Washington Business Journal, January 9, 2014

A Bethesda outpatient surgery center intends to begin performing operations that involve overnight patient stays, a significant — and controversial — expansion to its services that could have broad implications for Maryland's medical industry. If the Massachusetts Avenue Surgery Center's gambit succeeds and clears regulatory scrutiny, other outpatient centers could follow, launching a new threat to full-service hospitals already losing struggling to maintain volumes. But their plans encounter a regulatory gray area, because federal and state laws are not entirely clear on the definition of "overnight." The central question: Are stays at outpatient surgery centers limited to 23 hours and 59 minutes, or the same calendar day as the procedure?

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