COVER STORY


Experts discuss keys to success BY SAHELY MUKERJI Logistics of Overnight Care


A


s ASCs expand their services to include complex surgeries that


might require overnight recovery care, their state associations continue work- ing with policy makers to amend state laws and redefine ASCs. While the Centers for Medicare & Medicaid Ser- vices (CMS) defines ASCs as pro- viding surgical services in which the expected duration of services does not exceed 23 hours 59 minutes following admission, many states do not allow patients to stay overnight. State laws can be more restrictive than CMS reg- ulations when it comes to overnight stay, and ASCs should always check their local state laws, experts say. In addition to providing patient care


overnight in the ASC, a few centers in Colorado use convalescent centers (CC) to allow for extended recovery care, a trend that several states have tried to emulate.


10 ASC FOCUS SEPTEMBER 2015


If you are considering overnight stays at your ASC, work with your state ASC association because they are very impactful from a legislative perspective and they can help to identify opportunities for change if needed.”


— Michael J. Patterson, RN Mississippi Valley Health


Iowa


Michael J. Patterson, RN, member of ASCA’s Board of Directors and president and chief executive officer of Mississippi Valley Health in Davenport, Iowa, says state laws in Iowa allow patients to stay overnight in an ASC. “Typically, we have up to five patients stay the night and we


offer this service two days a week,” he says. “We have our physicians on call and two nurses and a nursing assistant providing their overnight nursing care. Patients have private rooms, which are just steps away from the operating room (OR) that their procedure was performed in. It is an efficient and high-quality experience for our patients.” You really need to understand your


state’s regulations before you can have a patient spend the night in your ASC, Pat- terson says. “A lot of people don’t under- stand when the clock starts ticking with the 23-hour-59-minute rule,” he says. “In our facility, the clock starts when the patient is brought into the preop area and prepared for surgery. However, each state has its own set of regulations, so it is a good idea to understand that expecta- tion from the beginning.” His ASC, typically, does not start a


case in which the patient will stay over- night until after 9 am or 10:00 am, Pat- terson says. “That way the patient’s fam- ily has plenty of time to pick them up


The advice and opinions expressed in this column are those of the interviewees’ and do not represent official Ambulatory Surgery Center Association policy or opinion.


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