(a) On receiving a license application and the license fee, the department shall issue a license if it finds that the applicant and the hospital comply with this chapter and the rules or standards adopted under this chapter.
(b) A license may be renewed every two years after payment of the required fee and submission of an application for license renewal that contains the information required by § 241.022(b).

(c) Except as provided by Subsection (c-1), the department may issue a license only for the premises of a hospital and person or governmental unit named in the application.
(c-1) The department may issue one license for multiple hospitals if:
(1) all buildings in which inpatients receive hospital services and inpatient services of each of the hospitals to be included in the license are subject to the control and direction of the same governing body;
(2) all buildings in which inpatients receive hospital services are within a 30-mile radius of the main address of the applicant;
(3) there is integration of the organized medical staff of each of the hospitals to be included in the license;
(4) there is a single chief executive officer for all of the hospitals who reports directly to the governing body and through whom all administrative authority flows and who exercises control and surveillance over all administrative activities of the hospital;
(5) there is a single chief medical officer for all of the hospitals who reports directly to the governing body and who is responsible for all medical staff activities of the hospital;
(6) each building of a hospital to be included in the license that is geographically separate from other buildings of the same hospital contains at least one nursing unit for inpatients, unless providing only diagnostic or laboratory services, or a combination of diagnostic or laboratory services, in the building for hospital inpatients; and
(7) each hospital that is to be included in the license complies with the emergency services standards:
(A) for a general hospital, if the hospital provides surgery or obstetrical care or both; or
(B) for a special hospital, if the hospital does not provide surgery or obstetrical care.
(c-2) The department may recommend a waiver of the requirement of Subsection (c-1)(7) for a hospital if another hospital that is to be included in the license:
(1) complies with the emergency services standards for a general hospital; and
(2) is in close geographic proximity to the hospital.
(c-3) The executive commissioner shall adopt rules to implement the waiver provision of Subsection (c-2). The rules must provide for a determination by the department that the waiver will facilitate the creation or operation of the hospital seeking the waiver and that the waiver is in the best interest of the individuals served or to be served by the hospital.
(d) Subject to Subsection (e), a license issued under this section for a hospital includes each outpatient facility that is not separately licensed, that is located apart from the hospital, and for which the hospital has submitted to the department:
(1) a copy of a fire safety survey that is dated not earlier than one year before the submission date indicating approval by:
(A) the local fire authority in whose jurisdiction the outpatient facility is located; or
(B) the nearest fire authority, if the outpatient facility is located outside of the jurisdiction of a local fire authority; and
(2) if the hospital is accredited by The Joint Commission or the American Osteopathic Association, a copy of documentation from the accrediting body showing that the outpatient facility is included within the hospital’s accreditation.
(e) Subsection (d) applies only if the federal Department of Health and Human Services, Centers for Medicare and Medicaid Services, or Office of Inspector General adopts final or interim final rules requiring state licensure of outpatient facilities as a condition of the determination of provider-based status for Medicare reimbursement purposes.
(f) A license may not be transferred or assigned without the written approval of the department.
(g) A license shall be posted in a conspicuous place on the licensed premises.