'Future remains healthy for us' despite challenges from pandemic, says Maryland ASC admin

Raghu Reddy, executive administrator of SurgCenter of Western Maryland in Cumberland outlines how his center is recovering from the pandemic and thinking about the future.

Question: What is your plan for resuming elective procedures in the future? What will be different at the center?

Raghu Reddy: We have created a three-phase approach to ramp our case volume. Phase one is for elective, essential cases lasting two to three weeks; phase two is for elective, semi-urgent cases lasting two to three weeks; and phase three is for routine elective procedures. These stages are not set in stone and can be altered based on several factors, such as the COVID-19 trend in our area, the governor's orders, and the recommendations made by our hospital partner.

We are incredibly conscious of our responsibility towards our patients, staff, and the community to avoid any unnecessary spread and have taken extraordinary precautions with stringent infection control and PPE requirements. We also have a three-person committee that is reviewing the cases and ensuring that the case selection meets the requirements for an essential procedure until we reach phase three. A lot has changed due to this COVID-19 outbreak and we have added additional measures to our already stringent infection guidelines and PPE protocols.

We will continue to proceed with extreme caution adhering to all CDC, HHS and ASCA recommendations and will have these COVID-19 protocols in place for an unforeseeable time. However, we are using this downtime to review our key performance indicators, and any operational efficiencies we can improve upon once we resume the normal operations. The staff furlough was stressful, and but we are thankful for everyone for being so supportive and understanding during this pandemic.

Q: How has the pandemic affected your plan for growth in the next 6 to 12 months?

RR: This pandemic has impacted us just as it did most of the ASCs in the country. We have about 400 case backlog to make up whenever we resume normal operations with our usual case volume. If the spread does not slow down, we anticipate losing the case volume as we will be constrained to how many cases we can perform each day, which will, in turn, impact our growth plan.

Due to our recent affiliation with UPMC Western Maryland Health System, we have plans to expand the current specialties and to add new ones over the next six to 12 month period. This pandemic, unless it's contained and/or until we meet the gating criteria, will significantly slow down our expansion plan this year while impacting our overall financial projections if we cannot resume normal operations at our center within a month or sooner.

We are cautiously optimistic and are already noticing some job losses which might impact the elective procedures due to loss of insurance coverage. However, we firmly believe that in the long run, the future remains healthy for us and the fact that we are the only free-standing multispecialty ASC in a 65-mile radius.

Q: What does the "new normal" look like for ASCs?

RR: The new normal for us will be to adapt to new work schedules, limit the number of people in the building, everyone requiring a face mask while in the center and ensuring that we operate with heightened caution and pace ourselves to perform these cases safely. These are even more important when we start performing cases where an airway is involved, and extra protections are in place for our staff and anesthesia providers.

The N95 masks, along with face shields and gowns, are necessary for everyone close to the airway, and any shortage in PPEs and N95 masks will limit what we can do at the center. From the business perspective, it is going to be challenging for a while to manage the accounts payable or any short liabilities until this pandemic slows down, and the RCM becomes normal. A great deal of anticipation and careful planning should be in place for us. Still, the execution is critical to safely care for our patients while coordinating with the local hospital and limiting the spread in the community.

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