What's worrying ASC leaders?

ASC leaders are navigating extensive industry shifts — from the recent surge in COVID-19 cases to CMS removing 258 procedures from the ASC payable list. 

Seven leaders spoke with Becker's ASC Review on their biggest concerns for the next six months. 

Editor's note: These answers were edited lightly for clarity and brevity. 

Question: What are you most worried about in the next six months?

Wendy King, BSN, RN. Director of The Corvallis (Ore.) Clinic Surgery Center: Healthcare is experiencing job openings without applicants or minimal applicants. This is for all positions, but most alarming is the lack of anesthesia providers. Our ASC contracts with an anesthesia group that staffs the local hospital, and they have been unable to recruit for open positions — they have providers retiring or moving. They have given their 180-day notice to the hospital and reassure us that they will continue to staff our ASC. I am sure there are a lot of reasons why there is turnover in all positions, but it seems these reasons have been magnified with COVID-19.

Helen Dickson, RN. Administrator of Premier at Exton (Pa.) Surgery Center: My biggest concern for the next six months is staying open if there is another COVID-19 surge.

Bonnie Lavoie, RN, CASC. Vice president of operations for the West Morris Surgery Center (Succasunna, N.J.): I am concerned about three items. First, CMS' proposal to remove many codes from the ASC-payable list, which would limit many centers from adding specialties such as vascular or cardiac. I'm sure there will be comments and pushback from these specialties, however. Secondly, vaccine mandates for a vaccine still under [emergency use authorization] may result in staffing issues for many centers. Finally, ASCs will lose their autonomy as they are "gobbled up" by hospitals and big healthcare systems.

Jennifer Myers, MBA, CASC. Business office manager at Pacific Surgical Center (Longview, Wash.): I think the biggest concern we have is the changing landscape we face dealing with COVID-19. This includes everything from changing restrictions and guidelines to whether we will have to limit the number of outpatient surgeries we will be allowed to do if we have another COVID-19 surge this coming winter.

Linda Deeming. Center director of Salud Family Health Centers (Fort Lupton, Colo.): In the next six months, staff retention is at the top of our list. Those who were not furloughed during COVID-19 are feeling "exhausted" from doing duties other than their "regular assigned" positions. Those who were furloughed or laid off are not "ready" to come back to work for a variety of reasons. As we have started operations towards a more-normal mode, we are certainly struggling with getting up to normal staffing and keeping the trained staff we currently have. The budget is also a concern; it's certainly a balancing act that is not easy at this point.

Ashley Fernandez. Administrator of Arrowhead Endoscopy & Pain Management Center (Glendale, Ariz.): With the COVID-19 case rates rising across the country, I feel we are in a better position compared to last year. We were forced to shut down last year in order to preserve hospital bed capacity and personal protective equipment supply. The hospital systems have more systems in place compared to last year to handle surges and supply chain issues. With that said, I would be lying if I were not concerned about what the next six months will look like. Our main focus is to secure PPE supply and to continue the necessary mitigation efforts to prevent an exposure at our ASC, as well as continuing to make adjustments whenever changes come down the pipeline during the pandemic.

David Pandit. Administrative director of ancillary services for Texas Health Huguley Hospital (Fort Worth): The main concern I have dealing in operations and the clinical hospital arena is the COVID-19 delta variant that could impact the outpatient business and reflect on the hospital (earnings before interest, taxes, depreciation and amortization) at the end of the year.

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