Outpatient Surgery Settings
Business and Professions Code section 2216.3 requires that accredited outpatient
surgery settings report adverse events to the Board no later than five days
after the adverse event has been detected, or, if that event is an ongoing urgent
or emergent threat to the welfare, health, or safety of patients, personnel, or
visitors, no later than 24 hours after the adverse event has been detected.
Do outpatient surgery settings or ambulatory surgery centers have to be accredited,
licensed or certified?
In order to protect consumers, the Legislature passed various laws to prevent surgeries
from being conducted in unregulated out-of-hospital settings. California law prohibits
physicians from performing some outpatient surgeries, unless they are performed
in an accredited, licensed, or certified setting. Specifically, if the surgical
procedure requires anesthesia to be administered in doses that have the probability
of placing a patient at risk for loss of the patient's life-preserving protective
reflexes, then the surgery must be performed in an accredited, licensed, or certified
setting.
If the surgery only requires local anesthesia or a peripheral nerve block (complying
with the community standard of practice), or if the setting administers anxiolytics
(anti- anxiety medications) or analgesics (“pain killers”) in doses that do not
place the patient at risk for loss of life-preserving protective reflexes, then
the surgery does not have to be performed in an accredited, licensed, or
certified setting.
Where can outpatient surgery take place?
Outpatient surgery, as described above, may take place at any of the settings listed
below. Questions or complaints about an individual facility should be directed to
the appropriate regulating agency.
The Medical Board of California only has jurisdiction over the accredited
outpatient surgery settings in that the Board approves the accreditation agencies
that inspect and accredit these settings.
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How do I find out if an outpatient surgery setting is accredited by one of the Board’s
approved accreditation agencies?
To determine whether a specific setting is accredited for outpatient surgery by
one of the Board’s approved accrediting agencies, click on this link:
You will be able to look up a setting by either its name or its owners.
After locating the setting in the database, make sure you click on the
see if the setting’s accreditation status is current, delinquent, suspended, on
probation, or revoked.
The Board’s list includes information on whether the setting's accreditation is:
- Current;
- Revoked, suspended, or placed on probation; and
- Whether the setting has received a reprimand by the accreditation agency.
Information is also provided on:
- Name, address, and telephone number of any owners, and their medical license numbers;
- Name and address of the facility;
- The name and telephone number of the accreditation agency that has accredited the
setting; and
- The effective and expiration dates of the accreditation.
Note: The Board’s list does include some outpatient surgery settings
that have been accredited pursuant to the Centers for Medicare and Medicaid Services
(CMS) requirements; this information was provided as a courtesy to the Board by
some of the Board’s approved accreditation agencies who also perform accreditation
services for CMS. The Board’s list does not include all CMS accredited settings
since CMS has more approved accreditation agencies than the Board. For a complete
list of accredited CMS settings, contact CMS.
Disclaimer: The information contained in the Outpatient Surgery
Setting Database has been received from an approved accreditation agency. The Board
cannot guarantee the accuracy of the information provided. Upon receipt of updated
information from an accreditation agency, the information will be made available
in the database.
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What if I can’t find the outpatient surgery setting on the Board’s list?
Not all outpatient surgery settings are required to appear on the Board’s list.
For example, Medicare/Medicaid certified outpatient settings that are regulated
by the Federal Government’s Center for Medicare/Medicaid Services (CMS) and surgical
clinics licensed by the California Department of Public Health’s Licensing and Certification
Program are not required to be accredited by one of the Board’s approved accreditation
agencies. For a complete list of surgery settings exempted from having to be accredited,
click on this link:
Types of Settings Not Required to Appear On List.
If you can’t find the surgery setting on the Board’s list, please contact CMS or
the California Department of Public Health to determine if the setting is CMS certified
or licensed:
If you cannot find the outpatient surgery setting after checking the Board’s list,
and contacting CMS and the California Department of Public Health, and
the outpatient surgery setting is performing surgery using anesthesia in doses that
have the probability of placing a patient at risk for loss of life-preserving reflexes,
please file a complaint with the Medical Board using the
Consumer Complaint Form.
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Which accreditation agencies have been approved by the board?
The Board is required to maintain a list of accredited outpatient settings from
the information provided by the accreditation agencies approved by the Board. The
Board currently approves the following accreditation agencies:
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What are the standards for an outpatient setting to become accredited?
California Health and Safety Code Section 1248.15 details the standards
required for an outpatient surgery setting to become accredited. The Board’s approved
accreditation agencies verify that each setting meets these standards before awarding
accreditation. The approved accreditation agency must inspect each setting at least
once every three years.
If the results of the inspection conclude that the setting is out of compliance
with the standards, the accreditation agency must issue a deficiency report and
may: 1) require correction; 2) issue a reprimand; 3) place the setting on probation;
or 4) suspend or revoke the accreditation. The accreditation agency must issue a
report to the Board within 24 hours if the setting has been issued a reprimand,
been placed on probation, or had its accreditation suspended or revoked. This information
is then posted on the Board’s website where it is available to the public. In addition,
if the accreditation agency identifies deficiencies related to patient safety (e.g.,
quality of care provided, anesthesia services, pharmaceutical services, etc.), this
information is forwarded to the Board’s Central Complaint Unit to initiate and refer
for formal investigation.
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What if I have a complaint about an outpatient setting?
Complaints about an outpatient surgery setting that is accredited by an accreditation
agency recognized by the Board may be submitted directly to the Medical Board.
Note: When completing the complaint form, please put the name of the outpatient
setting in the “Other” box.
For complaints regarding a CMS certified setting or a setting licensed by the Department
of Public Health:
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What happens after I submit a complaint?
If the Board receives a consumer complaint about an outpatient surgery setting that
is non-accredited, unlicensed, and not CMS certified, but is performing surgical
procedures using a level of anesthesia requiring the facility to be accredited,
licensed, or certified, it is referred to the appropriate Medical Board District
Office for investigation. If the consumer complaint is about a setting that is accredited,
the Board forwards the complaint to the appropriate accreditation agency for investigation;
if public safety is in jeopardy, an immediate inspection is initiated. After the
accreditation agency has completed its investigation or inspection, they submit
their findings to the Board for review and posting, if appropriate. For complaints
that pose an immediate risk to the public, the accreditation agency must submit
their findings within five business days; all other complaint investigations must
be submitted to the Board within 30 days. If a physician/provider issue is identified
during the scope of the investigation, these findings are forwarded to the Central
Complaint Unit for review and referral for formal investigation where appropriate.
The Medical Board is required to investigate complaints related to a violation of
Health and Safety Code Section 1248. Upon discovery that an outpatient surgery setting
is not in compliance with a specific provision, the Board can bring action through
or in conjunction with a district attorney to enjoin the outpatient setting’s operation.
Accredited outpatient surgery settings are also subject to the adverse event reporting
requirements under Business and Professions Code sections 2216.3 and 2216.4.
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Frequently Asked Questions
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Forms
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Helpful Links
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