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officers and chairmen of committees. Where legally permissible, physicians who are members of the medical staff shall be eligible for, and should be included in, full membership of the centers’ governing board and its action committees in the same manner as are other knowledgeable and effective individuals. Also, any other member of the medical staff shall be considered eligible for membership of the governing board. (b) Provide for the designation of officers, their duties, and for the organization of the governing board into essential committees with the number and type consistent with the size and scope of the center’s activities. (c) Coordinate through an executive committee or the governing board as a whole, the policies and activities of the center and special committees established by the governing board. (d) Specify the frequency of meetings, at regular stated intervals, with a majority of the members constituting a quorum and with the requirement that minutes be recorded and made available to all members of the governing board. (e) Establish the position of administrator, the incumbent of which shall be responsible for operation and maintenance of the center as a functioning institution, and define the methods established by the governing board for holding such designated person responsible. (f) Provide for the appointment, reappointment, or dismissal of members of the medical staff through a credentialing committee or its equivalent and a procedure for hearing and appeal. No action on appointment, reappointment or dismissal shall be taken without prior referral to the credentialing committee for their recommendation, provided that the governing board may suspend an medical staff member pending final determination of any reappointment or dismissal. The governing board shall only appoint members of the medical staff as recommended by the credentialing committee. (g) Provide for the approval of the bylaws, rules and regulations of the medical staff. (h) Require that every patient shall be admitted by and remain under the care of a member of the medical staff. (i) Require that all medications, treatments and procedures shall be administered upon specific orders of a member of the medical staff. (j) Require that all attending medical staff members who do not have admitting privileges at an acute care general hospital document a written agreement with a physician who has staff privileges with one or more acute care general hospitals licensed by the state to accept any patient who requires continuing care; or (k) Ensure that there is a written center agreement, with one or more acute care general hospitals licensed by the state, which will admit any patient referred who requires continuing care. (b) An anesthesiologist or other physician or a certified registered nurse anesthetist under the on-site medical direction of a licensed physician or an anesthesiologist assistant under the direct supervision of an anesthesiologist, shall be in the center during the anesthesia and post-anesthesia recovery period until all patients are cleared for discharge.(c) At least one registered professional nurse shall be in the recovery area during the patient’s recovery period. (d) Prior to the administration of anesthesia, patients shall have a history and physical examination including laboratory analysis when indicated.(e) Written policies and procedures relative to the administration of anesthesia shall be developed by the anesthesia service, approved by the medical staff and the governing board, and be reviewed annually, dated at time of each review, revised as necessary, and enforced. (f) Anesthetic safety regulations shall be developed, posted and enforced. Such regulations shall include the following requirements:1. All operating room electrical and anesthesia equipment shall be inspected on no less than a semi-annual basis, and a written record of the results and corrective actions be maintained;2. Flammable anesthetic agents shall not be employed in centers; 3. Electrical equipment in anesthetizing areas shall be on an audiovisual line isolation monitor, with the exception of radiologic equipment and fixed lighting more than 5 feet above the floor; 4. Each anesthetic gas machine shall have pin-index system or equivalent safety system and a minimum oxygen flow safety device; and 5. All reusable anesthesia equipment in direct contact with the patient shall be cleaned or sterilized as appropriate after each use; 6. The following monitors shall be applied to all patients receiving conduction or general anesthesia:e. An Inspired Oxygen Concentration Monitor and a Capnograph shall be applied to all patients receiving general anesthesia.(3) NURSING SERVICE. This service shall be organized under written policies and procedures relating to patient care, establishment of standards for nursing care and mechanisms for evaluating such care, and nursing services.(a) A registered professional nurse designated by the administrator shall be responsible for coordinating and supervising all nursing services. (b) There shall be a sufficient staffing pattern of registered professional nurses to provide quality nursing care to each surgical patient from admission through discharge. Such additional trained nursing service personnel shall be on duty as may be needed commensurate with the service of the center. (c) A registered professional nurse shall be assigned as the circulating nurse for one patient at a time for the duration of the surgical procedure for any procedure performed in the center. (1) Each ambulatory surgical center shall provide fire protection through the elimination of fire hazards; the installation of necessary safeguards such as extinguishers, sprinkling devices, and fire and smoke barriers as described in Rule 59A-5.022, F.A.C., to insure rapid and effective fire control; and the adoption of written fire control plans rehearsed four (4) times a year by all personnel. To safeguard patients, the ambulatory surgical center shall have: (2) Written fire control plan approved by the appropriate local fire authority shall contain provisions for prompt reporting of all fires; extinguishing fires; protection of patients, personnel and guests; evacuation; and cooperation with fire fighting authorities. (3) There shall be rigidly enforced written rules and regulations governing proper routine methods of handling and storing oxidizing, combustible, and flammable explosive agents. Rulemaking Authority 395.1055 FS. Law Implemented 395.001, 395.1055 FS. History–New 6-14-78, Formerly 10D-30.17, Amended 2-3-88, Formerly 10D-30.017, Amended 11-13-95. 59A-5.018 Comprehensive Emergency Management Plan. (1) Each center shall develop and adopt a written comprehensive emergency management plan for emergency care during an internal or external disaster or emergency which it shall review and update annually. (2) The emergency management plan shall be developed in conjunction with other agencies and providers of health care services within the local community pursuant to Section 252.32(2), F.S., and in accordance with the “Emergency Management Planning Criteria for Ambulatory Surgical Centers”, AHCA FORM 3130-2003 July 94, which is incorporated by reference. The form is available at: http://www.flrules.org/Gateway/reference. asp?No=Ref-04454 and available from the Agency for Health Care Administration at:http://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/Hospital_Outpatient/forms/ASC_CEMP_ Reconstructed_122104.pdf (a) Provisions for internal and external disasters, and emergencies; (b) A description of the center’s role in a community wide comprehensive emergency management plan; (c) Information about how the center plans to implement specific procedures outlined in its comprehensive emergency management plan; (d) Precautionary