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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Work with your local authorities when creating your emergency preparedness plan
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.
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Make emergency preparedness a top priority in your surgery center
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.
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ASCA’s second generation clinical and operational program offers apples-to-apples comparison
BY ROBERT KURTZ | OCTOBER 2016
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.
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Three new courses to be added in fall
BY SAHELY MUKERJI | OCTOBER 2016
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.
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Do it quickly and make sure that it is executable
BY ROBERT KURTZ | OCTOBER 2016
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.
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The value of nursing input into ASC building design
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.
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How to assess hand hygiene and stay compliant
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.
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Dearth of trained nurses has inspired surgery centers to develop their own programs
BY ROBERT KURTZ | SEPTEMBER 2016
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.
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Talk with your patients early to ensure success
BY ROBERT KURTZ | SEPTEMBER 2016
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.
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Benefits and drawbacks
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.
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Anesthesia can help ASCs overcome common accreditation pitfalls
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.
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Make your collections efforts successful
BY ROBERT KURTZ | AUGUST 2016
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.”
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Why that matters
BY ROBERT KURTZ | AUGUST 2016
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.
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Join PIH and ASCA to provide surgical services to those in need
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.
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The first of its kind for ASCs
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.
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Use your membership to your benefit
BY SAHELY MUKERJI | JUNE-JULY 2016
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.
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Leaner, more efficient practices result in financial savings, improved employee recruitment and retention
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.
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Keep your physicians, staff and patients happy
BY ROBERT KURTZ | JUNE-JULY 2016
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.
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Plan now to make the most of the opportunities there
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.
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Effective ways to keep on top of shortages and costs
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.”
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Detection and prevention advice
BY ROBERT KURTZ | MAY 2016
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.
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Find and retain the right match for your 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.
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Research, analyze and compare before you buy
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.”
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Follow these ‘Five Habits’
BY ROBERT KURTZ | APRIL 2016
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.
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New payment models promote cost-effective sites of service and patient choice
BY ROBERT KURTZ | APRIL 2016
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.
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New payment models promote cost-effective sites of service and patient choice
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.
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Sound strategies for employee termination
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.
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Follow these six easy steps
BY ROBERT KURTZ | MARCH 2016
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.
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Follow an ASC bill on its journey to becoming a law
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.
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How the regulatory requirements that apply to your ASC are created and changed
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.
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Do your research before you buy
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.
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Stand up for your center and the work that you do for your community
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.
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How to handle business with the company going under
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.”
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To be successful, be proactive in pursuing alignment strategies
BY ROBERT KURTZ | JANUARY 2016
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.”
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The agency will roll out its first advanced certification program for surgery centers this year
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.
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ASCA surveys also reveal small salary increases since 2012
BY ROBERT KURTZ | JANUARY 2016
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.
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