Effective Oct. 17, 2019, hospital outpatient departments (HOPDs) and other facilities which previously were exempt from the Ambulatory Surgical Facility (ASF) licensure requirement may now meet the criteria of an ASF. Governor Mike DeWine’s budget bill contained provisions which modified the definition of an ASF and will expand the number of facilities subject to regulation under Ohio law as an ASF. 

Under the former definition of an ASF, only surgical facilities which functioned separately from a hospital’s inpatient surgical unit or office of a physician, or which held itself out (e.g., for billing or accreditation purposes) as an ASF or ambulatory surgical center were deemed to be ASFs under Ohio law. HOPDs, which operate as part of a hospital and are integrated with the hospital’s inpatient surgical unit, fell outside of the definition of an ASF and thus, were exempt from the ASF licensure requirement. 

The new ASF definition includes facilities in which: (1) surgical services are provided to patients who do not require hospitalization for inpatient care, (2) services are not provided to any patient for longer than 24 hours after the patient’s admission, and (3) one of the following applies:

a.  Surgical services are provided in a building where no inpatient care is provided; or

b.  Surgical services are provided in a building where inpatient care is provided, but the surgical services portion of the building is operated by a different entity; or

c.  The facility is held out as an ASF or similar facility.

These changes will expand the number of facilities that will be subject to regulation as an ASF. Hospitals and other facilities previously exempt from ASF licensure should seek legal counsel on the implications of these changes.