LAC 48:I.4587. General Requirements

A. The standards in this Subchapter shall apply to any ASC constructed after the effective date of this rule, or an ASC that makes alterations, additions or substantial rehabilitation to an existing ASC or adaptation of an existing building to create an ASC. Cosmetic changes to the ASC such as painting, flooring replacement or minor repairs shall not be considered an alteration or substantial rehabilitation. Exception: For those applicants for ASC licensure who received plan review approval from the OSFM before the effective date of the promulgation of this Rule, or who have begun construction or renovation of an existing building before the effective date of the promulgation of this Rule, the physical environment requirements of §4587 shall not apply. B. An applicant for an ASC license shall furnish one complete set of architectural plans and specifications to the entity/office designated by the department to review and approve the facility’s architectural plans and the Office of State Fire Marshal. 1. The office designated by the department to review and approve architectural drawings and specifications and the Office of State Fire Marshal shall review and approve the Life Safety Code plans before construction is allowed to begin. 2. When the plans and specifications have been reviewed and all inspections and investigations have been made, the applicant will be notified whether the plans for the proposed ASC have been approved. C. No alterations, other than minor alternations, shall be made to existing facilities without the prior written approval of, and in accordance with, architectural plans and specifications approved in advance by the department, or its designee, and the Office of State Fire Marshal. D. All new construction, additions, and renovations other than minor alterations, shall be in accordance with the specific requirements of the Office of State Fire Marshal (OSFM) and the department, or its designee, who shall be responsible for the review and approval of architectural plans. Plans and specifications submitted to these offices shall be prepared by or under the direction of a licensed architect and/or a qualified licensed engineer and shall include scaled architectural plans stamped by an architect. 1. For all new construction, additions, and renovations, ambulatory surgical centers (ASC) shall follow the 2014 Edition of the Facility Guidelines Institute, Guidelines for Design and Construction of Hospitals and Outpatient Facilities, as adopted by the OSFM for building and construction. 2. The department’s secretary may, within his/her sole discretion, grant waivers to building and construction guidelines or requirements, and to provisions of the licensing rules involving the clinical operation of the ASC. The facility shall submit a waiver request in writing to the department’s licensing section on forms prescribed by the department. a. In the waiver request, the facility shall demonstrate the following: i. how patient health, safety, and welfare will not be compromised if such waiver is granted; ii. how the quality of care offered will not be compromised if such waiver is granted; and iii. the ability of the facility to completely fulfill all other requirements of the service, condition, or regulation. b. The department’s licensing section shall have each waiver request reviewed by an internal waiver review committee (WRC). In conducting such internal waiver review, the following shall apply: i. the WRC may consult subject matter experts, including the OSFM; and ii. the WRC may require the facility to submit risk assessments or other documentation to the department. c. The director of the department’s licensing section shall submit the WRC’s recommendation on each waiver to the secretary or the secretary’s designee for final determination. d. The department shall issue a written decision of the waiver request to the facility. The granting of any waiver may be for a specific length of time. e. The written decision of the waiver request is final. There is no right to an appeal of the decision of the waiver request. f. If any waiver is granted, it is not transferrable in an ownership change or change of location. g. Waivers are subject to review and revocation upon any change of circumstance related to the waiver or upon a finding that the health, safety, or welfare of a patient may be compromised. h. Any waivers granted by the department prior to February 15, 2026, shall remain in place subject to any time limitations on such waivers. Further, such waivers shall be subject to the following: i. review or revocation upon any change in circumstance related to the waiver or upon a finding that the health, safety, or welfare of a patient may be compromised; and ii. are not transferrable in an ownership change or change of location. E. All designs and construction shall be in accordance with the provisions of LAC Title 51, Public HealthSanitary Code. F. Facility within a Facility 1. If more than one health care provider occupies the same building, premises or physical location, all treatment facilities and administrative offices for each health care facility shall be clearly separated from the other by a clearly defined and recognizable boundary. 2. There shall be clearly identifiable and distinguishable signs posted inside the building as well as signs posted on the outside of the building for public identity of the ASC. Compliance with the provisions of R.S. 40:2007 shall be required. 3. An ASC that is located within a building that is also occupied by one or more other businesses and/or other healthcare facilities shall have all licensed spaces and rooms of the ASC contiguous to each other and defined by cognizable boundaries.