NC Register Volume 16 Issue 15 - Office of Administrative Hearings

Eff. November 1, 1990;Temporary Amendment Eff. September 1, 1993 for a period of180 days or until the permanent rule becomes effective,whichever is sooner;Amended Eff. January 4, 1994;Temporary Amendment Eff. July 1, 2001;Temporary Amendment Eff. January 1, 2002;Temporary Amendment effective January 1, 2002 amends andreplaces a permanent rulemaking originally proposed to beeffective August 1, 2002.10 NCAC 03R .2115 NEED FOR SERVICES(a) In projecting utilization for existing, approved, proposed andexpanded surgical programs, a program shall be considered to beopen five days per week and 52 weeks a year.(b) A proposal to establish a new ambulatory surgical facility, toincrease the number of operating rooms, to convert a specialtyambulatory surgical program to a multispecialty ambulatorysurgical program or to add a specialty to a specialty ambulatorysurgical program shall not be approved unless the applicantdocuments that the average number of surgical cases peroperating room to be performed in the applicant's facility isprojected to be at least 2.7 surgical cases per day for eachinpatient operating room, 4.3 surgical cases per day for eachoutpatient or ambulatory surgical operating room, 4.3 cases perday for each endoscopy procedure room, and 3.5 surgical casesper day for each shared operating room during the fourth quarterof the third year of operation following completion of theproject.(c) An applicant proposing to convert a specialty ambulatorysurgical program to a multispecialty ambulatory surgicalprogram or to add a specialty to a specialty ambulatory surgicalprogram shall provide documentation to show that each existingambulatory surgery program in the ambulatory surgical servicearea that performs ambulatory surgery in the same specialty areaas proposed in the application is currently operating at 4.3surgical cases per day for each outpatient or ambulatory surgicaloperating room, 4.3 cases per day for each endoscopy procedureroom, and 3.5 surgical cases per day for each shared operatingroom.(d) An applicant proposing to convert a specialty ambulatorysurgical program to a multispecialty ambulatory surgicalprogram or to add a specialty to a specialty ambulatory surgicalprogram shall provide documentation to show that each existingand approved ambulatory surgery program in the ambulatorysurgical service area that performs ambulatory surgery in thesame specialty areas as proposed in the application is projectedto be operating at 4.3 surgical cases per day for each outpatientor ambulatory surgical operating room, 4.3 cases per day foreach endoscopy procedure room, and 3.5 surgical cases per dayfor each shared surgical operating room prior to the completionof the proposed project. The applicant shall document theassumptions and provide data supporting the methodology usedfor the projections.History Note: Authority G.S. 131E-177; 131E-183(b);Eff. November 1, 1990;Amended Eff. March 1, 1993;Temporary Amendment Eff. September 1, 1993 for a period of180 days or until the permanent rule becomes effective,whichever is sooner;TEMPORARY RULES16:15 NORTH CAROLINA REGISTER February 1, 20021682Amended Eff. January 4, 1994;Temporary Amendment Eff. July 1, 2001;Temporary Amendment Eff. January 1, 2002;Temporary Amendment effective January 1, 2002 amends andreplaces a permanent rulemaking originally proposed to beeffective August 1, 2002.10 NCAC 03R .2116 FACILITY(a) An applicant proposing to establish a licensed ambulatorysurgical facility that will be physically located in a physician's ordentist's office or within a general acute care hospital shalldemonstrate that reporting and accounting mechanisms exist andcan be used to confirm that the licensed ambulatory surgeryfacility is a separately identifiable entity physically andadministratively, and is financially independent and distinctfrom other operations of the facility in which it is located.(b) An applicant proposing a licensed ambulatory surgicalfacility shall receive accreditation from the Joint Commissionfor the Accreditation of Healthcare Organizations, theAccreditation Association for Ambulatory Health Care or acomparable accreditation authority within two years ofcompletion of the facility.(c) An applicant proposing to establish a new ambulatorysurgical facility, to increase the number of operating rooms, toconvert a specialty ambulatory surgical program to amultispecialty ambulatory surgical program or to add a specialtyto a specialty ambulatory surgical program shall document thatthe physical environment of the facility conforms to therequirements of federal, state, and local regulatory bodies.(d) In competitive reviews, an applicant proposing to performambulatory surgical procedures in at least three specialty areaswill be considered more favorably than an applicant proposing toperform ambulatory surgical procedures in fewer than threespecialty areas.(e) The applicant shall provide a floor plan of the proposedfacility clearly identifying the following areas:(1) receiving/registering area;(2) waiting area;(3) pre-operative area;(4) operating room by type;(5) recovery area; and(6) observation area.(f) An applicant proposing to expand by converting a specialtyambulatory surgical program to a multispecialty ambulatorysurgical program or by adding a specialty to a specialtyambulatory surgical program that does not propose to addphysical space to the existing ambulatory surgical facility shalldemonstrate the capability of the existing ambulatory surgicalprogram to provide the following for each additional specialtyarea:(1) physicians;(2) ancillary services;(3) support services;(4) medical equipment;(5) surgical equipment;(6) receiving/registering area;(7) clinical support areas;(8) medical records;(9) waiting area;(10) pre-operative area;(11) operating rooms by type;