Most freestanding facilities have written transfer arrangements with hospitals or extended care facilities that enable the freestanding facility to admit patients if they do not meet discharge criteria from observation status. It is not a transfer of care but rather an admission to the hospital or extended care facility from the freestanding facility. Reasons for moving patients from a freestanding facility to a hospital or extended care facility can include unplanned medical emergencies (such as cardiac or respiratory problems), a situation where more extensive surgery is required, and/or a surgical complication has occurred (e.g., hemorrhage or dehiscence) (Burden et al., 2000; Odom-Forren, 2013; Schick & Windle, 2016).