How the Department of Health and Florida Boards of Medicine Discipline Office Surgery Facilities and Physicians

Office surgery regulation in Florida is complex, and for good reason. The stakes are high when procedures are performed outside of licensed hospitals or ambulatory surgical centers. To protect patient safety, the Florida Department of Health (DOH) and the Boards of Medicine and Osteopathic Medicine enforce rigorous oversight of office surgery facilities and the physicians who practice in them.

Understanding how these agencies exercise their disciplinary powers is critical for any office-based surgical practice and its Designated Physician (DP). Below, we break down the key distinctions between DOH and Board authority, the types of enforcement actions they take, and what you can do to stay compliant.

DOH Oversees and Disciplines the Facility

The Department of Health has jurisdiction over the office surgery facility itself. There is no independent “board” for office surgery registration; instead, DOH acts through its prosecutorial staff. When the DOH determines that an office surgery facility is not in compliance with Florida’s Office Surgery Registration (OSR) laws or rules, it may pursue administrative action—most often suspension or revocation of the facility’s registration.

Immediate Suspension

Under s. 458.328(1)(e)2., F.S., the DOH must immediately suspend the registration of any office that refuses an annual inspection. The suspension lasts a minimum of 14 days and cannot be lifted until the DOH conducts a reinspection and issues a written declaration authorizing the office to reopen. In practice, a facility that fails or refuses inspection should anticipate running into these issues.

Suspension or Revocation for Violations

The DOH may suspend or revoke an office registration for failure to comply with applicable laws or rules or if any of its physicians, owners, or operators fail to do so. If registration is revoked, the DOH can bar any person named in the facility’s registration, including owners or operators, from registering another office for five years following the revocation date.

Emergency Orders

In cases involving egregious events such as a patient death or severe harm, the DOH can issue an Emergency Suspension Order (ESO) or Emergency Restriction Order (ERO). These orders immediately limit or halt operations without prior notice or hearing, typically to protect public health and safety.

The Board’s Discipline of the Physicians

While the DOH handles the facility, the Florida Boards of Medicine and Osteopathic Medicine hold disciplinary authority over individual physicians.

The Designated Physician (DP)

Every registered office must name a Designated Physician responsible for ensuring compliance with health and safety requirements. The DP must hold a full, active, and unencumbered license and be actively practicing at the office. The Boards may impose penalties on the DP if the office fails to operate in compliance with OSR laws and rules. Common violations include failing an annual inspection, failing to submit or complete a Corrective Action Plan (CAP), or failing a re-inspection after deficiencies are cited.

These actions typically fall under s. 458.331, F.S. (or its osteopathic equivalent, s. 459.015, F.S.) and the general disciplinary authority of s. 456.072(1), F.S.

The Operating Surgeon

If a surgical incident or adverse event occurs during a procedure, the surgeon performing the procedure bears individual accountability. The Board may pursue discipline against the physician if a patient is harmed due to negligence or rule violations. Additionally, if the Designated Physician fails to report the adverse incident as required under s. 458.351, F.S., they too may face disciplinary action even if they were not the operating surgeon.

Common Compliance Triggers

Based on our firm’s experience representing medical professionals and facilities across Florida, the following situations frequently result in DOH or Board scrutiny:

• Failed or refused annual inspections
• Incomplete or ineffective Corrective Action Plans
• Failure to designate or timely replace a Designated Physician
• Unreported adverse incidents or hospitalizations
• Procedures performed beyond authorized surgical levels
• Improper delegation during gluteal fat grafting or similar procedures
• Operating without active financial responsibility documentation

Key Takeaways for Office Surgery Compliance

• Keep inspections current. Never delay or refuse a DOH inspection—it guarantees immediate suspension.
• Designate a qualified physician. Ensure the DP has an active, unencumbered license and is onsite regularly.
• Document corrective actions. If deficiencies are cited, follow through and verify completion before re-inspection.
• Report incidents promptly. The law requires reporting adverse events that result in hospitalization or harm.
• Seek legal counsel early. Once the DOH or a Board opens an investigation, proactive legal negotiation can protect your registration, license, and professional reputation.

Protecting Your License and Practice

The interplay between the Department of Health and the Florida Boards of Medicine and Osteopathic Medicine can be confusing and intimidating, especially when your livelihood and patient trust are at stake.

At Howell, Buchan & Strong, our attorneys are deeply experienced in representing physicians and facilities in matters involving DOH investigations, Board complaints, emergency suspension orders, and office surgery compliance. We understand how to negotiate with prosecutors, mitigate penalties, and, when necessary, defend your rights through administrative proceedings.

If your office surgery registrations or medical license is under review, or if you’ve received notice of a DOH inspection or Board inquiry, contact our office immediately. Early intervention can make the difference between a temporary correction and a full suspension or revocation.