1. (1) Registration.

   1. (a) Office Registration. An office in which a physician performs liposuction procedures where more than 1,000 cubic centimeters of supernatant fat is removed, a Level II office surgery, or a Level III office surgery shall register with the Department of Health (Department) unless the office is licensed as facility under Chapter 390 or Chapter 395, F.S. Every office performing surgery as defined in section 458.328, F.S., that is not licensed as a facility under Chapters 390 or 395, F.S., must register with the Department of Health by submitting Form DH-MQA 1031, Office Surgery Registration Application, Revised 8/2025, incorporated by reference and available at HYPERLINK "http://flrules.org/Gateway/reference.asp?No=Ref-19018"http://flrules.org/Gateway/reference.asp?No=Ref-19018.
   2. (b) Pre-Registration Inspection. The Department must complete an inspection of any location seeking registration under this section before the location may be registered as an office surgery registration. Any office seeking registration shall submit to the Department an executed application, along with all requisite supporting documentation and the registration fee required by Rule 64B-4.003, F.A.C. Upon receipt of the application, supporting documentation, and fee payment the Department shall contact the office to schedule the pre-registration inspection. The Department shall register the office upon receipt of a completed pre-registration inspection form demonstrating full compliance with Chapters 456, 458, F.S. and the rules adopted pursuant thereto. Upon a finding of any deficiencies in the initial inspection, the Department shall provide a written statement specifying said deficiencies to the designated physician at the time of inspection. Upon receipt of the written statement, the designated physician shall be given thirty (30) days to submit a corrective action plan and supporting documentation demonstrating compliance with all outlined deficiencies. The Department shall register the office upon receipt of a corrective action plan demonstrating full compliance with all identified deficiencies. If the office fails to submit a corrective action plan within thirty (30) days, or if the office submits a corrective action plan that fails to address all cited deficiencies, the request for registration shall be denied and the provisions of Chapter 120, F.S., shall apply.
   3. (c) Designated Physician. Each office registered in paragraph (1)(a) must designate a physician who is responsible for office’s compliance with the health and safety requirements of Section 458.328, F.S., Rule 64B8-9,009, F.A.C., and this rule, including any changes to the office registration in paragraph (1)(a) above. The designated physician is required to update within 10 days any modifications to the office surgery registration application regarding the recovery personnel and persons on the surgical team along with supporting documentation if said person is not a physician. The office must notify the Department within 10 calendar days after the termination of a designated physician relationship and must notify the Department of the designation of another physician to serve as the designated physician at that time or immediately cease performing office surgeries.

   4. (d) Physician Registration. Each physician practicing at a registered office shall notify the Board in writing within 10 calendar days after beginning or ending his or her practice at a registered office. The physician must comply with the requirements and qualifications of Section 458.328, F.S., Rule 64B8-9.009, F.A.C., and this rule. The written notification for beginning office surgery practice requires the physician to provide and document the following information:

      1. Financial Responsibility. All physicians practicing at a registered office must meet the financial responsibility requirements of Sections 458.320 and 459.0085, F.S., as applicable, and notify the Board of the option he or she elects.

      2. For surgeons:

      a. The level of surgery the physician intends to perform;

      b. The types of procedures the physician intends to perform at this registered office;

      c. Whether the physician holds current certification of eligibility with a specialty board approved by the Florida Board of Medicine and if so, to submit a copy of the certificate or board-eligibility letter with the notification;

      d. If the physician does not hold current certification or board eligibility, the physician must provide documentation to establish comparable background, training, and experience;

      e. If the physician does not hold current certification or board eligibility or provide documentation to establish comparable background, training, and experience, submission of a letter of good standing and a copy of the delineation of staff privileges as set forth in subparagraph 64B8-9.009 (4)(b)2., F.A.C.;

      f. If the physician does not provide a letter of good standing and a copy of the delineation of staff privileges as set forth in subparagraph 64B8-9.009(4)(b)2., F.A.C., the physician must provide a copy of a current transfer agreement with a licensed hospital within 30 minutes transport time from the surgery facility as set forth in subparagraph 64B8-9.009(4)(b)1., F.A.C.

      g. Submit a copy of the physician’s current Advanced Cardiac Life Support (ACLS) certification; and

      h. List the dates of attendance and specialty areas of all residency, fellowship, background experience, and additional training.

      3. For physicians who are anesthesia providers, submission of a current copy of the ACLS card or Pediatric Advanced Life Support (PALS) card (if appropriate), and

      4. For assistants to the surgeon, submission of a current copy of the Basic Life Support (BLS) card.

   5. (e) In order to register at an office for office surgery, the physician must comply with the Department’s Rule 64B-4.003, F.A.C., and provide documentation to support compliance with Rule 64B8-9.009, F.A.C., and this rule.
   6. (f) The registration shall be posted in the office.

2. (2) Inspection.

   1. (a) Unless the office has previously provided written notification of current accreditation by a nationally recognized accrediting agency or an accrediting organization approved by the Board, the office shall submit to an annual inspection by the Department. Nationally recognized accrediting agencies are the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), Accreditation Association for Ambulatory Health Care (AAAHC) and Joint Commission on Accreditation of Healthcare Organizations (JCAHO). American Accreditation Commission International (AACI) is an accrediting organization approved by the Board. All nationally recognized and Board-approved accrediting organizations shall be held to the same Board-determined surgery and anesthesia standards for accrediting Florida office surgery sites.
   2. (b) The office surgery inspection fee set forth in the Department’s Rule 64B-4.002, F.A.C., shall be remitted for each practice location.
   3. (c) For those inspections which are required to be announced, such inspections shall be announced at least one week in advance of the arrival of the inspector(s).
   4. (d) If the office is determined to be in noncompliance, the designated physician shall be notified and shall be given a written statement specifying the deficiencies at the time of inspection. If the designated physician is not present at the time of the inspection, the written statement shall be provided to the designated physician’s designee and a copy shall be provided to the designated physician. Unless the deficiencies constitute an immediate and imminent danger to the public, the designated physician shall be given 30 days from the date of inspection to correct any documented deficiencies and notify the Department of corrective action. Upon written notification from the designated physician that all deficiencies have been corrected, the Department is authorized to re-inspect for compliance. If the designated physician fails to submit a corrective action plan within 30 days of the inspection, the Department is authorized to re-inspect the office to ensure that the deficiencies have been corrected.

   5. (e) The deficiency notice and any subsequent documentation shall be reviewed for consideration of disciplinary action under any of the following circumstances below. However, nothing herein shall prevent the Board from considering disciplinary action when it is warranted by the particular facts and circumstances of the inspection, including evidence of repeated noncompliance regardless of the existence of a corrective action plan.

      1. When the initial notice of deficiencies contain deficiencies that constitute immediate and imminent danger to the public;

      2. When the initial notice of deficiencies contain deficiencies in the inspection immediately preceding the current inspection;

      3. The designated physician fails to provide the Department with documentation of correction of all deficiencies within thirty (30) days from the date of inspection; or

      4. Upon a finding of noncompliance after a reinspection has been conducted pursuant to paragraph (2)(d) of this rule.

   6. (f) Documentation of corrective action shall be considered in mitigation of any offense.
   7. (g) Nothing herein shall limit the authority of the Department to investigate a complaint without prior notice.

3. (3) Accreditation.

   1. (a) The office shall submit written notification of the current accreditation survey from a nationally recognized accrediting agency or an accrediting organization approved by the Board in lieu of undergoing an annual inspection by the Department.
   2. (b) An office shall submit, within thirty (30) days of accreditation, a copy of the current accreditation survey of its office and shall immediately notify the Department of any accreditation changes that occur.
   3. (c) If a provisional or conditional accreditation is received, the office shall notify the Department in writing and shall include a plan of correction.

Rulemaking Authority 458.309, 458.328 FS. Law Implemented 456.069, 458.328 FS. History–New 5-15-00, Amended 9-18-01, 8-5-03, 9-1-03, 2-9-05, 8-22-06, 10-30-07, 1-9-13, 3-3-13, 12-22-14, 3-10-20, 11-14-21, 9-11-22, 4-14-25, 3-2-26.