By Carol R. Sacks

PSP’s guide to finding the perfect surgical spaceSacks1

Looking for the perfect space to hang your shingle and open the plastic surgery practice of your dreams?

Sure, it can be tempting to go by address alone, but there are many technical factors to consider before putting an offer on a surgical suite.

For starters, can a medical practice legally operate within the zoning district of the building under evaluation? This can be a deal-breaker, so make sure any space is appropriately zoned in advance.

The next question to ask is if the facility is, or will be, up to standard.

The American Association for Accreditation of Ambulatory Surgery Facilities Inc (AAAASF) and others have established standards and practices for an office-based surgical practice (OBS). An OBS is a facility where the physician will perform invasive procedures such as breast augmentation or facelifts. Your real estate broker should be knowledgeable about basic standards as well as the state, local, and federal regulations governing these types of medical facilities.

The American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery Inc state that plastic surgery performed under anesthesia must be performed in a surgical facility that meets at least one of the following criteria:

It must be:

  • Accredited by a national or state-recognized accrediting agency/organization such as the AAAASF, the Accreditation Association for Ambulatory Health Care, or the Joint Commission on the Accreditation of Health Care Organizations.
  • Certified to participate in the Medicare program under Title XVIII.
  • Licensed by the state in which the facility is located.

What does an accredited facility look like? From a building perspective, there must be a proper number of exits. In addition, hallways, stairways, and elevators must be sufficiently wide to allow for emergency evacuation. Ask yourself, can a gurney fit through the door and easily turn? Is there enough space within the procedure room to house all necessary equipment and medication required for each type of procedure that could be performed?

Your broker should have an understanding of the physical, mechanical, electrical, and plumbing requirements of your surgical facility so they know if the space is an option to pursue.

All Eyes on the OR

The “right” space must accommodate the entire office layout, including exam rooms, reception/seating area, clerical/reception desk, patient bathrooms, storage, doctor’s office(s), and even a VIP exit (if one is indicated). Still, the most important room in the facility is the operating room.

Is there an area with a sufficient amount of unobstructed space to build an operating procedure suite? A procedure room must be able to accommodate a surgical table and other equipment (some of which can be rather large). It must be adequately ventilated for temperature and climate control and venting of gases. According to the AAAASF, the most common reason that a floor plan would not get approved is if the OR suite is not separate and physically segregated from the general office area.

There should be ample adjacent space to accommodate supporting services. These include scrub rooms, personnel lockers, and dressing areas, including shower and bathroom, anesthesia workroom, clerical control station, janitorial closet, and separate rooms for cleaned and soiled supplies and equipment.

If there is to be one procedure room within the facility, can it accommodate a recovery area or is there adjacent space to the procedure suite suitable for a recovery area?

Looking ahead, patient drop-off and pick-up may also be important as you build a practice. Can vehicles drive up to the entrance for easy patient drop-off or pick-up, or can patients easily access private and/or public transportation?

The last and final question is whether or not the landlord is willing to accept a surgical suite in the building. It’s always the landlord’s call whom he or she wants for a tenant.

The perfect space is out there, as long as you know what you are looking for and what questions to ask. Rely on an experienced commercial broker to identify those buildings and spaces that conform to the standards for the infrastructure’s basic requirements in advance. It won’t do any good to fall in love with a space that does not meet the necessary standards and codes.

Sacks-bio Carol R. Sacks is managing director at ABS Partners Real Estate LLC in New York City. She can be reached via PSPeditor@allied360.com.