Revises provisions of State law concerning licensure of ambulatory care facility.

A1830 TR

ASSEMBLY, No. 1830

STATE OF NEW JERSEY

222nd LEGISLATURE

�

PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION

Sponsored by:

Assemblyman ANTHONY S. VERRELLI

District 15 (Hunterdon and Mercer)

Assemblywoman� CAROL A. MURPHY

District 7 (Burlington)

Assemblywoman� MARISA SWEENEY

District 25 (Morris and Passaic)

SYNOPSIS

���� Revises provisions of State law concerning licensure
of ambulatory care facility.

CURRENT VERSION OF TEXT

���� As reported by the Assembly Health Infrastructure
Committee with technical review.

��

An Act
concerning licensure of ambulatory care facilities and
amending P.L.1971, c.136.

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

���� 1.��� Section 12 of P.L.1971,
c.136 (C.26:2H-12) is amended to read as follows:

���� 12. a. No health care service
or health care facility shall be operated unless it shall:� (1) possess a valid
license issued pursuant to
[
this
act
]

P.L.1971,
c.136 (C.26:2H-1 et al.)
, which license shall specify the kind or kinds of
health care services the facility is authorized to provide; (2) establish and
maintain a uniform system of cost accounting approved by the commissioner; (3)
establish and maintain a uniform system of reports and audits meeting the
requirements of the commissioner; (4) prepare and review annually a long range
plan for the provision of health care services; and (5) establish and maintain
a centralized, coordinated system of discharge planning which assures every
patient a planned program of continuing care and which meets the requirements
of the commissioner which requirements shall, where feasible, equal or exceed
those standards and regulations established by the federal government for all
federally funded health care facilities, but shall not require any person who
is not in receipt of State or federal assistance to be discharged against his
will.

���� b. (1) Application for a
license for a health care service or health care facility shall be made upon
forms prescribed by the department.� The department shall charge a single,
nonrefundable fee for the filing of an application for and issuance of a license
and a single, nonrefundable fee for any renewal thereof, and a single,
nonrefundable fee for a biennial inspection of the facility, as it shall from
time to time fix in rules or regulations, provided, however, that no such
licensing fee shall exceed $10,000 in the case of a hospital and $4,000 in the
case of any other health care facility for all services provided by the
hospital or other health care facility, and no such inspection fee shall exceed
$5,000 in the case of a hospital and $2,000 in the case of any other health
care facility for all services provided by the hospital or other health care
facility.� No inspection fee shall be charged for inspections other than
biennial inspections.� Any surgical practice required to apply for licensure by
the department as an ambulatory care facility pursuant to P.L.2017, c.283 shall
be exempt from the initial and renewal license fees required by this section.�
The application shall contain the name of the health care facility, the kind or
kinds of health care service to be provided, the location and physical
description of the institution, and such other information as the department
may require.

���� (2)�� A license shall be
issued by the department upon its findings that the premises, equipment,
personnel, including principals and management, finances, rules and bylaws, and
standards of health care service are fit and adequate and there is reasonable
assurance the health care facility will be operated in the manner required by
[
this act
]

P.L.1971,
c.136 (C.26:2H-1 et al.)
and rules and regulations thereunder.

���� (3)�� The department shall
post on its Internet website each inspection report prepared following an
inspection of a residential health care facility, as defined in section 1 of
P.L.1953, c.212 (C.30:11A-1) or licensed pursuant to P.L.1971, c.136 (C.26:2H-1
et
[
seq.
]

al.
),
that is performed pursuant to this subsection, along with any other inspection
report prepared by or on behalf of the department for such facility.

���� If an inspection reveals a
serious health and safety violation at a residential health care facility, the
department shall post the inspection report, including the name of the facility
and the owner of the facility, on its website no later than 72 hours following
the inspection.� If a license of a residential health care facility is
suspended, the department shall post the suspension on its website no later
than 72 hours following the suspension.� The department shall update its
website to reflect the correction of a serious health and safety violation and
the lifting of a suspension.

���� The department shall notify,
as soon as possible, the Commissioner of Human Services, or the commissioner's
designee, and the director of the county board of social services or county
welfare agency, as appropriate, in the county in which a residential health
care facility is located, of a serious health and safety violation at the
facility and of any suspension of a license to operate such facility.

���� If the inspection
responsibilities under this subsection with respect to such facility are
transferred or otherwise assigned to another department, that other department
shall post on its Internet website each inspection report prepared following an
inspection of such facility performed pursuant to this subsection, along with
any other inspection report prepared by or on behalf of that department for
such facility, and shall comply with the other requirements specified in this
subsection.

���� c.���� (Deleted by amendment,
P.L.1998, c.43)

���� d.��� The commissioner may
amend a facility's license to reduce that facility's licensed bed capacity to
reflect actual utilization at the facility if the commissioner determines that
10 or more licensed beds in the health care facility have not been used for at
least the last two succeeding years.� For the purposes of this subsection, the
commissioner may retroactively review utilization at a facility for a two-year
period beginning on January 1, 1990.

���� e.���� If a prospective
applicant for licensure for a health care service or facility that is not
subject to certificate of need review pursuant to P.L.1971, c.136 (C.26:2H-1 et
al.) so requests, the department shall provide the prospective applicant with a
pre-licensure consultation.� The purpose of the consultation is to provide the
prospective applicant with information and guidance on rules, regulations,
standards, and procedures appropriate and applicable to the licensure process.�
The department shall conduct the consultation within 60 days of the request of
the prospective applicant.

���� f.���� Notwithstanding the
provisions of any other law to the contrary, an entity that provides magnetic
resonance imaging or computerized axial tomography services shall be required
to obtain a license from the department to operate those services prior to commencement
of services, except that a physician who is operating such services on the
effective date of P.L.2004, c.54 shall have one year from the effective date of
P.L.2004, c.54 to obtain the license.

���� g. (1) (Deleted by amendment,
P.L.2017, c.283)

���� (2)�� (Deleted by amendment,
P.L.2017, c.283)

���� (3)�� (Deleted by amendment,
P.L.2017, c.283)

���� (4)�� A surgical practice in
operation on the date of enactment of P.L.2017, c.283 shall be required to
apply to the department for licensure as an ambulatory care facility licensed
to provide surgical and related services within one year of the date of enactment
of P.L.2017, c.283.

���� A surgical practice that is
certified by the Centers for Medicare and Medicaid Services (CMS) shall not be
required to meet the physical plant and functional requirements specified in
N.J.A.C.8:43A-19.1 et seq.� A surgical practice that is not Medicare certified,
either by CMS or by any deeming authority recognized by CMS, but which has
obtained accreditation from the American Association of Ambulatory Surgery
Facilities or any accrediting body recognized by CMS and is in operation on the
date of enactment of P.L.2017, c.283, shall not be required to meet the
physical plant and functional requirements specified in N.J.A.C.8:43A-19.1 et
seq.� A surgical practice not in operation on the date of enactment of
P.L.2017, c.283, if it is certified by CMS as an ambulatory surgery center
provider, shall also be exempt from these requirements.� A surgical practice
required by this subsection to meet the physical plant and functional
requirements specified in N.J.A.C.8:43A-19.1 et seq. may apply for a waiver of
any such requirement in accordance with N.J.A.C.8:43A-2.9.� The commissioner
shall grant a waiver of those physical plant and functional requirements, as
the commissioner deems appropriate, if the waiver does not endanger the life,
safety, or health of patients or the public.

���� Through State Fiscal Year
2025, a surgical practice required to be licensed pursuant to this subsection
shall be exempt from the ambulatory care facility assessment pursuant to
section 7 of P.L.1992, c.160 (C.26:2H-18.57), except that, if the entity expands
to include any additional room dedicated for use as an operating room, the
entity shall be subject to the assessment.� Beginning in State Fiscal Year
2026, a surgical practice required to be licensed pursuant to this subsection
shall no longer be exempt from the ambulatory care facility assessment.

���� (5)�� As used in this
subsection and subsection i. of this section, "surgical practice"
means a structure or suite of rooms that has the following characteristics:

���� (a)�� has no more than one
room dedicated for use as an operating room which is specifically equipped to
perform surgery and is designed and constructed to accommodate invasive
diagnostic and surgical procedures;

���� (b)�� has one or more
post-anesthesia care units or a dedicated recovery area where the patient may
be closely monitored and observed until discharged; and

���� (c)�� is established by a
physician, physician professional association surgical practice, or other
professional practice form specified by the State Board of Medical Examiners
pursuant to regulation solely for the physician's, association's, or other
professional entity's private medical practice.

���� (6)�� Nothing in this
subsection shall be construed to limit the State Board of Medical Examiners
from establishing standards of care with respect to the practice of medicine.

���� h.��� An ambulatory care
facility licensed to provide surgical and related services shall be required to
obtain ambulatory care accreditation from an accrediting body recognized by the
Centers for Medicare and Medicaid Services as a condition of licensure by the
department.

���� An ambulatory care facility
that is licensed to provide surgical and related services on the effective date
of this section of P.L.2009, c.24 shall have one year from the effective date
of this section of P.L.2009, c.24 to obtain ambulatory care accreditation.

���� i.���� Beginning on the
effective date of this section of P.L.2009, c.24, and as provided in P.L.2017,
c.283, the department shall not issue a new license to an ambulatory care
facility to provide surgical and related services unless:

���� (1)�� in the case of a
licensed facility in which a transfer of ownership of the facility is proposed,
the commissioner reviews the qualifications of the new owner or owners and
approves the transfer;

���� (2) (a) except as provided in
subparagraph (b) of this paragraph, in the case of a licensed facility for
which a relocation of the facility is proposed,
[
the relocation is within 20 miles
of the facility's current location or the relocation is to a "Health
Enterprise Zone" designated pursuant to section 1 of P.L.2004, c.139
(C.54A:3-7),
]

there is no expansion in the number of operating rooms provided at the new
location from that of the current location, and the commissioner reviews and
approves the relocation prior to its occurrence; or

���� (b)�� in the case of a
licensed facility described in paragraph (5) or (6) of this subsection for
which a relocation of the facility is proposed, the commissioner reviews and
approves the relocation prior to its occurrence;

���� (3)�� the entity is a surgical
practice required to be licensed pursuant to subsection g. of this section and
meets the requirements of that subsection;

���� (4)�� the entity has filed its
plans, specifications, and required documents with the Health Care Plan Review
Unit of the Department of Community Affairs or the municipality in which the
surgical practice or facility will be located, as applicable, on or before the
180th day following the effective date of this section of P.L.2009, c.24;

���� (5)�� the facility is owned
jointly by a general hospital in this State and one or more other parties;

���� (6)�� the facility is owned by
a hospital or medical school in this State, or the facility is owned by any
hospital approved on or before the effective date of P.L.2015, c.305 to provide
ambulatory surgery services in this State, or the facility is owned by a hospital
which applied on or before the effective date of P.L.2015, c.305 to provide
ambulatory surgery services in this State so long as the hospital is later
approved to provide ambulatory surgery services at the facility, or the
facility is owned by any hospital approved to provide ambulatory surgery
services at another facility in this State; or

���� (7) (a) the facility is a
newly licensed ambulatory surgical facility that was created by combining two
or more registered surgical practices, provided that the number of operating
rooms at the newly licensed facility is not greater than the total number of
operating rooms prior to the establishment of the newly licensed facility;

���� (b)�� the facility is a
licensed ambulatory surgical facility that has expanded by combining with one
or more registered surgical practices, provided that the number of operating
rooms at the newly expanded facility is not greater than the total number of
operating rooms prior to the combination of the practices and facility; or

���� (c)�� the facility is a
licensed ambulatory surgical facility that has expanded through the combination
of two or more licensed ambulatory surgical facilities, provided that the
number of operating rooms at the newly expanded facility is not greater than
the total number of operating rooms prior to the combining of the facilities.

���� Beginning on the effective
date of P.L.2017, c.283, the department shall not issue a new registration to a
surgical practice.� Any surgical practice in operation on the effective date of
P.L.2017, c.283 that proposes to relocate on or after the effective date of
P.L.2017, c.283 shall be required to be licensed by the department as an
ambulatory care facility providing surgical and related services pursuant to
subsection g. of this section.

���� j.���� (Deleted by amendment,
P.L.2017, c.283)

���� k.��� An ambulatory care
facility licensed to provide surgical and related services and a surgical
practice shall:

���� (1)�� report to the department
any change in ownership of the facility within 30 days of the change in
ownership; and

���� (2)�� annually report to the
department the name of the facility's medical director, physician director, and
physician director of anesthesia, as applicable, and the director of nursing
services.� The facility shall notify the department if there is any change in a
named director within 30 days of the change of the director.

(cf: P.L.2025, c.70, s.1)

���� 2.��� This act shall take
effect immediately.