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Converting an HOPD to an ASC What to know about renovating an existing space BY JULIE HAMBERIS, RN


healthcare


Increasing numbers of hospitals intend to expand their investments in ASCs going forward, according to a 2020 survey of senior executives conducted by


Avanza Healthcare Strategies. These hospitals use a few ways to grow the number of ASCs in their portfolio. One of those ways is exploring whether to convert existing hospital outpatient departments (HOPDs) to ASCs. Conversion can deliver significant


benefits over building a new facility. The hospital and any potential physi- cian partners can eliminate significant capital expenses, including those asso- ciated with researching and purchasing real estate, design and construction. The time to market for a renovation tends to be faster than for a new build. Finally, the HOPD is likely already in a good location for patients, surgeons, staff and vendors.


The process of converting an HOPD


to an ASC might seem like a straight- forward and cost-effective way to open an ASC. Since the facility is already being used by surgeons to perform out- patient surgical procedures, the conven- tional wisdom would say that a conver- sion is as simple as a few operational adjustments and a new sign on the door. It is not that easy, however, and such a mentality can be risky. Over- sights that occur from rushing to com- plete


the conversion without fully


understanding the process can stall the project, add significant expense or, ultimately, cause the loss of any poten- tial time or cost savings.


Key Conversion Considerations An existing HOPD will often require operational and licensing changes and


facility renovations to account for the unique requirements of an ASC. Fed- eral regulators and accreditation orga- nizations consider HOPDs and ASCs to be different types of facilities. While there is overlap with HOPDs, ASCs have their own sets of life safety guidelines and accreditation standards. One of the first steps the hospi-


tal and physician partners should take before proceeding with an HOPD-to- ASC conversion is to bring in a life safety expert with ASC knowledge and experience. This consultant will deter- mine what will need to occur to get the space compliant with ASC life safety requirements. Various regulatory bod- ies and their requirements must all be considered when assessing whether an HOPD can and should be converted to an ASC. Some that should be taken into account are Facility Guidelines Institute (FGI) standards, Centers for Medicare & Medicaid Services' Con- ditions for Coverage and state-specific


14 ASC FOCUS AUGUST 2021 | ascfocus.org


regulations, including evaluation of any state-required certificate of need process (identified in some states as “certificate of public need” or “deter- mination of need”).


Depending on the year the exist- ing space was constructed, the work required to bring the HOPD up to the current guidelines and building occupancy requirements might prove so difficult and expensive that they might serve as a deterrent to pursuing the conversion.


Other Factors to Address Hospital and physician partners should be prepared for the recommended life safety assessments to find certain issues they might find surprising and potentially expensive to address. For example, some of the engineering and mechanical services used by the HOPD can be carried over to the ASC, usually with a written agreement that the ASC’s owners will pay fair market value to the


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


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