News You Need: CMS Proposes Significant ASC Standards Additions

Now’s the time to make your voice heard -- and prepare to comply
If your ambulatory surgery center doesn’t have a policy for dealing with patient grievances, you could face survey nightmares. But that’s just one of the many requirements that CMS wants to issue, according to a new CMS proposed rule on ASC Conditions for Coverage (CfC).
The other proposed requirements include:
• A comprehensive quality improvement program, which would allow ASCs to take steps to improve their care. The ASC’s governing body would have to be in charge of this program.
• A disaster-preparedness plan that includes cooperation with local and state officials.
• New requirements for radiology services in an ASC to meet the same standards as laboratory services, including licensure.
• A new "patient rights" standard that would require you to disclose your doctor’s financial interest in the ASC, respect the patient’s advance directives and keep patient records confidential.
• An expanded infection-control standard; and
• A comprehensive patient assessment standard, so your staff assesses patients before they go into surgery, to make sure the patient can tolerate the planned procedure.
CMS is doubling the number of ASC standards, from 16 to 32, says Kathy Bryant, executive director of the Federated Ambulatory Surgery Association.
Note: These standards are only proposed.
What to do: You can comment on the proposed regulations at www.accessdata.fda.gov/scripts/oc/dockets/comments/commentdocket.cfm?AGENCY=CMS. But you should also prepare to comply with the new standards, experts say.
Most ASCs are probably already doing the things CMS wants to require, Bryant adds. But when you impose a government requirement, you add a whole layer of bureaucracy and recordkeeping to the process. And you’ll have different local surveyors independently -- and inconsistently -- interpreting the instructions.
For example: Having a grievance policy may be reasonable for an ASC, and many ASCs probably already have one. When CMS requires it, however, ASCs will have to keep detailed records of grievances. Questions of just how detailed the records need to be and whether they need to deal with oral, as well as written, complaints remain unanswered.
In addition, CMS wants to require a new infection- control standard -- although infection rates in ASCs are already "incredibly low," Bryant says. "ASCs already know how to prevent infections, and they’re already doing a good job of it."
Bryant is also disappointed that CMS didn’t remove any of the "old worthless standards." For example, CMS now requires that ASCs have a separate waiting room. But hospitals don’t have to have a separate waiting room for each of their outpatient departments.

- Published on 2007-10-25