This blog post is part of Holland & Knight's Garden State Initiative, a firmwide effort to enhance coordination among attorneys, clients and professional networks with ties to New Jersey to foster greater collaboration across offices and strengthen client relationships.
The New Jersey Department of Health (DOH) recently published Responses to Frequently Asked Questions (FAQs) regarding registered surgical practices (RSPs) that are statutorily required to apply for licensure as ambulatory surgery centers (ASCs). This Aug. 28, 2025, guidance summarizes various aspects of compliance, from operational standards to reporting obligations.
As the FAQs reiterate, RSPs are one-room surgical facilities owned and operated by physicians for use in their private practices. Historically, these private practices were subject to regulation by the New Jersey Board of Medical Examiners (BME), but pursuant to P.L. 2017, c.28, RSPs became obligated to file an application for licensure with the DOH as an ASC, a type of ambulatory care facility, by Jan. 15, 2019.
Below are highlights of a few material DOH responses in the FAQs:
1. RSPs that failed to apply for a license from the DOH within one year of Jan. 15, 2019, are no longer eligible to be licensed ASCs.
2. RSPs are no longer exempt from healthcare facility assessments. All ASCs are required to report their revenue beginning in the current fiscal year (FY) 2026 and to pay the ambulatory care assessment starting in FY 2027.
3. An RSP that is certified by the Centers for Medicare & Medicaid Services (CMS) is not required to meet physical plant and functional requirements.
a. An RSP that is not Medicare certified, either by CMS or any deeming authority recognized by CMS, but which has obtained accreditation from the American Association for Ambulatory Surgery Facilities (QUAD A) or any other accrediting body recognized by CMS, and was in operation on Jan. 16, 2018, is not required to meet physical plant and functional requirements.
b. In certain circumstances, an RSP may apply for a waiver of physical plant requirements, and the DOH may grant such a waiver if it deems that public health will be maintained.
4. DOH approval (and licensure as an ASC) is required to expand services from conscious sedation to general anesthesia.
5. Reporting
a. The DOH requires ASCs to report the name of the facility's medical director, physician director and physician director of anesthesia, as applicable, and director of nursing services annually and within 30 days of any change in a director.
b. The DOH requires a "Transfer of Owner" application when a new individual or entity will own 10 percent or more of the licensed operator, or when an existing owner increases its ownership from less than 10 percent to more than 10 percent.
6. Fees
a. RSPs licensed by the DOH as an ASC are exempted from DOH application and license renewal fees. This exemption expires if the RSP chooses to expand the scope of its practice by adding additional operating rooms.
b. Though exempt from paying a license renewal fee, the DOH requires that ASCs pay a biennial inspection fee of $2,000.
