Joint Commission's Office-Based Surgery program surveys a practice on site every three years, usually in one day, against a customised subset of the ambulatory care standards. Several states require office surgery under anesthesia to be accredited or registered, including New York, California, Florida and Texas.
The program
The Office-Based Surgery standards are a customised subset of Joint Commission's ambulatory care standards. A practice is surveyed on site every three years, and a typical survey lasts one day, by surveyors from the ambulatory field with experience of smaller surgery settings.1 Most surveys come with seven business days' notice, and an initial survey with 30 days' notice.2
The Office-Based Surgery National Patient Safety Goals for 2026 cover two patient identifiers, labelling medications in procedural settings, medication information, hand hygiene and the Universal Protocol.3 See the guide to the National Patient Safety Goals for ambulatory care for the full text.
What the surveyor asks to see
The Office Based Surgery Survey Activity Guide lists the documents to have ready, including the day's patient or surgery schedules, contacts for tracer selection, contracted patient care services, the latest culture of safety evaluation, the annual infection risk assessment, environment of care plans, 12 months of quality improvement data, the hazard vulnerability analysis and the emergency operations plan.2 The survey runs from arrival and planning, through an opening conference and orientation, to individual tracers of 60 to 120 minutes.2
State rules that sit beside accreditation
| State | What the state's own page says |
|---|---|
| New York | Office-based surgery is defined in Public Health Law 230-d. Adverse events are reported to the Department of Health within three business days of the occurrence of the event.48 |
| California | Surgery under anesthesia beyond local must be done in an accredited, licensed or certified setting. Approved accreditors include Joint Commission.5 |
| Florida | Offices doing Level II or III surgery register with the Department of Health. Accredited offices skip the annual inspection.6 |
| Texas | Physicians giving or performing procedures with level II to IV anesthesia in an outpatient setting register with the Texas Medical Board.7 |
Practices in New York City, Los Angeles, Miami and Houston each answer to these state rules as well as to Joint Commission. The Joint Commission hub lists the state body for every US city we serve.
- Confirm your state rule. Check whether your state requires accreditation, registration or both for the anesthesia levels you use.
- Assemble the document list. Use the Office Based Surgery Survey Activity Guide list, and know where each document lives.
- Walk a procedure. From identification and consent to verification, site marking, time-out and discharge.
- Check medication handling. Labelling on and off the sterile field, and the medication information the patient takes home.
- Set up adverse event reporting. Know your state's reporting window and who files the report.
- Trace a patient. Use one recent patient's record to explain their care from booking to follow-up.
- Patient identifiers used ______
- Consent discussion recorded by ______
- Preprocedure verification by ______ Site marked ______
- Time-out at ______ Led by ______
- Medications labelled, yes or no ______
- Discharge instructions given in writing ______
Questions
How long does a Joint Commission office-based surgery survey take?
Joint Commission says a typical survey lasts one day, every three years.
Is Joint Commission an approved accreditor for office surgery in California?
Yes. The Medical Board of California lists Joint Commission among the approved accreditation agencies for outpatient settings.
Do office-based surgery practices follow the National Patient Safety Goals?
Yes. The Office-Based Surgery program has its own National Patient Safety Goals chapter effective January 2026, including the Universal Protocol.
Sources
- 1Joint Commission, 2026Office-Based Surgery Accreditation ProgramRead source
- 2Joint Commission, 2026Office Based Surgery Accreditation Organization Survey Activity Guide, July 2026Read source
- 3Joint Commission, 2026National Patient Safety Goals, effective January 2026, Office-Based Surgery ProgramRead source
- 4New York State Department of Health, 2026Office-Based SurgeryRead source
- 5Medical Board of California, 2025Outpatient Surgery SettingsRead source
- 6Florida Board of Medicine, 2026Office Surgery RegistrationRead source
- 7Texas Medical Board, 2026Additional practice topics for physicians, office-based anesthesiaRead source
- 8New York State Department of Health, 2024Office-Based Surgery, Frequently Asked Questions for PractitionersRead source
Written by the wai team from Joint Commission guidance, checked on 15 October 2026. This is guidance, not legal advice. Joint Commission does not endorse wai or any software.