Use this conversion kit for hospital surgery centers
Use this conversion kit for hospital surgery centers
By Stephen W. Earnhart, MS
President and CEO
Earnhart and Associates
Dallas
Lately, I’ve had many calls dealing with the conversion of an existing hospital ambulatory surgery unit into a joint-ventured "independent" ASC. The reason so many hospitals are converting their existing space is fairly standard: They want to maximize their service or become a "full service" provider to insurance providers and physicians. Here is how to do it right.
Obviously, you need to obtain a different provider number from the hospital. To do that, you need state licensure and, if you are seeking reimbursement, you need Medicare certification and possibly accreditation by the Joint Commission on Accreditation of Healthcare Organizations or the Accreditation Association for Ambulatory Health Care. One typically follows the other.
Avoid making mistakes by not having all the facts. One recent call was from a hospital administrator who abandoned the hospital’s plans for an ASC because the cost of constructing the required incinerator was too high.
Hello?
A Texas Board of Health regulation issued July 1996 reads: "A gas, electric, or oil-fired incinerator shall be provided for the complete destruction of infectious waste. Infectious waste shall include, but shall not be limited to, dressings and material from open wounds and laboratory specimens." (Most states have similar requirements. Check with yours.)
Now what this person did not obtain from their consultant was the last sentence of the regulation that states: "Incinerator service may be by contract." Sub it out, in other words.
Other calls centered around the physical location of the facility. The Texas Board of Health regulation 135.41 reads: "This facility may be a distinct separate department operated by an existing hospital, it may be located in a separate freestanding structure, or it may be located in an office building."
Note: A distinct separate department does not mean your existing ORs if you want to make it a for-profit, physician joint-ventured center. That flies in the face of Stark II, to name one reason why not.
Many questions always come up about the number of ORs and the size of each.
According to the Texas Board of Health, "A minimum of one operating room is required in each facility. Each operation room shall have a minimum clear area of 240 square feet."
That is way too small. Go up to at least 400 or 500 square feet on your ORs. They fill up very quickly. I emphasize the wording "minimum clear area."
What about patient stations? "A minimum of two patient stations per operating room(s) for post anesthesia/recovery for surgical patients shall be provided. Provide at least three feet each side or between beds and space at foot of bed as needed for work and/or circulation. Patient access to toilet and changing area required may be shared with preop area." Other states may have different requirements.
I like this one: "Appropriate areas shall be provided for male and female personnel (orderlies, technicians, nurses, and doctors) working within the surgical suite. The areas shall contain clothing storage, toilets, lavatories, and space for donning scrub suits and boots. These areas shall be arranged to provide a one-way traffic pattern so that personnel entering from outside the surgical suite can change, gown, and move directly into the surgical suite."
You don’t need a consultant to deal with conversion issues. Get the rules and regulations from your state licensing agency and Medicare and just follow their instructions. It is all laid out for you. Save your money, and invest it back into the center. Also make sure your architect and consultants are familiar with the current rules and regulations.
[Editor’s note: To give feedback or suggest ideas for future columns, contact: Stephen W. Earnhart, Earnhart and Associates, 5905 Tree Shadow Place, Dallas, Texas 75252. E-mail: [email protected]. World Wide Web: http://rampages.onramp. net/~surgery.]
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.