Why Compass ASCs are thriving after shutdowns — Testing, trust, inventory & more

Seven of Compass Surgical Partners' nine active ASCs met or exceeded volume expectations as of June 23, a feat following weekslong closures due to COVID-19, according to Stacy Danahy, RN, regional director of operations for the Raleigh, N.C.-based management company.

Ms. Danahy, who oversees ASCs in Florida, told Becker's ASC Review that most of them closed soon after a March 20 executive order restricted elective procedures. By March 25, almost all of the centers' employees were furloughed. The executive order wasn't expected to expire until May 11, meaning weeks of delayed care and lost revenue.

In the two weeks leading up to the expiration date, Compass ASCs began developing plans to bring staff back, procure supplies and develop screening and prioritization protocols. With this proactive approach, they were able to reopen swiftly when the order lifted a week early, on May 4.

While the centers opened quickly, they also did so cautiously, according to Ms. Danahy. Initially, the centers resumed cases at about 50 percent capacity.

"We could have opened the doors and [gone] full steam ahead, but we decided to make sure our community trusts us, we have our plans down [and we're] not fumbling in front of physician partners or patients," she said. "We did phenomenally well the first week or two and were able to open up to our schedule to full capacity by week three."

Many centers are now back to somewhat normal volumes not only because they have backlogs of cases to work through, but also because they earned the trust of patients and staff. Across the board, July volumes look "as strong — if not stronger — than June," Ms. Danahy said. "We're already seeing cases booked into August."

Volumes for one multispecialty facility in Port St. Lucie, Fla., are particularly exciting, she added. The center is on track to complete 505 cases, compared to the budgeted 423. Last year, the center's volume was under 300 cases.

So, how did Compass Surgical Partners achieve such a solid turnaround? The key was strong partnerships with physicians, staff, patients, community members and vendors, Ms. Danahy said. She explained that these relationships were the foundation for success in five key areas:

1. Inventory. When centers initially shut down, they were required to document inventory and report it to the state, in case local hospitals needed those supplies to handle COVID-19 surges. So, when the ASCs prepared to reopen, they used those inventory levels on hand to inform purchasing decisions and work with vendors.

"[We] kept a good relationship with our vendors even though we closed down and weren't having any income coming in," Ms. Danahy said.

2. Collections. Compass' centers put patient collections on hold during elective shutdowns and the weeks following. They didn't resume sending out balances and statements until July, according to Ms. Danahy.

"People have lost their jobs, and if you're asking them for money, it doesn't go over so well with the trust in the community," she said.

3. Screening. One of the biggest challenges for Compass ASCs as they reopened was determining when and how to test patients for COVID-19, if at all. Some centers opted to follow the lead of hospital partners and test all patients. One multispecialty facility does testing through a partnership with a lab because its ENT specialists face higher risk of COVID-19 exposure.

However, other centers declined to universally test patients "because ultimately, you can't control whether somebody's going to self-isolate" while awaiting results, Ms. Danahy said. Plus, testing access was flawed.

While COVID-19 testing protocols vary among Compass facilities, "every patient — regardless of what center they're at — is screened at least three times" before their procedure, Ms. Danahy said. "Their caregiver is screened. Anybody that's coming into the center is screened. They're going through the [CDC] questionnaire, their temperature is taken before they're admitted into the center."

4. Staffing. All staff members came back from furlough when the centers reopened, which was especially notable because some scrub technicians and others were making more on unemployment, Ms. Danahy said. Still, they returned before the executive order was lifted to start revamping operations, running through safety drills, familiarizing themselves with new protocols and securing inventory. Ms. Danahy attributed this loyalty to Compass' emphasis on cultivating and maintaining partnerships with communities and physicians alike.

5. Surge preparations. With volumes at or above pre-COVID-19 projections, Compass ASCs are preparing for a potential second wave by maintaining sufficient supplies and staff for booked cases, according to Ms. Danahy. Additionally, they've expanded cash reserves.

"We normally reserve enough for one to two months of bills for the center," she said. "[We're] bumping it up to make sure that if a resurge does happen, the center can recover from it."

Want to share your thoughts on this topic? Email Angie Stewart: astewart@beckershealthcare.com.

More articles on surgery centers:
Top-paying jobs in 2020 — Surgeons are No. 1
The state of ASCs in June 2020: 10 observations on supply chain, payers, staffing & future growth
Optum leads $26M funding round for digital therapeutics startup

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