Freestanding Emergency Medical Care Facilities

As defined by Texas Health and Safety Code Section 254.001, a freestanding emergency medical care facility is a facility, structurally separate and distinct from a hospital, that receives an individual and provides emergency care.

In accordance with Texas Health and Safety Code Section 254.001 and Texas Administrative Code Title 26 Section 509.2, emergency care means health care services provided in an FEMC facility to evaluate and stabilize a medical condition of a recent onset and severity, including severe pain, that would lead a prudent layperson possessing an average knowledge of medicine and health to believe that the person's condition, sickness, or injury is of such a nature that failure to get immediate medical care could result in any of the following:

  • Placing the person's health in serious jeopardy
  • Serious impairment to bodily functions
  • Serious dysfunction of a bodily organ or part
  • Serious disfigurement
  • In the case of a pregnant woman, serious jeopardy to the health of the woman or fetus

Texas Health and Safety Code Chapter 254 establishes the state licensing requirements for FEMC facilities. Under state law, HHSC is responsible for the licensing and regulation of FEMC facilities in Texas, and the Regulatory Services Division within HHSC carries out these duties.

HHSC adopts rules for FEMC facilities including establishing standards for:

  • Licensing procedures and fees
  • License denial, probation, suspension, and revocation
  • Number, qualifications, and organization of the facility's professional staff and other personnel
  • Administration of the facility
  • Equipment essential to the health and welfare of facility patients
  • Sanitary and hygienic conditions within the facility and its surroundings
  • Requirements for the contents, maintenance, and release of medical records
  • Level of care requirements and standards for denial of care
  • Provision of laboratory and radiological services
  • Distribution and administration of drugs and controlled substances
  • Quality assurance program for patient care
  • Transfer protocols for patients requiring advanced medical care at a hospital
  • Other aspects of the operation of a facility necessary to protect the facility's patients and the public
  • Inspection, investigation, and enforcement procedures
  • Construction and design of the facility, including standards necessary to ensure the health and safety of patients

FEMCs are not certified to participate in the federal Medicare program.

Laws and Rules

Texas Laws


Find or Verify a License


An applicant seeking an FEMC facility license must submit a completed application, license fee, and other applicable documents to HHSC. The Health Facility Licensing Unit will not process an application until after HHSC Accounts Receivable receives and posts the license fee.

Refer to the application or instructions linked in this section for specific requirements.

HHSC must review and approve all required application materials received before issuing a license to an applicant.

Applications, Forms and Supporting Documents

Initial Licensure Application

Change of Ownership Application

Relocation Application

Renewal Licensure Application

Additional Documents

Architectural Review Information and Forms

Complaint and Incident Submission Information

Inspection Components

HHSC conducts health compliance on-site inspections to determine compliance with the provisions of the Health and Safety Code and associated rules listed in the Laws and Rules section of this page. During the inspection, HHSC staff will generally perform the following activities:

  • Conduct an entrance and an exit conference with applicable facility personnel
  • Explain the inspection process and answer questions
  • Review clinical records
  • Review facility and personnel records
  • Review facility policies and procedures
  • Review quality assurance activities
  • Interview staff
  • Assess the facility's compliance with applicable statutes and rules
  • Discuss final inspection findings with applicable facility personnel

Enforcement Actions

Human Trafficking Resources

Clinical Laboratory Improvement Amendments Information

Refer to our CLIA information page. For more information on CLIA, please contact your regional office (PDF).

Contact Information

Health Care Regulation

For Health Care Regulation contact information, visit our Contact Us page.

Health Care Facility Enforcement

Phone: 512-438-5439
Fax: 512-438-3697
Mailing Address:
Texas Health and Human Services Commission
Regulatory Services Division
Health Care Facility Enforcement, MC 1866
P.O. Box 149347
Austin, TX 78714-9347

Open Records Requests

Texas Health and Human Services is committed to providing full access to public information. For information on how to submit an open records request, read the Open Records Policy and Procedures.