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    The Health Facility Program is within the Division for Regulatory Services.

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End Stage Renal Disease Facilities - Health Facility Program


The End Stage Renal Disease (ESRD) Facility Licensing Act was first enacted in 1995 by the 74th Legislature.  The ESRD Facility rules became effective on September 6, 1996.  The Medical Review Board appointed by the ESRD Network of Texas Inc., works with the Texas Department of State Health Services (DSHS) in reviewing information relating to the quality of care provided by ESRD facilities and in determining an appropriate corrective action plan to be followed by an ESRD facility, when applicable.

The staff of the Facility Licensing Group is responsible for licensing and certifying End Stage Renal Disease (ESRD) facilities.

The Facility Licensing Group develops rules that establish minimum standards for ESRD licensing procedures; for granting, denying, suspending, and revoking a license; for license fees; for operation; and for requirements concerning design and space. The Architectural Program is responsible for conducting plan reviews and construction inspections of new and existing ESRDs.

To become licensed, please see How to Become a Licensed End Stage Renal Disease Facility and License Application.

End Stage Renal Disease Facilities (ESRDs) in Texas and Dialysis Machines in New Facilities

ESRD Additional Staffing Guidelines Chart

Chapter 117 ESRD Rule Clarifications and Instructions for Completing ESRD Facility Incident Report. 

Directories of ESRD Facilities

Medicare Information

ESRD facilities may choose to be certified to participate in the federal Medicare Program. For more information on the certification process, refer to Rules/Regulation link on right-hand side menu box or contact your zone office. Click here to find information to locate the appropriate zone office.


Survey Components

During the initial licensing period, department zone office staff will conduct an on-site survey to ascertain compliance with the provision on the Health and Safety Code and associated rules. Entrance conference with key facility personnel and department zone office staff. During the survey, zone office staff will explain the survey process and answer questions.

  • Review clinical records
  • Review facility policies and procedures
  • Review quality assurance activities
  • Review personnel records
  • Interview staff
  • Conduct site visits as applicable
  • Exit conference with key facility personnel. Discuss survey findings.

Audit Tool

Please see applicable state and federal rules and regulations.


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Last updated August 11, 2014