AHS Daily Client Update

May 29, 2020, 11:00 am

Good Morning,

Very Quick update this morning.
 
Live Podcast Today at 2 pm EDT
We will have a live podcast Today, Friday, May 29th at 2:00 PM EDT.  We will discuss the latest ASC News, Air Exchanges and Intubation and Turnovers, PPP Reporting Update, CARES Act Provider Relief Fund Reporting, PPE Requirements, and More.  We will also have brief section at the end where we will discuss some NYS Specific Issues
To access the live podcast:
You can also watch it live on YouTube by going to:
NY FORWARD
 
The NY Forward program has some specific requirements for being open in the current environment.  Click on the following website to see the status of reopening:
If you follow through – you will get to a point that says you can either open or not based on the status of your area – but in any event, you will eventually come to this link:
This requires you to have a Business Reopening Safety Plan (and provides you a template to do that).  By the way, this form is for EVERY business in NYS – from the corner ice cream stand to hospitals, etc.
While the form is overwhelming, it is not anything that we haven’t been preparing all of you for.  My team is now working on answers to the questions based on prior information that we have provided you and the training that we have made available to you.
We are in the process of completing this form for all of our retainer clients – there will be some specifics that we need to get from you as we complete.  This will no doubt take through the weekend and hopefully sometime on Monday or Tuesday will be complete.
This form does not need to be submitted to the State, however, we have been informed that Insurance Companies may be requiring you to submit this to them as a condition of payment of your claims.
That’s it for now – “see you” at 2pm!
John J. Goehle, MBA, CASC™, CPA
Chief Operating Officer
Ambulatory Healthcare Strategies, LLC
Rochester: 585-594-1167
Albany: 518-594-1167
Fax: 585-391-1402
Publications: 858-633-6392

May 28, 2020, 11:18 am

Good Morning Everyone!

Hope you all are doing well!
Live Podcast Tomorrow
We will have a live podcast Tomorrow, Friday, May 29th at 2:00 PM EDT.  We will discuss the latest ASC News, Air Exchanges and Intubation and Turnovers, PPP Reporting Update, CARES Act Provider Relief Fund Reporting, PPE Requirements, and More.
To access the live podcast:
You can also watch it live on YouTube by going to:
Guidance for Employees/Provider that are Traveling
 
The CDC has provided guidance for travelers in the United States at:
This is guidance that you should consider when deciding whether you should require providers or employees to self-quarantine after travel outside of their community.  Make sure you check the requirements for your local community and state.  Regardless of any self-quarantine requirements you should provide this guidance to your employees and providers.
Providers Must Act by June 3 to Receive Additional CARES Provider Relief Funds
As ASCA sent out this Morning from HHS, the second round of the HHS Grants are tied to submitting Tax and Financial information. This is required if you have already received payments in the second round of grants or if you have not received the second round of financing and wish to be considered (ie. it acts as your application for additional funds). The submission requires you to upload a statement of your losses  for March and April 2020.
Here is the link to the attestations and uploads.

 
Joint Commission Resuming Surveys in June
 
The Joint Commission will be initiating their survey activity again starting June 1. They have also stipulated a number of changes to their survey practices in order to stay safe in this COVID-19 environment.
Air Exchanges During and After Intubation

During an SIS Webinar in which I participated yesterday, an issue was raised regarding air exchanges and Intubation.  To clarify this issue, Laurie researched the AORN Guidance which follows:
 
Can the surgical team stay in the OR during intubation and start the surgical procedure before the minimum amount of air exchanges are complete? 

Answer:  Ideally intubation should occur with a minimal number of personnel at head of the bed utilizing properly fitted surgical N95 respirators, which have not been reprocessed, eye protection, gowns and gloves. If the surgical team remains in the OR with the necessary PPE, they should distance themselves from head of bed during intubation. Once patient is intubated and stabilized, surgical antisepsis, draping and procedure could begin without waiting for full air exchange. However, no one should enter or leave the OR during this initial timeframe.

Resources:

AORN Guideline for Transmission-Based Precautions. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html#take_precautions

The other issue that was discussed in yesterday’s session is the timing of setting up the sterile field. We are in the process of checking with AORN to see if there is any further guidance.
We will also discuss this in tomorrow’s Live Podcast.
Stay Safe!

John J. Goehle, MBA, CASC™, CPA
Chief Operating Officer
Ambulatory Healthcare Strategies, LLC
Rochester: 585-594-1167
Albany: 518-594-1167
Fax: 585-391-1402
Publications: 858-633-6392

May 26, 2020, 11:12 am

Good Morning Everyone!

Hope everyone had a good Memorial Day and were able to find some time to relax. There isn’t much going on right now as we wait for more regions to open and are busy assisting many of you in either reopening, resuming electives (where allowed), or continuing to document COVID-19 decisions.
Reminder for Clients
If you haven’t done so already, please keep us updated with any changes in decisions to change operations or protocols for COVID-19. Please reach out to your client representative.
NYS Cost Report Update
We have been informed by DOH that they will be using a new software called the Universal Data Collection System (UDCS) for the 2019 Cost Report and anticipate that the software will be issued around August 1, 2020 and that the report will be due by the end of October 2020.
The Cost Report Software Release is on schedule and will not be delayed due to COVID-19. For those of you whose cost reports we prepare, we will be reaching out to you today or tomorrow in preparation.
Education Opportunities
ASC Finance, Accounting and Reimbursement Seminar

Presented by: Coding Compliance Management, LLC and the ASC Podcast with John Goehle
June 11 and 12th 2020
Learn and Earn without the travel! Join ASC industry experts John Goehle MBA, CASC CPA, Cristina Bentin, CMA, CPPM, COC, CCS-P and Ann Geier, RN, CASC for this intensive 2-day Virtual conference with finance, accounting, and revenue cycle aspects explained!
ASC Administrators, Nurse Managers and Business Office Managers face unique challenges in managing the financial aspects of an ASC and understanding the crucial role coding experts play. Our experts will discuss various aspects of Finance, Accounting and Reimbursement in the ASC setting. It is ideal for anyone interested in understanding basic finance principles as well as those that know finance but want to learn how it differs in the ASC setting.
Our experts will also review the ASC reimbursement model to include an overview of fraud and abuse prevention, coding, documentation, outsourcing, and compliance audits in the ASC setting as well as the impact coding accuracy has on your organization’s financial health.
Continuing Education
This program is approved for up to 13.0 hours of AEUs by BASC Provider #2618.  This is for CASC Certified Administrators.
AAPC CEUs are available for up to 14 CEUs for coding, auditing/compliance, billing and/or certified physician practice manager professionals pending need for Core A, Core B, and/or specialty CEU requirements
Infection Control In-Service to Meet the Challenges of COVID-19
 
The in-service went very well yesterday. Thank you to everyone who participated live and to Laurie for her hard work!
Laurie Roderiques presented focused training related to COVID-19 infection control precautions. This included hand hygiene, environmental cleaning specific to frequently touched surfaces, PPE use, reprocessing and HLD considerations, social distancing, and considerations in specific clinical settings (ie. Preop/PACU/OR/Procedure Room).
 
This training is provided free to all Ambulatory Healthcare Strategies Retainer Clients.  For access, contact your AHS Coordinator. A recording is available to AHS clients.
You may access the recording here if you are not an AHS client once it is made available (in the next couple days).
Center Specific Education via Zoom Sessions
If you want something done specific to your center’s plans, policies, and protocols please contact your AHS Coordinator and arrangements will be made.
 
2020 Annual Mandatory Education Program Presentation
 
The recording of the  Mandatory Education Program is now available. Ambulatory Surgery Centers are required by CMS, State Licensure and Accreditation Organizations to provide annual training to staff on a variety of topics.  This module provides the training that is not specific to an individual center.  This training must be supplemented by facility specific training.

The recording is available to AHS retainer clients. Please contact your AHS contact if you would like a link to the recording.

Non-AHS clients can purchase access to this program to the recoding and use it to train all of their staff for a year.  You will only need to purchase access once to use for any number of staff members. To purchase access, visit: https://vimeo.com/ondemand/244403

Stay Safe!

John J. Goehle, MBA, CASC™, CPA
Chief Operating Officer
Ambulatory Healthcare Strategies, LLC
Rochester: 585-594-1167
Albany: 518-594-1167
Fax: 585-391-1402
Publications: 858-633-6392

May 22, 2020, 11:12 am

Good Morning Everyone!

Hope everyone is doing well! Happy Friday!
Patient Questionnaires and Preoperative Covid-19 Testing Protocols

 

Clients of AHS should reach out to their Client Representative if they have questions in regards to developing/updating these for their center, if they haven’t already.
Here are some examples of Patient Questionnaires. Remember, these are highly center specific and need to be developed based on the risk assessment by your governing body. Items in these Patient Questionnaires are not necessarily recommended for your center.
Infection Control Questions
Please feel free to reach out to lroderiques@ah-strategies.com with any COVID-19 related infection control questions.
Education Opportunities
ASC Finance, Accounting and  Reimbursement Seminar

Presented by: Coding Compliance Management, LLC and the ASC Podcast with John Goehle
June 11 and 12th 2020
Learn and Earn without the travel! Join ASC industry experts John Goehle MBA, CASC CPA, Cristina Bentin, CMA, CPPM, COC, CCS-P and Ann Geier, RN, CASC for this intensive 2-day Virtual conference with finance, accounting, and revenue cycle aspects explained!
ASC Administrators, Nurse Managers and Business Office Managers face unique challenges in managing the financial aspects of an ASC and understanding the crucial role coding experts play. Our experts will discuss various aspects of Finance, Accounting and Reimbursement in the ASC setting. It is ideal for anyone interested in understanding basic finance principles as well as those that know finance but want to learn how it differs in the ASC setting.
Our experts will also review the ASC reimbursement model to include an overview of fraud and abuse prevention, coding, documentation, outsourcing, and compliance audits in the ASC setting as well as the impact coding accuracy has on your organization’s financial health.
Continuing Education
This program is approved for up to 13.0 hours of AEUs by BASC Provider #2618.  This is for CASC Certified Administrators.
AAPC CEUs are available for up to 14 CEUs for coding, auditing/compliance, billing and/or certified physician practice manager professionals pending need for Core A, Core B, and/or specialty CEU requirements
Infection Control In-Service to Meet the Challenges of COVID-19
 
The in-service went very well yesterday. Thank you to everyone who participated live and to Laurie for her hard work!
Laurie Roderiques presented focused training related to COVID-19 infection control precautions. This included hand hygiene, environmental cleaning specific to frequently touched surfaces, PPE use, reprocessing and HLD considerations, social distancing, and considerations in specific clinical settings (ie. Preop/PACU/OR/Procedure Room).
 
This training is provided free to all Ambulatory Healthcare Strategies Retainer Clients.  For access, contact your AHS Coordinator. A recording is available to AHS clients.
Center Specific Education via Zoom Sessions
If you want something done specific to your center’s plans, policies, and protocols please contact your AHS Coordinator and arrangements will be made.
 
2020 Annual Mandatory Education Program Presentation
 
The recording of the  Mandatory Education Program is now available. Ambulatory Surgery Centers are required by CMS, State Licensure and Accreditation Organizations to provide annual training to staff on a variety of topics.  This module provides the training that is not specific to an individual center.  This training must be supplemented by facility specific training.

The recording is available to AHS retainer clients. Please contact your AHS contact if you would like a link to the recording.

Non-AHS clients can purchase access to this program to the recoding and use it to train all of their staff for a year.  You will only need to purchase access once to use for any number of staff members. To purchase access, visit: https://vimeo.com/ondemand/244403

Stay Safe!

John J. Goehle, MBA, CASC™, CPA
Chief Operating Officer
Ambulatory Healthcare Strategies, LLC
Rochester: 585-594-1167
Albany: 518-594-1167
Fax: 585-391-1402
Publications: 858-633-6392

May 21, 2020, 11:54 am

Good Morning Everyone!

Hope everyone is doing well!
Preoperative Covid-19 Testing Protocol Examples from around the US
Patient Testing Protocol should be center, state, and location specific. New York state has specific protocols that they should be following based on the guidance from DOH.
APSF has published a number of examples of Patient Testing Protocols that may be useful when creating your own.
Patient Questionnaires
Patient Questionnaires should be center, state, and location specific and determined by each center’s leadership team.
We are working on getting you some examples for tomorrow.
ASCA Update on CARES Grant Attestation Deadline Approaching

As a reminder, the attestation deadline for healthcare providers that wish to keep the grants the US Department of Health & Human Services (HHS) began distributing April 10 was extended from 30 to 45 days. Sign the attestation via the attestation portal on the Provider Relief Fund page. For providers that received payment on April 10, for example, the deadline was extended from May 9 to May 24.This grant fund is part of the $100 billion in relief included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 that was signed by President Trump on March 27, 2020. As a reminder, these are payments, not loans, to healthcare providers, and will not need to be repaid. Within 45 days of receiving the payment, providers must sign the attestation confirming receipt of the funds and agreeing to the Terms and Conditions of payment. If a provider receives payment and does not wish to comply with the Terms and Conditions, the provider must contact HHS within 45 days of receipt of payment and remit the full payment to HHS.For additional information or to check on the status of your grant, please visit the Provider Relief Fund page or call the CARES Provider Relief line at 866.569.3522.
Education Opportunities
ASC Finance, Accounting and  Reimbursement Seminar

Presented by: Coding Compliance Management, LLC and the ASC Podcast with John Goehle
June 11 and 12th 2020
Learn and Earn without the travel! Join ASC industry experts John Goehle MBA, CASC CPA, Cristina Bentin, CMA, CPPM, COC, CCS-P and Ann Geier, RN, CASC for this intensive 2-day Virtual conference with finance, accounting, and revenue cycle aspects explained!
ASC Administrators, Nurse Managers and Business Office Managers face unique challenges in managing the financial aspects of an ASC and understanding the crucial role coding experts play. Our experts will discuss various aspects of Finance, Accounting and Reimbursement in the ASC setting. It is ideal for anyone interested in understanding basic finance principles as well as those that know finance but want to learn how it differs in the ASC setting.
Our experts will also review the ASC reimbursement model to include an overview of fraud and abuse prevention, coding, documentation, outsourcing, and compliance audits in the ASC setting as well as the impact coding accuracy has on your organization’s financial health.
Continuing Education
This program is approved for up to 13.0 hours of AEUs by BASC Provider #2618.  This is for CASC Certified Administrators.
AAPC CEUs are available for up to 14 CEUs for coding, auditing/compliance, billing and/or certified physician practice manager professionals pending need for Core A, Core B, and/or specialty CEU requirements
Infection Control In-Service to Meet the Challenges of COVID-19
 
The in-service went very well yesterday. Thank you to everyone who participated live and to Laurie for her hard work!
Laurie Roderiques presented focused training related to COVID-19 infection control precautions. This included hand hygiene, environmental cleaning specific to frequently touched surfaces, PPE use, reprocessing and HLD considerations, social distancing, and considerations in specific clinical settings (ie. Preop/PACU/OR/Procedure Room).
 
This training is provided free to all Ambulatory Healthcare Strategies Retainer Clients.  For access, contact your AHS Coordinator. A recording is available to AHS clients.
You may access the recording here if you are not an AHS client once it is made available (in the next couple days).
Center Specific Education via Zoom Sessions
If you want something done specific to your center’s plans, policies, and protocols please contact your AHS Coordinator and arrangements will be made.
 
2020 Annual Mandatory Education Program Presentation
 
The recording of the  Mandatory Education Program is now available. Ambulatory Surgery Centers are required by CMS, State Licensure and Accreditation Organizations to provide annual training to staff on a variety of topics.  This module provides the training that is not specific to an individual center.  This training must be supplemented by facility specific training.

The recording is available to AHS retainer clients. Please contact your AHS contact if you would like a link to the recording.

Non-AHS clients can purchase access to this program to the recoding and use it to train all of their staff for a year.  You will only need to purchase access once to use for any number of staff members. To purchase access, visit: https://vimeo.com/ondemand/244403

Stay Safe!

John J. Goehle, MBA, CASC™, CPA
Chief Operating Officer
Ambulatory Healthcare Strategies, LLC
Rochester: 585-594-1167
Albany: 518-594-1167
Fax: 585-391-1402
Publications: 858-633-6392

May 19, 2020, 11:35 am

Good Morning Everyone!

Hope everyone had a good Monday.
 
***NY Elective Surgery Update***
We now have a directive from NYSDOH with guidance for resuming elective procedures ONLY IN ELIGIBLE COUNTIES of New York.
We recommend that you read this guidance in its entirely, but here are the main points:
  • ASC, OBS, and DTCs are all included
  • Must be in eligible county
  • Patients must be tested 3 days prior to the surgery or procedure according to the guidelines provided and have negative results.
  • There are preparedness and screening as well as Infection Prevention and Control requirements. There are requirements here that will still keep you from resuming normal operations/caseload.
  • Adequate PPE means a 7–day supply on hand and the ability of the practices supply chain to maintain that level.
  • “ASCs, OBSs, and DTCs located in counties that are not deemed eligible, and are performing these essential, non-elective and urgent procedures should also adhere to this Guidance.” – We will be seeking clarification of this guidance.
Our example protocols are being updated and will be sent out to include this new guidance in the coming days.
AHS and NYSAASC Virtual Meeting to Discuss the Elective Surgery Directive in NYS
We will be discussing the NYS Elective Surgery Directive for Facilities Eligible to Reopen for Elective Surgery. The directive also has an impact or organizations that are currently doing only non-elective procedures.

Time: May 19, 2020 03:30 PM Eastern Time (US and Canada)

Join Zoom Meeting
https://us02web.zoom.us/j/88345001229?pwd=YUd2dFVWMEFYbHNZOVBhczFpUWh5QT09

Meeting ID: 883 4500 1229
Password: 569200
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Find your local number: https://us02web.zoom.us/u/koTT9WdE3

PPP Loan Forgiveness Update
 
The SBA has released the LOAN FORGIVENESS APPLICATION (Form 3508), which every company that has received PPP money will need to complete in order to get Loan Forgiveness and determine the amount of the loan that may be “forgiven” by their lender. This is a complicated form that will require a significant amount of information.
There are has four components: (1) the PPP Loan Forgiveness Calculation Form; (2) PPP Schedule A; (3) the PPP Schedule A Worksheet; and (4) an (optional) PPP Borrower Demographic Information Form.  Borrowers are required to submit items (1) and (2) to their lender.
Last week, the Small Business Administration released an updated FAQ fact sheet on the Payroll Protection Program, the article summarizes the main points:
  • Businesses with a PPP loan under $2m are eligible for forgiveness without showing proof of financial hardship
    • Businesses longer have to prove that COVID-19 had a negative impact on your business
    • the assumption is any small business has suffered in some way.
    • This does not negate other requirements of the PPP program such as tracking how much money went to qualifying expenses like payroll and rent.
  • Partnerships and seasonal employers can go back for more money
    • There is new guidance on increasing PPP loan amounts for small businesses that are structured as partnerships or classified as seasonal employers.
    • if a partnership received a PPP loan “that did not include any compensation for its partners,” then “the lender may submit a request to increase the PPP loan amount to include appropriate partner compensation.”
  • There’s still money left in the PPP program
    • According to the article, There’s about $120B in PPP money left.
    • Businesses should still feel encouraged to take advantage of the funding.
  • Still waiting for guidance regarding reporting

Here is a Forbes Article that gives additional details.

Upcoming Education Opportunities
Infection Control In-Service to Meet the Challenges of COVID-19
Laurie Roderiques will be presenting focused training related to COVID-19 infection control precautions. This includes hand hygiene, environmental cleaning specific to frequently touched surfaces, PPE use, reprocessing and HLD considerations, social distancing, and considerations in specific clinical settings (ie. Preop/PACU/OR/Procedure Room).
 
May 20, 2020 from 9:00 AM to 3:00 PM (or when Laurie and John stop talking!).
 
This training is provided free to all Ambulatory Healthcare Strategies Retainer Clients.  For access, contact your AHS Coordinator. A recording will be available to AHS clients following the presentation.
You may register here if you are not an AHS client. The recording will be available following the Live In-service.
Center Specific Education via Zoom Sessions
If you want something done specific to your center’s plans, policies, and protocols please contact your AHS Coordinator and arrangements will be made.
 
2020 Annual Mandatory Education Program Presentation
 
The recording of the  Mandatory Education Program is now available. Ambulatory Surgery Centers are required by CMS, State Licensure and Accreditation Organizations to provide annual training to staff on a variety of topics.  This module provides the training that is not specific to an individual center.  This training must be supplemented by facility specific training.

The recording is available to AHS retainer clients. Please contact your AHS contact if you would like a link to the recording.

Non-AHS clients can purchase access to this program to the recording and use it to train all of their staff for a year.  You will only need to purchase access once to use for any number of staff members. To purchase access, visit: https://vimeo.com/ondemand/244403

Stay Safe!

John J. Goehle, MBA, CASC™, CPA
Chief Operating Officer
Ambulatory Healthcare Strategies, LLC
Rochester: 585-594-1167
Albany: 518-594-1167
Fax: 585-391-1402
Publications: 858-633-6392

May 18, 2020, 11:33 am

Good Morning Everyone!

 

Hope everyone had a great weekend. 

 

NYS Elective Surgery Update

 

Reminder, even though the Governor has stated in a press release that Ambulatory Surgery Centers may resume elected procedures in certain counties, ASCs should not resume elective procedures until we have an executive order from the Governor and a directive from the Commissioner of Health. We are expecting to hear more information soon, hopefully today. As soon as we hear anything we will send it along.  Beginning elective surgery without the guidance and without signing the expected attestation may subject your organization to significant legal and regulatory risk.

 

Upcoming Education Opportunities

 

Infection Control In-Service to Meet the Challenges of COVID-19

Laurie Roderiques will be presenting focused training related to COVID-19 infection control precautions. This includes hand hygiene, environmental cleaning specific to frequently touched surfaces, PPE use, reprocessing and HLD considerations, social distancing, and considerations in specific clinical settings (ie. Preop/PACU/OR/Procedure Room).

 

May 20, 2020 from 9:00 AM to 3:00 PM (or when Laurie and John stop talking!).

 

This training is provided free to all Ambulatory Healthcare Strategies Retainer Clients.  For access, contact your AHS Coordinator. A recording will be available to AHS clients following the presentation.

 

You may register here if you are not an AHS client. The recording will be available following the Live In-service.

 

Center Specific Education via Zoom Sessions

 

If you want something done specific to your center’s plans, policies, and protocols please contact your AHS Coordinator and arrangements will be made.

 

2020 Annual Mandatory Education Program Presentation

 

The recording of the  Mandatory Education Program is now available. Ambulatory Surgery Centers are required by CMS, State Licensure and Accreditation Organizations to provide annual training to staff on a variety of topics.  This module provides the training that is not specific to an individual center.  This training must be supplemented by facility specific training.

 

The recording is available to AHS retainer clients. Please contact your AHS contact if you would like a link to the recording. 

 

Non-AHS clients can purchase access to this program to the recoding and use it to train all of their staff for a year.  You will only need to purchase access once to use for any number of staff members. To purchase access, visit: https://vimeo.com/ondemand/244403

 

Live Podcast this Afternoon  

 

We will have a live Episode of the ASC Podcast with John Goehle today, May 18th, 2020 at 3:00 PM.   

 

Here is a link to the live episode on Podbean:  

https://www.podbean.com/lsw/John/s-rdYnuvRuqN

 

Link for Youtube Live Listeners:

https://www.youtube.com/channel/UC-hvEz0wQCixVHuMAODSiow

 

As always, please feel free to risk out to us if you need anything!!

 

John J. Goehle, MBA, CASC™, CPA

Chief Operating Officer

Ambulatory Healthcare Strategies, LLC

Rochester: 585-594-1167

Albany: 518-594-1167

Fax: 585-391-1402

Publications: 858-633-6392


May 13, 2020, 11:32 am

Good Morning Everyone!

 

Happy Wednesday! Hope you are all doing well! 

 

Upcoming Education Opportunities

 

Tomorrow’s Mandatory Education Program Presentation

Judie D’Ambrosio will be presenting the general education section of the mandatory education program. Ambulatory Surgery Centers are required by CMS, State Licensure and Accreditation Organizations to provide annual training to staff on a variety of topics.  This module provides the training that is not specific to an individual center.  This training must be supplemented by facility specific training. For a full list of items to be covered click here.

 

May 14, 2020 from 9:00 AM to 1:00 PM EDT

 

This training is provided free to all Ambulatory Healthcare Strategies Retainer Clients.  For access, contact your AHS Coordinator.

 

You may register here if you are not an AHS client.

 

Live  Attendees on May 14, 2020 will also receive a link after the day of the training to provide training to your staff for all of 2020. A recording will be available to AHS clients following the presentation

 

Non-AHS clients can purchase access to this program after the session is recorded and use it to train all of their staff for a year.  You will only need to purchase access once to use for any number of staff members.  Return here after May 14, 2020 to purchase access to the recording

 

Infection Control In-Service to Meet the Challenges of COVID-19

Laurie Roderiques will be presenting focused training related to COVID-19 infection control precautions. This includes hand hygiene, environmental cleaning specific to frequently touched surfaces, PPE use, reprocessing and HLD considerations, social distancing, and considerations in specific clinical settings (ie. Preop/PACU/OR/Procedure Room).

 

May 20, 2020 Starting at 9am and going until approximately 3pm (or when Laurie and John stop talking).

 

This training is provided free to all Ambulatory Healthcare Strategies Retainer Clients.  For access, contact your AHS Coordinator. A recording will be available to AHS clients following the presentation.

 

You may register here if you are not an AHS client. The recording will be available following the Live In-service.

 

Center Specific Education via Zoom Sessions

 

If you want something done specific to your center’s plans, policies, and protocols please contact your AHS Coordinator and arrangements will be made.

 

NYS Elective Surgery Update

 

We are expecting to hear more information soon, hopefully today. As soon as we hear anything we will send it along.

 

Stay Safe!  

John J. Goehle, MBA, CASC™, CPA

Chief Operating Officer

Ambulatory Healthcare Strategies, LLC

Rochester: 585-594-1167

Albany: 518-594-1167

Fax: 585-391-1402

Publications: 858-633-6392


May 11, 2020, 11:34 am

Good Morning Everyone!

Happy Monday! Hope you are all doing well!

Fit Testing Portability

“Fit testing can be done by your employer or an outside party, including a union, an apprenticeship program, a contractor’s association, or a past employer. Your current employer is permitted to accept fit testing you have received from an outside party (such as a former employer) within the last 12 months, as long as you use the same respirator make, model, style, and size at your new worksite. This is known as fit testing portability.”

https://www.osha.gov/video/respiratory_protection/fittesting_transcript.html

 

KN95 Discussion – Follow up

On May 7, 2020, the FDA reissued the Emergency Use Authorization (EUA) for Non-NIOSH-Approved Disposable Filtering Facepiece Respirators Manufactured in China to revise one of the eligibility criteria –  the criterion for authorization of respirators based on review of test reports from recognized independent test laboratories submitted to the FDA by the manufacturer or importer – and accordingly removed from Appendix A the respirators that had been authorized under that criterion, regardless of whether they passed or failed the NIOSH testing.1 The FDA is taking this public health action because a number of these respirators failed to demonstrate a minimum particulate filtration efficiency of 95 percent in testing conducted at NIOSH. See the full notice here.

In addition, NPPTL has completed International Assessments for multiple versions of the N95s according to the CDC. These assessments are not a part of the NIOSH respirator approval process and will in no way lead to or preclude NIOSH approval through the official approval process. No conclusions can be made regarding equivalency to N95 products that are NIOSH approved. Most of these products have an ear loop design. NIOSH-approved N95s typically have headbands. Furthermore, limited assessment of ear loop designs, indicate difficulty achieving a proper fit. While filter efficiency shows how well the filter media performs, users must ensure a proper fit is achieved. See the full document here.

As you can see below, KN95s use ear loops rather than headbands. As we have said before, AHS does not recommend KN95s as replacements for N95s. Per OSHA, you are responsible to provide your staff with the proper PPE to protect them. These documents suggest that they would not be effective as alternatives to N95s. We cannot direct you to use  products that have not been FDA approved, this is an internal decision directed by your governing board.

Upcoming Education Opportunities

May 14 Mandatory Education Program Presentation

Judie D’Ambrosio will be presenting the general education section of the mandatory education program. Ambulatory Surgery Centers are required by CMS, State Licensure and Accreditation Organizations to provide annual training to staff on a variety of topics.  This module provides the training that is not specific to an individual center.  This training must be supplemented by facility specific training. For a full list of items to be covered click here.

May 14, 2020 from 9:00 AM to 1:00 PM EDT

This training is provided free to all Ambulatory Healthcare Strategies Retainer Clients.  For access, contact your AHS Coordinator.

You may register here if you are not an AHS client.

Live  Attendees on May 14, 2020 will also receive a link after the day of the training to provide training to your staff for all of 2020. A recording will be available to AHS clients following the presentation

Non-AHS clients can purchase access to this program after the session is recorded and use it to train all of their staff for a year.  You will only need to purchase access once to use for any number of staff members.  Return here after May 14, 2020 to purchase access to the recording

Pandemic Focused Infection Control Training

Laurie Roderiques will be presenting focused training related to COVID-19 infection control precautions. This includes hand hygiene, environmental cleaning specific to frequently touched surfaces, PPE use, reprocessing and HLD considerations, and considerations in specific clinical settings (ie. Preop/PACU/OR/Procedure Room).A recording will be available to AHS clients following the presentation.

Date and Time are TBD, but it will most likely be ready in the next couple weeks.

Center Specific Education via Zoom Sessions

If you want something done specific to your center’s plans, policies, and protocols please contact your AHS Coordinator and arrangements will be made.

Testing of Patients for COVID-19

Right now, there is no guidance for ASCs on whether or not to test Patients prior to surgery (for NYS). We expect guidance to be released soon in a similar manner as it was for the hospitals. We would recommend that you test patients prior to surgery with an FDA approved test as the hospitals are required to do as supplies allow.

This is what the hospitals are required to conform with:

“Hospitals must test all patients receiving outpatient elective surgeries and non-urgent procedures for COVID-19 and patients must test negative for COVID-19 using a molecular assay for detection of SARS-CoV-2 RNA prior to any such surgery or procedure. The test must be administered no more than 3 days prior to the surgery or procedure.”

NYSAASC Group Mask Purchasing

See the email below from Jon VanValkenburg of NYSAASC:

“NYSAASC Members,

 

As mentioned on Daily Update calls over the past several days, we are looking into possibly aggregating PPE needs of our members for a bulk order to increase availability and/or reduce cost.  I don’t know what pricing will be at this point because I don’t know what the volume of such an order would be.  I am thinking mostly n95 masks, but if there are other needs you have, please include them.

 

If you are interested in doing this, please email me back and let me know the following (jvanvalkenburg@nysaasc.org):

 

How many units (individual pieces) of the following items would you be interested in ordering?

N95 Masks

Surgical Masks

Earloop Masks

Surgical (sterile) gowns

Other non-sterile gowns

Anything else

 

Please respond at your earliest convenience so I can get an idea of the size of the order.  I am not sure of what the logistics for payment and delivery would be since this would be a single bulk order…  I guess we might need to develop NYSAASC Distribution Services!”

Stay Safe!

John J. Goehle, MBA, CASC™, CPA

Chief Operating Officer
Ambulatory Healthcare Strategies, LLC
Rochester: 585-594-1167
Albany: 518-594-1167
Fax: 585-391-1402
Publications: 858-633-6392


May 8, 2020, 11:07 am

Good Morning Everyone!

Happy Friday and Day 8 of Nurses’ Month! Hope you are all doing well!
Upcoming Education Opportunities
Next Week’s Mandatory Education Program Presentation
Judie D’Ambrosio will be presenting the general education section of the mandatory education program. Ambulatory Surgery Centers are required by CMS, State Licensure and Accreditation Organizations to provide annual training to staff on a variety of topics.  This module provides the training that is not specific to an individual center.  This training must be supplemented by facility specific training. For a full list of items to be covered click here.
May 14, 2020 from 9:00 AM to 1:00 PM EDT
This training is provided free to all Ambulatory Healthcare Strategies Retainer Clients.  For access, contact your AHS Coordinator.

Live  Attendees on May 14, 2020 will also receive a link after the day of the training to provide training to your staff for all of 2020.

Non-AHS clients can purchase access to this program after the session is recorded and use it to train all of their staff for a year.  You will only need to purchase access once to use for any number of staff members.  Return here after May 14, 2020 to purchase access to the recording

Pandemic Focused Infection Control Training
Laurie Roderiques will be presenting focused training related to COVID-19 infection control precautions. This includes hand hygiene, environmental cleaning specific to frequently touched surfaces, PPE use, reprocessing and HLD considerations, and considerations in specific clinical settings (ie. Preop/PACU/OR/Procedure Room).
Date and Time are TBD, but it will most likely be ready in the next few weeks.
Center Specific Education via Zoom Sessions
If you want something done specific to your center’s plans, policies, and protocols please contact your AHS Coordinator and arrangements will be made.
Stay Safe!

John J. Goehle, MBA, CASC™, CPA
Chief Operating Officer
Ambulatory Healthcare Strategies, LLC
Rochester: 585-594-1167
Albany: 518-594-1167
Fax: 585-391-1402
Publications: 858-633-6392

May 7, 2020, 11:12 am

Good Morning Everyone!

Happy Nurses’ Month! We’d like to send our deepest gratitude to all of the nurses out there working through this Pandemic! Hope you are all doing well!
National Practitioner Data Bank Query Fees Waived

The NPDB is temporarily waiving query fees (both one-time query and continuous query) to support our users’ efforts in combating the COVID-19 pandemic. Read More Here.
Reopening for NY ASCs
We want to remind everyone that they can reopen to do non-elective procedures, if they have the supplies/PPE needed and are adopting infection control protocols for COVID-19. Right now, elective cases are still NOT allowed in NYS for ASCs, however hospitals that meet certain requirements are allowed to do this in their HOPD. NYSAASC among other associations have written a letter to NYS to contend this disparity. For those that are evaluating reopening, please refer to our full day seminar here. For clients of AHS, please contact your primary contact for access.
ASCQR Program 2020 Reporting is Voluntary

As a reminder, the Centers for Medicare & Medicaid Services (CMS) announced exceptions and extensions for its quality reporting programs, including the ASC Quality Reporting (ASCQR) Program. CMS is granting an exception to ASCs for data collection and submission requirements for CY 2019 data that relate to CY 2021 payment determinations. This exception applies to all data submitted via the QualityNet Secure Portal for the May 15, 2020, deadline. You can still voluntarily report if you would like, but you will not be penalized for failing to do so. For ASCQR Program claims-based measures during the encounter period January 1, 2020, through June 30, 2020, claims will not be included in calculations.

CMS recommends that you always maintain active Security Administrator (SA) accounts for at least two people in your facility. By having your SAs log in periodically, you can ensure you do not have to start the registration process over for data submission next year.

 

Staff Update
Our staff is doing well, we have been working overtime to give everyone the support they need. Please let us know with at least a week’s notice if you plan on starting back up so there is enough time for the documentation that must be prepared. For those who have emailed and called and are waiting for responses, please know we will respond – due to COVID-19 we are experiencing a higher volume than normal.
ASC Finance, Accounting and  Reimbursement Seminar

Presented by: Coding Compliance Management, LLC and the ASC Podcast with John GoehleJune 11 and 12th 2020
Ambulatory Surgery Center Administrators, Nurse Managers and Business Office Managers face unique challenges in managing the financial aspects of an ASC. Join us for this intensive, two-day virtual conference to discuss all aspects of Finance, Accounting and Reimbursement in the ASC setting sponsored by Coding Compliance Management, LLC and the ASC Podcast with John Goehle. This conference is ideal for anyone interested in understanding basic finance principles as well as those that know finance but want to learn more how it differs in the ASC setting. The conference also will provide an understanding of reimbursement and coding in the ASC setting. We are applying for AEUs for CASC Certified Administrators and CEUs for Physician Practice Managers, Coding, and Billing professionals certified through AAPC.
Please stay safe and wish all your nurses a happy nurses week!

John J. Goehle, MBA, CASC™, CPA
Chief Operating Officer
Ambulatory Healthcare Strategies, LLC
Rochester: 585-594-1167
Albany: 518-594-1167
Fax: 585-391-1402
Publications: 858-633-6392

May 5, 2020, 11:48 am

Dear Friends and Colleagues,

First of all, please notice that I have removed the word “Daily” from our email title.  We are hoping to back off on the daily nature of these updates given that not much is changing every day now.  This is of course not necessarily a good thing since most parts of the country are still unable to do elective procedures and we aren’t getting a lot of guidance on when we will be able to do so.
Rest assured that we will always keep you informed of important regulatory issues as they evolve!
John on the ASCA Podcast
 
If you are a member of ASCA, make sure you listen to the upcoming ASCA Podcast where I was interviewed by ASCA CEO Bill Prentice regarding the PPP Program.  If you are a member, follow this link: https://www.ascassociation.org/asca/resourcecenter/latestnewsresourcecenter/covid-19/covid-19-podcast. Note that this is only available to ASCA Members.  As of the time this email was sent out – the episode hadn’t yet been posted.
 
Live Podcast this Afternoon
 
We will have a live Episode of the ASC Podcast with John Goehle on Tuesday, May 5, 2020 at 3:00 PM.  Today we will be updating our audience on the latest Coronavirus news, discuss how you can use the staff that you brought back on the Paycheck Protection Program, Discuss elective versus non-elective procedures, and review the importance of continuing to follow the regulations, even in these extraordinary times and take live listener questions.
Here is a link to the live episode on Podbean:
The episode will also be simulcast with video on Youtube, use the following link to go to my Youtube channel:
Respirator Use in Your ASC (eg. N95 or KN95)
 
I am well aware that we are all very tired of talking about respirators such as the N95 masks, but I did want to remind everyone that if you are using respirators, you of course have to fit test your employees for them, but a lesser known rule is that you must also have a respiratory protection program.  Clients of AHS will be receiving some updates to their policy program shortly to assure that the program is up to date.
If you want more information about this OSHA requirement, visit:
Certified Ambulatory Surgery Center Administrator (CASC)
I thought I would take a few minutes to remind all of our clients about the importance of pursuing certification as a CASC Administrator.  To learn more about the CASC Certification, visit www.aboutcasc.org.  As the demands on administrators in ASCs get more complex, the importance of becoming certified is more apparent.  All of us at AHS are committed to helping you prepare for certification.  For nurses, the most challenging section of the test is finance.  To that end, we are working with Coding Compliance Management, LLC to present the Finance, Accounting and Reimbursement Seminar on June 11 and 12, 2020.  The Seminar will be presented virtually.  For more information, visit:  http://ascpodcast.com/finance-accounting-reimbursement/
 
Past Conferences
For more information about our past conferences, visit: http://ascpodcast.com/premium-podcasts/
That’s it for now, stay safe!

John J. Goehle, MBA, CASC™, CPA
Chief Operating Officer
Ambulatory Healthcare Strategies, LLC
Rochester: 585-594-1167
Albany: 518-594-1167
Fax: 585-391-1402
Publications: 858-633-6392

May 4, 2020, 12:04 pm

Good morning Everyone,

Happy Monday!
 
Re-Opening / Re-Starting Elective Procedures
As we all know, the country is starting the process of re-starting our economy and elective procedures.  However, the timing varies dramatically by state.  For example, Ohio is re-starting Electives this week, but New York hasn’t even set a date yet for ASCs.  In NYS, Hospitals can restart elective procedures if they meet certain criteria – which to our knowledge, no hospitals are currently able to meet – but expect to shortly.
Remember, however, if you wish to re-open to do “non-elective” procedures, you may still do that at this time.
As you begin planning for restarting electives, you might want to refer to our virtual conference from last week.  For more information, visit: http://ascpodcast.com/a-roadmap-to-recovery/.  A recording is available for no charge for AHS Clients.
For AHS clients, please reach out to your AHS Contact to keep them informed regarding your plans.
Mandatory Education Programs
 
As you bring your employees back to work, either under the PPP program or in preparation for re-opening, you might find it advantageous to do your annual mandatory education programs earlier than necessary to take advantage of any “downtime” and to get activities out of the way that might slow things down later in the year – better to take advantage of this time.  AHS is working on a “general” mandatory education (that doesn’t vary by facility) and more specific mandatory training based on your specific center.  We are hoping to put together the general training by the end of next week – you can either have your staff “attend” it live or (more likely) use the recording of it to present to your staff at your convenience.
As for the specific training, your AHS contact and our director of educational services will reach out about timing for that program.
In-Service Training for Staff Preparing to Re-Open
 
We are working on an in-service program for your staff to help them know what will be different as we re-open for elective procedures.  This will be presented both live and recorded. More details to come.
Live Podcast Tomorrow
 
We are currently planning a live podcast at 3 pm tomorrow afternoon.  More details tomorrow morning as plans solidify
 
ASCA Podcast
 
I am being interviewed for an ASCA Podcast this week regarding the PPP Program.  I will provide more details once I have them.
Okay – that’s enough for today – please stay safe and reach out to us if you need anything!
John
Upcoming Live Virtual Conference:
ASC Finance, Accounting and  Reimbursement Seminar
Presented by:
Coding Compliance Management, LLC and the ASC Podcast with John Goehle
June 11 and 12th 2020

Ambulatory Surgery Center Administrators, Nurse Managers and Business Office Managers face unique challenges in managing the financial aspects of an ASC. Join us for this intensive, two-day virtual conference to discuss all aspects of Finance, Accounting and Reimbursement in the ASC setting sponsored by Coding Compliance Management, LLC and the ASC Podcast with John Goehle. This conference is ideal for anyone interested in understanding basic finance principles as well as those that know finance but want to learn more how it differs in the ASC setting. The conference also will provide an understanding of reimbursement and coding in the ASC setting. We are applying for AEUs for CASC Certified Administrators and CEUs for Physician Practice Managers, Coding, and Billing professionals certified through AAPC.

John J. Goehle, MBA, CASC™, CPA
Chief Operating Officer
Ambulatory Healthcare Strategies, LLC
Rochester: 585-594-1167
Albany: 518-594-1167
Fax: 585-391-1402
Publications: 858-633-6392

May 1, 2020, 12:22 pm

Good Morning to our Clients and Dear Friends,
Happy Friday! Thank you to everyone that attended yesterday’s conference! The recording will be available over the next few days.
We will evaluate on a daily basis the need for daily updates moving forward (we want to make sure that when we send out information it is new and useful), but please continue to reach out and we will send out updates as more guidance is released.
For our paid retainer clients, we are in the process of updating that section of the mandatory education that is not specific to each individual ASC as well as the Emergency Plan that can help update your policy and procedure manual.
N95 Discussion
Unfortunately, there are no black and white answers here. You will need to make a decision on how you will proceed using a multi-disciplinary team and performing a risk assessment based on the prevalence of COVID-19 in your area.
When the status of the patient is unknown (which is most likely the case without a reliable test) and there is a high prevalence in your area, the highest standard is for all individuals in the room to use fitted N95 Masks for all aerosolizing procedures and then changing them for each patient.
According to the guidance given by ACS, ASA, AORN, and AHA, elective procedures should not be done without having the PPE supply needed.
For urgent, non-elective procedures, the center should provide staff with PPE at the highest standard possible with the available supply and a risk assessment performed for anything that is lower than the highest standards attached with documentation for the reason why it could not be met. See the non-elective guidance from ASA.
Ultimately the decision you make for your center that will lead to your PPE protocol needs to be made taking into account the following factors (at a minimum):
  1. Types of procedures being done
  2. Ability and Reliability of Testing Patients
  3. Supply/availability of PPE
  4. Prevalence of COVID-19 in your area
  5. Availability of Fit Testing
  6. Other protections in place
Stay safe!

John J. Goehle, MBA, CASC™, CPA
Chief Operating Officer
Ambulatory Healthcare Strategies, LLC
Rochester: 585-594-1167
Albany: 518-594-1167
Fax: 585-391-1402
Publications: 858-633-6392