BY ROBERT KURTZ | MARCH 2024
Discover the magic that comes with being surrounded by hundreds of colleagues and friends at the largest ASC conference of the year and less than a mile from Walt Disney World.
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A “constant concern” is how Rebecca Bowles-Paine, CASC, chief executive officer for Beckley Surgery Center in Beckley, West Virginia, describes anesthesia coverage at her ASC.
In Sg2’s 2023 Impact of Change Forecast Highlights report, the firm projected that ASCs would see 12 percent and 22 percent growth in the next 5 and 10 years, respectively. ASCs interested in capitalizing on this growth opportunity might need to expand the physical footprint of their facility.
BY SAHELY MUKERJI | FEBRUARY 2024
Now that the Centers for Medicare & Medicaid Services has added total shoulder arthroplasty (TSA) to the ASC Covered Procedures List (ASC-CPL), the healthcare system will save a considerable amount.
BY ROBERT KURTZ | FEBRUARY 2024
Insurance claims denials receive significant attention at Brunswick Surgery Center in Leland, North Carolina, because of their potentially extensive effects on the ASC and its patients, says Marian Emory, revenue cycle manager. “Denials represent money we cannot use to pay staff, pay our overhead and invest in projects and equipment so we can provide newer, better services to our patients.”
When you have three ASCs of different ages, capital equipment is almost always on your mind, says Erika Noll, chief operating officer of Peachtree Orthopedics. The organization operates a new ASC, a 10-year-old center and a 20-year-old center in the Greater Atlanta, Georgia, area.
Commercial payer perceptions of ASCs have changed a lot in recent years, says Andrew Weiss, CASC, administrator of Summit Surgical Center in Voorhees, New Jersey. He recalls a time when private payers were often skeptical about contracting with surgery centers.
Industry experts weigh in on what to expect this year and how to make the best of the circumstances.
BY ROBERT KURTZ | JANUARY 2024
Looking for an effective, cost-efficient way to expand your staff’s knowledge? Look within the walls of your ASC, says Aby Morris, RN, administrator and clinical director for Union City Surgery Center in Union City, Tennessee.
An ASC’s ability to effectively train staff on how to use new technology is a high-stakes proposition, says Michael Fahey, information technology manager for Magna Health Systems, which operates ASCs in Chicago and Bedford Park, Illinois.
BY ROBERT KURTZ | NOVEMBER-DECEMBER 2023
The Conditions for Coverage require Medicare-certified ASCs to develop a written infection control plan. The importance of this plan goes beyond compliance, says Allison Stock, RN, CASC, CAIP, vice president of clinical and operational services for Surgical Management Professionals in Sioux Falls, South Dakota.
Communication is the backbone of healthcare, and few processes are more important than others for a positive patient experience and outcome, says Brandon Daniell, cofounder and chief revenue officer of Dialog Health in Franklin, Tennessee. “Communication is everything a patient has prior to and after leaving your ASC,” he says.
INTERVIEWED BY ROBERT KURTZ | NOVEMBER-DECEMBER 2023
Rita Reyes-Williamson, the west region senior director of managed care for Surgery Partners in Brentwood, Tennessee, has extensive experience developing and supporting bundled payment programs for ASCs.
BY ROBERT KURTZ | OCTOBER 2023
North Pointe Surgery Center (NPSC), a facility designed to perform total joint procedures, opened in Lebanon, Pennsylvania, in 2015. In 2021, the ASC finally completed its first total joint replacement.
Patient care is the top priority for ASCs, but effective management of accounts receivable (AR) should not be far behind, says Tracey Erbert, president of Full Circle Medical Billing in Minneapolis, Minnesota.
Orthopedic surgeon Christopher Nanson, MD, places a high priority on the clinical metrics associated with his total joint procedures. “They provide a measuring stick for performance, so you can determine how to get better and demonstrate that you are a high-quality provider,” says Nanson.
BY ROBERT KURTZ | SEPTEMBER 2023
More than one in five US adults live with a mental illness, according to the Centers for Disease Control and Prevention. ASCs would be wise to consider how this statistic applies to them, says Amy Bussie, RN, owner at Blossom Partners in Atlanta, Georgia.
While the success of a surgery will largely be determined by what occurs on the operating table, laboratory and pathology services play important roles.
Union City Surgery Center (UCSC) operates in Union City, a small, rural town in Northwest Tennessee. This location presents a challenge in the event of an emergency, says Marcy Moon, RN, the ASC’s emergency coordinator.
BY ROBERT KURTZ | AUGUST 2023
Drug diversion represents a significant concern for ASCs and has the potential to lead to legal and liability risks, says John Karwoski, president and founder of JDJ Consulting LLC in Gloucester County, New Jersey.
Online, in print and on air, the daily news paints an uncomfortable truth about working in medicine: It has become more dangerous.
Installing security cameras in your ASC is not a decision to be made lightly, says Lani Dornfeld, a member at Brach Eichler LLC who works out of the firm’s Roseland, New Jersey, and West Palm Beach, Florida, offices.
BY ROBERT KURTZ | JUNE-JULY 2023
The challenges in delivering high-quality care to a more diverse society go beyond those associated with patients, says Traci Albers, interim chief executive officer of Surgical Management Professionals in Sioux Falls, South Dakota.
The high patient satisfaction scores at Cataract and Laser Center West in West Springfield, Massachusetts, help confirm what Administrator Patricia McKenna, RN, CASC, already believes: her staff is providing great care.
Valley Surgery Center in Hudson, Wisconsin, hired Sarah Karau, RN, as its director of operations as it was preparing to open last spring. Karau recognized her unique opportunity.
BY ROBERT KURTZ | MAY 2023
In recent years, Frederick Surgical Center in Frederick, Maryland, has seen a significant increase in the number of cases it performs, the addition of a breast service program and expansion of its existing service lines. While several factors contributed to these accomplishments, Eric Shepard, MD, the ASC’s anesthesia director, says one decision had the greatest impact.
With the right partners and models, bundled payments can benefit ASCs and help centers grow their surgical volume, says Matt Kilton, partner with ECG Management Consultants in Seattle, Washington.
Since 2018, SCA Health, headquartered in Deerfield, Illinois, has offered a development program for nurses interested in working in the operating room (OR) of its ASCs.
BY ROBERT KURTZ | APRIL 2023
“More than I can count.” That is how Ann Geier, RN, CASC, chief nursing officer for Ambulatory Healthcare Strategies in Rochester, New York, describes the number of nurses she has mentored during her career.
Standards and organizational changes have taken place at the Accreditation Association for Ambulatory Health Care (AAAHC) of Skokie, Illinois, the Accreditation Commission for Health Care (ACHC) in Cary, North Carolina, The Joint Commission of Oakbrook Terrace, Illinois, and QUAD A in Gurnee, Illinois.
ASCs that improperly handle, store or monitor their controlled substances can face a slew of citations from surveyors, says Lea Schilit, assistant vice president of clinical pharmacy services for the Eastern Region of the HCA Healthcare Ambulatory Surgery Division.
BY ROBERT KURTZ | MARCH 2023
Make your plans today to come to Louisville—home to the Kentucky Derby, “The Greatest” heavyweight boxer of all time, a legendary baseball bat museum and much more—for the ASCA 2023 Conference & Expo, May 17–20, 2023.
Considering selling a minority or majority of your ASC? This might be a good time. “If you think it is a good time to bring in an investment partner, you are likely going to have options," says Carole Guinane, RN, executive director of ASC operations for Cedars-Sinai in Los Angeles, California. “If you can find the right partner, it can do wonders for a surgery center, its owners and the community it serves.”
When healthcare professionals consider their employment options, many factors likely influence the jobs they apply for and the jobs they remain at. One of the top influencers is typically salary, but increasingly not far below in significance when evaluating employment opportunities is benefits, says Michael Cournyea, chief executive officer of Atlas Surgery Center in Williamsville, New York.
In the nearly four years Alina Brett has served as the business office manager at Live Oak Surgery Center (LOSC) in Plano, Texas, the ASC has grown significantly. It added several new specialties, built a gastroenterology suite and quadrupled monthly case volume. Many new physicians and clinical staff came aboard.
BY ROBERT KURTZ | FEBRUARY 2023
As competition for patients, staff and physicians has risen, so has the importance of marketing for ASCs. Erica Palmer, senior content marketing manager for HST Pathways in Nashville, Tennessee, says marketing has become an essential strategy for all surgery centers if they wish to remain a destination of choice.
BY KARA NEWBURY | FEBRUARY 2023
While advances in medical technology and changes in Medicare payment policy have expanded the list of procedures for which the Centers for Medicare & Medicaid Services (CMS) will reimburse ASCs, Medicare policies still lag innovation.
As marketing specialist for Missoula Bone & Joint and Surgery Center in Missoula, Montana, Julie McLennan sees the value of social media firsthand. The ASC operates accounts on multiple platforms to promote many topics, including the addition of providers, event participation, orthopedic education and job openings.
BY ROBERT KURTZ | JANUARY 2023
Six ASC leaders offer their take on what is in the pipeline for 2023.
To Jeri Lynn Bartha, good inventory management means her ASC—Endoscopy Center of Niagara (ECNI) in Niagara Falls, New York—can do what it was designed to do. “Essentially, everything we have is crucial to performing cases, right down to a syringe,” says Bartha, who has more than three decades of supply chain experience and serves as the ASC’s certified endoscopy technician.
Knoxville Orthopaedic Surgery Center (KOSC) in Knoxville, Tennessee, purchases a lot of implants. The ASC uses implants for its total joint replacements, anchors in sports medicine cases and plates and screws in fracture cases.
BY ROBERT KURTZ | NOVEMBER-DECEMBER 2022
Surgical site infections (SSI) are largely avoidable, says Terri-Marie Mahoney, RN, CASC, senior clinical director for Amsurg in Nashville, Tennessee. That puts the onus on ASCs to do whatever they can to keep their number of SSIs as low as possible.
Ever since Lakeview Surgery Center in West Des Moines, Iowa, opened its doors more than 20 years ago, quality improvement (QI) studies have played a key role in helping the ASC provide a better experience for its patients and achieve greater success, says Kate Foreman, the center’s quality coordinator.
By his estimate, Gregory Tertes, president of ASC Pharmacist Consultants in Oakland, California, says close to half of the medications used in ASCs fall under one of two important classifications: look-alike and sound-alike (LASA) or high-alert (HA) drugs.
BY ROBERT KURTZ | OCTOBER 2022
Ericka Lujan, RN, knows the exact effect information technology (IT) had on the time her ASC, Pima Heart and Vascular in Tucson, Arizona, spends maintaining its medical records. By moving from manual to IT-driven processes, the center cut this time in half.
As the clinical director for Roanoke Valley Center for Sight (RVCS) based in Salem, Virginia, Gwen Donithan, RN, appreciates the value of standardization. The ophthalmic center serves a high volume of patients across its four ASCs located in and around Salem. “When you can streamline best practices as much as possible, you are going to save time and money, and ensure better patient care,” she says.
Looking at everything from falls and surgical site infections to hospital transfers and emergency room visits within 24 hours, Surgery Center Cedar Rapids in Cedar Rapids, Iowa, tracks data on more than 20 patient safety metrics. It gathers that data from occurrence reports written by team members, information obtained on postoperative phone calls to patients, infection control and complication reports sent to physicians, and reports generated from its electronic medical records system.
BY ROBERT KURTZ | SEPTEMBER 2022
In Mesquite, Texas, you will not find a commercial recycling program. What you will find is that North Texas Team Care Surgery Center managed to establish a recycling program of its own. All it took was a little creativity and a team committed to making a difference, says the ASC’s administrator Adam Hornback, RN.
Erin Wieniewitz, RN, regularly witnesses the importance of effective communication in the face of an emergency. She is the nurse manager of Urology Surgery Center of Savannah in Savannah, Georgia, an area of the country that regularly encounters hurricanes, tornadoes and other natural disasters.
INTERVIEWED BY ROBERT KURTZ | SEPTEMBER 2022
Gregory DeConciliis, CASC, has served as administrator of Boston Out-Patient Surgical Suites in Waltham, Massachusetts, since it opened in 2004.
BY ROBERT KURTZ | AUGUST 2022
Joel Rainwater, MD, chief medical officer and founder of Comprehensive Surgical Care in Gilbert, Arizona, describes staff burnout as “a constant threat to the work environment.”
Over the past roughly three years, Constitution Surgery Alliance in Avon, Connecticut, has converted space in four nonmedical buildings into ASCs: a space previously belonging to a national payroll company, a warehouse and two commercial office buildings. One of the main reasons the organization decided to proceed with these conversions rather than construct a new building: time.
INTERVIEWED BY ROBERT KURTZ | AUGUST 2022
Kimi Hart, the chief executive officer (CEO) of Brass Surgery Center in Baton Rouge, Louisiana, joined the ASC in 2003 and became CEO in 2018.
BY ROBERT KURTZ | JUNE-JULY 2022
Physicians are like conductors of an orchestra with the orchestra comprising the activities that support patients on their care journey, says Don Bisbee, chief executive officer of ValueHealth, based in Leawood, Kansas. As the ASC industry continues to move toward value-based care, physicians must understand what activities might be missing from their orchestra, he says.
Christine Blackburn, RN, witnesses the value of an empowered medical director every day in her ASC. “Our medical director is a continuous resource for our clinical staff,” says Blackburn, administrator of South Kansas City Surgicenter in Overland Park, Kansas. “She is approachable and knowledgeable in all areas and is seen as an important part of the leadership team.”
The coders at UT Health Austin’s Ambulatory Surgery Center in Austin, Texas, do not go unnoticed, says Administrative Director Jessica Hovland, RN. “Our coders are an essential piece of the revenue cycle puzzle and its success. They make sure we are representing the care provided here accurately to ensure a seamless business process from beginning to end.”
BY ROBERT KURTZ | MAY 2022
The importance of sterile processing boils down to a single factor for Judy Nassif-Jutras, materials/central sterile manager for New England Surgery Center in Beverly, Massachusetts: safety. “That is the bottom line. If we do not perform proper sterile processing, our patients and staff will be at an increased risk of infection.”
Ask Aby Morris, RN, what she prioritizes in her role as administrator and clinical director of Union City Surgery Center in Union City, Tennessee, and she will tell you that the completion of accurate clinical records is high on the list.
Over the past few years, the transition of total joint replacement surgeries out of the hospital and into the ASC has accelerated for Timothy Alton, MD, an orthopedic surgeon at Proliance Surgery Center in Renton, Washington. A big reason for this increased shift has been his use of negative pressure therapy on incisions, he says.
BY ROBERT KURTZ | APRIL 2022
Failure to maintain compliance with the Health Insurance Portability and Accountability Act (HIPAA)—particularly when it leads to exposure of protected patient health information (PHI)—can have serious consequences for an ASC.
Alfonso del Granado, CASC, just wants his ASCs to catch a break. For the past two years, del Granado, administrator of Covenant High Plains Surgery Center in Lubbock, Texas, has seen his center experience one challenge after another with securing equipment and supplies.
INTERVIEWED BY ROBERT KURTZ | APRIL 2022
Duly Health and Care Surgery Center Lombard in Lombard, Illinois, added a robotic surgical system in spring 2021. Gregory Grant, MD, a general surgeon at the ASC, led the efforts championing for the robot.
BY ROBERT KURTZ | MARCH 2022
Recruiting nurses to Mercy River Hills Surgery Center in Des Moines, Iowa, never used to be difficult, recalls Rebecca Schossow, RN, the ASC’s nurse manager. These days, the center is finding it hard to fill openings and experiencing challenges retaining nurses.
Over the next several years, Richard Rosenfield, MD, a gynecologist and founder of Pearl SurgiCenter in Portland, Oregon, expects to see significant changes in gynecologic surgeries being performed in the ASC space. “It has taken a long time to get here, but now there is a terrific opportunity for those of us working in the vertical.”
Last spring, the US Preventive Services Task Force (USPSTF) recommended colorectal cancer screening tests begin at age 45, lowering the recommended age from 50. The announcement also expanded coverage of colonoscopy under the Affordable Care Act’s prevention benefit.
BY ROBERT KURTZ | FEBRUARY 2022
After two years of virtual conferences, the largest ASC event of the year is back in person. Join your colleagues in Dallas, Texas, for the ASCA 2022 Conference & Expo, April 27–30. This year, ASCA returns to the Gaylord Texan Resort & Convention Center for the first time since 2016 and brings with it one of the more impressive and diverse schedules for an ASCA conference yet.
BY KARA NEWBURY | FEBRUARY 2022
In early November, elected officials in both the US House of Representatives and the US Senate introduced the Outpatient Surgery Quality and Access Act of 2021 (H.R. 5818 and S. 3132). Representative John Larson (D-CT) and former Representative Devin Nunes (R-CA) introduced the legislation in the House and Senators Richard Blumenthal (D-CT) and Bill Cassidy, MD (R-LA) introduced it in the Senate.
From 2011 to 2018, ASCs saved Medicare $28.7 billion, and they are projected to save an additional $73 billion between 2019 and 2028. Forecasted savings, however, are threatened by problematic Medicare policies that result in continually declining reimbursement and other factors that limit Medicare beneficiaries’ access to outpatient surgical care.
INTERVIEWED BY ROBERT KURTZ | FEBRUARY 2022
The American Society of Anesthesiologists (ASA) has issued an update to its “Statement on Granting Privileges for Administration of Moderate Sedation to Practitioners Who are Not Anesthesia Professionals.” Accessible on ASA’s website, this is a guide to how to credential non-anesthesiology professionals to provide sedation.
BY ROBERT KURTZ | JANUARY 2022
Lisa Ishii, MD, hopes the ASC program she oversees can serve as a model for academic health systems nationwide. Ishii, an otolaryngologist, is the president of the Johns Hopkins Surgery Center Series (JHSCS), which comprises six ASCs in Maryland jointly owned by the Johns Hopkins Health System and Johns Hopkins University.
The second highest cost element on the profit and loss statement of SurgCenter of Western Maryland in Cumberland, Maryland, is supplies, says Raghu Reddy, the ASC’s chief administrative officer. That makes it imperative for the center to execute an effective strategy for keeping supply costs down as much as possible, he says.
Lora Reed, RN, figures her ASC’s vendor service contract manual is at least five inches thick. To best ensure the manual serves her ASC in the most effective manner, Reed, the administrative director of Live Oak Surgery Center in Plano, Texas, devotes significant time and energy to evaluating and negotiating her ASC’s service contracts.
BY ROBERT KURTZ | NOVEMBER-DECEMBER 2021
In mid-July, Howard Nam, MD, an otolaryngologist at Sutter North Surgery and Endoscopy Center in Yuba City, California, implanted an upper airway stimulator in a patient’s chest. This was the first time Nam had completed the procedure in the ASC.
Surgery on its own is a stressful experience for patients. Present them with an unexpectedly high bill on the day of their procedure and that stress level could rise significantly and might even cause postponement of the surgery.
INTERVIEWED BY ROBERT KURTZ | NOVEMBER-DECEMBER 2021
Janie Kinsey, RN, CASC, is the vice president of ASCA’s Board of Directors and the administrator of Surgicenter of Kansas City in Kansas City, Missouri.
BY ROBERT KURTZ | OCTOBER 2021
In the late 1990s, the US Department of Health & Human Services Office of Inspector General (OIG) began placing a heavy emphasis on corporate compliance plans, says Lani Dornfeld, a member at Brach Eichler who works out of the firm’s Roseland, New Jersey, and West Palm Beach, Florida, offices.
In 2010, after more than a year of research, Pasadena Plastic Surgery Center in Pasadena, California, invested in a new information technology (IT) system to better manage scheduling, inventory, billing and other key functions.
ASCs must take the threat of ransomware seriously because cybercriminals are hoping they do not, says Robert Banniza, associate vice president of information security for Amsurg in Nashville, Tennessee.
BY ROBERT KURTZ | SEPTEMBER 2021
Over the past several years, Helena Surgicenter in Helena, Montana, has purchased a lot of technology, including a new C-arm and imaging solutions. One of the most important investments in technology the ASC made, however, had little to do with clinical care.
The ASC industry has many impressive leaders who work tirelessly day in and day out to serve their community and their industry. They take care of their patients and their staff and advocate for the ASC industry on Capitol Hill. ASC Focus talked to two of these leaders—Leslie Scott and Katherine Horowitz—to find out what makes a good leader.
For ASC administrators planning to retire in the near future or those just wanting to take a more relaxing vacation, succession planning is essential, says Mary Ryan, RN, CASC, a senior consultant for Amblitel in Louisville, Colorado. “If you are in a leadership position, see who you have ‘sitting on the bench’ that you can mentor and help provide the education they need.
BY KARA NEWBURY | AUGUST 2021
The ASC community celebrated its 50th anniversary last year and has much to be proud of over the course of its history. The past decade alone has been full of advocacy achievements.
BY ROBERT KURTZ | AUGUST 2021
If you operate an ASC, do not be surprised if you hear from any number of organizations asking if you will engage in a conversation about the future of your center. The reason, says Michael McCaslin, principal at Somerset CPAs and Advisors in Indianapolis, Indiana: ASCs are a hot commodity.
After ASC owners engage ASCs Inc. in Valley Center, California, to help facilitate a sale, the process they follow involves collecting significant due diligence material and developing a confidential information memorandum (CIM), says Jonathan Vick, the company’s founder and managing partner.
INTERVIEWED BY ROBERT KURTZ | AUGUST 2021
In the wake of the COVID-19 pandemic, Ohio Surgery Center in Columbus, Ohio, hosted its first virtual facility tour. Suzi Walton, CASC, the ASC’s facility administrator, worked with ASCA to arrange a 30-minute virtual facility tour for Congressman Troy Balderson (R-OH) and several of his staff members.
BY ROBERT KURTZ | JUNE-JULY 2021
While it might appear as just a few lines in a document, the agenda for the quality assurance and performance improvement (QAPI) portion of Raleigh Orthopaedic Surgery Center’s (ROSC) medical executive committee (MEC) meetings serves several important purposes, says Andria Barnes, RN, quality manager for the Raleigh, North Carolina, ASC.
In early 2004, a group of surgeons operating at The Reading Hospital in Reading, Pennsylvania, approached hospital leadership with a proposal: partner on an ASC. Before year’s end, an outpatient department located a few miles from the hospital had been converted into a surgery center with ownership split between the physicians and the hospital.
If you are planning to build a new ASC, do not rush to get a shovel into the ground. “The pre-construction phase is a definitive component in the development of a new center,” says Ronald Blair, founder of Surgery Center Services of America in Mesa, Arizona.
BY ROBERT KURTZ | MAY 2021
The Ambulatory Surgical Center of Stevens Point in Stevens Point, Wisconsin, started performing total joint replacements in 2010. Since the program's launch, only a few patients have required postoperative transfer to a hospital.
Achieving ASC revenue cycle success is largely about timing, says Jenny Mishler, director of revenue cycle and payer relations for the Orthopaedic & Spine Center of the Rockies in Fort Collins, Colorado. From getting claims out the door to submitting denials before deadlines, timing, she says, is often the difference between receiving payment and leaving money on the table.
Wondering whether you are allowed to mandate that your staff receive the COVID-19 vaccination? The short answer is yes, you can, says Marianne Monroy, partner-director and co-chair of Garfunkel Wild's employment law practice group who practices out of the firm's Great Neck, New York, office and serves the tristate area of New York, New Jersey and Connecticut. A lot needs to be considered before proceeding, however.
BY ROBERT KURTZ | APRIL 2021
Over several years, congressional hearings and the continued rise in the cost of healthcare and patient copays contributed to a heightened awareness of the ill effects of surprise medical bills.
In its 2020 AAAHC Quality Roadmap, the Accreditation Association for Ambulatory Health Care identifies credentialing, privileging and peer review as high-deficiency standards for ASCs.
With staff wages one of the top expenses for Mohawk Valley Endoscopy Center in Utica, New York, Thomas P. Fiorentino, the ASC's chief financial officer, keeps a watchful eye on them.
BY ROBERT KURTZ | MARCH 2021
Add the ASC supply chain to the list of the pieces of the US healthcare system that will be dealing with the effects of the COVID-19 pandemic for years to come.
While optimistic about the future of cardiology in ASCs, Janet Dees cautions about rushing to bring in too many cases within a specialty that is in its infancy in the ASC setting.
Innovative technology drew Traci Kubaiko to the cardiology specialty more than 20 years ago when she started working in a hospital heart catheterization lab.
BY ROBERT KURTZ | FEBRUARY 2021
Reinforcing that your ASC is on par with like facilities. Identifying trends in need of improvement. Validating your commitment to the provision of high-quality care.
For the second consecutive year, ASCA's annual conference will be a virtual event. While the COVID- 19 pandemic will keep everyone physically apart again, ASCA is taking what it learned from hosting the ASCA 2020 Virtual Conference & Expo online to deliver an improved experience for attendees.
BY SAHELY MUKERJI | FEBRUARY 2021
Like the rest of the world, the COVID-19 pandemic has impacted Honduras and the Dominican Republic (DR), the two countries where One World Surgery (OWS) sends its medical mission teams.
Overlooking critical benchmarks can cause service quality to falter, physicians to become disgruntled and patients to be unhappy, says Nan Finch, CASC, president of Diverse Health Consulting in Austin, Texas.
The COVID-19 pandemic wreaked havoc around the world in 2020 and threw all forecasts and projections out the window. As the country continues to respond, ASCs can keep rolling with the changes, delivering high-quality, lower-cost services to their community, and sharing their story with their patients.
BY ROBERT KURTZ | JANUARY 2021
In 2018, staff at Wichita Falls Endoscopy Center in Wichita Falls, Texas, completed the Agency for Healthcare Research and Quality’s (AHRQ) Ambulatory Surgery Center Survey on Patient Safety Culture. This served as the foundation for the ASC's development of a culture of safety, says Jeremy Watkins, RN, clinical manager.
There is no hesitation in Cynthia Armistead's voice when speaking about the challenges of confronting the COVID-19 pandemic. “I have worked in healthcare for about 40 years," she says. “I have never navigated something as unusual and stressful.”
Stuart Simon, MD, is the medical director for United Surgical Partners International (USPI) in Dallas, Texas, which owns and operates more than 400 ambulatory facilities. He is a practicing anesthesiologist and chairman of the department of anesthesiology at North Central Surgical Center in Dallas, Texas, and serves on ASCA's Board of Directors.
BY ROBERT KURTZ | NOVEMBER-DECEMBER 2020
For an ASC to be successful, its marketing must be successful, says Melissa Hermanson, RN, CASC, administrator of Ambulatory Care Center in Vineland, New Jersey.
The COVID-19 pandemic further put into focus that preventing infections depends upon everyone working in an ASC, says Debra Yoder, RN, director of clinical operations and corporate compliance officer for Surgical Management Professionals in Sioux Falls, South Dakota.
Rockford Ambulatory Surgery Center in Rockford, Illinois, assumes every patient who walks in the door to be potentially infectious. That mentality, says Gina Hartman, RN, CASC, the ASC’s director of perioperative services, helps keep staff focused on effectively cleaning any surface that might come into contact with patients.
BY ROBERT KURTZ | OCTOBER 2020
Most of John Blanck’s work as senior vice president of operations for Surgery Partners in Kansas City, Missouri, focuses on ophthalmology, which he says is primed for steady growth.
Limiting close face-to-face contact with individuals not in your household is considered by the Centers for Disease Control and Prevention to be the most effective way of reducing the spread of COVID-19.
Surgical Eye Center in Greensboro, North Carolina, resumed surgery in early May following several weeks of suspended operations due to the COVID-19 pandemic. In the weeks that followed, Clinical Director Carrie Nitz, RN, was not surprised to see patient cancellations increase.
BY ROBERT KURTZ | SEPTEMBER 2020
A pandemic was not something Raghu Reddy ever expected to confront as executive administrator of SurgCenter of Western Maryland in Cumberland, Maryland. Navigating COVID-19, however, has been easier thanks to support from UPMC Western Maryland, the hospital that jointly owns the ASC with local physicians, he says.
COVID-19 has not changed the importance of proper disinfection, handling and storage of endoscopes to ensure patient and staff safety. What the virus has done, says Shelley Allison, RN, director of nursing at EndoCenter in Covington, Louisiana, is further underscore it.
BY SAHELY MUKERJI | SEPTEMBER 2020
Complications surrounding drug shortages stemming from the COVID-19 pandemic continue to emerge.
INTERVIEWED BY ROBERT KURTZ | SEPTEMBER 2020
Nader Samii, the chief executive officer of National Medical Billing Services in St. Louis, Missouri, has guided the company into its position as one of the largest and most reputable revenue cycle management companies in the ASC market.
BY ROBERT KURTZ | AUGUST 2020
Many factors contribute to the Buffalo Ambulatory Surgery Center’s success, but few might be more important than ensuring operational efficiency, says Christina Norman, RN, administrator of the center in Cheektowaga, New York.
BY SAHELY MUKERJI | AUGUST 2020
As the country comes out of the COVID-19 lockdown, elective surgeries have resumed in most states.
The data is in and it shows Americans struggling to understand their health coverage.
Thanks to technological advances, ASCs can now choose from multiple ways to communicate with patients.
BY ROBERT KURTZ | JUNE-JULY 2020
When Clay Landry, director of central sterile for Saratoga Surgery Center in Saratoga Springs, New York, began working in sterile processing in the late 1970s, standards for reprocessing equipment were few and far between. “What we did back then was basically the best we could without guidance or technology.”
BY SAHELY MUKERJI | JUNE-JULY 2020
In light of the COVID-19 pandemic and the consequent demand for certain medications, the US Food & Drug Administration (FDA) updated its list of extended-use drugs on April 3. The updated list now includes 569 drugs that may be used beyond the manufacturer’s labeled expiration date.
As COVID-19 continues to ravage the US, healthcare workers across the country face shortages of personal protective equipment (PPE) and medical gear needed to treat patients. At press time, many surgery centers have shut down temporarily in compliance with their governors’ stay-at-home orders.
An operating room (OR) produces a lot of waste. But waste can create opportunity.
By embracing clinical innovation, ASCs can continue to be the preferred site for outpatient surgery among patients and physicians. “We should not sit back and only perform those procedures already coming our way,” says Alfonso del Granado, CASC, administrator of Covenant High Plains Surgery Center in Lubbock, Texas.
BY ROBERT KURTZ | MAY 2020
Gwen Donithan, RN, Laurri Wallace and Teresa Burwell, RN, have one thing in common: Each helped open a new surgery center.
Unity Surgical Center in Lafayette, Indiana, opened in 2001, with its spine surgery program already in place. That program continues to thrive, says spine surgeon Mario Brkaric, MD, who joined the ASC in 2006. The key to its success, he adds, is its team.
Submitting clean claims to payers in a timely manner does not ensure getting paid appropriately. The complicated nature of insurance leaves a lot of potential for errors.
BY ROBERT KURTZ | APRIL 2020
In 2018, two high-volume orthopedic surgeons left CenterOne Surgery Center in Jacksonville, Florida, to pursue a new endeavor. While the loss was not crippling, says Executive Director Robert Haen, their unexpected departure left a challenging void.
When considering the importance of building and maintaining a strong staff, a quote attributed to Douglas Conant comes to mind, says Meg Wiebel, RN, CASC, administrative director of Crow Valley Surgery Center in Bettendorf, Iowa. “He said, ‘To win in the marketplace, we must win in the workplace,’” Wiebel says.
When ASC staff are productive, the positive effects can be wide-reaching: more efficient care that results in patients spending less time in the ASC; more satisfied physicians who appreciate efforts to help them provide high-quality care at a low cost; and more engaged staff as a result of seeing how their work directly affects the ASC’s performance.
BY ROBERT KURTZ | MARCH 2020
Experience the magic of being surrounded by thousands of your colleagues, just miles from Disney World at the largest ASC conference of the year. Register now for the ASCA 2020 Conference & Expo, May 13–16, at the Orlando World Center Marriott in Orlando, Florida. This year’s conference will run concurrently with SAMBA 2020, the annual meeting of the Society for Ambulatory Anesthesia.
In an optimal situation, any opening in an ASC’s surgical schedule would be filled by an investor physician. Often, that scenario is just wishful thinking, says John Piccione, CASC, a regional director for Surgery Partners based in Lake Worth, Florida.
To be a good provider, says Cori Prisco, RN, you must be able to confidently act on your instinct and experience. This can be difficult for staff members following an adverse event.
BY ROBERT KURTZ | FEBRUARY 2020
Completing a quality assessment and performance improvement (QAPI) project can take considerable time and effort. As long as your ASC is making that kind of investment, some who have managed QAPI studies in the past advise, make sure that your project goes beyond just meeting the requirements and provides real benefits to your facility.
Irina Morrow knows that a lot is riding on her ability to consistently code her ASC’s procedures correctly.
For payers on the fence about whether to provide your ASC with a new or improved managed care contract, sharing quality data could be what you need to swing the tide in your favor.
Industry professionals weigh in on the key trends.
BY ROBERT KURTZ | JANUARY 2020
Still a relatively new specialty for ASCs, cardiology is quickly cementing itself as one of the most promising.
Fiona Stephan, RN, considers her ASC—Vanguard Surgical Center in Maywood, New Jersey—fortunate. It has never experienced a malignant hyperthermia (MH) event.
While your ASC will likely never be mistaken for Disney World, strive to provide the same level of attention and service that helps attract millions of people to the resort every year, advises Susan Burkett, RN, senior director of clinical services with Amsurg in Nashville, Tennessee.
BY ROBERT KURTZ | NOVEMBER-DECEMBER 2019
If your ASC’s primary motivation for developing an emergency preparedness plan is compliance with regulatory requirements, that is acceptable, says Mary Ann Gellenbeck, senior vice president of implementation services for Physicians Endoscopy in Jamison, Pennsylvania.
INTERVIEWED BY ROBERT KURTZ | NOVEMBER-DECEMBER 2019
Brad Lerner, MD, CASC, is the medical director of Summit ASC, the surgery center division of Chesapeake Urology Associates in Baltimore, Maryland. Summit ASC comprises 16 single-specialty urology ASCs located throughout Maryland.
You cannot control when your ASC might encounter a natural or man-made hazard. You can, however, control your readiness to tackle those hazards.
BY ROBERT KURTZ | OCTOBER 2019
Stephanie Rodriguez, RN, has been punched, kicked and bitten. All these incidents occurred while she was working in the medical intensive care unit and emergency department at a hospital.
BY SAHELY MUKERJI | OCTOBER 2019
Patient interest in medical tourism, a small but growing trend in the ASC setting, shows an uptick. “Patients [are] willing to travel short distances to receive care from a provider that has a contract for a bundled transparent rate for surgery,” says Christopher D. Stine, bundled payments & corporate compliance officer at Regent Surgical Health in Westchester, Illinois.
Tri-State Centers for Sight Surgery Center in Cincinnati, Ohio, relies on a transportation service to bring many of its patients to and from the ASC. About 20 percent use the service, says Deborah Bray, RN, the ASC’s director.
The ASC industry is a hotbed of transaction activity. That activity is helping to drive up the value of facilities and likely spurring the development of new centers.
In 2012, Colorado and Washington became the first states to legalize marijuana for recreational purposes. Since then, the number of states where the drug has been legalized for medical and/or recreational purposes has increased.
BY SAHELY MUKERJI | SEPTEMBER 2019
When Key Whitman Surgery Center in Dallas, Texas, had the option of either renovating or building new, it decided to opt for the latter and insisted on an experienced healthcare architect who specialized in ophthalmology.
BY ROBERT KURTZ | SEPTEMBER 2019
While most components of an ASC’s heating, ventilation and air-conditioning (HVAC) system are typically out of sight, they should never be out of mind. A properly functioning HVAC system is vital to keeping patients safe, says Donald Smith, vice president of Agnew Associates in Austin, Texas.
Months. That is how long the likes of Clostridium difficile, Methicillin-resistant Staphylococcus aureus, Vancomycin-resistant Enterococcus and many other harmful pathogens can survive on surfaces within an ASC. How can an ASC keep its patients safe?
Scrubs. Gloves. Scalpels. Drapes. A rowboat. Which of these is not like the others?
INTERVIEWED BY ROBERT KURTZ | SEPTEMBER 2019
Michael Gordon is founder and president of Gordon & Associates in Mount Dora, Florida.
BY ROBERT KURTZ | AUGUST 2019
Ophthalmology procedures continue to migrate out of hospitals and into ASCs, thanks to new clinical developments.
The good news: Workers’ compensation collections can be easy. The bad news: There are several obstacles that can make a simple experience difficult.
BY ROBERT KURTZ | JUNE-JULY 2019
In early January, Sovereign Healthcare’s North Valley Surgery Center received its robot. Less than a week later, the Scottsdale, Arizona, ASC performed its first cases using the orthopedic surgical system. Andrea Lessner, RN, North Valley’s outpatient total joint coordinator, expects the technology to help the ASC achieve its objective of doubling the number of joint replacement procedures performed this year compared to 2018.
Thinking about starting a robotics program in your ASC? The time is now, says Jess Lonner, MD, orthopedic surgeon and member of Rothman Orthopaedic Institute in Philadelphia, Pennsylvania. Lonner has used robotics technology to perform surgery in multiple outpatient settings, including an ASC.
Walk around Copper Ridge Surgery Center in Traverse City, Michigan, and you will soon spot the “infinity loop.” Looking like an angled 8 with multi-colored dots on and around it, the infinity loop identifies every manner—direct or indirect—in which the ASC and its team members interact with patients.
BY ROBERT KURTZ | MAY 2019
Total hip. Total knee. Partial knee. Total shoulder. Lumbar fusion. Lumbar laminectomy. Cervical disc replacement. Anterior cervical discectomy and fusion. Extreme lateral interbody fusion.
Total joint replacement in an ASC was once a far-fetched idea, but now surgeons are performing these procedures safely in surgery centers every day.
In an industry that undergoes frequent changes, Dianne (Wallace) Appleby, RN, found comfort in a constant: her ASC’s coder.
BY DANIELLE KASTER | APRIL 2019
The ASC community had one of its most successful legislative and regulatory years in 2018.
BY ROBERT KURTZ | APRIL 2019
Sara Ebert knows that nothing good can come from inefficiencies creeping into her ASC’s billing workflows.
BY JEFF EVANS | APRIL 2019
As the final year of this decade, 2019 brings with it a new Congress and plenty of fresh, and many familiar, faces on Capitol Hill. As a result of last November’s election, the US House of Representatives is now under a Democratic majority and the US Senate is operating with a larger Republican majority than in 2018.
Improving your ASC’s bottom line does not necessarily require adding new procedures, physicians or specialties. Taking a closer look at some of the services and products your ASC is already paying for might be all you need to do.
ASCA would like to recognize and thank all the individuals who have participated in ASCA’s advocacy opportunities, including attending National Advocacy Day, hosting a facility tour and writing a letter to Congress.
BY ROBERT KURTZ | MARCH 2019
Polish your rhinestones, put on your Stetson and join thousands of your colleagues in Nashville, Tennessee, for the largest ASC meeting of the year, the ASCA 2019 Conference & Expo, May 15–18.
Given the market trajectory, it might be time for GI ASCs to explore additional revenue sources.
A few years ago, colonoscopes with three camera lenses entered the market. Until then, gastroenterologists who performed colonoscopies had relied for decades on a single-lens platform that provided a 180-degree field of view.
BY ROBERT KURTZ | FEBRUARY 2019
Pain management is ripe for significant growth in ASCs, says Ronnie Pennell, executive vice president and chief operating officer for PhyBus in Brentwood, Tennessee. To support this belief, he points to the history of gastroenterology (GI).
ASCs that adopt new technology can expect some resistance to change, says Steve Campbell, chief operating officer of Oppor Infrastructure in Overland Park, Kansas.
In 2013, Christus Good Shepherd Surgery Center in Longview, Texas, was the site of a fatal stabbing that claimed the life of a nurse and visitor. In response, the ASC implemented numerous security measures, several of which relied upon a new technology: radiofrequency identification (RFID).
Experts within the ASC community share their opinion on what is coming down the pipeline this year.
BY ROBERT KURTZ | JANUARY 2019
For an ASC to thrive, its staff must possess essential “hard” skills or the knowledge and technical expertise necessary to fulfill specific job responsibilities. For staff to get their jobs done and done well, however, says Lori Post, director of human resources for Medical Consulting Group, in Springfield, Missouri, “soft” skills are equally important.
When Sabrina Westbrook, administrator for Premier Surgical Center in Madison, Mississippi, was helping her ASC prepare to open in June 2018, she had a lot of work on her plate. Still, she made sure developing the surgery center’s employee handbook received the attention it needed. The importance of an employee handbook should not be underestimated,” she says.
BY SAHELY MUKERJI | NOVEMBER-DECEMBER 2018
ASCA’s 2019 Winter Seminar will take place January 17–19 in Austin, Texas. This is a smaller, more focused and intimate seminar than ASCA’s annual conference and offers Administrator Education Units (AEU), Certified Ambulatory Infection Preventionist (CAIP) and Certified Administrator Surgery Center (CASC) credits.
BY ROBERT KURTZ | NOVEMBER-DECEMBER 2018
In August 2017, Mississippi Valley Surgery Center in Davenport, Iowa, began work on a multi-million-dollar addition and renovation. One year later, the project is going “relatively smoothly,” says Michael Patterson, RN, ASCA Board member and the ASC’s president and chief executive officer.
A significant focus on ASC expense management is directed toward labor costs, and rightfully so, considering they are a large piece of a surgery center’s overall spend, says Stephanie Martin, CASC, vice president of operations, clinical, for Westchester, Illinois-based ASC management and development company Regent Surgical Health.
Thinking about renovating your ASC? Do not be too quick to break down a wall; you may be wiser to break ground.
BY ROBERT KURTZ | OCTOBER 2018
In her nine years as an ASC administrator, Angie Jimenez has come to appreciate the importance of complying with the Life Safety Code (LSC).
BY SAHELY MUKERJI | OCTOBER 2018
Brenda Page, RN, director of Carolina Center for Specialty Surgery in Charlotte, North Carolina, discusses regulatory compliance and how her ASC consistently stays ahead of the curve. Carolina Center for Specialty Surgery performs minimally invasive spine procedures.
Even the most well-designed machines eventually fail. That includes the computers, servers and any other information technology (IT) in your ASC. Do you have a plan in place to respond when this day comes?
For ASCs struggling to manage their information technology (IT) while maintaining cyber security and compliance, partnering with a managed services provider (MSP) might provide needed relief.
BY ROBERT KURTZ | SEPTEMBER 2018
A 2013 study of Medicare data by research scientists at the University of California-Berkeley found that in just four years, between 2008 and 2011, ASCs saved the Medicare program and its beneficiaries $7.5 billion. In 2011 alone, they report, the savings to Medicare and its beneficiaries totaled $2.3 billion.
It is a good time to be a seller of an ASC, says Glenn Prives, an attorney at the law firm of McElroy, Deutsch, Mulvaney and Carpenter in Morristown, New Jersey. “Numerous parties are interested in acquiring well-run ASCs these days. Hospitals are shopping, private equity firms are hungry for deals and management companies are looking to expand their portfolios.”
When HealthCrest Surgical Partners, an Edmond, Oklahoma-based ASC management company, set out in 2017 to build comprehensive total joint replacement programs at its two Maryland ASCs the team decided it also wanted to develop a supporting opiate-sparing pain management program that delivered excellent pain relief. HealthCrest manages Frederick Surgical Center in Frederick, Maryland, and Cumberland Valley Surgery Center in Hagerstown, Maryland.
While the generation an individual is born into cannot paint the entire picture of a person’s attributes and attitudes, it can provide insight for ASC leaders, says Margaret Chappell, RN, CASC, senior vice president of operations for ASC management and development company Ambulatory Surgical Centers of America, based in Hanover, Massachusetts.
Do not think of complying with emergency preparedness requirements as a regulatory burden, says Kris Kilgore, RN, administrative director at Surgical Care Center of Michigan in Grand Rapids, Michigan. Rather, think of it as an opportunity.
If you want your ASC to provide a better experience for its patients and physicians, focus on ways to get the most out of your staff, says Anne Hargrave-Thomas, chief executive officer of OakLeaf Surgical Hospital in Altoona, Wisconsin, and vice president of operations for Surgery Partners, a nationwide operator of surgical facilities based in Nashville, Tennessee.
One World Surgery in Chicago, Illinois, a nonprofit, partners with communities, health care providers and leaders in health care to deliver surgical services globally. ASCA has joined hands with the organization to help fulfill its mission. Below is an excerpt from an interview with Claire Cunningham, executive director of the organization.
Paralyzed patients rarely come into Reading Hospital SurgiCenter at Spring Ridge in Reading, Pennsylvania, says Brandi Reisch, RN, a perioperative nurse at the ASC. That, however, does not mean the ASC is any less prepared to meet their needs.
Northwest ENT Surgery Center in Woodstock, Georgia, started observing a trend around 2011–2012, says Shatul Parikh, MD, otolaryngologist and medical director of the ASC.
“There was a change in the tide of the insurance market,” he says. “The Affordable Care Act marketplace and employers started offering higher deductible plans. When patients had a $250 or $500 deductible, surgery was affordable, regardless of the type of procedure. Then deductibles started to rise sharply.”
Different people take the Certified Administrator Surgery Center (CASC) examination for different reasons. ASC employers, however, say that to them the credential stands for one thing: validation that the credential- holder has mastered the skills that an ASC administrator needs.
Go looking for Occupational Safety and Health Administration (OSHA) regulations concerning eyewash stations and you might be surprised by what you find—or more likely what you will not find, says Cathy Montgomery, RN, CASC, president and managing partner of ASC and physician practice consulting firm Excellentia Advisory Group in St. Peters, Missouri.
Depending on specialty, geography, payer mix and technology, the critical components of an ASC revenue cycle can change, says Lindsay Miller, executive vice president of operations at National Medical Billing Services in St. Louis, Missouri. “The ASC revenue cycle is nuanced because of its complexity in all of these areas. Each ASC faces its own set of challenges,” she says.
The future of ophthalmology in ASCs looks bright, says George Violin, MD, board-certified ophthalmologist and one of the founding principals of ASC management and development company Ambulatory Surgical Centers of America, based in Hanover, Massachusetts.
Whether your ASC is in- or out-of-network with a payer, payment denials, payment delays and underpayments are inevitable, says Brian Hufford, health care attorney with the law firm of Zuckerman Spaeder in New York, New York.
Infection preventionists in ASCs have their own certification program with the official launch of the Certified Ambulatory Infection Preventionist (CAIP) credential in January. This credential represents the culmination of extensive planning over several years, says Gina Throneberry, RN, CASC, executive director of the Board of Ambulatory Surgery Certification (BASC), which administers the CAIP exam.
Where can you find thousands of your peers, ASC industry leaders, cutting-edge technology, the Green Monster, chowder and duck tours all in one place? Boston, Massachusetts, of course, between April 11 and 14, when ASCA 2018 convenes at the Hynes Convention Center. Need some more reasons why you need to be at this meeting? Read on.
Over the last several years, patients have been bearing the brunt of the first dollars coming off the top for their care, says Stanford Plavin, MD, ASCA Board member, an anesthesiologist and owner of consulting firm Technical Anesthesia Strategies and Solutions in Atlanta, Georgia. “As insurance plans have transitioned from low co-pays and low deductibles with good out-of-network benefits to higher co-pays and higher deductibles with little to no out-of-network benefits, patients are receiving what they perceive as inordinate bills. They might not have been previously privy to these bills, but they have essentially been around all along. That is where the ‘surprise’ comes in.”
In 2014, the Andrews Institute Ambulatory Surgery Center in Gulf Breeze, Florida, conducted its first annual safety culture survey. It asked the employees to rank the ASC’s performance in areas including safety priority within the facility, safety as part of the ASC’s ongoing agenda, accountability, issues corrected, teamwork and training.
An electronic medical record (EMR) system can be a valuable tool in helping ASCs improve their billing performance, says Nanette Reintges, founder and principal consultant at Finance and Information Technology Performance Strategies, a consulting firm in Odenton, Maryland. It is vital, however, that use of the EMR does not streamline documentation to the point where potential problems can occur, she cautions.
Last year was an important year for the ASC community, as ASCA and its members achieved several beneficial policy changes through steadfast federal and state advocacy efforts. ASCA is optimistic about 2018 and, with its members, continues to work with Congress, regulatory agencies and state legislatures across the country to ensure ASCs are represented as policy decisions are made.
ASCA created its Advocacy Fund as a way to solicit support from the ASC community and help communicate its legislative and regulatory agenda to federal and state policymakers. In particular, the fund was created to garner support from the many companies that sell products and services to ASCs and, therefore, benefit from a thriving ASC model.
As more complex procedures move to the outpatient setting, ASCs should be looking at where patients can receive the best post-acute recovery care, recommends Rebecca Craig, RN, CASC, ASCA Board president and chief executive officer of Harmony Surgery Center and Peak Surgical Management in Fort Collins, Colorado.
More than 5,600 Medicare-certified ASCs provide care to patients across the US. Despite the expanded access to top-quality care that ASCs offer and the billions of dollars ASCs save patients, Medicare and private insurers each year, many elected officials do not fully understand the role ASCs play in health care.
Arthritis and spine- and backrelated conditions in adults aged 18 and older will grow from 54 million in 2014 to 63 million by 2020 and 78 million by 2040, according to the Centers for Disease Control and Prevention (CDC).
To say some ASCs do not enjoy the benchmarking process may be an understatement, says Carol Hiatt, RN, CASC, owner of Surgery Center Consulting Services in Ocala, Florida.
Health care consumers are at a disadvantage when it comes to researching their surgical options, says Thomas Wilson, chief executive officer of Monterey Peninsula Surgery Center in Monterey, California.
ASC staff typically have limited time to spend with patients. This makes it imperative for staff to take advantage of every moment available to provide critical education to patients, says Missy Soliz, RN, quality and risk manager for Mississippi Valley Surgery Center and Mississippi Valley Endoscopy Center in Davenport, Iowa. “We must also do so without overwhelming them or talking over their heads,” she says.
Developments over the past few years have made this a particularly exciting time for outpatient foot surgery, says Scott VanValkenburg, MD, foot and ankle surgeon at Upstate Orthopedics Ambulatory Surgery Center in East Syracuse, New York.
Three experts share their view on the future of the ASC industry and what surgery centers can ep[axpect to see this year. While ASCs are poised to grow and evolve, especially, with more higher acuity cases moving into the ASC setting, cyber security remains a threat.
Although rare, surgical fires continue to occur in health care facilities. Their prevention must be an ongoing area of focus for ASCs, says Mark Bruley, vice president of accident and forensic investigation for ECRI Institute, a Plymouth Meeting, Pennsylvania-based organization that researches approaches to improving patient care.
While ASCs have no role in the US Food & Drug Administration’s (FDA) pre-market notification 510(k) medical device clearance process, it is imperative that they understand what the clearance does and does not include and cover, says Barbara Ann Harmer, president at MedAssist Consultants, a provider of medical and surgical consulting services based in Gainesville, Florida.
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Price is not the only factor to take into consideration when purchasing a new piece of equipment, but it is an important one, says Sherrie Landry, materials manager for Bayou Region Surgical Center in Thibodaux, Louisiana. “You really want to make sure you make the right purchase the first time.”
If you want to keep your surgeons happy, give them the surgical technology they want, says Brian Brown, regional vice president of operations for AmSurg Corporation, an ASC management and development company based in Nashville, Tennessee.
The opioid crisis presents both a challenge and an opportunity for ASCs, says Amy Mowles, president and chief executive officer of Edgewater, Maryland-based Mowles Medical Practice Management, an ASC regulatory and development company.
Looking to grow your case volume while accommodating the needs and wishes of patients from within— and even potentially outside—your community? Consider offering a cashpay program, say ASC managers who are already offering this option.
The clinical staff at Lakeview Surgery Center in West Des Moines, Iowa, believed their patients always received their prophylactic intravenous (IV) antibiotics “on time,” recalls Kate Foreman, the ASC’s quality coordinator.
“On time,” according to the definition used in Medicare’s ASC Quality Reporting (ASCQR) Program’s ASC-5: Prophylactic Intravenous (IV) Antibiotic Timing measure meant these antibiotics were initiated within one hour prior to the time of the initial surgical incision or the beginning of the procedure, or two hours prior if Vancomycin or fluoroquinolones were administered.
The Accreditation Association for Ambulatory Health Care of Skokie, Illinois, the American Association for Accreditation of Ambulatory Surgery Facilities of Gurnee, Illinois, and The Joint Commission of Oakbrook Terrace, Illinois, described the upcoming changes in their standards for ASC Focus. Learn what to expect from your survey experience, the steps you need to take to stay on top of your game and how to comply with the changed standards.
BY SAHELY MUKERJI | SEPTEMBER 2017
If an ASC needs to participate in the continuity of care across a surgical episode, it needs to have an IT system that speaks to a physician partner’s electronic health records (EHR), says Roy Georgia, partner in the ASC Division of ICE Technologies, headquartered in Pella, Iowa. “Herein comes the need for interoperability,” he says. “With a lot of consolidation in the ASC software space, there is going to be more standardization and increased adoption of EHR products. With that, there will be a more specific need for interoperability.”
BY ROBERT KURTZ | SEPTEMBER 2017
Electronic medical records (EMR). Patient portals. Electronic scheduling. Patient tracking. Analytics.
ASCs, today, have their choice of many different types of information technology (IT) systems and many different suppliers. The IT systems have tremendous potential to help ASCs achieve their growth objectives, says Paul Davis, chief executive officer and president of Amblitel, a provider of ASC accounting and back-office services based in Louisville, Colorado.
The primary focus for everything that happens at the Orthopedic Surgery Center of Orange County in Newport Beach, California, is patient safety, says Karen Ollila, the ASC’s operations manager. Peer review, she says, is a critically important part of that focus.
An ASC that wants to capitalize on its investment in information technology (IT) has to invest in training staff to operate the new system, says Matt Petty, senior vice president of IT for Surgery Partners, a nationwide operator of surgical facilities based in Nashville, Tennessee.
BY SAHELY MUKERJI | AUGUST 2017
The term “scope of practice” has different definitions in policy and professional documents, which is why it is critical to know how your state’s regulations define the term, says Debra Stinchcomb, RN, CASC, consultant with Progressive Surgical Solutions in Fayetteville, Arkansas.
Staffing optimally to achieve the greatest productivity while keeping your staff happy can be challenging. Administrators at three different ASCs share their secrets to success.
BY ROBERT KURTZ | AUGUST 2017
Between November 2014, when Jennifer Morris became the administrator of Surgicare of Wichita in Wichita, Kansas, and May 2017, the ASC added 26 physicians across seven specialties. She says that part of the reason for that is because she is always working on physician recruitment since it is vital to sustaining an ASC.
When Sarah Malaniak, CASC, was brought on as administrator for the Ambulatory Center for Endoscopy in North Bergen, New Jersey, one of her first assignments was to tackle the ASC’s overtime problem.
Gaining staff support is essential for a change to achieve its desired outcome, says Don Bartnick, chief executive officer of Annapolis Surgery Center in Annapolis, Maryland, and Maryland Eye Surgery Center in Prince Frederick, Maryland.
BY SAHELY MUKERJI | JUNE-JULY 2017
When The Joint Commission looked at the 10 most challenging accreditation guidelines for ASCs in 2016, it found that three of the 10 were related to medication management.
BY ROBERT KURTZ | JUNE-JULY 2017
Compounding pharmacies can play an important role in supplying ASCs with medications they need to provide patient care, says Sharon Johnson, RN, CASC, senior vice president of operations for ASC management and development company Ambulatory Surgical Centers of America, based in Hanover, Massachusetts.
Montgomery Surgical Center in Montgomery, Alabama, considers patient engagement to be a vital component for a successful surgical experience, says Linda Westhoff, RN, CASC, the ASC’s administrator.
Last year was a difficult year for the gastroenterology service line at the Surgery Center of Farmington in Farmington, Missouri, says Cindy Young, RN, CASC, the ASC’s administrative director. After starting the year with five gastroenterology physicians, only one remained at the end.
BY SAHELY MUKERJI | MAY 2017
More than 3 billion people use the Internet and more than 2 billion of those users have active social media accounts, according to an August 2016 Hootsuite column. Given the widespread use, social media is no longer optional for businesses, says Kelly David, director of marketing and public relations at Spectrum Medical Group in Portland, Maine. “The more we become patient and customer focused, the more important a tool social media becomes to connect.”
BY ROBERT KURTZ | MAY 2017
At a time when Washington, DC, is under the world’s microscope, it seems fitting that ASCA is bringing the ASC community into the heart of the action at ASCA 2017, May 3–6, at the Gaylord National Resort & Convention Center in National Harbor, Maryland.
“Attending an ASCA meeting continues to be an unparalleled opportunity for all attendees, regardless if it is your initial meeting or your 25th,” says Jo Vinson, CASC, director of integration management for Deerfield, Illinois- based Surgical Care Affiliates.
Even in an ASC with great information technology infrastructure, human error can open the door for cyber criminals, says Tracy Rubino, privacy officer of ambulatory surgery centers for not-for-profit health system Sutter Health in Sacramento, California. In fact, Verizon’s 2016 Data Breach Investigations Report cites human error as one of the leading causes of health care cyber security incidents.
ASCs need to prepare for the possibility of a data breach and be ready to respond if it happens, says Michael Wells, chairman of Hylant of Indianapolis, an insurance brokerage and risk management solutions provider in Indianapolis, Indiana.
BY SAHELY MUKERJI | APRIL 2017
Coding modifiers—usually two digits—can increase or decrease reimbursement and cause claims not to be paid properly or denied if used incorrectly or not used when necessary. “Modifiers are added to the main procedure code to signify that the procedure has been altered by a distinct factor,” says Stephanie Ellis, RN, president of Ellis Medical Consulting Inc. in Franklin, Tennessee. “Modifiers are accepted by most payers.”
BY ROBERT KURTZ | APRIL 2017
For an ASC striving to bring about improvements throughout the facility, applying Lean Six Sigma principles can be an effective method to achieve desired results, says Erin Huston, RN, the Lean Six Sigma Black Belt continuous improvement specialist for The Urology Group and its ASC, The Urology Center, in Cincinnati, Ohio.
Regardless of the changes that will be made to the US health care system in the coming years, at least one thing seems to be certain, says Gregory Horner, MD: Value-based care is here to stay. Horner, an ASCA Board member, works as a managing partner at HealthPoint Ambulatory Surgery Company, an ASC management and development company in Newbury Park, California.
Andy Whitener is the chief executive officer and administrator of Gainesville Surgery Center in Gainesville, Georgia, an affiliate of Surgical Care Affiliates. Write him at Andy.Whitener@SCASurgery.com.
BY ROBERT KURTZ | MARCH 2017
What you do not know about your ASC’s water could harm patients and damage devices, says Barbara Ann Harmer, RN, director of clinical services for Innovative Sterilization Technologies in Dayton, Ohio, a company that developed and markets a sealed sterilization container system.
BY SAHELY MUKERJI | MARCH 2017
Knowledge is power when it comes to getting a good price on implants, says Tim Burney, founder and chief executive officer of Advantien in Greenwood Village, Colorado. “You need to know the market and your alternatives,” he says. “Do not accept that you cannot get the same price as the hospitals. You can, believe me, you can.”
Running an ASC in a low-income area is fraught with risks, delays in payment, demands from the Department of Health and the fire department, and other adverse factors, says Roy Bejarano, president of Frontier Healthcare in New York, New York. “It is a fragile and delicate situation,” he says. “ASCs, however, are the smarter health care option for low-income areas because they offer high-quality care at a lower cost than hospitals and are more specialized than hospitals.”
In a disaster, either natural or manmade, continuity of operations planning helps an ASC protect and preserve its critical infrastructure, says Lynne Bergero, project director for the division of health care quality evaluation at The Joint Commission in Oakbrook Terrace, Illinois.
Do you know what it costs when patients are in your ASC’s operating room (OR), asks Ann Geier, RN, CASC, chief nursing officer for SourceMed, a Birmingham, Alabama-based provider of software and ASC advisory services for ASCs and other organizations. Since the OR is where an ASC generates revenue, she says, understanding the costs incurred there is an essential management tool for an ASC.
BY DANIELLE KASTER | FEBRUARY 2017
As rising costs, inadequate payment updates and the steady growth of hospital-employed physicians continue to threaten ASCs, ASCA’s ongoing efforts to promote the interests of the ASC community before the legislative and regulatory bodies that set ASC policies grow increasingly important. The success of ASCA’s advocacy efforts, however, relies on the participation of everyone in the ASC community.
BY ROBERT KURTZ | FEBRUARY 2017
If you do not know how your ASC’s revenue cycle is performing, you will not know how to improve it says Crystal Ewing, manager of data integrity for ZirMed, a provider of claims management solutions based in Louisville, Kentucky.
BY KRISTIN MURPHY AND KARA NEWBURY | FEBRUARY 2017
In 2017, ASCA will be working on many levels with multiple regulatory agencies and Congress to ensure that ASCs are at the table and in the conversation when federal policy decisions that affect surgery centers are made.
BY SAHELY MUKERJI | FEBRUARY 2017
ASCA’s Government Affairs Department leads ASCA’s efforts to promote the interests of the ASC community before federal and state legislative, regulatory and executive agencies. Working with state ASC associations and industry leaders, the department staff identify and analyze critical health policy issues concerning ASCs and act to enhance and protect each ASC’s ability to continue providing high-quality patient care.
The culture that an ASC is aiming for doesn’t just develop naturally, says Jo Ellen Braden, RN, CASC, quality assurance performance improvement (QAPI) coordinator at Taylor Station Surgical Center in Columbus, Ohio. It requires hard work and commitment.
ASCAPAC is the only political action committee in Washington, DC, that represents the interests of the entire ASC community. Through the contributions it receives, ASCAPAC helps ensure that the policymakers who support and understand the importance of the ASC delivery model remain in Congress.
BY SAHELY MUKERJI | JANUARY 2017
Drug shortages continue to be a challenge for ASCs as they impact providers with little or no warning and potentially threaten patient safety, says Norman Tomaka, clinical consultant pharmacist in Melbourne, Florida.
BY ROBERT KURTZ | JANUARY 2017
It is a good time to own an ASC, says Mark Weiss, an attorney with The Mark F. Weiss Law Firm, which has offices in California and Texas.
“The health care landscape is changing quickly, and ASCs look to be positioned for success,” says Weiss, the author of The Impending Death of Hospitals: Why You Must Plan Your Medical Practice’s Survival and other health care books. “The evolving hospital model is creating a growing pool of potential opportunities for surgery centers.”
The Centers for Disease Control and Prevention (CDC) reports that more people died from drug overdoses in 2014 than any other year on record (www.cdc.gov/drugoverdose/ epidemic/index.html). A majority of drug overdose deaths—more than 60 percent—involve an opioid. And nearly 80 Americans die daily from an opioid overdose.
BY SAHELY MUKERJI | NOVEMBER-DECEMBER 2016
The number of anterior cervical discectomy and fusion (ACDF) surgeries, one of the most common spine procedures performed in the US today, continues to rise as a result of the growing elderly population in the country, says Anthony L. Asher, MD, ASCA Board member, director of the Neuroscience Institute at Carolinas HealthCare System and a senior partner at Carolina Neurosurgery and Spine Associates in Charlotte, North Carolina.
COMPILED BY SAHELY MUKERJI | NOVEMBER-DECEMBER 2016
The federal government has initiated broad adoption of bundled payment methodologies in inpatient settings including the Bundled Payment for Care Improvement (BPCI) initiative and, more recently, the Comprehensive Care for Joint Replacement (CJR) regulations. According to the Centers for Medicare & Medicaid Services (CMS) more than 500 hospitals now participate in these programs.
BY ROBERT KURTZ | NOVEMBER-DECEMBER 2016
Steven Sanchez, network administrator and facilities manager for Pend Oreille Surgery Center in Ponderay, Idaho, says ransomware is an issue of growing concern for his ASC. He points to the increasing number of organizations affected by this cybersecurity threat.
Rancho Bernardo Surgery Center makes medication preparation a constant area of focus, says Stephanie McIntosh, RN, administrator for the San Diego, California-based ASC. “Keeping it at the forefront of everyone’s mind is what keeps us vigilant with following regulations and proper practices.”
Social media usage has jumped nearly tenfold from 7 percent in 2005 when the Pew Research Center began tracking social media usage to 65 percent in 2015, according to an October 2015 Pew Research report. Consequently, there is increasing pressure on ASCs to develop an online presence, says Charlie Leonard, a public affairs adviser based in Santa Barbara, California.
BY SAHELY MUKERJI | OCTOBER 2016
For Chris Bland, director of safety and security at Good Shepherd Medical Center and Good Shepherd Ambulatory Surgery Center in Longview, Texas, the definition of a disaster is when the need outweighs the resources.
“When you have an emergency or a natural disaster, your resources are overwhelmed and you need more resources than you have,” he says. “So you need help from your local police department, fire department and all other emergency responders.” Given that, it is in an ASC’s best interest to establish good relations with local authorities before disaster strikes, he says.
BY ROBERT KURTZ | OCTOBER 2016
For most ASCs, it is not a matter of if, but when they will face a disaster, says Anne Haddix, the disaster preparedness coordinator for the Indiana Federation of Ambulatory Surgical Centers and chief executive officer of Southwest Surgical Suites in Fort Wayne, Indiana. ASCs must ensure they are effectively prepared to respond when a disaster strikes, she says.
Castle Surgicenter in Aurora, Illinois, benchmarks to ensure that it is providing the best quality, safest care possible, says Patricia Darimont, RN, the ASC’s clinical director. “If benchmarking reveals an opportunity for improvement, we work to make changes,” she says.
ASCA will add three new courses to its Regulatory Training Series this fall: Hand Hygiene, Latex Allergy, and Prevention of Healthcare Associated Influenza. This addition will bring the total number of interactive courses in the series to 24, with 18 offering continuing education (CE) credits to facility learners. Current subscribers will automatically receive the new courses once they are released.
Act fast, and take it seriously. That is the advice that retired Medicare surveyor and current regulatory and accreditation compliance consultant Bruce Ettinger, MD, of Santa Monica, California, has for ASCs that are required to submit a plan of correction (POC) to address deficiencies found during a Medicare survey. Ettinger is also an ASCA Board member.
BY ROBERT KURTZ | SEPTEMBER 2016
Whether building a new ASC or expanding an existing facility, developers would be wise to include nurses on their design team, says Stephanie Leventis, RN, vice president of development for SurgCenter Development, an ASC development company based in Pismo Beach, California.
BY SAHELY MUKERJI | SEPTEMBER 2016
Despite years of hard work to promote and attain hand hygiene compliance in the health care setting, the industry continues to struggle to achieve goals that are set by external agencies and within the facilities themselves, says Phenelle Segal, RN, president of Infection Control Consulting Services in Delray Beach, Florida.
Declining numbers of available operating room (OR) nurses have led some ASCs to develop their own perioperative RN training programs. Examples of those programs can be found in Florida Medical Clinic’s two ASCs in Tampa, Florida, and Zephyrhills, Florida, and in the Ambulatory Surgery Center of Niagara in Niagara Falls, New York.
William E. Lindeman is the president of WEL Designs PLC of Tucson, Arizona, a consulting firm for health care facility development and regulatory compliance. As a licensed architect working with health care providers since 1983, he has helped plan and design millions of square feet of ASCs, medical practice suites and other facilities.
BY SAHELY MUKERJI | AUGUST 2016
In April, insurance giant Aetna won $37.4 million in a jury verdict against Bay Area Surgical Management (BASM), based in Saratoga, California. The 2012 law suit against BASM alleged that the firm recruited physicians to refer their patients for out-of-network procedures at overblown prices and billed Aetna millions of dollars fraudulently.
BY ROBERT KURTZ | AUGUST 2016
ASCs looking to improve their accreditation survey performance would be wise to involve anesthesia personnel in the preparation efforts, advises Thomas Wherry, MD, cofounder of Total Anesthesia Solutions, a provider of anesthesia service solutions in Ellicott City, Maryland, and a former surveyor for the Accreditation Association for Ambulatory Health Care.
Collection from patients will become more challenging as the insurance plans change, says Melodie Garrobo, CASC, administrator for Golden Ridge Surgery Center in Golden, Colorado.
“The patient population became accustomed to coming into a facility, receiving care and worrying about payment later,” she says. “This used to be acceptable with most health care institutions but that was when insurance covered most of the payment. Consumers are moving to high-deductible insurance plans, which means less of the payment comes from insurance and more must come from patients. This is a new world, and ASCs must make patient collections a priority.”
In March, the US Department of Health & Human Services’ Office for Civil Rights (OCR) announced the launch of its next phase of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) audits of covered entities and their business associates. Click here for more information.
“This news should be a wake-up call for ASCs and all health care providers covered under HIPAA to take a close look at what they are doing and have in place concerning HIPAA compliance,” says Lani Dornfeld, head of law firm Brach Eichler’s Palm Beach, Florida, office and a member of the firm’s health law practice group.
BY AMBER GAUMNITZ | JUNE-JULY 2016
Around the world, two billion people lack access to surgical care and many more struggle to find and pay for it, according to an article in the June 2015 issue of The Lancet.
The poorest third of the world’s population receives less than 4 percent of all surgical services, according to a June 2011 World Health Organization report. The impact is devastating on impoverished nations. And every day, Partners In Health (PIH), a global health nonprofit, headquartered in Boston, Massachusetts, strives to fight this tragedy, bringing high-level surgical care where it is most needed—from Haiti to Rwanda and around the world.
BY SAHELY MUKERJI | JUNE-JULY 2016
The Joint Commission launched its Total Hip and Knee Replacement Advanced Certification Program and began to accept applications from interested facilities on December 17, 2015. On-site reviews started on March 14, says Wendi Roberts, executive director of certification at The Joint Commission. “We are getting applications every week and currently have approximately 15 applications, including one from an ASC [as of April 15, 2016],” she says.
While being a member of ASCA gives an ASC a broadened view of the industry, an understanding of national policies and guidelines and networking benefits on a global scale, being a member of a state association comes with its own set of benefits, says Andrew Weiss, president of the New Jersey Association of Ambulatory Surgery Centers (NJAASC) and administrator of The Endo Center at Voorhees in Voorhees Township, New Jersey.
BY ROBERT KURTZ | JUNE-JULY 2016
An ASC can have a positive impact on its community both inside and outside the facility, environmental experts say.
“It is important for health care providers like ASCs to practice what they preach in terms of embracing the connection between environmental and human health, to promote health and wellness for the people in their community by doing what they can to support a cleaner environment,” says Kaeleigh Sheehan, member engagement manager for Practice Greenhealth, a Reston, Virginia-based nonprofit member organization that provides environmental solutions for the health care sector.
As health care organizations continue to compete for physicians, staff and patients, ASCs need to make themselves the facility of choice or lose to other players in the field, says Kris Sabo, RN, executive director of Pend Oreille Surgery Center in Ponderay, Idaho. “We need to be providing better customer service to our physicians, staff and patients than our competition or we could easily lose them all,” she says.
BY SAHELY MUKERJI | MAY 2016
In a year filled with change and uncertainty in health care, ASCA is offering ASC professionals a one-stop shop where they can get everything they need to manage their facility more effectively and make critical decisions that will ensure their ASC’s future success. ASCA 2016, May 19–22, at the Gaylord Texan Resort & Convention Center in Dallas, Texas, is that destination.
BY ROBERT KURTZ | MAY 2016
Managing her ASC’s medication inventory is not just an occasional part of the job for Cheryl Ezerskis, CASC, executive director at West Parkway Ambulatory Surgery Center in Pompton Plains, New Jersey. “I spend more time managing our inventory than I care to admit,” she says. “I have to monitor medications every day. Getting the medications we need to do our procedures is a never-ending game I have to play.”
Drug diversion and poor management of controlled substances in a health care facility can lead to serious consequences. This illegal transfer and use of prescription medicines could result in patient harm and fines and loss of license for an ASC.
BY SAHELY MUKERJI | APRIL 2016
Experts agree that inpatient coding and ASC coding are completely different. Therefore, it would be a mistake to hire an inpatient coder and expect them to code ASC procedures accurately.
BY ROBERT KURTZ | APRIL 2016
Acapital purchase mistake can have a significant financial impact on an ASC, says Jennifer Butterfield, RN, CASC, administrator of Lakes Surgery Center in West Bloomfield, Michigan. “Unfortunately, we do not have very deep pockets. If you are going to be taking on the burden of a large purchase and, with it, a large monthly payment, you need to have the cases to justify and then support that payment.”
In mid-2014, Deerfield, Illinois-based surgical solutions provider Surgical Care Affiliates (SCA) set out to determine what could be done for every patient to consistently improve the patient experience. To achieve this objective, SCA formed a committee that looked at organizations and companies known for their customer service excellence, including the Cleveland Clinic, Disney and Starbucks.
ASCs have many reasons for replacing one piece of equipment with another. Some are under the ASC’s control, but others are not. Careful planning and the five tips that follow can help ensure that an ASC is buying wisely and help make the changes involved easier for everyone.
BY SAHELY MUKERJI | MARCH 2016
As the US health care system continues to look for ways to provide better patient care at a lower price, insurers are exploring innovative payment policies.
BY ROBERT KURTZ | MARCH 2016
While you might hope that you never need to terminate an employee, ASC leaders always need to be prepared to do so, says Damaris L. Medina, JD, a health care attorney with Michelman & Robinson, LLP, who is based in Los Angeles, California.
ASC management experts Kelli McMahan, vice president of operations for Pinnacle III, a Lakewood, Colorado-based ASC development and management company, and Jesseye Arambide, RN, executive director of Oregon Outpatient Surgery Center in Tigard, Oregon, and past president of the Oregon Ambulatory Surgery Center Association, offer advice on ways ASCs can make their quality improvement (QI) studies easier and more valuable.
BY KRISTIN MURPHY | FEBRUARY 2016
ASCA and ASCs across the country are on the precipice of a major legislative victory this year: the adoption of the Electronic Health Fairness Act. In 2015, the US House of Representatives and the US Senate unanimously passed slightly different versions of the act which, if enacted, will provide relief to ASC physicians who face penalties due to Medicare’s meaningful use requirements tied to electronic health records (EHR) systems. As this article goes to press, Congress is reconciling the two versions of the bill; the reconciled bill must be passed before it can be signed into law by President Barack Obama.
BY STEVEN SELDE | FEBRUARY 2016
Just as there is a legislative process that all bills must go through to become law [see page 10], there is a regulatory, or rulemaking, process that determines the rules that will be adopted to enforce new laws. Most laws contain language that helps to identify which federal agency will set those rules. Often, the laws also identify specific areas that the rules should address.
BY ROBERT KURTZ | FEBRUARY 2016
ASCs have many reasons to purchase an electronic medical records (EMR) system. One is that health care providers of every kind are rapidly adopting electronic records, says Cindy Klein, vice president and chief medical information officer of United Surgical Partners International, an owner, operator and developer of ASCs and short-stay surgical hospitals nationwide based in Addison, Texas.
BY DANIELLE KASTER | FEBRUARY 2016
For more than 40 years, ASCs have provided millions of Americans with high-quality, cost-efficient surgical care, yet many legislators are unaware of their work and how they have transformed the outpatient experience. While ASCA continues to advocate for ASCs and serve as the voice of the ASC community, there is no substitute for individual ASC leaders and staff who lobby their legislators as constituents.
BY ROBERT KURTZ | JANUARY 2016
Organizations often use bankruptcy as a financial tool to upright their financial stability, says Timothy Walsh, JD, international head of the restructuring and insolvency practice in the law firm of McDermott Will & Emery, who practices out of the firm’s New York office. “All bankruptcy means is your inability to pay your debts as they become due. That is the only requirement you need to be able to file.”
Under the federal budget adopted last November, hospitals and health systems are no longer able to buy ASCs, convert them to hospital outpatient departments (HOPD) and charge HOPD prices in those facilities. Even without that option, the trend toward consolidation in the US health care marketplace continues. Many are trying to determine how consolidation is affecting individual ASCs throughout the country, but the only definitive answer seems to be “It depends.”
BY SAHELY MUKERJI | JANUARY 2016
The Joint Commission is planning the launch of a new product called Total Hip and Knee Replacement Advanced Certification Program this year. The agency has been working with ASCA for the last couple of years to develop this program.
ASCs across the country invest more in employee benefits and pay modestly higher salaries to nearly all staff today than in 2012, according to an analysis of data from ASCA’s recently released 2015 ASC Salary and Benefits Survey report and ASCA’s 2012 survey. The analysis also shows that while more ASCs pay bonuses to more staff, the amounts of those bonuses are slightly under those paid in 2012, the last year ASCA conducted its compensation survey. The 2015 survey results, collected from 846 participants, include data on 20 ASC job positions, employee benefits and ASC demographics.