Can ASCs help with the COVID-19 surge?

Converting surgery centers into COVID-19 care sites could prove valuable, but the idea also raises questions about staffing, regulations and reimbursement, according to the Published Reporter.

CovidVent, a 75-member physician coalition, is one group calling for a federal executive order that would enable the conversion of surgery centers and hospital rooms into COVID-19 treatment facilities.

William Prentice, president and CEO of the Ambulatory Surgery Center Association, believes it could soon happen. In the coming days, Mr. Prentice told the Reporter he expects CMS will provide waivers allowing ASCs to keep patients overnight or provide services they don't currently offer.

"Once we get that flexibility, we can find the best way to help," Mr. Prentice said. "Decisions about how best to use ASCs need to be made in conjunction with hospitals at the local level."

It's yet to be determined how surgery centers would be reimbursed if they do treat COVID-19 patients. Plus, changing the scope of services that ASCs offer would require caution and consideration, healthcare experts told the Reporter.

"Even if we lifted the regulatory restrictions, surgery centers are licensed to do a certain thing," said Steven Dalbec, MD, a Missouri-based anesthesiologist who once ran a surgery center in Arizona. "If we could say, 'OK, we're going to lift all those restrictions and let you take care of critically ill patients,' it’s not something that could happen overnight."

Many surgery centers may not have the skills or supplies to treat critically ill patients, Dr. Dalbec said. Although some have fully configured operating rooms with ventilators, ASCs are also unlikely to stock all the medications used in an ICU.

Surgery centers could lack appropriate staffing levels and training, especially if anesthesiologists, nurses and nurse anesthetists are called to the front lines. But right now, needed specialists are sitting on the bench, according to Adam Schlifke, MD, an anesthesiologist and clinical assistant professor at Stanford (Calif.) University.

"Half of the surgery centers in New York are not doing anything," Dr. Schlifke said. "All these anesthesiologists and nurses who are sitting on the sidelines, they want to help. They don't know how to help. There's nowhere for them to help. What if they could work in the surgery centers?”

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