprinkler systems.

    14414. The locations of all plumbing and other equipment requiring plumbing and/or gas services.

    14595. Locations of smoke, radiation or chemical vents.

    14696. The locations of all medical gas outlets, piping distribution risers, fittings, alarm panels, emergency low-pressure oxygen connections, zone/isolation valves, and gas source locations.

    14947. The locations and relative sizes of major mechanical equipment such as chillers, air handling units, fire pumps, medical gas storage tanks, boilers, vacuum pumps, air compressors and fuel storage tanks.

    15268. The location of the dangerous areas and the quantity of products contained therein.

    15419. The location of the fire pump, risers and sprinklers.

    1552(k) Electrical Drawings.

    15561. Single-line diagram of normal and basic electrical power systems, showing service and input transformers, switchboards, transfer switches, distribution feeders and overcurrent devices, switchboards and step-down transformers. The diagram shall include a preliminary list and description of new and existing, normal and emergency loads, preliminary estimates of available short-circuit current to all new and existing equipment for all new equipment, short-circuit and resistance ratings of existing equipment to new loads, and any new or revised grounding requirements.

    16362. See fire detection zones and relate to life safety plan.

    1648(l) Frame Specifications. Sectoral specifications must provide a general description of the construction, including building classification and classification of fittings, interior finishes, general types and locations of acoustical material, flooring, ventilation equipment, plumbing, fire protection equipment, medical gas equipment and electrical equipment .

    1692(m) When an existing building is converted into a health facility, the general plan of the existing building must be submitted with drafts for the proposed facility.

    1726(n) If an extension, alteration, renovation or renovation of an existing facility is proposed, the general plan of the existing facility with drafts must be submitted.

    1756(12) Level III, Construction Documents.

    1761The Phase III Construction Record is an extension of the Phase II Preliminary Design Submission and must provide a full description of the proposed construction. Construction documents must be signed, stamped and dated and submitted to the Office of Design and Construction for written approval by a Florida registered architect and a Florida registered professional engineer. These documents include works related to civil engineering, building, mechanical and electrical works, fire safety, lightning protection, landscape architecture and all architectural works. In addition to the Phase II submission requirements, the construction documentation must include the following:

    1857(a) Site and civil engineering plans detailing building and site elevations, site services, paving plans, grading and drainage plans and details, locations of the two fire hydrants used to perform the water flow test, and landscaping plans.

    1895(b) Life safety plans for the entire project. Projects located on floors above or below the outlet runoff level must also include safety plans for the runoff serving the project area.

    1928(c) Architectural Works.

    19311. Typical large-scale details of all standard internal and external walls and smoke screens, horizontal exits and exit passages.

    19502. Complete roof plans showing all utilities, light fixtures, smoke detectors, air handling units, sprinkler locations and fire rated roof support locations, if applicable.

    19753. Floor/ceiling and ceiling/ceiling installation descriptions for all conditions.

    19844. Details and other instructions to the contractor in the construction documents describing the techniques to be used to seal floor construction penetrations necessary to prevent smoke migration from one floor to another during a fire.

    2019(d) Structural plans, schedules and details.

    2026(e) Engineering plans, including fire and smoke control plans. Consider any devices that require mechanical aids2043.2044Provide a clear and concise narrative control sequence for each mechanical device, including but not limited to air conditioning, heating, ventilation, medical gas, plumbing and fire protection and any system interconnections. Engineering drawings must fully represent the systems to be used, new or existing, from the point of origin to the end point of the system. Provide a tabular table detailing the required airflow (calculated from the information provided in the ventilation rate table) in cubic feet per minute (cfm) for supply, return, exhaust, outside air and ventilation for each space indicated on the architectural documents. The program should also include the design airflow rates of the HVAC system and the resulting relative room pressures. The table, or part of the table, must be placed on each plan drawing sheet containing the spaces shown on the drawing.

    2194(f) Fire protection system layout documents as defined by the Ministry of Commerce and Professional Regulation in Regulation221261G15-32.002,2213F.A.C., where applicable, incorporating the existing system to the extent necessary to define the new work. These documents must be signed and stamped by a registered professional engineer in Florida.

    2241(g) Electrical Drawings describing complete power, lighting, alarm, communications and lightning protection systems and power system study.

    2259(h) A performance study including a failure study with calculations demonstrating that surge devices, transfer switches, switchboards, switchboard panels, motor controls, transformers and feeders are of sufficient size to withstand fuse the available phase-to-phase overcurrent devices -Earth fault. The study also includes an analysis of generator performance under fault conditions and a tuning study leading to tabulation of settings for all adjustable relays, timings, relays and ground fault tuning of overcurrent devices. This must be provided for all new devices and existing devices for all new devices. Performance studies for retrofits of existing distribution systems should include only new equipment and existing equipment upstream of the new equipment's normal and emergency feeders. A full energy study is not required for retrofits involving only junction panels with no changes to the feeder. Instead, the performance study is limited to the calculation of new and existing loads on the supply compartment.

    2415(13) A complete set of specifications for all work to be performed.

    2427(a) Any test and/or certification reports required for the project provided by the contractor must be submitted in writing on standard forms, reviewed and accepted by the engineer-in-charge before being sent to the Agency for review.

    2461(b) The specifications require performance verification testing and reporting of balanced airflow values ​​with the specified air filters installed for each air handling unit system operating at minimum pressure drop (clean filter condition) and maximum pressure drop (dirty filter condition).

    2508(14) All construction documents must be coordinated2515Ensure design consistency across documents2524and phasing plans should be clear and ensure continuity of required services. In the case of extensions to existing facilities, it is particularly essential that the mechanical and electrical systems, in particular the existing basic electrical systems, and all other relevant requirements form part of this submission.

    2570(a) Any subsequent additions, change orders, field orders and other documents modifying the foregoing2584small2585The room must also be signed, stamped and dated and sent to the Planning and Building Office in advance2604Analysis. The agency will approve or deny the request based on compliance with all applicable codes and standards and provide a written list of deficiencies2632.

    2633(b) All submissions will be processed by the Agency within 60 days of receipt of completed construction documentation and initial payment of the design review fee. The agency will approve or reject the submission and provide a written list of deficiencies. Any deficiencies identified by the Agency must be satisfactorily resolved before final approval is granted by the Agency.

    2700(15) Modifications or changes made2705increase the project scope of work by more than fifty percent 2716or change the original project object2724more than fifty percent 2728must be submitted as a new project.

    2738(16) registration plans. A complete set of legible registration plans detailing all construction, fixed equipment, and installed mechanical and electrical systems must be provided to the Design and Construction Office within 60 days of receipt of final design approval from the Agency. These plans must include life insurance plans. Registration plans can be submitted electronically in Portable Document Format (PDF). If the design documentation is not received within the time specified in this section, only the construction document and design file will be retained.

    2831regulating authority2833395.1055 VAT. 2835applicable law2837395.0163,2838471.025,2839481.221,2840553,73,2841633.033 FS. History - New 6/14/78, formerly 10D-30.21, amended. 2/3/88, 5/6/92, formerly 10D-30,021, amended 12/11/96, 7/9/15.


Which part of the Code of Federal Regulations CFR provides requirements for ambulatory surgical services? ›


Who regulates surgery centers in Florida? ›

The state organization with the primary responsibility for licensing and regulating ambulatory surgical centers is the Agency For Health Care Administration (AHCA).

What is ASC in insurance? ›

Administrative Services Contract (ASC) – ASC is a contract that differs from ASO only in that, with ASC, claims are paid from a bank account owned by the insurer and the insurer needs to seek reimbursement from the plan sponsor to cover the claim payments.

Who is CFR mandated by? ›

In the law of the United States, the Code of Federal Regulations (CFR) is the codification of the general and permanent regulations promulgated by the executive departments and agencies of the federal government of the United States.

What is a Level 3 surgery? ›

Level III Office Surgery is surgery that in which: Involves, or reasonably should require, the use of a general anesthesia or major conduction anesthesia and pre-operative sedation.

Is Florida a con state for ASC? ›

* As of 2019, Florida general hospitals —including acute care facilities, long-term care facilities, and rural hospitals — are no longer subject to CON approval, though the program still exists for other providers like hospices and children's hospitals.

Who regulates medical billing in Florida? ›

The Department of Health investigates complaints and reports involving health care practitioners and enforces appropriate Florida Statutes.

What is the difference between ASO and ASC insurance? ›

There is no difference between ASO and ASC. They are both types of contracts in which the organization assumes some of the financial risks for paying claims.

What is ASC billing examples? ›

Examples of Covered ASC Facility Services are:
  • Nursing services, technical personnel furnished services, and other related services.
  • Drugs and biologicals for which Medicare makes no OPPS separate payment; surgical dressings; supplies; splints; casts; appliances; and equipment.
May 16, 2019

How are ASC claims billed? ›

How are basic ASC charges coded and billed? An ASC uses a combination of physician and hospital or clinical billing, employing the CPT and HCPCS level codes (as do most physicians), some insurance carriers permit an ASC to bill using ICD-10 procedure codes as does a hospital.

Who must comply with 21 CFR Part 11? ›

21 CFR Part 11 applies to clinical trial sponsors, including pharmaceutical and medical device companies, who are conducting FDA-regulated research. It also applies to Clinical Research Organizations (CROs) and research sites.

What is the CFR rules and regulations? ›

The Code of Federal Regulations (CFR) presents the official and complete text of agency regulations in an organized fashion in a single publication. The CFR is updated by amendments appearing in the daily Federal Register. Used together, these two publications establish the latest version of any given rule.

What are the CFR rules? ›

The Code of Federal Regulations (CFR) is an annual codification of the general and permanent rules published in the Federal Register by the executive departments and agencies of the Federal Government.

What is the highest qualification in surgery? ›

The Master Chirurgiae (MCh), considered the highest master's degree in Surgical Science, is a highly advanced and specialized postgraduate/doctoral degree following Master of Surgery that provides an individual with a technical grasp of complex surgical techniques.

What does Level 1 2 or 3 mean at a hospital? ›

The different levels (ie. Level I, II, III, IV or V) refer to the kinds of resources available in a trauma center and the number of patients admitted yearly. These are categories that define national standards for trauma care in hospitals. Categorization is unique to both Adult and Pediatric facilities.

Does Florida require a Certificate of Need? ›

Compared to other states with a Certificate of Need policy, healthcare law in Florida is considered to be minimally regulated. The state established its Certificate of Need Law in 1973, but following the current healthcare policy, it does not regulate all hospital projects.

Does Florida have a Certificate of Need? ›

Since 1973, Florida has restricted the supply of health care with certificate-of-need (CON) programs. These programs prohibit health care providers from entering new markets or making changes to their existing capacity without first gaining the approval of state regulators.

What is Certificate of Need Florida? ›

The Certificate of Need program is a regulatory process that requires certain health care providers to obtain state approval before offering certain new or expanded services.

What happens if you can't pay a hospital bill in Florida? ›

If they're unable to collect on your debt, the hospital or collections agency could decide to sue you. Lawsuits are expensive and an additional emotional burden on top of your medical debt.

How far back can a doctor bill you in Florida? ›

The statute of limitations for medical debt in Florida is five years.

What is a fee schedule? ›

A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers.

What is 42 CFR part? ›

Statutory authority for confidentiality of substance use disorder patient records.

Which part of the Code of Federal Regulations CFR provides requirements for conditions for participation for hospitals? ›

eCFR :: 42 CFR Part 482 -- Conditions of Participation for Hospitals.

What is Code of Federal Regulations CFR Title 21cfr? ›

The Code of Federal Regulations (CFR) is a codification of the general and permanent rules published in the Federal Register by the Executive departments and agencies of the Federal Government.. Title 21 of the CFR is reserved for rules of the Food and Drug Administration.

What is the Naics code for ambulatory surgery center? ›

621493 Freestanding Ambulatory Surgical and Emergency Centers.

What is as required by 49 CFR Part 40? ›

49 CFR Part 40, or Part 40 as we call it, is a DOT-wide regulation that states how to conduct testing and how to return employees to safety-sensitive duties after they violate a DOT drug and alcohol regulation.

What are 21 CFR Part 11 user requirements? ›

Part 11 requires you to have a complete version history available for every quality document in your system, through the: “Use of secure, computer-generated, time-stamped audit trails to independently record the date and time of operator entries and actions that create, modify, or delete electronic records.”

What is 42 CFR Part 2 and why is it important? ›

To address this issue, federal regulations known as "42 CFR Part 2" protect the confidentiality of addiction treatment records of any person who has sought treatment for or been diagnosed with addiction at a federally assisted program.

Are regulations in the CFR binding? ›

The first edition of the CFR was published in 1938, and it has since gone through many changes. These rules are considered legally binding just as any statute. The Office of the Federal Register publishes the CFR annually in 50 titles.

What is an example of conditions of participation? ›

For example, a typical provision was a medical staff meetings standard calling for regular efforts to review, analyze, and evaluate clinical work, using an adequate evaluation method.

What is 42 CFR 482.15 condition of participation emergency preparedness? ›

§ 482.15 Condition of participation: Emergency preparedness. The hospital must comply with all applicable Federal, State, and local emergency preparedness requirements.

What is the difference between CFR and Federal Register? ›

The Federal Register is the chronological publication of proposed regulations, final regulations, and related materials. The Code of Federal Regulations (CFR) is a subject arrangement of regulations.

What are the CRF regulations? ›

The Code of Federal Regulations (CFR) is a codification (arrangement of) the general and permanent rules published in the Federal Register by the executive departments and agencies of the Federal Government.

What is 21 CFR compliance? ›

What is 21 CFR Part 11? CFR stands for “Code of Federal Regulation.” 21 CFR Part 11, in particular, details the criteria under which electronic records and signatures are considered to be trustworthy and equivalent to paper records.

What is the SIC code for ambulatory surgery center? ›

SIC Code 8011 - Freestanding Ambulatory Surgical and Emergency Centers.

What is the SIC code for ambulatory services? ›

SIC Code 8099 - All Other Misc. Ambulatory Health Care Services.

What is the Naics code for provides surgery services? ›

NAICS Code: 621111 Offices of Physicians (except Mental Health Specialists) | NAICS Association.

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