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The Ohio Revised code clearly distinguishes between hospitals and ambulatory surgical facilities and treats them separately. Compare O.R.C. 3727.01 Health maintenance organization, hospital defined and O.R.C. 3702.30 Ambulatory surgical facilities. Prohibition of the term “hospital” by a surgical outpatient facility therefore enforces state law definitions. The word “safe” can be misleading as no surgical procedure anywhere can be guaranteed as “safe,” particularly when informed consent of the risks is required of every patient undergoing surgery. The American College of Obstetricians and Gynecologists has engaged in extensive studies on how to improve patient safety to make procedures more safe with less risk, but ACOG does not claim that improved methods will guarantee a safe result in every case. “Patient Safety in the Surgical Environment,” ACOG, Committee Opinion, Committee on Patient Safety and Quality Improvement, No. 464, Sept. 2010, reaffirmed 2014. However, the government could not prohibit a statement by a facility such as “Endeavors to provide as safe a surgical environment as possible.” Nat'l Inst. of Family & Life Advocates v. Becerra, 138 S. Ct. 2361 (2018)(“\[T\]his Court’sprecedents have long protected theFirst Amendment rights of professionals,” 138 S.Ct., at2374. 4. 503.03 THROUGH503.16 CONSTRUCTION ANDSERVICES REQUIREMENTS The abovesectionslaid outspecificationsfor theconstruction of freestandingsurgicalfacilities and the services that they are requirements to haveavailable.O.R.C. 3702.30 Ambulatory surgical facilities applies to such facilities and Ohio Administrative Code sections 3701.83.01 to 3701.83.22 now describes the state regulations that apply. 5. 503.17 TRANSPORTATION SERVICES A facility shall have available immediately adequate transportation services for emergency patients requiring transfer to a hospital. A facility shall be located not more than fifteen minutes normal travel time from the hospital with which written emergency admission arrangements are made. When indicated, a physician or nurse from the facility shall accompany the patient to provide emergency care enroute. Comment: Since 2013, Ohio law now defines the requirements between ambulatory surgical facilities and hospitals. O.R.C.3702.303. In relevant part, the statute requires “an ambulatory surgical facility shall have a written transfer agreement with a local hospital that specifies an effective procedure for the safe and immediate transfer of patients from the facility to the hospital when medical care beyond the care that can be provided at the ambulatory surgical facility is necessary, including when emergency situations occur or medical complications arise. A copy of the agreement shall be filed with the director of health.” O.R.C. 3702.303(A). The requirement in this section for expeditious emergency treatment may not reflect the contemporary geographical medical environment of Lakewood. There is no longer a hospital definitely available within fifteen minutes of every location in the city where a surgical facility could be established, although Metro and Fairview Park hospitals could possibly be reached within that period of time. There is also an emergency department in the Cleveland Clinic 4