Ohio Revises Definition of Ambulatory Surgical Facilities

March 2020 ~

Ohio has released the recently revised the definition of an Ambulatory Surgical Facility (ASF), as part of the new 2020/2021 general operating budget legislation. The change expanded the ASF definition, which may require some previously unlicensed facilities to obtain licensure.

Under the revised definition (3702.30) an ASF is defined as:

A facility in which surgical services are provided to patients who do not require hospitalization for inpatient care, the duration of services for any patient does not extend beyond twenty-four hours after the patient’s admission, and to which any of the following apply:

• The surgical services are provided in a building that is separate from another building in which inpatient care is provided, regardless of whether the separate building is part of the same organization as the building in which inpatient care is provided.
• The surgical services are provided within a building in which inpatient care is provided and the entity that operates the portion of the building where the surgical services are provided is not the entity that operates the remainder of the building.
• The facility is held out to any person or government entity as an ambulatory surgical facility or similar facility by means of signage, advertising, or other promotional efforts.
  1. The ambulatory surgical facility does not include a hospital emergency department or an office of a physician, podiatrist, or dentist.

Also under the revision, a health care facility means any of the following:

• An ambulatory surgical facility;
• A freestanding dialysis center;
• A freestanding inpatient rehabilitation facility;
• A freestanding birthing center;
• A freestanding radiation therapy center;
• A freestanding or mobile diagnostic imaging center.

According to the Ohio Department of Health, a certified ambulatory surgical center (ASC) may be either hospital-operated or independent. If hospital-operated, the ASC must be a separately identified entity, physically and administratively distinct from other inpatient operations of the hospital.  An ASC may not provide a surgical procedure on a Medicare patient when, before surgery, an overnight hospital stay is anticipated. In cases where hospitalization after surgery is warranted, the ASC must be able to provide immediate transfer to a hospital. Ambulatory Surgical Facilities are licensed and regulated as Health Care Facilities under Chapter 3701-83 of the Ohio Administrative Code.

Prior to the update, any state facility offering outpatient surgical services within a building that also offered inpatient services was not included in the definition of an ASF, regardless of entity affiliation. Under the revised definition, a facility providing outpatient surgical services will be considered an ASF if it is located within an inpatient care building but the outpatient surgical portion is not operated by the same entity offering the inpatient services. Since the state requires ASFs to be licensed by the Ohio Department of Health, this change could require some previously unlicensed facilities to become licensed.

Applications for licensure, Change of Ownership (CHOW), and capacity increases and decreases can be accessed at the following links:

• Initial License Packet
• Renewal License Packet
• Change of Ownership (CHOW) Packet
• Capacity Increase
• Capacity Decrease

Source(s): Ohio Department of Health; Lawriter Ohio Laws and Rules; Lexology; National Law Review; Mondaq; Triage Health Law;