3701-83-17 Admission; transfer; discharge - ambulatory surgical facilities.

(A) Each ASF shall only admit patients who do not require planned inpatient care and who shall be kept in the ASF for less than twenty-four hours. The twenty-four hour period begins at the start of the operation or procedure, or the induction of anesthesia, whichever is first. The twenty- four hour period may include an overnight stay if such stay meets all of the conditions set forth in this rule and does not extend the length of time a patient remains in the ASF.

(B) Prior to operation or procedure, each patient shall have a comprehensive medical history and physical exam performed or updated, along with associated pre-procedure studies. The different components of the history and physical may be performed by different health care professionals, consistent with the type of information required and the professionals' scope of practice, as defined by applicable law. This history and physical exam shall document the pre-operative diagnosis and the procedure to be performed and shall become part of the patient's medical record prior to surgery.

(C) Documentation, as contained in paragraphs (A)(3), (C)(1), and (C)(7) to (C)(9) of rule 3701-83-21 of the Administrative Code shall be in a patient's medical record prior to surgery.

(D) Immediately before surgery, the attending physician, podiatrist, or dentist shall examine the patient to evaluate the risks of the procedure to be performed. Each patient shall also be examined by an anesthesiologist, physician, podiatrist, anesthesia qualified dentist, or CRNA, as appropriate, to evaluate the risks of anesthetics and for proper anesthesia recovery before discharge from post anesthesia care.

(E) The attending or other designated physician, podiatrist, or anesthesia qualified dentist shall discharge a patient meeting discharge criteria from the ASF within twenty-four hours of the start of the operation or procedure, or induction of anesthesia, whichever is first, or transfer the patient to a setting appropriate for the patient's needs.

(F) Patients transported to a hospital shall be accompanied by their medical records that are of sufficient content to ensure continuity of care.

(G) Prior to discharge, the ASF shall provide each patient with both verbal and written instructions for post-treatment care and procedures for obtaining emergency care.

(H) The physician, podiatrist, dentist, or a nurse shall ensure that the patient or patient's representative acknowledge, in writing, receipt of the physician's, podiatrist's, or dentist's written discharge instructions.

(I) Each ASF shall discharge a patient only if accompanied by a responsible person, unless the attending or discharging physician, podiatrist, or anesthesia qualified dentist determines that the patient does not need to be accompanied and documents the circumstances of discharge in the patient's medical record.

Effective: 7/1/2016
Five Year Review (FYR) Dates: 02/16/2016 and 02/15/2021
Promulgated Under: 119.03
Statutory Authority: 3702.13, 3702.30
Rule Amplifies: 3702.12, 3702.13, 3702.30
Prior Effective Dates: 1/13/1996, 6/27/96, 9/5/02, 6/1/06