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23 hour CMS rule

Proposed CMS changes to the 23 hour rule state, "ASC means any distinct entity that operates exclusively for the purpose of providing surgical services to patients not requiring an overnight stay following the surgical services....". "Overnight stay" is being defined as "patient's recovery requires active monitoring by qualified medical personnel, regardless of whether it is provided in the ASC, beyond 11:59 p.m of the day on which the surgical procedure was performed." Ultimately, there would be no planned 23 hour stays allowed under this rule, correct? What impact would this revision have on your ASC? Please comment.

CMS's changes can be viewed at the following site: http://www.ascassociation.org/redlinecfc.pdf

Started by: Mary Haskins (Director, Surgical Services/Director of Nursing) at January 6, 2012 (12:27 pm)

Comments and Responses

View: latest first

The DHEC regulation in our state defines the Ambulatory Surgery Center as a distinct entitiy that provides surgical care and discharge on the same day. Based on that description, we must have all patients out by 11:59. The Medicare statment does not change anything for us.

B. Rutledge (Administrator/Director/Manager/Owner/Exec. Officer) at January 9, 2012 (9:39 am)

Could someone please send a link to the proposed rule change? This is the first I am hearing of this. Thanks!!

Lynn Feldman (Administrator/Director/Manager/Owner/Exec. Officer) at January 9, 2012 (9:54 am)

I too would like the link. Does it say that no patient can be in the facility past 11:59??

thanks.

Donna Jacobsen (OR Manager/Supervisor) at January 9, 2012 (10:12 am)

Could someone please send a link to the proposed rule change? This is the first I am hearing of this. Thanks!!

Lynn Feldman (Administrator/Director/Manager/Owner/Exec. Officer) at January 9, 2012 (10:13 am)

I too would like the link. Does it say that no patient can be in the facility past 11:59??

thanks.

Donna Jacobsen (OR Manager/Supervisor) at January 9, 2012 (10:36 am)

Hi....... a "link" would be great since most info "pathways" are not "user friendly".......

This "rule" has been in effect for a while....so an updated interpretation would be interesting......my question is, "If a patient needed further care per se past the 23 hours, would they be transferred to another facility or would they, per MD decision, be allowed to stay past the 23 hours "under" the monitoring of "qualified staff" or just maybe "under" the monitoring of "UAPs i.e. aides, unlicensed staffers", or whatever "verbiage " would be deemed per legal terms?"
My opinions and my concerns,
Helen M. French RN,BSN

Helen French (Other) at January 9, 2012 (10:39 am)

I have not heard of any changes either. We have been doing 23 hour stay for 3 years in Orthopedics, we had a recent CMS surprise visit with no mention of any problems or changes.
I just googled this topic and there is nothing recent pulled from CMS or other.

G. White (Administrator/Director/Manager/Owner/Exec. Officer) at January 9, 2012 (11:07 am)

Sorry - not sure why it keeps reposting my comment.

Donna Jacobsen (OR Manager/Supervisor) at January 9, 2012 (11:21 am) [last edited on January 9, 2012 (11:22 am)]

I too would like the link. Does it say that no patient can be in the facility past 11:59??

thanks.

Donna Jacobsen (OR Manager/Supervisor) at January 9, 2012 (11:22 am)

I also have not heard of this proposed change and would appreciate a valid link or resource to review. The CMS site indicated nothing about this proposed change, nor could I find information on other sources I use. The current CMS definition for an ASC is a "distinct entity that operates exclusively for the purpose of providing surgical
services to patients not requiring hospitalization and in which the expected duration of services would not
exceed twenty-four hours following
admission." The recent update to the CfCs in October did not affect this definition, that I am aware of. Our facility does provide overnight services for some procedures, so I am very interested to find further information.

Missy Soliz (Other) at January 9, 2012 (11:52 am) [last edited on January 9, 2012 (11:53 am)]

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