What ASCs need to know about FDA 510(k)
NOVEMBER-DECEMBER 2017
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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Plan ahead, take your time and do your research before making a purchase
NOVEMBER-DECEMBER 2017
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.”
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Invest in OR technology
NOVEMBER-DECEMBER 2017
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.
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Responsibilities of ASCs
OCTOBER 2017
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.
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Know your procedure costs, set fees that ensure a reasonable margin and keep your costs low
OCTOBER 2017
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.
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ASCs nationwide are using ASCA Benchmarking to improve their performance
OCTOBER 2017
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.
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Three accrediting agencies explain upcoming modifications in their standards
SEPTEMBER 2017
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.
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In the absence of CEHRT, ASCs adapt to reach clinical integration
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.”
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Look beyond the price tag, choose carefully
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.
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Stay on track with an ongoing, active process
BY ROBERT KURTZ | SEPTEMBER 2017
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.
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Staff training is key
BY ROBERT KURTZ | SEPTEMBER 2017
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.
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Educate yourself to avoid adverse outcomes and litigation
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.
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Adaptability and flexibility play key roles
BY SAHELY MUKERJI | AUGUST 2017
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.
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Develop a long-term plan, be responsive to your doctors’ needs and make sure staff is happy
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.
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Hire smart, cross-train and keep staff morale high
BY ROBERT KURTZ | AUGUST 2017
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.
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Communicate clearly, gain staff support and hold employees accountable
BY ROBERT KURTZ | AUGUST 2017
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.
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Accreditation standards that can challenge ASCs
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.
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Check accreditation, state registration and licensure, and FDA track record
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.
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Participation leads to better outcomes
BY ROBERT KURTZ | JUNE-JULY 2017
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.
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‘Scopes for Hope’ at Surgery Center of Farmington sees early success
BY ROBERT KURTZ | JUNE-JULY 2017
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.
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How to create and maintain a social media site
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.”
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Take advantage of more than 60 educational sessions and advocate for your ASC
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.
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Train staff to maintain data security and privacy
BY ROBERT KURTZ | MAY 2017
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.
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Reduce your risk and the cost of protection
BY ROBERT KURTZ | MAY 2017
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.
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What ASCs need to be on the lookout for
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.”
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Streamline production, eliminate waste and improve efficiency
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.
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Surgery centers should seize the opportunity
BY ROBERT KURTZ | APRIL 2017
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.
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Skilled nursing facilities would work with surgery centers
BY ROBERT KURTZ | APRIL 2017
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.
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Avoid contaminants with careful testing and vigilance
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.
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Reduce costs, increase value, maintain choice
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.”
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Be cognizant of financial obstacles and cultural differences
BY SAHELY MUKERJI | MARCH 2017
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.”
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Effective communication, drills and working with your local organizations are key
BY ROBERT KURTZ | MARCH 2017
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.
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ASCs that do can reduce expenses and improve contracts
BY ROBERT KURTZ | MARCH 2017
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.
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Sign up for National Advocacy Day when you register for ASCA 201
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.
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Gauge the health of your ASC’s collections, billing processes and contracts
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.
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ASCA’s 2017 advocacy agenda
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.
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Meet the Government Affairs team
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.
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Government support continues to grow
BY ROBERT KURTZ | FEBRUARY 2017
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.
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These contributions ensure that the ASC message is heard in Congress
BY DANIELLE KASTER | FEBRUARY 2017
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.
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As FDA requirements changed, manufacturing costs escalated, production decreased and needs increased
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.
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The numbers of community hospitals and ASCs are going in different directions
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.”
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What ASCs can do
BY ROBERT KURTZ | JANUARY 2017
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.
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Patient selection and tracking metrics under bundled care
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.
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Will the bundled payment model work for ASCs?
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.
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Prevention and backups are the best defense
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.
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Train, monitor and audit
BY ROBERT KURTZ | NOVEMBER-DECEMBER 2016
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.”
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Avoid eight common mistakes
BY ROBERT KURTZ | NOVEMBER-DECEMBER 2016
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.
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