To embed, copy and paste the code into your website or blog: In 2007, the South Carolina Board of Medical Examiners (Medical Board) promulgated S.C. Code Ann. Regs. 81-96 (2007 and Supp. 2012)[1] governing the practice of office-based surgery.[2] The regulation’s promulgation reflected significant research and the development of consensus regarding the prevailing standard of care with input from various stakeholders, including anesthesiologists and certified registered nurse anesthetists (CRNAs). Concerns regarding the safety of patients under sedation outside the hospital or ambulatory surgical facility settings made the regulation necessary as more and more procedures move into the office environment. However, a recent review of the regulation’s enforcement over the past 13 years revealed a disconnect between the intended impact and its actual application.