Make sure that you understand the laws that regulate Ambulatory Surgery Centers (ASCs) in your state. Because regulatory mistakes can be very costly, it is wise to seek resources to assist in interpretation of the regulations — and the exceptions to the regulations— that will govern your ASC. A good financial feasibility study that includes an analysis of the number and type of surgical procedures required, the availability of adequate reimbursement, and the cost of ASC startup will help you assess the viability of a proposed ASC. The feasibility study is also an important part of the analysis that the lender will use when determining financing. Have someone knowledgeable in patient care, storage needs and business office functions review your architect’s initial space plan and schematic design to make sure that you will not outgrow the facility prematurely. As soon as the feasibility analysis is complete and there is a tentative approval from the lender regarding financing, develop a budget that is governed by the needs of the facility, not the desires of the owners and staff. Develop relationships with equipment manufacturers and reputable re-manufacturers. Items such as sterilizers, surgical tables, lights and anesthesia machines need not be new. Many re-manufacturers return equipment to its new state and provide equipment warranties similar to the original warranties — and, cost savings can be significant.