Private health facilities licensing
In South Australia, private hospitals and private day procedure centres are licensed under the Health Care Act 2008 (the Act) and associated Health Care Regulations 2008 (the Regulations).
Private hospitals are defined in the Act as being an entity (whether corporate or unincorporated and including a partnership or other structure) by which health services are provided, being health services that include services provided to persons on a live-in basis”.
Institutions conducted by or on behalf of the State, including public hospitals and nursing homes, and premises licensed under the Supported Residential Facilities Act 1992 are not included in the definition of private hospital under the Act.
Private day procedure centres provide prescribed health services to patients who are admitted and discharged on the same day. Under the Act a person must not provide a ‘prescribed health service’ at unlicensed premises (maximum penalty: $60,000)
A ‘prescribed health service’ is defined as involving the administration of:
- General, spinal, epidural or major regional block anaesthetic; or
- Intravenous sedation (only if greater than ‘conscious sedation’); or
- Local anaesthetic (except provided by a general practitioner, or in general dentistry practice, or excluded by the Regulations*); or
- Health services prescribed by the Regulations**
*Under the Regulations, health practitioners registered with a national board and authorised under law to administer local anaesthetic are excluded from the requirement to only perform local anaesthetic procedures in a licensed facility. Topical local anaesthetic is also excluded.
**There are currently five prescribed classes of health services listed in the Regulations:
- Cardiac catheterisation
- Gastrointestinal endoscopy
- Renal dialysis
- Cosmetic surgery
Licence and building applications
Health facility licensing is managed using a single online form which allows users to nominate the purpose of the application. Supporting documentation is required and will be requested during the application. Applicants must obtain written approval from the Minister for Health and Wellbeing’s delegate before any changes such as building works or the provision of new services may commence.
Obtain a new licence
- This is to obtain a licence for either a new premises or an existing premises that is not currently licensed.
- It includes premises which are already providing healthcare services, but have not to date required a licence.
Vary an existing licence or conditions
- This is to alter specific condition(s) in the existing licence of a premises. Please note that building works and changes of service provision are covered by specific applications.
- Changes applied for here may include the name of the premises, or the name of the licensee (where the licensee remains the same entity but changes only its name).
Change the services provided under an existing licence
- This is to change the services provided at existing premises which already hold a licence.
- Details regarding building works, staffing and other effects of the service change will be prompted in the application.
Transfer an existing licence to a new licensee
- This is to assign a new licensee to an existing licence.
- The licence continues to be attached to the same premises and is not transferred between premises.
Alter or extend an existing licenced premises
- This is to conduct alterations including building works at an existing premises.
- A licence must already be in effect at that premises.
Facilities are also required to pay a prescribed fee. Details of the current fees can be found on the fees and charges page.
Timeframe for Health Licensing to assess and approve licensing applications
The following timeframes apply for routine alterations and private health facility constructions. Major multi-phased constructions or projects with unique requirements, including remote locations, will require preliminary discussions to review and plan the applicable timelines. 1-2 weeks after an application is submitted and checked for completeness: an acknowledgement email.
- One to two months (minimum), following receipt of a complete application, to complete design approval assessment against Australasian Health Facilities Guidelines and relevant standards.
- Where further information is requested, or changes are made to the submitted application, a review of new information will be made within 28 days (from last day submitted), and the timeframe for design approval assessment will extend beyond one to two months.
- After design assessment approval is granted, building works must commence within 12 months and be completed within three years (unless otherwise agreed), to ensure the approved design is current against the relevant guidelines and standards which apply. After three years, design approval will lapse.
- Before ‘approval to use premises’ can be granted, the completed building works/alteration must be inspected. Applicants are to contact with SA Health at least four weeks in advance of the proposed inspection date, to ensure that inspectors are available.
- The Minister’s delegate will not grant ‘approval to use premises’ until after a satisfactory site inspection and assessment of commissioning/certification results. This can take one to three weeks for alterations to premises or one to five weeks for new premises.
- A satisfactory site inspection requires that all building works are complete, and all furniture, fixtures and equipment are in place. Scheduling a site inspection before works are completed, or final commissioning/certification results are available will delay the granting of ‘approval to use premises’.
- Using premises before ‘approval to use premises’ has been granted, is a breach of the Health Care Act 2008 and penalties can be applied by the Minister, including the suspension/revoking of a licence.
Please refer to the processing of licences page for further details regarding these timeframes.
Design assessment of an application
Applications and architectural plans are assessed against requirements in the Australasian Health Facilities Guidelines, the construction standards gazetted by the Minister. The following will also be considered:
- The flow of patients through the floor plan of the facility service;
- The follow of equipment and waste from delivery to disposal (‘dirty’ to ‘clean’ spaces);
- Reprocessing and storage of reusable medical devices;
- Infection control processes and risks;
- The evacuation of patients, including on stretchers, through doorways in a medical emergency; and where the building height/width departs from published guidelines, whether SA Ambulance Service (SAAS) will need to independently inspect the vehicle and stretcher access to carpark and premises.
Site inspection of the approved design
SA Health will perform a site inspection to ensure the private health facility was built or altered in accordance with the approved design plans and complies with relevant legislation. Applicants need to contact SA Health at least four weeks in advance of the proposed completion date to ensure inspectors are available.
A site inspection should not be scheduled until all building works are finished and all furniture, fixtures and equipment are in place. Final commissioning/certification results must be available for services, plant and equipment, e.g. air and water sampling, electrical, medical gases, nurse call, duress alarm, fire systems and emergency resuscitation procedures. It is the responsibility of the applicant to anticipate four weeks’ notice of the completion date, for a site inspection, and timeframe for assessing commissioning results, so that ‘approval to use premises’ is received from the Minister’s delegate before the site is used.
After the site inspection, applicants will receive written findings indicating if there are any remedial actions required before ‘approval to use premises’ is granted, or if there are actions which are required to meet the Australasian Health Facilities Guidelines, but are suitable to be completed after the site is approved for use.
The site can only become operational once approval has been formally provided by the Minister’s delegate. Using premises without approval is a breach of the Health Care Act 2008 and penalties can be applied.
Ongoing compliance requirements
The Health Care Regulations 2008 provides details of the annual returns that must be submitted by private health facilities to SA Health. These returns are due by 30 April each year and SA Health will contact each facility prior to this date to provide further information. Facilities are also required to pay an annual licence fee.
Annual returns are now submitted electronically. All information including supporting documents can be submitted using the online smartform for annual returns.
Facilities must also ensure that they operate in accordance with any specific licence conditions imposed on them.
This includes maintaining accreditation to the Australian Commission on Safety and Quality in Health Care’s National Safety and Quality Health Service Standards.
Review of decisions
Under s87 of the Health Care Act 2008, an applicant or licensee has a right of appeal against a decision or order of the Minister in relation to private hospital licensing.
A right of appeal is handled by the Supreme Court and must be initiated within one month of the decision or order that is being challenged. The Supreme Court has the power to extend that one month period, if it is satisfied that it is just and reasonable in the circumstances to do so.
Commonwealth provider numbers
The Australian Government’s Department of Health manages this process.
Following the issue of a licence, SA Health will advise this department that it has no objection to a provider number being issued to the facility under the Commonwealth Private Health Insurance Act 2007.
If a facility wishes to be declared for private health insurance purposes, they must complete the ‘Private Hospital Information Form’ and submit it to the Australian Government’s Department of Health. The form and further information about the process can be found at the Australian Government’s Department for Health website.
For more information including whether your premises require a private hospital or private day procedure centre licence, please contact the Health Licensing Unit, and their authorised officers will respond to your query.