3701-83-20 Building and site requirements; equipment - ambulatory surgical facilities.

(A) Each ASF shall have one or more operating rooms or procedure rooms, each of which is designed and equipped so that the types of surgery conducted can be performed in a manner that protects the health and well-being of all individuals in the area. The recovery area shall be adequately equipped for the proper care of post anesthesia recovery of surgical patients.

(B) Each ASF shall have the following equipment accessible to the operating suite and recovery area:

(1) Adequate resuscitation equipment:

(a) ASFs providing surgical procedures under topical and local infiltration blocks with or without oral or intramuscular preoperative sedation shall have: airways, bag mask respirator, oxygen source, suction equipment, and age-appropriate resuscitative drugs;

(b) ASFs providing surgical procedures performed in conjunction with oral, parenteral, or intravenous sedation or under analgesic or dissociative drugs or providing surgical procedures that require general or regional block anesthesia and support of vital bodily functions shall have: airways, endotracheal tubes, laryngoscope, oxygen delivery capability under positive pressure, suction equipment and suitable resuscitative drugs.

(2) Appropriate monitoring equipment:

(a) Each ASF shall have size-specific blood pressure apparatus and stethoscopes, electrocardiogram, oscilloscopes and when pediatric patients are treated, size-specific emergency equipment and medications;

(b) ASFs performing surgical procedures in conjunction with oral, parenteral, or intravenous sedation or under ananalgesic or dissociative drugs, or performing surgical procedures that require general or regional block anesthesia and support of vital bodily functions shall have a defibrillator, pulse oximeter with alarm, and temperature monitor.

(c) ASFs using inhalation anesthesia shall have an anesthesia machine.

(3) Each ASF shall have suitable surgical instruments customarily available for the planned surgical procedure in the operating suite.

(4) Each ASF shall have in the recovery room, an emergency call system that is connected electronically, electrically, by radio transmission or in a like manner and that effectively alerts staff.

(C) Each ASF shall establish and follow a preventive maintenance program which includes periodic calibration, cleaning and adjustment of all equipment in accordance with manufacturer's instructions. Each ASF using inhalation anesthesia shall develop and follow policies and procedures for monitoring the anesthesia machine which are consistent with the standards recommended by the American society of anesthesiologists.

(D) Each ASF shall have appropriate ventilation and humidity levels in order to minimize the risk of infection and to provide for the safety of the patient.

(E) Each ASF shall have emergency power available in operative, procedure, and recovery areas.

(F) Each ASF shall have separate closed off and distinct areas used as waiting rooms, recovery rooms, treatment rooms, toilet facilities, and storage rooms. The ASF and another entity may not mix functions and operations in a common space during concurrent or overlapping hours of operation. Operating, procedure, and recovery rooms must be used exclusively for surgical procedures.

(G) New construction, alterations or renovations that provide space for operating rooms or procedure rooms may not be used or occupied until authorization for such occupancy has been received by the ASF from the department.

(H) Each ASF shall develop and follow policies and procedures for the storage and use of all medical gases in accordance with the requirements of the national fire protection association (NFPA) 99.

(I) If the ASF uses medications or drugs that may induce malignant hyperthermia, it shall have policies and procedures in place, as well as equipment and medication available, to treat it.

(J) Each ASF shall have appropriate intravenous fluids and administration equipment.

(K) Each ASF shall have sufficient and appropriate stretchers and wheelchairs for the services performed.

Effective: 04/24/2011
R.C. 119.032 review dates: 02/07/2011 and 02/10/2016
Promulgated Under: 119.03
Statutory Authority: 3702.13 , 3702.30
Rule Amplifies: 3702.12 , 3702.13 , 3702.30
Prior Effective Dates: 9/5/2002, 6/1/06