I have worked at 2 such facilities that are prototypes for this; staffed with em docs and pa's, ct, u/s, and lab on site, ties to a larger facility with guaranteed transfers for admission( ie they can never be on divert to us).
on the positive side they can do most of what a regular ed can do for pts not requiring surgical intervention. on the downside if you need a surgeon/ortho/ent etc to take the pt to the o.r. they need to be transfered to another facility with an o.r./icu/etc
so for the 90%+ of pts who don't require emergent operations it's a great concept. for anyone really just needing a surgeon and all the bells and whistles of a full hospital(icu, etc) a stop at this facility is a delay in care when the "real" hospital is usually within the same town and within 30 min of driving.
my current facility is thinking about adding one as part of a new medical complex that includes a medical specialty office building and outpt ambulatory surgical ctr so it would have an o.r. and availability of specialty consults during the day but no beds for admissions after surgery.