REGULATORY REVIEW
On the Regulatory Side What to expect in 2016 BY KARA NEWBURY
Trying to predict all of the regulatory requirements that may change for ASCs in 2016 would require clairvoyant abilities that
most do not possess. It is possible, however, to look to proposed rules and language in the past to determine what might be coming our way in 2016.
Survey and Certification Emergency preparedness
In December 2013, the Centers for Medicare & Medicaid Services (CMS) proposed emergency preparedness requirements that would be consis- tent and enforceable for all Medicare and Medicaid providers and suppli- ers. While the intent of that proposed rule is to align standards across all health care providers, there are two exceptions given for ASCs. ASCs will not need to provide occupancy infor- mation in their communication plan because occupancy usually refers to bed occupancy in an inpatient facility. In addition, CMS is not proposing that facilities provide for subsistence needs for their patients and staff, as will be required of other facility types. In ASCA’s comments submitted in March 2014, we raised concerns that the proposed requirements go beyond what is practical for the ASC setting. One example of this is the proposal to require ASCs to develop arrange- ments with other ASCs and provid- ers to “receive patients in the event of limitations or cessation of opera- tions to ensure the continuity of ser- vices to ASC patients.” In case of an emergency, ASCs would cancel upcoming procedures for that day, stabilize any patients already in the facility and transfer to a higher level of care if needed. They also would ensure that all ASC staff and volun-
teers are accounted for and can either shelter in place or return home safely. This proposal demonstrated a lack of understanding of the ASC setting, and ASCA requested it be removed. Also, CMS proposed to require ASCs to release patient information and have a communication system in place capable of generating timely, accurate information that could be disseminated, as permitted, to family members and others. CMS appropri- ately excluded several facility types from this requirement, providing the rationale that “this requirement would best be applied only to providers and suppliers who provide continuous care to patients, as well as to those providers and suppliers that have responsibilities
and oversight for
care of patients who are homebound or receiving services at home.” Since ASCs fall outside of this standard, ASCA asked that ASCs be exempted from this requirement.
ASCA anticipates the new require- ments will become effective sometime this year and remains hopeful that CMS will take the association’s comments into consideration before finalizing the rule.
Life Safety Code
In the spring of 2014, CMS proposed changes to fire prevention require- ments for certain health care facil- ities, including the adoption of the National
Fire Protection Associa-
tion’s (NFPA) 2012 editions of the Life Safety Code (LSC) and the Health Care Facilities Code (HCFC). Currently, CMS employs the standards in the 2000 edition of the LSC. Although adoption of the 2012 edi- tion of the LSC itself might not be overly burdensome for ASCs, other NFPA documents referenced in the LSC as mandatory extensions of the LSC would
dramatically increase
costs to both new and existing ASCs. ASCA submitted comments on behalf
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