REGULATORY REVIEW


Humidity and Temperature The revised guidance goes on to state, regarding OR humidity level, that ASCs must ensure that the “humidity level is appropriate for all of their sur- gical and anesthesia equipment, and that supplies which require a different level of humidity than that in the OR are appropriately stored until used.” ASCA is concerned about the pro- vision in the interpretive guidelines that “each operating room should have separate temperature control,” believing this provision should have been amended once the definition of OR was revised to include procedure rooms since many procedure rooms do not have separate temperature con- trol. ASCA will work with CMS to get this corrected.


Medicare Beneficiary Ombudsman Address §416.50(a) ASCs must provide in their notice of rights the web site for the Office of the Medicare Beneficiary Ombudsman. CMS has updated the interpretive guide- lines to include the current website: www.medicare.gov/claims-and- appeals/medicare-rights/get-help/ ombudsman.html.


Informed Consent §416.50(e) Although most ASCs are probably already doing this, CMS clarified that the informed consent form must be “signed by the patient, or as appropri- ate, the patient’s representative.”


Physician Discharge §416.52(c) Finally, the interpretive guidelines previously included the expectation that a patient would leave the ASC


within 15–30 minutes after the per- forming physician signed the dis- charge order. ASCA advocated for this to be changed, contending that it was unrealistic to expect the sur- geon to stay until the patient was stabilized just to sign the discharge order. Our advocacy efforts were rewarded, as CMS added to the inter- pretive guidelines that “it is permis- sible for the operating physician to write a discharge order indicating ‘the patient may be discharged when stable.’” If facilities follow this new language, there must be documenta- tion as to when the patient was sta- ble, even if it is not provided directly from the supervising physician.


Kara Newbury is ASCA’s regulatory counsel. Write her at knewbury@ascassociation.org.


ASC FOCUS MAY 2015


25


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34