FEATURE Caring for Paralyzed Patients


Keep ADA requirements in mind BY ROBERT KURTZ


P


aralyzed 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. “We have everything necessary to


provide these patients with the same exceptional care as any other patient,” she says.


That is important for ensuring opti- mal outcomes and meeting regulatory requirements, says Roy Breitenbach, a partner/director for the law firm Gar- funkel Wild, practicing out of Great Neck, New York. “ASCs are considered public accom- modations because they are open to the public,” he says. “Therefore, ASCs are subject to the provisions under Title III of the Americans with Disabilities Act (ADA). This federal regulation prevents disability discrimination in


various aspects of life, including pub- lic accommodations. Almost all states have their own laws against disability discrimination. There are also some city and local laws.”


Understand the Rules When assessing whether they meet ADA requirements, Breitenbach says ASCs must focus on the ability of patients to enter the facility and have their path of travel accommodated. “Title III of the ADA has a concept called ‘reasonable accommodation,’” he says. “If there is a barrier or issue that prevents a disabled person from fully enjoying the goods and services that the facility is offering, you have an obligation to provide a reasonable accommodation if it can overcome that barrier.”


This can include making changes to


the physical structure of the facility. “If you are buying, constructing or making


12 ASC FOCUS JUNE/JULY 2018 |www.ascfocus.org


significant alterations to a facility, make sure the construction is compliant with ADA accessibility guidelines,” Breiten- bach says. “For example, if you have an office with a check-in or registration desk, at least one part of the desk should be at wheelchair height.” He says language in the ADA con- siders challenges ASCs might face in altering an existing building. “ADA includes a concept stating that if you are not doing major construction or renovations, you only have to make accessibility changes that are ‘readily achievable’—i.e., easy to accomplish without much difficulty or expense. Readily achievable for ASCs has gen- erally been construed as a simple path of travel—from the front door of a facility, into the waiting room and back into the clinical area.” The other area that falls under the


rubric of readily achievable is the pro- vision of medical equipment, Breiten- bach says. “A lot of the exam tables can be lowered to a height in which some- one in a wheelchair can scoot over. You might need to provide wheelchair lifts. You need handicapped-accessible bath- rooms. You need to consider height of switches and location of signage.”


Be Ready Caring for paralyzed patients requires more than just meeting rules, says Devonna Hamilton, RN, a health facil- ity survey and accreditation consultant in Garland, Texas. “Help provide these patients dignity. Allow them to move themselves as much as possible, only stepping in when assistance is needed.” She says communication with patients is critical. “Do not assume you know what is best for these patients. Moving them around without speak- ing about their needs first could make them uncomfortable. They want to feel they are in control of their lives just like anyone else, and you need to respect that. Much of the time they will tell you what they can do and where they need help.”


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