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Licensing Requirements - General Hospitals

Thank you for visiting the General Hospital Licensing program webpage. The Department of State Health Services maintains this webpage, but pursuant to Senate Bill 200, regulatory authority over General Hospital Licensing has transferred to the Health and Human Services Commission. (HHSC) as of September 1, 2017.

The Facility Licensing Group is responsible for developing rules that establish minimum standards for general hospital licensing procedures; fees; operational requirements; inspection and investigation procedures; construction; fire prevention and safety requirements; license denial, probation, suspension and revocation.

For consideration of a general hospital license, an establishment must meet the following two components:

  • Offer services, facilities and beds for use for more than 24 hours for two or more unrelated individuals requiring diagnosis, treatment or care for illness, injury, deformity, abnormality or pregnancy; and
  • Regularly maintain, at a minimum, clinical laboratory services, diagnostic x-ray services, treatment facilities including surgery or obstetrical care or both, and other definitive medical or surgical treatment of similar extent.


Hospitals may be accredited by the Joint Commission on Accreditation of Health Care Organizations (JCAHO) or the American Osteopathic Association (AOA).

Applying for an Initial General Hospital License

The application process for general hospital licensing involves:

  • Health Facility Licensing Group staff who review the application and required documents for deficiencies.
    Refer to the application form for fee amount, mailing address and instructions.
  • Health Facility Compliance Group staff who are responsible for conducting a pre- survey conference and surveying the facility for compliance with the provisions on Health and Safety Code, Chapter 241 and TAC Chapter 133. Refer to the application form for timelines.
  • Architectural Review Group staff who are responsible for approving final construction documents, plans and specifications, as well as, conducting inspections. Click here for more information on the architectural review process.


$39 per bed for licensing application fee
Refer to architectural forms included in license application packet for appropriate plan review and inspection fees.
Application fees are not refundable.

Medicare Information

Hospitals may be certified to participate in the federal Medicare program. The Secretary of the Department of Health and Human Services (DHHS) directs state health agencies or other appropriate agencies to determine if health care entities meet federal standards. This helping function is termed "provider certification."

Health Facility Compliance Group staff is responsible for certifying hospitals. For more information on the certification process, refer to Rules/Regulation link on right-hand side menu box or contact your zone office. See the City-Region-Zone List to find your appropriate zone office.

Critical Access Hospital

(CAH)- This type of hospital is a federal designation. See the Center for Medicaid and Medicare Services'web site for information on attaining Medicare certification. The Office of Rural Community Affairs maintains a list of CAHs in Texas.

Last updated November 9, 2017