ASC Waiting Area

Q: I am looking at a hospital facility with an Ambulatory Surgery Center in an existing building that is a Business Occupancy and construction type – II (222). We are working to separate the Ambulatory Surgery Center from the other business in the building with a two-hour fire rated partition. The waiting area, which is adjacent to the lobby/elevator area is enclosed by glass. Can we leave the waiting area out of the Ambulatory Surgery Center and make the separation behind the waiting area? This would be just separating the Ambulatory Surgery rooms and recovery area from the rest of the building (i.e. enclosed by a two-hour fire-rated wall).

A: No… I believe you are not permitted to do that. Actually, the LSC does not address this, but the CMS Conditions for Coverage (CfC) does address this. According to CMS Conditions for Coverage §416.44(a)(2), the ASC must have a separate recovery room and waiting area.

The Interpretive Guidelines for §416.44(a)(2) says this about waiting rooms:

The ASC is required to have both a waiting area and a recovery room, which must be separate from each other as well as other parts of the ASC. They may not be shared with another healthcare facility or physician office. (See the interpretive guidelines for §416.2 concerning sharing of physical space by an ASC and another entity.)

While the CfC does not specially say the waiting area must be inside the fire-barriers surrounding the ASC, if the waiting area was outside of these boundaries the surveyors could conclude that the waiting area is shared with other another healthcare facility or physician office.

I suggest you make sure the waiting area is inside the fire-rated barrier separating the ASC from the other entities.