OFFICE-BASED ANESTHESIA FACILITIES

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REQUIRED QUESTIONS

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1. Patient and Procedure Selection: The applicant must be able to demonstrate that:
   1. Anesthesiologists are satisfied that the procedures to be undertaken are within the scope of practice of the health care practitioners and the capabilities of the facility.
   2. The procedures are of a duration and degree of complexity that permit the patients to recover and be discharged from the facility.
   3. Patients who by reason of pre–existing medical or other conditions that may be at undue risk for complications are referred to an appropriate facility for performance of the procedure and the administration of anesthesia.
2. Perioperative Care — The applicant must be able to demonstrate that:
   1. Anesthesiologists and CRNAs adhere to the "Basic Standards for Pre-Anesthesia Care," "Standards for Basic Anesthetic Monitoring," "Standards for Post-anesthesia Care," and "Guidelines for Ambulatory Anesthesia and Surgery" as currently promulgated by the American Society of Anesthesiologists.
   2. Anesthesiologists and CRNAs are physically present during the intraoperative period and immediately available until the patient has been discharged from anesthesia care.
   3. The decision to discharge patients is made by a physician and documented in the medical record.
   4. Personnel with training in advanced resuscitative techniques (i.e., ACLS, PALS) are immediately available until all patients are discharged home.
3. Monitoring and Equipment: The applicant must be able to demonstrate that:
   1. At a minimum, all facilities have a reliable source of oxygen, suction, resuscitation equipment, and emergency drugs. Specific reference is made to the ASA "Statement on Non-operating Room Anesthetizing Locations."
   2. There is sufficient space to accommodate all necessary equipment and personnel and to allow for expeditious access to the patient, anesthesia machine (when present,) and all monitoring equipment.
   3. All equipment is maintained, tested, and inspected according to the manufacturer's specifications. Backup power sufficient to ensure patient protection in the event of an emergency is available.
   4. In any location in which anesthesia is administered, there is appropriate anesthesia apparatus and equipment which allow monitoring consistent with ASA "Standards for Basic Anesthetic Monitoring."
   5. In an office where anesthesia services are to be provided to infants and children, required equipment, medication, and resuscitative capabilities appropriate for the pediatric population?

OPTIONAL QUESTIONS

1. Is there a method to identify an unconscious patient (i.e., name tag, name band?)
2. Does the practice contact the patient/family prior to the day of surgery?
3. Does a mechanism exist to allow the anesthesiologist to review the patient's medical record prior to the day of surgery?

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