Complete Story
05/02/2013
CMS Revises Interpretive Guidelines
The Centers for Medicare & Medicaid Services (CMS) has released updated interpretive guidelines to CMS state survey agencies and CMS regional offices. The guidelines reflect changes for ASCs in the areas of advanced directives, emergency equipment and patient rights.
Advanced Directives
While ASCs are still allowed to refuse to honor advance directives, the latest interpretive guidelines state: “A blanket statement of refusal by the ASC to comply with any patient advance directives is not permissible. However, if and to the extent permitted under State law, the ASC may decline to implement elements of an advance directive on the basis of conscience or any other reason permitted under State law if it includes in the information concerning its advance directive policies a clear and precise statement of limitation.” CMS specifically states that an ASC’s notice of limitation could, if permitted by State law, indicate that it would always attempt to resuscitate a patient and transfer that patient to a hospital in the event of deterioration.
Emergency Equipment
The regulation no longer prescribes a specific list of emergency equipment that must be available in every ASC operating room. Instead, the ASC’s governing body and medical staff are required to specify the types of emergency equipment required that are appropriate to the ASC’s patient population, to make it available immediately during emergencies, and to ensure it is maintained by appropriate personnel.
Notification of Patient Rights
An ASC is no longer required to provide notice of patient rights in advance of the date of the procedure. Provision of both verbal and written notice on the same day as, but prior to the start of, the surgical procedure is acceptable.
CMS Memorandum
CMS Crosswalk with 4.2013 changes
Interpretive Guideline 042013
CASA has developed a document that can be personalized by centers, for a small fee, to meet the patient rights and advanced directive notification. A sample can be obtained at the following link CASA Patients rights notification template. If you are interested in utilizing this document for your center contact Shellee Randol at 209.384.1640 or randolgraphics@yahoo.com.
Humidity Requirements
In regards to physical plant changes, CMS has widened the range of acceptable humidity levels for ASC operating and procedure rooms. Under the new standards, the relative humidity of anesthetizing locations in ASCs and other settings must be maintained between ≥20% and ≤60%. Previously, CMS required relative humidity to be between ≥35% and ≤60%.
Quality Reporting Update
Still have questions regarding the CMS mandated ASC Quality Reporting Program (ASCQR)? The following link holds the answers to frequently asked questions: ASC Frequently Asked Questions About the ASCQR Program
Additional information and reporting tools for the ASCQR Program can be found at http://www.oqrsupport.com, or contact the ASCQR Program Support Contractor at 866-800-8756.
