1. (a) All facilities that provide dialysis services, regardless of affiliation or modality, shall be licensed as an end stage renal disease (ESRD) facility. A patient of an ESRD facility receiving home dialysis services, as defined in §507.2 of this chapter (relating to Definitions), shall receive the services under the purview of a licensed ESRD facility.
2. (b) A facility shall obtain a license before admitting patients.
3. (c) A facility shall prominently and conspicuously display the license in a public area of the facility that is readily visible to patients, employees, and visitors.
4. (d) A facility shall not alter the ESRD facility license.
5. (e) An ESRD facility license is nontransferable. The facility shall comply with the provisions of §507.12 of this subchapter (relating to Application and Issuance of Initial License) in the event of a change in the ownership.
6. (f) The Texas Health and Human Services Commission (HHSC) issues an ESRD facility license for the facility site and person named in the application.

7. (g) An ESRD facility may share a building with other licensed health care facilities.

   1. (1) The ESRD facility shall be licensed separately from the other licensed facilities.
   2. (2) No identifiable part of the building may be dually licensed by more than one person.

8. (h) The following facilities are not required to be licensed under this chapter:

   1. (1) a home and community support services agency licensed under Texas Health and Safety Code Chapter 142 (relating to Home and Community Support Services), with a home dialysis designation;

   2. (2) a hospital licensed under Texas Health and Safety Code Chapter 241 (relating to Hospitals) that provides dialysis only to individuals receiving:

      1. (A) inpatient services from the hospital; or
      2. (B) outpatient services due to a disaster declared by the governor or a federal disaster declared by the president of the United States occurring in this state or another state during the term of the disaster declaration;

   3. (3) a hospital operated by, or on behalf of, the state as part of the managed health care provider network established under Texas Government Code Chapter 501 (relating to Inmate Welfare) that provides dialysis only to individuals receiving:

      1. (A) inpatient services from the hospital; or
      2. (B) outpatient services while the individual is serving a term of confinement in a facility operated by, or under contract with, the Texas Department of Criminal Justice;
   4. (4) an ESRD facility operated by, or on behalf of, the state as part of the managed health care provider network established under Texas Government Code Chapter 501 that provides dialysis only to individuals receiving those services while serving a term of confinement in a facility operated by, or under contract with, the Texas Department of Criminal Justice; or
   5. (5) the office of a physician unless the office is used primarily as an ESRD facility.

Source Note:The provisions of this §507.11 adopted to be effective December 23, 2025, 50 TexReg 8289.