Generated by All in One SEO v4.9.10, this is an llms.txt file, used by LLMs to index the site. # Progressive Surgical eSupport Membership The leading online membership program for ASC nurse leaders ## Sitemaps - [XML Sitemap](https://progressivesurgicalsolutions.com/sitemap.xml): Contains all public & indexable URLs for this website. ## Posts - [ASC Industry News](https://progressivesurgicalsolutions.com/asc-industry-news-september2025/) - [ASC Industry News](https://progressivesurgicalsolutions.com/asc-industry-news-august2025-2/) - [ASC Industry News](https://progressivesurgicalsolutions.com/asc-industry-news-july2025/) - [ASC Industry News](https://progressivesurgicalsolutions.com/asc-industry-news-june2025/) - [ASC Industry News](https://progressivesurgicalsolutions.com/asc-industry-news-may2025/) - [ASC Industry News](https://progressivesurgicalsolutions.com/asc-industry-news-august2024/) - [ASC Industry News](https://progressivesurgicalsolutions.com/asc-industry-news-july2024/) - [ASC Industry News](https://progressivesurgicalsolutions.com/asc-industry-news-june2024/) - [ASC Industry News](https://progressivesurgicalsolutions.com/asc-industry-news-october2023/) - [The Key to Top-Performing ASCs: Physician Leadership](https://progressivesurgicalsolutions.com/the-key-to-top-performing-ascs-physician-leadership/) - The Key to Top-Performing ASCs: Physician Leadership Regina Boore, MS, BSN, RN, CASC Over the last 33 years, I have had the privilege of visiting and engaging in some way with hundreds of ASCs across the USA and in Canada and Puerto Rico. e spectrum of the field is vast and disparities are immediately perceptible. e - [Most Prevalent ASC Deficiencies in 2023](https://progressivesurgicalsolutions.com/most-prevalent-asc-deficiencies-in-2023/) - [Podcast: Advancing Surgical Care](https://progressivesurgicalsolutions.com/podcast-advancing-surgical-care/) - [Developing Your ASC Leaders](https://progressivesurgicalsolutions.com/developing-your-asc-leaders/) - [The Unity Benefits of Community](https://progressivesurgicalsolutions.com/the-unity-benefits-of-community/) - [Key Data to Lead Your Business](https://progressivesurgicalsolutions.com/key-data-to-lead-your-business/) - [The ASC Nurse Leadership Conference 2022](https://progressivesurgicalsolutions.com/the-asc-nurse-leadership-conference-2022/) - [10 Tips to Enhance the ASC Patient Experience](https://progressivesurgicalsolutions.com/10-tips-tp-enhance-the-asc-patient-experience/) - [ASC Quality Improvement: It Takes a Village](https://progressivesurgicalsolutions.com/asc-quality-improvement-it-takes-a-village/) - [Heightened Awareness and New Normals Position ASCs to Chart a New Course](https://progressivesurgicalsolutions.com/heightened-awareness-new-normals-asc/) - Notes from the Field | Heightened Awareness and New Normals Position ASCs to Chart a New Course Administrative EyeCare, July/August 2020 Written by: Regina Boore, MS, BSN, RN, CASC "Now, however, living through this pandemic has turned prevailing wisdom on its head. COVID-19 has forced us all to think differently. lt has become the great - [ASCs are the Clear Choice for Cataract Surgery](https://progressivesurgicalsolutions.com/asc-clear-choice-for-cataract-surgery/) - ASCs are the Clear Choice for Cataract Surgery Ophthalmology Management | The Ophthalmic ASC, February 2021 Written by: Regina Boore, MS, BSN, RN, CASC "Cataract surgery is one of those rare procedures that goes beyond solving a problem or curing a disease; it literally transforms lives. Sight restoration through cataract surgery markedly improves quality of - [Survey Says: COVID-19 Burnout is Real](https://progressivesurgicalsolutions.com/survey-says-covid-19-burnout-is-real/) - [The Cost of Compliance: COVID and Ophthalmic ASCs](https://progressivesurgicalsolutions.com/the-cost-of-compliance-covid-and-ophthalmic-ascs/) - [Documenting your ASC COVID Emergency Response](https://progressivesurgicalsolutions.com/documenting-your-asc-covid-emergency-response/) - [Survey Watch](https://progressivesurgicalsolutions.com/asc-survey-watch/) - Survey Watch Administrative EyeCare, Jul/Aug 2019 Written by: Vanessa Sindell, MSN, BSN, RN "Ambulatory Surgery Centers(ASCs) have been in the news lately and for all the wrong reasons. In March 2018, USA Today and Kaiser Health News joined forces and published two such articles: “How a Push to Cut Costs and Boost Profits at Surgery - [Informed Consent in Your ASC](https://progressivesurgicalsolutions.com/informed-consent-in-your-asc/) - Informed Consent in Your ASC Administrative EyeCare, Sep/Oct 2019 Written by: Debra Stinchcomb, MBA, BSN, RN, CASC "While ASCs require that the patient gives an informed consent, the process actually begins in the surgeon’s office. Informed consent is a process rather than “the” form that we are all so focused on getting signed. The goal - [Risk Assessments for ASCs](https://progressivesurgicalsolutions.com/risk-assessments-for-ascs/) - Risk Assessments for ASCs Administrative EyeCare, May/June 2020 Written by: Debra Stinchcomb, MBA, BSN, RN, CASC "Every ambulatory surgery center (ASC) has a Quality Assessment and Performance Improvement (QAPI) program. This program includes risk management (RM) activities used to identify, prioritize, and proactively respond to threats while maximizing opportunities for improvement. While incident or occurrence - [Making a Difference | Nursing Leadership](https://progressivesurgicalsolutions.com/making-a-difference-nursing-leadership/) - Making a Difference | Nursing Leadership Administrative EyeCare, March/April 2020 Written by: Dawn Laundrup, MBA, MHA, BSN, RN "Ambulatory surgery center (ASC) nurse leaders are faced with juggling multifaceted patient care, regulatory standards, and countless other responsibilities in a competent, efficient fashion. While these tasks are the foundation of daily duties, the ability to manage - [Passing the Torch: Empowering Future ASC Nurse Leaders](https://progressivesurgicalsolutions.com/passing-the-torch-empowering-future-asc-nurse-leaders/) - [Documentation Best Practices in the ASC](https://progressivesurgicalsolutions.com/documentation-best-practices-in-the-asc/) - [Common ASC Deficiencies to Look Out For](https://progressivesurgicalsolutions.com/common-asc-deficiencies-to-look-out-for/) - [How to Increase Cultural Sensitivity in Your ASC](https://progressivesurgicalsolutions.com/increase-cultural-sensitivity-asc/) - [How to Successfully Talk to Surveyors](https://progressivesurgicalsolutions.com/how-to-successfully-talk-to-surveyors/) - [Developing the Leader Within: Choose Your Energy](https://progressivesurgicalsolutions.com/leadership-choose-your-energy/) - [Promoting a Culture of Safety in Your ASC](https://progressivesurgicalsolutions.com/promoting-a-culture-of-safety-in-your-asc/) - [Are You Primed for Premium?](https://progressivesurgicalsolutions.com/are-you-primed-for-premium/) - Are You Primed for Premium? The Ophthalmic ASC, August 2018 Featuring Vanessa Sindell, MSN, BSN, RN By setting up to provide state-ofthe-art refractive cataract surgery, an ASC can differentiate itself as a technologically advanced facility where leading surgeons want to bring their cases. “It increases your market reach,” says Vanessa Sindell, MSN, BSN, RN. - [Emergency Preparedness Update](https://progressivesurgicalsolutions.com/emergency-preparedness-update/) - Emergency Preparedness Update Administrative EyeCare Jan/Feb 2019 By: Crissy Benze, MSN, BSN, RN Blizzards, floods, wildfires, and hurricanes have killed thousands, cost billions of dollars, and stressed local healthcare systems, emergency responders, and utilities in recent years. In response, the Centers for Medicare and Medicaid Services (CMS) proposed a new Emergency Preparedness (EP) rule to - [Keeping Tabs: Stay Up to Date on Evolving ASC Infection Control Strategies](https://progressivesurgicalsolutions.com/keeping-tabs-stay-up-to-date-on-evolving-asc-ic-strategies/) - Keeping Tabs: Stay Up to Date on Evolving ASC Infection Control Strategies Administrative EyeCare Nov/Dec 2018 By: Vanessa Sindell, MSN, BSN, RN In an environment of ever-increasing scrutiny of infection control practices, it is important that ambulatory surgery center (ASC) leaders stay up to date. Maintaining compliance with current infection control regulations allows ASCs to - [Road Map for Integrating MIGS](https://progressivesurgicalsolutions.com/road-map-for-integrating-migs/) - Road Map for Integrating MIGS Logistical tips for bringing today's glaucoma surgery to your ASC The Ophthalmic ASC, October 2018 Featuring Vanessa Sindell, MSN, BSN, RN In 2018, chances are good that minimally invasive glaucoma surgeries (MIGS) are either in your ophthalmic ASC or coming soon. New technologies that were exciting for glaucoma specialists from - [How Does Your Surgical Tech Training Measure Up?](https://progressivesurgicalsolutions.com/how-does-your-surgical-tech-training-measure-up/) - How Does Your Surgical Tech Training Measure Up? The Ophthalmic ASC, May 2018 Featuring Vanessa Sindell, MSN, BSN, RN In many respects, you could say the surgical technician — or scrub tech — serves as the “center” of the ASC team. Far from simply “snapping” the surgeon the next instrument, these key players are also - [Operation Patient Satisfaction](https://progressivesurgicalsolutions.com/operation-patient-satisfaction/) - Operation Patient Satisfaction Focusing on the Fundamentals of Care from Pre-Op to Post-Op The Ophthalmic ASC, February 2018 Featuring Vanessa Sindell, MSN, BSN, RN As an owner or operator of an ASC, your goal is to keep a steady flow of patients coming through your doors. Whether you operate a small surgery center or a - [The Why, What and How of ASC Staff Training](https://progressivesurgicalsolutions.com/the-why-what-and-how-of-asc-staff-training/) - The Why, What, and How of ASC Staff Training Administrative EyeCare Sep/Oct 2018 Regina Boore, MS, BSN, RN, CASC Physician and writer Atul Gawande addressed the complexity, cost, and surprising lack of efficacy of our healthcare system in a TED Talk on Apr 16, 2012, called “How do we heal medicine?” He concluded our medical - [In Flux: How Private Equity (PE) is Changing Our Work Activities](https://progressivesurgicalsolutions.com/in-flux-how-private-equity-pe-is-changing-our-work-activities/) - [Tips For Making An ASC's Medical Records More Compliant](https://progressivesurgicalsolutions.com/tips-for-making-an-ascs-medical-records-more-compliant/) - Tips For Making An ASC's Medical Records More Compliant Administrative EyeCare May/Jun 2018 Vanessa Sindell, BSN, RN Medical records are legal documents, and it is critically important they are consistently accu­rate, thorough, and or­ganized. You only have to be deposed once to fully appreciate the importance of the medical record. Months or years after a - [ASC Staffing Roles and Considerations](https://progressivesurgicalsolutions.com/asc-staffing-roles-and-considerations/) - ASC Staffing Roles and Considerations Administrative EyeCare Jan/Feb 2018 Regina Boore, MS, BSN, RN, CASC Debra Stinchcomb, MBA, BSN, RN, CASC Allied Ophthalmic Personnel (AOP) perform a wide variety of tasks and procedures under the direction of a licensed ophthalmologist in the practice setting. They collect data, perform procedures, administer medication and treatments, and supervise - [Compounding Problems](https://progressivesurgicalsolutions.com/compounding-problems/) - Compounding Problems Administrative EyeCare Nov/Dec2017 Regina Boore, MS, BSN, RN, CASC Anthony Dziabo Mark T. Livingston In the fall of 2011 more than 20 people were injured when compounding pharmacies repackaged the anti-cancer drug, Avastin, into smaller doses for treating macular degeneration. Many lost their eye-sight and one patient suffered brain - [The Never-Ending Quest for Quality](https://progressivesurgicalsolutions.com/the-never-ending-quest-for-quality/) - The Never-Ending Quest for Quality Administrative Eyecare July/Aug 2017 Regina Boore, MS, BSN, RN, CASC In recent years, surgery centers have heightened their focus on quality. An active Quality Assess-ment and Performance Improvement (QAPI) program has always been required for accredited surgery centers. Fortunately, the Medicare requirements effected in 2009 (416.43 Condition for Coverage: Quality - [Controlling Infection in the ASC](https://progressivesurgicalsolutions.com/controlling-infection-in-the-asc/) - Controlling Infection in the ASC The Ophthalmic ASC October 2017 With a low incidence of infection, ASCs dispute sterilization standards that threaten the bottom line Robert Calandra, Featuring Regina Boore, MS, BSN, RN, CASC Cataract surgery is among the most widely performed operations in ASCs across the United States, with 2.6 million surgeries in 2010, according to the - [Creating a Culture of Safety in your ASC](https://progressivesurgicalsolutions.com/creating-a-cultur-of-safety-in-your-asc/) - Creating a Culture of Safety in your ASC AE Magazine March/April 2017 Regina Boore, MS, BSN, RN, CASC Culture encompasses the values and attitudes of the employees in an organization. Employees working in an unhealthy culture are individually focused, placing priority on their wants and needs. In a healthy culture, employees share values and attitudes. - [Office Based Cataract Surgery: Questions and Concerns](https://progressivesurgicalsolutions.com/office-based-cataract-surgery-questions-and-concerns/) - Office Based Cataract Surgery: Questions and Concerns Lori Baker-Schema, MBA, EdD EyeNet Magazine Commentary by Regina Boore, MS, BSN, RN, CASC I am frequently asked about my opinion on cataract surgery moving into an office based environment. This has been a hot topic for a while in our industry, especially since the release of the Kaiser - [Tips for Femtosecond Laser Cataract Surgery](https://progressivesurgicalsolutions.com/tips-for-femtosecond-laser-cataract-surgery/) - Tips for Femtosecond Laser Cataract Surgery Jared R. Younger, MD, MPH Regina Boore, MS, BSN, RN, CASC Pearls for smoothly integrating a new laser and quickly achieving profitability A femtosecond laser is a major capital investment for any ASC. After much planning and deliberation, our private ophthalmic ASC in Newport Beach acquired a laser for - [Experts Can Help ASC Leaders Solidify Building Safety](https://progressivesurgicalsolutions.com/experts-can-help-sac-leaders-solidify-building-safety/) - Experts Can Help ASC Leaders Solidify Building Safety Featuring: Debra Stinchcomb, MBA, BSN, RN, CASC For an ambulatory surgery center (ASC), maintaining a safe physical environ- ment for patients generally falls to the administrator and governing board. 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[Medical Staff Credentialing Overview](https://progressivesurgicalsolutions.com/md-staff-credentialing-overview/) - [Medication Management: Infection Control](https://progressivesurgicalsolutions.com/medication-management-infection-control/) - [Life Safety Code: HVAC Maintenance](https://progressivesurgicalsolutions.com/lsc-hvac-maintenance/) - [Display Certificate](https://progressivesurgicalsolutions.com/display-certificate/) - [wdm_display_certificate] - [OSHA: Bloodborne Pathogen Plan](https://progressivesurgicalsolutions.com/osha-bloodborne-pathogen-plan/) - [Accreditation Association for Ambulatory Health Care (AAAHC)](https://progressivesurgicalsolutions.com/resources/accreditation-overview/accreditation-association-for-ambulatory-health-care-aaahc/) - [OSHA: Hazard Communication Program](https://progressivesurgicalsolutions.com/osha-hazard-communication-program/) - [Government Resources](https://progressivesurgicalsolutions.com/resources/government-resources/) - [Professional Organizations](https://progressivesurgicalsolutions.com/resources/professional-organizations/) - [Facility Library](https://progressivesurgicalsolutions.com/resources/facility-library/) - [Patient Safety: Safety Resources](https://progressivesurgicalsolutions.com/patient-safety-safety-resources/) - [Medication Management: Medication Labeling](https://progressivesurgicalsolutions.com/medication-management-medication-labeling/) - [Patient Safety: Universal Protocol](https://progressivesurgicalsolutions.com/patient-safety-universal-protocol/) - [Leadership: Resources](https://progressivesurgicalsolutions.com/leadership/leadership-resources/) - [Leadership: Purpose](https://progressivesurgicalsolutions.com/leadership/leadership-purpose/) - [Leadership: Emotional Intelligence](https://progressivesurgicalsolutions.com/leadership/leadership-emotional-intelligence/) - [LSC: Inspection, Testing, and Maintenance](https://progressivesurgicalsolutions.com/lsc-inspection-testing-and-maintenance/) - [LSC: Initial Approval Documents](https://progressivesurgicalsolutions.com/lsc-initial-approval-documents/) - [Surgical Review Corporation (SRC)](https://progressivesurgicalsolutions.com/resources/accreditation-overview/surgical-review-corporation-src/) - [Are You Licensed? (Staff)](https://progressivesurgicalsolutions.com/are-you-licensed-staff/) - [OSHA: Injury and Illness Prevention](https://progressivesurgicalsolutions.com/osha-injury-and-illness-prevention/) - [HIPAA: Disaster Recovery Plan](https://progressivesurgicalsolutions.com/hipaa-disaster-recovery-plan/) - [HIPAA: Risk Assessment](https://progressivesurgicalsolutions.com/hipaa-risk-assessment/) - [HIPAA: Privacy vs. Security Officer](https://progressivesurgicalsolutions.com/hipaa-privacy-vs-security-officer/) - [Medication Management: Resources](https://progressivesurgicalsolutions.com/medication-management-resources/) - [Medication Management: Formulary](https://progressivesurgicalsolutions.com/medication-management-formulary/) - [Fire Safety](https://progressivesurgicalsolutions.com/fire-safety/) - [My Transcript](https://progressivesurgicalsolutions.com/my-transcript/) - [web demo thank you](https://progressivesurgicalsolutions.com/web-demo-thank-you/) - [Tools](https://progressivesurgicalsolutions.com/tools/) - [Account](https://progressivesurgicalsolutions.com/account/) - [Resources](https://progressivesurgicalsolutions.com/resources/) - Resources This section has general information useful to ASCs including links to government agencies and professional organizations, as well as information on accreditation and ASC informations systems. We also have our recommendations for a facility resource library and products which have been recommended by eSupport subscribers! Let us know if you have suggestions or ideas - [Business](https://progressivesurgicalsolutions.com/business-consulting/) - [Updated](https://progressivesurgicalsolutions.com/edit-my-profile/updated/) - Your contact information has been successfully updated! ## Forums - [ASC Inspections](https://progressivesurgicalsolutions.com/forums/forum/asc-inspections/) - Is it time for re-accreditation? Did CMS just make a visit? Am I meeting OSHA requirements? - [Other](https://progressivesurgicalsolutions.com/forums/forum/other/) - Don't see your category above, don't worry....look here! You may find what you are looking for. If not go ahead and start a new thread. - [HIPAA](https://progressivesurgicalsolutions.com/forums/forum/hipaa/) - HIPAA is more than patient confidentiality and required releases. Learn about what you need to do to keep your facility data, emails and EMR secure. We bet it's more than you think - [Human Resources](https://progressivesurgicalsolutions.com/forums/forum/human-resources/) - PTO, breaks, personnel files...HR can be overwhelming! Ask us for help. - [Quality Management](https://progressivesurgicalsolutions.com/forums/forum/quality-management/) - A QAPI program is a requirement and must be integrated into many parts of your ASC's operation. Ask us how? - [Emergency Preparedness](https://progressivesurgicalsolutions.com/forums/forum/disaster-preparedness/) - What are you going to do in a case of emergency? What policies is CMS looking for? Do I have reach to reach out to my local community to be a part of the emergency preparedness plan? - [Infection Control](https://progressivesurgicalsolutions.com/forums/forum/infection-control/) - Infection Control has taken off..Now on the minds of every surveyor and scrutinized like no other regulation. Make sure you compliance by asking the experts! - [Medications Management](https://progressivesurgicalsolutions.com/forums/forum/medications-management/) - Compounding, labeling, single dose versus multi dose vials. Look here to get a handle on medication management. - [OSHA](https://progressivesurgicalsolutions.com/forums/forum/osha/) - Sharps containers, regulated waste vs. pharmaceutical waste, engineered controls. What are the rules and regulations am I required to follow? - [Patient Safety](https://progressivesurgicalsolutions.com/forums/forum/patient-safety/) - Patient safety is a healthcare discipline that emphasizes the reporting, analysis, and prevention of medical error that often leads to adverse healthcare events. Are you following best practices? - [Policy And Procedures](https://progressivesurgicalsolutions.com/forums/forum/policy-and-procedures/) - Have a question on policy and procedures and cant find it on the policy and procedure page? Ask us, we can help. - [Life Safety Code](https://progressivesurgicalsolutions.com/forums/forum/life-safety-code/) - CMS expects a “complete and comprehensive” assessment of LSC compliance with every ASC Medicare survey. Get help navigating the new requirements per the 2012 edition of NFPA's Life Safety Code. - [Business Operations](https://progressivesurgicalsolutions.com/forums/forum/business-operations/) - Run your business office better . Improve collections, fee schedules and insurance questions, scheduling, administrative job duties, financial benchmarks and more. - [Contracts](https://progressivesurgicalsolutions.com/forums/forum/contracts/) - CMS requires that your contracted services are provided in a safe and effective manner. What does that mean and what contracts do I need? - [Credentialing](https://progressivesurgicalsolutions.com/forums/forum/credentialing/) - One of the most frequently sited deficiencies...How are your credentialing files going to match up? Can I run the AMA proof even though I haven't received the application? Do CRNA's have to be credentialed the same as physicians? - [COVID-19](https://progressivesurgicalsolutions.com/forums/forum/covid-19/) - The COVID-19 Pandemic and its impact on your ASC operations is ever evolving. Get the answers and clarifications you need and find out what your peers are doing to implement new protocols. ## Topics - [using enzymatic cleaners on ophthalmic](https://progressivesurgicalsolutions.com/forums/topic/using-enzymatic-cleaners-on-ophthalmic/) - I have seen a lot of conversation regarding using enzymatic cleaners on ophthalmic instruments, especially on ASCA. For 20 years plus we have been under the understanding that this was a huge no-no for ophthalmic instruments. We have never had AAAHC nor CMS cite us for not using. We have our AAAHC survey in 2 - [Allied Health Professional Recredentialing (PA)](https://progressivesurgicalsolutions.com/forums/topic/allied-health-professional-recredentialing-pa/) - On the policy for AHP recredentialing it states An Annual Competency Assessment will be completed annually. Where can I find an annual competency assessment for a PA that works under a surgeon? - [Surgical Time Out](https://progressivesurgicalsolutions.com/forums/topic/surgical-time-out/) - I noticed in the survey watch that CMS cited a facility for "failing to ensure staff verbally conducted a Fire Risk Assessment Time Out prior to the start of the surgical procedure." I do not see anything regarding this on the Surgical Time Out Policy. I am also not able to find a specific conditions - [YAG Laser](https://progressivesurgicalsolutions.com/forums/topic/yag-laser/) - Do Yag procedures have to be done in the OR? Can they be done in a pacu bay with just the closed curtain? - [EPA training](https://progressivesurgicalsolutions.com/forums/topic/epa-training/) - We had a Joint Commission inspection and they are requiring DOT and EPA training. The DOT training is available through VGM Health and Stericycle but I am not finding anything about ASC specific EPA trainings. Anyone ever heard of this or know of what specific training we are supposed to have? We have been with - [Laser only ASC](https://progressivesurgicalsolutions.com/forums/topic/laser-only-asc/) - Due to retirement of a provider we have a Medicare certified ASC in California that is no longer doing any surgery. The current provider is operating in another facility but is doing lasers at this facility. We currently have not been billing them in the ASC but would like to start. Since the facility will - [Elevated blood pressure policy](https://progressivesurgicalsolutions.com/forums/topic/elevated-blood-pressure-policy/) - We are wanting to add a policy to guide the nurses on when we should automatically cancel a surgery due to elevated blood pressure or blood sugar. Does anyone have a policy they are willing to share? I like having a starting point when creating a new policy. Thanks in advance. - [Annual Tb Education](https://progressivesurgicalsolutions.com/forums/topic/annual-tb-education/) - Hi! Does PS have education strictly on TB- that would qualify for yearly education? - [OR temperature](https://progressivesurgicalsolutions.com/forums/topic/or-temperature/) - Is there a policy or protocol on PSS if OR temperature falls out of range for an extended period of time? Thank you! - [Temporary Privileges](https://progressivesurgicalsolutions.com/forums/topic/temporary-privileges-2/) - If using a Locum CRNA for a single day of Surgery, what are the credentialing requirements? Do I need to complete an entire Credentialing Checklist or just the Temporary Privileges Application and verification of BLS, ACLS, OIG, DEA, Malpractice? We use locum CRNA's pretty often and I have been fully credentialing each of them for - [Board of Phamracy location change](https://progressivesurgicalsolutions.com/forums/topic/board-of-phamracy-location-change/) - We are moving our ASC. Our lease expired so we will bne moving lcoations to a new ASC. We are keeping all legal items the same- NName, Tax ID NPI etc.. Does anyone know how to do a location change with the Board of Phamacy? - [Biologicals](https://progressivesurgicalsolutions.com/forums/topic/biologicals/) - What does CMS require for timing of biological results prior to running instruments? - [controlled substances](https://progressivesurgicalsolutions.com/forums/topic/controlled-substances-3/) - Question: This is under your medication management: There is a dated controlled substance inventory and a control record that includes the use of controlled substances on individual patients. Such records must be kept in the form of a sequentially numbered, bound journal from which pages may not be removed, or in a tamper -proof, secure - [ADA 504 Rule](https://progressivesurgicalsolutions.com/forums/topic/ada-504-rule/) - Good morning everyone, I am looking for some clarification and guidance on the ADA 503 rule which will be in effect on 7/8/2026. We are an ENT ASC and we do weigh our patients day of surgery. We have one scale for our ASC, but it doesn't accommodate a wheelchair. We rarely have patients that - [Electronic Record Chart Note Generation](https://progressivesurgicalsolutions.com/forums/topic/electronic-record-chart-note-generation/) - We are having some back and forth with our providers on who should be "generating" the chart/procedure notes once the procedure is completed. I will upload a picture of what our system looks like. We currently have our nurses generate the Chart note for the in OR surgical procedures, but have the physicians generate the - [credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-24/) - A CRNA that worked for us 4 years ago is returning as PRN. Do I have to begin a new employee file? Do I need new references? I realize I will need current documents but I didn't know if I could use any of the old information I already have? - [Tissue Policy](https://progressivesurgicalsolutions.com/forums/topic/tissue-policy/) - Are there any policies available relating to tissue? We are an ophthalmology ASC and have an Oculoplastic doctor in house who performs a variety of eyelid/brow procedures which results in tissue excision/waste. We rarely send specimens for his routine eye lid cases (unless excising a lesion for biopsy which is handled differently) but am looking - [Lens choice on Consent](https://progressivesurgicalsolutions.com/forums/topic/lens-choice-on-consent/) - Is there a requirement that the patients IOL choice be on the consent? Such as "Monofocal" "Toric" "Multifocal" "LAL" ETc - [Testing Strips to test water quality](https://progressivesurgicalsolutions.com/forums/topic/testing-strips-to-test-water-quality/) - Hi! Are there any testing strips/ vials for testing water quality? This is new to our facility. We use tap water to wash our instruments and distilled water for our autoclaves, Any assistance would be greatly appreciated. Thanks! - [TB testing in physician owned surgery center- CALIFORNIA](https://progressivesurgicalsolutions.com/forums/topic/tb-testing-in-physician-owned-surgery-center-california/) - Hi, I have been trying to find an answer re: TB testing in California for a physician owned plastic surgery center in California. We are at an extremely low risk surgery center and do only outpatient and elective surgeries. Cal Osha defers it to state and local health dept, CDPH defers it to the Medical - [Disposal of Flushes/Syringes](https://progressivesurgicalsolutions.com/forums/topic/disposal-of-flushes-syringes/) - What are the guidelines for disposal of syringes/flushes? We have some ASC staff members who have worked in the hospital and it is a requirement at the hospital to place used syringes/flushes in the sharps containers. I'm not sure of the reasoning for this and wondering what your recommended guidelines are for syringe disposal? Is - [Clinical staff scheduling their own appointments?](https://progressivesurgicalsolutions.com/forums/topic/clinical-staff-scheduling-their-own-appointments/) - We are a surgery center that is a separate facility from our clinic. We've recently run into an issue where a clinical staff member not only signed themselves up and scheduled their own surgery but also ran their own prior authorization. Is this any guidelines or literature against doing this? It feels on our end - [COVID reporting](https://progressivesurgicalsolutions.com/forums/topic/covid-reporting/) - What is the policy on COVID reporting for staff now? - [Authorization to Verbally Discuss Protected Health Information](https://progressivesurgicalsolutions.com/forums/topic/authorization-to-verbally-discuss-protected-health-information/) - I'm trying to find guidance on this topic. What are the guidelines legally for Authorization to Verbally Discuss Protected Health Information with individuals other than the patient (i.e. their husband). - [Flu Vaccine Reporting](https://progressivesurgicalsolutions.com/forums/topic/flu-vaccine-reporting-2/) - We are an ASC in Oregon, are we required to report Flu Vaccination for 2025 to NHSN or are okay just report to the state of Oregon? - [Patient Satisfaction Surveys](https://progressivesurgicalsolutions.com/forums/topic/patient-satisfaction-surveys-4/) - Since CMS does not allow us to perform surveys on the same population that we are sending to our OAS CAHPS, then how are facilities meeting the AAAHC requirements for Patient Satisfaction surveys? Are the OAS CAHPS surveys taking the place of them? Have any other centers had issue when inspected? - [Liability](https://progressivesurgicalsolutions.com/forums/topic/liability/) - Credentialing and re-credentialing: we recently got some pushback about how far back we need to get this information for, so I asked a AAAHC surveyor and she said it's up to our Governing Board to decide how far back to go. My medical director is conflicted and would like to know what others do. For - [Oxygen competency](https://progressivesurgicalsolutions.com/forums/topic/oxygen-competency/) - Hi there - is there an elearning for oxygen competency including: oxygen administration, patient monitoring, emergency response, and recovery care? - [Incapacitated surgeon or anesthesia](https://progressivesurgicalsolutions.com/forums/topic/incapacitated-surgeon-or-anesthesia/) - Is there a policy available on here regarding this? Thank you! - [Surgeon and Anesthesia required education- Quad A](https://progressivesurgicalsolutions.com/forums/topic/surgeon-and-anesthesia-required-education-quad-a/) - Hello, Specifically for Quad A accredited centers, is there a list of education that the surgeons AND anesthesiologist need to complete annually? Also, do anesthesia providers need to be up to date on WAG education and update that annually? Thank you, - [pre-op labs](https://progressivesurgicalsolutions.com/forums/topic/pre-op-labs/) - for our surgery charts (we are paper), are the surgeons required to initial the labs and ekg? One of our surgeons does not want to initial EKG, he states that he is not the one interpreting it therefor should not be initialing it. - [Bloodborne Exposure Protocol](https://progressivesurgicalsolutions.com/forums/topic/bloodborne-exposure-protocol-2/) - Hi there. Just going through my books. I am missing the form for: Informed Refusal of Post Exposure Prophylaxis against HIV. Would you please forward this form to me? Thank you in advance. :) - [Record retention policy](https://progressivesurgicalsolutions.com/forums/topic/record-retention-policy/) - Hi, I've been going through all of the policies that were created with PSS and I'm having a hard time finding a Record Retention policy for our office based surgery center. Do you have any idea what binder or category that should be under? We are in Utah. wondering if yo also have a link - [Voluntary measure for Quality Reporting](https://progressivesurgicalsolutions.com/forums/topic/voluntary-measure-for-quality-reporting/) - If one of the measure for quality reporting is voluntary, do we even need to report "0" for no data? We are not reporting on Pro-PM THA/TKA pre-op. Do I need to put any info for that measure? - [AAAHC Ambulatory Accreditation vs Deemed Status Accreditation](https://progressivesurgicalsolutions.com/forums/topic/aaahc-ambulatory-accreditation-vs-deemed-status-accreditation/) - I'm wondering if someone can outline the differences between the standard ambulatory accreditation vs the deemed status accreditation for AAAHC? I know achieving deemed status omits the "surprise" CMS state inspections but how do the requirements differ when it comes to the deemed inspection? I assume there are more criteria to meet, but am having - [Detained patient](https://progressivesurgicalsolutions.com/forums/topic/detained-patient/) - We might possibly have a surgery pt that is a current inmate in an ICE detention facility. What policies/procedures to others have regarding admission? We assumed the guard would have to stay with him. Any guidance is greatly appreciated. Thanks. - [Automated drug dispensing system](https://progressivesurgicalsolutions.com/forums/topic/automated-drug-dispensing-system/) - I am looking into getting an automated drug dispensing system. We are a small ASC. What brand would anyone recommend? Need to keep it simple. - [Controlled Substances](https://progressivesurgicalsolutions.com/forums/topic/controlled-substances-2/) - Is there a policy available on PSS for when a narcotic count is off by a small amount at the end of surgery day? - [Nursing Policies and Procedures](https://progressivesurgicalsolutions.com/forums/topic/nursing-policies-and-procedures/) - I recently read an article by April that discussed the increased co-morbidities and complexities of pts coming to ASCs for surgery. We are seeing this in our facility with our pts. They are just a lot more complex to work with in regards to managing blood pressure and blood sugar, not to mention other co-morbidities. - [ASC operational budget](https://progressivesurgicalsolutions.com/forums/topic/asc-operational-budget/) - Any recommendations for a percentage breakdown of an operational ASC budget? For example: What percentage of overall budget should be personnel, supplies, rent, fixed operating expenses etc? - [Nurse and Tech staff document requriements.](https://progressivesurgicalsolutions.com/forums/topic/nurse-and-tech-staff-document-requriements/) - Hi, I'm going through staff files and wanting to be sure we have the necessary documents. We have a credentialing binder for medical staff and allied health but many of the items required do not seem applicable to nurse (RN) and Tech staff. Is there a list somewhere specific to these non practitioner positions? Do - [OBS QUAD A QAPI anf infection control program annual assessment guide](https://progressivesurgicalsolutions.com/forums/topic/obs-quad-a-qapi-anf-infection-control-program-annual-assessment-guide/) - Is this guide mandatory for an office-based surgery center? I have not noticed it as something required in the QUAD A standards nor the compliance calendar. It seems a bit tedious as all the topics are covered each quarter during our meetings. - [QUAD A Annual Review Exposure plan/ hazard communication plan](https://progressivesurgicalsolutions.com/forums/topic/quad-a-annual-review-exposure-plan-hazard-communication-plan/) - Under the QUAD A compliance calendar, it lists that the Written exposure plan and written chemical hazard communication program be reviewed and updated annually. I looked on progressive at the items listed under OSHA bloodborne pathogen and OSHA hazard communication plan. It appears that our policies match what is on your website. Is there something - [laundering of curtains](https://progressivesurgicalsolutions.com/forums/topic/laundering-of-curtains/) - How often should the curtains in PACU be laundered? - [Peel Pack sterility](https://progressivesurgicalsolutions.com/forums/topic/peel-pack-sterility/) - How long are surgical instruments sterilized in peel packs considered sterile? I'm reading conflicting information; 6 months, a year, until an event makes the pack no longer sterile. - [Fall Risk Assessment](https://progressivesurgicalsolutions.com/forums/topic/fall-risk-assessment-2/) - Does Progressive have a policy template for fall risk assessments for patients? I cannot find one anywhere. Thank you! Diane - [Humidity in sterile processing room](https://progressivesurgicalsolutions.com/forums/topic/humidity-in-sterile-processing-room/) - Hi, Is it mandatory through Quad A, that the sterile processing room must be monitored for humidity? We have a dirty and clean side, and the clean side has sterile supplies..... we already monitor the OR, just wasn't sure about this room. Thank you! - [Safety Drill](https://progressivesurgicalsolutions.com/forums/topic/safety-drill/) - Is there a drill template that my facility can use for the annual safety drill? (security emergencies) This is something that we have not been doing. Thank you, - [Life Safety - OR](https://progressivesurgicalsolutions.com/forums/topic/life-safety-or/) - Our ceiling tiles in our OR are loose and move when opening and closing the OR door. Who would I contact to stabilize and secure the tiles in order to comply with life safety code? Emily - [Placement of Steri-Gauges for Ophthalmic Instrument Sterilization-Clarification](https://progressivesurgicalsolutions.com/forums/topic/placement-of-steri-gauges-for-ophthalmic-instrument-sterilization-clarification/) - I’m looking for clarification and best practices regarding the placement of steri-gauges when sterilizing ophthalmic instruments. We do have a policy in place; however, the guidance around where exactly the steri-gauge should be placed within instrument trays/sets seems somewhat ambiguous. Specifically, I’m hoping to better understand: -Recommended steri-gauge placement within ophthalmic trays or cassettes -Whether - [Documentation Requirements While Transitioning from Paper to EMR](https://progressivesurgicalsolutions.com/forums/topic/documentation-requirements-while-transitioning-from-paper-to-emr/) - With our Ophthalmology ASC transitioning from paper charts to an EMR, I want to ensure we are aligned on current documentation expectations. Can someone point me to where the required documentation elements for patient charts are outlined (policies, regulatory guidance)? Any direction would be greatly appreciated. Thank you! - [Application for appointment](https://progressivesurgicalsolutions.com/forums/topic/application-for-appointment/) - Hi there- I see the application for RE-appointment on the site, but I don't see the initial application for appointment anywhere? - [2026 Medicare Fee Schedule for ASCs](https://progressivesurgicalsolutions.com/forums/topic/2026-medicare-fee-schedule-for-ascs/) - When will you have this up on this website? I received notification today that it is complete. - [Quality Improvement Occurrence Reporting and Tracking](https://progressivesurgicalsolutions.com/forums/topic/quality-improvement-occurrence-reporting-and-tracking/) - I would like to know if anyone has an updated Quality Improvement Occurrence Tracking and Reporting report that they use for their facility. We are looking to update ours and I want to make sure that we keep pertinent information to track for QAPI, board meetings as well as facility tracking. What is required for - [pt refusal sending down pathology](https://progressivesurgicalsolutions.com/forums/topic/pt-refusal-sending-down-pathology/) - Hi, Is there a form for patient refusal for treatment? Our patient refused to send down her tissue to pathology. Thanks, - [Reporting](https://progressivesurgicalsolutions.com/forums/topic/reporting/) - Hello, I am wondering what needs to be done to report probable endophthalmitis that occurred months after a glaucoma surgery? Does it need to be reported to CMS/AAAHC? If so, what exactly needs to be reported and where? - [Policy and Procedure update process](https://progressivesurgicalsolutions.com/forums/topic/policy-and-procedure-update-process/) - Hi, I'm new to this and trying to figure things out. We have our PSS binders with policies and procedures. I am wanting to update one of those policies. I can do this correct? each policy has a stamp at the top with a date for Approved, the one for revised for several years following - [On line BLS classes](https://progressivesurgicalsolutions.com/forums/topic/on-line-bls-classes/) - Can you tell us if AAHC frowns upon having staff do BLS on line? Our current instructor, who we have used for many, many years has cancelled on us twice in 2 weeks and now has informed us that she is retiring effective immediately. Some of our staff's BLS certification expires at the end of - [Required Annual Education](https://progressivesurgicalsolutions.com/forums/topic/required-annual-education/) - The "Required Annual Education" filter reduces the CE courses to just one module. Does this mean that this individual module satisfies the requirement for annual staff online training? This is confusing to me as in the past, I've been required to do all of the other course materials on a yearly basis while working in - [Syringe Labeling](https://progressivesurgicalsolutions.com/forums/topic/syringe-labeling/) - I'm looking for clarification regarding medications drawn into syringes for immediate use and the proper labeling. I saw in your references that compounded medications are now good for 4 hours, instead of 1 hour. Does this apply to a single mediation drawn into a syringe as well? Example- Can a syringe with Versed be labeled - [Reverse Distributor](https://progressivesurgicalsolutions.com/forums/topic/reverse-distributor/) - Hello, Can anyone recommend a reverse distributor to dispose of our expired controlled substances? Thank you, Vicki - [Medciation and equipment recalls](https://progressivesurgicalsolutions.com/forums/topic/medciation-and-equipment-recalls/) - How long are we required to keep safety recall notifications on medications or supplies? Do we need to keep a log? We always note whether we have the item or not. - [ASC Quality Reporting Changes](https://progressivesurgicalsolutions.com/forums/topic/asc-quality-reporting-changes/) - Looking for confirmation to ensure I'm understanding correctly. It appears the proposal to remove ASC 20, ASC 22, ASC 23, and ASC 24 was finalized in November. Does this mean we no longer need to gather this data? Is there is a certain date we need to submit the COVID data through? Wanting to ensure - [medical refrigerator and freezer temperature ranges.](https://progressivesurgicalsolutions.com/forums/topic/medical-refrigerator-and-freezer-temperature-ranges/) - Question, reviewing for our visit next summer I came across an error in our policy regarding medication frig and freezer temps. We are an ophthalmology center and do not store any meds that require freezing (we just keep ice bags) but we do use the frig part for medications. Our old policy states frig range - [Local Anesthesia Policy](https://progressivesurgicalsolutions.com/forums/topic/local-anesthesia-policy/) - Would anyone have a straight local anesthesia policy (no sedation) they might be willing to share? Is your BMI max the same as with anesthesia? We are revising our policy and interested in what others require? If interested, you may send to my email - Leslie.cottrell@bhsi.com. Thank you. - [CRNA Labeling Syringes](https://progressivesurgicalsolutions.com/forums/topic/crna-labeling-syringes/) - I am looking for some clarity on labeling sedation syringes in the ASC. The last discussion thread I found in relation was from 2016 and I know the landscape of compliance has changed since then. I was under the impression that IV sedation would fall under the immediate use provision and would not need labeled - [23 Hour Stay](https://progressivesurgicalsolutions.com/forums/topic/23-hour-stay/) - Hello, I am reaching out to see if anyone has a 23 hour stay policy they could share with me? Thank you, Lindsey - [Cyber Data Breech](https://progressivesurgicalsolutions.com/forums/topic/cyber-data-breech/) - Hi, Unfortunately, our facility was just involved in a cyber data breech. It is being investigated by the FBI and proper steps are being taken, Is there anything that needs to be done on the surgery centers side? Thanks so much, - [Utilization Review Committee](https://progressivesurgicalsolutions.com/forums/topic/utilization-review-committee/) - Hey all! We recently completed our state survey, and one of the findings was that we’re not fully meeting the requirements for a Utilization Committee. The surveyors clarified that this committee needs to be separate from our surgeon peer review process and must include at least three surgeons, maintain quarterly meeting minutes, and follow the - [Biennial Inventory for Controlled Substances](https://progressivesurgicalsolutions.com/forums/topic/biennial-inventory-for-controlled-substances/) - Does a specific form (6A or 6B) need to be filled out for ASC's with controlled substances per DEA, AAAHC or CMS? We only have 2 controlled substances at our facility where we just order more quantities as needed. We have a separate DEA binder where all of our receipts go in after ordering, a - [Medical staff credentialing](https://progressivesurgicalsolutions.com/forums/topic/medical-staff-credentialing/) - Hello, Recently audited by ACHC, we have been using our TSCA application from MD's credentialing in our clinic as our initial application. ACHC explained that this application is not permissible as it states on the form " not to be used for employment purposes". Does anyone mind sending me their credentialing application as a reference, - [Sharing OR time](https://progressivesurgicalsolutions.com/forums/topic/sharing-or-time/) - Hi there. We are having discussion at our office about sharing OR time with the office. For example, the OR was booked for general and local cases. At the end of the day, the office had a local case they wanted to do in the OR. Are there any restrictions for this? And what is - [IPCH Credits](https://progressivesurgicalsolutions.com/forums/topic/ipch-credits-2/) - Do any of your education modules offer IPCH Credits? if not could this be something you could consider with future offerings? - [Clarification Needed: Transcription Services in Ambulatory Surgery Centers](https://progressivesurgicalsolutions.com/forums/topic/clarification-needed-transcription-services-in-ambulatory-surgery-centers/) - Are ASCs required to provide transcription services for their surgeons? One of our physicians is questioning our current process and I’d appreciate any guidance on regulatory requirements or industry standards related to this. We are a single specialty ASC (Ophthalmic) located in Louisiana. - [Pharmacy consultant](https://progressivesurgicalsolutions.com/forums/topic/pharmacy-consultant-3/) - Does the consulting pharmacist need to carry liability insurance on himself? He is responsible for checking documentation and medication outdates. We are in Texas. Thanks for any information. - [ASC Autoclave Replacement](https://progressivesurgicalsolutions.com/forums/topic/asc-autoclave-replacement/) - I am looking for options to replace the 2 autoclaves in our ASC. The autoclaves need to run every 30 minutes. Does anyone have any suggestions as to where to purchase, brand, and model? Thank you, Gabby, RN, DON - [credentialing retired surgeon](https://progressivesurgicalsolutions.com/forums/topic/credentialing-retired-surgeon/) - The sole owner of my facility has recently retired. He is currently the primary member of the Governing Body. He is up for re-credentialing. Does he need to be credentialed since he has retired? Does he need to stay credentialed due to being the sole owner of the facility and the primary member of the - [OAS CAHPS survey return](https://progressivesurgicalsolutions.com/forums/topic/oas-cahps-survey-return/) - Is there any official word that if a CMS approved vendor has collected data and our facility still does not meet the "200" response requirement ..... will facility still be subject to 2% payment reduction?? Our rate of return has reduced dramatically since we discontinued our own and switched to the required mode. Not to - [OSHA Training](https://progressivesurgicalsolutions.com/forums/topic/osha-training/) - Hi! I have a surveyor currently at a facility. AAAHC. He is stating that OSHA training has to be done PRIOR to hire. IS this correct???? - [MRSA Patients](https://progressivesurgicalsolutions.com/forums/topic/mrsa-patients/) - Hello, What are facilities MRSA policies. If a patient was positive months prior do you require negative testing before they come to your center? No open wounds etc.? Thank you - [Crash Cart - Trach kit](https://progressivesurgicalsolutions.com/forums/topic/crash-cart-trach-kit/) - We are an Eye Surgery Center and am updating our crash cart list. Do we need a trach kit? - [Dual Physician Case](https://progressivesurgicalsolutions.com/forums/topic/dual-physician-case/) - Hi Everyone, I am wondering what other centers do when you have a case that requires to separate procedures with two different surgeons. Are both surgeons present for the initial time out? Or is just the starting physician present for the first part and then another time out is performed while patient is sleeping for - [Flu/Covid requirement](https://progressivesurgicalsolutions.com/forums/topic/flu-covid-requirement/) - Is it a requirement that as an ASC, we have to either offer the flu/covid vaccine or pay for the employee to get one at the pharmacy if they choose? We do not offer any vaccinations at our facility so when having employees fill out the informed consent/declination, I was wondering if they choose to - [AAAHC Annual Attestation and Gap Analysis](https://progressivesurgicalsolutions.com/forums/topic/aaahc-annual-attestation-and-gap-analysis/) - What is required for the AAAHC Annual Attestation? I saw there was a self-assessment available in the Help Curtain on 1095 Engage but wondered if that full assessment was required or if we could submit a narrative stating we are remaining complaint with current standards, etc. Also- "gap analysis" what does this entail? Thank you! - [Continuous EKG Monitoring](https://progressivesurgicalsolutions.com/forums/topic/continuous-ekg-monitoring/) - In the process of opening a 1-procedure room pain management ASC and for our IV Conscious (Moderate) sedation cases wondering if we absolutely have to do continuous EKG monitoring - most of our cases are short (15 - 30 minutes) and patients are fully conscious and communicating during the procedure. - [Methotrexate/Mitosol](https://progressivesurgicalsolutions.com/forums/topic/methotrexate-mitosol/) - Hi everyone! We utilize Methotrexate and Mitosol at our ASC. We have employees sign off on our Hazardous Drug Policy and also host USP800 in-services annually. We follow the standards where all precautions are taken- double glove (chemo), chemo gown, goggles and dispose of everything properly. Our mitosol is a closed system. We have a - [Vancomycin in Cataract Surgery](https://progressivesurgicalsolutions.com/forums/topic/vancomycin-in-cataract-surgery/) - Our consulting pharmacist disagrees with our ASC's practice of using one vial of vancomycin (a new vial is made daily) for multiple BSS bags. We inject 0.2 ml of vancomycin into each BSS bag for cataract surgery. Because the vials do not explicitly say that they are "multi-use", our pharmacist has raised the alarm (the - [Prep trays for cleaning instruments](https://progressivesurgicalsolutions.com/forums/topic/prep-trays-for-cleaning-instruments/) - Hello- Is there a specific color prep tray that needs to be used when cleaning dirty instruments in decontam? We have always used and ordered the blue prep trays, but there are clear ones that are more cost effective. I wasn't sure if there was a known reason that blue trays needed to be used - [Consent to Radiation Exposure](https://progressivesurgicalsolutions.com/forums/topic/consent-to-radiation-exposure/) - I am updating our procedure consent form and wondering if it is required to include language informing the patient of radiation exposure during the procedure. We are a pain ASC so all of our procedures are under fliouro. - [Criteria for visitors and observers](https://progressivesurgicalsolutions.com/forums/topic/criteria-for-visitors-and-observers/) - Looking for specific policies, health questionnaires or screening documents related to non-employee observers. Thanks! - [credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-23/) - Do you have to query SAM.Gov when credentialing physicians or allied health? - [SDS](https://progressivesurgicalsolutions.com/forums/topic/sds/) - If you have a product but get a different manufacturer are you required to keep an SDS for the specific manufacturer or are they universal? For instance if I have Brilliant Green Stain and it's made by Pfizer and the next shipment we get is from Delasco do I need to keep updating my book - [Credentialing - Staff member name change](https://progressivesurgicalsolutions.com/forums/topic/credentialing-staff-member-name-change/) - Hello, I have CST whom had a name change. Do I need her to refill out paperwork with new name information? - [Credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-22/) - Hi there. I am credentialing a new physician. Please refresh my memory. Do I need to have anesthesia providers complete the annual training. Meaning do they need to complete all the tests for a new hire? Or can I just send the information to them for their reference? Do I need to have all the - [Boil Water Notice](https://progressivesurgicalsolutions.com/forums/topic/boil-water-notice/) - Does anyone have a policy on what to do if the city issues a "Boil Water Notice"? This is one policy I have not been able to find a sample to help me get started on one of our own. Thanks in advance. - [Oral Valium for cataract cases](https://progressivesurgicalsolutions.com/forums/topic/oral-valium-for-cataract-cases/) - Hey all! We are restructuring our anesthesia process due to changes with our CRNA. We have been wanting to take the leap to oral sedation and this is pushing us to do it. Is anyone else doing Valium for your cataracts, CLE's, and ICL's? With this process do you need 2 RN's in the OR- - [Hospital Transfer Agreement](https://progressivesurgicalsolutions.com/forums/topic/hospital-transfer-agreement-2/) - Hello! I was wondering if it is required by CMS/AAAHC to have a transfer agreement with a local hospital? I was told CMS no longer requires it and it is up to each state? Thank you! - [Anesthesia Temperature Documentation](https://progressivesurgicalsolutions.com/forums/topic/anesthesia-temperature-documentation/) - I have recently read there was a change in intervals regarding anesthesia documenting patient temperature. I cannot find it now. The regulation 8-H-9 does not specify the intervals in which to document. My policy does not even mention temperature as part of anesthesia documentation. Would you please inform me of the correct intervals for intra-op - [Oral Valium Procedures](https://progressivesurgicalsolutions.com/forums/topic/oral-valium-procedures/) - We perform Cross linking cases at our surgery center and give the patients Oral Valium. There is 2 RNs in the room- one monitoring the patient and their vital signs and the other strictly doing the hands on portion of the procedure. Does the surgeon need to have a a Post operative Exam Note prior - [IPCH Credits](https://progressivesurgicalsolutions.com/forums/topic/ipch-credits/) - do any of your educational offerings provide IPCH credits? - [AAMI RO system](https://progressivesurgicalsolutions.com/forums/topic/aami-ro-system/) - For a new ASC build with only GI is a RO system required to meet the AAMI standards? - [Ophthalmology Reporting Texas](https://progressivesurgicalsolutions.com/forums/topic/ophthalmology-reporting-texas/) - Hello! We are a small Ophthalmology ASC in Texas with one OR operating only 1 day/week and lasers 1 day/week. We are looking to update/simplify our reporting. Is there an ASC with a similar setup willing to visit with me? Thanks so much in advance! - [Multiple fee schedules](https://progressivesurgicalsolutions.com/forums/topic/multiple-fee-schedules/) - One of my owners wants to have multiple fee schedules for the following: 1. Cash pay 2. Liens 3. Percentage of Medicare It is my understanding that CMS does not allow multiple fee schedules. Does anyone have the CMS guideline on this topic? - [QAPI](https://progressivesurgicalsolutions.com/forums/topic/qapi-4/) - Is the Quality Studies/Quality Program with new gap analysis for AAAHC just the 6 step Quality Study instead of the previous 10? Thank you! - [Cornea transplant](https://progressivesurgicalsolutions.com/forums/topic/cornea-transplant/) - We are an ophthalmology ASC in TX that will be doing cornea transplants this Fall. Please let me know of any policies or procedures. - [OR Suite Temp and Humidities](https://progressivesurgicalsolutions.com/forums/topic/or-suite-temp-and-humidities/) - In one of our facilities, the OR suite temps and humidity are constantly at war being located in GA. Our ORs are typically below the recommended 68 degrees, especially SPD. Our policy states to notify management and document corrective action then recheck until back in range... but it is only in range for a brief - [Anesthesia Providers](https://progressivesurgicalsolutions.com/forums/topic/anesthesia-providers/) - Limited Anesthesia Providers. We currently have a CRNA that works under the supervision of our surgeons. Recruitment for a CRNA is extremely competitive with the shortage of Anesthesia providers. Is it possible to work without an anesthesia provider for Ophthalmic procedures? - [OAS CAHPS](https://progressivesurgicalsolutions.com/forums/topic/oas-cahps-7/) - Do you have a script we can have our receptionist tell patients when they check in for surgery that CMS requires pt satisfaction survey by a vendor and they may be contacted? We are thinking "I want to inform you that you may be contacted by a third-party Medicare approved survey organization. They will ask - [Restructuring OR flow](https://progressivesurgicalsolutions.com/forums/topic/restructuring-or-flow/) - Hello. We are a new one room Ophthalmology ASC. Our Physician is contemplating restructuring the processes in the OR. We have an Ante Room and the OR which collectively is the intraoperative area. Our RN's stay with their patient in the intraoperative area throughout both areas and we have two OR RN's assigned daily. Currently - [Local Only Procedure](https://progressivesurgicalsolutions.com/forums/topic/local-only-procedure/) - Hell, We are starting to do more local procedures in the OR (Breast implant exchanges, liposuction of submental) Is there a policy that I can reference when we are doing these cases? Ie. RN present, tech, vital signs, are vital signs required in the PACU? Thank you, Anna Lozano, RN - [Terminal Cleaning if OR Sanitation Compromised](https://progressivesurgicalsolutions.com/forums/topic/terminal-cleaning-if-or-sanitation-compromised/) - Hello, We recently had an event where EMS had to enter our OR suite during a case (entering the OR in street clothes). Does a full terminal clean of the OR and restricted area hallway need to be performed before the next case? If so, what does the terminal clean look like? The terminal clean - [Joint Commission Licensed Practitioner Education on Pain](https://progressivesurgicalsolutions.com/forums/topic/joint-commission-licensed-practitioner-education-on-pain/) - Joint Commission stated that I needed to give annual education for Licensed Practitioners (Physicians, Anesthesiologists) with documentation to their employee file. Do you have any suggestions as to what method would work best? We are a small Ophthalmology surgery center and don't prescribe narcotics at all. We have 5 physicians and use an anesthesiology group - [Emergency Management Policies](https://progressivesurgicalsolutions.com/forums/topic/emergency-management-policies/) - do i need specific policies for specific events? such as active shooter, bomb threat, etc... or can we just have policies for shelter in place, evacuation, etc... - [Ophthalmology ASC](https://progressivesurgicalsolutions.com/forums/topic/ophthalmology-asc/) - Hi! We are an Eye Surgery Center in Illinois. Our owner has 4 clinics. We wanted to know if anyone has the patient's bring their own post-op drops that the clinic prescribes to them ? Instead of using our own at the ASC. - [X-Ray Tech for Ortho Services and THA Education](https://progressivesurgicalsolutions.com/forums/topic/x-ray-tech-for-ortho-services-and-tha-education/) - Hello, We will be starting to do THA's at our center in the fall. How are other centers staffing the X-ray tech role/duties? We hesitate to hire an X-ray tech as this is not a full time position and the need will be minimal. Also, I am wondering what THA education is best for staff - [5 Domains in ASC-24](https://progressivesurgicalsolutions.com/forums/topic/5-domains-in-asc-24/) - Regarding ASC-24 Facility Commitment to Health Equity, as an Ophthalmic ASC that does not have an EHR, conducts paper surveys, and logs the results on a spreadsheet, are we unable to achieve all five domains? Do we have to accomplish all 5? According to the employee training sheets provided here at PS, we will only - [Ordering medications for ASC](https://progressivesurgicalsolutions.com/forums/topic/ordering-medications-for-asc/) - Hello, Our ASC in Washington State, I’m seeking clarification regarding the scope of practice for Medical Assistants (MAs) as it relates to medication ordering responsibilities. Specifically, I would like to know: Are medical assistants in Washington State permitted to order medications (including legend drugs and controlled substances) for inventory or patient use in an ASC, - [Credentialing forms](https://progressivesurgicalsolutions.com/forums/topic/credentialing-forms-2/) - I am looking for credentialing forms, specifically a liability questionnaire. Is there a place I could get some blank sample forms? - [ASCQR Submission](https://progressivesurgicalsolutions.com/forums/topic/ascqr-submission/) - Good Afternoon, What website do I submit the ASCQR Quality Data that is due on May 15? I cannot find the site to submit. Thank you, Alexis - [Risk Assessments](https://progressivesurgicalsolutions.com/forums/topic/risk-assessments/) - Hi, We are accredited by the Joint Commission. I am looking for clarification around risk assessments and when they need to be performed. Do they each need to be performed annually or only as an issue, change, or concern arises? The Joint Commission site doesn't clearly state and when I have reached out to them, - [90 day window visit with surgeon prior to ASC procedure](https://progressivesurgicalsolutions.com/forums/topic/90-day-window-visit-with-surgeon-prior-to-asc-procedure/) - We have a historical policy of 90 day window visit with surgeon prior to ASC procedure. Looking if someone can help us find data to support this? Our medical director is potentially canceling this. We are not sure if it is a requirement by WA DOH, CMS, Joint Commission or best practice? This is separate - [Arbor Associates OAS CAHPS](https://progressivesurgicalsolutions.com/forums/topic/arbor-associates-oas-cahps/) - Does anyone else use Arbor Associates for patient satisfaction surveys? They had a data leak and I am waiting to see if our facility was affected. I notified our administrator and our security officer. Looking for additional guidance and/or policy. Thank you! - [ACA 1557 trainings](https://progressivesurgicalsolutions.com/forums/topic/aca-1557-trainings/) - Affordable Care Act: Does Progressive have any trainings for ACA 1557 which is required : Training for staff on nondiscrimination and Section 1557 policies. - [Consent for patient after needlestick injury](https://progressivesurgicalsolutions.com/forums/topic/consent-for-patient-after-needlestick-injury/) - Our current policy is to draw labs on the patient before they leave the facility if an employee has a needlestick injury. Since this can happen during the surgery, if the patient has had sedation (conscious sedation, no general), are they still able to sign a consent form in order to draw their blood for - [PF Kenalog (Triamcinolone)](https://progressivesurgicalsolutions.com/forums/topic/pf-kenalog-triamcinolone/) - The compounding pharmacy we currently use has paused the production of PF Triamcinolone. We've looked into Triesence, but it's very cost prohibitive. Is anyone having luck with different options? - [Minor Ownership changes](https://progressivesurgicalsolutions.com/forums/topic/minor-ownership-changes/) - We are adding two additional owners to our facility which each will have 4% ownership. Does this need to be reported to anyone since it's less than 5%? When I log into my CMS account, the only option is 5% or more. We are also AAAHC accredited. - [TB testing](https://progressivesurgicalsolutions.com/forums/topic/tb-testing-4/) - At the conference, I was told that all employees need to be tested for TB upon hire. From what I am reading under Tuberculosis Screening and Testing on VMG, "The CDC recommends TB screening and testing of HCP as part of a TB Control Plan and might be required by state regulations. For TB regulation - [Consent for Transfer](https://progressivesurgicalsolutions.com/forums/topic/consent-for-transfer/) - I am working to update paperwork that we use at our ASC to urgently/emergently transfer patients to a hospital setting (we do not perform planned transfers). We currently have in our process that a "consent to transfer" document must be signed either by the patient or their representative. I see this as a requirement for - [Surgical Consents](https://progressivesurgicalsolutions.com/forums/topic/surgical-consents-4/) - Are full legal names for signatures required on surgical consents? We currently do this as it seems like better practice, but many patients sign with nicknames or first initial and last name, and then we need to correct them. Curious to know what other facilities are doing. I cannot find any specific signature requirements relating - [Consent form for controlled substance](https://progressivesurgicalsolutions.com/forums/topic/consent-form-for-controlled-substance/) - Is it a compliance requirement to have all surgery patients sign a controlled substance consent? We have ours sign one, but i'm trying to see if this is a requirement or if we're doing it for a different reason. - [CRNA orders](https://progressivesurgicalsolutions.com/forums/topic/crna-orders/) - Our CRNA orders narcotics and other medications for our patients on occasion. Our "Medication Administration" policy states that, Medication will be administered only on the order of a physician who has been granted privileges in this facility? Do we need to change this and add physician or "CRNA" or is this acceptable the way it - [Anuual Education Classes- MDs and CRNAs](https://progressivesurgicalsolutions.com/forums/topic/anuual-education-classes-mds-and-crnas/) - Are there specific classes that I required for the MDs and CRNAs in terms of the annual education requirements? - [infection/complication letter](https://progressivesurgicalsolutions.com/forums/topic/infection-complication-letter/) - Hi, when typing the infection/complication letter for the previous month are patients who had surgery from only that month the only ones I look at? Or can I list a name on there who developed an infection that month but did not have surgery in the same month. For instance, a patient has surgery in - [LARYNGOSCOPE FOR CRASH CART](https://progressivesurgicalsolutions.com/forums/topic/laryngoscope-for-crash-cart/) - IM IN THE PROCESS OF CHANGING TO DISPOSABLE LARYNGOSCOPE AND BLADES FOR OUR CRASH CART. ANY SUGGESTIONS ON WHAT SIZES AND TYPE I WOULD NEED. - [Credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-21/) - Is there any forms available for the process of suspending or terminating clinical privileges and the process for the appeal of decisions to suspend or terminate privileges has been approved? - [Change in ASC name and owners](https://progressivesurgicalsolutions.com/forums/topic/change-in-asc-name-and-owners/) - Hello- We are changing some of our owners, 2 of current 6 will still have a stake, and adding 3 investors. We are keeping the same legal name and adding a DBA. We will also be adding a specialty. Continuing as the same entity and tax ID number. Do you have any guidance or checklist - [CST Scope of Practice](https://progressivesurgicalsolutions.com/forums/topic/cst-scope-of-practice/) - Hi everyone! Is there any statement that states on the CST scope of practice that they cannot hold the needle for the surgeon while she is injecting gas during the procedure? Thanks! - [Off label use of dexamethasone](https://progressivesurgicalsolutions.com/forums/topic/off-label-use-of-dexamethasone/) - I have a surgeon who is requesting to use IV/ IM/ intra lesion dexamethasone PF 4mg/mL intracamerally. This is an off label use of this medication. What are the possible implications of letting this surgeon use a medication off label? He claims that he does it at other surgery centers, but im preparing for my - [Pain Management](https://progressivesurgicalsolutions.com/forums/topic/pain-management-2/) - We have Joint Commission here and they are asking why our education does not include pain management as required by Joint Commission. Can you help with this? - ["Medical Transport" provided by insurance plan](https://progressivesurgicalsolutions.com/forums/topic/medical-transport-provided-by-insurance-plan/) - We are having an issue where patients are coming in for surgery with an arranged ride provided and paid for by their insurance. Many times this ride is literally an Uber that the insurance company has arranged. We spoke to a driver of one of these transports and he said that he has no way - [Signing consent forms/medical POA](https://progressivesurgicalsolutions.com/forums/topic/signing-consent-forms-medical-poa/) - For patients that sign consent upon check in, the morning of surgery... Is it a requirement for a patient to be able to say what we are doing for surgery (i.e. having cataract surgery on right eye) in order for them to sign the consent form? If they can't tell us, are we not able - [CEUS-medical staff and PSDR infection reporting](https://progressivesurgicalsolutions.com/forums/topic/ceus-medical-staff-and-psdr-infection-reporting/) - Do CEUs from progressive surgical solutions need to be completed upon hire and annually for medical staff such as doctors and anesthesia? I have incident reports for infection, but a culture was not done, it is just suspected infection and being treated as such, do I still report it even if we have not swabbed - [UPS battery vendor](https://progressivesurgicalsolutions.com/forums/topic/ups-battery-vendor/) - Our ASC is based in Seattle, we have historically used Eaton for UPS battery. Do you recommend any other vendors? Do other ASCs have a battery back up or gas? Curious what others are doing. - [Pre Admission Requirements](https://progressivesurgicalsolutions.com/forums/topic/pre-admission-requirements/) - Currently a nurse creates the schedule, calls the patient, reviews directions with the patients. Is there any requirement for an pre nursing / pre admission interventions? Does this have to be a nurse? does this even have to happen? I know at some point we started having nursing do it - I think because it - [Evaluations](https://progressivesurgicalsolutions.com/forums/topic/evaluations/) - For the evaluation examples you have on E-support. You have boxes where the managers score them. Where is your scoring chart ? On how you base that because you have example, 100 points- you are considered Commendable. Thanks - [MKO Melts](https://progressivesurgicalsolutions.com/forums/topic/mko-melts/) - Are there any ASC's administering MKO Melts without the presence of a CRNA or Anesthesiologist? - [Generator 4 hour Load test](https://progressivesurgicalsolutions.com/forums/topic/generator-4-hour-load-test/) - The (natural gas) generator 4 hour load test was last performed March 2022. Since the 4 hour load test is due every 3 years, I show that it is due March 2025. The generator contractor told me that I can combine this test with the annual PM due in June. Can the 4 hour load - [building specifications](https://progressivesurgicalsolutions.com/forums/topic/building-specifications/) - Are there specific criteria for flooring in a surgery center? Specifically in the OR and sterile corridor areas? - [RAD Tech](https://progressivesurgicalsolutions.com/forums/topic/rad-tech/) - Would anyone have a JD for RAD tech in an ASC for C-Arm use only. - [Autoclave service providers](https://progressivesurgicalsolutions.com/forums/topic/autoclave-service-providers/) - Located in MS and in desperate need of a new service provider for our Primus autoclave. We seem to be running into dead ends trying to find anyone. Thanks - [Physician Credentialing](https://progressivesurgicalsolutions.com/forums/topic/physician-credentialing/) - Good afternoon, We have a new physician coming to our facility, and I am trying to get him credentialed. He will be the only Ophthalmologist on site. Our previous physician has retired. Can our Anesthesiologist approve his request for appointment and privilege request, or do we need an outside Ophthalmologist to review his credentialing file? - [ASC-24 Facility Commitment to Health Equity](https://progressivesurgicalsolutions.com/forums/topic/asc-24-facility-commitment-to-health-equity/) - Has there been any updates/more information for this measure since the Webinar on January 6th? - [The use of 10% phenylephrine drops pre-operatively](https://progressivesurgicalsolutions.com/forums/topic/the-use-of-10-phenylephrine-drops-pre-operatively/) - I have seen it standard practice to use Proparacaine, TPC, and 10% phenylephrine all x3 preoperatively. I also have seen it where the phenylephrine is used x2 only PRN. I would like to do more research into this topic in regards to whether patients have improved outcomes / dilation, the safety of it's use in - [Patients with Dementia](https://progressivesurgicalsolutions.com/forums/topic/patients-with-dementia/) - Please advise best practices regarding the care of patients with dementia in an ASC setting. As the population continues to age, we have seen an increase in patients with a designated MPOA that are seeking surgical services. Our practice often finds this situation unpredictable and challenging if the patient does not want medical care. We - [OR Observers and TB](https://progressivesurgicalsolutions.com/forums/topic/or-observers-and-tb/) - Our facility is having a surgical preceptorship for one surgical day, one of the surgeons does not have a recent TB test so I was just going to have them complete a questionnaire, Is there a better questionnaire than this one? We currently have employees get an annual TB test, but I am anticipating that - [Medical Board of California - 805 report](https://progressivesurgicalsolutions.com/forums/topic/medical-board-of-california-805-report/) - Hi! Anyone from California and run an 805 report for the osteopathic docs? I run them for my MD's, but can't seem to find where to run the reports for osteopathic physicians. Any feedback would be appreciated. Thanks! - [Proparacaine- Storage and Usage](https://progressivesurgicalsolutions.com/forums/topic/proparacaine-storage-and-usage/) - We just had our "surprise" CMS inspection from the Dept. of Health and one of the items that came up was our storage/usage of our Proparacaine 0.5% drops. The package insert states to store it between 36-46 degrees F and we do store it in our monitored medication fridge, but take it out to use - [Actual Fire Alarm & Evacuation](https://progressivesurgicalsolutions.com/forums/topic/actual-fire-alarm-evacuation/) - We had a fire alarm and evacuation and want to use this for our annual exercise. Can you suggest appropriate documentation to support this? Thanks. - [CE Courses](https://progressivesurgicalsolutions.com/forums/topic/ce-courses-2/) - Hello, Do the education courses count towards our nursing CEs for the state of Illinois ? - [Heparin](https://progressivesurgicalsolutions.com/forums/topic/heparin-2/) - We are an ophthalmic ambulatory surgery center. We have had Heparin on our formulary and was wondering if it is needed? We have never used any and its hard to obtain. Just curious. - [post exposure consent form](https://progressivesurgicalsolutions.com/forums/topic/post-exposure-consent-form/) - Hello, is there an example of a consent form on PSS for post exposure testing of HIV/Hepatitis? - [credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-20/) - Our new administrator mentioned that starting in 2025 that ASCs need to perform a Sam.Gov query on our physicians as part of the credentialing process. Is this the same as the OIG? Anyone heard of this? - [COVID Vaccine Reporting](https://progressivesurgicalsolutions.com/forums/topic/covid-vaccine-reporting/) - Is the weekly reporting still required into 2025 or did this requirement end in 2024? - [Patient Right/Responsibilities in Spanish](https://progressivesurgicalsolutions.com/forums/topic/patient-right-responsibilities-in-spanish/) - Hi, there used to be a Patient Rights/ Responsibilities form in Spanish on PSS, where can I find it again? Thanks! - [New Medicare Rates for ASC 2025](https://progressivesurgicalsolutions.com/forums/topic/new-medicare-rates-for-asc-2025/) - Does anyone have the new rates for ASCs for Medicare 2025? - [AAAHC Performance Improvement Study Format](https://progressivesurgicalsolutions.com/forums/topic/aaahc-performance-improvement-study-format/) - Was there revised guidelines for AAAHC Performance Improvement Study Format? And where would I find it? - [Hoyer Lift - ASC](https://progressivesurgicalsolutions.com/forums/topic/hoyer-lift-asc/) - In our ASC our policy regarding patient transfers, They are required to transfer if they need assistance with a transfer, they must have a next in kin/ assist them with a transfer to the gurney. A waiver is signed with details regarding risk of transfer. My question is to remain ADA compliant what are some - [Contract with Hospital???](https://progressivesurgicalsolutions.com/forums/topic/contract-with-hospital/) - If you have several physicians at your surgery center and they have privileges at different hospitals, do we have to have a contract with all hospitals or is a contract even needed to admit patients when necessary???? - [Local Anesthesia toxicity](https://progressivesurgicalsolutions.com/forums/topic/local-anesthesia-toxicity/) - Is there any training for local anesthesia toxicity? We would like to update the information that we have and would like to have a competency available within the progressive platform. - [Adequate Staffing Ratios](https://progressivesurgicalsolutions.com/forums/topic/adequate-staffing-ratios/) - Is there a policy on progressive regarding adequate staffing ratios? - [AAAHC Saf 160](https://progressivesurgicalsolutions.com/forums/topic/aaahc-saf-160/) - AAAHC SAF .160 states that a written policy is needed for monitoring and disposal of products with expiration dates is present. We have one for RX. When checking with AOR online site, , it has the AAAHC standard that specifically states" RX, reagents, solutions and supplies", but only shows examples of Policies R/T RX. Does - [OAS CAHPS](https://progressivesurgicalsolutions.com/forums/topic/oas-cahps-6/) - I'm looking for guidance on the best practices for obtaining patient consent to release their information to an OASCAHPS vendor at our surgery center. Specifically, I’m wondering if anyone has an example of a consent form that they use for this purpose. Any insights or samples you can provide would be greatly appreciated! - [QAPI study](https://progressivesurgicalsolutions.com/forums/topic/qapi-study/) - One of our QAPI studies were patient satisfaction surveys. Since required vendors are now overseeing this it will eliminate one of our QAPI studies. Is there a requirement on how many studies need to be maintained? - [ConMed/Hall Power Batteries](https://progressivesurgicalsolutions.com/forums/topic/conmed-hall-power-batteries/) - We have batteries that are less than 1 year old and that are failing. We are following the IFUs for cleaning/sterilizing. Sales rep claims we are leaving them in the autoclave too long, but my CPD department doesn't have time to NOT take them out at the end of each cycle. Wondering if anyone else - [NEW OR RN training](https://progressivesurgicalsolutions.com/forums/topic/new-or-rn-training/) - Hi, our current OR RN is headed for maternity leave and I am looking for the best most cost effective curriculum to get our pre op RN trained to circulate in the OR. She does have some OR knowledge but I I couldn't find exactly which course would be best from AORN. Or if you - [Cidex OPA](https://progressivesurgicalsolutions.com/forums/topic/cidex-opa/) - Can anyone explain the Cidex OPA log in the Daily with Occurrance? We use this for our Occuloplastics. - [reappointment](https://progressivesurgicalsolutions.com/forums/topic/reappointment/) - when reappointing a CRNA, is a NPDB search, NBCRNA search required or both? Thank you - [OAS CAHPS data extraction from NEXTECH](https://progressivesurgicalsolutions.com/forums/topic/oas-cahps-data-extraction-from-nextech/) - Does anyone who use NEXTECH find a way to extract the data to be sent to the OAS CAHPS vendor? I opened a ticket with nextech support but curious if any members figured this out yet? Data Element Value Labels and Use: Patient First Name The name of the patient is needed for telephone survey - [Expansion](https://progressivesurgicalsolutions.com/forums/topic/expansion/) - I was wondering if anyone has ever expanded their ASC in Texas and what steps did it involve. We are looking to add an additional OR suite to our existing ASC. I reached out the State of Texas architectural review board and they want me to submit plans for a formal discussion when I'm only - [Caviwipes Causing Breakdown of Machines](https://progressivesurgicalsolutions.com/forums/topic/caviwipes-causing-breakdown-of-machines/) - Hello! I oversee quality for an eye surgery center, and we have had issues with our phacoemulsification machines breaking down from repeated Caviwipe use. We recently purchased a new type of wipes (SaniCloth Plus, with a red lid, which I believe were recommended by the Alcon reps, if I’m not mistaken). These were meant to - [Translation Service](https://progressivesurgicalsolutions.com/forums/topic/translation-service/) - What translation service does anyone recommend? It appears that Section 1557 is requiring ASC's to have a translation service available. - [ASCQR - Health Equity Measure](https://progressivesurgicalsolutions.com/forums/topic/ascqr-health-equity-measure/) - Do you have any policies or information regarding how to meet this new measure for 2025? Will you be offering a Webinar? - [Staff postoperative infection/complication report](https://progressivesurgicalsolutions.com/forums/topic/staff-postoperative-infection-complication-report/) - Hello, I am currently reviewing our infection control policies and procedures. In looking through the policies and procedures>QAPI>Infection Control tabs, I could not find the staff postoperative infection/complication report online. Can I get the most recent update of this form? - [GLP-1 and SGLT-2 drugs](https://progressivesurgicalsolutions.com/forums/topic/glp-1-and-sglt-2-drugs/) - We are recieving a lot of push back on canceling patients that do not hold these drugs for the recommended time prior to cataract surgery. I'm curious as to what other centers are doing. Lisa - [ASC 15 OAS CAHPS](https://progressivesurgicalsolutions.com/forums/topic/asc-15-oas-cahps/) - I just got an email that said that ASC 15 is no longer required for 2025??? I can't find confirmation from CMS. - [CURRENT ABN FORM](https://progressivesurgicalsolutions.com/forums/topic/current-abn-form/) - Does anyone have the most current ABNs available to share? - [Background Check on new CRNA](https://progressivesurgicalsolutions.com/forums/topic/background-check-on-new-crna/) - Our facility will be having some traveling CRNA, until the group we lease, gets more permeant employees. I have begun the process of credentialing them. Please help with how detailed or, which background check do I have to do for this process. Ex just the State Patrol one, for if the person has been fingerprinted, - [Consents](https://progressivesurgicalsolutions.com/forums/topic/consents-7/) - Hi, I was always taught if you are adding something on to the procedure (we type our consents out and then handwrite anything that was forgot or added on) after the patient has signed the consent, that they should initial by what was added on. Is there any documentation to support this? Or what is - [Generator testing](https://progressivesurgicalsolutions.com/forums/topic/generator-testing-4/) - Hello! Is there somewhere I can find the specific requirements for generator testing for an ASC? Specifically, I am trying to see how often it is required to do a load test and how long the load test needs to be. Also, how is it annually that our generator needs to be serviced by a - [Water softener installation considered construction?](https://progressivesurgicalsolutions.com/forums/topic/water-softener-installation-considered-construction/) - We are potentially installing a water softener in our facility and I'm wondering if AAAHC needs to be notified, is it considered construction for a project like this? Are there additional compliance requirements I could be missing. Thank you for any insight! - [instrument cleaning before repairs](https://progressivesurgicalsolutions.com/forums/topic/instrument-cleaning-before-repairs/) - We are needing a policy on cleaning instruments prior to sending them out for repair. Does anyone have a policy they are willing to share to give me a starting point? Thank you in advance. - [Water Quality](https://progressivesurgicalsolutions.com/forums/topic/water-quality/) - . Is there a sample form for required monitoring / proof of compliance of this policy? - [Autoclave chamber descaling and cleaning](https://progressivesurgicalsolutions.com/forums/topic/autoclave-chamber-descaling-and-cleaning/) - Hi everyone! Does anyone have a contact or any information about having a large autoclave cleaned? We are experiencing scale buildup and possible cassette and tray infiltration. The company who services our autoclaves mentioned he thought there was a company out there that cleans the autoclave chambers. Thank you! - [OAS CAHPS](https://progressivesurgicalsolutions.com/forums/topic/oas-cahps-5/) - Curious if anyone is willing to share which vendor they are working with and why? 200 per year is a high number for us and I am not sure if our population will use web based. Looking at phone or mail. - [Facility Consent](https://progressivesurgicalsolutions.com/forums/topic/facility-consent/) - Is an ASC Facility Consent a CMS and AAAHC requirement? - [Medication waste used syringes](https://progressivesurgicalsolutions.com/forums/topic/medication-waste-used-syringes/) - Hi, just wondering if you can give guidance with WA state laws reguarding waste of syringes with trace medications and other medications. We use Stericycle, black bin for medical waste. And CsRx containers for controlled medication waste. Over the last 8 years-Historically, all (non-controlled) medications and syringes used for the day went into the black - [E-scribing medications](https://progressivesurgicalsolutions.com/forums/topic/e-scribing-medications/) - Hello, My surgeons are requesting the RN's have the ability to e-scribe medications to the patient's pharmacy in the event they are missing drops or additional meds are needed upon discharge. I have searched CMS SOP and TSPB and have not found any specific restrictions on this. I just want to make sure I'm not - [Surgery time limit](https://progressivesurgicalsolutions.com/forums/topic/surgery-time-limit/) - What is the standard length of surgery time, in an ASC, with general anesthesia? We have a retina surgeon that is wanting to schedule a case that he anticipates will be 3-4 hours long. He would like anesthesia to be a general. I feel we are stepping into a length of time that is out - [InfluenzVaccine](https://progressivesurgicalsolutions.com/forums/topic/influenzvaccine/) - Hello! There were a couple of posts on the forum regarding flu vaccinations but there were from 2016. I would like to understand if the flu vaccine is required for ASC employees. Thank you! - [Laser Safety Officer](https://progressivesurgicalsolutions.com/forums/topic/laser-safety-officer-3/) - Do I need to have a job description signed and placed in the employee file of the person appointed to this position? If so, does anyone have a job description they could share? Thanks in advance. - [Life Safety Drawings](https://progressivesurgicalsolutions.com/forums/topic/life-safety-drawings/) - During our Joint Commission survey we were dinged because our life safety drawings did not identify the hazardous rooms. Our building was completed in 2015, I have all our plans or so I thought. I see the life safety plans and the legend about fire walls but I do not see anything about "hazardous rooms." - [flu vaccination](https://progressivesurgicalsolutions.com/forums/topic/flu-vaccination/) - When does flu season vaccination start and end? I can't find it any where. I believe its start of September to end of march? Thank you - [Anesthesia Outsourcing](https://progressivesurgicalsolutions.com/forums/topic/anesthesia-outsourcing/) - Our Anesthesia providers recently filled Chapter 11. We are currently trying to decide what to do going forward. What anesthesia models do you currently use? - [Discharge criteria for ride](https://progressivesurgicalsolutions.com/forums/topic/discharge-criteria-for-ride/) - What are the criteria for a patient receiving Versed or fentanyl for surgery, for taking Uber or a Taxi home. I have documentation/codes from Texas administrative code and CMS that says if the doctor writes an order stating "the patient may leave without the company of a responsible adult " And it should be an - [Laser Safety Officer Education](https://progressivesurgicalsolutions.com/forums/topic/laser-safety-officer-education/) - Would anyone have a recommendation for Laser Safety Officer education other than AORN? Thank you. Leslie - [Service Animal Policy](https://progressivesurgicalsolutions.com/forums/topic/service-animal-policy/) - I need to make a service animal policy for our ASC. Does anyone have a good one to share?? Or a link to one? - [Physician Order for Supplemental O2](https://progressivesurgicalsolutions.com/forums/topic/physician-order-for-supplemental-o2/) - We are an Ophthalmic ASC and most of our patients are receiving minimal to moderate sedation. We usually put our patients on 2L O2/NC during their admission in preop and continue it's use throughout the procedure. It's discontinued and the end of the case, and the patient's are sent to post-op without (unless on continuously - [How long to Keep](https://progressivesurgicalsolutions.com/forums/topic/how-long-to-keep/) - we have a folder of protected information (new hire labs, titers, physicals) of previous employees (yes, locked up safe). How long do we need to keep them? Or do we even need to keep them once no longer employed? thanks - [Section 1557 Coordinator](https://progressivesurgicalsolutions.com/forums/topic/section-1557-coordinator/) - What position is being recommended for the Section 1557 Coordinator? Is this best suited for an HR person, Corporate Compliance Officer or Clinical Administration? Thank you for your help. Leslie - [OAS CAHPS](https://progressivesurgicalsolutions.com/forums/topic/oas-cahps-4/) - Does Medicare require that ASCs continue to do their own surveys in conjunction with OAS CAHPS surveys? I saw that if we do our own surveys then to pick a different patient sample, but don't see where we are required to do them as well. - [Anesthesia billing sheet](https://progressivesurgicalsolutions.com/forums/topic/anesthesia-billing-sheet/) - Hello- Looking for anesthesia meds check off list for individual patients Thank you - [Recommended RN Conscious Sedation Course](https://progressivesurgicalsolutions.com/forums/topic/recommended-rn-conscious-sedation-course/) - Looking for a good RN Conscious Sedation Course. If anyone has one to recommend via online and/or in person (In-person preferably in Texas). We appreciate your input/recommendation. L Graham, RN - [Hazard Vulnerability Analysis](https://progressivesurgicalsolutions.com/forums/topic/hazard-vulnerability-analysis-2/) - Do the Joint Commission required risk assessments like Safety and Security for people, Utilities, Hazardous Materials, etc. have to be on a Hazard Vulnerability Analysis (HVA)? I have an individual risk assessment for each in our Safety manual, "Management Plans." If so, are they on a separate HVA where I have to rate them or - [General questions](https://progressivesurgicalsolutions.com/forums/topic/general-questions/) - Hello, Few questions- 1- Is a post laser (Yag, Slt, Focal) blood pressure required? Blood pressure is taken prior to the laser but there is no recovery period, patients leave right after the laser is performed. 2- We have a consultant as our primary Infection Control Preventionist. What is the educational requirements for someone on - [Webinar Slides](https://progressivesurgicalsolutions.com/forums/topic/webinar-slides/) - Are the slides from the July 29th webinar on RCM available yet? - [Premium Lens Payments](https://progressivesurgicalsolutions.com/forums/topic/premium-lens-payments/) - One of our surgeon office's wants us to bill them for the specialty lens for a group of 10 patients that they received a special package price from lens manufacturer. It has always been our policy to collect specialty lens costs directly from the patient on DOS to avoid any compliance issues. What are the - [Opthalmic betadine](https://progressivesurgicalsolutions.com/forums/topic/opthalmic-betadine/) - To prep the eye we currently use 5% betadine from Alcon and draw it up into individual pt syringes. I am wondering if we use sterile technique, can we transfer the 5% betadine into a sterile eye dropper bottle and use that for the administration rather than the individual syringes? We would be using it - [Annual training of staff for Patients rights and responsibility](https://progressivesurgicalsolutions.com/forums/topic/annual-training-of-staff-for-patients-rights-and-responsibility/) - On ASCA connect- ASCA members community a nurse wrote that they were sited by AAAHC for not having an annual pt's rights and responsibilities training. We do an annual Risk management training but not the pt's rights. do you have any information on what this training would include? - [Accreditation](https://progressivesurgicalsolutions.com/forums/topic/accreditation-3/) - Hi, we are an ophthalmology only ASC- 1 OR, 2 surgeons, doing around 2000 surgeries a year. We would like to become accredited- what accrediting agency would you all recommend? And what does 'deemed status' mean? - [Epinephrine in BSS](https://progressivesurgicalsolutions.com/forums/topic/epinephrine-in-bss/) - Good morning, Our surgeon is wanting to start using preservative free epinephrine in BSS instead of Omidria for cataract surgery. What is the correct ratio that needs to be used for this? Thank you, Alexis - [ANSI/AAMI ST108](https://progressivesurgicalsolutions.com/forums/topic/ansi-aami-st108-2/) - Is the new standard by ANSI/AAMI ST108 a requirement for ASC's or just a recommendation. - [Additional patient beds- Notification](https://progressivesurgicalsolutions.com/forums/topic/additional-patient-beds-notification/) - We are adding 8 new pre/post beds at our facility. Is there anyone we need to notify? Medicare? Guidance is appreciated. - [Credentialing for a PA in ASC](https://progressivesurgicalsolutions.com/forums/topic/credentialing-for-a-pa-in-asc/) - One of our surgeons wants to have his PA come and assist in his surgeries. Does anyone have a privilege request form they could share? Are privileges determined by the scope of practice in our state? Thank you - [Confused/ High-alert Medication labeling](https://progressivesurgicalsolutions.com/forums/topic/confused-high-alert-medication-labeling/) - Looking for a better strategy for labeling our confused and high-alert medications. Currently we have lists with color coordinated stickers coding green for confused (look-a-like, sound-a-like) and red for high-alert medications. The nurses are placing stickers on each individual vial when they are adding it to their medication carts. The constant stickering seems to be - [Covid isolation for healthcare workers](https://progressivesurgicalsolutions.com/forums/topic/covid-isolation-for-healthcare-workers/) - Hi! In California.... What is the guideline for isolation for a healthcare worker that tests + for Covid. Everything I can find on CDPH and CDC for healthcare workers still shows isolation, 5 days - [Suction Filters](https://progressivesurgicalsolutions.com/forums/topic/suction-filters/) - How often should the filters from the wall suction be replaced? - [Todays Webinar](https://progressivesurgicalsolutions.com/forums/topic/todays-webinar/) - Hi there, Is anyone able to share the link for todays webinar that is happening right now? I never received a link after registering and cannot get ahold of anyone to help get it for me. Thank you! - [OAS CAHPS](https://progressivesurgicalsolutions.com/forums/topic/oas-cahps-3/) - Do ASCs need to register for OAS CAHPS?? - [Disaffiliation Letter](https://progressivesurgicalsolutions.com/forums/topic/disaffiliation-letter/) - One of our physicians does not want to renew privileges and I was wondering if anyone had an example of a disaffiliation letter. - [Strategic Plan](https://progressivesurgicalsolutions.com/forums/topic/strategic-plan/) - Does anyone have a template and/or ideas for creating, monitoring, maintaining, and updating a strategic plan? - [Handwashing sign](https://progressivesurgicalsolutions.com/forums/topic/handwashing-sign/) - Is there specific handwashing instructions that are required to be posted for an ASC? If so, where is the best place to get? Thanks! - [Surgeon fellowship in the ASC](https://progressivesurgicalsolutions.com/forums/topic/surgeon-fellowship-in-the-asc/) - Introducing a surgeon fellow into our ASC Ophthamology practice. I’ve done some research but can’t seem to find specific guidelines for attending supervision required or if the consent needs to specifically have the fellow’s name. Does anyone have a policy outlying the specifics? - [Ultrasonic Cleaning for ophthalmic instruments (How Often?)](https://progressivesurgicalsolutions.com/forums/topic/ultrasonic-cleaning-for-ophthalmic-instruments-how-often/) - We recently had our AAAHC inspection, and it was suggested that we should use our ultrasonic cleaner after every surgery. I cannot find any information supporting this and was wondering if this was common practice at other ophthalmic centers. - [Infection Control- TB Risk Assessmt](https://progressivesurgicalsolutions.com/forums/topic/infection-control-tb-risk-assessmt/) - I am updating our annual TB risk assessment and Item # 7 on the RA for ASC refers to "Respiratory Protection Program" and asks if we have a written respiratory- protection program". My understanding of this was that we are not required to have a Respiratory Protection Program if we do not have a high - [Annual Evaluation QAPI program Form](https://progressivesurgicalsolutions.com/forums/topic/annual-evaluation-qapi-program-form/) - We are looking for an annual evaluation form for the QAPI program. - [meeting minutes](https://progressivesurgicalsolutions.com/forums/topic/meeting-minutes/) - How much detail should go in meeting minutes when a discussion takes place that leads to a decision not to credential a provider? - [Notifiable disease reporting requirements](https://progressivesurgicalsolutions.com/forums/topic/notifiable-disease-reporting-requirements/) - Do you have a policy and procedure for the CMS infection control surveyor worksheet for 18c. "does the asc have a policy/procedure in place to comply with state notifiable disease reporting requirements?" I purchased all of the P&P's through progressive but I am not seeing one that looks like it will comply with this. Do - [Heparin in BSS](https://progressivesurgicalsolutions.com/forums/topic/heparin-in-bss/) - Do you have any experience/guidance on the use of Heparin in BSS irrigation solution for cataract surgeries to decrease fiber formation on the IOL? One of our surgeons is asking about this since he sees "fibers" post-operatively on the Clareon IOL's. He does not believe it is visually significant but heard of other surgeons using - [Medical Staff Credentialing Guide](https://progressivesurgicalsolutions.com/forums/topic/medical-staff-credentialing-guide-2/) - I noticed on the E-Support updated Medical Staff Credentialing Guide that in California we need to do a MediCaid State Exclusion Database Report. Can you provide the site where we obtain this report where we just put in the physician's name and it verifies or is there a list that we need to look at - [Infection Surveillance Reporting](https://progressivesurgicalsolutions.com/forums/topic/infection-surveillance-reporting/) - We are an Opthalmic surgery center located in Texas. We currently do infection surveillance monthly on our patients, but do not report it to NHSN. We recently had a case of endophthalmitis. Do I need to be submitting the monthly surveillance to NHSN? Additionally, do I need to report the case of endophthalmitis to NHSN? - [Radiation Safety Oficer](https://progressivesurgicalsolutions.com/forums/topic/radiation-safety-oficer/) - Does anyone have a job description for Radiation Safety Officer? - [Steam Sterilization use of biological](https://progressivesurgicalsolutions.com/forums/topic/steam-sterilization-use-of-biological/) - My question is related to infection control and the use of biologicals in steam sterilization. We use 3M brand biologicals and they recommend running a biological with every cycle which is what we presently are doing. However, AORN recommends daily testing on patient care days or even as little as once a week. Should we - [Health statements](https://progressivesurgicalsolutions.com/forums/topic/health-statements/) - Good morning, Do you have any examples to share for healthcare statements? Initial and annual questionnaire statement? - [Ebola Screening](https://progressivesurgicalsolutions.com/forums/topic/ebola-screening-2/) - Is the Ebola Screening still required by CDC upon admisiion? - [Cleaning of sterilization trays and lids](https://progressivesurgicalsolutions.com/forums/topic/cleaning-of-sterilization-trays-and-lids/) - We use Aesculap sterilization containers for our cataract surgery instrument trays and I am wondering if facilities are cleaning the tray and lid after each use and if yes, what are you using? Aesculap IFUs say if the tray bottom and lid are removed from the OR before the patient enters and are not visibly - [CAHPS survey consent](https://progressivesurgicalsolutions.com/forums/topic/cahps-survey-consent/) - Is there any specific consents we need to get from patients for participation in the CAHPS survey? - [Security Guard](https://progressivesurgicalsolutions.com/forums/topic/security-guard/) - Does anyone have a job description for a security guard they would share? - [LVN in a surgery setting](https://progressivesurgicalsolutions.com/forums/topic/lvn-in-a-surgery-setting/) - Is an ASC authorized to use a LVN? What are the limitations? - [air balance](https://progressivesurgicalsolutions.com/forums/topic/air-balance/) - I'm looking all over esupport and I'm not seeing information on air balance. I need to do my annual air balance test but i'm looking everywhere in esupport and not seeing any information on it, Which rooms besides the procedure rooms do we need to have air balanced? Is this a requirement for TJC annually? - [Pediatric ophthalmic lasers](https://progressivesurgicalsolutions.com/forums/topic/pediatric-ophthalmic-lasers/) - We are an ophthalmology only ASC. Our policy states we do not serve patients under the age of 15. Because of this, we do not have to have specific pediatric drugs or emergency equipment. One of our docs has a 13 year old patient who had cataract surgery in another state and since moved here, - [QAPI](https://progressivesurgicalsolutions.com/forums/topic/qapi-3/) - My question relates to QAPI monitoring/ data collection and evaluation. Our policy (as per PSS) Under Thresholds reads that each performance measure has a threshold that triggers further investigation. Our quarterly & annual quality indicator monitoring tools have a collum for "goal". Do we have to set our thresholds at the same level as our - [New OR medication narcotic for anesthesia use](https://progressivesurgicalsolutions.com/forums/topic/new-or-medication-narcotic-for-anesthesia-use/) - Hello, We are a 1 OR ophthalmic ASC, Joint Commission and CMS accredited. Our anesthesia MDs (MAC) have continuously requested we stock fentanyl for discomfort. Currently, we offer 5mg Valium PO and have PRN Midazolam. What steps are necessary to start offering PRN Fentanyl to be administered by the anesthesiologist? - [Smoke Evacuation Education](https://progressivesurgicalsolutions.com/forums/topic/smoke-evacuation-education/) - I see the new smoke evaculation policy provided but are there any education courses for staff to comply with the policy? - [Post Laser Vital Signs](https://progressivesurgicalsolutions.com/forums/topic/post-laser-vital-signs/) - Is it necessary to complete post op VS on laser procedures (YAG, SLT & all)? Where I worked before we added a comment 'MD deferred VS, pt stable & discharged from laser room' - [QAPI Dashboard - Relationships Category](https://progressivesurgicalsolutions.com/forums/topic/qapi-dashboard-relationships-category/) - On the QAPI Indicator Dashboard under the category for relationships, on the DB there is an indicator that states "physician satisfaction". We do not have a tool for measuring this indicator and we only have 2 physicains who do cases at our facility. We did use the satisfaction survey for employees and added this to - [BUSINESS STAFF EMPLOYEE FILE REQUIREMENTS](https://progressivesurgicalsolutions.com/forums/topic/business-staff-employee-file-requirements/) - ARE BUSINESS OFFICE AND FRONT DESK STAFF IN AN ASC REQUIRED TO HAVE BLS CERTIFICATION? - [benchmarking](https://progressivesurgicalsolutions.com/forums/topic/benchmarking-3/) - Will PSS be doing a benchmarking survey for 2024? Thanks - [ASC Liability Insurance](https://progressivesurgicalsolutions.com/forums/topic/asc-liability-insurance/) - Is there a minimum amount of liability insurance required for an ASC? I have found Florida Hospitals required $1.5/$5 million, but I have been unable to locate any information for ASC's specifically. - [DEA verification](https://progressivesurgicalsolutions.com/forums/topic/dea-verification/) - Hello, How do you verify that the DEA is valid? The DEA website I used to verify now asks for a token entry to verify. Any suggestions? Thanks. - [Policy for Pediatric Patients](https://progressivesurgicalsolutions.com/forums/topic/policy-for-pediatric-patients/) - Does anyone have a template or sample policy for caring for Pediatric Patients? We are currently going through a AAAHC survey and they are asking for a separate policy on this. We have some criteria outlined in a different policy but they are requiring an entire policy summarizing the care of pediatric patients. Any guidance - [Shredding surgical charts](https://progressivesurgicalsolutions.com/forums/topic/shredding-surgical-charts/) - Hello, Our current medical records policy states we will retain medical records for 10 years. WA State Medical Quality Assurance Commission states "Retention of Records 1. There is no general law in Washington requiring a practitioner to retain a patient’s medical record for a specific period of time.1 The Commission concurs with the Washington State - [Post-op calls](https://progressivesurgicalsolutions.com/forums/topic/post-op-calls/) - Can any staff member complete pre-op and follow up calls or does it have to be a nurse? - [Adding surgery day](https://progressivesurgicalsolutions.com/forums/topic/adding-surgery-day/) - As Director of Nursing at a Joint Commission-accredited ophthalmic surgery facility, surgeries are once a week, we're considering adding surgery days on Mondays or Wednesdays instead our current Tuesday/Thursday schedule, potentially starting in December. Seeking guidance on necessary steps, in addition to updating the day of operation in our scope of care: Regulatory Compliance: Any - [Ultrasonic cleaning machine](https://progressivesurgicalsolutions.com/forums/topic/ultrasonic-cleaning-machine/) - Does anyone use an ultrasonic machine that doesn't warm up? Is this a function that is mandatory? - [Intralipid Protocol](https://progressivesurgicalsolutions.com/forums/topic/intralipid-protocol/) - Hi, Does anyone use an intralipid protocol for their surgery center? Thanks! - [sharing equipment between clinic and ASC](https://progressivesurgicalsolutions.com/forums/topic/sharing-equipment-between-clinic-and-asc/) - Our ASC is owned by 1 doctor who also owns the clinic. We are in the same building. Can we share a cryoablation tank? If it was checked by our Bio med company, can we both use the same machine? It is on wheels and can be moved easily between the offices - [Annual Mandatory In-service Education Requirements Medical Staff](https://progressivesurgicalsolutions.com/forums/topic/annual-mandatory-in-service-education-requirements-medical-staff/) - Are the CRNAs and MDs required to have Annual Education Inservices done and documented in their employee files? I know that at the time of hire/privileging, these individuals complete the general orientation checklist for medical staff, so, should this be updated annually, and if so can we use the General Orientation Checklist and adapt it - [Wet Pipe Sprinkler Inspection](https://progressivesurgicalsolutions.com/forums/topic/wet-pipe-sprinkler-inspection/) - We currently check our sprinklers monthly. Are we required to check them weekly? Thank you, Alexis - [ANSI/AAMI ST108](https://progressivesurgicalsolutions.com/forums/topic/ansi-aami-st108/) - I'm still struggling with this topic, I reached out to the joint commission, they stated that they are not enforcing any standard on this new guideline, and they responded with : you should reach out to your local or health department to obtain guidance in helping to determine the requirements for your organization. I've called - [Anesthesia Time Billing](https://progressivesurgicalsolutions.com/forums/topic/anesthesia-time-billing/) - What is the rule on when anesthesia starts billing for their anesthesia time. Example: anesthesia sees patient and performs evaluation/consent in the preop area and then leaves for 10-15 min waiting on room to be cleaned. When can they legally start billing the patient for anesthesia time? - [In office procedures - narcotics](https://progressivesurgicalsolutions.com/forums/topic/in-office-procedures-narcotics/) - Our group has a in office procedure room and we are wondering what the process is for use of narcotics? Do they need to be counted in and out, same as an ASC? Where can we find guidance? - [Peer Reviews](https://progressivesurgicalsolutions.com/forums/topic/peer-reviews/) - We are an ophthalmology surgery center with one surgeon. We consult with outside physicians for the peer review process. Do the outside physicians need to sign any sort of agreement if the patient charts are de-identified? - [USP 797, Compounding medications](https://progressivesurgicalsolutions.com/forums/topic/usp-797-compounding-medications/) - We have a few surgeons who would like four products to be compounded in the ASC for tumescent solution. With USP 797, it states no more than three products should be mixed. It is not feasible for us to use a compounding pharmacy for this. Is it a CMS and/or AAAHC requirement to not mix - [SDS sheets](https://progressivesurgicalsolutions.com/forums/topic/sds-sheets/) - Good afternoon, We have an SDS binder. Can the binder be placed in a cabinet with glass doors. If so, does there need to be a sign designated that the SDS sheets are in there? Or is it fine to simply label the binder and inform all staff where the binder is located? Thank you, - [street clothing in OR](https://progressivesurgicalsolutions.com/forums/topic/street-clothing-in-or/) - We are a small 3 operating room ASC and Im curious if our cataract patients can wear street clothes with a gown over or is it NO street clothes past the red line? thank you for any information you can provide! also, do housecleaners need to wear a bunny suit when terminally cleaning daily? - [Glucose monitoring](https://progressivesurgicalsolutions.com/forums/topic/glucose-monitoring/) - Now that so many patients have devices to monitor their blood sugar, should we take their reading in PreOp/PACU or do our own test with our machine? - [OAS-CAHPS](https://progressivesurgicalsolutions.com/forums/topic/oas-cahps-2/) - Researching CMS-Vendor approved Surveyors, are there any stand out companies on the list that anyone recommends? - [ANSI/AAMI ST108 water quality monitoring guide- what are you other ASC's doing?](https://progressivesurgicalsolutions.com/forums/topic/ansi-aami-st108-water-quality-monitoring-guide-what-are-you-other-ascs-doing/) - hey guys! for the new ANSI/AAMI ST108 for water quality monitoring are all other local ASC's installing new water filtration systems? I brought in a company to discuss and they wanted to add in a ton of filtration systems and its a huge and expensive undertaking. were in california. what are you other ASC's doing - [Medication Reconciliation](https://progressivesurgicalsolutions.com/forums/topic/medication-reconciliation-6/) - Does the medication reconciliation form have to be completed on paper? We currently have a medications section in our EHR, but we also have patients sign a paper copy of those medications while we are updating their med list. Are both necessary? We are accredited by AAAHC. Thank you, Alexis - [Annual Training on paper](https://progressivesurgicalsolutions.com/forums/topic/annual-training-on-paper/) - Can we print out the annual training module and have ASC staff complete the quiz on paper? We have limited computer access on surgery days and it would be much quicker this way. Is admin able to create an annual training certificate of completion or grant credit on staff online Transcript? Please let me know - [NFPA 99 Risk Assessment](https://progressivesurgicalsolutions.com/forums/topic/nfpa-99-risk-assessment/) - Anyone have an editable NFPA 99 Risk assessment for life safety? I'm having a hard time finding one and did not see one on PSS. Thanks Carson - [Capsular tension ring](https://progressivesurgicalsolutions.com/forums/topic/capsular-tension-ring/) - Good afternoon, We are an opthalmic surgery center. We are looking for CTRs at a lower price than we are currently getting. Where do you order CTRs from? We use size 10,11, and 12. Thank you, Alexis - [QAPI Performance Indicator Pain Effectiveness on Dashboard](https://progressivesurgicalsolutions.com/forums/topic/qapi-performance-indicator-pain-effectiveness-on-dashboard/) - I have two questions related to the QAPI performance indicator on patients "being treated as effectively as possible for pain". We assess all patients for pain as per best practice, but when obtaining the QAPI tracking data should we just include patients treated for pain and exclude patients who have c/o pain but refused treatment.? - [Sharps Container Requirements](https://progressivesurgicalsolutions.com/forums/topic/sharps-container-requirements/) - What are current requirements for ASCs for sharps containers - must they be wall mounted, what is the definition of "free from tampering", etc.? - [Water Quality Questions](https://progressivesurgicalsolutions.com/forums/topic/water-quality-questions/) - Hello, I have some questions regarding what categories our water sources would qualify as. We use our own distilled water produced via steam process from a Durastill distiller to put in our Statim 5000 units to sterilize our instruments. We also use sterile water purchased from McKesson for use with cleaning instruments on the field - [AMA Core principle 7 ( Quad A)](https://progressivesurgicalsolutions.com/forums/topic/ama-core-principle-7-quad-a/) - Can anyone help me with this requirement for Quad A... "ABMS-certified or eligible medical specialists who perform surgical procedures within the accredited facility may perform only those surgical procedures delineated in their ABMS board certification and/or covered by American Medical Association (AMA ) Core Principle #7." I can not find anything for core principal # - [templates for governing body](https://progressivesurgicalsolutions.com/forums/topic/templates-for-governing-body/) - im looking for templates for meeting minutes, by laws etc... - [Credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-19/) - A retiring surgeon that was Chief Medical Officer. He will remain an owner of 15% interest in ASC. Does he relinquish clinical privileges for the credentialing file? What is required for him to remain on as a Board Member or as a part owner? - [operating room wet area risk assessment](https://progressivesurgicalsolutions.com/forums/topic/operating-room-wet-area-risk-assessment/) - I have completed the risk assessment but am wondering where to keep this and if PSS has any policy and procedures that go along with it. Also, is this something I need to do yearly or is it a one and done as long as our procedure types do not change - [MH Algorithm](https://progressivesurgicalsolutions.com/forums/topic/mh-algorithm/) - Hello, I am looking for a MH Algorithm, is it located anywhere in the forum? - [Instrument soap](https://progressivesurgicalsolutions.com/forums/topic/instrument-soap/) - Question for any ophthalmic surgery centers.... what are you using for soap to clean instruments during manual washing? Thanks for any suggestions. - [Water quality testing](https://progressivesurgicalsolutions.com/forums/topic/water-quality-testing-2/) - At no point in our processing of instruments do we use tap water, only bottled distilled water and sterile water. Are we still required to perform water testing? - [General anesthesia vs MAC](https://progressivesurgicalsolutions.com/forums/topic/general-anesthesia-vs-mac/) - My ASC is considering converting to offering general anesthesia. What medications, equipment, and medical supplies would be required for this. - [Infection Control Compliance Surveillance Audit Tool](https://progressivesurgicalsolutions.com/forums/topic/infection-control-compliance-surveillance-audit-tool/) - Hi, my question is related to the use of the IC compliance surveillance audit sheet and the frequency of sampling for QAPI compliance. I noticed that under the "Sample Size" column on the Progressive Quality Indicator Monitoring sample, it states under sample size "Quarterly Walkthrough". Presently we use the IC Compliance Surveillance Audit sheet provided - [QI -Chart Review](https://progressivesurgicalsolutions.com/forums/topic/qi-chart-review/) - Hi In reviewing our policy for documentation / incomplete charts, I realized that our policy states the "chart review for completeness will begin before the patient leaves the facility. PACU nurse will review the chart before discharge". Our patient turnover time is very quick (15-20 mins) in recovery and we are a small facility with - [Staffing in ASC](https://progressivesurgicalsolutions.com/forums/topic/staffing-in-asc/) - My ASC recently acquired another Ophthalmology ASC in Ca. Currently the ASC uses 1 RN in pre/post op with an MA and 1 RN in the OR. Is this acceptable practice or are they required to have an RN or other licensed staff member for pre op and another for post? - [Sterile Water Recall](https://progressivesurgicalsolutions.com/forums/topic/sterile-water-recall/) - Good afternoon, We are an ambulatory surgery ophthalmology center. A couple of months ago there was a recall on single-use sterile water for irrigation. We mix this with iodine 10% to prep the patient's eye for surgery. We are about to run out of the single-use sterile water that we have in stock, and we - [Fire Walls](https://progressivesurgicalsolutions.com/forums/topic/fire-walls/) - I know the wall between the other building occupant and the ASC has to be a 1 hour fire wall. What is the code for interior walls that encompass supply rooms and such but are not on the outer perimeter that separates occupants? Thanks - [Preventative Maintenance Requirements for Ice Machines](https://progressivesurgicalsolutions.com/forums/topic/preventative-maintenance-requirements-for-ice-machines/) - Good afternoon, Are there specific requirements related to preventative maintenance for Ice Machines? Thank you, Alexis - [peer review confidential agreement](https://progressivesurgicalsolutions.com/forums/topic/peer-review-confidential-agreement/) - Hello, Does anyone have a peer review confidential agreement to share? jgarces@azulvision.com - [Carm policies and procedures](https://progressivesurgicalsolutions.com/forums/topic/carm-policies-and-procedures/) - Hello, Does anyone have any policy and procedure or c-arms, the handling, requirements, and apron testing?? Appreciation - [MA in an ASC](https://progressivesurgicalsolutions.com/forums/topic/ma-in-an-asc/) - If the Board approves are you able to use MAs in an ASC? - [History and Physical](https://progressivesurgicalsolutions.com/forums/topic/history-and-physical-4/) - Must the pre-op H&P include previous surgeries? - [water quality testing](https://progressivesurgicalsolutions.com/forums/topic/water-quality-testing/) - I'm having a hard time understanding the new AAMI/ANSI water quality monitoring guidelines, We are endoscopy so I believe we would fall under critical water. And I do see all the different things we need to be testing for, Is there a specific dipstick test we can purchase to monitor these items? Does PSS have - [AAAHC, MDS notification requirements](https://progressivesurgicalsolutions.com/forums/topic/aaahc-mds-notification-requirements/) - We are an ASC with two operating rooms. When we were initially accredited, only one operating room was being used, however we are getting ready to open the second. I am going to be notifying AAAHC of the change- does anyone have experience with this and has AAAHC requested a CMS approval letter of change? - [facility logs](https://progressivesurgicalsolutions.com/forums/topic/facility-logs-2/) - We are limited on document storage. How long do you need to keep your facility logs ( daily EKG strips, monthly directional flow, medication refrigerator temperature log, warmer log, , pregnancy tesst kit log, daily blood glucose QC, crash cart and MH logsOR temp and humidity logs, etc.). I have mine from 2015-16 and on. - [Removal of Jewelry Before Surgery](https://progressivesurgicalsolutions.com/forums/topic/removal-of-jewelry-before-surgery/) - Does anyone have a form that they have their patients fill out about any jewelry, studs, etc. that they cannot remove before surgery? Our nurses are concerned that maybe patients are not telling us about all of the additional jewelry, studs, etc. that they may have that we cannot see. - [Storage - Use of Frozen Ammonitic Tissue for Pterygium Surgery](https://progressivesurgicalsolutions.com/forums/topic/storage-use-of-frozen-ammonitic-tissue-for-pterygium-surgery/) - Hi, and Happy New Year. I have a two-part question concerning the use and storage of frozen amniotic membrane specimens for use in a pterygium procedure. First, do we have to follow any specific mandates or guidelines when receiving and storing the frozen tissue to be used (I did not see anything about this in - [New policies to address EHR charting](https://progressivesurgicalsolutions.com/forums/topic/new-policies-to-address-ehr-charting/) - Hello- We are transitioning from paper charting to eCharts. Our current policies address paper charting, do you have policies that support eCharting? - [Waste Management](https://progressivesurgicalsolutions.com/forums/topic/waste-management/) - We currently have a large garbage dumpster within a gated enclosure. The truck that empties the dumpster is huge. It constantly spills oil and hydraulic fluid. We also have noticed the concrete cracking in some areas due to the weight of the truck. Although we only perform surgery one day per week, with deliveries and - [2024 NEW MEDICARE RATES](https://progressivesurgicalsolutions.com/forums/topic/2024-new-medicare-rates/) - Has anyone seen the Excel Spreadsheet with the new 2024 Medicare rates yet? - [ASC Facility Contract Documentation](https://progressivesurgicalsolutions.com/forums/topic/asc-facility-contract-documentation/) - I noticed on the ASC Facility Contract Documentation example that Patient Transfer Agreement was at the top of the list. From newer guidelines Medicare does not require patient transfer agreements any more and that we just need to notify the hospital our hours and scope of practice. So we don't need to do an OIG - [Accreditation requirements in California](https://progressivesurgicalsolutions.com/forums/topic/accreditation-requirements-in-california/) - If a 100% physician owned facility in California is CMS certified to accept Medicare then they are not required to be accredited by AAAHC, AAAASF etc, is this correct? - [Pts. walking to OR after sedation?](https://progressivesurgicalsolutions.com/forums/topic/pts-walking-to-or-after-sedation/) - I recently visited a California ophthalmology surgery center that has one RN in pre-post op along with a medical assistant. The patients are sedated by a CRNA in pre-op and then the eye is blocked by the surgeon. At that point the pt. walks to the OR and then walks back to post op after - [Senate Bill 809](https://progressivesurgicalsolutions.com/forums/topic/senate-bill-809/) - Does anyone know if we still need to fill out the monthly report for SB 809 for COVID funding? - [Joint Commission vs. AAAHC](https://progressivesurgicalsolutions.com/forums/topic/joint-commission-vs-aaahc/) - Hi! I am wondering if anyone has used Joint Commission for ASC deemed status recently. We have used AAAHC for years. But lately on a couple recent siurveys, we are feeling they have changed quite a bit. I am not sure if it is them or Medicare standards, but it seems that they are citing - [Laser room requirements](https://progressivesurgicalsolutions.com/forums/topic/laser-room-requirements/) - Hi, I am trying to make sure our laser room has all required documents and proper signage, looking on the TAC site there is a ton of information but very user friendly language, does anyone know of a site that would give me the required information in a user friendly version? - [Anesthesia Privilege Document](https://progressivesurgicalsolutions.com/forums/topic/anesthesia-privilege-document/) - I am looking for an anesthesia privilege form template. We currently utilize only CRNA's and no general anesthesia is administered in our ASC. Thank you - [Space Heaters](https://progressivesurgicalsolutions.com/forums/topic/space-heaters/) - My front desk staff are requesting a space heater. I know that has always been a big no no in surgery centers and medical facilities. Has anything changed? are there any types of space heaters allowed at this point? - [Smoke Detectors](https://progressivesurgicalsolutions.com/forums/topic/smoke-detectors/) - Is a smoke detector required in the generator room? - [Recredentialing and Peer Review](https://progressivesurgicalsolutions.com/forums/topic/recredentialing-and-peer-review/) - We have a physican that is with our group who has not performed any cases at our facility for the past 2 years and is now up for recredentialing. He still wants to have privileges here. He mostly does all his cases at the hospital and now and then would occasionally do a closed manipuation - [Discharge requirements](https://progressivesurgicalsolutions.com/forums/topic/discharge-requirements/) - If a patient is evaluated and approved for discharge in PACU by the physician, can the CRNA stay with staff and the patient (until the patient has left) if the physician is not available? - [Use of Vision Blue](https://progressivesurgicalsolutions.com/forums/topic/use-of-vision-blue/) - Does the use of Vision Blue qualify a cataract surgery to be coded as complex? - [Monitoring vitals intraoperatively](https://progressivesurgicalsolutions.com/forums/topic/monitoring-vitals-intraoperatively/) - Hello, At my facility we also do pain management. Some patients get sedation interoperatively, and some only do local anesthesia such as epidurals. With that said, do the patients not getting any type of sedation need their vitals to be monitored monitored throughout the procedure? Interoperatively? Or will preoperatively and post operatively suffice since no - [Back Ordered Single Dose Medications](https://progressivesurgicalsolutions.com/forums/topic/back-ordered-single-dose-medications/) - Hello. I am looking to see if there are any exceptions made by CMS/the CDC regarding single dose medications being utilized as a multi dose medication due to a nationwide back order? I am unable to find anything with a quick search and seeking some expert information! Thank you Megan - [Using aseptic technique to open and preparing clean syringes prior to DOS](https://progressivesurgicalsolutions.com/forums/topic/using-aseptic-technique-to-open-and-preparing-clean-syringes-prior-to-dos/) - We are exploring options to save time DOS. We notice it is time consuming to open each syringe and needle it prior to clean drawing up medication. The medication, such as betadine or lidocaine is drawn up with clean technique in the medication room then brought into the OR, it is injected into a sterile - [Local Anesthesia staffing requirements in OR](https://progressivesurgicalsolutions.com/forums/topic/local-anesthesia-staffing-requirements-in-or/) - Hello- When performing a local anesthetic only for minor procedures do we need to have 2 RNs present in the OR room? One to monitor the patient and one to circulate, or can this be done by one nurse? The surgeon has their own tech to help with the actual procedure. I know with conscious - [Agency Staffing paperwork requirements](https://progressivesurgicalsolutions.com/forums/topic/agency-staffing-paperwork-requirements/) - What documentation are ASC's required to carry on each agency staff member? Is there a required orientation checklist for the first time they are at the facility? - [Employee Health Program- FLU VACCINE Requirement](https://progressivesurgicalsolutions.com/forums/topic/employee-health-program-flu-vaccine-requirement/) - Hi, I am trying to get confirmation about steps that must be taken at our facility (St Luke's Surgery Center) as it relates to employees who decline to get the Flu Vaccine. I have had everyone who refuses sign a declination with/ reason but PSS's recent topics Employee Health Program Policy states that "If HCP - [Op Notes](https://progressivesurgicalsolutions.com/forums/topic/op-notes/) - I have 2 newer surgeons that don't appreciate the importance of the op note. What have others done to educate surgeons? Is there a resource that I can reference? The basic definition of what needs to be in an op note are very basic. I feel the op note should tell the "story" of what - [Policy & Procedures on ORA](https://progressivesurgicalsolutions.com/forums/topic/policy-procedures-on-ora/) - Are we required to have a P&P regarding ORA? Our nurses operate ORA during cataract surgery. If so, do you have a template I can use? - [HVF prior to a blepharoplasty](https://progressivesurgicalsolutions.com/forums/topic/hvf-prior-to-a-blepharoplasty/) - What is the time interval within which a HVF must be performed before a blepharoplasty? - [Closure of a center and storage of documents](https://progressivesurgicalsolutions.com/forums/topic/closure-of-a-center-and-storage-of-documents/) - Hello, How long after a surgery center closed are you required to keep the QA records and medical records? - [Bed Bugs](https://progressivesurgicalsolutions.com/forums/topic/bed-bugs-3/) - Good Afternoon We have noticed a significant increase in patients with bedbugs. Some are being noticed by staff in the clinic, on preoperative patients, some are being noted on preoperative clearance letters from PCPs in the area, and some are being found by preop nursing staff when the patient has been admitted to the ASC. - [USP 797 competency](https://progressivesurgicalsolutions.com/forums/topic/usp-797-competency/) - Does anyone have a UPS 797 competency tool/test that they've created and would be willing to share? - [Patient hospital admission after surgery](https://progressivesurgicalsolutions.com/forums/topic/patient-hospital-admission-after-surgery/) - We had a patient that had cataract surgery, everything went well, and the patient was discharged same day with stable vital signs. We received a call that the patient went to the ER that evening and had a stroke. What are our reporting requirements given that it was on the same day of surgery but - [Exhaust Fan Compliance](https://progressivesurgicalsolutions.com/forums/topic/exhaust-fan-compliance/) - On the July 2023 AAAHC Survey watch it mentioned " The exhaust fans serving the soiled utility room and the decontamination rooms were lacking the required biohazard warning signs located at the point of the exhaust." Can you clarify what this means? Where would you put a sign? - [Generator testing](https://progressivesurgicalsolutions.com/forums/topic/generator-testing-3/) - I DOWNLOADED THE MOST RECENT GENERATOR WEEKLY INSPECTION REPORT AND THE GENERATOR MONTHLY LOAD TEST LOGS. THESE LOGS ARE ARE EXTENSIVE AND WOULD SEEM TO REQUIRE A TECHNICIAN FROM OUR GENERATOR REPAIR AND MAINTENANCE COMPANY. IS THIS CORRECT?' - [Administration of IV sedation (Versed)](https://progressivesurgicalsolutions.com/forums/topic/administration-of-iv-sedation-versed/) - I am wondering if there are any ASCs that do not utilize CRNAs or other anesthesia personnel to administer IV sedation (Versed)? If yes, who gives it and is there specific qualifications required? i.e. ACLS Is it correct that if a Registered Nurse gives it, there must be a specific physician order and they must - [Sterilization (Documentation)](https://progressivesurgicalsolutions.com/forums/topic/sterilization-documentation/) - Is there a requirement to link a sterilization cycle and contents to a patient? We all document sterilization cycles by all those things required such as, contents of load, initials of personnel, the print out of the cycle, indicators, biologicals, etc. Is there a requirement to identify the same info by documentation in a patient - [Re-Credentialing-Liability Questionnaire and Documentation](https://progressivesurgicalsolutions.com/forums/topic/re-credentialing-liability-questionnaire-and-documentation/) - We send out re-credentialing packets to the physicians that are re-credentialing with us. Included in that packet is the liability questionnaire. On the inital credentialing, the physican had marked yes to the question (and provided documentation in 2008) if they had any judgements or settlements made against them in a professional liability case or any - [Annual training documentation](https://progressivesurgicalsolutions.com/forums/topic/annual-training-documentation/) - When we complete any education or training, we use the staff in-service form that everyone signs. I feel like we should also be documenting this training in each employee file. Is that necessary? Looking at the personnel records worksheet from AAAHC, they are looking for that documentation in each employee file. What is the best - [Immediate Post-Op Note](https://progressivesurgicalsolutions.com/forums/topic/immediate-post-op-note/) - Is an immediate post-op note required if the completed operative report is not available until the following day? I can't find any requirements in CMS CfC or any AORN recommendations. I imagine best practice says there should be one in there, but wondering if there is a requirement. Thanks! - [crash cart strips](https://progressivesurgicalsolutions.com/forums/topic/crash-cart-strips/) - Does anyone know if we need to keep the daily print out strip when we check the defib daily? - [job description forms](https://progressivesurgicalsolutions.com/forums/topic/job-description-forms/) - Does anybody know where the job descriptions are located in Esupport? I've been looking for a long time and cant find them. Thank you! - [Walking patients to their ride](https://progressivesurgicalsolutions.com/forums/topic/walking-patients-to-their-ride/) - Good Morning - I was wondering if any of the centers are having their techs walk the patients to their rides at discharge. Thank you. - [Alcohol based hand rubs](https://progressivesurgicalsolutions.com/forums/topic/alcohol-based-hand-rubs/) - How does ones test the functionality of an ABHR? - [Medical Record](https://progressivesurgicalsolutions.com/forums/topic/medical-record/) - Must an RN perform the quarterly medical record audits? Could the administrator do this (not an RN)? - [Job Description](https://progressivesurgicalsolutions.com/forums/topic/job-description-3/) - Does anyone have a job description for a Safety Coordinator/Safety Officer they would be willing to share? We would like to appoint a person to safety to be in charge of our CEMP. Thanks. - [CRCST](https://progressivesurgicalsolutions.com/forums/topic/crcst/) - Good Afternoon! My sterile processing tech has been diligently studying and has registered to sit for the CRCST exam in just a few short weeks. She has read the text several times through and also studied using a few different study guides. She was using a Quizlet, but realized that many of the answers were - [Enzyme cleaner](https://progressivesurgicalsolutions.com/forums/topic/enzyme-cleaner/) - Hello, I recently had an audit where the conversation came up regarding enzyme cleaner for Ophthalmic instruments. It was discussed that Ophthalmic instruments do not need to use enzyme cleaner for routine between case cleaning. Ex. Rinse, enzyme clean , rink, dry, wrap, sterile. Do to the TASS Factor and potential. With that said do - [Sterilizers per instrument IFU and wrapped cycles CfC 416.51 (a)](https://progressivesurgicalsolutions.com/forums/topic/sterilizers-per-instrument-ifu-and-wrapped-cycles-cfc-416-51-a/) - Looking for advise from other ASCs, IC.02.02.01 EP 2 The organization did not follow the IFU for their instruments (for example, Katena surgical handpiece and Ellips Phaco handpiece in prevac pulse sterilizer that required 270F for 4 minutes). The organization was using the preset cycles on its sterilizers with settings of 274F for 8 minutes. - [CEMP policies](https://progressivesurgicalsolutions.com/forums/topic/cemp-policies/) - After completing the hazard vulnerability analysis... I feel our center may need some additional policies pertaining to snow fall/ice storm, temp extremes/drought, and possibly external flood. Does anyone have policies pertaining to any of these they could share? Thanks in advance. - [Work Place Violence - Annual Education](https://progressivesurgicalsolutions.com/forums/topic/work-place-violence-annual-education/) - I was wondering if the E-Support CEU on Workplace Violence should be included in the Annual training. It is not on the mandatory Orientation and annual Education list, but I am aware that it is part of the annual educational training at other facilities in our area (Louisiana). Thank you. Sharon Bour - [Nursing Policy & Procedures Emergency](https://progressivesurgicalsolutions.com/forums/topic/nursing-policy-procedures-emergency/) - We are an ASC - Eye specialty facility and we only do surgery one day per week and we are closed on Fridays (and weekends). Presently we only do a check of our crash cart on our scheduled surgery day prior to the start of patient care. My question is "Should we be doing daily - [CMS / Joint Commission Requirements for OR staffing and OR RN](https://progressivesurgicalsolutions.com/forums/topic/cms-joint-commission-requirements-for-or-staffing-and-or-rn/) - Hello, Our ophthalmic ASC is Joint Commission/ CMS accredited. We have always had an ACLS RN in the OR circulating. We have Anesthesiologist MD in the OR for MAC, and most patients receiving PO Valium pre op and PRN Midazolam intra op. Our administrator learned from another CMS ophthalmic ASC in WA state we do - [Billing/Bundling](https://progressivesurgicalsolutions.com/forums/topic/billing-bundling/) - When is it appropriate to bill for things outside of our 66984 standard of care for a cataract procedure. We have seen an increase in morbidities that are requiring extra interventions (D50, hot compresses, ephedrine etc.) These interventions are causing extra investments to be made and our team was wondering if there are any ways - [Facility Temps](https://progressivesurgicalsolutions.com/forums/topic/facility-temps/) - Hello, Our facility frequently experiences extreme cold temperature situations. The AC unitl is controlled by a computer and on occassions hits 57-64* which is obviously outside of the range. We contact and ajust ranges, but still experience these temperatures. When documenting the current temperature is logged. What are the steps we need to take to - [Succinylcholine](https://progressivesurgicalsolutions.com/forums/topic/succinylcholine/) - I recently became aware that if you have succinylcholine in your facility you need to have Dantrolene in the facility also. We do not do any general anesthesia at our facility. We only do cataract or trabeculectomy procedures with local anesthesia and low level sedation, is there a real need for us to have Succinylcholine - [Pathology result reconciliation](https://progressivesurgicalsolutions.com/forums/topic/pathology-result-reconciliation/) - Hello, What is the responsibility of the ASC when it comes to pathology results. We have a log to confirm submission and pick up of the path/culture, confirmation of final result received, and we only fax the malignant or time sensitive, out of the norm results to the doctor. It is to be the surgeons - [CMS and over processing instruments](https://progressivesurgicalsolutions.com/forums/topic/cms-and-over-processing-instruments/) - Looking for advise, we were cited on the following: IC.02.02.01 EP 2 The organization did not follow the IFU for their instruments (for example, Katena surgical handpiece and Ellips Phaco handpiece in prevac pulse sterilizer that required 270F for 4 minutes). The organization was using the preset cycles on its sterilizers with settings of 274F - [ST108](https://progressivesurgicalsolutions.com/forums/topic/st108/) - Has anyone had a chance to get into ST108? Do we need to start looking into new policies/procedures in regards to these new standards? - [CMS Regulations re: Laser Room Staffing](https://progressivesurgicalsolutions.com/forums/topic/cms-regulations-re-laser-room-staffing/) - I am looking for guidance regarding the requirements in staffing our Laser room. I am having trouble finding clear guidelines that indicate there needs to be a RN involved in the laser room process . I have seen it mentioned on this forum, however, I need to show our partners the regulation(s). They currently utilize - [Decontamination IC.02.02.01 EP 2](https://progressivesurgicalsolutions.com/forums/topic/decontamination-ic-02-02-01-ep-2/) - Hello, looking for guidance on keeping instruments moist in the OR prior to decontamination. Currently our policy from 2011 states "Instruments should be wiped with a moist cloth or immersed in sterile water immediately following use on the sterile field.". I am having a hard time finding Progressive updated policy. I am aware "Guidelines for - [Sterilization Records](https://progressivesurgicalsolutions.com/forums/topic/sterilization-records/) - Are there any specific requirements stating the length of time to store Sterilization Records in our CS/Sterilization department? Our policy currently states to store them for 3 years. - [Offering new/ additional surgical procedure in our ophthalmic ASC](https://progressivesurgicalsolutions.com/forums/topic/offering-new-additional-surgical-procedure-in-our-ophthalmic-asc/) - Hello, I am a new DON and looking for resources for adding new surgical procedure in our ASC. Our medical director would like to start offering EVO Visian ICL lens, which is an implanted contact. Currently we offer Cataract surgery and Refractive Lens exchange. Our surgeon has done this procedure elsewhere, and we have scheduled - [pediatric crash cart/braslow bag](https://progressivesurgicalsolutions.com/forums/topic/pediatric-crash-cart-braslow-bag/) - Do we need a cart or bag for each peds patient? We have one crash cart and it goes with patient to OR and if there is a patient in recovery do they need one as well? - [Medical Supply Storage and Transport](https://progressivesurgicalsolutions.com/forums/topic/medical-supply-storage-and-transport/) - We are an ambulatory surgery center (3 OR's) located on the 6th floor of a building with a variety of different medical specialties. Due to changes in the organization, we will no longer be able to have our primary central supply storage on our floor, and are looking at have to move it to a - [AAAHC Satellite locations](https://progressivesurgicalsolutions.com/forums/topic/aaahc-satellite-locations/) - HI! I am trying ot get inofmation from anyone familiar with AAAHC satellite locations- we are considering it but I am looking for more information. Experiences with it, is Medicare billing # different for each location, Tax ID same or different. Pros/Cons - [TJC Accreditation expiring](https://progressivesurgicalsolutions.com/forums/topic/tjc-accreditation-expiring/) - Hi, I am a new DON at an ophthalmic ASC. Our Joint Commission accreditation expires next week and I submitted our application a month ago. I understand the survey is unannounced. My question is, what happens if they don't come before expiration? Is that common? Are we still able to serve medicare/medicaid patients? Please advise. - [Medical Record Audits](https://progressivesurgicalsolutions.com/forums/topic/medical-record-audits/) - With the advent of Electronic Medical Records, our current medical record audit form seems outdated and more appropriate for paper charts. With our EHR, we run a report at the end of the day for any unsigned charts and you can't sign the chart until all required elements are completed on that document. Do you - [LOT #'s](https://progressivesurgicalsolutions.com/forums/topic/lot-s-2/) - Is there a requirement for tracking Lot #'s Cataract/Glaucoma facility. We have historically not tracked lots for items used for every surgery (BSS bag, provisc, alcon pack). We began this practice and I can see why it would be best practice but with such quick turn over and sometimes switching of patient order at last - [Saline Flushes](https://progressivesurgicalsolutions.com/forums/topic/saline-flushes/) - We are having the debate at our facility about how long saline flushes are good for once they are opened. Due to the speed at which our outpatient surgeries are completed, our nurses try to prepare ahead of time. They attach a saline flush to an IV extension and keep in the anesthesia cart for - [Bariatric patient laser chair (no arms)](https://progressivesurgicalsolutions.com/forums/topic/bariatric-patient-laser-chair-no-arms/) - I am wondering what kind of ophthalmic laser stools (on wheels) that facilities are using for patients. Most stools are only rated for up to 250lbs. We feel we need a safer chair rated for much higher weights. This chair or stool works best with a back but no arms as they tend to hit - [Donning gloves for instillation of eye drops](https://progressivesurgicalsolutions.com/forums/topic/donning-gloves-for-instillation-of-eye-drops/) - I notice the policy for instillation of eye drops and administration of eye ointments has been updated to include donning gloves. Our medical director is wondering if this directly from CMS? Historically hand hygiene is required, not gloves. Are gloves REQUIRED? Or is it only Recommended? We are aware- it is a violation of the - [Q0042 Hospitalization Requirements](https://progressivesurgicalsolutions.com/forums/topic/q0042-hospitalization-requirements/) - Are there policies and procedures on a biennial basis for: 1) Annual scheduled polarity and tension testing 2) Annual scheduled electrical panel infrared testing. 3) Fire wall penetration checks - [Culture of safety evaluation tools](https://progressivesurgicalsolutions.com/forums/topic/culture-of-safety-evaluation-tools/) - The Culture of Safety policy states we will evaluate the culture of safety using valid and reliable tools. Can I get a link to these tools? For TJC survey- How does one evaluate the culture of safety as required document list requests "most recent culture of safety and evaluation data". Would it be the same - [Infection control coordinator/ officer](https://progressivesurgicalsolutions.com/forums/topic/infection-control-coordinator-officer/) - Can someone assist with providing resources we may use to show proof of infection control training for our infection control coordinator / officer. We would like additional tools other than the infection control E-courses in the continued education tab. I have seen AORN ASC Academy: Infection Prevention Online Course is costly. Looking for other affordable - [Cancellation follow ups](https://progressivesurgicalsolutions.com/forums/topic/cancellation-follow-ups/) - We seem to be dealing with quite a few surgery cancellations where the patient does not reschedule at the time of cancellation. We are ophthalmology, so most surgeries are non-emergent. Do any centers have a follow up protocol for pts that don't reschedule? i feel we are losing a lot of surgery volume because of - [Yag eval by 1 doc, and yag cap by another](https://progressivesurgicalsolutions.com/forums/topic/yag-eval-by-1-doc-and-yag-cap-by-another/) - Is there an issue in CA with a yag eval for a patient being conducted by one doctor, and then the actual yag cap completed by a different doctor? Thank you for the help! - [employee vaccinations](https://progressivesurgicalsolutions.com/forums/topic/employee-vaccinations/) - All of our staff on hire show proof of vaccinations or document if they had the virus such as Varicella. All clinical personnel get titers for Hep B, Tdap and MMR if they don't have recent titers. Does non-clirical staff such as medical records, front desk and surgery scheduler need these titers as well? - [BBP Exposure Sharps Injury](https://progressivesurgicalsolutions.com/forums/topic/bbp-exposure-sharps-injury/) - Hi, my question is related to the protocol that should be followed after an employee sharps injury. Our instrument technician sustained a pin prick-sized injury to her thumb while cleaning instruments following a cataract procedure. The injury site was thoroughly cleaned and blood was drawn from the patient and employee and sent for lab testing - [Betadine Alternative](https://progressivesurgicalsolutions.com/forums/topic/betadine-alternative/) - Our ASC specializes in Ophthalmology and we currently use PCMX as an alternative surgical prep for patients with a Betadine allergy/sensitivity. I'm wondering what others are using as an alternative for betadine allergic patients aside from PCMX? - [ICRA](https://progressivesurgicalsolutions.com/forums/topic/icra-2/) - Hi. I was wondering if the infection control risk assessments are to be done at the beginning of each year for the prior year or at the end of each year? The one that we currently use asks for population statistics and I can't get that from the census until the next year. - [Operating Hours](https://progressivesurgicalsolutions.com/forums/topic/operating-hours/) - We are an Ophthalmic ASC with Business Hours of 7am - 4:30pm, Surgery start times 7:45am to 8am. Are there any laws/rules that state we are not able/will get cited if we operate earlier or later than our "Business Hours"? Thanks for your help! Caroline, RN - [Conscious Sedation](https://progressivesurgicalsolutions.com/forums/topic/conscious-sedation-3/) - Is an additional RN needed in the OR for patients receiving Conscious sedation ( PO Valium) ? - [Ozempic](https://progressivesurgicalsolutions.com/forums/topic/ozempic/) - What protocols have been suggested for pt's on Ozempic? How many days/weeks do they have to be off the medication prior to surgery? - [Weekly/Quarterly COVID Vaccination Reporting](https://progressivesurgicalsolutions.com/forums/topic/weekly-quarterly-covid-vaccination-reporting/) - Is this still mandatory now that they're no longer declaring COVID as an emergency? We've continued to report quarterly but wondered if anyone had come across anything stating it is no longer necessary? - [Temperature and Humidity Monitoring After Hours](https://progressivesurgicalsolutions.com/forums/topic/temperature-and-humidity-monitoring-after-hours/) - We are currently utilizing a temp/RH monitoring product from ThermoData to monitor in areas as required. It utilizes our WiFi to download to the cloud where over/under alarms are sent to several employees mobile phones. Is there any other system out there being used that reports these conditions; specifically alarms being sent out when the - [Laundering](https://progressivesurgicalsolutions.com/forums/topic/laundering/) - Where is the best place to find any state specific requirements regarding laundering in facility rather than using an external company? (Idaho) - [Instrument Sterilization: Required Documentation?](https://progressivesurgicalsolutions.com/forums/topic/instrument-sterilization-required-documentation/) - Is it necessary to retain the the indicator from each, individual sterilized item/instrument/tray used in a case? Our indicator tags have a place to write item, load number, date and SPD Tech's initials and are placed in with the item to be sterilized. The tags from items used in a case are taped to a - [ASC educational handouts](https://progressivesurgicalsolutions.com/forums/topic/asc-educational-handouts/) - Does anyone know of, or can anyone share informational ASC handouts? I am working with our organization, and we are trying to educate the non-surgical team about ASCs. Curious if anyone has any to share - [Hand Hygiene/ Glove Use](https://progressivesurgicalsolutions.com/forums/topic/hand-hygiene-glove-use/) - Hello All. I work in an Ambulatory Eye Surgery Center in Albuquerque. We have been having a lot of discussions lately about gloves with instillation of eye drops. Our previous practice was to instill preop drops without gloves but post op drops were always done with gloves. It was recently recommended that we glove for - [Eye Wash Stations](https://progressivesurgicalsolutions.com/forums/topic/eye-wash-stations/) - Our eye wash station broke, and we were unable to obtain the parts needed to fix it. They have been on back-order for many months. We have installed a wall unit that is composed of 1 squeeze bottle. Reading the eye wash policy on your website, it looks as though this would not be up - [USP](https://progressivesurgicalsolutions.com/forums/topic/usp/) - I was wondering if PSS or anyone else has an example of a competency that was discussed in this webinar regarding aseptic technique and drawing up medications in a syringe. The webinar stated all staff and physicians must have documentation of competency in this area. I am looking for a form or tool for this. - [Tissue test requirements](https://progressivesurgicalsolutions.com/forums/topic/tissue-test-requirements-2/) - Where can I find info for checking pressures in OR and dirty SPD every month? Is this mandatory? Is it required to do tissue test monthly? or annual pressures testing? - [Tissue test requirements](https://progressivesurgicalsolutions.com/forums/topic/tissue-test-requirements/) - Where can I find info for checking pressures in OR and dirty SPD every month? Is this mandatory? Is it requred to do tissue test monthly? or annual pressures testing? - [Restoration repair from minor water leak in ASC](https://progressivesurgicalsolutions.com/forums/topic/restoration-repair-from-minor-water-leak-in-asc/) - Our ASC had a water leak in our clean utility room. We are contracting with a restoration company for repairs including cutting holes into dry wall to repair water damage. This is during non surgery day and we cancelled upcoming surgery day. The leak and construction repairs are located on the other side of red - [Storage In Biohazard Room](https://progressivesurgicalsolutions.com/forums/topic/storage-in-biohazard-room/) - I am needing "in writing on a CMS or Joint Commission resource" supporting my stance that the ASC cannot store left over building supplies (carpet squares, laminate floor, ceiling tiles) in a biohazard room, electrical room, gas storage closet, and or sterile storage area. All I can find are codes pertaining to building codes, not - [Bloodborne Exposure Protocol](https://progressivesurgicalsolutions.com/forums/topic/bloodborne-exposure-protocol/) - We are currently reviewing our Bloodborne Exposure Protocol. We do not conduct blood draws at our facility. How do other facilities, that do not perform blood draws, obtain blood samples from a patient after a known exposure? - [AEU information](https://progressivesurgicalsolutions.com/forums/topic/aeu-information/) - I am in need of AEU for my CSAC cert renewal and i am looking on the education tab and all i see is CEU can you please direct me where i might obtain AEU credit through the education tab? specifically right now in need of the Regulatory and legal issue AEU, thank you - [Education - In-service Requirements for Scrub Tech](https://progressivesurgicalsolutions.com/forums/topic/education-in-service-requirements-for-scrub-tech/) - Hi, our facility has an employee who has experience in instrument cleaning processing, but has no training or experience as a scrub technician and we would like to train him to scrub on our cataract cases. Our state regulations do not indicate that formal training and certification are required and so other than the obvious - [History & Physical &/or Medical Assessment](https://progressivesurgicalsolutions.com/forums/topic/history-physical-or-medical-assessment-2/) - If your policy excludes certain patients or surgical procedures from having a comprehensive history & physical, how are you accomplishing the then required physician medical assessment including their "determination of whether the patient can tolerate the surgical procedure based on age, diagnosis, the type and number of procedures scheduled to be performed on the same - [Voicemail for doctor on-call, multiple specialities](https://progressivesurgicalsolutions.com/forums/topic/voicemail-for-doctor-on-call-multiple-specialities/) - Wondering what other ASCs do with their voicemail box setup and how you direct patients to the doctor on call. We have multiple specialties and if it's after hours we want to make sure the patient can get in touch with the correct provider if they have questions or concerns. My thought is to say - [EMR](https://progressivesurgicalsolutions.com/forums/topic/emr-2/) - We are an ophthalmology ASC and are looking at computerized charting. We have narrowed our search to SIS Complete and HST. Looking for positive/negative feedback on either system. - [Personnel Terminal Cleaning Infection Control Training Requirements](https://progressivesurgicalsolutions.com/forums/topic/personnel-terminal-cleaning-infection-control-training-requirements/) - Are there any specific infection control training requirements for Housekeeping personnel who perform terminal cleaning of ORs besides the documented completion of the IC e-support CEU courses? Would employees who are conducting terminal cleaning require more than an in-service on our policy & procedure, AORN cleaning/sanitizing guidelines review, and watching a video that follows AORN - [In-services/Training](https://progressivesurgicalsolutions.com/forums/topic/in-services-training/) - Is there a specific CMS requirement in regards to in-services/ education, other than the classes taken on this website and our employers website? - [Patient Satisfaction Surveys](https://progressivesurgicalsolutions.com/forums/topic/patient-satisfaction-surveys-3/) - Since SPH sold to Press Ganey, does anyone have recommendations for a survey that is more geared towards ASC's? - [USP 797 STERILE PREPARATION REQUIREMENTS](https://progressivesurgicalsolutions.com/forums/topic/usp-797-sterile-preparation-requirements/) - The USP 797 requirements will be updated in November 2023. Will AAAHC or CMS be changing their requirements to match these requirements? In particular I am wondering about the 4 hour requirement for administering medications. My policies state we give all medications within 1 hour of drawing them up. Should I change my policies now - [OR cleaning schedule](https://progressivesurgicalsolutions.com/forums/topic/or-cleaning-schedule/) - Does someone have a good source for what is required and when (i.e. daily, monthly, quarterly) etc. for environmental cleaning in an ASC? I am looking for like a spread sheet that shows when things like supply lockers, inside storage cabinets, code carts, storage carts, refrigerators, etc. need to be cleaned and the frequency. - [Age requirement policy](https://progressivesurgicalsolutions.com/forums/topic/age-requirement-policy/) - Hello, I am looking for a policy that goes more into detail about the age requirement to have surgery at my facility. We do not do peds patients that are not at least of adult size. Any input would be appreciated. Thanks!! - [Laundering of scrubs](https://progressivesurgicalsolutions.com/forums/topic/laundering-of-scrubs/) - We are an ASC performing opthalmology surgeries. We are currently using a commercial laundry to wash and dry our surgical scrubs. However, we have had nothing but problems with getting them returned to us in a timely manner. Does anyone know if scrubs can be laundered in house and what are the regulations if so? - [policy for infusions](https://progressivesurgicalsolutions.com/forums/topic/policy-for-infusions/) - We are possibly going to start doing infusions for pain in our surgery center. We are not doing full out pain management, just infusions. Do I need any specific policy/procedures for this? - [Policy and Procedure for Real-Time Ultrasound-Assisted Gluteal Fat Grafting.](https://progressivesurgicalsolutions.com/forums/topic/policy-and-procedure-for-real-time-ultrasound-assisted-gluteal-fat-grafting/) - Hi, I am looking for a P&P regarding Real-Time Ultrasound-Assisted Gluteal Fat Grafting. - [Product vendor policy](https://progressivesurgicalsolutions.com/forums/topic/product-vendor-policy/) - I am looking for a policy on allowing a product vendor to bring in new products and/or observe in the OR. We have several new surgeons and rather than get approval from the surgery director, the rep will just ask the surgeon. I need to have a little better control on this issue.Thanks! - [Diamond Knife Repair](https://progressivesurgicalsolutions.com/forums/topic/diamond-knife-repair/) - For the ophthalmology centers, who do you use for diamond knife repairs? We are not too happy with our current providers services. Thank you! - [YAG laser documentation](https://progressivesurgicalsolutions.com/forums/topic/yag-laser-documentation/) - We are overwhelmed with the paperwork we are doing to perform a YAG laser procedure. this can be be done months or years after a cataract surgery. We are using the exact paperwork we use for a surgical patient and the procedure takes about 1 minute. It is done in our ASC in a small - [Home Narcotic Medication Policy](https://progressivesurgicalsolutions.com/forums/topic/home-narcotic-medication-policy/) - We prescribe all patients post operative medications during pre op. They bring all the medication with then the morning of surgery. Is there a policy regarding home medications/home narcotics regarding counts, double lock storage, administration, ect.. ? - [NARCOTIC AUDIT FORM](https://progressivesurgicalsolutions.com/forums/topic/narcotic-audit-form/) - DO YOU HAVE A QUARTERLY NARCOTIC AUDIT FORM AVAILABLE? - [CGB vs MAC](https://progressivesurgicalsolutions.com/forums/topic/cgb-vs-mac/) - Can the same individuals be on the governing body and the mac committee? - [Pulling in Pharmacy Meds](https://progressivesurgicalsolutions.com/forums/topic/pulling-in-pharmacy-meds/) - Our EMR system has the option for pulling in medications from the outside pharmacy (like I'm sure many do). However when we start to click that option, a default pops up that says, do you have consent from the patient? However, another EMR representative recently told us that we do not need a separate signed - [C arm policy](https://progressivesurgicalsolutions.com/forums/topic/c-arm-policy/) - We have a c arm at our facility. Use it on occasion. Does anyone know or have policies and procedures to share? The led tabs, what's the protocol for that? - [Return to OR same day](https://progressivesurgicalsolutions.com/forums/topic/return-to-or-same-day/) - What documentation is needed when a patient returns to the OR the same day? Are there specific policies and procedures we need to have in place? If so can you share those with us? - [Policy and Procedure Attestation Form](https://progressivesurgicalsolutions.com/forums/topic/policy-and-procedure-attestation-form/) - Can you please remind me where I can find the attestation form that goes in front of every policy binder? It's the form that is signed annually. - [National Patient Safety Goal 16](https://progressivesurgicalsolutions.com/forums/topic/national-patient-safety-goal-16/) - Suggestions on addressing or complying with requirements for NPSG 16 Improve Health Care Equity. We utilize a discharge planning summary, which assesses affordability of post-op medications, presence of a caregiver. transporation etc. Suggestions? - [Prescription Pads](https://progressivesurgicalsolutions.com/forums/topic/prescription-pads/) - I recently found some older prescription pads ( approx 2+ years ago) in a cabinet. With most prescriptions being electronic, can the older carbon copy ones still be used? Or should I discard them? - [Patient Rights and Protections against Surprise Medical Bills Facility Notice](https://progressivesurgicalsolutions.com/forums/topic/patient-rights-and-protections-against-surprise-medical-bills-facility-notice/) - Can some one explain the Patient Rights and Protections against Surprise Medical Bills facility Notice. What I am specifically interested in is what should be posted in the facility and what information is necessary for the patient to receive. I have read your policy but really need examples. Thank you - [Pathology requirements for AAAHC](https://progressivesurgicalsolutions.com/forums/topic/pathology-requirements-for-aaahc/) - We occasionally use pathology and have an agreement with a few places. We are preparing for AAAHC and I was questioning what documentation I needed from them to fulfill the requirements? I have called some of the labs and often it is received with a lot of questioning. Thank you - [Shoe covering in an ASC](https://progressivesurgicalsolutions.com/forums/topic/shoe-covering-in-an-asc/) - Hello, For infection control purposes we put show covers on all our patients upon admission to pre op, along with bouffant caps. Is this best practices and ok to do or would it be justifiable to just remove the shoes? - [Sterilization Indicator Storage](https://progressivesurgicalsolutions.com/forums/topic/sterilization-indicator-storage/) - Where are the Sterilization indicator strips stored? On the pt Chart? In a log book? Or do you keep them at all? - [Cataract Femto operative report](https://progressivesurgicalsolutions.com/forums/topic/cataract-femto-operative-report/) - I am being asked by a couple of my providers if there was a specific way that is mandatory to document combination of femtolaser and cataract. We understand not all patients are candidates for these procedures but apparently Corcoran states there must be specific terminology documented to ensure compliance? Anyone have any guidance or templates - [Medication lot/expiration numbers](https://progressivesurgicalsolutions.com/forums/topic/medication-lot-expiration-numbers/) - We are wondering if some medications given to the patient either pre-op or intraop can be written without lot numbers/expiration date. For example, our current pre-op orders do not have us list lot and expiration numbers for our ophthalmic drops given (numbing/dilating drops), but, all of our intraop drops are written so that these items - [Patient fall](https://progressivesurgicalsolutions.com/forums/topic/patient-fall/) - When a patient falls at the facility, does this need to be documented in the medical record? Or proper incident reports and quality assurance follow through will suffice. It is understood that this is a reportable incident. Please advise as far as the required compliance components needed to be done when a patient falls in - [Poor response rate of patients completing the patient satisfaction survey.](https://progressivesurgicalsolutions.com/forums/topic/poor-response-rate-of-patients-completing-the-patient-satisfaction-survey/) - Any ideas as to how to increase completion of pt satisfaction surveys? Everything we have tried does not work. - [IV sedation/MAC vs General anesthesia](https://progressivesurgicalsolutions.com/forums/topic/iv-sedation-mac-vs-general-anesthesia/) - Hello, Our board is debating if we should start doing general anesthesia at our ASC. What are the requirements, medications, and equipment needed to get this accomplished should they agree to do GA? - [Signatures on discharge forms](https://progressivesurgicalsolutions.com/forums/topic/signatures-on-discharge-forms/) - Is a signature "required" on postop discharge instructions or responsible driver form? If driver does not come in with patient, we are having difficulty chasing them down for a signature. - [COVID Temperature Monitoring](https://progressivesurgicalsolutions.com/forums/topic/covid-temperature-monitoring/) - COVID-19 Temperature Monitoring ----I'm new to the ASC Nurse Manager Role. The position was vacant for about 6 months prior to me starting . Basically, not much was being done with temp checks, etc. Does anyone know when the CDC stopped requiring them? - [Expired lens implantation reportable](https://progressivesurgicalsolutions.com/forums/topic/expired-lens-implantation-reportable/) - Hello, In the event a lens I'm correctly implanted BUT expired with no need for surgical intervention is this reportable? Gcode G8912/G8913 wrong site, wrong side, wrong patient, wrong procedure, wrong implant However, the implant wasn't wrong it was just expired Thank you in advance - [TB Testing](https://progressivesurgicalsolutions.com/forums/topic/tb-testing-3/) - Hi. Currently I am testing employees yearly for TB , but I don't believe that this is currently the case anymore. However, I cannot find any literature on it. I am in California and we are AAAASF certified. Can you assist me with this? Thanks Anna - [Who can scrub in?](https://progressivesurgicalsolutions.com/forums/topic/who-can-scrub-in/) - We have an employee who has been working on our clinic side for 2 years with the doctor and he wants to start training her to scrub in with him in the OR. She does not have her COA yet. Is it ok for her to start "training" to scrub with the current COA as - [Safety Data Sheets](https://progressivesurgicalsolutions.com/forums/topic/safety-data-sheets-2/) - Good Afternoon! I am interested in an online platform/database that provides Safety Data Sheets for ASCs. Does anyone have the name of a good company that they use, you would be willing to share? Thank you very much! - [New Chief Executive Officer](https://progressivesurgicalsolutions.com/forums/topic/new-chief-executive-officer/) - Hi, at our Podiatry ASC we have now brought in our own Anesthesiologst and CRNA's as apart of our staff rather than contracting out an Anesthesia group. Due to this our medical director is still the same but our Chief Executive officer would need to change under the new anesthesiologist. Besides the initial appointment and - [Eyelash Extensions worn in OR](https://progressivesurgicalsolutions.com/forums/topic/eyelash-extensions-worn-in-or/) - We recently had a provider ask us about a policy for fake eyelashes being worn by employees working in the OR. In researching this, I cannot find and agency or accrediting body that takes a position on this topic. Has anyone else encountered this or developed a policy regarding this? Thank you. - [Requirements for contacting a patient postoperatively](https://progressivesurgicalsolutions.com/forums/topic/requirements-for-contacting-a-patient-postoperatively/) - Several of the staff are questioning the rationale of contacting a patient for a post op call when they see their doctor the next day. Could someone please give me a regulation or standard that addresses this. - [Universal Masking and Patient Screening](https://progressivesurgicalsolutions.com/forums/topic/universal-masking-and-patient-screening/) - Do you have guidance for us on universal masking for staff and patients in the ASC in Texas? I am also wondering if we still have to screen patients. I noticed the CDC tracker for COVID community transmission level was discontinued. There were some changes on May 11th. https://covid.cdc.gov/covid-data-tracker/#datatracker-home - [ACLS for Surgeons](https://progressivesurgicalsolutions.com/forums/topic/acls-for-surgeons/) - Hello, Is there a CMS requirement which states that a surgeon needs to be ACLS certified? We always have two ACLS and our RNs and anesthesiologist are ASCLS certified. - [History & Physical &/or Medical Assessment](https://progressivesurgicalsolutions.com/forums/topic/history-physical-or-medical-assessment/) - I am looking for sample forms used to complete a "medical assessment". In Ohio, both the Dept of Health & CMS used to require a comprehensive history and physical before any surgery, including cataract surgery with just IV sedation. Both the ODH and CMS now say that the facility can choose when a medical assessment - [ASC Surgeon required to be on staff at a hospital](https://progressivesurgicalsolutions.com/forums/topic/asc-surgeon-required-to-be-on-staff-at-a-hospital/) - We are a freestanding ophthalmology ASC. Recently a hospital that the surgeons have had "courtesy staff" privileges'. On the last reappointment application to a hospital they were denied because they did not perform any surgeries there and therefore need to be an active member of a hospital or ASC that is accredited by The Joint - [Adding courses for staff](https://progressivesurgicalsolutions.com/forums/topic/adding-courses-for-staff/) - I would like to add specific courses for staff in their PSS profile. How can I do this? - [Body Mass Index Policy](https://progressivesurgicalsolutions.com/forums/topic/body-mass-index-policy/) - Is there a Body Mass Index Policy for Ambulatory Surgery Centers? - [Physician Annual Education - Pain](https://progressivesurgicalsolutions.com/forums/topic/physician-annual-education-pain/) - Are there any educational resources available specific to assessing and managing pain that is required for Licensed Practitioners? (TJC HR.02.02.01) - [Consultant Pharmacist](https://progressivesurgicalsolutions.com/forums/topic/consultant-pharmacist-3/) - Does anyone have a pharmacist they could recommend that would come to Alabama? Ours out of Atlanta quit showing up and won't return my calls. I haven't been able to find anyone local that knows anything about ASC's or surgery. - [Destruction of Controlled Substances](https://progressivesurgicalsolutions.com/forums/topic/destruction-of-controlled-substances/) - I have a question regarding disposal of Versed or Fentanyl that is expired. Does anyone know if we have to use a reverse distributor or whether a Rx Destroyer can be used and what is the process? - [fire drills in ASC](https://progressivesurgicalsolutions.com/forums/topic/fire-drills-in-asc/) - Do we need to have the actual fire alarm on for our fire drills? currently we have a company who comes quarterly and tests our pull stations and the transmission times. I am just curious if the actual alarm should or need to be audible? Thank you - [pediatric patients](https://progressivesurgicalsolutions.com/forums/topic/pediatric-patients/) - At what age are you not required to have a PALS nurse present and pediatric medications and supplies on the crash cart? We currently serve Adolescent (14-18) to adult patients. Need to be 14 years and to be at least 120lbs. Patients under 15 years are required to have a anesthesia consult prior to scheduling - [Transfer of sterile instruments](https://progressivesurgicalsolutions.com/forums/topic/transfer-of-sterile-instruments/) - Hello! We recently had our CMS audit and the only citation we received was regarding our transfer of sterile instruments from a sterile field in the clean room "where it was uncovered and unsupervised" to the OR table (transferred uncovered). What is the most efficient way to remedy this? Per the citation, the field should - [Follow up call](https://progressivesurgicalsolutions.com/forums/topic/follow-up-call/) - Is documentation of the post-op follow up call required in the surgery chart? - [Ice Maker Temperature Ranges](https://progressivesurgicalsolutions.com/forums/topic/ice-maker-temperature-ranges/) - Can anyone tell me what the temperature min and max should be for a free standing ice maker? We have one that we use for patient refreshment post surgery. - [Anesthesia -CRNA Application](https://progressivesurgicalsolutions.com/forums/topic/anesthesia-crna-application/) - Good morning, Do we need to have a separate application for crna versus MD anesthesia Credentialing application - CPPA - [Surgeons 'Writs rest' for cataract surgery](https://progressivesurgicalsolutions.com/forums/topic/surgeons-writs-rest-for-cataract-surgery/) - We are looking for an accessory to the operating table called a "wrist rest". Anyone familiar with this? where to purchase? - [Recredentialing of physicians](https://progressivesurgicalsolutions.com/forums/topic/recredentialing-of-physicians/) - My understanding is that this is to be done every 2 years as listed in the compliance calendar. I received an email stating that Joint Commission, with whom we are accrediated, has changed this process from 2 to 3 years. I'm trying to verify this. Has anyone else heard anything about this? - [Narcotic Waste Containers](https://progressivesurgicalsolutions.com/forums/topic/narcotic-waste-containers/) - We have been purchasing Rx destroyer bottles for our narcotic waste receptacles. Can we use something else as long as the container is labeled medication waste and it contains an absorbent material like cat litter or charcoal? - [Multi-Dose Medications (28 day)](https://progressivesurgicalsolutions.com/forums/topic/multi-dose-medications-28-day/) - Do Betadine, Hibiclens or liquid Rubbing Alcohol have to be disposed of 28 days after opening like medications that are multi-dose???? - [Using new patient monitors](https://progressivesurgicalsolutions.com/forums/topic/using-new-patient-monitors/) - We purchased a new patient monitor. Are we able to start using it on patients in the ASC or does our BioMed guy have to check it first? - [Transfer of non admission](https://progressivesurgicalsolutions.com/forums/topic/transfer-of-non-admission/) - Hello, My inquiry is regarding hospital transfers for a non-admitted patient. We had a patient at our surgery center who checked in at the front desk, had not been admitted into pre-op. Patient began to seize in the waiting room patient was immediately brought into the pre-op area. Proper protocols had taken place, IV, etc. - [Urgent procedures without CRNA](https://progressivesurgicalsolutions.com/forums/topic/urgent-procedures-without-crna/) - My question is can we do conscious sedation for an emergency add on case, and utilize an RN monitor versus a CRNA when one is not available? We use RN monitors at our facility when we are short staffed for CRNA's but there is always one in house. This would be a situation where we - [What is the rule for NON ambulatory patients in the ASC?](https://progressivesurgicalsolutions.com/forums/topic/what-is-the-rule-for-non-ambulatory-patients-in-the-asc/) - How do you handle patients that are not ambulatory and able to transfer from wheelchair to procedure bed independently? Is there an actual rule that we should not accept these patients? - [Patient transportation](https://progressivesurgicalsolutions.com/forums/topic/patient-transportation-2/) - We have many patients who don't have transportation. If they are unable to use there insurance is there a company that can assist? Are there any guidelines as far as an ASC providing transportation so long as there is a responsible party with a good driving record? Can patients be charged for services as such? - [Surgeon Provided Anesthesia](https://progressivesurgicalsolutions.com/forums/topic/surgeon-provided-anesthesia/) - We have a CRNA group who manages our sedation for surgeries and it works quite well. In the event that one of our CRNA's are unable to make it to the facility for surgeries on any given day, what would it look like to have the Surgeon prescribe sedation for nurses to administer? What additional - [Additional Pre op beds](https://progressivesurgicalsolutions.com/forums/topic/additional-pre-op-beds/) - Our facility intends to add 10 additional pre op beds. We are CMS accredited, do we need to inform any agency other than local city and permits? - [MEETINGS](https://progressivesurgicalsolutions.com/forums/topic/meetings/) - Do you need to have three staff meetings a quarter OR will the monthly in-services and quarterly QA meetings suffice? Following a MEC and/or Board meeting? - [clinical consents needed at an ASC](https://progressivesurgicalsolutions.com/forums/topic/clinical-consents-needed-at-an-asc/) - Hello, Is it mandatory to have a copy of the clinical consent for surgery at the surgery center. Example: consent signed in office for cataract surgery- does the ASC need to obtain a copy for records or standard? - [Translation services](https://progressivesurgicalsolutions.com/forums/topic/translation-services/) - Are Translation services required for AAAHC accreditation? We had a vendor in our files, however, we have NEVER utilized their services (and likely never will). We require any patients needing a translator to bring a family member or friend to translate. So my question in do we need to have a vendor "on stand-by" just - [TB previously positive skin test](https://progressivesurgicalsolutions.com/forums/topic/tb-previously-positive-skin-test/) - We have an employee who is starting who states they have had a positive TB skin test in the past but prior Quantiferon is negative. Is standard practice to test with the TB 2 step skin test first, and if positive, send in for a chest x-ray or are we able to accept a negative - [Surgical Site Mark by Ophthalmologist Prior to Anesthesia Meds](https://progressivesurgicalsolutions.com/forums/topic/surgical-site-mark-by-ophthalmologist-prior-to-anesthesia-meds/) - Before we give any sedation medication, if the site has been verified with the orders and patient and nurse and anesthesia provider, are we able to give sedation medication before the Ophthalmologist sees the patient and marks the eye prior to surgery or do we need to have the "blessing" of a marked eye prior - [Community Based Disaster Drill](https://progressivesurgicalsolutions.com/forums/topic/community-based-disaster-drill/) - I am the Compliance Manager at an ASC specifically for Ophthalmology. I understand that CMS requires a Community Based Disaster Preparedness drill yearly. However, I have no idea how to find drills to participate in. In a real disaster, we would close because all of our patients are having elective surgeries. I have called several - [Consent Form](https://progressivesurgicalsolutions.com/forums/topic/consent-form/) - Oculoplastic Procedure Question. When scheduling a Mohs reconstruction case, the surgeon sends over EVERY possible code/procedure he MAY perform. Instead of listing every one of these procedures and the insurance verbiage that goes along with it on the consent form, can the ASC simply use "Repair of Defect After Skin Cancer Removal Procedure, Possible Skin - [Prep in Pre-OP](https://progressivesurgicalsolutions.com/forums/topic/prep-in-pre-op/) - Do you have any literature that dissuades the prepping of patients in the Pre-Op area rather than the OR? Do any centers do this? - [California Chart guidelines](https://progressivesurgicalsolutions.com/forums/topic/california-chart-guidelines/) - Hello All, Can anyone provide any insight on how long we need to keep paper charts? I know per AAAASF, Its 3 years, but after that is it safe to scan them in our system and then shred them? Any suggestions would be appreciated. - [Research policy](https://progressivesurgicalsolutions.com/forums/topic/research-policy/) - Is there anyone who has implemented a research policy for their ASC? - [Advance directive notification](https://progressivesurgicalsolutions.com/forums/topic/advance-directive-notification/) - When scheduling surgery we provide patient a list of right, responsibility, npp, and advance directives information. Is there a time frame in which we need a response from the patient that they received and not have an advanced directive? Otherwise, is it acceptable for the patients to sign at the center, day of surgery we - [Surgical paperwork](https://progressivesurgicalsolutions.com/forums/topic/surgical-paperwork/) - When scheduling surgery what is mandatory for ASCs to have? I.e., pre post op orders, H&P,etc... Does the patient have to complete there own H&P OR is it acceptable for the comprehensive history and physical which includes the medical history and meds. (Attached) - [SURGEON ACLS](https://progressivesurgicalsolutions.com/forums/topic/surgeon-acls/) - Do all surgeons need to have an ACLS or will RNs and anesthesia ACLS suffice? - [Preop Phone call](https://progressivesurgicalsolutions.com/forums/topic/preop-phone-call/) - Is a preop phone call mandated? If so what exactly has to be documented? In the past our nurses were the ones scheduling the patients after their clinic evaluation but we are stopping this practice. - [Post ophthalmic laser lens cleaning process](https://progressivesurgicalsolutions.com/forums/topic/post-ophthalmic-laser-lens-cleaning-process/) - How are eye surgery centers cleaning, disinfecting and sterilizing ophthalmic laser lens post use? - [Cultures](https://progressivesurgicalsolutions.com/forums/topic/cultures/) - Currently, anytime we use an amniotic graft for surgery, we culture the donor media. We recently had an incident where 2 cultures sent on the same day can back positive for the same thing. We completed our investigation and we feel it was actually lab contamination. After speaking with our graft rep, she was very - [ASC Flooring Requirements in California](https://progressivesurgicalsolutions.com/forums/topic/asc-flooring-requirements-in-california/) - Hello, We are planning to change the vinyl floors at our surgery center and the question came up what is the requirement for the floors to be coved (and how high) vs just a regular baseboard? For example, should we have the vinyl coved in PACU, patient bathrooms, and OR? Or does it also need - [Use of Multi-dose Versed in the OR](https://progressivesurgicalsolutions.com/forums/topic/use-of-multi-dose-versed-in-the-or/) - We purchase multi dose vials of Versed in 10 mg bottles. The majority of our patients get 3 mg or less for cataract surgery. We keep our Versed and Fentanyl locked in a small portable metal box that the sedating RN or CRNA keeps with them at all times. Is this acceptable practice or do - [Crash Cart Medications & Supplies list](https://progressivesurgicalsolutions.com/forums/topic/crash-cart-medications-supplies-list/) - Where can I find a checklist of must have Crash Cart Medications & Supplies that is based on current recommendations? - [pre-op covid monitoring](https://progressivesurgicalsolutions.com/forums/topic/pre-op-covid-monitoring/) - Are there any AAAHC or CDC requirements for pre-op covid monitoring? Temp checks? Ophthalmology, we only check temps on surgery pt's and not laser procedure pt's. We also have pt's sign a covid consent acknowledging the risks and pt's agreeing to and accepting the risks. Any info would be greatly appreciated. Thanks! - [Generator Notification](https://progressivesurgicalsolutions.com/forums/topic/generator-notification/) - Is there a requirement to be notified if we lose power and our generator kicks on? Like, have it connected to the alarm company or something so we know in the middle of the night or a weekend? - [AAAHC drill requirement](https://progressivesurgicalsolutions.com/forums/topic/aaahc-drill-requirement/) - We are preparing for AAAHC, I really need to make sure of the quantity and content of the drills required by AAAHC - [EMR and HIPPA](https://progressivesurgicalsolutions.com/forums/topic/emr-and-hippa/) - Our ASC is owned by a single physician. Is the ASC allowed to access the patient's information on his practice side and vice versa? We were informed we could not do this when we first opened in 2015. Has anything changed? Is this a CMS rule? - [H&P](https://progressivesurgicalsolutions.com/forums/topic/hp-6/) - AAAHC has now changed their standards to match CMS in regards to determining timing of a pre-surgical H&P. I am considering changing our policy to require the pt have an H&P completed within 90 days of surgery rather than the 30. I am curious what others are doing and if this time frame would be - [NPDB REPORTING](https://progressivesurgicalsolutions.com/forums/topic/npdb-reporting/) - What are the exceptions when needing to report for an ASC. I see"5 cases in at least 2 of the 6 measures." Does this mean 25 cases per quarter? - [change NPI](https://progressivesurgicalsolutions.com/forums/topic/change-npi/) - Hello, My ASC shares and NPI with our office upstairs in the same building. This seems to be an issue on a few levels. We are wondering what the requirement to is revise an NPI? We would like to essentially have an NPI for the office and an NPI for the office and it be - [Discharge Instructions](https://progressivesurgicalsolutions.com/forums/topic/discharge-instructions-2/) - We are looking into implementing an online portal for patients to complete paperwork prior to their day of surgery. Can we include discharge instructions and have the patient's sign prior to the day of surgery? Once they submit online, we cannot edit the form, so there would be no witness signature from ASC staff. We - [Extra staff during intubation and extubation](https://progressivesurgicalsolutions.com/forums/topic/extra-staff-during-intubation-and-extubation/) - Hi, Are there any policies regarding the need for staff ( tech and nurse) to be present for intubation and extubation? Thanks! - [Dismissal of anesthesia provider](https://progressivesurgicalsolutions.com/forums/topic/dismissal-of-anesthesia-provider/) - Hi, We recently terminated privileges to one of our anesthesia providers. They are not an employed by our surgery center, but are independent contractors. What, if any, are the necessary documentation that needs to be complete because of this? I appreciate any feedback. Thank you!!! - [Hospital Credentialing](https://progressivesurgicalsolutions.com/forums/topic/hospital-credentialing/) - I have an eye surgeon interested in privileges at our facility. when it comes to being privileged at a hospital, she is only privileged at Select Specialty Hospital San Diego, and Kindred Hospital which are both only long-term acute care/rehab facilities in which patients are referred. I don't think this fits the credentialing requirement of - [High Risk Fire Protocol](https://progressivesurgicalsolutions.com/forums/topic/high-risk-fire-protocol/) - On Nursing Fire Risk Assessment form, there's a box to check "High Risk Fire Protocol Initiated" but I am unable to find this form/policy for this protocol on ESUPPORT. - [Afrin, Cepacol, & Bacitracin ointment out dating](https://progressivesurgicalsolutions.com/forums/topic/afrin-cepacol-bacitracin-ointment-out-dating/) - I had a question in regards to expirations of Afrin nasal spray, Cepacol, & Bacitracin ointment. We are an ambulatory ENT surgery center. We use these medications in the OR frequently. My circulating nurse had a question as to how far out we date the expirations of these multi-use medications. As far as I can - [Annual Skills competency training](https://progressivesurgicalsolutions.com/forums/topic/annual-skills-competency-training/) - One of our nurses is asking if nurses must do annual skills competency training similar to the skills competency checklist they go over at orientation? I assumed the annual CE and drills was sufficient. What do you recommend? - [Incident Report](https://progressivesurgicalsolutions.com/forums/topic/incident-report-2/) - Hi, Is there a templated incident report? - [Or Operating Process](https://progressivesurgicalsolutions.com/forums/topic/or-operating-process/) - Hey all! We currently have two surgery days that we are not operating. We have a surgeon reaching out requesting to use our facility on these days. We would like to help him out but want to be sure logistically we are doing things appropriately. Does anyone else do this? If so would you mind - [Disposal of IV catheters, tubing, and bags](https://progressivesurgicalsolutions.com/forums/topic/disposal-of-iv-catheters-tubing-and-bags/) - Should IV catheters, tubing, and IV bags be placed in a sharps container? if not, what type of waste container is appropriate? - [Annual Product Safety Evaluations](https://progressivesurgicalsolutions.com/forums/topic/annual-product-safety-evaluations/) - Are annual product safety evaluations still required? If so does any one have any ideas? In the past years we have performed safety evaluations on syringes, masks, gloves, warming blankets, needles, biohazard containers , and scapels. With all the back orders and supply shortages, sometimes you just order what you can get. - [Sharps Counts for Oculoplastics](https://progressivesurgicalsolutions.com/forums/topic/sharps-counts-for-oculoplastics/) - We are an ASC that does mostly cataracts, retina and cornea surgeries. However, we do have 2 days a month that a plastic surgeon does blepharoplasty. During a recent AAAHC survey we were told that we need to do sharps counts for oculoplastics. Does anyone have any experience with this and if so any help - [Hospital Grade Outlets](https://progressivesurgicalsolutions.com/forums/topic/hospital-grade-outlets/) - Just a question about the outlets. We are a non-MDS facility, but are Medicare certified by the state (not sure if that makes a difference). We were built in 2006, but had our scope room renovated in 2020. I just became aware of the Life Safety code regarding hospital grade outlets. Do all of our - [Tumescent Tubing Shortage (PT-INF-T)](https://progressivesurgicalsolutions.com/forums/topic/tumescent-tubing-shortage-pt-inf-t/) - This may not be the place to put this but we are having trouble getting tumescent tubing for our Byron Medical LipoMachine. If anyone has more of this than they need or know where we can get it, please get back to me with the information. Thanks in advance. - [Personnel records](https://progressivesurgicalsolutions.com/forums/topic/personnel-records/) - Is there any regulations that require personnel records for ASC employees must be kept on site in the ASC?? My ASC is in the same building as the owner's ophthalmology practice (medical office). A Human Resource Director was recently hired for the entire practice. Her office is in the medical practice office, not ASC. Per - [PATIENT SATISFACTION SURVEY](https://progressivesurgicalsolutions.com/forums/topic/patient-satisfaction-survey-3/) - WHAT IS EVERYONE DOING SINCE SPH ANALYTICS WAS ACQUIRED BY PRESS GAINEY? ARE THERE ANY OTHER COMPANIES? OUR CENTER DID NOT GO WITH PRESS GAINEY - [AED vs Defibrillator](https://progressivesurgicalsolutions.com/forums/topic/aed-vs-defibrillator/) - We have recently learned that our defibrillator is no longer in FDA compliance. We do have an AED in the Pre-Op/PACU. Would an additional AED be sufficient for the OR's or do we need a full defibrillator? We are AAAHC accredited no Medicare. - [Workplace Violence Policy](https://progressivesurgicalsolutions.com/forums/topic/workplace-violence-policy/) - I am looking for a workplace violence policy. Can someone please share their policy or suggest where I should look for some guidance. - [YAG Room Temperatures and Humidity](https://progressivesurgicalsolutions.com/forums/topic/yag-room-temperatures-and-humidity/) - Our YAG laser room temperatures and humidity levels have recently dropped since the heat has been turned on. Therefore, our temps and humidity is out of range for 68-75 degrees F and 30-60% humidity. In finding a solution I looked in the instruction book for our YAG laser and found that the temperature range is - [Environment of Care Plan](https://progressivesurgicalsolutions.com/forums/topic/environment-of-care-plan/) - I am with a life safety surveyor, and he is asking about a environment of care plan. Does anyone have a sample form they could share or direct me too. - [Tracking: Incidents, Logs, Surveys, Credentialing etc. on an Online Platform](https://progressivesurgicalsolutions.com/forums/topic/tracking-incidents-logs-surveys-credentialing-etc-on-an-online-platform/) - We have binders upon binders that help us keep track of different logs for all around the facility. We have been looking into some online tracking platforms that would help us maintain this information in the palm of our hands. Is anyone currently using these platforms? Are they accepted by CMS auditors as acceptable tools - [P&P for COVID-19 Screening & Vaccination](https://progressivesurgicalsolutions.com/forums/topic/pp-for-covid-19-screening-vaccination/) - I was reviewing the updated template for this P&P and am confused about the definition of fully vaccinated. The new PSS P&P from November reads "Fully vaccinated is defined as initial vaccination with a booster (state dependent)". This differs from the CDC's definition from September, where booster requirements differ based on age (under/over 50). Isn't - [Anesthesia](https://progressivesurgicalsolutions.com/forums/topic/anesthesia-3/) - We are a GI facility and use propofol for sedation. Our CRNA has asked that we change our forms to say TIVA/General instead of MAC. Is this acceptable? - [Graduate Nurse Policy](https://progressivesurgicalsolutions.com/forums/topic/graduate-nurse-policy/) - I am looking for guidelines to write a policy for Graduate Nurses working in an ASC. Any help or guidance is appreciated. - [PACU Requirements](https://progressivesurgicalsolutions.com/forums/topic/pacu-requirements/) - I want to change our policy for PACU. I inherited my ASC using a modified Aldrete Score. In researching AAAHC and State regs I do not see where I need to use standardize documentation/assessment. Am I correct? I also don't see any specific times (i.e q 5 minutes), amount of times (x2), for vitals. Am - ["Opening " Surgical Instruments](https://progressivesurgicalsolutions.com/forums/topic/opening-surgical-instruments/) - Hi! Does anyone use a policy regarding when to open surgical instruments/ supplies before a case? I have heard multiple answers ( 30 min, 15 min, not until the patient is in the room...) and wanted to get further info on it. Thanks!!! - [DVT Assessment](https://progressivesurgicalsolutions.com/forums/topic/dvt-assessment/) - Does anyone have a DVT assessment sheet they could share? We use the caprini scoring sheet but it is three pages long and pretty antiquated. For reference, we do mostly self pay cosmetic surgery so we pay for and supply the SCDs to go home. Thanks! Elizabeth - [expired medication](https://progressivesurgicalsolutions.com/forums/topic/expired-medication-2/) - In these times of limited supply and endless backorders ..... is it possible to use medications beyond the manufacturers' date of expiration? We are unable to attain lidocaine and our present supply expire the end of this month. Would it be possible for the "medical director" to approve? - [Multi-dose vials in operating room](https://progressivesurgicalsolutions.com/forums/topic/multi-dose-vials-in-operating-room/) - One of my doctors brought to my attention from the infection control 2 in the ASC CE course 2021 that it states, " Do not keep multi-dose vials in the immediate patient care areas (i.e., operating room, patient bay) and store in accordance with the manufacturer's recommendations; discard if sterility is compromised or questionable." He - [Credentialing a fellow who becomes a Medical Staff phsyician](https://progressivesurgicalsolutions.com/forums/topic/credentialing-a-fellow-who-becomes-a-medical-staff-phsyician/) - We have a fellow who was credentialed with our facility for his sports medicine surgery fellowship August 2021 - August 2022. He has now joined the medical group on 9/1/22 and will be performing surgeries at our facility. Do I need to do the entire credentialing process over again or can I just up date - [Sharing check in desk](https://progressivesurgicalsolutions.com/forums/topic/sharing-check-in-desk-2/) - I am seeking guidance in regard to CMS Appendix L , specifically addressing “Distinct Entity” (47 FR 34085). We are a Physician owned ASC with 2 rooms sectioned off via 1 hour rated Firewall where LASIK is performed. The LASIK Suite is not part of the ASC and it clearly marked as being separate, however - [WAG Education](https://progressivesurgicalsolutions.com/forums/topic/wag-education/) - I am looking for WAG education/ training for staff. AAAASF surveyor is asking for this education and we do not have it. - [Declination Fit Testing for N95s](https://progressivesurgicalsolutions.com/forums/topic/declination-fit-testing-for-n95s/) - We have a few Staff RN's who declined to have fit testing for wearing N95s. Can they sign a declination form for this or is it a mandatory OSHA requirement. - [TB Skin Test Refusal](https://progressivesurgicalsolutions.com/forums/topic/tb-skin-test-refusal/) - Have you ever experienced anyone not wanting to take the two-step TB test? Is there a declination form they can fill out? Would love some guidance. - [Expired IOL Lenses](https://progressivesurgicalsolutions.com/forums/topic/expired-iol-lenses/) - Does anyone have any policy or procedures for expired lenses? - [Surgeon Job Description](https://progressivesurgicalsolutions.com/forums/topic/surgeon-job-description/) - Hi all, Is there a job description for a surgeon available? Or does anyone know of a good place to find and modify? Thanks so much! - [Patient Satisfaction Surveys](https://progressivesurgicalsolutions.com/forums/topic/patient-satisfaction-surveys-2/) - Does anyone use electronic patient satisfaction surveys? If so, which company? Pros and Cons? - [Cornea Tissue Policies](https://progressivesurgicalsolutions.com/forums/topic/cornea-tissue-policies/) - Are there any specifc policies that I need to create as we are adding DSEK and DMEK to our schedule?If you have and are willing to share i would really appreciate it. I am not finding much online. - [Yag lasers done in an ASC](https://progressivesurgicalsolutions.com/forums/topic/yag-lasers-done-in-an-asc/) - We are being yag to our ASC rather than clinic for a facility fee. What documentation is mandatory to.be within compliance. If the patient isn't taken into the OR and this is done in a procedure room what are the minimum requirements? - [Masking Requirements](https://progressivesurgicalsolutions.com/forums/topic/masking-requirements/) - Is CMS recognizing the CDC guidance of no masking required in hospitals/ASC’s for low risk communities? - [Certified scrub technician](https://progressivesurgicalsolutions.com/forums/topic/certified-scrub-technician/) - I've posted jobs for surgical scrub technician, CST. I have received multiple responses, however, many of the scrub technicians are not certified. Is there a standard that scrub technicians must be certified and effort to assist the surgeon and surgery? Can this be done on site? I was under the impression if approved by the - [Clinical Trials / Research](https://progressivesurgicalsolutions.com/forums/topic/clinical-trials-research/) - Would anyone be willing to share any policies and information about doing clinical trials and research in the ASC? I have a retina surgeon asking that we become certified for clinical trials and this is new to me. You can also email me directly at mhilton@johnsoncityeye.com. Thanks. - [AAAASF deemed status](https://progressivesurgicalsolutions.com/forums/topic/aaaasf-deemed-status/) - Do you have any insight into Medicare deemed status with AAAASF (now rebranded to QUAD A) I was told a CMS has done away with surveying deemed status facilities. We are looking in to getting Medicare back still have to submit 855 B application. Is the application process still taking a year? do you still - [FLU](https://progressivesurgicalsolutions.com/forums/topic/flu/) - I am confused on where, when and how I am supposed to submit employee flu vaccination information. I got an email from the CDC regarding reporting but this is my first time and I'm not even sure if its required and what it means to our facility. - [Minor procedures](https://progressivesurgicalsolutions.com/forums/topic/minor-procedures/) - Is an ASC able to do minor procedure without sedation without an anesthesiologist? For example minor lesion removals, Lri just numbing locally? I understand there needs to be at least one ACLS certified individual, routine admission process and paperwork, but do we also need anesthesia or can these be done in an ASC without anesthesia - [Bilateral cataract](https://progressivesurgicalsolutions.com/forums/topic/bilateral-cataract/) - Is it ok to complete a bilateral cataract procedure? I know insurance doesn't authorize but if a patient wants to pay cash for a bilateral cataract and understands the potential risks. - [Family Members in OR](https://progressivesurgicalsolutions.com/forums/topic/family-members-in-or/) - Are there any state regulations for Texas code that would prohibit a family member from being back in surgery with the patient if the operating doctor gave the green light ? Is this up to the facility and doctors discretion or could we be cited for this scenario? - [Central Sterile Staffing](https://progressivesurgicalsolutions.com/forums/topic/central-sterile-staffing/) - I was wondering how other facilities staff their CS department on surgery days. We are an ophthalmic ASC performing around 25 cataract cases on a surgery day. We have 11 sets of instruments and currently only one person cleaning and sterilizing instruments after each case. How do others handle this? Do you have more than - [Vaccine Policy and Procedure](https://progressivesurgicalsolutions.com/forums/topic/vaccine-policy-and-procedure-2/) - I have been told by an employee that the CDC requires nurses to take a training course on vaccine administration prior to administering vaccines, including the Flu vaccine? Does anyone know about this requirement? - [QAPI](https://progressivesurgicalsolutions.com/forums/topic/qapi-2/) - Does QA need to be a licensed RN or could a LVN do it in California? What about infection control? - [ACLS/BLS AAHC/MCR ACCREDITATION](https://progressivesurgicalsolutions.com/forums/topic/acls-bls-aahc-mcr-accreditation/) - Hello, I was seeing if anyone know the laws, not recommendation regarding ACLS. I am an out patient gastroenterology ASC in California wit AAAHC and Medicare accreditation. Are my nurses required to have an ACLS to be in the floor? Are my medical assistants required to have a BLS to be on the floor? Any - [CMS Eye drops open past 28 days](https://progressivesurgicalsolutions.com/forums/topic/cms-eye-drops-open-past-28-days/) - We are currently in the middle of a CMS inspection. They are asking why we no longer date our eye drop bottles. We amended our polices based on the June 2022 update that eye drop bottles/ointments no longer need to follow the 28 day expiration requirements. I've looked through the updated CMS Infection Control Survey - [Jewelry/Necklaces in Operating Room](https://progressivesurgicalsolutions.com/forums/topic/jewelry-necklaces-in-operating-room/) - Looking for some input regarding jewelry in the OR. We are an outpatient ophthalmology facility with AAAHC accreditation and our current policy states that "Jewelry including earrings, necklaces, watches, and bracelets that cannot be confined within the surgical attire should be removed before entry into the semi-restricted and restricted areas." The circulating nurses and CRNAs - [Defibrillator](https://progressivesurgicalsolutions.com/forums/topic/defibrillator/) - I just recently found out our Defibrillator is no longer FDA approved. Because of the nightmare the FDA caused by removing so many units from service, there is a massive backlog of defibs available. Has anyone had an issue finding a Defibrillator. At this point we only have an AED not even sure this is - [H&P vs. Screening Question](https://progressivesurgicalsolutions.com/forums/topic/hp-vs-screening-question/) - I have read through the previous H/P posts but still can't find my answer. We are an Ophthalmology-only ASC (CMS and State accredited). We are going back and forth about the H/P requirements vs. performing a screening to determine if a patient actually needs an H/P. I'm interested if other ASCs use this process? Basically, - [Policy for COVID positive employees](https://progressivesurgicalsolutions.com/forums/topic/policy-for-covid-positive-employees/) - Hi, does PSS have a policy for ASC employees who test positive for COVID? - [Credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-18/) - Is a copy of a Physicians driver's license necessary for credentialing. It is unbelievably difficult to obtain a copy including when the DLs expires I get asked why it's necessary they even get argumentative - [Physicians orders page](https://progressivesurgicalsolutions.com/forums/topic/physicians-orders-page/) - We have a physicians orders page in our surgery packets. All of our standing orders and most commonly used PRN orders are printed on the sheet. (See attached). The nurses sign orders that pertain to them, ex. Pre-op nurse signs under pre-op section, intra op nurse signs under intra op section...etc. My question is, does - [Age Specific Competency](https://progressivesurgicalsolutions.com/forums/topic/age-specific-competency/) - I thought you had a module for this education but no longer see it. Am I missing it? If no longer available what are you / others doing for this topic? - [Conray back order](https://progressivesurgicalsolutions.com/forums/topic/conray-back-order/) - We are a Urology ASC and are having trouble getting Conray. It is currently on back order and we have been able to get other contrast such as Isovue. The problem with this, is that it states that it's only for Intrathecal installation. We administer via catheter to the bladder and ureters. We found a - [Warmed blankets](https://progressivesurgicalsolutions.com/forums/topic/warmed-blankets/) - Our new blanket warmer has a factory setting of 150°F. Our PSS policy says our warming cabinet temperature should not exceed 130°. Can we change our policy or is this a standard temperature requirement per regulatory bodies? - [AAAASF three-year survey](https://progressivesurgicalsolutions.com/forums/topic/aaaasf-three-year-survey-2/) - We had our AAAASF survey Monday, 8/29/2022 This was one of our deficiencies. One sterilized pack was dated in 2014 and 3 packs dated in 2019. There was no policy of when the sterilized packs would expire and need to be resterilized do you have a P&P stating something like this. I got this from - [COVID Testing](https://progressivesurgicalsolutions.com/forums/topic/covid-testing-3/) - Had a MD inform me that a hospital community is pausing with their Covid testing protocol. Are any of you in the ASC world pausing your covid testing of non vaccinated staff?? Thank you for your time. . Trudy Grieff Midwest Eye Surgery Center - [AAAHC Drop expiration](https://progressivesurgicalsolutions.com/forums/topic/aaahc-drop-expiration/) - Hello, Does AAAHC follow CMS ruling on using the expiration date stated on the bottle for multiuse eye drops? - [Emergency Credentialing](https://progressivesurgicalsolutions.com/forums/topic/emergency-credentialing/) - We are a AAAHC accredited ASC. Is there an appropriate way to do emergency credentialing of an anesthesia provider? We occasional run into coverage issues with our anesthesia group that we use and they try to "rush through" credentialing in a 48-72 hr period. I feel that everything should be easily obtainable aside from peer - [Annual Reviews- RN](https://progressivesurgicalsolutions.com/forums/topic/annual-reviews-rn/) - Does CMS requiring annual reviews (or peer reviews) be performed for all ASC staff, just RN’s? And what is considered satisfactory for this documenation? Does biannual competency documentation meet the requirements or should their be an actual annual review that is discussed with each staff member? - [Billing](https://progressivesurgicalsolutions.com/forums/topic/billing/) - If I have orders and H & P from doctor A, and doctor B is observing him all day. Then they decide, on their own, to switch and let doctor B perform one of the cases. Patient was informed and consented as ok with the switch. However, the orders were written by doctor A, not - [Facilities in California not using an anesthesiologist for topical or Versed](https://progressivesurgicalsolutions.com/forums/topic/facilities-in-california-not-using-an-anesthesiologist-for-topical-or-versed/) - Please let me know if there are facilities in California, not using an Anesthesiologist for topical or Versed. Your feedback is much appreciated. - [disposing of expired Versed](https://progressivesurgicalsolutions.com/forums/topic/disposing-of-expired-versed/) - How do other facilities dispose of expired controlled substances? we waste an expired drug with the usual witnesses and documentation. How do you handle expired Versed? - [ACLS](https://progressivesurgicalsolutions.com/forums/topic/acls/) - Is online only ACLS and BLS re-certification acceptable? - [Pre-op Orders](https://progressivesurgicalsolutions.com/forums/topic/pre-op-orders/) - New ocuplastics MD wants to draw up and administer his numbing solution in pre-op. Requesting pre-op RNs simply place the lidocaine/bupivacaine vials on the bedside table. If he documents the medication and amount in his operative note, is this sufficient? Would the nurse need to document in Nurses Notes the time/amount/medication he injected? Just need - [Medical Bylaws for reappointment](https://progressivesurgicalsolutions.com/forums/topic/medical-bylaws-for-reappointment/) - I am working on reappointment of my medical staff. Is there an example of the medical bylaws that should be included? Or can anyone provide me of examples? Thanks!!! - [staff training related to enhanced infection control protocols for COVI](https://progressivesurgicalsolutions.com/forums/topic/staff-training-related-to-enhanced-infection-control-protocols-for-covi/) - 1. Do you have training related to this? The facility must maintain documentation of all staff training provided related to enhanced infection control protocols for COVID-19. 2. The facility should remove items and surfaces that cannot be easily cleaned (e.g., cloth or covered fabric-covered surfaces). If unable to remove, the facility must have a written - [Allergy questions r/t Benchmarking](https://progressivesurgicalsolutions.com/forums/topic/allergy-questions-r-t-benchmarking/) - Questions regarding patient allergies: 1. Do we have to have documented the severity of the reaction? (Severe, intolerance or sensitivity) we usually list the allergy and what kind of reaction they had (symptoms). 2. Should we be asking specifically about Latex allergies or continue to let pt's tell us if they have this allergy? When - [Transcription of Surgical Operative reports](https://progressivesurgicalsolutions.com/forums/topic/transcription-of-surgical-operative-reports/) - We currently have an outside transcription company who transcribes our operative reports. Is it mandated by AAAHC or Medicare that we use an outside company for the transcription or can the Surgeons dictate and have it transcribed through Allscripts ? - [OR floor cleaning](https://progressivesurgicalsolutions.com/forums/topic/or-floor-cleaning/) - We have been using bleach and water (1:10) dilution to clean our OR floors in between cases and at the end of the day. The cleaning crew states that it removes the wax and it is hard to get marks off the floors. What are others using to mop the floors in between cases? - [Surgical Site Identification](https://progressivesurgicalsolutions.com/forums/topic/surgical-site-identification/) - I have reviewed your policy on Surgical site identification. My question is: Can you put a "Y" for Yes or do you have to write out the word? I'm revising my policy and want to make sure it's correct. - [State mandated Reporting](https://progressivesurgicalsolutions.com/forums/topic/state-mandated-reporting/) - Hello, I have searched and searched everywhere to see if our state has mandated reporting. Is there somewhere where I can find this information? - [staff Covid training related to enhanced infection control protocols for COVID19](https://progressivesurgicalsolutions.com/forums/topic/staff-covid-training-related-to-enhanced-infection-control-protocols-for-covid19/) - 1. Do you have training related to this? The facility must maintain documentation of all staff training provided related to enhanced infection control protocols for COVID-19. 2. The facility should remove items and surfaces that cannot be easily cleaned (e.g., cloth or covered fabric-covered surfaces). If unable to remove, the facility must have a written - [P&P for Infection Transmission-Based Precautions.](https://progressivesurgicalsolutions.com/forums/topic/pp-for-infection-transmission-based-precautions/) - Do you have a P&P for Infection Transmission-Based Precautions. The facility must have a written policy/procedure for Infection Transmission-Based Precautions. The policy/procedure should be in accordance with the CDC infection precautions based on Community Transmission rates for COVID-19, including the necessity for: • Social Distancing. • Wearing a face covering. • Hand Hygiene, cough etiquette - [CMS requirements fire alarm system](https://progressivesurgicalsolutions.com/forums/topic/cms-requirements-fire-alarm-system/) - We are prepping for TJC accreditation, deemed status CMS. Can you tell me what the CMS regs for Fire Alarm Systems are? This is a new construction, single story ASC, 2 procedure rooms, 4700 sq ft. - [Ryanodex](https://progressivesurgicalsolutions.com/forums/topic/ryanodex/) - Is one vial of Ryanodex in the MH cart appropriate for a 2 OR ASC? A BMI of 40 is generally our max, we will consider patients as high as 45 but if they are otherwise healthy, and for sedation cases with propofol, no Sevo. We are blocks away from a major hospital where patient - [ASC COVID19 Vaccination Reporting - Contracted Housekeeping Included??](https://progressivesurgicalsolutions.com/forums/topic/asc-covid19-vaccination-reporting-contracted-housekeeping-included/) - Looking for some input on the reporting standards for Staff Vaccination for COVID19. We are a AAAHC accredited facility and everything I've read suggests that our contracted house keeping service needs to be included in this reporting/standard of 100% vaccination compliance. Can anyone offer input as to how they've been proceeding with this? This person - [Annual Reviews for RN's (all ASC staff?)](https://progressivesurgicalsolutions.com/forums/topic/annual-reviews-for-rns-all-asc-staff/) - Does CMS requiring annual reviews be performed for all ASC staff, just RN's? And what is considered satisfactory for this documenation? Does biannual competency documentation meet the requirements or should their be an actual annual review that is discussed with each staff member? - [AAAASF/CMS ASC - COVID-19 Worksheet](https://progressivesurgicalsolutions.com/forums/topic/aaaasf-cms-asc-covid-19-worksheet/) - Thought I would share this - attached is the new work sheet AAAASF came out with a new CMS ASC - COVID-19 Worksheet The Secretary of Health and Human Services has again extended the current Public Health Emergency (PHE) related to the COVID-19 virus. In response to this extension, AAAASF will be requiring surveyors to - [RN Coverage](https://progressivesurgicalsolutions.com/forums/topic/rn-coverage/) - Is there a standard, a minimum the total RNs that need to be at an ASC for operation? I.e, Four cases= one pre op RN, one post RN, one Circulator (2 ACLS RNs) at all times. - [ketamine infusions](https://progressivesurgicalsolutions.com/forums/topic/ketamine-infusions/) - Is anyone doing IV Ketamine Infusions in their ASC for chronic pain? I see red flags, but am trying to research. Thank you. Leslie Cottrell - [consents](https://progressivesurgicalsolutions.com/forums/topic/consents-6/) - WHAT SIGNATURES ARE REQUIRED ON AN ANESTHESIA CONSENT? PATIENT, ANESTHETIST, AND A WITNESS? - [P&P patient positive Covid test](https://progressivesurgicalsolutions.com/forums/topic/pp-patient-positive-covid-test/) - Do you have a P&P regarding wait time for surgery if a patient test positive Covid We make the patient wait 21 days to have surgery if they've tested + This is also the Policy of the hospital - [Double peel pack](https://progressivesurgicalsolutions.com/forums/topic/double-peel-pack/) - We had an audit it 2020 and I was told that the ASC can not double peel pack instruments..we stayed hours re packing everything in a single pack. Now as I visit other locations I see many locations double peel pack instruments. Any guidance? - [Benchmark Eye Center Sterilization](https://progressivesurgicalsolutions.com/forums/topic/benchmark-eye-center-sterilization/) - I would love to be do a benchmark study on sterilization, ifu, cleaning , etc... Would I be able to use this forum or the FB forum to conduct a survey? I would put it all together and aggregate the date to share. Is that acceptable? If not I can do one more unofficially - - [ICRA](https://progressivesurgicalsolutions.com/forums/topic/icra/) - We had our AAAHC audit yesterday and our auditor said that we do not have an Infection Control Risk Assessment in place. I showed him our policies as well as our annual TB risk assessment but it wasn't what he was looking for. He said his facility has it on an excel sheet with tabs - [Cost Tracking](https://progressivesurgicalsolutions.com/forums/topic/cost-tracking/) - Hi all, Looking into a better way to track inventory and costs of supplies. But I don't really want to reinvent the wheel. Does anyone have a system that works well for them? - [Bilateral Cataract Surgery Completed Same Day](https://progressivesurgicalsolutions.com/forums/topic/bilateral-cataract-surgery-completed-same-day/) - Are there any facilities/doctors that you know of who are doing bilateral cataract surgery on the same day? If so, are there two separate marks given to the eyes? Two separate surgical preps done? Two separate time-outs etc? We have a doctor interested in trying this, and having not done it before, I am wanting - [COVID 19 REPORTING THROUGH NHSN (SAMS)](https://progressivesurgicalsolutions.com/forums/topic/covid-19-reporting-through-nhsn-sams/) - Regarding the mandatory CDC COVID-19 reporting. Do you have any guidance, policies, and insight on this regulation? If it isn't reported by 8/15 there is a 2% penalty. Do you have a step by step guidance document to share? Does this need to be done annual or every quarter? - [Conferences](https://progressivesurgicalsolutions.com/forums/topic/conferences/) - I am new to the role of clinical director of a new ASC in Overland Park, Kansas. I would like to attend a couple of conferences to get more education in different areas. Which conferences would be most beneficial for me? - [Human Trafficking Education](https://progressivesurgicalsolutions.com/forums/topic/human-trafficking-education/) - Does anyone have ideas on where we can get the Human Trafficking Education required in Florida? - [Vaccine Policy and Procedure](https://progressivesurgicalsolutions.com/forums/topic/vaccine-policy-and-procedure/) - I was told during a recent AAAHC survey that we need to have a policy for vaccine storage because we stock Flu vaccines in the fall and an occasionally Hep B vaccine. I have never written a policy from scratch. Does anyone have a P&P they could share so that I can have a starting - [Covid-19 screening requirements for patients/visitors and employees](https://progressivesurgicalsolutions.com/forums/topic/covid-19-screening-requirements-for-patients-visitors-and-employees/) - What is currently required regarding screening of patient/visitors upon entry into an ambulatory surgery center? Does the patient/visitor have to sign the screening questionnaire? And is that questionnaire scanned in their EMR? What is the current protocol for screening employees? Can they self screen and report to administration any exposure or positive symptoms, or do - [New water testing regulations in the ASC?](https://progressivesurgicalsolutions.com/forums/topic/new-water-testing-regulations-in-the-asc/) - Are you aware of new water quality testing regulations in regards to instrument cleaning and sterilization for ASC's in the last year? - [COVID Testing](https://progressivesurgicalsolutions.com/forums/topic/covid-testing-2/) - Do employees who received the initial COVID vaccine series who have declined the booster have to be tested weekly with those who are unvaccinated? - [tattoos and facial piercing policy](https://progressivesurgicalsolutions.com/forums/topic/tattoos-and-facial-piercing-policy/) - Does anyone have a tattoo and facial piercing policy they could share? - [Physician Pre-Surgical Assessments required by CMS](https://progressivesurgicalsolutions.com/forums/topic/physician-pre-surgical-assessments-required-by-cms/) - Just asking if anyone has started to evaluate this new requirement by CMS related to the assessment itself and/or new policies? Thanks, Stacey Munsell Sunset Surgical Centre - [Unplanned Vitrectomy](https://progressivesurgicalsolutions.com/forums/topic/unplanned-vitrectomy-2/) - Where are you documenting your anterior vitrectomies? Do I need to be reporting this anywhere besides our complication log & quarterly minutes? - [Portable Dehumidifier use](https://progressivesurgicalsolutions.com/forums/topic/portable-dehumidifier-use/) - Is a portable dehumidifier permitted to be used in the LenSx Laser room? The humidity has been high which is concerning for the function of the laser. It is not in the OR or restricted area of our facility. - [Joint Commission](https://progressivesurgicalsolutions.com/forums/topic/joint-commission/) - We are preparing for our upcoming survey through Joint Commission and was wondering when they follow a patient throughout the surgical process, do we need to get some kind of consent or permission from the patient for observers? - [ETCO2](https://progressivesurgicalsolutions.com/forums/topic/etco2/) - Does anyone know whether it is a requirement for ETCO2 to be monitored on every patient receiving Moderate Sedation by an RN? - [Repiratory drug requirements](https://progressivesurgicalsolutions.com/forums/topic/repiratory-drug-requirements/) - Hello, we have Albuterol inhalation solution n our ASC to use PRN. It this a requirement from CMS or AAAHC? We throw it away every year when it expires and buy new but I'm wondering if we even need to have it on hand. We ask patients with respiratory meds to bring their own for - [REVOKED SURGICAL PRIVILEGES](https://progressivesurgicalsolutions.com/forums/topic/revoked-surgical-privileges/) - IF a board has collectively decided to revoke/suspend a providers privileges to ASC and give them notice in writing to be effective immediately. Are there any specific steps that need to be formally documented to protect the ASC and be in compliance? Besides a collection of data? - [hospital transfer agreement](https://progressivesurgicalsolutions.com/forums/topic/hospital-transfer-agreement/) - Now that a written "transfer agreement" is no longer required ..... is there a template for what ASCs need to inform their local hospitals? 1. ASCs won't have to have a written transfer agreement or hospital planning privileges for all physicians. Centers will need to provide hospitals with a document that includes information about their - [Employee training in OR during nursing school](https://progressivesurgicalsolutions.com/forums/topic/employee-training-in-or-during-nursing-school/) - I have an employee of our company. She is not my employee. She is a medical assistant who is going to school to become a RN. She would like to do an OR rotation in our surgery center. She has her own insurance, but from our stand point, do we need a policy on this? - [Durable Power of Attorney](https://progressivesurgicalsolutions.com/forums/topic/durable-power-of-attorney/) - We have come across multiple patients, that we have had to cancel days before surgery or day of surgery, because they have no documentation of durable power of attorney. Is there any situation, other than a life-threatening surgical emergency, that if a patient is incompetent, that two nurses or physician may cosign consent? Or have - [Quality Project](https://progressivesurgicalsolutions.com/forums/topic/quality-project/) - We worked on a QAPI project last year to improve hand-off report between pre-op staff and OR nurses. We set a goal to improve compliance to 75%, from our original data of 55%. We improved by 10%, to 65%, but are still short of our goal, even after we implemented education intervention. My question is - [Emergency Drills & Codes](https://progressivesurgicalsolutions.com/forums/topic/emergency-drills-codes/) - Can you clarify the drill requirements? I am reading different things and am getting confused. Disaster Fire Mock Code Also is it a requirement to Have Codes? Like Code Red? Code Grey? etc.... we are a very small center and it is much easier to remember fire. Also if required do they have to be - [Internet Policy](https://progressivesurgicalsolutions.com/forums/topic/internet-policy/) - Just checking to see if anyone has a Internet Usage Policy that they would care to share? - [LPN's in the ASC, OR Setting](https://progressivesurgicalsolutions.com/forums/topic/lpns-in-the-asc-or-setting/) - Does anyone have any experience and guidance on that capacity to which a LPN can practice in the ASC OR setting? What tasks are they unable to complete? Can they do IVP? Thank you, Ashlee - [Crash Cart Ventilator](https://progressivesurgicalsolutions.com/forums/topic/crash-cart-ventilator/) - Are ASC's required to have ventilator on crash cart? - [QAPI Tool Kit](https://progressivesurgicalsolutions.com/forums/topic/qapi-tool-kit/) - Where do I find the ASC COVID-19 QAPI Tool kit? - [Annual competencies for staff of ASC](https://progressivesurgicalsolutions.com/forums/topic/annual-competencies-for-staff-of-asc/) - What are the specific skills competencies for ASC staff? - [MMC/USP 800](https://progressivesurgicalsolutions.com/forums/topic/mmc-usp-800/) - We are adding Mitomycin to our formulary list and I'm reviewing all necessary policy changes etc. PLEASE clarify USP . The eSupport module states USP are requirements; but then my pharmacist says "If you're not going to follow those then you have to document why." He provided me a Hazardous Drug Assessment of Risk - [Accredidation survey](https://progressivesurgicalsolutions.com/forums/topic/accredidation-survey/) - We have an upcoming every three-year survey with AAAASF (non- Medicare) anyone recently had a survey. If so any suggestions? thanks! - [Physician signing pre printed orders](https://progressivesurgicalsolutions.com/forums/topic/physician-signing-pre-printed-orders/) - I have a surgeon that is having one of the techs date and time the pre-printed orders. Historically, the surgeons have signed, dated, and timed their own orders but all of a sudden it is an issue. I can find information about hospitals but I need one specifice for ambulatory surgery centers to have this - [DEA REGISTRATION REVOKED.](https://progressivesurgicalsolutions.com/forums/topic/dea-registration-revoked/) - What Steps are to be taken if DEA REGISTRATION REVOKED? Is the provider able to provide anesthesia services? - [HDS](https://progressivesurgicalsolutions.com/forums/topic/hds/) - We are going to start using Mitomycin in our facility. I have already made an exhaustive "to do" list including creating a Hazardous Drug List. Is it unusual to only have one drug on this list? Where should this list be kept? - [DOT Training](https://progressivesurgicalsolutions.com/forums/topic/dot-training-2/) - For employees that complete the DOT eSupport module, do they need to do this annually? - [Assessment](https://progressivesurgicalsolutions.com/forums/topic/assessment/) - For a GI procedure in an ASC in California, does there need to be a pre-op assessment in pre-op before the procedure, then a pre-op assessment in the room, right before the procedures. A post-op assessment in the room, after the procedure, then another post-op assessment when the patient is wheeled to post-op? - [Standing Order](https://progressivesurgicalsolutions.com/forums/topic/standing-order/) - Our anesthesiologist is wanting standing pre-op orders; however, some patients may end up being evaluated/monitored by his subcontracted CRNA who monitors the other room. My question: Is his signed standing orders still valid if a different person, CRNA, is the actual provider the day of surgery. Furthermore, if the CRNA evaluates the patient and finds - [H&P](https://progressivesurgicalsolutions.com/forums/topic/hp-5/) - Idaho Based Surgeon Owned Ophthalmic Surgery Center What is considered best practice as far as making H&P before surgery. Clinic is separate from surgery center and it is our understanding that H&P's should be coming from clinic the day before surgery but RN's are not staffed there to assist MD who is seeing patients. Is - [Phaco machines and tubing](https://progressivesurgicalsolutions.com/forums/topic/phaco-machines-and-tubing/) - I am just inquiring to see if other facilities doing cataract surgeries are experiencing supply shortages with things such as phaco tubing and accessories? In particular with J&J and Alcon. We have a J&J machine (Compact) and can not get the disposable tubing. We can sometimes get the reusable tubing and are being told there - [HIPAA risk assessment](https://progressivesurgicalsolutions.com/forums/topic/hipaa-risk-assessment/) - For the annual HIPAA risk assessment, The compliance calendar states we should have an outside company perform this, do you have any contacts I could use to do this? Thanks, - [Staff Member who cannot find Immunization records](https://progressivesurgicalsolutions.com/forums/topic/staff-member-who-cannot-find-immunization-records/) - If an employee cannot find immunization records because they do not have a PCP or their PCP has retired and records are no longer available, is there something we put in the employee records to indicate we cannot get this info and have tried or leave it empty? Just trying to stay compliant, but what - [removal of sutures](https://progressivesurgicalsolutions.com/forums/topic/removal-of-sutures/) - Does a physician need to remove the stitches for oculoplastic patients post operatively or can a technician? i.e., Bleph cases - [aldrete score](https://progressivesurgicalsolutions.com/forums/topic/aldrete-score/) - Does an ophthalmology ASC need to have an actual aldrete score on the PACU form? - [Intra operative cancellation](https://progressivesurgicalsolutions.com/forums/topic/intra-operative-cancellation/) - If a patient is cancelled intra operative / aborted procedure is it the PACU RN to inform the patients family without a physicians orders? Or is it the anesthesiologist or surgeons responsibility to inform the patient and the family? In my experience intra op when aborted the physician and or anesthesia should, unless ordered on - [OR Medications](https://progressivesurgicalsolutions.com/forums/topic/or-medications/) - Apologies, I do not have OR nursing background, so this is a remedial and long winded question! Surgeon's orders are for 3mL Lidocaine to be administered to the sterile field. Our scrub techs tend to pull more than 3mL "just incase he needs more throughout the case". The circulating OR nurses are uncomfortable with this - [Labeling Chemicals in the workplace](https://progressivesurgicalsolutions.com/forums/topic/labeling-chemicals-in-the-workplace/) - We are accredited by Joint Commission. Are we required to label our chemicals using OSHA guidelines? - [Surgery/IOL logs](https://progressivesurgicalsolutions.com/forums/topic/surgery-iol-logs/) - How long do we need to keep our surgery/IOL logs in an ophthalmic only ASC? Our last survey was in 2018. Wondering if I can shred the ones prior to that year. Controlled substance logs we keep for 7 years, is that correct? - [Cameras](https://progressivesurgicalsolutions.com/forums/topic/cameras/) - Hello, What are the rules on having cameras in the ASC Thank you, Kim - [Peer Review](https://progressivesurgicalsolutions.com/forums/topic/peer-review-4/) - Is it acceptable to complete a peer review every two years at re-appointment rather than quarterly? - [Defective Lens](https://progressivesurgicalsolutions.com/forums/topic/defective-lens/) - When completing an incident form related to a a defective lens, is that considered an "equipment malfunction" ? - [Appointment Re-appointment forms](https://progressivesurgicalsolutions.com/forums/topic/appointment-re-appointment-forms/) - Are we able to create an Appointment/ Re-appointment form all in one? - [Consent Forms](https://progressivesurgicalsolutions.com/forums/topic/consent-forms-3/) - Is IOL an acceptable abbreviation on a consent form? I am used to NO abbreviations, but staff states because it's an abbreviation for an implant and not the procedure itself, it's ok. - [COVID 19 LOGS](https://progressivesurgicalsolutions.com/forums/topic/covid-19-logs/) - We are in an area of the country with low COVID volume and no hospital cases currently. How much longer must we perform employee COVID-19 check-in logs each surgery day? - [COVID-19 HCP Vaccination Reporting](https://progressivesurgicalsolutions.com/forums/topic/covid-19-hcp-vaccination-reporting/) - Our single specialty ophthalmic ASC is connected to our clinic where we see patients. Most of the HCP do not work in the ASC. The clinic, like the ASC, accepts Medicaid/Medicare. It is my understanding that if we accept payments from Medicaid/Medicare, that we are to report all HCP vaccine status. Am I to report - [Annual Evaluations](https://progressivesurgicalsolutions.com/forums/topic/annual-evaluations-2/) - Are we required to have a "Self Evaluation" in an employee's records. I find for one year, it is a good tool, but repetitive years, I find it overkill and my staff hates filling them out! - [In-service and education](https://progressivesurgicalsolutions.com/forums/topic/in-service-and-education/) - Do you have an In-service training on reduction to workplace exposure to anesthetic gases? - [Mock Survey](https://progressivesurgicalsolutions.com/forums/topic/mock-survey/) - How do we go about arranging for you to come and complete a mock survey at our facility? - [Annual Vendor Review](https://progressivesurgicalsolutions.com/forums/topic/annual-vendor-review/) - Our Annual Vendor Review form is very straight forward. States Continue/Discontinue and comments regarding service. I recently was informed that TJC requires a metric measurement on each vendor. They provided me with a form that had a rating scale from poor to excellent as well as a competency like evaluation including "mode of evaluation" for - [Hospitalization following surgery](https://progressivesurgicalsolutions.com/forums/topic/hospitalization-following-surgery/) - Hey all! Looking for some guidance in a new area for me. We had a situation where a diabetic patient had surgery with us. In PACU the patient hit all measures to discharge, was in good standing, alert and oriented, etc. We offered nutrition and hydration and the patient declined saying nothing sounded good. We - [Medication Management Nurse Leader](https://progressivesurgicalsolutions.com/forums/topic/medication-management-nurse-leader/) - Does anybody have a competency for a nurse leadership position related to oversight of your medication management program that you would be willing to share? Thank you in advance! - [Changing Account Administrators](https://progressivesurgicalsolutions.com/forums/topic/changing-account-administrators/) - How do we change the Administrator of our PSS membership? My last day at my facility is 4/19 and need to make sure the new Administrator has full access to PSS resources and CE management. Thanks! - [Director of Nursing](https://progressivesurgicalsolutions.com/forums/topic/director-of-nursing-2/) - We are a gastro ASC and no longer have a Director of Nursing. What are the requirements for the position? Do they HAVE to be a RN? Can they be part time? Can it be a consulting position? - [Incident Reports](https://progressivesurgicalsolutions.com/forums/topic/incident-reports-2/) - Ophthalmology ASC: My OR RNs are asking if they need to complete an incident report when the surgeon asks for a BCL for loose epithelium. They are stating it was an expected event, therefore an incident report is warranted. The surgeon states it's anatomy related and not preventable. He also argues it's noted in his - [Credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-17/) - We do brachytherapy cases here in the ASC. Our process is that the Urologist is the primary physician who places the needles and the assistant is the Oncologist who places the seeds. Because the Oncologist is the assistant, I understand he has to be credentialed, but does he have to be peer reviewed? The Urologist - [CMS Accreditation](https://progressivesurgicalsolutions.com/forums/topic/cms-accreditation/) - Hello I have submitted an 855b to Noridian for processing and it was approved. The center conducted their survey with AAAHC Deem status and was recommended for accreditation with CMS, AAAHC sent the results of the survey to the Regional and Central office. Now CDPH is asking to submit a centralize application for processing. My - [UPS backup generator and documentation](https://progressivesurgicalsolutions.com/forums/topic/ups-backup-generator-and-documentation/) - Hello, When running the 30-minute monthly backup generator test. What is required to be documented? The form we have is way too long and makes no sense even to our PM guy. He says we should not have to document so many Parameters values, loads etc. that is out of our scope thank you, Kim - [Integrating health professionals from State and Federal Agencies in and emergenc](https://progressivesurgicalsolutions.com/forums/topic/integrating-health-professionals-from-state-and-federal-agencies-in-and-emergenc/) - I am looking for a policy about integrating health professionals from both State and Federal agencies during and emergency. - [Social Distancing](https://progressivesurgicalsolutions.com/forums/topic/social-distancing/) - One of our first policies during COVID for social distancing stated that responsible adults will not be allowed to wait in waiting room of the facility. We allowed only one responsible adult to stay in the waiting room, but did not allow any family to enter the pre-op area. Are there any state or federal - [Fire Safety](https://progressivesurgicalsolutions.com/forums/topic/fire-safety-2/) - Do we need to do a fire door audit or some sort of inspection of our fire door monthly, quarterly, or is this something a building management company would do? We test our fire system monthly, sprinklers quarterly, exit lights monthly and the management company does one yearly, extinguishers monthly, and of course our fire - [Conscious Sedation](https://progressivesurgicalsolutions.com/forums/topic/conscious-sedation-2/) - Are there any laws against having a LVN and a Doctor in a GI procedure room, where the doctor mushes the meds and the LVN monitors the patient? I know guidelines do not recommend it but are there any laws or regulations against it? - [PACU](https://progressivesurgicalsolutions.com/forums/topic/pacu/) - In California, how long (minutes and vitals) must a patient stay in PACU after: 1. Conscious Sedation 2. Propofol - [CE Courses](https://progressivesurgicalsolutions.com/forums/topic/ce-courses/) - Our employees no longer have work emails. I am needing to send them their annual Progressive training. I cannot find where I can edit their email. Do I have to remove them completely, then add them back with their personal email? If so, I assume their transcript will not save? Suggestions or instructions please! - [Insurance Contracting](https://progressivesurgicalsolutions.com/forums/topic/insurance-contracting/) - I became a new administrator at a GI ASC in southern California in the Inland Empire in San Bernardino County. The facility has not renegotiated payer contracts in 25 years, so we are getting paid contracted rates from 1997. I need to renegotiate these contracts and am completely lost on how to do it. It - [Discharge Instructions](https://progressivesurgicalsolutions.com/forums/topic/discharge-instructions/) - Currently our patients receive their dc instructions with their registration forms that are on paper during check-in. The patient signs (paper) and then upon admission into Pre-op, the pre-op nurse asks if they have any questions and signs as well. However, pt. registration forms are now electronic and pts. sign on a signature pad during - [Director of Nursing](https://progressivesurgicalsolutions.com/forums/topic/director-of-nursing/) - I am looking for a director of nursing for our GI ASC. We are located in Redlands, CA. If anyone knows anyone please let me know. - [In House Anesthesia and Pathology](https://progressivesurgicalsolutions.com/forums/topic/in-house-anesthesia-and-pathology/) - Hello All. I run a GI ASC in Southern California and we are looking at bringing anesthesia (CRNA) and pathology in house, where both will be employees and we, the ASC can bill for the services and no longer use 3rd parties. Has anyone on here done this or can point me in the direction - [CRNAs](https://progressivesurgicalsolutions.com/forums/topic/crnas/) - Due to the anesthesiologists shortage we are thinking about getting CRNAs to help with our cases. We are new to this ideas and have questions: Is there a ratio of anesthesiologist supervision to CRNAs in the state of California or with CMS? Can they work independently if the anesthesiologist is sick or off? Does anyone - [ASC Scribes](https://progressivesurgicalsolutions.com/forums/topic/asc-scribes/) - I cannot find a Use of Scribe Policy or Scribe job description and/or competencies. Our surgeon no longer wants to chart the immediate operative note for YAG procedures. He's requesting the tech that is in the room holding the pt's head be responsible for entering the grade of the cataract (as he verbally calls it - [Latex Sensitivity/Allergy](https://progressivesurgicalsolutions.com/forums/topic/latex-sensitivity-allergy/) - It has been our policy in our outpatient surgery center that any patient stating they have a latex allergy/sensitivity is sent for allergy testing before their surgical procedure. We have yet to have anyone have a true allergy to latex and proceed with the surgery once we receive the report. Our policy is not to - [Replacing flooring in the OR & PACU in our ASC](https://progressivesurgicalsolutions.com/forums/topic/replacing-flooring-in-the-or-pacu-in-our-asc/) - What are the regulations/restrictions needed for flooring in the OR/PACU? Thank you, Elayne - [Annual Education Day](https://progressivesurgicalsolutions.com/forums/topic/annual-education-day/) - Hey all! I am preparing for an annual education day coming up. Plan to utilize the quizzes and courses here on PSS, but also looking for other ideas to keep everyone tuned in! Would love any and all ideas that you have used or heard of. A few things in regards to requirements for the - [Time out in the laser room](https://progressivesurgicalsolutions.com/forums/topic/time-out-in-the-laser-room/) - We employ several LPN's at our ASC. They are often assigned to our laser room. Does this pose a compliance problem for the time out that must occur pre procedure? We have "gotten by" before I became administrator by saying the physicians are doing the time out. Just need to make sure this is correct - [QAPI- where to start?](https://progressivesurgicalsolutions.com/forums/topic/qapi-where-to-start/) - Hello, I am new to the ASC QAPI world and am trying to learn QAPI by reviewing previous studies. Are there any good resources you can recommend for introductory staff? I started after the previous ASC manager left so I did not really get any guidance from them. I appreciate your time. Jamie - [Multi dose vials](https://progressivesurgicalsolutions.com/forums/topic/multi-dose-vials-2/) - My question is regarding pre op eye drop administration at our ophthalmic ASC. We use these as multi dose vials on multiple patients, labeled upon opening, etc. What I am wondering is if we keep the most common bottles of drops in a top drawer at the bedside in each pre op bay, are we - [Masks](https://progressivesurgicalsolutions.com/forums/topic/masks/) - What's the latest on masks? Our adjoining clinic is wanting to do away with mask requirements. My understanding is CDC is still recommending hospital and ASCs mask use. I strongly believe the clinic and the ASC should be a united front, seeing patients don't see the difference. Can you please update me on the current - [Orientation, Periodic Appraisals](https://progressivesurgicalsolutions.com/forums/topic/orientation-periodic-appraisals/) - I find it hard to be believe but in reviewing our policies I am struggling to find one that discusses our orientation and periodic reviews of employees. Do you have one here that I am missing? What policy would this be included in or would it stand independently. Thoughts? - [Contracted Vendors Annual Education](https://progressivesurgicalsolutions.com/forums/topic/contracted-vendors-annual-education/) - We have an outside contract for our housekeeping. Do we need annual proof/letter/something annually to show that they have received appropriate education re: Infection Control, OSHA, Emergency Management etc... all those things our employees receive? If so any examples of documentation? Thank you - [CRNA / Surgeon Education](https://progressivesurgicalsolutions.com/forums/topic/crna-surgeon-education/) - I know our CRNAs and MDs need to do OSHA and HIPAA training. However, is there any way to download the exam from you instead of having each of them log in to complete this? I know the course can be downloaded but I did not see the test available. Thank you, Lynn - [Instrument Lubrication](https://progressivesurgicalsolutions.com/forums/topic/instrument-lubrication/) - I am wondering what products ASCs are using to milk eye instruments. Is any brand of lubricant OK as long as it does not contain mineral oil or silicone?? - [Plastic Surgery Duration](https://progressivesurgicalsolutions.com/forums/topic/plastic-surgery-duration/) - My questions is, can a surgeon perform plastic, elective cases that last more than 5 hrs in an ACS? Currently the cases last anywhere between 5-10 hrs per case. In other words is there a regulation or mandatory guideline that states cases at a surgery center last a certain time frame, just like they can - [Safe injection practice](https://progressivesurgicalsolutions.com/forums/topic/safe-injection-practice/) - Is there a standard (APIC) for transferring a medication already drawn up into a syringe, into another syringe. For example, a medication already drawn up in syringe, then physician needs more during procedure to supplement eye block, yet the scrub is sterile and can not take original syringe. Scrub tech takes plunger out of a - [Post Anesthesia Discharge Criteria](https://progressivesurgicalsolutions.com/forums/topic/post-anesthesia-discharge-criteria/) - Is it a requirement to use an Aldrete Score to discharge patients after receiving anesthesia, moderate, or conscious sedation? We are only accredited through Medicare. - [infection control query](https://progressivesurgicalsolutions.com/forums/topic/infection-control-query/) - Hi, I can't find on Esupport since it was changed where the monthly infection control query for the physician letter template is located now. Can you please advise? Thank you - [Surgery Center within an office](https://progressivesurgicalsolutions.com/forums/topic/surgery-center-within-an-office/) - Hello, Can a surgery center be built inside a current office? If so does the scrub sink can be located inside the OR or does it have to be located outside? - [Hand Hygiene Policy](https://progressivesurgicalsolutions.com/forums/topic/hand-hygiene-policy/) - Good morning, we are getting ready for a AAAASF survey an I am reviewing one of the requirements. It requires a hand hygiene policy and procedure that includes the preferred use of alcohol-based hand sanitizer based upon CDC guidelines. We have a hand hygiene policy but we don't discuss the preferred use of alcohol-based hand - [Covid mandate](https://progressivesurgicalsolutions.com/forums/topic/covid-mandate/) - Regarding the Medicare/Medicaid programs Omnibus Covid-19 ASC attachment: QSO-22-07-ALL Under P&P section it states that a variety of actions or job modifications a facility CAN implement to potentially reduce the risk of COVID-19 transmission but are not limited to: Are all of these required, or are they suggestions of actions?? Especially, the one that says - [Medical director job description](https://progressivesurgicalsolutions.com/forums/topic/medical-director-job-description/) - Hi, I am looking for a medical director job description for my personnel files. Is there one available here, or does someone have a sample? Thanks! - [Annual training requirements](https://progressivesurgicalsolutions.com/forums/topic/annual-training-requirements/) - Is there a list of courses that are required for staff continuing education on an annual basis? We plan to assign CE Courses from the Course Catalog, We don't want to unnecessarily overburden the staff with assignments, but we want to make sure we cover the minimum required. Thanks! - [Guidelines for policies](https://progressivesurgicalsolutions.com/forums/topic/guidelines-for-policies/) - Our last Joint Commission visit recommended that we have guidelines that we follow with policies and need to include for sterilization. Can you help? I need to know how to include this in our policies. - [CMS requirements](https://progressivesurgicalsolutions.com/forums/topic/cms-requirements/) - I am a new ASC surgical administrator. My center is only accredited with Medicare, and we are in the state of Oregon. Do you know if CMS requires documentation of glucometer competency by staff, eye wash stations checks, and things under the sinks? Or would we defer to state regulations on these topics. Also the - [Infection Control Program](https://progressivesurgicalsolutions.com/forums/topic/infection-control-program/) - Hello, I am new to ASC nursing management and am wanting to verify what type of training I need to be compliant with CMS for our Infection Control Plan. Can you tell me what type of training the infection control coordinator needs? - [Medication lot numbers and expiration dates](https://progressivesurgicalsolutions.com/forums/topic/medication-lot-numbers-and-expiration-dates/) - Is it required to document medication lot numbers and expiration dates in the peri-op medical record? - [ACLS for Physician Assistants](https://progressivesurgicalsolutions.com/forums/topic/acls-for-physician-assistants/) - Is it a requirement that Physician Assistants have ACLS? - [Clinical Director of ASC duties split](https://progressivesurgicalsolutions.com/forums/topic/clinical-director-of-asc-duties-split/) - Hello- We are discussing dividing up the clinical director position. Currently we do not have any charge nurses so the clinical director manages the day to day operations, staffing, compliance, accreditation and quality and infection control. We would like to divide the staff management and the administrative into separate roles. Could we have a clinical - [Vital sign monitoring](https://progressivesurgicalsolutions.com/forums/topic/vital-sign-monitoring/) - What part of vital sign monitoring is required for a completely "local", no sedation, no anesthesia procedure performed in an ASC? - [Patient Experience Questions & Process](https://progressivesurgicalsolutions.com/forums/topic/patient-experience-questions-process/) - We are using 5 basic questions for our patient experience and consistently are 99%. I am looking for other examples of what you may be using to determine patient experience. Also how are you getting the information/performing the survey? Our system currently is not great. Thank you in advance. - [annual vendor evaluations](https://progressivesurgicalsolutions.com/forums/topic/annual-vendor-evaluations/) - I am trying to figure out what qualifies as a vendor who needs evaluated annually for the ASC. I know our med gas companies, and housekeeping, IT, ect. However, do our larger vendors, such as Alcon and McKesson, and even our contracted pharmacist fall under this evaluation requirements for QAPI? I want to be sure - [DOT training for biohazardous waste](https://progressivesurgicalsolutions.com/forums/topic/dot-training-for-biohazardous-waste/) - Is DOT training required annually or just a hire, for those who handle biohazardous waste or sign manifests etc.? - [Vendor Vaccination Declaration](https://progressivesurgicalsolutions.com/forums/topic/vendor-vaccination-declaration/) - Do you have a form for them to fill out? Do you keep a copy of their vaccination card or exception? Thank you in advance - [Advanced Directives](https://progressivesurgicalsolutions.com/forums/topic/advanced-directives-2/) - Can you please specify who, where, and how advanced directives are required to be addressed? We address advanced directives in a number of places, by multiple staff members, and all with different verbiage. I am attempting to streamline this to ONE person in ONE place. Does it have to addressed on the consent form? And - [credentialing service fee](https://progressivesurgicalsolutions.com/forums/topic/credentialing-service-fee/) - Hello, Are there ASCs who are charging service fees to new applicants for credentialing? any fee for reappointments? If you do, can you please provide the process and details of charges? We are looking into implementing service fees for credentialing initial appointments and re-appointments. We would appreciate your input. We are a busy orthopedic ASC - [Repair Log](https://progressivesurgicalsolutions.com/forums/topic/repair-log/) - Is a Repair Log required? I currently have a PM binder and report any ongoing issues, services needed, or contracts needed at quarterly QAPI. We also keep invoices from all vendors. Do I have to have a separate log for every issue? - [Quality Indicators](https://progressivesurgicalsolutions.com/forums/topic/quality-indicators-2/) - Inheriting the QAPI program from previous DON, the Quality Indicators include: Consent was correct and completed, Time Out was completed prior to start time, Implant was documented, Anesthesia assessed patient prior to discharge with written discharge order, If IV was placed, dc cannula assessment completed These items are typically 100%, anesthesia orders were missing in - [covid vaccination reporting](https://progressivesurgicalsolutions.com/forums/topic/covid-vaccination-reporting/) - I'm in CA, and our ASC does mandate that everybody does get vaccinated, and everybody is and we have records of all staff vaccinations. do we need to upload this information anywhere or submit it to anybody? Or is keeping our own records good enough? Thank you. - [Safe handling of medical gases](https://progressivesurgicalsolutions.com/forums/topic/safe-handling-of-medical-gases/) - Does anyone have a simple video or powerpoint presentation for safe handling of medical gases? We used the AirGas University video until they had to take it down due to adobe flash going away. I haven't been able to find another good one for ASC use. - [Charging Physicians for Credentialing](https://progressivesurgicalsolutions.com/forums/topic/charging-physicians-for-credentialing/) - I was wondering if anyone charges the physicians, themselves, for doing their credentialing. This would mainly apply to anesthesiologists that rarely come to the facility - maybe only 1-2x/year - but that their group would like to remain credentialed with you. There's a lot of time and money that goes into the process (as you - [COVID booster shots for staff that have had COVID](https://progressivesurgicalsolutions.com/forums/topic/covid-booster-shots-for-staff-that-have-had-covid/) - I am trying to find documentation on when vaccinated but not yet boosted employees should get their booster shot after recently having COVID . I can't find this on the CDC or CDPH website. Anyone have a recent website citing or reference? - [Boxes and ceiling height](https://progressivesurgicalsolutions.com/forums/topic/boxes-and-ceiling-height/) - Hi, Is there any regulations on how close cardboard boxes can be stacked to the ceiling? I remember reading something, but I can't find where it is referenced. I am in California and go through AAAASF. I will be having my survey in a few weeks so wanted to double check on this. - [Surgical Attire](https://progressivesurgicalsolutions.com/forums/topic/surgical-attire-3/) - Is there a new guideline, allowing OR staff to wear surgical caps from home? - [Controlled Substance Book](https://progressivesurgicalsolutions.com/forums/topic/controlled-substance-book/) - I am wanting to purge and clean out our current narcotic record book. How long are we required to hold/store the pages removed? We have sheets from 2018 and 2019 still in the current book. - [Tracking COVID Positive Employees](https://progressivesurgicalsolutions.com/forums/topic/tracking-covid-positive-employees/) - Good Morning Are facilities required to track COVID positive employees any differently than other illnesses. I am currently tracking when staff are out , how many days they are absent. Fortunately our facility has not had any COVID positive employees the since the start of the pandemic until this past week . Therefore, this is - [Discharge of patient](https://progressivesurgicalsolutions.com/forums/topic/discharge-of-patient/) - Hello, We are a small ASC one OR, two beds. We have a pre op, post op RN, CRNA, surgeon, and circulator, ACLS certified at the ASC. Question is, can the patient wait in the waiting room under these circumstances? Does the patient need to be held in the PACU area until family comes? An - [Shelter in Place Policy](https://progressivesurgicalsolutions.com/forums/topic/shelter-in-place-policy-2/) - Hi there, Does anyone have a standalone policy for Shelter in Place? Thanks so much! - [COVID testing](https://progressivesurgicalsolutions.com/forums/topic/covid-testing/) - If an ASC (we are in MO) opts to have COVID testing available mostly for staff members to have access to testing more readily, are we required to report each test and those results to a state authority? Does anyone have any experience with this? We do not have a lab, so would simply be - [Religious Exemption for Contract CRNAs](https://progressivesurgicalsolutions.com/forums/topic/religious-exemption-for-contract-crnas/) - We contract with and credential CRNA services. We have 2 religious exemption requests from CRNAs. Our governing board has voted to deny these requests. We follow federal guidelines in consideration of these denials, but since they are contracted an not center employees can we simply draft a letter of denial? I couldn't find any sample - [Venous Thromboembolism](https://progressivesurgicalsolutions.com/forums/topic/venous-thromboembolism/) - Is a Caprini risk assessment model or Venous Thromboembolism a mandated document needed to complete and to keep in the surgical file for a one OR ophthalmology ASC? If so, does anyone have a document to share? - [ASC consents](https://progressivesurgicalsolutions.com/forums/topic/asc-consents/) - Is it necessary to have multiple consent forms? I.e., Billing consent, anesthesia consent, and surgical consent. Is a COVID consent mandated ? - [Credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-16/) - When credentialing a new physician in california, do we need 2 peer review forms from other physicians, or recommendation letters? or both? Thank you, - [Surgical consent](https://progressivesurgicalsolutions.com/forums/topic/surgical-consent-2/) - How long is a surgical consent valid? - [standard lens credit on premium](https://progressivesurgicalsolutions.com/forums/topic/standard-lens-credit-on-premium/) - Hello, I am an ophthalmology ASC in California. In the past we have always billed providers for premium lenses used at our facility (i.e. lens cost $995 we will bill provider $1050). It was practiced at another location to invoice the cost of the lens the ASC pays and shares that same cost with the - [No Surprises Act](https://progressivesurgicalsolutions.com/forums/topic/no-surprises-act/) - Has PSS come up with any guidance, recommendations and/or P&P in regards to ASC compliance with the upcoming No Surprises Act? Would appreciate any help you can provide to assist with this so we are prepared. - [Versed multidose use procedure](https://progressivesurgicalsolutions.com/forums/topic/versed-multidose-use-procedure/) - We have recently been unable to acquire versed in a single use 2mg/2ml vial. All of our 3 vendors state it is on backorder. In the interim can you tell me the proper procedure for using a multidose vial 5mg/5ml of a sedative? We have a difference of opinion between our pharmacist/ anesthesia/clinical director. Specifically, - [Rescheduling](https://progressivesurgicalsolutions.com/forums/topic/rescheduling/) - What is everyone else doing when it comes to rescheduling patients with COVID exposure? I'm attaching what we have been doing for the past year. In looking to see if there are any updates, it's muddy waters as always so I thought I'd check with all you amazing people for opinions! A little back story - [72 hour sterilization consent expiration time?](https://progressivesurgicalsolutions.com/forums/topic/72-hour-sterilization-consent-expiration-time/) - Hello- In California, (not sure if it is everywhere), we have a requirement for a sterilization consent to be signed at least 72 hour prior to procedure so the patient has time to consider and change their mind. Do you know what the expiration time is on this consent. Currently I have a patient that - [Covid-19 vaccine mandate](https://progressivesurgicalsolutions.com/forums/topic/covid-19-vaccine-mandate/) - Has the CMS mandate for healthcare providers changed? I know there was about ten states or so who had filed a suit and were on hold in those states but I have heard that perhaps this has now been extended to all states. Is this true? Is the mandate still in place?? - [Third Party Credentialing](https://progressivesurgicalsolutions.com/forums/topic/third-party-credentialing/) - Is there anyone in the North Dallas Area that can recommend a third party credentialing service? I can't keep up with our growth and short notice of anesthesia hires. - [Incident Report](https://progressivesurgicalsolutions.com/forums/topic/incident-report/) - Good morning, Our incident report is okay but I'm working on improving it. One thing I noticed is that the forms I've read have a "Patient" line to fill out at the top, however many incidents don't involve a patient. Is this where I would write the employees name? Or should it read Patient/Staff member. - [Controlled substances](https://progressivesurgicalsolutions.com/forums/topic/controlled-substances/) - We are a small surgery center that only operates 1-2 days/week. As the administrator, I am here everyday but we only have nurses on days when patients are present or when they do nursing administration duties. I order the controlled substances via the CSOS system using the managing surgeon's DEA license. When controlled substances arrive, - [reappointment for low/no volume of cases](https://progressivesurgicalsolutions.com/forums/topic/reappointment-for-low-no-volume-of-cases/) - What is the process for reappointing providers who has not done any cases or has done low volume of cases during his/her appointment? Unable to do peer review due to low/no cases done. I asked for the provider's work history in the hospital he is currently practicing from his chief of surgery. What is the - [Arm Band](https://progressivesurgicalsolutions.com/forums/topic/arm-band/) - What must be present on a pt. label and arm band? - [Fall Risk Assessment](https://progressivesurgicalsolutions.com/forums/topic/fall-risk-assessment/) - Our new software system does not include a Morse Fall Risk measuring tool. It gives a pick list, for example: Fall Risk - Yes, pt uses walker OR Fall Risk - Yes, pt reports fall within the last 2 months. It does not assign a low, medium, high or give a number. Furthermore, this is - [necessity of application](https://progressivesurgicalsolutions.com/forums/topic/necessity-of-application/) - is an initial job application and reference check absolutely necessary? Thanks - [Medication Reconciliation](https://progressivesurgicalsolutions.com/forums/topic/medication-reconciliation-5/) - Our surgery center is accredited through Joint Commission. I am trying to figure out Medication Reconciliation. I'm seeing that they don't want a summary statement to resume medications for patients. Can you explain what this exactly means? More forms??? Can we amend a form??? - [Flu vaccine exemption/declination](https://progressivesurgicalsolutions.com/forums/topic/flu-vaccine-exemption-declination/) - I know this is a topic every year, but with the new COVID-19 mandate I am looking at our flu vaccine policy and forms as well. With the new vaccine regulations that came out our ASC opted to not offer the flu vaccine to employees due to the hoops simply to offer 1 vaccine a - [Patient Health History](https://progressivesurgicalsolutions.com/forums/topic/patient-health-history/) - Our "local anesthesia" charts contain an H and P completed by the physician. Is it necessary for there to be a full patient history documented by the RN in the Pre- op nurse section along with a day of assessment? - [YAG Total Power](https://progressivesurgicalsolutions.com/forums/topic/yag-total-power/) - Our new software only has documentation areas for Power and # of Spots but not a Total Energy. Must Total Energy be documented. On the same note, does this have to be charted in the intra-op documentation if it will appear in the operative note? Just seems like double charting. - [DEA for CRNA](https://progressivesurgicalsolutions.com/forums/topic/dea-for-crna/) - We have used a group of anesthesiologists for the past 20+ years but have been notified that their group will no longer be able to provide coverage. We have found a CRNA that would be able to provide coverage for our facility. As we started the credentialing process, we found that he does not have - [Chart Audits](https://progressivesurgicalsolutions.com/forums/topic/chart-audits-2/) - Our new software does not have an auditing tool. Are there mandatory items that must be on a chart audit or is it facility discretion? - [Admissions](https://progressivesurgicalsolutions.com/forums/topic/admissions/) - Is a facility able to deem a patient not appropriate for ASC admission related to mobility issues. We have had a few patient admissions approved by anesthesia, but when they arrive, the nurses are challenged with a non-ambulatory/full assist patient BEFORE sedation. We currently don't have lift devices and I am concerned for not only - [Education - Customer Service Quiz](https://progressivesurgicalsolutions.com/forums/topic/education-customer-service-quiz/) - Just wanted to let someone know that questions 3 and 4 on the Customer Service Quiz are incorrect. Might want to check and correct. - [looking for forms](https://progressivesurgicalsolutions.com/forums/topic/looking-for-forms/) - Hi, I'm searching Esupport for the following forms and I can't find them, can you please direct me where to find them if you have them? Thanks -abuse acknowledgement - I found some job descriptions but not for all positions in an ASC -BBP risk classification - [Operative Reports](https://progressivesurgicalsolutions.com/forums/topic/operative-reports-2/) - Our new software system allows the surgeon to download a "default" operative report. If the case turns complex, they are instructing us to add Macros to the end of the report. For example, there will be the body of the default operative note and at the bottom it will state: Complex case - small pupil - [Covid-19 vaccination mandate](https://progressivesurgicalsolutions.com/forums/topic/covid-19-vaccination-mandate/) - What documentation is required for an employee who does not have and will not get the Covid-19 vaccine due to religious beliefs? Everything seems vague. My suggestion is for the employee to write a statement that there is a conflict between their sincerely held religious beliefs and the employer's Covid-19 vaccination requirement. It is my - [Intra-Op MAR](https://progressivesurgicalsolutions.com/forums/topic/intra-op-mar/) - We are in the process of implementing a new software program and the developers are stating that we do NOT need an intra-op MAR. They state as long as there are surgeon orders and they are acknowledged by the OR RN and then documented in the OP note, there is no need for an intra-op - [Consent Forms](https://progressivesurgicalsolutions.com/forums/topic/consent-forms-2/) - Who is able to witness a consent? We would like for all paperwork to be completed in registration/lobby while waiting for pre-op. Are registrars able to obtain the pt's signature and witness that signature for surgical consent? On the same note, we have had several requests from pts that discharge instructions be given to read/review - [Sterile Field Meds](https://progressivesurgicalsolutions.com/forums/topic/sterile-field-meds/) - Currently, our OR techs prepare a "bin" for each individual case. They all include BSS 500mL, sterile gloves, single use instruments, needles, and Amvisc. They bring these bins into the OR and assist in room set up, spiking the BSS and unpacking the instruments onto the sterile field. Is this compliant with techs spiking the - [OR "dirty" vs clean cases](https://progressivesurgicalsolutions.com/forums/topic/or-dirty-vs-clean-cases/) - Does anyone have documentation that supports doing "dirty" OR cases after clean cases. Obvioulsy terminal cleaning is done between each OR case. However, it has been past practice that clean cases- such a a port placement would be done before any hemorrhoidectomy or condoloma removals. This is on our general surgey day- so the surgeons - [Revoking Privileges](https://progressivesurgicalsolutions.com/forums/topic/revoking-privileges-2/) - Is there a formal process for revoking privileges for safety/quality care concerns for a provider that held provisional privileges, up for reappointment 11/2021. The provider is longer employed at the practice, and we would not allow the provider to come back with a different practice. - [Revoking Privileges](https://progressivesurgicalsolutions.com/forums/topic/revoking-privileges/) - Is there a formal process for revoking privileges for safety/quality care concerns for a provider that held provisional privileges, up for reappointment 11/2021. The provider is longer employed at the practice, and we would not allow the provider to come back with a different practice. - [Sterile Processing Technician Job Description](https://progressivesurgicalsolutions.com/forums/topic/sterile-processing-technician-job-description/) - I am searching for a SPD job description. Does anyone have one they can share? - [Employee handbook](https://progressivesurgicalsolutions.com/forums/topic/employee-handbook/) - Does anyone have a simple employee handbook they could share? Something that talks about expected work ethic, paid time off, employer and employee contributions to retirement, who to contact if you need to call off work unexpectedly, etc. - [Laser Safety Requirements](https://progressivesurgicalsolutions.com/forums/topic/laser-safety-requirements/) - Hello! We use an outside company to run our laser for urology cases. In my experience, laser safety requirements include covering OR windows prior to laser use. The new laser tech is insisting that is no longer a requirement. Does anyone know if this is true, and if so, where this information was published? Thank - [H&P](https://progressivesurgicalsolutions.com/forums/topic/hp-4/) - We are a privately owned ophthalmology ASC with an adjoining clinic. We are converting from two different software systems to one called Nextech. We are revisiting ALL our processes and documentations to make things more efficient. All the patient's information that is entered during the pre-op visit is auto-populated and shared in the ASC chart. - [Record keeping](https://progressivesurgicalsolutions.com/forums/topic/record-keeping/) - How long do we have to keep expired documents for those we have contracts with? I am specifically asking about expired liability insurance and OIG exclusion documents. Thank you, Thelma - [Emergency Codes with Disaster Plan with Joint Commission](https://progressivesurgicalsolutions.com/forums/topic/emergency-codes-with-disaster-plan-with-joint-commission/) - I'm presently working on our disaster plan. Per Joint Commission, what are the emergency codes to be utilized in an accredited facility? I am in need of colors and codes that correspond. - [Is your facility utilizing CRNA’s? Can you share your experience? Any in CA?](https://progressivesurgicalsolutions.com/forums/topic/is-your-facility-utilizing-crnas-can-you-share-your-experience-any-in-ca/) - Is your facility is using CRNA’s? If your in CA, could you please share? we are a very small Ophthalmic OR (about 5 surgeons) just doing MAC, and looking to future possibilities. Do your P & P’s state that you have an Anesthesiologist on call in the event of an emergency? I understand CA to - [Surgical Tech certification](https://progressivesurgicalsolutions.com/forums/topic/surgical-tech-certification/) - In the state of South Dakota does a person need certification to be a Surgical Tech? If not can an Ophthalmic Tech or RN be used as a Surgical Tech? - [Satellite phones](https://progressivesurgicalsolutions.com/forums/topic/satellite-phones/) - Does anyone have a satellite phone to use as part of their disaster preparedness? We have walkie talkies. It may be over the top, but should we need to shelter-in-place and the phones are down as well as cell towers/service, it would be a good thing to have to communicate with the "outside" world. Any - [Vaccination status](https://progressivesurgicalsolutions.com/forums/topic/vaccination-status/) - Hello! We have had a patient that is coming in for a procedure ask that no one caring for her is unvaccinated. I am wondering what we are and are not allowed to disclose about ouyr staff and if we have to compy with this. We will obvioulsy do our best, but it may not - [BRN investigation](https://progressivesurgicalsolutions.com/forums/topic/brn-investigation/) - Hi! We have a CRNA that had a complaint filed on her and the BRN has contacted us and is requesting numerous amount of documentation I am wondering what we are required to provide them The patient did not even end up coming to our facility- the complaint was filed only after a conversation that - [OR floors](https://progressivesurgicalsolutions.com/forums/topic/or-floors/) - Hello, I am having trouble ordering the current OR floor cleaner that we normally use. Can I have some suggestions on common OR floor cleaners or is there a website I can look at for direction? - [Minimum amount of procedures to be operable](https://progressivesurgicalsolutions.com/forums/topic/minimum-amount-of-procedures-to-be-operable/) - Hello, I am a one OR Ambulatory surgery center, we are in currently in a transitioning state of operation. By transitional state of operation, I mean we are taking many of our cases to one of our other surgery centers rather than taking the full load of cases. Do you know if there is the - [BIOMED INSPECTIONS](https://progressivesurgicalsolutions.com/forums/topic/biomed-inspections/) - Are Biomed inspections annual or semi-annual?? - [EMPLOYEE HEALTH CARE](https://progressivesurgicalsolutions.com/forums/topic/employee-health-care/) - Are we required to have our employees have annual physicals per Joint Commission and CMS? It seems in the past it was required by CMS - [MD education](https://progressivesurgicalsolutions.com/forums/topic/md-education/) - What type of proof of ongoing education must be included in a surgeon and/or anesthesia provider's file? Are they required to perform the facilities annual education that the rest of staff complete? Do they have to provide proof of their required CMEs? - [TB skin tests](https://progressivesurgicalsolutions.com/forums/topic/tb-skin-tests-2/) - I'm understanding that annual TB skin tests are not mandatory in MS anymore. We are accredited by Joint Commission. Would there be a policy about TB skin tests? Do we need them at all anymore? - [PRN Xanax Order](https://progressivesurgicalsolutions.com/forums/topic/prn-xanax-order/) - We typically only medicated with oral Xanax at our facility for cataract extractions. We currently have an anesthesiologist and surgeon who are requesting our oral Xanax order be a standing PRN order. The MDs state that as long as the pt's anxiety level is measured (1-10 just like a pain scale), the nurses can choose - [Materials management job description](https://progressivesurgicalsolutions.com/forums/topic/materials-management-job-description/) - Does anyone have a materials management job description that they would share? - [Return to OR documentation needed](https://progressivesurgicalsolutions.com/forums/topic/return-to-or-documentation-needed/) - We have a patient who rubbed her eye in post op and caused an abrasion and iris capture. Questioned the paper work necessary since we have in our consent "and other indicated procedures deemed necessary by the surgeon". The second consent to return was signed under versed so not sure it is legal. Would love - [Physician Verification of Hospital Privileges](https://progressivesurgicalsolutions.com/forums/topic/physician-verification-of-hospital-privileges/) - I am in the process of finishing up credentialing for an eye surgery center. I have one anesthesiologist that no longer has privileges at any hospitals. In 2020 when he applied, he had two hospitals. The question is do all staff including anesthesia need verification of hospital privileges? This particular one is older and semi-retired. - [Medical transport](https://progressivesurgicalsolutions.com/forums/topic/medical-transport/) - Are there any specific regulations for what type of medical transport a post-surgical patient must have? We occasionally have patients with no one to bring them to and from surgery. Does the transport service need to be able to assure the patient gets into their home and settled? If regs are out there,, do they - [COVID-19 decision tree](https://progressivesurgicalsolutions.com/forums/topic/covid-19-decision-tree/) - I work in an ambulatory surgery center/clinic. Does anyone have a simplified decision tree for vaccinated and unvaccinated staff who call in sick for work?? I know the CDC has pages of how to mitigate healthcare staffing shortages ...... but i need something I can look at at 5am when I get the call. Does - [Volunteers for Emergency Prepardness Plan](https://progressivesurgicalsolutions.com/forums/topic/volunteers-for-emergency-prepardness-plan/) - Does anyone have a volunteer policy for their Emergency Preparedness Plan? - [CPT Code- Nurse Pre-op visit](https://progressivesurgicalsolutions.com/forums/topic/cpt-code-nurse-pre-op-visit/) - What CPT code are you using for a nurse pre-op visit? Pre-op instructions, vitals, assessment, surgical consents, medication review and instructions prior to surgery. We are a small ophthalmology ASC, the office techs have always done the preops, but an RN is now taking over the surgery scheduling and pre-op visits. Thanks!! - [Medical Record Audit](https://progressivesurgicalsolutions.com/forums/topic/medical-record-audit/) - Do you or anybody have an medical record audit form they could share? We have an EMR so would want it to be more focused on that type of charting. Also please confirm - should these be done quarterly? - [credit card merchant service](https://progressivesurgicalsolutions.com/forums/topic/credit-card-merchant-service/) - Would anyone recommend a competitive low cost credit card merchant service provider? I need to get some bids and so far only have my local bank and Instamed. - [PRN CRNA's and Credentialing](https://progressivesurgicalsolutions.com/forums/topic/prn-crnas-and-credentialing/) - Hey everyone! Previously we had one in house CRNA to provide all anesthesia. She has recently "started her own business" and is now considered her own entity and performing all of her own billing, etc. She has since hired a few other CRNA's under her to provide anesthesia PRN. All of these providers are crednetialed - [Gas Room temp and humidity](https://progressivesurgicalsolutions.com/forums/topic/gas-room-temp-and-humidity/) - Good morning! While evaluating some of our processes it has been questioned if we need to be monitoring and doing a checklist of the temperature and humidity in our gas supply room. Is this something other centers are doing or something we should start to implement? Our gas room is on the outside of our - [Quality Assurance Audit requirements](https://progressivesurgicalsolutions.com/forums/topic/quality-assurance-audit-requirements/) - Previously our quality assurance audit was done prior to the chart being finished. Obviously this wasn't helpful since you can't audit a chart that is not done. So I started having them pull the audits and paperclip them to the front of the chart. Then when we do the post op call that nurse does - [building manager part of the ASC staff](https://progressivesurgicalsolutions.com/forums/topic/building-manager-part-of-the-asc-staff/) - We just hired a building manager to assist with the generator testing and arrange for the other Life Safety testing requirements, and building issues. Do I need to add him to my surgery center employee roster? He will be taking care of the entire building needs (Clinic, and ASC) and was hired by the administrator - [New Multi-Specialty ASC and New DON](https://progressivesurgicalsolutions.com/forums/topic/new-multi-specialty-asc-and-new-don/) - Hi All, I am helping to get a brand new Multi-Specialty ASC in Idaho up and running by Oct. 2021. I am looking for any helpful initial guidance I may need. I.e, is there an initial new employee competency or skills check off that are required? TIA for helping, I need every little bit I - [OSHA](https://progressivesurgicalsolutions.com/forums/topic/osha-3/) - I see under OSHA, THe bloodborne pathogen program, it states we should include this in our plans/ protocols, Exposure Determination Plan (with 2 categories based on job description) Exposure Control Methods (PPE, safety sharps, hands free instrument passing, etc) Housekeeping/Waste Management Protocols Vaccination Plan Safety Device Evaluations Training and Education Employee Exposure Protocol I didn't - [COVID-19 Exemption form for non- vaccinated healthcare workers](https://progressivesurgicalsolutions.com/forums/topic/covid-19-exemption-form-for-non-vaccinated-healthcare-workers/) - Hello, Is there a current exemption form for the non- vaccinated healthcare workers provided here? Or any suggestions on where to find a template? Thanks! - [BLS and ACLS for Anesthesia providers](https://progressivesurgicalsolutions.com/forums/topic/bls-and-acls-for-anesthesia-providers/) - We recently had a AAAHC survey and the surveyor told us that anesthesia providers should have BOTH ACLS and BLS. Her explanation was that the courses teach different skills and you must have your BLS in order to get your ACLS. This is not the first time I’ve heard this but I always get pushback - [CMS Transparency Requirements](https://progressivesurgicalsolutions.com/forums/topic/cms-transparency-requirements/) - Hi, I am a new Clinical Director of an ambulatory Surgery Center in Napa County Ca. Does anyone know the transparency requirements for the website? I am also looking at the requirements for reporting patient demographics for CMS. Thanks, All! Suellen Bradley - [compliance calendar](https://progressivesurgicalsolutions.com/forums/topic/compliance-calendar/) - hi, when I had my initial meeting Vanessa showed me there was a specific compliance calendar that had blank spaces where we could document the completion date that we worked on that specific item. I can't find it on esupport. can you please show me that specific calendar? Thank you, - [SARS-CoV2 diagnostic screening testing for nonvaccinated HCP](https://progressivesurgicalsolutions.com/forums/topic/sars-cov2-diagnostic-screening-testing-for-nonvaccinated-hcp/) - Has anyone created a policy for the CDPH mandated verification vaccination status and SARS-CoV2 diagnostic screening testing for nonvaccinated HCP that they are willing to share? - [COVID Vaccine](https://progressivesurgicalsolutions.com/forums/topic/covid-vaccine/) - One of our board members is pushing for a mandate for all employees to be vaccinated. Currently all employees are vaccinated except 2 that have documented physician letters requiring them to wait to be vaccinated for a current health condition. This board member is pushing for us to force the employees to either get vaccinated - [Odds and Ends Questions](https://progressivesurgicalsolutions.com/forums/topic/odds-and-ends-questions/) - Hey all! I have several random questions- we are preparing for our Joint Commission survey and just want to be sure I'm understanding and preparing correctly. We have also had some recent provider changes and questions from our anesthesia providers to spark these as well. 1. Are we required to keep Hep B vaccines on - [TJC vs. AAAASF](https://progressivesurgicalsolutions.com/forums/topic/tjc-vs-aaaasf/) - We are currently accredited by Joint Commission, however, our owner/surgeon is wanting to visit the option of changing to AAAASF for a variety of reasons. Attempting to find content comparing the two has proven difficult; therefore, if anyone can provide me with the good, bad, ugly of AAAASF I would sure appreciate it. The thought - [Sprinkler system Life n Safety](https://progressivesurgicalsolutions.com/forums/topic/sprinkler-system-life-n-safety/) - If a building is 4 story and was built around 1930, in Burbank, CA. will the center need to have a sprinkler system? Also the 2 Emergency exit doors, will they need to have the pull manual or the exit building door is sufficient? - [Infection control report waiting period.](https://progressivesurgicalsolutions.com/forums/topic/infection-control-report-waiting-period/) - In your recent infection control webinar, there was a slide stating surgeons are queried at either 30 or 90 days regarding infections depending on the type of surgery. Where would I find the type of surgery and the number of days required to wait before querying? - [CMS Conditions for Coverage](https://progressivesurgicalsolutions.com/forums/topic/cms-conditions-for-coverage/) - Hello, I am going through our binders and I have the State Operations Manual; Guidance for Surveyors for Surgery Centers. This is the guideline the surveyors use, but is there a manual for the actual ASC? Like how will I know where we are deficient if we don't have the written expectations. Or am I - [QI Study- confused pts](https://progressivesurgicalsolutions.com/forums/topic/qi-study-confused-pts/) - I was wondering if anyone has done a study regarding dementia/confused pts that come for surgery but do not really know what procedure they are having. what is the percentage of those pts having a POA in place and what percentage do not? Any ideas are greatly appreciated. - [Infection Control Coordinator](https://progressivesurgicalsolutions.com/forums/topic/infection-control-coordinator/) - Do you have a role description for an Infection Control Coordinator? Thank you in advance, Kathy - [Personal vs Work Email Address for CE](https://progressivesurgicalsolutions.com/forums/topic/personal-vs-work-email-address-for-ce/) - I am trying to set up online continuing education for my staff and was wondering if it is ok to use personal email addresses or does it require work email addresses. Our administrator has never set up work emails for the staff members of the surgery center. My mind is in survey mode. - [Separate waiting area](https://progressivesurgicalsolutions.com/forums/topic/separate-waiting-area/) - Good morning, We have a small surgery center owned by three plastic surgeons and the surgery center is connected to their office. Historically CMS required we have a separate waiting area (not our office waiting room) for surgical patients and families. We had a small room off of our main waiting room with a few - [Medical Records](https://progressivesurgicalsolutions.com/forums/topic/medical-records-4/) - I have pharmacy records from 2015. My pharmacist said I didn't need to retain 2015 records for the DEA or pharmacy. Do I need to keep them for other purposes? Some of the records show where a narcotic was issued to a certain patient. This information is also on the patient's medical record. - [Medical Record Storage](https://progressivesurgicalsolutions.com/forums/topic/medical-record-storage/) - Our facility is currently half paper, half computerized charting. All physical documents (ie consents, covid questionnaire, registration paperwork, etc) is scanned into the EMR. My question is, is the ASC required to keep all physical paperwork after it has been scanned in? I have run out of storage space, paying for off site storage is - [Annual Reviews/Competencies](https://progressivesurgicalsolutions.com/forums/topic/annual-reviews-competencies/) - Our facility is looking to streamline our annual reviews and competencies. I reviewed the mandatory orientation and annual education, but I am not clear what needs to be reviewed annually on the HR file. Does the Employee need to sign off each year on the Job Description/job competency plus complete waive testing (Glucose, hCG) How - [Responsible Driver Signature](https://progressivesurgicalsolutions.com/forums/topic/responsible-driver-signature/) - We are reviewing our policy on discharging patients with a responsible adult. Like some ASC's, we have drivers that leave the building once the patient has been called back for surgery. When it is time to discharge the patient to the driver/responsible adult, we are having to call the driver and wait for their arrival - [Pharmacy Audits](https://progressivesurgicalsolutions.com/forums/topic/pharmacy-audits/) - I am new to a Clinical Director position in MS. We are accredited through CMS and Joint Commission. I have been looking up information about Pharmacy Audits. I noticed that the director before me designated a Pharmacy Nurse to do the audits. Is this permitted or do I need a pharmacist to do the audits? - [Pharmacy Inspection (Alabama)](https://progressivesurgicalsolutions.com/forums/topic/pharmacy-inspection-alabama/) - I am seeking some clarification on a ruling for consulting Pharmacists in the state of Alabama. We are credentialed through AAAHC and CMS. Is it clearly stated somewhere a number of inspections to be conducted every year? We are currently doing them every quarter but are considering going to a semi annual inspection. All I - [Staffing](https://progressivesurgicalsolutions.com/forums/topic/staffing-4/) - 1. Does the infection control officer have to be an RN? 2. Does the OSHA officer have to be an RN? 3. Can an LVN be an ADON? In the state of Texas what are the guidelines for the ASC having a medical assistant/SPD tech being an infection control officer? - [Lost needle/sharps form](https://progressivesurgicalsolutions.com/forums/topic/lost-needle-sharps-form/) - Hi again, I have been tasked with creating a form that the surgeon can sign in the event a needle/sharp was unrecovered during an operation. After exhausting all avenues to find a lost needle/sharp, our surgeons would like to have something they can sign that the needle was unrecoverable after an exhaustive search. Does anyone - [Non Medical Observer consent form](https://progressivesurgicalsolutions.com/forums/topic/non-medical-observer-consent-form/) - Hi there, I am looking to find an observer consent form that would allow non medical observers into the OR to observe surgery upon the patients consent. Does anyone have a form they would be willing to share? thank you - [consents](https://progressivesurgicalsolutions.com/forums/topic/consents-5/) - Are consents required when a patient is tapped at their post-op visit? - [Patient Surgical Database](https://progressivesurgicalsolutions.com/forums/topic/patient-surgical-database/) - Hi! We are a small ophthalmic ASC without a specific surgical EMR system. The ASC has recently gained access to the EMR that is used in the physicians' office. We will be using this for running reports, scheduling, and accessing patient files, but not charting. We currently keep an OR database on Excel as well - [consents](https://progressivesurgicalsolutions.com/forums/topic/consents-4/) - I posed this question on June 7 but have yet to receive a reply. When a patient is tapped in the clinic at their post op visit, must they sign a consent? - [credentialing forms](https://progressivesurgicalsolutions.com/forums/topic/credentialing-forms/) - good morning, I will be credentialing a new physician, and this is my first time credentialing so I'm totally lost. I did download the medical staff credentialing guide and it lists a few forms, ilke the privilege request form, conflict of interest form ect. are any of these forms on esupport? Thanks - [Allergic to shellfish?](https://progressivesurgicalsolutions.com/forums/topic/allergic-to-shellfish/) - Is there any documentation that you can use betadine scrub and betadine ophthalmic eye drops if you are allergic to shellfish or ivp dye for cataract surgery? - [clinic/asc emergencies](https://progressivesurgicalsolutions.com/forums/topic/clinic-asc-emergencies/) - I run a small ophthalmic surgery center, (2 OR's), that is connected to our clinic. The buildings are considered 2 separate entities. Our ASC is open 2-3 days a week for cataract surgeries. We are always open for YAG lasers and SLT lasers. Yesterday our ASC was "closed" for surgeries and we were seeing patients - [Template for an OR 'card'](https://progressivesurgicalsolutions.com/forums/topic/template-for-an-or-card/) - Hello, Our ASC is pretty small and we have always used index cards for preference cards, however when I was working in the hospital they were all on sheets of paper in a binder. Our index cards are hard to read and with some of our bigger cases we don't have room to add stuff. - [credentialing fellows](https://progressivesurgicalsolutions.com/forums/topic/credentialing-fellows/) - We have orthopedic fellows that do a year fellowship with some of the sports medicine doctors here at our facility. In the past I have credentialed them like I do the rest of the medical staff, but I am not sure if their privileges are done correctly. Since they are not performing the surgeries without - [Clearance for surgery](https://progressivesurgicalsolutions.com/forums/topic/clearance-for-surgery/) - Does anyone know if CMS/AAAHC have guidelines regarding how long a clearance is good for?or is this up to the facility to decide? I have a surgeon that would like to use a clearance that is up to 6 months old; so much can happen in 6 months! - [Policies](https://progressivesurgicalsolutions.com/forums/topic/policies/) - Where can I find the attestation form like the one attached for our manuals? - [PACU monitoring](https://progressivesurgicalsolutions.com/forums/topic/pacu-monitoring/) - Hi1 Are there requirements for PACU recovery monitoring post procedure( GI,Pain) If they are reciving Propofol only or minimal versed only- do we have to monitor EKG- or is BP and O2 sufficient? - [ASC Software](https://progressivesurgicalsolutions.com/forums/topic/asc-software/) - We are evaluating new software systems to upgrade to EHR, patient engagement, billing, credentialing, scheduling and bench-marking reports. Please share recommendations. - [Credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-15/) - Medical Director and practicing physician is retiring from practicing in the OR. He remains an owner and wishes to remain Administrative as the Medical Director. Is this acceptable? How should his credentialing for the ASC to be handled? - [Re-credentialing](https://progressivesurgicalsolutions.com/forums/topic/re-credentialing-3/) - It is time for me to re-credential one of our CRNAs. Since I did it 3 years ago, she has discontinued her affiliation with 2 of her 3 previous affiliations (not counting us). She has 2 new affiliations. We have no issues with her performance in the last 3 years with us. Do I need - [Exhaust Fan - Dirty Sterile/Instrument Decontamination](https://progressivesurgicalsolutions.com/forums/topic/exhaust-fan-dirty-sterile-instrument-decontamination/) - The company that performed our recent Air Exchange Test in the OR reported to us that the exhaust fan in the dirty sterile room was not running. Upon further investigation, there is no exhaust fan installed at the base of the duct work in the ceiling. We have an exhaust fan duct, and a vent, - [Chemo precautions Policy](https://progressivesurgicalsolutions.com/forums/topic/chemo-precautions-policy/) - We are starting a new treatment process to instill mitomyacin in the OR soon and are in process of creating a policy and procedure document.. Is there a P&P addressing the use of chemo drugs in the OR and recovery area including PPE, disposal, and patient care precautions? - [Time frame for Surgical consents](https://progressivesurgicalsolutions.com/forums/topic/time-frame-for-surgical-consents/) - How long is a surgical consent good for before you will need to have you patient sign a new one? Is the surgical consent good for 30 days or one year prior to surgery ? For example, if the patient signs a consent in preparation for surgery in one month and something occurs where the - [CMS certification letter](https://progressivesurgicalsolutions.com/forums/topic/cms-certification-letter/) - Does anyone know if CMS gives out certification letters once a CMS health and life safety code survey is passed? Is there any form of passing and certificate other than the POC? Is there a way to get proof? - [patient consent](https://progressivesurgicalsolutions.com/forums/topic/patient-consent/) - When a patient is tapped in the clinic after cataract surgery (one day post op), must they sign a consent? - [Covid -19 updated pre procedural testing guidelines](https://progressivesurgicalsolutions.com/forums/topic/covid-19-updated-pre-procedural-testing-guidelines/) - We are in Fishkill, NY. NY state DOH and our local Dept. of health has updated the covid-19 screening guidelines for fully vaccinated patients for elective out patient procedures. as per new Guidelines Effective May-21st-2021 ,Fully vaccinated (Covid-19) patients are not required to get pre procedural covid-19 PCR test and for non vaccinated patients (without - [Tracking surgical site infections for cataract surgery](https://progressivesurgicalsolutions.com/forums/topic/tracking-surgical-site-infections-for-cataract-surgery/) - I am from a surgery center attached to an office where all surgical patients are seen post-operatively at the facility next door. Do any of you have a similar set up and a way that you document tracking of infections. I currently walk a letter over attached to the surgeon's schedule each month and the - [Patient and staff COvid-19 screening](https://progressivesurgicalsolutions.com/forums/topic/patient-and-staff-covid-19-screening/) - Good Afternoon, Are all the ASC's still do Covid-19 screenings and temperature checks on patients with the lighter restrictions starting? How about for staff? From what I have found on the CDC and APIC we should still be doing it, but would like to know if anyone else has seen something else. Thank you! - [CEMP](https://progressivesurgicalsolutions.com/forums/topic/cemp/) - How many emergency drills are required per year? - [Middle Initial/Suffix on Medical Records](https://progressivesurgicalsolutions.com/forums/topic/middle-initial-suffix-on-medical-records/) - I am looking for some guidance regarding demographics on Medical Records. Is it required that the patient's middle initial/suffix be present on all documentation? For example, if the middle initial is documented on the H&P, does it need to also be on the consent? Does CMS require consistency with middle initial/suffix throughout the chart? Thank - [Anti fatigue mat in Procedure Room](https://progressivesurgicalsolutions.com/forums/topic/anti-fatigue-mat-in-procedure-room/) - Hello Everyone We had one of our physician was out for one full week because of backache. He is back but now want to have anti-fatigue mat to stand on which will help with his backache. we are accredited with AAAHC. would like to know if it is ok to have anti-fatigue mat in the - [Glucose monitor](https://progressivesurgicalsolutions.com/forums/topic/glucose-monitor/) - I am trying to replace our glucose monitor. We are a small physician owned surgery center and have probably had to check a blood glucose maybe twice in the past year. We are a primarily cosmetic facility. That said, are there requirements for what kind of monitor I need to have in an ASC? Thank - [TB skin test](https://progressivesurgicalsolutions.com/forums/topic/tb-skin-test/) - If a new employee has a positive TB skin test whose responsibility is it to pay for a chest xray? This is a physician owned out patient surgery center not affiliated with the local hospital. - [NP and H&Ps](https://progressivesurgicalsolutions.com/forums/topic/np-and-hps/) - We are considering hiring an NP to perform H&P's on our surgical patients. I have read several articles and I cannot fine one that clearly states that we can bill for this exam. If someone has some experience in this area I would appreciate your help. I know Medicare changed some of the requirements in - [Committees / Governance](https://progressivesurgicalsolutions.com/forums/topic/committees-governance/) - I am doing our annual evaluations of infection control, quality program, etc.... In all honesty all of our documents look great BUT we are a small surgery center and I have an Infection Control Committee, Quality Improvement Committee, etc....like one for every area that is needed. All are the same members can I just make - [Patient transfer in case of disaster](https://progressivesurgicalsolutions.com/forums/topic/patient-transfer-in-case-of-disaster/) - I see in the CMS regulations regarding emergency preparedness a requirement to be able to track where patients went if it was necessary to transfer them to another facility and sending records of care with them. Do you have any suggestions of an easy way to comply with that requirement? I'm envisioning that if there - [Unplanned Vitrectomy](https://progressivesurgicalsolutions.com/forums/topic/unplanned-vitrectomy/) - If your standard consent states that there is a risk of an anterior vitrectomy and the doctor has an unplanned vitrectomy do you still have to report that to CMS since you had the patient sign the consent that stated the risk. - [Scrub tech certificaiton](https://progressivesurgicalsolutions.com/forums/topic/scrub-tech-certificaiton/) - Hi everyone I have had a scrub tech apply for position He is not certified but told me he was "grandfathered" in. In NJ scrub techs must be certified. From what I have read about this he was "grandfathered in" if he was already working at the time the law was passed in 2011 but - [Tranexamic acid](https://progressivesurgicalsolutions.com/forums/topic/tranexamic-acid/) - Hi, Does anyone use Tranexamic acid in their center? I wanted to get info on it to use for bleeding in plastic surgery. I know it is used for ortho but wanted to hear any fed back on it, Thanks. Anna - [Skin prep for anesthesia blocks](https://progressivesurgicalsolutions.com/forums/topic/skin-prep-for-anesthesia-blocks/) - What are facilities using to prep for anesthesia blocks since Chloraprep and Duraprep are back ordered? Anesthesia Doctors don't feel the little alcohol swabs are enough and the Betadine is hard to remove off the ultrasound probes. - [Employee Covid-19 Vaccine Policy](https://progressivesurgicalsolutions.com/forums/topic/employee-covid-19-vaccine-policy/) - I was just wondering if surgery centers are required by CMS/AAAHC to have an Employee Covid-19 Vaccine Policy? If so , does anyone have one to share? - [Question regarding loading of IOLs](https://progressivesurgicalsolutions.com/forums/topic/question-regarding-loading-of-iols/) - We use J&J Z9002 as our primary IOL. We have had some trouble recently with loading them. These are not pre-loaded. We have had cartridges crack, trouble advancing the lens, sheared off haptics, etc. My staff is very experienced and has been doing this for 10-25 years. I am told there have been no other - [Antibiotic Stewardship program in Ophthalmic ASC](https://progressivesurgicalsolutions.com/forums/topic/antibiotic-stewardship-program-in-ophthalmic-asc/) - Suggestions on how to meet requirement needs for an Antibiotic Stewardship program in an ophthalmic ASC? Are there existing blogs or policies available on your site. - [Recredentialing](https://progressivesurgicalsolutions.com/forums/topic/recredentialing-2/) - Do we have reach out to every hospital/facility that the physician has privileges at or just the primary hospital affiliation during the re-appointment process? - [Anesthesia Orientation](https://progressivesurgicalsolutions.com/forums/topic/anesthesia-orientation/) - Hello- We are returning to an anesthesia group that worked with us over a year ago. We are debating if the providers that have worked in our facility before need to go through orientation again, or if we can use the documentation from when they were here previously. We are updating all of their credentials. - [Covid 19 Patient Testing or Vaccine?](https://progressivesurgicalsolutions.com/forums/topic/covid-19-patient-testing-or-vaccine/) - Currently our facility is requiring our patients to have a negative Covid test within 5 days prior to their procedure. I am wondering if there are any guidelines or other facilities that have started accepting patient proof of full vaccination instead of requiring them to test for Covid. Has this been a difficult transition? Is - [Medical Gas Inspections](https://progressivesurgicalsolutions.com/forums/topic/medical-gas-inspections-2/) - How frequently are we required per LSC to have our med gas vendor perform inspections, testing and preventative maintenance? - [Wet Procedure Room Risk Assessment](https://progressivesurgicalsolutions.com/forums/topic/wet-procedure-room-risk-assessment/) - I have a question about your wet procedure room risk assessment. The answers to questions are given a number according to response. They start with 1 which is usually No risk/none or Yes risk/none. At the end it says a total score of 3 or more requires mitigation. Even if all the answers are NO - [Infusion](https://progressivesurgicalsolutions.com/forums/topic/infusion/) - My physicians want to start doing infusion in the ASC instead of their office. The medicare codes are 96416, 96370, 96379, 96376,C8957,96416,96440,96446. Would anyone know if a facility fee would be paid and wether or not it is approved for ASC. - [Classifying Propofol](https://progressivesurgicalsolutions.com/forums/topic/classifying-propofol/) - We recently hired a CRNA who wanted to give Propofol during a case. We typically utilize only oral Xanax and previous CRNAs use Fentanyl/Versed if more sedation is needed. She stated she would need a general anesthesia consent form seeing our current consent lists MAC. Our anesthesiologist on campus stated low doses of Propofol is - [compounding drops](https://progressivesurgicalsolutions.com/forums/topic/compounding-drops/) - During our recent AAAHC reaccreditation we were told that if we give patients compounded dilating drops (from an accredited 503B compounding pharmacy), we must log all those patients and perform quarterly audits on those logs. I can not find any information on this. Are you aware of any requirement regarding this? - [Pharmacy Monthly Audit Tool](https://progressivesurgicalsolutions.com/forums/topic/pharmacy-monthly-audit-tool/) - Looking for a pharmacy monthly audit tool that can be uploaded and modified. Thank you kindly in advance. - [Recording lot numbers on meds given](https://progressivesurgicalsolutions.com/forums/topic/recording-lot-numbers-on-meds-given/) - Is there a requirement to record lot numbers of all eye drops or any medications administered in the ASC including the operating room? - [Lipid Rescue Kit](https://progressivesurgicalsolutions.com/forums/topic/lipid-rescue-kit/) - We were recently told in a survey that we are required to have a lipid rescue kit if we use epi in our MH protocol. Have you any experience with this? - [OP REPORTS](https://progressivesurgicalsolutions.com/forums/topic/op-reports-2/) - Is there a time frame that a medical record needs to be completed per CMS (TX)? Specifically, Op Reports? I audit charts the day of surgery, but it is a constant battle to get signatures and Op Reports needed from the surgeons. - [Consultant Pharmacist](https://progressivesurgicalsolutions.com/forums/topic/consultant-pharmacist-2/) - Is there a requirement for Consultant Pharmacist review of Drug Program? If so, where can that be found? The frequency of the Consultant Pharmacy reviews? - [Terminal Cleaning](https://progressivesurgicalsolutions.com/forums/topic/terminal-cleaning-2/) - I see there are logs for terminal cleaning. There are daily and monthly ones. Is there anything that needs to be done quarterly if these are done daily and monthly?? What resource was used to build these logs?? CMS requirements, AORN, etc??? - [IV WASTE](https://progressivesurgicalsolutions.com/forums/topic/iv-waste/) - What is everyone using to waste partially used narcotics? Trash, Cactus receptacles, other? - [pre-op requirements](https://progressivesurgicalsolutions.com/forums/topic/pre-op-requirements/) - We seem to have ongoing discussions regarding what is and is not required prior to cataract surgery. Can you suggest where I might find answers to many of the questions below: - We require a refraction within 90 days. Is Glare required as well? - Is an auto refraction required before cataract surgery - Is - [TB Testing Requirements for Providers](https://progressivesurgicalsolutions.com/forums/topic/tb-testing-requirements-for-providers/) - We are following the CDC guidelines for TB testing of employees, however I am having difficult finding information on provider requirements for TB testing if a provider goes to multiple facilities. Will the baseline test suffice and then annual S/S screening thereafter? - [Infection Control Personnel Requirements](https://progressivesurgicalsolutions.com/forums/topic/infection-control-personnel-requirements/) - Hello, I would like to appoint my ASC Medical Assistant to help with some of the simple Infection Control tasks such as reviewing patient/surgeon questionnaires, environmental swabs, hand hygiene audits, etc. I am technically the IC nurse for the facility, but wondering if it is appropriate for me to appoint my MA to the the - [AAAHC Construction](https://progressivesurgicalsolutions.com/forums/topic/aaahc-construction/) - Hello all, Does anyone have a policy they are willing to share about doing a risk assessment before construction or renovations. It is a AAAHC requirement in the environment of care/Safety program section Chapter 7 (page 63) B. The safety program requires performance of a proactive, documented risk assessment before commencing demolition, construction, or renovation - [COVID Restrictions: Nursing Home Patients](https://progressivesurgicalsolutions.com/forums/topic/covid-restrictions-nursing-home-patients/) - Hello. My peer and I decided to restrict nursing home and patients from other congregate settings from our ASCs due to the high COVID activity within these centers in our area. Is anyone else doing this? Have you discussed how you will determine when it is time to admit these higher risk patients again? - [Wall suction vs. Portable Unit](https://progressivesurgicalsolutions.com/forums/topic/wall-suction-vs-portable-unit/) - Hello, we are a small single OR ophthalmology ASC in California. Can anyone tell me if we are required to specifically have an in-wall suction in our OR, or if a well-functioning portable suction meets regulatory requirements? Are we required to have suction in pre-op as well, or only OR and Recovery? Thanks. - [Opening/Closing Checklist](https://progressivesurgicalsolutions.com/forums/topic/opening-closing-checklist/) - Hey all! Is it a requirement to have an opening and closing checklist completed each day we operate? Our OR team is fantastic at doing this but our Pre/Post team doesn't feel it is necessary. Wondering what other centers do and if this is a requirement. Thank you for any help or guidance! - [Surgical scrub products](https://progressivesurgicalsolutions.com/forums/topic/surgical-scrub-products/) - I have a new scrub nurse starting who can not use Chlorhexadine (in Avagard)? What alternatives have you used? I need something for initial scrub of the day and then between cases. Thanks - [Pre-op refractions](https://progressivesurgicalsolutions.com/forums/topic/pre-op-refractions/) - We have an ongoing discussion regarding required pre-op refractions. From reviewing literature from CMS, it seems that upon diagnosis of a cataract a refraction is performed to insure vision is not capable of being improved with glasses. Must there be any further refractions performed prior to surgery? Is there a time limit between diagnosis (and - [Oxygen safe handling](https://progressivesurgicalsolutions.com/forums/topic/oxygen-safe-handling/) - Does anyone have training for safe oxygen cylinder handling that you would be willing to share? Thank you. - [Scrub Dresses in the OR](https://progressivesurgicalsolutions.com/forums/topic/scrub-dresses-in-the-or/) - Does anyone know if "Scrub Dresses" are acceptable in the OR? I am old & remember if you wore a dress, you must wear hose to prevent perineal fall out. I have a scrub tech who has asked & I can not find recent literature on this topic. HELP!! Thank you. Leslie :) - [Generator Services & Refueling](https://progressivesurgicalsolutions.com/forums/topic/generator-services-refueling/) - Historically, our generator service provider has refueled our generator when servicing it. However they've recently stopped offering the refueling service to their customers and we are seeking alternate solutions. Does anyone refuel their own generator? Are there any regulatory red-flags I should be aware of regarding either us refueling it ourselves, or the refueling process - [Staffing](https://progressivesurgicalsolutions.com/forums/topic/staffing-3/) - How can unlicensed personnel be utilized in an ASC? We currently utilize all RNs with the exception of our scrub position. Currently: RN in preop, RN in recovery, RN as Circulator, and either a scrub tech, LPN or RN as the scrub person. Lasers-RN How can a non-licensed person be utilized in pre and or - [Controlled Drug Auditing](https://progressivesurgicalsolutions.com/forums/topic/controlled-drug-auditing/) - I am working on updates to our Controlled Substance policy. Could I have some guidance as to auditing compliance? Should we be auditing every patient record if a patient receives a controlled drug or a percentage? Also how often? Daily, monthly, quarterly, etc.??? Thank you! - [Discharge to Responsible Adult](https://progressivesurgicalsolutions.com/forums/topic/discharge-to-responsible-adult/) - I have just read a blog on here titled FOCUSING ON THE FUNDAMENTALS OF CARE FROM PRE-OP TO POST-OP THE OPHTHALMIC ASC, FEBRUARY 2018. In that article it states that a patient could take a taxi with a physician order. Can you provide more inforamation on this exception? Cite the regulation verbiage on this practice. - [AAAHC](https://progressivesurgicalsolutions.com/forums/topic/aaahc/) - AAAHC has a requirement for policies related to accounting and financial spending. I have searched the policies on Progressive and cant seem to find anything. Do you know where I can find them or anyone have any examples they are willing to share? AAAHC Listed Requirements: 1. Appropriate and adequate policies and procedures are in - [History and Physical](https://progressivesurgicalsolutions.com/forums/topic/history-and-physical-3/) - I understand that the History and Physical form needs to be within 30 days of the surgery and that the patient needs to be re-assessed the day of the procedure. The H&P needs to be signed and dated , but does it need to be timed? - [Infection Control Risk Assessment](https://progressivesurgicalsolutions.com/forums/topic/infection-control-risk-assessment-2/) - Is there a sample Infection Control Risk Assessment available on Progressive? - [Toric/Multi-focal IOLs](https://progressivesurgicalsolutions.com/forums/topic/toric-multi-focal-iols/) - Would love to hear how other ophthalmic ASCs are handling Toric and Multi-focal IOL implants. In particular, the flow of information from Ophthalmologist office to the ASC including: who orders this IOL if not part of your consignment?; how is the patient educated prior to making a decision about which IOL; does the Ophthalmologist have - [Annual Evaluations](https://progressivesurgicalsolutions.com/forums/topic/annual-evalautions/) - As requested in our Facebook group. Here is our annual evaluations. The document ASC Annual Template 2020 is one i put together every year. It serves as a checklist for the employees on what needs to be done. So all the PSS education requirements are there and then once they submit this to me I - [Active Shooter Drill & Policy](https://progressivesurgicalsolutions.com/forums/topic/active-shooter-drill-policy/) - In response to the requests on FB group I am including our active shooter drill activity here along with our P&P. - [Electrostatic disinfecting](https://progressivesurgicalsolutions.com/forums/topic/electrostatic-disinfecting/) - Looking for information on the use of Electrostatic Spray cleaning for the Ophthalmology Clinic space after having Covid positive patients and or personnel in the office? Has anyone had this performed at their clinic and were there any concerns with the diagnostic equipment being damaged or harmed? I have used it at my former ENT - [PRN CRNA](https://progressivesurgicalsolutions.com/forums/topic/prn-crna/) - We are in the process of looking for a PRN CRNA from a staffing agency. I have no idea how this works. Am I responsible for credentialing? Is there anywhere specific I can look for guidance? - [CEU education](https://progressivesurgicalsolutions.com/forums/topic/ceu-education/) - Do you have any CEU education On ; Smoke in The OR Active Shooter Aseptic Technique Retained Foreign objects prevention - [Staff roles](https://progressivesurgicalsolutions.com/forums/topic/staff-roles/) - Hi all! What do you guys think about having your nurses pre op/circulate/post op their patient? What concerns would you all have? What are the benefits? Do you know of any restrictions or guidelines for this type of staffing set up? Thanks! - [ASC Staffing Question](https://progressivesurgicalsolutions.com/forums/topic/asc-staffing-question/) - I am a newer nurse manager for an ophthalmology ASC. What do you all think about hiring staff that have not completed a surgical tech program for a scrub tech position? It is hard to find scrub techs that want to just do eyes and my manager is suggesting we train someone for the role. - [Activity Improvement Section of MIPS](https://progressivesurgicalsolutions.com/forums/topic/activity-improvement-section-of-mips/) - Do any of you have any suggestions on how to include anesthesia in the 'activity improvement' portion of the MIPS? I manage an ophthalmology ASC and we need to incorporate this somehow. - [Mandate Covid Vaccine](https://progressivesurgicalsolutions.com/forums/topic/mandate-covid-vaccine/) - Is anyone mandating the covid vaccine at their facility? We have the vaccine available and are having discussions about what happens if employees don't get the vaccine. Any thoughts? - [California IV narcotic waste management](https://progressivesurgicalsolutions.com/forums/topic/california-iv-narcotic-waste-management/) - Hi. Any California ASC'S here that can give me some guidance on wasting IV narcotics? Right now we are wasting any unused amount of narcotics, per pt, in the trash can. I am trying to find info on the California websites that gives me the proper way of disposal, all I can find is for - [Flexible Endoscope drying cabinets](https://progressivesurgicalsolutions.com/forums/topic/flexible-endoscope-drying-cabinets/) - GI facilities: Do you use endoscope drying cabinets? If so, which ones do you recommend? - [Covid vaccination](https://progressivesurgicalsolutions.com/forums/topic/covid-vaccination/) - Anyone know or have any information on when vaccinations will be available to medical staff at the surgery centers? I would appreciate any insight. Thanks - [Education Inservice](https://progressivesurgicalsolutions.com/forums/topic/education-inservice/) - Hey Guys! Just planning and brainstorming some ideas. How do you all educate/test for your inservice? any fun games/projects/readings/powerpoints etc? Thanks!-Jamie - [Sample Agreement for sharing medication](https://progressivesurgicalsolutions.com/forums/topic/sample-agreement-for-sharing-medication/) - Hello, Does anyone have a sample agreement I can look at between your facility and another facility? I am drafting one for AAAASF to share Dantrolene with another facility but would like to see a another facilities agreement for comparison. Any suggestions/ comments would be helpful. Thank you, Anna Lozano , RN - [Prescription Drug Monitoring Program](https://progressivesurgicalsolutions.com/forums/topic/prescription-drug-monitoring-program/) - Our anesthetists use Fentanyl during MAC which we purchase using out doctor's DEA license. Our doctors do not prescribe opioids of any kind to individual patients. Are we required to participate in the Prescription Drug Monitoring Program? - [BMI](https://progressivesurgicalsolutions.com/forums/topic/bmi/) - Curious to see what other facilities policies are on BMI requirements/cutoffs. If anyone is willing to share, would appreciate it. - [Fire Alarm Testing](https://progressivesurgicalsolutions.com/forums/topic/fire-alarm-testing-2/) - How often should the fire alarm system get a physical inspection? I thought it was semi-annual, but the current alarm company says it's only required annually. - [Code Blue Policy](https://progressivesurgicalsolutions.com/forums/topic/code-blue-policy/) - Hi, I am looking for an updated code blue policy. I have one from 2008, but I can not find another one. Any advice? Thank you, Anna Lozano, RN - [Thermometer for Fridge/Freezer --](https://progressivesurgicalsolutions.com/forums/topic/thermometer-for-fridge-freezer/) - Who loves what product; I see the suggestions on PSS -- seeking feedback prior to purchase! - [Patients Driving Themselves](https://progressivesurgicalsolutions.com/forums/topic/patients-driving-themselves/) - Hi-Wondering if anyone allows their patients who come in for surgical procedures such as cataract surgery to have surgery without sedation and then drive themselves home? We seem to be running into more of this. - [Mitomycin](https://progressivesurgicalsolutions.com/forums/topic/mitomycin/) - We are currently using Mitosol kits for Mitomycin and they are wonderful but expensive. Is there any new data on using Mitomycin C again? I did see the previous posts from last year, but I couldnt find any recent information. Thanks! - [Expired Meds](https://progressivesurgicalsolutions.com/forums/topic/expired-meds/) - What do you do with all of your expired meds? Is there a place we can donate them too? - [Dobutamine in crash cart?](https://progressivesurgicalsolutions.com/forums/topic/dobutamine-in-crash-cart/) - Is Dobutamine still stocked in the crash cart? - [Patient Transfer Reporting Form](https://progressivesurgicalsolutions.com/forums/topic/patient-transfer-reporting-form/) - Is the Patient Transfer Reporting form (rev. 11/2018) the correct reporting form for transferring patients to the ER/hospital for i.e.: chest pain,aspiration, etc? I don't see the Patient Transfer Reporting form (rev 11/2018) on your site. Would you use the Medical Board of CA adverse event reporting form ( Accredited Outpatient Surgery Settings form 1/2019) - [Job Description](https://progressivesurgicalsolutions.com/forums/topic/job-description-2/) - Would there be a job description for Charge Nurse and/or Clinical Director Assistant available? We are looking at adding a position within our facility. - [COVID](https://progressivesurgicalsolutions.com/forums/topic/covid-2/) - Does the COVID questionnaire need to be signed by the patient or their transportation if they are entering the building? - [Hospital Transfers](https://progressivesurgicalsolutions.com/forums/topic/hospital-transfers/) - Does anyone have a form for documenting hospital transfers that you would be willing to share? - [AAAHC CoVID-19 considerations](https://progressivesurgicalsolutions.com/forums/topic/aaahc-covid-19-considerations/) - The AAAHC readiness checklist related to Covid-19 states that patients responsibilities have been updated to include responsibility for adherence to COVID-19-related policies and procedures. Has anyone done this? - [Iv fluids warming](https://progressivesurgicalsolutions.com/forums/topic/iv-fluids-warming/) - Hi. I am trying to get information on iv fluid warming. I can't seem to find the temperature guidelines or how long to keep them in the warmer. This what I found from the manufacturers website... B. Braun conducted chemical and biological stability testing of 0.9% Sodium Chloride in the EXCEL IV container throughout the - [Positive Drug Screen because of taking Vyvanse](https://progressivesurgicalsolutions.com/forums/topic/positive-drug-screen-because-of-taking-vyvanse/) - Has anyone heard of this drug causing positive drug screen tests for amphetamines and what proof do you have the employee show as a result of this? A copy of the prescription bottle with the drug screen in his/her employee binder? Thank you! - [Extended stay after elective procedure](https://progressivesurgicalsolutions.com/forums/topic/extended-stay-after-elective-procedure/) - Is there a policy/protocol for patients that elect to stay 23 hours? Reasons for this... Their responsible party doesn't feel comfortable after a multiple cosmetic surgery procedures, they elect to have extra nursing care, from out of town. The patients in our ASC can stay longer if desired but not more than 23 hours. Of - [Virtual Surveys](https://progressivesurgicalsolutions.com/forums/topic/virtual-surveys/) - Is anyone aware of a survey company that is doing virtual surveys in California for Office Based Surgery Centers???? - [FDA compliant AED's](https://progressivesurgicalsolutions.com/forums/topic/fda-compliant-aeds/) - Has anyone heard about the FDA mandating manufacturers of AED'S to have pre-market approval? I was told by a sales rep that all facilities were going to be required to have a pre-market approved AED (semi or automatic) in order to be in compliance. - [COVID-19 restrictions](https://progressivesurgicalsolutions.com/forums/topic/covid-19-restrictions/) - I am the clinical director of a small ophthalmic surgery. Everyone (especially my doctors) are tired of the increased restrictions for COVID. I have emphasized that with cases increasing, I didn't think we could relax any restrictions. Is temperature still required to enter your facility?? Is family still required to stay in their vehicle (our - [Code Blue Drill](https://progressivesurgicalsolutions.com/forums/topic/code-blue-drill/) - Do you know if there is a policy regarding whether an ACLS staff member should accompany a patient in the ambulance in the event of a code blue? Does the CRNA accompany the patient? We are updating our policy and procedure for Code Blue Drills and this question was asked. - [Legal authorization to sign surgical consent](https://progressivesurgicalsolutions.com/forums/topic/legal-authorization-to-sign-surgical-consent/) - Where would I look to find guidance about who can legally sign the surgical consent form for patients who are mentally unable to sign for themselves? If they have a POA, do we have to have the paperwork in our chart? If they have a legal guardian, does there have to be legal paperwork stating - [Pharmacy Consultant Cost](https://progressivesurgicalsolutions.com/forums/topic/pharmacy-consultant-cost/) - Hello everyone, I am looking to do a quality study on the cost of pharmacy consultants in a ASC setting. Would anyone be willing to share what they pay for a pharmacy consultant? I recently discovered that we are paying almost $900 a quarter for our current pharmacy consultant. I believe that is too high, - [Emergency Plan](https://progressivesurgicalsolutions.com/forums/topic/emergency-plan/) - Do you have any policies that include evacuation for an ASC located on the second floor? We are moving our ASC in December. The new ASC was built on the second floor. We are looking at updating all policies that would pertain to evacuating patients from the second floor as opposed to the ground floor - [Combine Emergency Crash Cart contents and Malignant Hyperthermia Cart contents i](https://progressivesurgicalsolutions.com/forums/topic/combine-emergency-crash-cart-contents-and-malignant-hyperthermia-cart-contents-i/) - We have a new Administrator who wants our Surgery Center to combine contents of Malignant Hyperthermia cart contents with Emergency Crash Cart contents into one Cart. Does anyone do this elsewhere? Please share comments to help us to make our decision. - [Allied Health: Physician Assistants](https://progressivesurgicalsolutions.com/forums/topic/allied-health-physician-assistants/) - One of our MDs would like his PA's to perform minor procedures in our procedure rooms. I am not familiar with allied health workers and what they can or cant do in a ASC setting. Our facility is in Indiana the PA's would be performing pain injections. I found the credentialing guide and duties request - [Urology Privilege](https://progressivesurgicalsolutions.com/forums/topic/urology-privilege/) - Does anyone have a Urology Privilege they could share? Thank you!!! - [TB tests for new hires](https://progressivesurgicalsolutions.com/forums/topic/tb-tests-for-new-hires/) - How long must we wait between TB tests for those new hires who require the 2 step TB test? - [Independent Contractor](https://progressivesurgicalsolutions.com/forums/topic/independent-contractor/) - Our facility is a AAAHC accredited non-deemed status privately owned ASC. Two of the surgeons have partnered with a hair restoration company, and they over see a few procedures a month. The staff that participate in the cases are contracted through the restoration company. I have a few questions: For these contractors- since they are - [Biomed checks](https://progressivesurgicalsolutions.com/forums/topic/biomed-checks/) - We are in the process of hiring a new bio-med company to inspect our equipment. I wanted to be sure that the requirement is still 6 months for equipment that has direct patient contact. I looked at TJC (EC 02.04.03) and CMS requirements but I do not see 6 months specifically. Maybe I overlooked it - [Regulatory Requirment](https://progressivesurgicalsolutions.com/forums/topic/regulatory-requirment/) - Are there a temperature requirements mandated for procedure rooms (Not OR)? - [Receipt of payment for services](https://progressivesurgicalsolutions.com/forums/topic/receipt-of-payment-for-services/) - Hello all, I have a question regarding the receipt of payment for services. We are an ophthalmology facility that is owned in conjunction with a clinic by a group of surgeons. The question that has been brought forth- Can the facility receive the professional fee and vice versa since it is owned by the same - [REAPPOINTMENT LETTER](https://progressivesurgicalsolutions.com/forums/topic/reappointment-letter/) - Hi, I need to send out reappointment letters to our surgeon and anesthesiologists. Do you have any pointers for this process? What should be included? The medical bylaws, regulations? Thanks! - [Order for Surgery](https://progressivesurgicalsolutions.com/forums/topic/order-for-surgery/) - Does anyone know if the surgeon's order for surgery is time-limited in California? For example, if he creates a plan/order for "Cataract surgery OU, OS first then OD", does said order have to be executed within a certain amount of time (such as 30 days) or else a new/updated order must be written? - [Privilege Request](https://progressivesurgicalsolutions.com/forums/topic/privilege-request-2/) - Does anyone have privilege request for Gynecology that they would be willing to share? - [incident reporting software](https://progressivesurgicalsolutions.com/forums/topic/incident-reporting-software/) - HI, Does any one have experiencing utilizing a incident/ adverse reporting software? we are looking tot move our facility to an electronic system. Thanks in advance Lorie - [Summary list](https://progressivesurgicalsolutions.com/forums/topic/summary-list-2/) - Has the summary list requirement been deleted? We use the Joint Commission and we previously got written up for this standard. RC.02.01.07 I just read something that says the standard was deleted. If so, is this a requirement for CMS or anyone that might survey us? - [Malignant Hyperthermia - Specific Consent](https://progressivesurgicalsolutions.com/forums/topic/malignant-hyperthermia-specific-consent/) - Has anyone ever used a separate consent specific to the risk for Malignant Hyperthermia in patients whose direct relatives reportedly suffered MH as a child? My anesthesiologist thinks we need a specific consent for an upcoming case whereas the biological mom says she had an MH crisis as a child but knows no other details. - [What is the CMS requirement for Generator Load Transfer Testing?](https://progressivesurgicalsolutions.com/forums/topic/what-is-the-cms-requirement-for-generator-load-transfer-testing/) - What is the CMS requirement for Generator Load Transfer testing. I was under the impression that the 30/30/30 (every 30 days, load transferred to generator for 30 minutes, at a minimum of 33% power usage) rule was the one that ASC's followed. I recently heard that an annual load transfer could be performed for two - [OPPE (Ongoing Professional Practice Evaluations)](https://progressivesurgicalsolutions.com/forums/topic/oppe-ongoing-professional-practice-evaluations/) - Is OPPE (Ongoing Professional Practice Evaluations) a Joint Commission requirement for Ambulatory Settings? If so, can you direct me to the requirement? This is being requested by a hospital credentialing department of our surgeons. - [Transition of care](https://progressivesurgicalsolutions.com/forums/topic/transition-of-care/) - Does anyone have a written policy on the transfer of a patient's care from one provider to another? - [Pathology](https://progressivesurgicalsolutions.com/forums/topic/pathology/) - Does anyone have a policy regarding tissue that is not sent to pathology, for example, fat, bone chips, etc. Does anyone know if this is necessary for AAAHC to be a written policy? - [Receptacle Testing Form](https://progressivesurgicalsolutions.com/forums/topic/receptacle-testing-form/) - Does anyone have a receptacle testing form? Any info appreciated, new to me. - [Flu Vaccination for 2020/2021](https://progressivesurgicalsolutions.com/forums/topic/flu-vaccination-for-2020-2021/) - Has anyone heard that CDC is mandating flu vaccinations for this flu season? - [PPE Eye Protection](https://progressivesurgicalsolutions.com/forums/topic/ppe-eye-protection/) - Are you REQUIRING Safety Glasses/Eye Protection PPE to ALL staff who provide direct patient care at ALL times even with negative tested patients? - [Eyelid Surgeries](https://progressivesurgicalsolutions.com/forums/topic/eyelid-surgeries/) - Are there any practices that use the Ellman Surgitron for Blepharoplasty? What type of needle tips do you use? Are they reusable or single use? Are there other cost effective alternatives? We just bought one to use on our cases but we purchased this from a third party so in-service is not available from the - [Cataract numbing gel](https://progressivesurgicalsolutions.com/forums/topic/cataract-numbing-gel/) - Hi- I was curious what other facilities are using to numb the eye for cataract surgery beside the drops. All the lidocaine gel we come across is super expensive. Does anyone have a good manufactuer/brand they use? - [Compounded dilation drops](https://progressivesurgicalsolutions.com/forums/topic/compounded-dilation-drops/) - Our ASC uses several different drops for dilation during pre-op for Cataract Surgery and Femtolaser. We are interested in using the compounded drops for dilation from Imprimis. Mydriatic 4 Multi-Dose (Tropicamide 1%, proparacaine 0.5%, phenylephrine 2.5% and ketorolac 0.5%). Are we able to use these drops in the ASC? It looks like they formulated this - [Legal guardian](https://progressivesurgicalsolutions.com/forums/topic/legal-guardian-2/) - A patient needing a procedure is living in a long-term facility and has a legal guardian that lives out of town. The consent will have to be signed from a distance since the guardian cannot be here. Due to COVID restrictions at our facility, the patient will have to come in alone. Is it okay - [OR Time Costs](https://progressivesurgicalsolutions.com/forums/topic/or-time-costs/) - Hello All, I am curious, are most of you charging per case or by time for OR use. Are you charging different rates per type of surgeon? What kind of rates are you charging? - [Air Balance report](https://progressivesurgicalsolutions.com/forums/topic/air-balance-report/) - Does the air balance test have to be a "Certified?" We recently had an our Medical gases/piped gas inspection and they performed a ventilation assessment for us. Does this meet the requirements or does the test have to be performed by a special vendor? Thelma - [Staffing Shortage / Agency Assistance Requested](https://progressivesurgicalsolutions.com/forums/topic/staffing-shortage-agency-assistance-requested/) - Has anyone used a good medical temp agency in IN? We are going to have a staffing shortage in Aug. & Sept. & looking for an emergency back up plan. I need help with names of reputable agencies in Indiana please. Thank you, Sarah Jefferis RN, BSN - [Letter of communication](https://progressivesurgicalsolutions.com/forums/topic/letter-of-communication/) - Who would I send the Letter of Communication and Inquiry to Local Community Emergency Command authority to? - [Surgery Day Orders - Time limit?](https://progressivesurgicalsolutions.com/forums/topic/surgery-day-orders-time-limit/) - Hello, I am wondering if anyone can tell me if there is a time-limit on how far in advance surgery day orders can be written and signed by the surgeon? For example, can the surgeon complete and sign orders during the surgical consult for staff to follow on day of surgery? Thanks! - [Ectoparasite Policy](https://progressivesurgicalsolutions.com/forums/topic/ectoparasite-policy/) - I am looking for a policy on ectoparasites. The State of Michigan has made this a new requirement and I'm curious if anyone already has a policy. Thank you! - [Asymptomatic positive exposure](https://progressivesurgicalsolutions.com/forums/topic/asymptomatic-positive-exposure/) - We are continuing to evolve our policy on surgical patients and COVID-19 exposure and I would love some guidance/thoughts. If you have a patient scheduled for a procedure that is urgent but not an emergency and they are living in a household with an individual who has tested positive x 2 and has remained asymptomatic - [AAAHC policy](https://progressivesurgicalsolutions.com/forums/topic/aaahc-policy/) - I am working out of the 2018 volume for accreditation and would appreciate some help. There is a written requirement for a policy to safeguard against cross infection. What kind of policy would be best to use to answer this? - [Bleph RMW](https://progressivesurgicalsolutions.com/forums/topic/bleph-rmw/) - We are a small OPH ASC primarily doing cataracts so our RMW is basically just sharps. We started doing Blephoroplasty and I tried to do some research and am coming up empty handed so I am hoping someone could help me. What are you doing for Bleph r/t RMW? It is not much at all - [HIPPA](https://progressivesurgicalsolutions.com/forums/topic/hippa/) - What protocols should be in place before employees are given access to the facilities network so they can work from home? Is there any additional forms we should have them sign? We want to be sure we remain HIPPA compliant. - [Proctorship](https://progressivesurgicalsolutions.com/forums/topic/proctorship/) - Hi, Can someone show me an example of a proctoring form? I couldnt find it on here. - [AAAAHC Inf. control](https://progressivesurgicalsolutions.com/forums/topic/aaaahc-inf-control/) - The 2018 edition (which is what we are following is asking for "Requirements for the written infection prevention and control program" Where would those requirements be listed? - [QI study](https://progressivesurgicalsolutions.com/forums/topic/qi-study/) - Does anyone have a written policy for a description for QI studies? Working on AAAHC and not sure what will satisfy the requirement. Thanks!!! - [Intubation/Extubation Question](https://progressivesurgicalsolutions.com/forums/topic/intubation-extubation-question/) - Our center does a majority of MAC anesthesia, but have 2 general anesthesia cases scheduled and need some clarification. We had both patients tested and they came back negative for COVID-19. My question is do we still follow all the procedures per the intubation/extubation P&P for COVID-19, including N95 masks, face shields, double gloving and - [Credentialing Anesthesiologists](https://progressivesurgicalsolutions.com/forums/topic/credentialing-anesthesiologists-2/) - Does a retired anesthesiologist, that would like to work for a limited time, have to have hospital privileges? - [Surgical pre op testing](https://progressivesurgicalsolutions.com/forums/topic/surgical-pre-op-testing/) - I am wondering if anyne can give me guidance on their P&P on pre op testing for muti specitaly ASC's We are battling with the medical offices for our surgical patients on the pre op testng and gettinghtose results to the surgery center prior to the surgery. What are your guidelines that you have for - [COVID](https://progressivesurgicalsolutions.com/forums/topic/covid/) - In the event that an employee tests positive for COVID, do patients have to be notified? - [Time lapse in between reappointments](https://progressivesurgicalsolutions.com/forums/topic/time-lapse-in-between-reappointments/) - If there is a time lapse in 10 days from first appointment due date to the next reappointment date, any suggestions on how to correct this? An example is if next reappointment was due on 3/1/2020 but the board did not approve until 3/10/2020. How would you amend this? Thank you. - [Pest control in the AC Setting](https://progressivesurgicalsolutions.com/forums/topic/pest-control-in-the-ac-setting/) - My landlord asked me yesterday if she could have pest control spray the INSIDE of our ASC (on a non-surgery day of course) for bugs. I told her I wanted to hold-off until I knew if there were any regulatory or other reasons this may or may not be allowed? Does anyone have any experience - [COVID questions](https://progressivesurgicalsolutions.com/forums/topic/covid-questions/) - Hi! Just a few thoughts and questions from you all. 1. If cases are rising in your area(county) what actions need to take place? Where do you begin to adjust what you are doing if so? 2. In the OR setting, is it just your Intra OP(OR) staff changing masks between cases? 3. For non - [Patient tested positive for COVID](https://progressivesurgicalsolutions.com/forums/topic/patient-tested-positive-for-covid/) - In the policy and procedure "Screening of Patients", it states that if required by local or state department of health, all patients will be tested for COVID-19 prior to surgery. Our local health department is not requiring us to test our patients prior to surgery, however we decided to test all patients. We have obviously - [LPN Duties in the ASC](https://progressivesurgicalsolutions.com/forums/topic/lpn-duties-in-the-asc/) - Does anyone else let LPN's sign off orders? If so, does an RN have to sign off those orders as well? Can the RN just sign off on the pre-op or post-op assessment record? I've looked through our P&P and it is vague on the actual duties of an LPN & no where does it - [Social Distancing in Pre-op and Recovery](https://progressivesurgicalsolutions.com/forums/topic/social-distancing-in-pre-op-and-recovery/) - We are not allowing visitors at this time and have the waiting room set up for social distancing if necessary. What are other surgery centers doing about patient volume in pre-op and recovery? Our bays are 6 feet apart and separated by a curtain. We were keeping every other bay open, but looking to ramp - [Credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-14/) - When applying for staff appointment, does an actual copy of the social security card need to be on file? Or are they able to write in on application? - [Ophthalmology instrument detergent](https://progressivesurgicalsolutions.com/forums/topic/ophthalmology-instrument-detergent/) - Hello Group, Ophthalmology Surgery Centers: Would you mind sharing what detergent your facility uses to clean the Ophthalmology instruments? We don't use enzymatic cleaner, and most of our IFU's want us to use a neutral detergent. I was hoping to hear what other facilities might be using. Thank you, Jennifer J. - [Credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-13/) - Hi All, Hope I can get a fast reply from you guys. I am currently credentialing a new doctor who's currently on probation for some technicality. He does not have privileges at any hospital but is credentialed at a near by ASC. Besides proctoring, what requirements would he need? Does he need to have hospital - [Credentialing](https://progressivesurgicalsolutions.com/forums/topic/credentialing-12/) - When you appoint someone on the medical staff and give them provisional privileges, does that mean they only have a limited amount of time to be privileged in their specialty? And I'm assuming they would then need to go through the reappointment process again? What are the benefits of giving some one provisional status as - [external benchmarking](https://progressivesurgicalsolutions.com/forums/topic/external-benchmarking-2/) - I saw in old forums that PSS was creating a benchmarking. Was this ever completed? If so, where can I find information for it? Thanks - [Covid Consent](https://progressivesurgicalsolutions.com/forums/topic/covid-consent/) - I am hearing that people are possibly changing/adding a disclaimer on their consents regarding Covid, Similar to other risks for the procedures they are undergoing. I am wondering if anyone has done this or has heard about it. - [OR Air Exchange](https://progressivesurgicalsolutions.com/forums/topic/or-air-exchange/) - How often should an air exchange inspection be performed? What is the regulations or standard of practice on this? Thank you, Kristen - [Employee COVID-19 Post-Exposure Policy](https://progressivesurgicalsolutions.com/forums/topic/employee-covid-19-post-exposure-policy/) - One of our surgeons had prolonged direct contact with an employee at another facility who tested positive for COVID-19. We were informed of this the day before his planned surgical date, and his rapid test results wouldn't be back in time to know whether he is positive or negative prior to his scheduled cases. Because - [N-95](https://progressivesurgicalsolutions.com/forums/topic/n-95/) - How are facilities obtaining more N-95 We have five left. No idea where to get more to do perform ENT cases - [CRNA performance eval](https://progressivesurgicalsolutions.com/forums/topic/crna-performance-eval/) - Anyone have a good CRNA performance eval I could use (I would edit to fit our facility)? Thanks Carson - [QAPI- EHR](https://progressivesurgicalsolutions.com/forums/topic/qapi-ehr/) - What is a good QAPI project to do that incorporates transitioning from paper to EHR? We go live at the end of the month and wanted to see what kind of project we could do. - [Medical Assistants in ASC](https://progressivesurgicalsolutions.com/forums/topic/medical-assistants-in-asc/) - Hi there! Where can i find scope of practice for medical assistants in a surgery setting? I can see their scope by state but as I recall from nursing school, medical assistants can not assess(meaning vitals as well) or anything when planning for surgery. I just want to be sure we can utilize one to - [Handbook/Policy& Procedures](https://progressivesurgicalsolutions.com/forums/topic/handbook-policy-procedures/) - Hi there! You all have an Employee handbook in addition to all of your policy and procedures? We have an orientation program which goes over Mission, goals, objectives, organization chart, job description, all human resource info, policies and procedures. Thank you! - [Medical Staff OSHA/HIPAA Annual Training](https://progressivesurgicalsolutions.com/forums/topic/medical-staff-osha-hipaa-annual-training/) - I'm trying to find clarification on if we are required to provide annual OSHA/HIPAA training to our LIP's like we do for our employees. Thanks in advance for your help! - [APRN/NP peer review](https://progressivesurgicalsolutions.com/forums/topic/aprn-np-peer-review/) - Is peer review required for APRN/NP? Our NP is licensed in Hawaii (full practice license per state law). Thanks. - [Patient population for elective procedures in COVID-19 times](https://progressivesurgicalsolutions.com/forums/topic/patient-population-for-elective-procedures-in-covid-19-times/) - I am wondering what patient population policies others have in place and the time-line for getting back to the "before COVID-19" population for elective procedures. Currently we are not scheduling anyone 1. 80+ 2. anyone with comorbidity that will make them susceptible to major complications from COVID-19 3. anyone from assisted living, SNF, long-term care - [bouffant shortage with COVID-19](https://progressivesurgicalsolutions.com/forums/topic/bouffant-shortage-with-covid-19/) - What are the thoughts on how best to proceed if we are unable to get disposable bouffant hats? Are people having their laundry facility launder cloth hats for staff or developing other contingency plans / policies? We are having a difficult time getting them. We are an ophthalmic ASC. Thanks! - [Texting Orders](https://progressivesurgicalsolutions.com/forums/topic/texting-orders/) - Is there a policy and procedure for texting orders,or not texting orders? - [Risk Assessment EHR](https://progressivesurgicalsolutions.com/forums/topic/risk-assessment-ehr/) - We are transitioning to electronic records. Anyone have a risk assessment I can use and alter to fit my facility? Thanks. Carson - [COVID patient screening](https://progressivesurgicalsolutions.com/forums/topic/covid-patient-screening/) - Our facility has currently began COVID testing on adult patients. We are only patient screening the pediatric patients. If patient tests positive for COVID, they are cancelled and rescheduled. One of our pediatric patients is going to see their primary for the antibody testing. If this comes back positive, would this constitute a cancellation? - [Medical Records](https://progressivesurgicalsolutions.com/forums/topic/medical-records-3/) - We are on paper medical records. Wanted to clarify that it is necessary for the Surgeon to sign off on the path report in the Surgery Center even though the Surgeons get the path report in their offices? Looking for any literature to back this up. Thank you! - [Alternatives to N95 Respirators?](https://progressivesurgicalsolutions.com/forums/topic/alternatives-to-n95-respirators/) - Is anyone using an alternative to N95 masks due to the shortage? For example, KN95 Respirators? - [vital signs](https://progressivesurgicalsolutions.com/forums/topic/vital-signs/) - We only do ophthalmology cases, mostly cataracts and other short procedures. How many sets of vitals are being performed and at what interval before discharge? Thanks Carson - [Use of Invasive Arterial Pressure Lines in Outpatient Surgery Centers](https://progressivesurgicalsolutions.com/forums/topic/use-of-invasive-arterial-pressure-lines-in-outpatient-surgery-centers/) - We are a Medicare Certified (non accredited) Outpatient Ambulatory Surgery Center. Our Medical Director wants to start using Arterial Pressure Lines during our long Spine Cases. I am extremely uncomfortable with this plan for many reasons.Does Medicare or any other Governing Body prohibit the use of these in the Outpatient Ambulatory Surgery Setting?I want to - [N95 Supplies and Use](https://progressivesurgicalsolutions.com/forums/topic/n95-supplies-and-use/) - Like everyone else, obtaining N95's to use for aerosol-generating procedures has been a challenge for our surgery center. I have been requesting supplies from the local public health department, as our normal vendors are giving us an earliest delivery date of November 2020 for N95 delivery. I have a total of 600 masks from the - [Generator Testing](https://progressivesurgicalsolutions.com/forums/topic/generator-testing-2/) - Our surgery center performs surgery one day per week. I run the generator every week for 20-30 minutes and keep a log of all required parameters. Currently, I also do a monthly transfer test. Does the Life Safety Code require this transfer test be performed every month? - [Medicare Requirement of pre-surgery H&P](https://progressivesurgicalsolutions.com/forums/topic/medicare-requirement-of-pre-surgery-hp/) - We Live in California. We are an ASC. We are not accredited. Only certified by Medicare. What requirements do we have regarding the surgeon's History & Physical(H&P)? We have always had a rule that the surgeon had to provide a current H&P within the last 30 days. Is this still the current Medicare standard? - [Mitomycin C](https://progressivesurgicalsolutions.com/forums/topic/mitomycin-c/) - Where do other facilities purchase Mitomycin C from? We are looking a several different vendors currently. For those that are using this product, how are you storing and handling? - [initial appointment application date](https://progressivesurgicalsolutions.com/forums/topic/initial-appointment-application-date/) - Does the application date for a new provider appointment have to be within 180 days of Board approval? If not, what is the required time frame from application date to Board approval date? - [Updating Employee Handbook for Covid-19](https://progressivesurgicalsolutions.com/forums/topic/updating-employee-handbook-for-covid-19/) - I posted this question to the FB page but I thought I'd post here as well in case there is a different audience. I think I remember hearing something on the re-opening webinar (or was it in a post) about updating the Employee Handbook in reference to Covid-19. What updates/changes are recommended? Does anyone have - [Narcotic Book (Book Keeping) Ledgers](https://progressivesurgicalsolutions.com/forums/topic/narcotic-book-book-keeping-ledgers/) - Hello, The ASC I work for has kept our Narcotic book since 2013 to the present, and we are switching online book keeping, from hard copies to soft copies with a lot of our binders. 1) Can we do that with the Narcotic Books Ledger,? 2) What do we have to keep in our shelves? - [Peer Review Covid](https://progressivesurgicalsolutions.com/forums/topic/peer-review-covid/) - We did not do peer review for Q1 due to closure for COVID. Now we are reopen, can we just put that it was waived for Q1 due to circumstances and continue in Q2? -Carson - [peer review](https://progressivesurgicalsolutions.com/forums/topic/peer-review-3/) - Can an OD perform peer review on an MD? - [Admission](https://progressivesurgicalsolutions.com/forums/topic/admission/) - I am in process of reviewing documents we currently use. Can you give me a list of admission documents that must be signed? I feel like we have too much and want to consolidate but want to maintain compliance. Thanks Carson - [Air exchanges in procedure rooms](https://progressivesurgicalsolutions.com/forums/topic/air-exchanges-in-procedure-rooms/) - In regards to Endoscopy Centers; Do we need a certain amount of air exchanges in procedure rooms? Has anybody purchased a "plasma air purifier" to use in procedure rooms for COVID? We are utilizing two procedure rooms and bouncing patients between both rooms to allow for air circulation and disinfection. Is that enough with colonoscopy - [Surgical Safety Checklist](https://progressivesurgicalsolutions.com/forums/topic/surgical-safety-checklist-2/) - What are people adding to the Safety Checklist regarding COVID/Covid Testing? Thank you. - [Absent CRNA due to COVID 19](https://progressivesurgicalsolutions.com/forums/topic/absent-crna-due-to-covid-19/) - We are currently working on a PLAN B - for anesthesia coverage in the case that our CRNAs are sick and unable to come to work. Does anyone have a policy or guidance for when Anesthesia or a CRNA is not available on a surgical day? Our RN's are not trained on IV conscious sedation - [eye drop administration post-Covid-19??](https://progressivesurgicalsolutions.com/forums/topic/eye-drop-administration-post-covid-19/) - We have always used multi-dose eye drops for prep/OR/postop drops, yet are concerned that this might not be best practice now??? We are very diligent with using aseptic technique and hand washing, yet are trying to limit any exposure possible?? Am I overthinking this or not?? Any comments, ideas or suggestions??? - [Consent/disclosure statement regard Covid-19?](https://progressivesurgicalsolutions.com/forums/topic/consent-disclosure-statement-regard-covid-19/) - It is my understanding that additional verbiage should be added to our facility or surgery consent regarding Covid-19??? Can anyone confirm this as well as share their verbiage??? - [Elective Surgery on patient who was COVID +](https://progressivesurgicalsolutions.com/forums/topic/elective-surgery-on-patient-who-was-covid/) - Good Afternoon, What is the guidance on elective surgery for a patient who had COVID 19? Should they be retested? Or does a 14 day self-quarantine and s/s free mean they are safe to operate on? We are thinking at a minimum they should be cleared for surgery by their PCP. Anything else to consider? - [COVID-19 Policies and Procedures](https://progressivesurgicalsolutions.com/forums/topic/covid-19-policies-and-procedures/) - Our facility provides pediatric dental procedure/surgeries for children 2 years old and older. I was wondering what other facilities were going to do to follow the new recommendations for screening patients for COVID-19. Will they require their pediatric clients to be tested for COVID-19? Will they also be required to wear a cloth mask before ## Replies - [](https://progressivesurgicalsolutions.com/forums/reply/43930/) - You're so welcome! - [](https://progressivesurgicalsolutions.com/forums/reply/43929/) - Thank you so much!! - [](https://progressivesurgicalsolutions.com/forums/reply/43927/) - Hi Diane. Thank you for this question! This has become less about enzymatic vs. non-enzymatic and more about following the MIFU. Historically, ophthalmology has avoided enzymatic cleaners because of TASS concerns, and many of us have practiced that way for years without issue. Our recommendation would be to verify the current MIFUs for your instruments - [](https://progressivesurgicalsolutions.com/forums/reply/43761/) - Hi Lauren. Thank you for this question. This isn't on eSupport and is only available through our comprehensive P&P program. However, this should include the competencies specific to your PA's role (privileges) within the center. In example, do they conduct H&Ps thoroughly, remove sutures and report complication back to the surgeon appropriately, or competently assist - [](https://progressivesurgicalsolutions.com/forums/reply/43602/) - Hi Keri. Thanks for the follow up question. Yes, the order needs to be unique for each patient. Your facility must develop policies that address what criteria a physician should consider when deciding a patient does not need to be discharged in the company of a responsible adult. Exemptions must be specific to individual patients, - [](https://progressivesurgicalsolutions.com/forums/reply/43601/) - In response to the later portion about discharge. If the physician orders for each individual patient state that they can be discharged home without an accompanying adult and these orders are signed and noted by the nurse does this cover the discharge? - [](https://progressivesurgicalsolutions.com/forums/reply/43600/) - Hi Lexee. Thank you for this question. This depends upon the accrediting organization, the facility's policy, and the circumstances in the OR. Some AOs require this and if it is written into facility policy, then it must be done. You'll also find these CMS CfC interpretive guidelines helpful: §416.42 Condition for Coverage: Surgical Services Surgical - [](https://progressivesurgicalsolutions.com/forums/reply/43599/) - Hi Julia. Thank you for this question. It is a common one! A YAG laser capsulotomy does not typically need to be performed in an OR, as it is a non-incisional procedure commonly done in a laser or procedure room. A PACU bay with only a privacy curtain may be possible, but the facility should - [](https://progressivesurgicalsolutions.com/forums/reply/43596/) - You're so welcome, Anna! - [](https://progressivesurgicalsolutions.com/forums/reply/43594/) - HI, Yes, after looking at this a little more, I do see this. Thank you so much! - [](https://progressivesurgicalsolutions.com/forums/reply/43593/) - Hi Laura. Thank you for this follow up question. The key is balancing ADA accommodations with patient and staff safety. The ADA does not require staff to perform unsafe manual lifts or place themselves at risk of injury. Attempt to identify transfer needs during scheduling so appropriate accommodations can be arranged in advance. Depending on - [](https://progressivesurgicalsolutions.com/forums/reply/43592/) - Hi Anna. I see what you mean, that there is only one question regarding TB on the OSHA quiz. However, the content of the modules includes TB education, new employee screening, management of positive TB tests, ongoing monitoring, facility TB risk assessment, annual surveillance, and documentation. This hits the required elements of TB education for - [](https://progressivesurgicalsolutions.com/forums/reply/43590/) - Hello, Piggybacking this with a somewhat related question. What is the recommendation for handling wheelchair bound patients who cannot transfer on their own into the surgical stretcher? We do not have a lift in our facility and also have a number of staff members who refuse to "lift" due to back injuries, etc. We typically - [](https://progressivesurgicalsolutions.com/forums/reply/43589/) - Thank you Apryl. The only question I see on TB is; " What is the correct way to perform a Tuberculin Skin Test (TST) for a new hire?" Is there more information elsewhere that I am not seeing? This question is under OSHA. Thanks! - [](https://progressivesurgicalsolutions.com/forums/reply/43584/) - Thank you for this question, Michelle. Most facility's policies establish parameters that require further evaluation by the surgeon and/or anesthesia provider rather than automatic cancellation thresholds. The decision should take into account the patient's baseline values, symptoms, comorbidities, urgency of the procedure, type of anesthesia, and overall clinical status. For example, many facilities identify elevated - [](https://progressivesurgicalsolutions.com/forums/reply/43583/) - Hi Tricia. Thank you for this question. We are not aware of any ASC-specific EPA training requirement at this time. I would recommend waiting to see how the citation is ultimately issued, if at all. In many cases, surveyors use the term "EPA training" when referring to hazardous waste management or environmental compliance activities rather - [](https://progressivesurgicalsolutions.com/forums/reply/43582/) - Thank you for sharing, Tricia. Yes, every MIFU will read a little different, which is why it is so critical to start there. - [](https://progressivesurgicalsolutions.com/forums/reply/43580/) - Hi Keri. Thank you for this question. If you bill for a facility fee, then the CMS CfCs apply. Meaning, both still apply, even if performing lasers without anesthesia. Lasers, by definition, are still considered surgery in the ASC. §416.52(a): Standard: Patient assessment and admission. (1) The ASC must develop and maintain a policy that - [](https://progressivesurgicalsolutions.com/forums/reply/43579/) - Hi Anna. Thank you for this question. Annual TB education is included in the "Annual Training" module. This topic isn't separated out into it's own module. - [](https://progressivesurgicalsolutions.com/forums/reply/43578/) - We run our instruments through the ultrasonic after every surgery. That is also what our IFUs state we must do. - [](https://progressivesurgicalsolutions.com/forums/reply/43577/) - You're so welcome, Anna! - [](https://progressivesurgicalsolutions.com/forums/reply/43559/) - Thank you! - [](https://progressivesurgicalsolutions.com/forums/reply/43550/) - Hi Whitney and Anna! Thank you for this question. This depends upon how temporary privileges are addressed in your medical staff bylaws. If your bylaws don't address this, then you can either a.) credential and privilege that CRNA as a full active medical staff member or b.) modify your bylaws to accommodate temporary privileges in - [](https://progressivesurgicalsolutions.com/forums/reply/43549/) - No, it is definitely a revision we need to make on our end. We appreciate you letting us know! - [](https://progressivesurgicalsolutions.com/forums/reply/43548/) - Hi Lexee. Thank you for this question. Yes, a risk assessment must be conducted in this case. Please see eSupport > P&P > Nursing > Intraop > Environmental Standards. If you need further assistance with this, just email me at apryl.mcelheny@vmghealth.com. - [](https://progressivesurgicalsolutions.com/forums/reply/43547/) - following - [](https://progressivesurgicalsolutions.com/forums/reply/43544/) - No worries! It may be my mistake. Thank you!!! - [](https://progressivesurgicalsolutions.com/forums/reply/43539/) - Our interpretation is that this requirement would not apply if the facility does not maintain a scale and does not routinely obtain patient weights. Many ASCs rely on patient-reported weights or weights documented in the H&P. However, if the facility obtains weights on site, particularly when weight is necessary for clinical decision-making such as pediatric - [](https://progressivesurgicalsolutions.com/forums/reply/43538/) - Hi Michelle. Thank you for this question. I'm not sure which state you're in so I have provided the following link: https://nabp.pharmacy/about/boards-of-pharmacy/ You'll need to address the change of address with your state's board. Just as an FYI, the change in address will more than likely result in a visit from your state and accrediting - [](https://progressivesurgicalsolutions.com/forums/reply/43537/) - Is this for all ASC's? Or only if your ASC has a scale in the facility? what if you are not weighing patient DOS and using their health history but verifying DOS? - [](https://progressivesurgicalsolutions.com/forums/reply/43531/) - Hi Susan. Thank you for this question. CMS doesn't dictate how often you conduct biologicals or what the result time of those need to be. However, CMS does require that you adhere to both the manufacturer instructions for the autoclave/sterilizer and the biologicals themselves and to industry best practices. AORN and ANSI/AAMI state at least - [](https://progressivesurgicalsolutions.com/forums/reply/43528/) - Hi Miguel. Thank you for this question. There is generally no requirement for a separate witness signature on either the anesthesia consent or facility consent unless required by state law or facility policy. For anesthesia consents, the anesthesia provider may serve as the witness since the consent discussion occurs directly with the patient. For procedural - [](https://progressivesurgicalsolutions.com/forums/reply/43526/) - Hi Diane. Thank you so much for this question. This is a standard that is specific to QUAD A accredited facilities only. The QUAD A title/heading must have fallen off. Thank you for bringing this to our attention and we will have that fixed. - [](https://progressivesurgicalsolutions.com/forums/reply/43490/) - Sorry to bring up an old conversation but I too am curious about witness signatures. Crissy, does your reply also apply to the procedural consent? The primary question from one of the RNs was if the witness signature time needed to match the patient/MD signature times. Thanks! - [](https://progressivesurgicalsolutions.com/forums/reply/43471/) - Hi Jenni. Thank you for this question. Yes, if you have a scale in the ASC then it must be ADA compliant. - [](https://progressivesurgicalsolutions.com/forums/reply/43464/) - It sounds like you're on the right path with that, Laura. Developing policies that aren't backed in regulation or recognized guidelines can cause more trouble than they're worth sometimes. Happy to help! - [](https://progressivesurgicalsolutions.com/forums/reply/43457/) - Thank you, Apryl. No, we weren't cited for it. I called to seek guidance when it came up and after she made a few calls herself, she called back stating we need to have a policy to address this, including that documentation. We will develop a policy, but sounds like less could be more in - [](https://progressivesurgicalsolutions.com/forums/reply/43439/) - Hi Laura. Thank you for this question. The CMS CfC aren't that specific about tissue that is removed and exempt from pathology. Meaning, this is the purpose of the exempt tissue list. This may be a specific state regulation or a best practice recommendation. Were you cited for it? However, this isn't something that we - [](https://progressivesurgicalsolutions.com/forums/reply/43438/) - Oh, no! I was able to get it to load this way: https://progressivesurgicalsolutions.com/wp-content/uploads/2020/06/Informed-Consent-in-your-ASC_AE_SepOct-2019_DS.pdf If it still isn't working for you, I am happy to email it to you. We'll get that fixed ASAP - thank you for letting us know. - [](https://progressivesurgicalsolutions.com/forums/reply/43437/) - Hi Thelma. Thank you for this question. Yes, this CRNA needs to go through a new application for appointment to the medical staff. This is because her appointment lapsed and it isn't considered a reappointment. Her credentialing file should reflect an individual that is new to the organization, even if you include the old documents. - [](https://progressivesurgicalsolutions.com/forums/reply/43436/) - Hi Erin. Thank you for this question. If this is their operative note that is signed and dated by them (the surgeon), then they need to review this document prior to becoming a permanent part of the patient's medical record. The scribe should not be electronically signing off on something for the surgeon (like they - [](https://progressivesurgicalsolutions.com/forums/reply/43435/) - Hi Erin. Thank you for this question. It isn't necessarily the issue of who "generates" this document in your EHR. The most important part is that documentation is accurate, timely, and signed/dated correctly. Accrediting organization standards come into play here, too. We also need to consider the exact document(s) we're referring to and what purpose - [](https://progressivesurgicalsolutions.com/forums/reply/43423/) - Hi, What was the verdict for this, I have physicians who also are pushing back on having to sign and generate the electronic document for lasers. - [](https://progressivesurgicalsolutions.com/forums/reply/43420/) - Hi Apryl, The informed consent article linked in that esupport area brings up a 404 page not found error. - [](https://progressivesurgicalsolutions.com/forums/reply/43418/) - Thank you! We do have an Exempt Tissue List that includes eyelid tissue. We had a scenario last week where a patient wanted to take her tissue home. We don't have a specific tissue policy to address this (we really only have the exempt list and a human tissue policy for corneal transplants.) When I - [](https://progressivesurgicalsolutions.com/forums/reply/43414/) - Hi Laura. Thank you for the question. Your policies and procedures should include an Exempt Tissue List, which would include tissue that is removed from the patient that doesn't need to be sent for pathology. See CMS §416.47(b) Standard: Form and Content of Record The ASC must maintain a medical record for each patient. Every - [](https://progressivesurgicalsolutions.com/forums/reply/43413/) - Hi Erin. Thank you for this question. No, the specific make/model/diopter of the IOL to be implanted is not necessary on the consent. However, the name of the procedure and the laterality must be listed. The clinic may opt to have this on the informed consent document (signed between the physician and the patient) but - [](https://progressivesurgicalsolutions.com/forums/reply/43412/) - Hi Anna. Thank you for this question. If your facility is using tap water during instrument cleaning or reprocessing activities, then the recommendations within ANSI/AAMI ST108 may apply to your process. We would encourage you to carefully review your instrument MIFUs, as many instruments now require decontamination or final rinsing with critical water rather than - [](https://progressivesurgicalsolutions.com/forums/reply/43411/) - Hi Anna. Yes, this is certainly a "gray" area with CA not licensing ASCs. QUAD A may "defer to the state" but hopefully they have more concrete feedback specific to your center! - [](https://progressivesurgicalsolutions.com/forums/reply/43407/) - Ok Thank you so much for your response. That is pretty much what I am seeing. But no one actually wants to take make the final decision. I am also following up with quad A to understand their input. - [](https://progressivesurgicalsolutions.com/forums/reply/43406/) - Megan - my pleasure! - [](https://progressivesurgicalsolutions.com/forums/reply/43405/) - Thank you for your answers and guidance! - [](https://progressivesurgicalsolutions.com/forums/reply/43404/) - Hi Anna. Thank you for this question. You are definitely not alone in this confusion. California TB requirements for healthcare personnel are still somewhat fragmented between CDC guidance, Cal/OSHA, CDPH, and Title 22 regulations. For many low-risk outpatient ASCs, facilities are now using: Baseline TB screening/testing upon hire Annual TB symptom/risk assessment Post-exposure testing only - [](https://progressivesurgicalsolutions.com/forums/reply/43324/) - Hi Anna. Thank you for the follow up question. If your facility is using tap water during instrument cleaning or reprocessing activities, then the recommendations within ANSI/AAMI ST108 may apply to your process. We would encourage you to carefully review your instrument MIFUs, as many instruments now require decontamination or final rinsing with critical water - [](https://progressivesurgicalsolutions.com/forums/reply/43323/) - You're so welcome, Laura! - [](https://progressivesurgicalsolutions.com/forums/reply/43291/) - Thanks Apryl, Are there any supplies or strips to test our water? This is new to me. We use faucet water to wash and decontaminate our instruments and then use distilled water in our autoclaves. Thanks so much for assisting me. - [](https://progressivesurgicalsolutions.com/forums/reply/43282/) - Thank you for the clarification! - [](https://progressivesurgicalsolutions.com/forums/reply/43281/) - Hi ladies. Thank you for your questions/feedback! There can definitely be some variation in practice here. From an OSHA/infection prevention standpoint, the primary requirement is that sharps (needles, blades, etc.) go into approved sharps containers. Syringes or flushes without needles are not always required to be disposed of in sharps containers unless otherwise required by - [](https://progressivesurgicalsolutions.com/forums/reply/43280/) - Hi Laura. Thank you for this question. Your facility can still administer its own internal patient satisfaction survey, even to patients who may also receive the OAS CAHPS Survey. However, CMS guidance recommends a few rules. The OAS CAHPS sample must be selected first each month by the approved vendor. Because OAS CAHPS responses are - [](https://progressivesurgicalsolutions.com/forums/reply/43199/) - Hi, In our ASC we also only dispose in the sharps. For us this is due to the fact that we have a high number of individuals that go through the regular trash to find syringes (outside of the facility). It might depend on the area you live in, ours is due to the high - [](https://progressivesurgicalsolutions.com/forums/reply/43196/) - Could you clarify on this part- "CMS doesn't allow surveys on same population as CAHPS"? We participate in OAS CAHPS, but we also send home a paper survey in a prepaid envelope with every patient with their post-op paperwork. We track both the returned surveys and the CAHPS results. We typically have strong participation for - [](https://progressivesurgicalsolutions.com/forums/reply/43195/) - Hi Anna. The standards for QUAD A (and for all AOs) and for CMS is to follow the instrument MIFUs and the MIFU for the ultrasonic. You must defer to your specific instruments prior to selecting how they're decontaminated and sterilized. The same goes for the ultrasonic. Each ultrasonic manufacturer will have a unique set - [](https://progressivesurgicalsolutions.com/forums/reply/43194/) - Hi, Is this a standard for Quad A? I see CMS mentioned previously. Also , are the test strips that are used? Or do we test the water? Thank you!!! - [](https://progressivesurgicalsolutions.com/forums/reply/43193/) - Hi Erin. Thank you for this question. In our experience, while there is not typically a specific CMS or accrediting standard that explicitly prohibits an employee from scheduling their own procedure or completing their own prior authorization, it is generally not considered best practice from a compliance and internal-controls standpoint. The concern is less about - [](https://progressivesurgicalsolutions.com/forums/reply/43191/) - Hi Pattie. Thank you for this question. CMS removed ASC-20 (COVID-19 Vaccination Coverage Among Healthcare Personnel) from the ASCQR Program beginning with the CY 2024 reporting period/CY 2026 payment determination. As a result, there is currently no federal ASCQR requirement for ASCs to report COVID-19 healthcare personnel vaccination data through NHSN. COVID-19 vaccination requirements for - [](https://progressivesurgicalsolutions.com/forums/reply/43186/) - Erin. That's understandable, especially these days with PHI security. Yes, if a spouse or family member is listed in the patient’s chart as a contact/caregiver, we can reasonably infer they’re involved in the patient’s care, particularly in our setting. Under HIPAA, providers may use professional judgment to share information directly relevant to that person’s involvement - [](https://progressivesurgicalsolutions.com/forums/reply/43183/) - Thank you! We've run into some of our nurses being uncomfortable with talking to a patient's family member over the phone for pre-op assessment calls, as the patient isn't there or we don't have written or verbal authorization from the patient in the moment. But in this case, having the family members number in the - [](https://progressivesurgicalsolutions.com/forums/reply/43182/) - Hi Erin. Thank you for this question! HIPAA allows healthcare providers to verbally discuss relevant patient information with a spouse, family member, or other individual involved in the patient’s care, as long as the patient agrees, does not object, or it can be reasonably inferred that they’re OK with the discussion (i.e., the patient brings - [](https://progressivesurgicalsolutions.com/forums/reply/43180/) - Hi Marci. Thank you for this question. Yes, you need to report through the NHSN by the end of May. See info under the heading "Healthcare Worker Influenza Vaccination Reporting" on this page: https://www.oregon.gov/oha/ph/diseasesconditions/communicabledisease/hai/pages/reporting.aspx You will see the regulation about this here: https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=1233 under section 333-018-0127 Annual Influenza Summary CMS doesn't require this anymore and - [](https://progressivesurgicalsolutions.com/forums/reply/43178/) - Hi Heather. Thank you for this question. Yes, use the OAS CAHPS survey data from your vendor to track/trend patient satisfaction data for your QAPI program. - [](https://progressivesurgicalsolutions.com/forums/reply/43164/) - You're so welcome, Anna. Glad we could help! - [](https://progressivesurgicalsolutions.com/forums/reply/43163/) - Hi Jessica. Thank you for this question! Yes, AAAHC (and other AOs) leaves this to the Governing Body BUT from a risk standpoint, most centers should take a conservative approach: In example: Adverse actions (suspensions, restrictions, license issues): typically, ever Malpractice: can be a 10–20 year lookback but many still ask if they’ve ever been - [](https://progressivesurgicalsolutions.com/forums/reply/43160/) - Thanks! - [](https://progressivesurgicalsolutions.com/forums/reply/43132/) - Hi Lexee. Thank you for this question. Yes! Please see eSupport > Policies and Procedures > Nursing > Nursing | Emergency - [](https://progressivesurgicalsolutions.com/forums/reply/43131/) - Hi Claire. Thank you for this question. This has been a common request lately and we're adding this material to the Quick Training library shortly. This will be under Education > Webinars & Training > Quick Training. - [](https://progressivesurgicalsolutions.com/forums/reply/43127/) - That's right, Laura. You can be Medicare certified through your state or through an accrediting organization. However, the state will always have the right to survey your center (regardless of who maintains your CMS certification) due to your state licensure. - [](https://progressivesurgicalsolutions.com/forums/reply/43121/) - Thank you for the reply! I'm not familiar with any additional surveys for licensure aside from the State survey which covers CMS and LSC. Perhaps it's lumped into the state survey? We are in South Dakota, can you elaborate on this more? - [](https://progressivesurgicalsolutions.com/forums/reply/43117/) - Hi Carrie. Thank you for the info. The physician/facility that orders the EKG is responsible for interpretation, not the surgeon. However, if preop labs/testing are on the chart on the day of surgery then the surgeon does need to acknowledge it, as this is a required component of the preoperative assessment standards. The surgeon wouldn't - [](https://progressivesurgicalsolutions.com/forums/reply/43116/) - The surgeons require the labs for pre-op so it is usually the PCP ordering it with the medical clearance. - [](https://progressivesurgicalsolutions.com/forums/reply/43109/) - Hi Anna. Thank you for this question. QUAD A covers this in Sub-section I: Personnel Training (11-I-1 to 11-I-13). QUAD A doesn't differentiate between clinical and medical staff when providing requirements for training. It is important to note, also, that eSupport modules cover education but training must be specific to your facility. This is how - [](https://progressivesurgicalsolutions.com/forums/reply/43100/) - Hi Carrie. Thank you for this question. Who is ordering the testing? ⏳ Time Is Running Out — Registration Is Now Open! Join us April 17–18, 2026 for the ASC Nurse Leadership Conference. Seats are limited and are filling quickly. Save your spot today: https://ascnurseleadership.com/ - [](https://progressivesurgicalsolutions.com/forums/reply/43095/) - Hi Diane. Thank you for this question! This form should be in the OSHA manual Appendix and it is called, "Informed Refusal of Post-Exposure Injury Evaluation". I am going to email this to you right now. ⏳ Time Is Running Out — Registration Is Now Open! Join us April 17–18, 2026 for the ASC Nurse - [](https://progressivesurgicalsolutions.com/forums/reply/43086/) - Hi Hannah. Thank you for this question. This depends solely upon your state. I will share, depending upon when your policies and procedures were written, the medical records retention information may be in the Medical Records section under the P&P titled "Medical Records" under the heading "Retention of Patient Records". Utah regulates ASCs but exempts - [](https://progressivesurgicalsolutions.com/forums/reply/43085/) - Hi Michelle. Thank you for this question. That's right. You don't have to input any data into optional reporting fields. ⏳ Time Is Running Out — Registration Is Now Open! Join us April 17–18, 2026 for the ASC Nurse Leadership Conference. Seats are limited and are filling quickly. Save your spot today: https://ascnurseleadership.com/ - [](https://progressivesurgicalsolutions.com/forums/reply/43009/) - Amazing - thank you, Katherine! ⏳ Time Is Running Out — Registration Is Now Open! Join us April 17–18, 2026 for the ASC Nurse Leadership Conference. Seats are limited and are filling quickly. Save your spot today: https://ascnurseleadership.com/ - [](https://progressivesurgicalsolutions.com/forums/reply/43007/) - Here is our policy if it helps. We only ever needed it once! It was uneventful. - [](https://progressivesurgicalsolutions.com/forums/reply/43002/) - Hi Laura. Thank you for this question. Deemed status means that your AO is authorized to conduct surveys on behalf of CMS, rather than CMS certifying the facility through the state survey agency. In this model, the AAAHC survey is not limited to the Ambulatory Health Care handbook standards alone, it also incorporates the CMS - [](https://progressivesurgicalsolutions.com/forums/reply/42973/) - Hi Michelle. Thank you for this question. Yes, we have clients that use MedServe and this works very well in the ASC environment. Here is the link: https://medserverx.com/ Also, MedServe will be at the NLC this year so if you're registered or plan to register, you can come see the product firsthand! ⏳ Time Is - [](https://progressivesurgicalsolutions.com/forums/reply/42969/) - Hi Michelle. Thank you for this question. First, you may adopt a policy not to treat incarcerated individuals if the facility is not equipped to safely accommodate the security, custody, and logistical requirements associated with correctional patients. Incarceration status is not a protected class under federal nondiscrimination regulations, so this type of policy is permissible. - [](https://progressivesurgicalsolutions.com/forums/reply/42965/) - Hi Allison. Thank you for this question. This topic continues to be studied/evolve (even 10+ years since this initial post!). Yes, this remains a cause for concern when it comes to both the safety of the patient and the informed consent process. The ASA and AORN have recent information on this. You can either chose - [](https://progressivesurgicalsolutions.com/forums/reply/42963/) - Have you developed a policy for this issue? We had recent questions about the legality of consenting for surgery while under the influence of marijuana or use within the past 24-hours. - [](https://progressivesurgicalsolutions.com/forums/reply/42950/) - Thank you, Miguel! Awesome suggestion... https://samba.memberclicks.net/assets/docs/SAMBA_Statements/Preoperative_Care_for_Cataract_Surgery__The.11.pdf REGISTRATION NOW OPEN FOR THE APRIL 17-18 2026 ASC NURSE LEADERSHIP CONFERENCE: https://ascnurseleadership.com/ - [](https://progressivesurgicalsolutions.com/forums/reply/42949/) - Hi Lexee. Thank you for this question. There is not a sample Controlled Substance P&P available on eSupport.If you have a Consulting Pharmacist, you should speak to them about this and how to handle this in your state specifically, as this would more than likely default to your state Board of Pharmacy laws. Your P&Ps - [](https://progressivesurgicalsolutions.com/forums/reply/42947/) - Michelle, Something that really helped our asc/crna in determining criteria was the SAMBA guidelines for cataract surgery. Although we do other types of procedures, the bulk of our caseload is from cataracts. the SAMBA Guidelines for Cataract Surgery article which can be easily googled is a great place to start. I especially like the rationales - [](https://progressivesurgicalsolutions.com/forums/reply/42899/) - Hi Michelle. I know you might be looking for just a small set of policies and procedures. Let me know if you're in need of a new set of policies and procedures, which is a service we provide. To help you get started, you'll be looking for policies and procedures that speak to your inclusion - [](https://progressivesurgicalsolutions.com/forums/reply/42898/) - Does anyone happen to have policies addressing these issues they would be willing to share? - [](https://progressivesurgicalsolutions.com/forums/reply/42893/) - Hi Michelle. Thank you for this question and for taking the time to read my article! You're right - our ASCs can feel like a Med/Surg floor sometimes! We have a hypertensive crisis in bay 1 and a blood sugar of 600 in bay 2 all while trying to turn out a high quality and - [](https://progressivesurgicalsolutions.com/forums/reply/42892/) - Hey Leslie. Great question! In most ASCs, payroll is the largest expense, often accounting for around 25-33% of net revenue when salaries, wages, and benefits are combined. Supply costs, including drugs and medical/surgical supplies (also represent a significant portion of total operating expenses) account for roughly 25-30% of revenue. Other major categories such as rent/lease - [](https://progressivesurgicalsolutions.com/forums/reply/42872/) - Hi Hannah. Thank you for this question. Clinical staff (non-medical or allied health professional staff) do not need credentialed or a credentialing file. They need a personnel file. Visit eSupport > Human Resources > Personnel Files and then Employee Health Files. This should be helpful for you. There is also info about Allied Health Workers, - [](https://progressivesurgicalsolutions.com/forums/reply/42869/) - Hi Rosie. Thanks for the follow up question. Medical Staff complete the Medical Staff Education module when they are first appointed and then annually thereafter. This is a new module that we added recently to be more specifically geared towards medical staff. We're actually holding a webinar this month (on Feb 27th) about our eSupport - [](https://progressivesurgicalsolutions.com/forums/reply/42864/) - Hi Apryl, Thank you for your response, I just wanted to clarify should medical staff be completing annual training each year and the medical staff education or are they completing the medical staff education instead of the annual training? - [](https://progressivesurgicalsolutions.com/forums/reply/42863/) - You're so welcome, Beverly! I hope you're able to attend the NLC this year. If so, please make sure you come say hello! - [](https://progressivesurgicalsolutions.com/forums/reply/42862/) - Thanks so much! - [](https://progressivesurgicalsolutions.com/forums/reply/42859/) - This is up, everyone! Please see eSupport> Business Ops > Medicare Fee Schedule > 2026 ASC Medicare Fee Schedule – Q1. - [](https://progressivesurgicalsolutions.com/forums/reply/42853/) - Hi Beverly. You can access this information here, it was released 7 days ago: https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-payment-rates-addenda REGISTRATION NOW OPEN FOR THE APRIL 17-18 2026 ASC NURSE LEADERSHIP CONFERENCE: https://ascnurseleadership.com/ - [](https://progressivesurgicalsolutions.com/forums/reply/42852/) - Hi Rosie. Thank you for this question. The annual evaluation of facility programs and the QAPI program review by the GB comes from CMS CfC §416.43(e) Governing body responsibilities, which applies to ASCs only. If you're reviewing the data quarterly, like you stated, per QUAD A 10-B-2: The facility has a written quality improvement program - [](https://progressivesurgicalsolutions.com/forums/reply/42850/) - This applies to the OBS, too. See QUAD A 2-E-1: Sterile supplies and equipment are stored away from potential contamination in closed cabinets/drawers; or if not, sterile supplies must be stored away from heavy traffic areas and potential contamination hazards, which includes "compliance with environmental standards for temperature and humidity" in the evaluating compliance section - [](https://progressivesurgicalsolutions.com/forums/reply/42849/) - Hey Rosie! Thank you for the question. The board should review and approve all your policies and procedures annually and reflect this on the policy adoption page (PAP) at the front of your manuals (since you have VMG Health P&P manuals). These OSHA things don't really change much BUT the board does need to review - [](https://progressivesurgicalsolutions.com/forums/reply/42848/) - Is this true for an office-based surgery center as well? Currently we only track the operating rooms. - [](https://progressivesurgicalsolutions.com/forums/reply/42846/) - Does anyone have this now that they would be willing to share? - [](https://progressivesurgicalsolutions.com/forums/reply/42844/) - Hi Susan. Thank you for this question. This is a super common area of debate. However, there are best practices and guidelines for this topic. Have a clear process for deciding how long sterilized items can be considered safe to use. In most cases, sterility does not expire by time, but by events that could - [](https://progressivesurgicalsolutions.com/forums/reply/42843/) - Hi Julie. Thank you for the further explanation. Yes, this is totally fine! As long as you have a policy to back up what you're doing and the staff are educated and consistently applying what the policy states, you're good to go! You can always track incidents for a period of time and determine if - [](https://progressivesurgicalsolutions.com/forums/reply/42842/) - Hi Carrie. Thank you for this question. This is one of those items that is left to your policy per AORN standards. There isn't a specified mandatory replacement/laundering schedule in the regulations or guidelines (unless your state or the curtain MIFU provides one). Otherwise, you develop a policy/schedule and stick with it. This should be - [](https://progressivesurgicalsolutions.com/forums/reply/42841/) - I have my curtains laundered every quarter and as needed for stains, per our facility policy - [](https://progressivesurgicalsolutions.com/forums/reply/42830/) - Thank you! The majority of our patients are elderly and use canes and walkers and all have IVs, and of course we are Ophthalmology so they cant see too :) We used to do the Morse risk assessment, but it stopped during my leave. I could not find a current fall risk policy in our - [](https://progressivesurgicalsolutions.com/forums/reply/42829/) - Our pleasure, Anna! As a follow up, be sure to check out our Compliance Calendars under eSupport > Compliance Calendar. There, you will find some specifics for daily temperature and humidity monitoring and the sample Environmental Standards P&P is under eSupport > Policies and Procedures > Nursing > Intraoperative. - [](https://progressivesurgicalsolutions.com/forums/reply/42828/) - You're so welcome, Anna! - [](https://progressivesurgicalsolutions.com/forums/reply/42827/) - Hi Diane. Thank you for this question. We don't have our fall-related P&Ps on eSupport. You have the option to implement a formal risk assessment tool (i.e., Morse), or implement your own protocol (i.e., ask questions, then implement mitigative efforts), or treat all your patients as a fall risk (due to your patient population, all - [](https://progressivesurgicalsolutions.com/forums/reply/42825/) - Thank you! - [](https://progressivesurgicalsolutions.com/forums/reply/42824/) - Thank you Apryl! - [](https://progressivesurgicalsolutions.com/forums/reply/42815/) - Hi Anna. Thank you for this question. Yes, QUAD A requires that you follow ASHE/ASHRAE environmental standards and this does include tracking temperature and humidity in sterile processing and where sterile supplies are stored. These are: Clean Utility – T: 68-73, H: Max 60% Sterile Storage – T: Max: 75, H: Max 60% Soiled Utility - [](https://progressivesurgicalsolutions.com/forums/reply/42814/) - Hi Anna. Thank you for your question. Yes, please see eSupport > Emergency Preparedness Program > Training & Testing Program > CEMP Activation Evaluation (Disaster Drill) (at the very bottom of the page). You can use this form to evaluate almost all of your emergency drills. REGISTRATION NOW OPEN FOR THE APRIL 17-18 2026 ASC - [](https://progressivesurgicalsolutions.com/forums/reply/42756/) - Hi Emily. Thank you for this question. Under the 2012 NFPA 99 and NFPA 101, ORs are classified as anesthetizing locations and must have ceilings that are tight-fitting, sealed, and cleanable to maintain proper air pressure relationships and prevent contamination from the plenum space. Drop-in ceiling tiles are not airtight, and when tiles move with - [](https://progressivesurgicalsolutions.com/forums/reply/42749/) - Hi Patricia. Thank you for this question. Are you referring to the chemical indicators by 3M, the SteriGage? I'm going to answer your question assuming this so please let me know if you mean something else... The guidelines talk more about the principle than an exact spot. ANSI/AAMI ST79 and AORN both say an internal - [](https://progressivesurgicalsolutions.com/forums/reply/42748/) - Hi Patricia. Thank you for this question. For this, you need to adhere to your existing facility policy, accrediting organization, state requirements, and the CMS §416.47 Condition for Coverage: Medical Records. This CfC has a couple standards so be sure to check out the entire section, but what you're looking for is: §416.47(b) Standard: Form - [](https://progressivesurgicalsolutions.com/forums/reply/42726/) - Hi Jessica, thank you for this question. The initial appointment application for medical staff is part of a larger Credentialing & Privileging Program that we have available for purchase. I have attached (below) what's included with this program. It requires customization for your specific facility. This is done under an hourly consulting agreement. If you're - [](https://progressivesurgicalsolutions.com/forums/reply/42713/) - Thanks for the question, Beverly. We are currently working on this. It will be posted under eSupport > Business Ops > Medicare Fee Schedule when it makes it through the quality checks! REGISTRATION NOW OPEN FOR THE APRIL 17-18 2026 ASC NURSE LEADERSHIP CONFERENCE: https://ascnurseleadership.com/ - [](https://progressivesurgicalsolutions.com/forums/reply/42712/) - Hi Jenni. Thank you for this question. It sounds like you're looking for a QI Dashboard. This is a tracking tool that you can use on a monthly/quarterly/annual basis to track and trend your quality indicator data (i.e., patient falls, infections, etc.).. We have a sample one here on eSupport! The "pertinent information" you need - [](https://progressivesurgicalsolutions.com/forums/reply/42690/) - Hi Anna. Thank you for this question. I have attached a sample form that you can review and make your own. You'll want to take this to the board or to the medical director for review and approval prior to implementation. Check and make sure this is aligned with you current policies and procedures, too. - [](https://progressivesurgicalsolutions.com/forums/reply/42688/) - Hi Lexee. Thank you for this question. No, you do not report actual nor suspected postoperative infections to CMS nor AAAHC. Some states have mandatory reporting that requires this be reported, but there is usually a timeframe for this (i.e., 30 days). Each state varies. Further, your QAPI program would also have a reporting timeframe - [](https://progressivesurgicalsolutions.com/forums/reply/42684/) - Hi Hannah. Thank you for the question. We're so glad you have PSS/VMG Health manuals! Of course you can update your policies! You go into the electronic version of you manuals, which should have been saved somewhere from the USB (or disk depending upon how old your manuals are) and access that policy. Then, once - [](https://progressivesurgicalsolutions.com/forums/reply/42482/) - You're so welcome, Julie! - [](https://progressivesurgicalsolutions.com/forums/reply/42481/) - Thank you so much! - [](https://progressivesurgicalsolutions.com/forums/reply/42480/) - Hi Julie. Thank you for this question. AAAHC permits the didactic (educational) portion of BLS to be completed online; however, the hands-on skills verification (practicum) must be completed in person. Staff may complete a blended BLS course, but a qualified instructor from a nationally recognized program (i.e., AHA) must directly observe and verify the hands-on - [](https://progressivesurgicalsolutions.com/forums/reply/42479/) - Hi Miguel. Thank you for this question. You only need to complete all the modules under the "Required Upon Hire" filter if it is the first time you're using eSupport for CE purposes (at hire or when your center first joins eSupport). After that, you only need to complete the "Annual Training" module that shows - [](https://progressivesurgicalsolutions.com/forums/reply/42392/) - Hi Laura. Thank you for this question! The UPS has a very broad definition of compounding, which expands beyond how we usually use the word. The USP definition includes any of the following: combining, admixing, diluting, pooling, reconstituting, repackaging, or altering a drug or bulk drug substance to create a sterile preparation. So yes, once - [](https://progressivesurgicalsolutions.com/forums/reply/42375/) - Hi Vicki. Thank you for this question! We see Stericycle a lot in the ASC space. They have some additional compliance resources, too. Here is the link to learn more: https://www.stericycle.com/en-us/solutions/regulated-waste-disposal/controlled-substance You may also want to ask your question on the Facebook group! If you haven't joined, here is the link: https://www.facebook.com/groups/ascmanagers/ REGISTRATION NOW OPEN - [](https://progressivesurgicalsolutions.com/forums/reply/42374/) - My pleasure, Julie / Diane - happy holidays! - [](https://progressivesurgicalsolutions.com/forums/reply/42346/) - Perfect!! Thank you so much for clarifying. - [](https://progressivesurgicalsolutions.com/forums/reply/42345/) - Hi Julie, thank you for this question. Thank you, Laura, for your response. Julie, if you do not store medications in your freezer, you do not need to log the temperature of the freezer. If you'd like to continue to do so, as Laura mentioned, just in case, the parameters would need to be kept - [](https://progressivesurgicalsolutions.com/forums/reply/42344/) - Hi Thelma, This should go back to your policy and procedure on this topic. Yes, it is best practice to keep a log. Your log doesn't need to be anything fancy, something like: date of recall notice, recall description or ID number, whether the facility even had the item on stock, corrective action taken (i.e., - [](https://progressivesurgicalsolutions.com/forums/reply/42342/) - Hi Laura. Thank you for this question. No, you can stop submitted data right away for this measure. The measure is removed beginning with the CY 2024 reporting period / CY 2026 payment determination. Meaning, ASCs are not required to submit any ASC-20 data collected after 2024 under ASCQR. Crazy, huh? REGISTRATION NOW OPEN FOR - [](https://progressivesurgicalsolutions.com/forums/reply/42331/) - Our freezer log range is -4 degrees to -14 degrees. We also do not store any frozen meds at this time, but continue to log "just in case." - [](https://progressivesurgicalsolutions.com/forums/reply/42330/) - I just saw you updated your page with this information. Only lingering question I have is regarding the COVID reporting. Do we need to complete this through 2025? - [](https://progressivesurgicalsolutions.com/forums/reply/42284/) - Hi Leslie. Thank you for this question. I hope a fellow eSupport user can help you out with your "Local Only" policy and procedure sample. You might consider posting this on the Facebook group page, too. https://www.facebook.com/groups/ascmanagers/ A quick word of caution: you cannot apply different standards of care based on whether or not a - [](https://progressivesurgicalsolutions.com/forums/reply/42249/) - Hi Julie, North Carolina does not require ASCs to form a committee or conduct any internal review of the state-mandated charge and procedure data; the requirement is limited to reporting the information externally. However, CMS and AOs require you to incorporate all meaningful facility data into their QAPI Program, including trends in procedure volume, charges, - [](https://progressivesurgicalsolutions.com/forums/reply/42248/) - My pleasure, Alissa! - [](https://progressivesurgicalsolutions.com/forums/reply/42244/) - And what about NC? Thank you! - [](https://progressivesurgicalsolutions.com/forums/reply/42243/) - Thank you so much, Apryl! - [](https://progressivesurgicalsolutions.com/forums/reply/42241/) - Hi Alissa. Thank you for this question. Under USP , medication syringes only fall under the immediate-use exemption if they are drawn up and administered immediately by the same provider with no storage or delay. If CRNAs draw syringes in advance, this no longer qualifies as immediate-use and the syringes must be fully labeled with - [](https://progressivesurgicalsolutions.com/forums/reply/42227/) - Hi Alyssa and Julie. Thank you for sharing where you're from because this answers the question entirely. This isn't a CMS or accrediting organization requirement. This is a state requirement. In Indiana, ASCs are regulated under 410 IAC 15, which outlines specific requirements for the Governing Body of the center. According to 410 IAC 15-2.4-1(e)(5), - [](https://progressivesurgicalsolutions.com/forums/reply/42226/) - Julie I did think the same thing- and we have something similar through our surgeon peer review and they mentioned these should be two separate committees. Apryl, we are in Indiana! Thank you for your help and advice! - [](https://progressivesurgicalsolutions.com/forums/reply/42179/) - Sorry to hear that happened, Anna. This seems to happen more and more, unfortunately... It sounds like you're off to a good start with your response. An ASC that experiences a data breach involving protected health information (PHI), it must act under the HIPAA Breach Notification Rule: 45 CFR §§164.400–414. The ASC must immediately investigate, - [](https://progressivesurgicalsolutions.com/forums/reply/42178/) - Hi Lindsey. Thank you for this question. Please feel free to reach out at apryl.mcelheny@vmghealth.com. VMG Health's consulting division has an "Extended Stay" set of policies and procedures for customization and purchase. This may take a little research, to confirm compliance with state and AO requirements, as applicable, prior to implementation. There is also a - [](https://progressivesurgicalsolutions.com/forums/reply/42177/) - Hi Alyssa! Thank you for this question. This sounds like a specific state requirement and not necessarily an accrediting organization or CMS requirement. This isn't a term that is used by AOs or CMS. States often require different committees that report to the board and have certain delegated functions. Which state are you in? We - [](https://progressivesurgicalsolutions.com/forums/reply/42165/) - I haven't heard this term before either. Wouldn't this committee function the same as a QAPI Committee?? Thank you! - [](https://progressivesurgicalsolutions.com/forums/reply/42154/) - Hi Lexee. Thank you for this question. There are no DEA, AAAHC, or CMS requirements for a specific Form 6A or 6B for ASCs managing controlled substances. The DEA only requires Form 222 for ordering Schedule II medications, Form 41 for documenting destruction, and Form 106 for reporting theft / loss. AAAHC and CMS require - [](https://progressivesurgicalsolutions.com/forums/reply/42153/) - Hi Keyanna. Thank you for this question. VMG Health does offer customized credentialing and privileging packets, if you need to look into purchasing this. Feel free to reach out if none of the other centers share their forms: apryl.mcelheny@vmghealth.com You may also want to reach out on the Facebook Group: https://www.facebook.com/groups/ascmanagers/ - [](https://progressivesurgicalsolutions.com/forums/reply/42027/) - Hi, Nicole. Thank you for this question. Yes, the OR can be used by the office after ASC hours, but not during active ASC operating hours unless the case is performed under the ASC license and fully meets CMS requirements (i.e., charting, staffing, policies, billing). Both CMS and QUAD A require clear separation of space, - [](https://progressivesurgicalsolutions.com/forums/reply/42025/) - Hi Katherine! Thank you for this question. If you're referring to Infection Prevention and Control contact hours, is there a specific board you’d like to submit the certificates to for credit? Our continuing education credits are accepted by all state nursing boards, and we also participate with other certification boards as an approved CE provider. - [](https://progressivesurgicalsolutions.com/forums/reply/42023/) - Hi Rena. Thank you for this question. No, you aren’t required to provide transcription services. What’s required is a complete, legible, and timely operative report, but this can be documented by any compliant method (typed, handwritten, EHR, or dictation). However, if your governing body identifies it as a need, you can choose to contract with - [](https://progressivesurgicalsolutions.com/forums/reply/41890/) - Hi Michelle. Thank you for this question. I can tell you're thinking ahead! Texas doesn’t actually require pharmacists to carry their own liability insurance, whether they’re consulting or employed. If they’re an independent contractor, having their own coverage is a smart way to protect both them and your center. Even for employed pharmacists, many still - [](https://progressivesurgicalsolutions.com/forums/reply/41888/) - Hi Gabby. Thank you for this question. We can’t necessarily endorse a specific manufacturer or vendor. However, we do strongly recommend that you work directly with the manufacturer to ensure that all applicable state regulations related to the boiler are met and that the plumbing specifications for feedwater are followed. It’s also a good idea - [](https://progressivesurgicalsolutions.com/forums/reply/41883/) - Hey Michelle. Thank you for this question! If the retired physician no longer provides patient care, he does not need to remain credentialed or privileged. Credentialing applies only to practitioners who actively perform procedures or deliver clinical services. However, if he continues to serve on the Governing Body, his participation should be documented as more - [](https://progressivesurgicalsolutions.com/forums/reply/41867/) - Hi Kim. Thank you for this question. This is a very common issue. The OAS CAHPS website provides the following on their FAQ: We do not serve enough patients to get 300 or 200 completes. What do we do? The target for the statistical precision of OAS CAHPS Survey results that will be publicly reported - [](https://progressivesurgicalsolutions.com/forums/reply/41861/) - Thank you Apryl! Sent you an email :) - [](https://progressivesurgicalsolutions.com/forums/reply/41856/) - Hi Julie. Thanks for this follow up question. Congrats on stepping back into the role! You’re right, adding meds to BSS has been common practice for years, but surveyors are watching this more closely now. With the enforcement of USP in ASCs, there’s now heightened awareness around USP . While isn't the exact - [](https://progressivesurgicalsolutions.com/forums/reply/41852/) - Hello! We also use Vanc in our BSS (.2ml), as well as Epi (.3ml) and Tobramycin (.05ml) All of our surgeons use the Epi in BSS, but only 2 MDs use the combination of the 3. Only one surgeon uses the Omidria only if insurance pays. Our pharm consultant has not said anything to us.... - [](https://progressivesurgicalsolutions.com/forums/reply/41741/) - Hi Tanya. Thank you for this question. You don't necessarily need a "Mitosol" policy but you do need to have one regarding the handling of hazardous drugs, which is available under eSupport > Policies & Procedures > Medication Management. It is critical that the USP risk assessment and staff training is done for staff. - [](https://progressivesurgicalsolutions.com/forums/reply/41739/) - Can someone share the policy in place for Mitosol THANKS! - [](https://progressivesurgicalsolutions.com/forums/reply/41738/) - Hi Michelle. Thank you for this question. ADM.150.50 state that the "Orientation and training address the infection prevention and control program, including bloodborne pathogen and other training required by OSHA." Of course, the employee should be trained prior to being exposed to any hazards (chemical, BBP, etc.). However, we don't see anything that requires OSHA - [](https://progressivesurgicalsolutions.com/forums/reply/41735/) - Hi Lindsey. Thank you for this question. Getting a negative test may not always be possible depending upon the patient's colonization status and environment. However, this is best practice and recommended for the ASC environment. Active MRSA cases shouldn't be brought into the ASC. If a patient was positive months ago but has had no - [](https://progressivesurgicalsolutions.com/forums/reply/41673/) - Hi Emily. Thank you for this question. Accrediting organizations (with the exception of QUAD A) and CMS generally allow each facility to determine what emergency equipment should be maintained on the crash cart. However, certain state regulations specifically require that particular items be available either on the crash cart or elsewhere in the facility at - [](https://progressivesurgicalsolutions.com/forums/reply/41656/) - Hi Miguel. Happy to help here. The history and physical (H&P) is not the same as the pre-surgical assessment. The surgeon may review the H&P as part of the pre-surgical assessment, but the assessment itself must be conducted by a physician after admission, this is not optional. As you mentioned, there is some flexibility in - [](https://progressivesurgicalsolutions.com/forums/reply/41655/) - Hi Lindsey. Thank you for this question. This depends upon facility policy and both ways can be done safely. However, most surgeons have busy schedules and therefore, it may be best to have the first surgeon participate in the first timeout and then have the second surgeon participate in the second timeout when the time - [](https://progressivesurgicalsolutions.com/forums/reply/41654/) - Hi Lexee. Thank you for this question. You do not have to provide, nor pay for, the influenza or COVID vaccinations for staff. This is not a requirement. Some facilities opt to provide these as a courtesy, but this isn't required either. The important part is to stick to the policy that your center has - [](https://progressivesurgicalsolutions.com/forums/reply/41653/) - You should be able to find the templates on the 1095 Engage website. There are also some training items available, too. If you can't find what you're looking for, reach out to AAAHC. - [](https://progressivesurgicalsolutions.com/forums/reply/41648/) - Thank you Apryl, Could you perhaps point me to the guideline that says we have to subject all patients admitted to the ASC the same as far as presurgical assessments are concerned? I read over the guideline you attached. It mentions: (1) The ASC must develop and maintain a policy that identifies those patients who - [](https://progressivesurgicalsolutions.com/forums/reply/41367/) - Thank you for your reply. Do you know if there is a template available somewhere for either of these? - [](https://progressivesurgicalsolutions.com/forums/reply/41351/) - Hi Laura. Thank you for this question. AAAHC’s 1095 Engage platform requires accredited organizations to complete two compliance activities: the Gap Analysis and the Annual Attestation. The Gap Analysis is a structured self-assessment tool that helps you compare current practices and documentation against AAAHC standards, identify deficiencies, and develop corrective actions. The Annual Attestation is - [](https://progressivesurgicalsolutions.com/forums/reply/41350/) - Hi Miguel. Thank you for this follow up question. The CMS CfCs don't provide different standards of care based upon the level of anesthesia and/or invasiveness of the procedure to be performed. You have to subject all patients admitted to the ASC the same as far as presurgical assessments are concerned. In example, if you - [](https://progressivesurgicalsolutions.com/forums/reply/41349/) - Hi Kristina. Thank you for this question. First, check with your accrediting organization standards. There may be specific requirements that you need to follow. Next, it is advisable to that you comply with the guidelines set forth by the ASA. See here: https://www.asahq.org/standards-and-practice-parameters/standards-for-basic-anesthetic-monitoring - [](https://progressivesurgicalsolutions.com/forums/reply/41335/) - Apryl, I agree with Diana on the amount of paperwork and documentation needed for such a short procedure. I did take a look at the forms which are nicely formatted, but were does one find what exactly needs to be documented for these procedures? Allergies, Medications (dose, route, frequency, last taken) etc. Thanks! - [](https://progressivesurgicalsolutions.com/forums/reply/41279/) - Hi Natasha. Thank you for this question. You’re already compliant with USP . These are hazardous drugs that can affect pregnancy, so it’s reasonable for your pregnant employee to request not being in those rooms. Check with your employment attorney first but most likely, under pregnancy protection laws, you should treat this as a reasonable - [](https://progressivesurgicalsolutions.com/forums/reply/41278/) - Hi Caity. Thank you for this question. Unless the medication is FDA-approved to be added to the BSS, you cannot add anything to it. Right now, OMIDRIA is the only medication with this approval. Yes, this is compounding under the USP 797 because the MIFU for the Vancomycin isn't going to include instructions for use - [](https://progressivesurgicalsolutions.com/forums/reply/41277/) - Hi Alissa. Thank you for this question. No, the color of the trays shouldn't matter. I'm not sure what you mean by a "prep tray" that is used to clean dirty instruments though. Typically, a prep tray is what is used to prep the sterile field (i.e., compartment tray with a betadine basin, sterile water - [](https://progressivesurgicalsolutions.com/forums/reply/41057/) - Hi David. Thank you for this question. This depends upon the nature of this individual's visit to the center. Please see eSupport > Policies and Procedures > Administration > Visitors for a sample P&P for visitors. You may opt to add additional items to this policy if you're concerned about illness, such as checking yes/no - [](https://progressivesurgicalsolutions.com/forums/reply/41056/) - Hi Kristina. Thank you for this question. Yes. The informed consent should include the fact that the patient will be exposed to radiation and include the risks of this exposure. The risks of the procedure should be reviewed by the surgeon with the patient during the informed consent process and this should be documented on - [](https://progressivesurgicalsolutions.com/forums/reply/41055/) - Hi Annette. Thank you for this question. This check isn't required but is recommended as a best practice. It would be unlikely to receive a citation for this from an accrediting organization for not running this query but it certainly represents your due diligence in credentialing that individual or vendor. - [](https://progressivesurgicalsolutions.com/forums/reply/41054/) - Hi Nicole. Thank you for this question. Yes, you need to keep the SDS for the specific manufacturer of the product you actually have. SDSs aren’t universal, even if the product name is the same. If you switch manufacturers, put the new SDS on file and archive/remove the old one. If you use both manufacturers, - [](https://progressivesurgicalsolutions.com/forums/reply/41039/) - Hi Bayli. Thank you for this question. No, you don't need her to refile existing paperwork, with the exception of some verifications/copies of official documents. You'll want to document her name change in her file through a copy/online verification of her name change on her CST certification. You'll also want a new driver's license, SS - [](https://progressivesurgicalsolutions.com/forums/reply/41038/) - Hi Nicole. Thank you for this question. Yes, anesthesia providers are required to have documented training on file for mandatory items (i.e., OSHA, BBP, infection control) and then facility-specific items (i.e., emergency preparedness plan, fire safety, etc). You don't need to have a test but you do need to have some record of training in - [](https://progressivesurgicalsolutions.com/forums/reply/41036/) - Hi Michelle. Thank you for this question! The ST108 provides this guidance: 10.4 for routine water quality sampling - Water quality should be evaluated on a periodic basis or after interruptions and restoration or supply, boil-water situations, repairs or disinfection of the distribution system. So, if you're following ST108, this should be reflected in your - [](https://progressivesurgicalsolutions.com/forums/reply/41033/) - The standard doesn't specify this. It would be advisable to speak with whomever would manage the transfer agreements and/or other agreements you may maintain or could maintain with the hospital. - [](https://progressivesurgicalsolutions.com/forums/reply/41032/) - Thank you! Is there a specific department or title of person at the hospital that we need to send that notice to? - [](https://progressivesurgicalsolutions.com/forums/reply/41030/) - Hi Alyssa. Thank you for this question! When you do not have an anesthesia provider in the OR (CRNA or anesthesiologist) and the patient has relieved or is receiving sedation (oral or IV) there must be an RN dedicated to monitoring the patient and/or managing the sedation only. The other RN is to be working - [](https://progressivesurgicalsolutions.com/forums/reply/41029/) - Hi Lexee. Thank you for this question. A transfer agreement is not required per CMS or AAAHC. However, some states require a transfer agreement. You do need to issue your local hospital a periodic written notice per CMS §416.41(b) Standard: Hospitalization (3) The ASC must periodically provide the local hospital with written notice of its - [](https://progressivesurgicalsolutions.com/forums/reply/41013/) - Hi Nicole. Thank you for this question! You're right. QUAD A doesn't provide specific guidelines for frequency of temperature documentation. 8-H-9 states, "Clinical records must contain evidence of temperature monitoring when clinically significant changes in body temperature are expected." It may be helpful to note that this is for Class C facilities only and the - [](https://progressivesurgicalsolutions.com/forums/reply/40990/) - Hi Kristina, Thank you for keeping this convo going! Preop phone calls can be conducted by someone other than a nurse and this individual doesn't need to licensed or have a certification but they do need to be trained and understand their scope. However, be careful regarding instructions related to medications or medical advise/counseling/education. Those - [](https://progressivesurgicalsolutions.com/forums/reply/40988/) - What about pre-op phone calls? Specifically for patients that will be receiving moderate sedation, not general anesthesia. Does it need to be an RN or can it be a medical assistant? - [](https://progressivesurgicalsolutions.com/forums/reply/40974/) - Hi Katherine. Thank you for this question. The CE modules on eSupport were previously registered with the IPCH website. Did they show up when you logged in to record your CEs? We're going to confirm that we're still on the website as an approved education provider. Try the website if you haven't yet, or check - [](https://progressivesurgicalsolutions.com/forums/reply/40973/) - You're so welcome, Julie! Glad we could help. - [](https://progressivesurgicalsolutions.com/forums/reply/40972/) - Hi Natasha. Thank you for this question. §416.52(b) Standard: Post-surgical Assessment. (1) The patient’s post-surgical condition must be assessed and documented in the medical record by a physician, other qualified practitioner, or a registered nurse with, at a minimum, post-operative care experience in accordance with applicable State health and safety laws, standards of practice, and - [](https://progressivesurgicalsolutions.com/forums/reply/40950/) - Thanks you! That helps so much! - [](https://progressivesurgicalsolutions.com/forums/reply/40948/) - Hi Heather. Thanks for the question. Please navigate to eSupport > Policies and Procedures > OSHA > Hazard Communication Program. The checklist is within that document. - [](https://progressivesurgicalsolutions.com/forums/reply/40947/) - @Crissy - Where are the Hazard Communication Checklists located? I've looked on this site and unable to find them. - [](https://progressivesurgicalsolutions.com/forums/reply/40939/) - Hi Julie. Thank you for the clarification. No, you do not need to attach a list of patients to the IC or chart audit. You only need to have documentation that the surgeon(s) were queried on a monthly basis concerning postoperative infections. The surgeon(s) may prefer that you include a list so that they don't - [](https://progressivesurgicalsolutions.com/forums/reply/40927/) - We have always used Excel for our patient database, and then I form a monthly Excel patient database and use it for our IC and Chart Audit reports. I am trying to simplify the reporting, but I want to be state compliant. We do not use computer charting, but I do have access to our - [](https://progressivesurgicalsolutions.com/forums/reply/40921/) - Hi Michelle. Thank you for this question. ST108 only applies to the water that touches your surgical / procedural instruments. Therefore, if you only use water that goes through your washers to process your scopes, then you wouldn't need an RO system. Instead, the water that feeds your washers would need to meet the MIFU - [](https://progressivesurgicalsolutions.com/forums/reply/40918/) - Hi Kevin. Thank you for this question. This sounds like he/she is looking for a Fee Matrix, charge master. This is one set fee, always the same regardless of payer, a cash fee schedule for plastics or uninsured and a medical lien / legal rate. I have attached a sample tool to this thread. If - [](https://progressivesurgicalsolutions.com/forums/reply/40917/) - Hi Julie. Thank you for this question. Could you please elaborate on what reporting you are referring to? The THCIC for TX? The ASCQR? - [](https://progressivesurgicalsolutions.com/forums/reply/40893/) - Thank you!!! - [](https://progressivesurgicalsolutions.com/forums/reply/40891/) - The 1095 Engage website is how you interact with AAAHC now. If you haven't set up a login, please reach out to them ASAP. Here is the link: https://www.aaahc.org/login/ You can contact AAAHC through phone or email: 847.853.6060, info@aaahc.org or at https://www.aaahc.org/here-to-help/ - [](https://progressivesurgicalsolutions.com/forums/reply/40890/) - Thank you so much for your response! Do you happen to know where I can find that in 1095 engage? I am looking through help curtain but do not see it. Thank you! - [](https://progressivesurgicalsolutions.com/forums/reply/40888/) - Hi Lexee. Thank you for this question. You may be referring to the gap analysis that occurs during a routine QI Study. Yes, this is now 6 steps instead of 10. However, AAAHC also requires that you conduct an annual self-assessment on 1095 Engage, which is not a QI study. Both involve a gap analysis. - [](https://progressivesurgicalsolutions.com/forums/reply/40882/) - Hi Heather. Thank you for this question. This depends upon if you already have policies and procedures in place for tissue management. This should include inspection and approval protocols for receipt of the tissue, storage, handling, prep, return, and disposal of the tissue, which would be per the supplier's specifications. There should also be a - [](https://progressivesurgicalsolutions.com/forums/reply/40874/) - We had this exact issue come up at our last CMS/Dept of Health Inspection in February. We are also an ambulatory ophthalmology center. Our temps were consistently running low and we had no documented "action" to support what we were doing to get them back into range. They were concerned mostly with the OR suites, - [](https://progressivesurgicalsolutions.com/forums/reply/40873/) - Hi Carol. Thank you for this question! I would assume your condensing units are working overtime to combat the intense heat and humidity, which results in cooler temps than intended. The HVAC system modifications for this issue are expensive but you may want to consider this because 62 is quite cold, especially for our elderly - [](https://progressivesurgicalsolutions.com/forums/reply/40834/) - Thank you for this question, Leslie. Yes, you are able to provide anesthesia services without a CRNA or anesthesiologist. RNs are capable of administering IV anesthesia for procedures. This is referred to as an RN IV conscious sedation (IVCS) program. There are quite a few things to take into consideration when implementing this sort of - [](https://progressivesurgicalsolutions.com/forums/reply/40810/) - Hi Emily. Thank you for this question. This is fine. There are rules about what you can and cannot say to patients about the survey. This doesn't appear to violate any of the rules. If you need to review these, see the OAS CAHPS website and see the Communications With Patients About the OAS CAHPS - [](https://progressivesurgicalsolutions.com/forums/reply/40798/) - Thank you!!! - [](https://progressivesurgicalsolutions.com/forums/reply/40797/) - CMS §416.48(a) Standard: Administration of Drugs Drugs must be prepared and administered according to established policies and acceptable standards of practice The administration of the drugs or biologicals must be by, or under the supervision of, nursing or other personnel in accordance with applicable laws, standards of practice and the ASC’s policies. Survey Procedures: §416.48(a) - [](https://progressivesurgicalsolutions.com/forums/reply/40796/) - .Hi Apryl, Can you tell me where in regulations this is found? Thank you - [](https://progressivesurgicalsolutions.com/forums/reply/40795/) - Hi Tammy. Thank you for this question. It is against best practice and AORN guidelines to prep the patient (betadine surgical prep) in another room, other than the OR where the procedure is to be conducted. This may present an issue for you on future surveys. Technicians cannot administer medications in the ASC. Medications must - [](https://progressivesurgicalsolutions.com/forums/reply/40792/) - Hi Anna. Thank you for this question. It is important to keep the same standard of care for all your patients, regardless of anesthesia or invasiveness level. CMS doesn't have different standards for different levels of anesthesia in the ASC. Patients that received local only are still at risk for complications and should still have - [](https://progressivesurgicalsolutions.com/forums/reply/40791/) - Hi Lindsey. Thank you for this question. Yes, a terminal cleaning of the OR and hallway is necessary following an event like this. Moving equipment to clean the floors should occur each evening when the ORs are terminally cleaned and when needed. This is under eSupport > Infection Control > Environmental Sanitation > Terminal Cleaning - [](https://progressivesurgicalsolutions.com/forums/reply/40784/) - Hi Emily. Thank you for this question. Yes, this is a TJC requirement. First, the providers should be given a copy of your policy and procedure regarding pain management. They should acknowledge that they reviewed this. Next, you can provide them the Quick Training we have on pain management under Education > Quick Training. We're - [](https://progressivesurgicalsolutions.com/forums/reply/40783/) - Hi Katherine and Natasha. Administering the patient's drops in the ASC is not recommended because the chain of custody for those medications were not monitored by the ASC. You can have the patient bring them for verification purposes but there is a risk of what Katherine mentioned, losing or mixing up these medications. The medications - [](https://progressivesurgicalsolutions.com/forums/reply/40782/) - Hi Katherine. Thank you for this question. The policies and procedures found within your comprehensive emergency management program (CEMP) must correlate with the findings on your hazard vulnerability analysis (HVA). This means that whatever your facility is susceptible to or at risk for, you should have a policy and procedure for it and your staff - [](https://progressivesurgicalsolutions.com/forums/reply/40767/) - We only do cataract surgeries and the drops the patient takes are not what we use for surgery so not applicable to us. However, when I first came to this center they used to have the patients bring their drops to verify and educate. I found that they were getting erroneously placed and or mixed - [](https://progressivesurgicalsolutions.com/forums/reply/40710/) - This would be recommended. Reason being, you still want to make an effort to report "yes" to the other items within the domain so that you're making a good faith effort to achieve the intent of the measure. Also, without working towards the other items, you're missing critical components of the overall FCHE. - [](https://progressivesurgicalsolutions.com/forums/reply/40709/) - Thank you! But we do still have to keep up with the surveys and spreadsheet, even though we don't get the credit for it, correct? - [](https://progressivesurgicalsolutions.com/forums/reply/40692/) - Hi Lindsey. Thank you for this question. This may be a great question to ask on the FB Group! If you haven't joined yet, here is the link: https://www.facebook.com/groups/ascmanagers/ In the meantime, review your state regs to see if x-ray techs need to be certified within your state. You'll also want to see what the - [](https://progressivesurgicalsolutions.com/forums/reply/40691/) - Hi Phyllis. This is correct. The domains are "all or nothing" so you will lose credit for Domain #2 because you aren't using EHR, even if you do the other items under that domain. Just remember, you won't be financially penalized for this. You just won't be able to report "yes". The important part is - [](https://progressivesurgicalsolutions.com/forums/reply/40687/) - Hi Emily. That are no standards that come right out and say in black and white that an MA shouldn't or can't order medications for an ASC from a distributor. However, you are able to infer this via CMS §416.48 Condition for Coverage: Pharmaceutical Services The ASC must provide drugs and biologicals in a safe - [](https://progressivesurgicalsolutions.com/forums/reply/40685/) - I am taking about medication procurement from a vendor/distributor. Do you have a specific Cfc or joint commission standard I can use to support this? - [](https://progressivesurgicalsolutions.com/forums/reply/40684/) - Hi Emily. Thank you for this question. I want to clarify, when you say "order", do you mean issue a written order to administer a medication to a patient or do you mean submit an order with a vendor/pharmacy/distributor to have medications shipped to your facility? Medications may only be administered to a patient under - [](https://progressivesurgicalsolutions.com/forums/reply/40682/) - What I found- Under Washington State law, specifically RCW 18.360.060 and WAC 246-827-0110, medical assistants (MAs) are not permitted to independently order medications, including legend drugs or controlled substances. These tasks involve clinical judgment, legal authorization, and accountability that are explicitly outside the MA scope of practice. While MAs can assist with inventory monitoring or - [](https://progressivesurgicalsolutions.com/forums/reply/40668/) - Hi Margaret. Thank you for this question. Please see eSupport > Medical Staff Credentialing. There are some forms on there for credentialing purposes. I have attached a sample liability questionnaire for you to review for your purposes. If you need a comprehensive set of customized credentialing forms, please email me at apryl.mcelheny@vmghealth.com for additional assistance. - [](https://progressivesurgicalsolutions.com/forums/reply/40637/) - Thanks for providing this, Jessica. It looks like for the time being, it is unknown if any PHI was breached. Just be sure to keep your Security Officer appraised of the situation and any follow-up letters. - [](https://progressivesurgicalsolutions.com/forums/reply/40636/) - Hi Andi. Thank you for this question. ASCQR data is reported through 2 different websites. COVID-19 vaccination reporting (ASC-20) is done through the NHSN and all the other measures (with the exception of OAS CAHPS reporting) is done through the Hospital Quality Reporting (HQR) website. You need to create an account through HARP for HQR - [](https://progressivesurgicalsolutions.com/forums/reply/40633/) - Arbor Associates Inc. (“Arbor”) is writing to provide notice of a security incident involving its systems. On April 17, 2025, Arbor was made aware of unauthorized network activity involving certain network servers. Arbor has engaged external experts to assist in its response and remediation of the incident, as well as to conduct a comprehensive forensic - [](https://progressivesurgicalsolutions.com/forums/reply/40629/) - Hi Lindsey. Thank you for this question. Risk assessments are to be conducted upon opening your facility and then annually thereafter. The Governing Body should review/approve annually and this should be indicated in your minutes. The only risk assessments that don't need to be conducted annually include the wet room risk assessment (only done initially - [](https://progressivesurgicalsolutions.com/forums/reply/40603/) - Hi Emily. Thank you for this question. There is no regulatory requirement for office visit to surgical encounter timeframe. However, the payers may have an established timeline for this so check your contracts. In other words, you may run into a payment issue if the patient was seen in clinic outside of that timeframe prior - [](https://progressivesurgicalsolutions.com/forums/reply/40602/) - Hi Emily. Thank you for this question. Has Arbor notified you yet? You should contact them directly to determine what has occurred and if your ASC will be impacted. Depending upon what they tell you (has the breach ended or not?) you'll need to begin a response to the breach. You'll have to determine if - [](https://progressivesurgicalsolutions.com/forums/reply/40598/) - Hi Lexee. Thank you for this question. We should never have a patient sign anything after they've received anesthesia. Therefore, moving forward, it would be best practice to include the consent for blood draw for HIV and Hep B testing in the event of needlestick injury/exposure to an employee in the facility consent language or - [](https://progressivesurgicalsolutions.com/forums/reply/40589/) - Hi Laura. Thank you for this question. This may be a great question for the Facebook Group! Have you joined? Here is the link: https://www.facebook.com/groups/ascmanagers/ - [](https://progressivesurgicalsolutions.com/forums/reply/40588/) - Hi Lexee. If you're able to get this in writing or document your phone call, you may be able to skip the at hire testing entirely. However, you may still need to conduct at hire testing per the CDC guidelines if the state officially defers to the CDC. I would call back and seek further - [](https://progressivesurgicalsolutions.com/forums/reply/40587/) - Hi Annette. Thank you for this question. Section 1557 changes often with each final ruling so highly-specific training isn't offered. We do have an HHS Section 1557 page under eSupport but the majority of the links aren't working at present due to the communication freeze within the government. This training needs to be relatively specific - [](https://progressivesurgicalsolutions.com/forums/reply/40586/) - Hi Amanda. Thank you for this question. More than likely, no. However, if you have a state license, you'll need to check with them to see what the threshold is for ownership percentage changes. AAAHC requires notification of a "Change in majority interest" so this wouldn't necessarily classify. However, we encourage you to log into - [](https://progressivesurgicalsolutions.com/forums/reply/40580/) - Thank you for your response! I did contact our local health department and they said that we live in a low incidence area so our risk is very low and there are no local requirements for testing. Does this mean that it is not necessary to have employees tested as you stated above? Thanks again - [](https://progressivesurgicalsolutions.com/forums/reply/40577/) - Hi Lexee. Thank you for this question. The CDC recommends TB testing (PPD skin or QuantiFERON blood) at hire if the employee hasn't been tested within the last 12 months or doesn't have record of testing in the last 12 months. If they have a PPD at hire then it should be a 2-step. Testing - [](https://progressivesurgicalsolutions.com/forums/reply/40567/) - We only have a UPS. We contract with a company that comes monthly to do the inspection. Coincidentally they are changing batteries this month. They are using EATON. Any other questions let me know. - [](https://progressivesurgicalsolutions.com/forums/reply/40565/) - Hi Wendy. Thank you for this question. We recommend you add consent to transfer language to the facility consent that the patient signs with the ASC during registration. See an example on eSupport > Form Samples > Medical Record Forms > Facility Consent 1. If you're transferring a patient out urgently, they probably won't be - [](https://progressivesurgicalsolutions.com/forums/reply/40557/) - Hi Laura. Thank you for this question. Typically, this is per facility policy. Yes, asking the patient to sign the name reflected on the written document (full legal name) is best practice but isn't always possible. In the end, this is best left to your facility's risk management team per the advise provided by your/the - [](https://progressivesurgicalsolutions.com/forums/reply/40544/) - Hi Thelma, In the State of Texas, they can be delegated Administration of Anesthesia services, by a physician. So, it depends on what privileges they have been appointed. If they are truly working under the surgeon and it is documented that way in the medical record, then your policy is good. - [](https://progressivesurgicalsolutions.com/forums/reply/40542/) - Hi Stacy. Thank you for this question. Depending on the structure of these transactions, you may have a change in ownership (CHOW) that may need reported to both your state, CMS (855b), and your accrediting organization. Also, these bodies would need to be informed of the CHOW or ownership percentage changes and the new DBA. - [](https://progressivesurgicalsolutions.com/forums/reply/40541/) - Hi Lexee. Thank you for this question. The process for suspending and terminating clinical privileges of a medical staff member is outlined in your medical staff bylaws. These bylaws must be adhered to when taking action concerning medical staff appointments, credentialing and privileging. The same goes for the appeal process. This is something that the - [](https://progressivesurgicalsolutions.com/forums/reply/40540/) - Hi Emily. Thank you for this question. The type and size of emergency supplies must be determined by your governing body at the opinion of your medical staff and anesthesia providers. It would be best to check with them as they will be able to make recommendations that are appropriate for your patient population, the - [](https://progressivesurgicalsolutions.com/forums/reply/40539/) - Hi Rosie. Thank you for this question. Patients that develop an infection outside of the month in question may not necessarily be identified using the monthly letter to the surgeon, and that's okay. Just have the surgeon complete a follow-up document regarding the details of the infection and the outcome. Not all infections or complications - [](https://progressivesurgicalsolutions.com/forums/reply/40538/) - Hi Natasha. Thank you for this question. The education required for medical staff is driven by your accrediting organization standards. Each one calls out specific training for medical staff in the standards. However, as a general rule, the "Annual Training" module (plus laser, MH, radiation safety PRN) covers the vast majority of what is required - [](https://progressivesurgicalsolutions.com/forums/reply/40537/) - Hi Frank. Thank you for this question. This is not necessary nor customary in the ASC. When a patient signs the consent for treatment, this includes the administration of medications deemed necessary by the provider(s). - [](https://progressivesurgicalsolutions.com/forums/reply/40536/) - Hi Natasha. Thank you for this question. The scope of practice for a CST is determined by your state, facility policy, and the individual's certification board. That being said, holding a needle does not appear to be outside the scope of a CST so long the surgeon feels confident that the CST is properly trained - [](https://progressivesurgicalsolutions.com/forums/reply/40463/) - Hi Keri. Thank you for this question. Yes, this is a tricky situation. Are you able to verify if someone will be waiting for the patient at home when the patient arrives? You could review the discharge instructions with the individual over the phone prior to discharge. If the patient is taking he Uber home - [](https://progressivesurgicalsolutions.com/forums/reply/40479/) - Hi Lauren. Thank you for this question. The off-label use of medications in ophthalmology is commonplace. In example, using antibiotic eye gtts preoperatively as a prophylactic in the prevention for endophthalmitis is off-label. As always, patients should be educated via the informed consent process that medications used before/during/after surgery may be off-label but are deemed - [](https://progressivesurgicalsolutions.com/forums/reply/40466/) - Hi Emily. Thank you for this question. TJC requires, "The organization provides staff with educational resources to improve pain assessment, pain management, and the safe use of opioid medications based on the identified needs of its patient population." This is why you'll find Pain Management as a required topic for inservice and policy review on - [](https://progressivesurgicalsolutions.com/forums/reply/40465/) - Hi Tiffany. Thank you for this question. This goes back to the comments Crissy made previously regarding a "standard of care". You cannot treat an admitted patient differently based upon the level of anesthesia or type of care they're going to receive. Just because a patient isn't going to have sedation, doesn't mean the ASC - [](https://progressivesurgicalsolutions.com/forums/reply/40462/) - Hi Wendy. Thank you for this question. While this isn't required, it isn't a bad idea. And your ASC can enforce this sort of policy. You may also want to check your state regs and make sure there isn't anything there that speaks to this - ASC or medical board rules. We don't recommend a - [](https://progressivesurgicalsolutions.com/forums/reply/40453/) - I am struggling to understand the necessity of a documented ASA status on non sedation, non IV, topical analgesia only YAG laser patients. Last year our state inspector insisted that asa status be documented in the preoperative area for all yag laser patients, which I can understand if the patient is receiving sedation or anesthesia. - [](https://progressivesurgicalsolutions.com/forums/reply/40452/) - Are the physicians that are overseeing the administration required to be certified for moderate sedation? - [](https://progressivesurgicalsolutions.com/forums/reply/40443/) - Hi Lexee. Thank you for this question. If the patient is incapable of telling you (even in layman's terms: i.e., "I'm having eye surgery.") then they shouldn't be signing the facility consent and the validity of the surgical consent should be verified. These are situations in which the patient may be incompetent and incapable of - [](https://progressivesurgicalsolutions.com/forums/reply/40440/) - Hi Rosie. Thank you for your question! Medical staff aren't required to complete all the modules that clinical staff have to complete. For QUAD A, assign the medical staff Infection Control, Fire Safety, QAPI, OSHA, Emergency Prep, and MH individually upon hire or when they first join the center. For every year thereafter, the Annual - [](https://progressivesurgicalsolutions.com/forums/reply/40438/) - Hi Emily. Thank you for this question. The majority of ASCs use a generator for backup power (diesel or natural gas). ASC must have backup power to comply with the Life Safety Code. Obviously, these need to be commercial grade and you have to ensure that power is supplied to the critical areas within your - [](https://progressivesurgicalsolutions.com/forums/reply/40437/) - Hi Katherine. Thank you for this question. No, there is no requirement that your patients be "screened" prior to admission. No, the individual conducting screening doesn't need to be a nurse. However, just be cautious if you get into medication management as the individual needs to be working within their scope (i.e., holding certain medications - [](https://progressivesurgicalsolutions.com/forums/reply/40406/) - Hi Natasha. Thank you for this question. The performance assessments we have on eSupport are part of a much larger program that tallies that employees scores automatically. These are just samples and the numbers aren't accurate because the formula isn't applied. However, you would take the maximum achievable point value and divide that by 6 - [](https://progressivesurgicalsolutions.com/forums/reply/40405/) - Hi Kristi. Thank you for this question. Yes, there are ASCs that administer MKO without a CRNA or anesthesiologist present. However, this means that the operating surgeon is responsible for the management of the dosing of this medication and also the oversight of anesthesia services and crisis intervention (i.e., running an ACLS code). An RN - [](https://progressivesurgicalsolutions.com/forums/reply/40372/) - Hi Thelma. Thank you for this question. The Life Safety Code states every 36 months. This would be over the 36 months (March 22 - June 25) and you may be subject to a citation for this reason. A surveyor may not allow for this grace period and there isn't any wiggle room in the - [](https://progressivesurgicalsolutions.com/forums/reply/40365/) - It is up to the board in which your CSTs are certified by to determine if they accept PSS as an authorized provider of CEUs. The CST staff could ask their board for further details. - [](https://progressivesurgicalsolutions.com/forums/reply/40364/) - Hi, Wendy. Thank you for this question. Yes, this is a tricky for the ASC to be in. Even with a legal informed consent process and corresponding documentation in place, this doesn't mean the patient is going to comply on the day of surgery. This begins with educating the POA about how the patient will - [](https://progressivesurgicalsolutions.com/forums/reply/40363/) - Hi Leslie. Thank you for this question. There are centers that don't use anesthesiologists and/or CRNAs for anesthesia services. However, the operating physician has to be comfortable with managing a crisis (code blue, respiratory distress) or a deeper level than intended scenario, just like an anesthesia provider would be. Further, the level of anesthesia is - [](https://progressivesurgicalsolutions.com/forums/reply/40362/) - Hi Andi. Thank you for this question. It is important to refer back to your medical staff and governing body bylaws before credentialing this provider. These bylaws are written to your operating agreement and probably address what happens to your organizational structure when a sole-surgeon retires. You need a board and/or individual (i.e., medical director) - [](https://progressivesurgicalsolutions.com/forums/reply/40361/) - Hi Jessica. Thank you for this question. We would suggest you contact the manufacturer of your autoclave to see if they have local representatives or a company that would suggest. You may also want to reach out to the local hospital(s) to see who they use to service their autoclaves. Finally, you current biomedical engineering - [](https://progressivesurgicalsolutions.com/forums/reply/40360/) - Hi Olivia. Thank you for this question. Before creating this job description, confirm your state requirements and regulations concerning the operation of the c-arm. We do have a sample policy and procedure section, which includes the JD, for Radiation Services for purchase, if you're interested. Please reach out to apryl.mcelheny@vmghealth.com if you'd like to learn - [](https://progressivesurgicalsolutions.com/forums/reply/40359/) - Hi Susan. Thank you for this question. Yes, ASCs must be constructed and furnished per the Life Safety Code and in most states, the FGI guidelines. This is why you should always work with an architect and engineering team that is familiar with the requirements in this space. There are a great deal of requirements - [](https://progressivesurgicalsolutions.com/forums/reply/40350/) - Hi Lexee. Thank you for this question. There is a checklist on the eSupport > Quality Reporting > Data Reporting page that can help you determine which questions you'd be able to answer yes to at this point in time. We also plan to publish a P&P to help centers implement the necessary measures to - [](https://progressivesurgicalsolutions.com/forums/reply/40349/) - Hi Carol. Thank you for this question. You may be able to find some articles or papers written by ophthalmologists regarding this topic. It may be more difficult to find an actual study. Hopefully this group has some feedback for you regarding their experiences. I think your questions would make for an excellent QAPI study. - [](https://progressivesurgicalsolutions.com/forums/reply/40335/) - Are there any Opthalmic Surgery Centers that do not use anesthesia services? Is that the reason for the RN IV Conscious Sedation Program was reference above? With the increasing shortage of anesthesia providers, would topical/ local anesthesia with RN IV sedation be acceptable option for ophthalmic procedures? - [](https://progressivesurgicalsolutions.com/forums/reply/40332/) - Last question- do you know if these also count for CSTs? - [](https://progressivesurgicalsolutions.com/forums/reply/40331/) - Thank you!! :) - [](https://progressivesurgicalsolutions.com/forums/reply/40306/) - Hi Laura. Thank you for this question. Yes, you are to keep proparacaine in the fridge when being stored. However, as you stated, if the medication is being used, it isn't feasible to store in the fridge between patients. You will need to either a.) refer back to the package insert or the manufacturer to - [](https://progressivesurgicalsolutions.com/forums/reply/40305/) - Hi Anna. Thank you for this question. The annual TB testing is not straightforward in CA due to Cal-OSHA. Most states have adopted the CDC guidelines. This questionnaire is a baseline individual risk assessment should be used in addition to a 2-step PPD or Quantiferon blood test if there hasn't been testing on this individual - [](https://progressivesurgicalsolutions.com/forums/reply/40304/) - Hi Anna. Thank you for this question. The Board processes 805 reports on the following health care professionals: Physicians and Surgeons (MDs) Licensed Midwives (LMs) Doctors of Podiatric Medicine (DPMs) CA's 805 website refers you to the CA Osteopathic Medical Board for these purposes. GRAB YOUR SEAT!! Registration is now open for the 2025 ASC - [](https://progressivesurgicalsolutions.com/forums/reply/40294/) - Hi Katherine. Thank you for this question. Translation services that are offered through apps and computer programs are known to be less than 100% accurate, especially when it comes to medical jargon. This would be a great idea if you have the resources to accomplish this. GRAB YOUR SEAT!! Registration is now open for the - [](https://progressivesurgicalsolutions.com/forums/reply/40293/) - Hi Katherine. Thank you for this question. If you're administering O2 outside of an emergency situation, nurses should have a physician's order to do so. You can always check your state's Nursing Board/Scope of Practice for specifics. GRAB YOUR SEAT!! Registration is now open for the 2025 ASC Nurse Leadership Conference in Dallas, April 3-4 - [](https://progressivesurgicalsolutions.com/forums/reply/40292/) - Hi Katherine. Thank you for this question. Yes. Actual events can be written up as an exercise. According to Appendix Z: If the facility experiences an actual natural or man-made emergency that requires activation of the emergency plan, the facility is exempt from engaging in its next required community-based or individual, facility-based functional exercise following - [](https://progressivesurgicalsolutions.com/forums/reply/40291/) - When a patient comes in for surgery and is on their own O2 we transfer them to our O2 to conserve. Would that need an order? - [](https://progressivesurgicalsolutions.com/forums/reply/40289/) - do you recommend having someone 'proof' it or do you think that it is sufficient as is? - [](https://progressivesurgicalsolutions.com/forums/reply/40288/) - Beverly, this is now available! Thank you for your patience! See eSupport > Business Ops > Medicare Fee Schedule - [](https://progressivesurgicalsolutions.com/forums/reply/40285/) - Hi Natasha. Thank you for asking this question. Yes! Please see https://www.ilga.gov/commission/jcar/admincode/068/068013000A01300R.html and then read section Section 1300.130 Continuing Education - L) Providers approved by another state's board of nursing. GRAB YOUR SEAT!! Registration is now open for the 2025 ASC Nurse Leadership Conference in Dallas, April 3-4 – REGISTER NOW!! Seats are limited!! https://ascnurseleadership.com/ - [](https://progressivesurgicalsolutions.com/forums/reply/40283/) - Coming very soon, Beverly. The tool is in the final phases of quality control. Thank you for checking in! - [](https://progressivesurgicalsolutions.com/forums/reply/40262/) - Any updates on this? - [](https://progressivesurgicalsolutions.com/forums/reply/40250/) - Hi Emily. Thank you for this question. Unless your medical or anesthesia director feel(s) this is necessary, no, you do not need heparin on your formulary. For the most part (unless you're QUAD A accredited or your state has specific regulations) your facility has the autonomy to create your own formulary and determine what is - [](https://progressivesurgicalsolutions.com/forums/reply/40240/) - Thanks for bringing this important topic back up, Lauren! The required education/training for medical staff can vary based upon your accrediting organization. So, always check your standards before creating your medical staff education/training documentation. In general, medical staff should be oriented to the facility (physical plant) and your facility program (policies and procedures), fire safety - [](https://progressivesurgicalsolutions.com/forums/reply/40237/) - Kim, this is fantastic. Thanks so much for sharing! - [](https://progressivesurgicalsolutions.com/forums/reply/40201/) - Thank you Apryl. - [](https://progressivesurgicalsolutions.com/forums/reply/40200/) - Hi Beverly. Thank you for this question. We are working on collecting this information and should be able to post it soon. Check back under the Business Operations section in the coming weeks! REGISTER NOW! Join us for the 2025 ASC Nurse Leadership Conference, April 3-4, in Dallas, TX. Seats are limited and sell out - [](https://progressivesurgicalsolutions.com/forums/reply/40199/) - Hi Lexee. Thank you for this question. Each state has their own laws surrounding the consent of a patient for HIV testing. We would recommend you speak with your local health department, occupational health department (that conducts source patient testing) or a hospital to get a sample of what this consent should include. REGISTER NOW! - [](https://progressivesurgicalsolutions.com/forums/reply/40198/) - Hi Annette. Thank you for this question. SAM.gov and the OIG are not the same. SAM.gov is a government website that maintains a database of debarment actions taken by federal agencies, while the OIG is an office within the Department of Health and Human Services (HHS) that maintains a list of individuals and entities excluded - [](https://progressivesurgicalsolutions.com/forums/reply/40194/) - Happy to help, Laura! - [](https://progressivesurgicalsolutions.com/forums/reply/40191/) - Yes, I worded that wrong and didn't mean weekly reporting, I meant the week per month we've been reporting on. Awhile back it sounded like it was required through 2024 but hadn't heard of any changes for 2025. Thank you for confirming, we will continue doing what we've been doing. - [](https://progressivesurgicalsolutions.com/forums/reply/40180/) - Hi Tabatha. Thank you for this question. ASC-20 under the ASCQR is still very much required in 2025. However, weekly reporting is not necessary for ASCs, nor has it been in the past. ASCs are required to report one week of data for each month and the deadlines are quarterly. Listening to this month's webinar - [](https://progressivesurgicalsolutions.com/forums/reply/40179/) - Hi Heather. Thank you for this question. You can easily translate your Patient Rights & Responsibilities (or any other document you'd like) on Microsoft Word. Just open your document in Word and then hit Review at the top. Under this heading, you will see an option to Translate into the language of your selection. REGISTER - [](https://progressivesurgicalsolutions.com/forums/reply/40154/) - Hi Tammy. Thank you for this question. In the v43, AAAHC reduced their 10-step QI Study model to a 6-step model. AAAHC made this template available here: https://www.aaahc.org/uploads/2024/02/240204_IQI_DOC_Documenting-QI-Using-6-Component-Criteria.pdf and these additional resources: https://www.aaahc.org/quality-institute/quality-resources/ You can also access a template to complete under eSupport > Quality Management > Quality Improvement Study > Quality Improvement Study Format - [](https://progressivesurgicalsolutions.com/forums/reply/40132/) - Hi Wendy. Thank you for this question. Yes, ADA compliance is a consideration for patients with disabilities. As far as the waiver is concerned, you may want to seek legal counsel with this. Typically, the ADA would require that you not treat this patient differently. Meaning, you couldn't require they have someone accompany them for - [](https://progressivesurgicalsolutions.com/forums/reply/40105/) - Hi Emily. Thank you for this question. Some states require a transfer agreement, regardless of admitting privileges with your surgeons so please check there first. The accrediting organizations have aligned with CMS on the concept of transfer agreements. This is that a transfer agreement is no longer required. However, communication between the hospital and ASC - [](https://progressivesurgicalsolutions.com/forums/reply/40097/) - Hi Chrissy. Thank you for this question and for the suggestion for additional eSupport content! It is suggestions like yours that makes eSupport what it is! The American Society of Regional Anesthesia and Pain Medicine (ASRA) has a checklist for LAST management: https://www.asra.com/docs/default-source/guidelines-articles/local-anesthetic-systemic-toxicity-rgb.pdf?sfvrsn=33b348e_2 AORN also has guidelines for the management of LAST, which reference ASRA. - [](https://progressivesurgicalsolutions.com/forums/reply/40095/) - Hi Heather. Thank you for this question. No, there is not. Staffing ratios are dependent upon the acuity, volume, and complexity of your services and facility layout and how many ORs you have. However, the mean is around 13.5 for nurse FTEs and 5.5 for Tech FTEs. GRAB YOUR SEAT!! Registration is now open for - [](https://progressivesurgicalsolutions.com/forums/reply/40094/) - Hi Marissa. Thank you for this question. The entire standard reads, "All products, including medications, reagents, solutions, and supplies that have a manufacturer's printed expiration date are monitored and disposed of in compliance with facility policy and manufacturers' guidelines" and... 1. A written policy for the monitoring and disposal of products with expiration dates is - [](https://progressivesurgicalsolutions.com/forums/reply/40071/) - Hi Min and thank you for this question. Patient satisfaction surveys alone are not a QI Study unless you're using the data from the surveys as a data source to implement and study corrective actions. In example, if you find via patient satisfaction data one quarter that 80% of your patients think their wait time - [](https://progressivesurgicalsolutions.com/forums/reply/40070/) - Hi Emily. Thank you for this question. Individual patient consent is not necessary but you can add this language to your consent if you'd like. You can also review the language in the agreement you have with your vendor to protect patient information and/or a BAA. We recommend you speak with your vendor representative about - [](https://progressivesurgicalsolutions.com/forums/reply/40067/) - Our contracted anesthesia group is recommending patients hold for 1 week prior to surgery. Hope this helps, Emily - [](https://progressivesurgicalsolutions.com/forums/reply/40059/) - Hi Bradley. Thank you for this question. How long does the MIFU state the batteries should be sterilized? Exposure time and dry time? If you're going over the MIFU on the exposure or dry times, you may want to consider changing work flows to reduce the time spent in the autoclave. Unfortunately, there is such - [](https://progressivesurgicalsolutions.com/forums/reply/40052/) - Thank you Denise!!! - [](https://progressivesurgicalsolutions.com/forums/reply/40047/) - We have nextech and it has been a struggle but here are the instructions. I had to call someone at Nextech to turn it on for me. It has been very frustrating and they won't add extra items to be extracted other than what CMS has requested. I have attached what I was sent. - [](https://progressivesurgicalsolutions.com/forums/reply/40000/) - Hi Nicole. Thank you for the question. Yes, when you reappoint a CRNA, you need to run a NPDB on them (or confirm that your inquiry is continuous and is within the active timeframe and renew if necessary) and confirm that they board certification is still current from the NBCRNA. You'll want to check out - [](https://progressivesurgicalsolutions.com/forums/reply/39999/) - Hi Heather. Thank you for reaching out again. I apologize that I missed what you were asking for! Please see eSupport > Infection Control > Infection Prevention and Investigation > SSI Investigation Toolkit. This is what the ASC director fills out in the event on an infection or even an outbreak. GRAB YOUR SEAT!! Registration - [](https://progressivesurgicalsolutions.com/forums/reply/39994/) - Hi Emily. Thanks for the question. We recommend you visit the NIFA website to learn more about NISE at https://www.rnfa.org/niseprogram/ or AORN for Periop 101 for the ASC at https://www.aorn.org/education/periop-courses/periop-101-a-core-curriculum/periop-101-a-core-curriculum-asc GRAB YOUR SEAT!! Registration is now open for the 2025 ASC Nurse Leadership Conference in Dallas, April 3-4 – REGISTER NOW!! Seats are limited!! https://ascnurseleadership.com/ - [](https://progressivesurgicalsolutions.com/forums/reply/39977/) - Hi Emily. Thank you for this question. This is on the compliance calendar as "daily with occurrence" because you only need to log this on the days you use the Cidex, Cidex OPA has multiple items that need to be logged when used, including the date the solution was opened and when it expires, test - [](https://progressivesurgicalsolutions.com/forums/reply/39974/) - Apryl, the form is actually for the ASC director to fill out after an infection or complication has been identified. It is called the 'Staff Postoperative Infection/Complication Report". - [](https://progressivesurgicalsolutions.com/forums/reply/39968/) - Hi Keyanna, You would not have to apply for a new license, but you would need to get plans approved from the State of Texas, which your architect would assist with. We always recommend a qualified, ASC experienced architect, sometimes with renovations/expansion it triggers other or additional physical plant regulations to be met, this is - [](https://progressivesurgicalsolutions.com/forums/reply/39966/) - Hi Emily. Thank you for this question. Hopefully you get some feedback from a fellow Nextech user. In the meantime, I would highly suggest you ask your question on our Facebook Group. Here is the link to join, if you haven't already: https://www.facebook.com/groups/ascmanagers/ We're always talking about OAS CAHPS prep on there. More and more - [](https://progressivesurgicalsolutions.com/forums/reply/39959/) - Hi Caitlyn. Thank you for this question. The manufacturer's instructions for use (MIFU) for your phaco machines more than likely prohibit the use of hospital-grade disinfectant wipes. Typically, electronic machines should be disinfected with alcohol if made of plastic. If you have Alcon machines, you may want to visit this page if you haven't already: - [](https://progressivesurgicalsolutions.com/forums/reply/39958/) - Hi Heather. Thank you for this question. Yes, you do need to have a designated way to communicate with patients that don't speak English, per the 1557. LanguageLine Solutions is a very common resource for this service. If you have Facebook, we encourage you to join our Facebook group and ask your question there, too. - [](https://progressivesurgicalsolutions.com/forums/reply/39950/) - Hi Heather. Thank you for this question. The letter/form you provide the medical staff to determine if there has been any infections and/or complications from the proceeding month is on eSupport > Policies and Procedures > QAPI > QAPI Infection Control. GRAB YOUR SEAT!! Registration is now open for the 2025 ASC Nurse Leadership Conference - [](https://progressivesurgicalsolutions.com/forums/reply/39949/) - Hi, Leslie. Thank you for this question. There won't be data to collect in CY 2025 reporting period, for data submission period 2026, payment determination 2027. This is because the facility will be required to answer only "yes" or "no" to five domain attestation questions regarding the facility's commitment to health equity. Per usual, we - [](https://progressivesurgicalsolutions.com/forums/reply/39948/) - Hi Lisa. Thank you for this question. Here is some recent news from the ASA regarding this topic that may help you evaluate your options: https://www.asahq.org/about-asa/newsroom/news-releases/2024/10/new-multi-society-glp-1-guidance You may also want to ask your question on our Facebook page. GRAB YOUR SEAT!! Registration is now open for the 2025 ASC Nurse Leadership Conference in Dallas, April - [](https://progressivesurgicalsolutions.com/forums/reply/39932/) - Hi Lisa and Heather, We sincerely apologize for this unfortunate typo that slipped through our quality control checks. The email meant to say "no longer voluntary". Again, we're very sorry for the confusion. Wishful thinking, I suppose! GRAB YOUR SEAT!! Registration is now open for the 2025 ASC Nurse Leadership Conference in Dallas, April 3-4 - [](https://progressivesurgicalsolutions.com/forums/reply/39924/) - I saw that too! Did the PSS email mean to say "it is no longer voluntary" instead of "no longer mandatory"? - [](https://progressivesurgicalsolutions.com/forums/reply/39909/) - Hi Linda. Thank you for this question. You won't find this restriction in the CMS CfCs but legally, patients have to be of sound mind to sign an informed consent and/or facility consent document. Once the patient is in the OR, they may have already received medication that impacts their thinking. It is not best - [](https://progressivesurgicalsolutions.com/forums/reply/39910/) - Hi Jazmine, Thank you for this question. Here is the link you need: https://www.cms.gov/medicare/forms-notices/beneficiary-notices-initiative/ffs-abn GRAB YOUR SEAT!! Registration is now open for the 2025 ASC Nurse Leadership Conference in Dallas, April 3-4 – REGISTER NOW!! Seats are limited!! https://ascnurseleadership.com/ - [](https://progressivesurgicalsolutions.com/forums/reply/39906/) - Is it a CMS requirement that the informed consent must be obtained outside the procedure room? Each of my surveyors have always asked me to confirm this process but I'm having a hard time finding this regulation. - [](https://progressivesurgicalsolutions.com/forums/reply/39898/) - Thank you so much Apryl. Have a great day! - [](https://progressivesurgicalsolutions.com/forums/reply/39895/) - Hi Arlene. Thank you for this question. A traveling CRNA will require the same credentialing a privileging processes as your primary group does. The same information must be collected (background checks, NPDB, board certification, state licensure, etc.). The extent to which your previous CRNAs had their backgrounds checked, is the same extent you should use - [](https://progressivesurgicalsolutions.com/forums/reply/39890/) - Hi Anna. Thank you for this question. The consent must be completed in its entirety prior to the patient signing it. Also, keep in mind, there is a difference between the consent signed by the patient and the surgeon (the material proof of a well-designed informed consent process) and the facility consent between the ASC - [](https://progressivesurgicalsolutions.com/forums/reply/39889/) - Hi Lexee and Emily. Thank you for your question, Lexee. These generator requirements are set forth by the Life Safety Code. Often times, your accrediting organization will provide these in their standards, too. The Life Safety Code states that diesel generator sets are exercised at least monthly for 30 minutes under loading that maintains minimum - [](https://progressivesurgicalsolutions.com/forums/reply/39886/) - We are joint commission certified and have had annual load run down test for 90 minutes. - [](https://progressivesurgicalsolutions.com/forums/reply/39801/) - Hi Gabrielle. Thank you for this question. The important thing to consider here is if this will interrupt service and if it will present an infection and/or safety risk to your patients. If this will interrupt your ability to provide service to your patients then yes, this is something you should notify AAAHC about. If - [](https://progressivesurgicalsolutions.com/forums/reply/39800/) - Hi Michelle. Thank you for this question. This should be done per the instrument's manufacturer instructions for use and by the directions provided by the vendor that will be conducting the repair (if different). If the damaged instrument doesn't present a safety issue during the cleaning and sterilization processes, this should be performed prior to - [](https://progressivesurgicalsolutions.com/forums/reply/39106/) - Hi Lauren. Thank you for this question. The manufacturer of your autoclave should be contacted regarding this issue so that a certified technician can come to your center to determine the issue and develop a plan to correct the issue. Descaling a sterilizer is a common practice, especially in areas where there is a lot - [](https://progressivesurgicalsolutions.com/forums/reply/39105/) - Hi Cortney. Thank you for this question. Compliance with the ST108 can't be proven via one form. It is evidenced by the risk assessment, meeting minutes of your water quality committee (which can be your QAPI Committee), and documentation of quality testing. Please see eSupport > Infection Control > Water Quality to learn more about - [](https://progressivesurgicalsolutions.com/forums/reply/39104/) - Hi Emily. Thank you for this question. I would suggest you join Progressive's Facebook Group, "ASC Nurse Managers and Administrators" as there has been a lot of conversation about this topic recently. Here's the link: https://www.facebook.com/groups/ascmanagers/ Mark your calendars! The 2025 ASC Nurse Leadership Conference is April 3 – 4 in Dallas, TX! - [](https://progressivesurgicalsolutions.com/forums/reply/39087/) - Hi Kristi. Thank you for this question. Without a facility consent, there is no consent between the ASC and the patient. This isn't necessarily a standard requirement, it is more so a legal requirement. However, it is a standards requirement that the patient attest to the fact that he/she underwent the informed consent process with - [](https://progressivesurgicalsolutions.com/forums/reply/39086/) - Sounds like a great QI study in the making, Keyanna! Mark your calendars! The 2025 ASC Nurse Leadership Conference is April 3 – 4 in Dallas, TX! - [](https://progressivesurgicalsolutions.com/forums/reply/39082/) - Thank you April, that makes sense. Essentially these will initiate as verbal orders from the MD because they might be in surgery when the post-op nurse notices the rx wasn't given but we hope to catch these errors in pre-op and can address with MD when they are interviewing the patient. Which would have to - [](https://progressivesurgicalsolutions.com/forums/reply/39080/) - Hi Keyanna. Thank you for this question. The most important part of this is streamlining the physician's orders for the medications and preventing transcription errors. Will these be written/verbal orders? How will the nurse access the order while e-prescribing? An advantage of e-prescribing is to prevent errors. We would suggest the order be written/entered electronically - [](https://progressivesurgicalsolutions.com/forums/reply/39079/) - Hi Emily. Thank you for this question. If there are used sharps in the black bins, this should not be dumped out to remove the syringes. This is a safety hazard for your staff. Instead, this should be disposed of as a biohazard with your sharps, like the red bins. Black bins are for hazardous - [](https://progressivesurgicalsolutions.com/forums/reply/39078/) - Hi Michelle. Thank you for this question. First, it is important to review your state's ASC regulations regarding anesthesia and recovery times. Some states limit this (collectively or individually). In example, a state may prohibit taking a case back to the OR when you anticipate the anesthesia time will be greater than 4 hours. Next, - [](https://progressivesurgicalsolutions.com/forums/reply/39074/) - Hi Kim. Thank you for this question. Back in the day, Influenza vaccination reporting to the NHSN was required, just like COVID-19 is now. However, just like the COVID-19 vaccination, the Influenza vaccine is not mandatory for ASC staff. You do, however, have to follow your policy. This policy can require whatever your Governing Body - [](https://progressivesurgicalsolutions.com/forums/reply/39072/) - Hi Michelle. Thank you for this question. Yes, if you have lasers in your facility, you should have a Laser Safety Officer that is appointed by your Governing Body. Please check your state regulations for specifics of this role. Some states elaborate on this. - [](https://progressivesurgicalsolutions.com/forums/reply/39059/) - Hi Megan. Thank you for this question. Correct. The state of CA has additional requirements in addition to CMS/accreditation requirements. As long as you're adhering to those requirements and those of your state pharmacy board, you're good. We always recommend you work with a consulting pharmacist that is licensed within your state to ensure you're - [](https://progressivesurgicalsolutions.com/forums/reply/39057/) - Is this quarterly audit required in other states other than California? I am at a Ophthalmic surgery center in Maine Thank you! - [](https://progressivesurgicalsolutions.com/forums/reply/39051/) - Hi Leslie. Thank you for this question. Have you checked with your state? They may have training options. Sometimes these are more affordable. Here are some other options for you to consider: https://www.compliancetrainingonline.com/laser-safety-officer-medical.cfm?utm_source=google&utm_medium=cpc&utm_campaign=21376015327&utm_id=21376015327&utm_content=167706554127&utm_term=laser%20safety%20officer%20training&gad_source=1&gclid=Cj0KCQjwo8S3BhDeARIsAFRmkONC0OmMqKea_VEWPuGS6muwE6RUmGhnwwQX1_ji7LcDiBHZHp8CrpgaArZLEALw_wcB https://www.lia.org/training/medical/classroom-courses/medical-laser-safety-officer-training https://www.lasersafetycertification.com/healthcare/?gad_source=1&gclid=Cj0KCQjwo8S3BhDeARIsAFRmkOMimGEM3LsCjZJ1kYAD9OhbEQTWu6HZGYMl66RmApct_cUp3r4jXi4aAn1tEALw_wcB - [](https://progressivesurgicalsolutions.com/forums/reply/39050/) - Hi Diana. Thank you for this question. Discharging a patient with a responsible adult is a CMS requirement. If you're accredited, be sure to read the specific standard(s) concerning this, too. Some accrediting organizations expand on this requirement. If the physician is comfortable with the patient leaving without a responsible adult such as Uber (this - [](https://progressivesurgicalsolutions.com/forums/reply/39049/) - Hi Lisa. Thank you for this question. Most ASCs use a contracted anesthesia company. Paying a stipend has become the new normal, unfortunately. If you're interested in learning more about RN IV Conscious Sedation Programs, please email me to learn more at apryl@pss4asc.com. - [](https://progressivesurgicalsolutions.com/forums/reply/39048/) - Hi Thelma. Thank you for this question. October - May is flu season. It is best to get vaccinated in September or October and by the end of October/early November. Flu peaks in December - February. There isn't necessarily an "end" for vaccination, just for the season and some seasons run longer or end earlier. - [](https://progressivesurgicalsolutions.com/forums/reply/39047/) - Hi Heather. Thank you for this question. PSS does not have a sample P&P that deals with patient satisfaction surveys alone. We consider that to be part of your QAPI Program and selected quality indicators. However, establishing a P&P that states you will use the OAS CAHPS data in place of traditional patient satisfaction surveys - [](https://progressivesurgicalsolutions.com/forums/reply/39038/) - Thank you so much for the information!! I am obviously late seeing this! I appreciate the response and guidance. :) Leslie - [](https://progressivesurgicalsolutions.com/forums/reply/39020/) - Can you share a sample Patient Satisfaction policy that incorporates the OAS CAHPS? - [](https://progressivesurgicalsolutions.com/forums/reply/39007/) - Hi Lisa. Thank you for the question. eSupport > Policies and Procedures > Administration > Service Animals - [](https://progressivesurgicalsolutions.com/forums/reply/39006/) - Hi Lexee, Idaho is silent on this matter. Therefore, you must follow your bylaws and policies and procedures. - [](https://progressivesurgicalsolutions.com/forums/reply/38998/) - Hello! Do you know a place to check for each state laws regarding the reappointment? I am unable to find anything for Idaho. Thank you - [](https://progressivesurgicalsolutions.com/forums/reply/38997/) - Hi Tabatha. Thank you for this question. Administering supplemental O2 should be on the physician's orders. Nurses can administer oxygen without an order in emergency situations but if each patient is to receive this upon admission and throughout the intraoperative event, then adding this to the orders sheet is recommended. You can check your state's - [](https://progressivesurgicalsolutions.com/forums/reply/38996/) - In that case, this site may be helpful, too: https://www.in.gov/iara/divisions/records-management/records-retention-schedules/ - [](https://progressivesurgicalsolutions.com/forums/reply/38975/) - no HR here, we are located in indiana - [](https://progressivesurgicalsolutions.com/forums/reply/38974/) - Hi Lisa. Thank you for this question. The retention of personnel files may be dictated by your state's regulations. Do you have an HR expert on staff at your center? Some documents you may only need to keep for a year and some you may need to keep for 30. The EEOC has a rule: - [](https://progressivesurgicalsolutions.com/forums/reply/38967/) - Hi Heather. Thank you for this question. No, you can use the data your vendor collects for your own internal indicator analysis for the QAPI Program. You do not have to sample an additional patient population in addition to the OAS CAHPS population. - [](https://progressivesurgicalsolutions.com/forums/reply/38966/) - Hi Leslie. Thank you for this question. This role is typically filled by the Administrator or the Clinical Director/Director of Nursing in the ASC. However, for larger organizations that have a more complex executive or administrative team, you may opt to use the facility Compliance Officer, CEO, or other individual. The important part is that - [](https://progressivesurgicalsolutions.com/forums/reply/38965/) - Hi Margaret. Thank you for this post. To clarify, are you requesting a medication administration record for anesthesia or are you looking for an intraop record for anesthesia? - [](https://progressivesurgicalsolutions.com/forums/reply/38951/) - @LETICIA-GRAHAMTHURMONDEYE-COM These are 2 resources that we recommend for training on RN conscious sedation: https://www.asahq.org/shop-asa/umb_sst_mod https://sedationcertification.com/ We do also have a toolkit for purchase with all the documents required for implementing RN conscious sedation program at your ASC. I have attached a summary of what is included in the toolkit and a list below. The - [](https://progressivesurgicalsolutions.com/forums/reply/38950/) - Yes, all the risk assessments have to be done separately, you may include the hazards you identify in the risk assessments on the HVA (and some already are), but you still need to document each one individually. - [](https://progressivesurgicalsolutions.com/forums/reply/38939/) - Hi Min. Thank you for your questions! 1. All patients must be subjected to the standard of care for admission and discharge. Meaning, you treat all patients the same, regardless of the procedure they underwent or the level of anesthesia administered. CMS requires patients be assessed upon admission and discharge. 2. CMS provides this, "...it - [](https://progressivesurgicalsolutions.com/forums/reply/38931/) - Hi Susan. Thank you for checking in on this. Due to unforeseen circumstances, we decided to cancel the July webinar on the topic of revenue cycle management. We will be rescheduling this session in our planning for 2025. Our August webinar will move forward as planned on August 26. You can check out the content - [](https://progressivesurgicalsolutions.com/forums/reply/38930/) - Emily, Pine Pharmaceuticals sells a multi-use 1ml or 5ml Betadine drop. Here is the link for the 5ml we use. https://portal.pinepharmaceuticals.com/IPFSitePages/ProductDetails.aspx?ipff=1P%3BItem%3B0s745 - [](https://progressivesurgicalsolutions.com/forums/reply/38923/) - Hi Amy. Thank you for this question. Can't the manufacturer just extend the special IOL pricing to you on behalf on the patients sent by that physician? Then, the surgeon's office can collect what they want for the remainder of the package price, minus the IOL. What they propose isn't unheard of and since we - [](https://progressivesurgicalsolutions.com/forums/reply/38922/) - Hi Emily. Thank you for this question. Is the betadine you receive from Alcon single patient use? This may be marked "Single Use Only". If so, you cannot draw this up for multiple patients. If this betadine is permitted to be used on multiple patients, the USP guidelines would apply because you are repackaging - [](https://progressivesurgicalsolutions.com/forums/reply/38921/) - Hi Diana. Thank you for this question. Yes, AAAHC will site you for this if not properly documented. In fact, this was a new standard for AAAHC this year (v43 identifier ADM.150.10). Employee training should occur at hire during orientation and then annually. The training must include your facility's patient rights and responsibilities and then - [](https://progressivesurgicalsolutions.com/forums/reply/38919/) - Let me clarify: We will continue to purchase the lens from the manufacturer. The manufacturer has agreed to reimburse the surgeon's office directly for the premium lens package that is usually charged to the pt, which includes the specialty lens. Instead of us collecting from the patient, the office wants us to bill them for - [](https://progressivesurgicalsolutions.com/forums/reply/38901/) - Hi Heather. Thank you for this question. Progressive Surgical Solutions works with all four accrediting organizations (AO) that accredit ASCs and are able to provide deemed-status surveys. They are the AAAHC, ACHC, QUAD A, and TJC. All four AOs have their own set of standards that both align with and build upon the CMS CfC. - [](https://progressivesurgicalsolutions.com/forums/reply/38900/) - Hi Alexis. Thank you for this question. The physician should make this call, ultimately. Make sure the nursing staff have an order for mixing this prior to surgery and that there is a written protocol. The American Society of Cararact and Refractive Surgery (ASCRS) Cataract Clinical Committee and the ASCRS Toxic Anterior Segment Syndrome Task - [](https://progressivesurgicalsolutions.com/forums/reply/38866/) - Hi Olivia. Thank you for this question. ST108 is a set of guidelines provided by ANSI/AAMI. ANSI/AAMI is not a regulatory board like CMS. What they provide is essentially recommendations (like AORN or the CDC) and it isn't law. As you know, CMS requires that we consider and adopt nationally-recognized guidelines as part of our - [](https://progressivesurgicalsolutions.com/forums/reply/38865/) - Hi Jazmine. Thank you for this question. Since the state of CA doesn't license ASCs, you do not need to notify the state. If your center is accredited, you may want to inform your accreditation organization if this requires renovation. Also, if renovating, you'd want to make sure your local/state building authority is notified for - [](https://progressivesurgicalsolutions.com/forums/reply/38860/) - Surglogs is a good one! - [](https://progressivesurgicalsolutions.com/forums/reply/38856/) - Thank you for this question, Gabrielle. Yes, your state determines the scope of practice for PAs and the MD supervision requirements. You will credential this individual as an allied health professional. The privilege request form will include items such as, "assist in surgery", "retract tissue", "suture under physician supervision", "conduct history and physicals", "order medication", - [](https://progressivesurgicalsolutions.com/forums/reply/38853/) - Hi Danielle. Thanks for this question. Do your nurses administer the LA/SA drugs that you have on formulary in the same setting? In example, do nurses have both prednisoLONE and predniSONE in their carts? If the two medications are stored and administered separately, individually labeling these medications may not be necessary. Also, remember that you - [](https://progressivesurgicalsolutions.com/forums/reply/38827/) - We use Surglogs and it works extremely well for us. Staff has an App and can log from their phone or can use a computer. It is efficient and always up to date. We upload photos of our implant logs and sterilization records and that is all saved in the system. You are also able - [](https://progressivesurgicalsolutions.com/forums/reply/38826/) - Bumping this post. Does anyone use an online log tracking company? - [](https://progressivesurgicalsolutions.com/forums/reply/38824/) - Hi Michelle. Thank you for this question. This depends upon the health status of your employee and whether or not they were symptomatic. See the link from the CDC. These are just guidelines however, and not regulations. You could also ask the employee to see their PCP for guidance on when they should return to - [](https://progressivesurgicalsolutions.com/forums/reply/38813/) - Hi Barbie. Thank you for this question. This will depend upon the manufacturer's instructions for the suction. You should speak with the vendor that maintains your clinical vacuum system to determine this. - [](https://progressivesurgicalsolutions.com/forums/reply/38794/) - Hi Vonda. Thank you for this question. We apologize about not receiving the link following registration. We'll be sure to follow up on this issue. In the meantime, you can access all of our webinars following the live presentation from Eduction > Progressive Huddle / Half Time. They are recorded so you can watch whenever - [](https://progressivesurgicalsolutions.com/forums/reply/38768/) - Hi Jeannelle. Thank you for your question. This letter doesn't need to be lengthy. Send them the letter and put in their file before you archive it. Make sure this gets reported at the next GB/MAC that the provider lapsed. Of course, after the last date of their active appointment period, the surgeon can no - [](https://progressivesurgicalsolutions.com/forums/reply/38767/) - Hi Emily. Thank you for your question. Yes, OAS CAHPS is a mandatory component of the ASCQR in 2025. We suggest you begin interviewing vendors ASAP so you're ready to roll on Jan 1 2025. For more information, go to eSupport > Quality Reporting > OAS CAHPS. - [](https://progressivesurgicalsolutions.com/forums/reply/38766/) - Hi Bradley. Thanks for your question. BSM Consulting provides this service for ophthalmology practices. https://www.bsmconsulting.com/ You may also want to ask this question on our Facebook page: https://www.facebook.com/groups/ascmanagers/ - [](https://progressivesurgicalsolutions.com/forums/reply/38752/) - Hello, Mike, Our instruments are cleaned on the field with water, and treated in ultrasonic in de-ionized water after every case. After US, they are rinsed with flowing de-ionized water, sprayed with alcohol to promote drying, and then blow-dried with forced air before passed to clean side for packaging for sterilization. We do check IFUs - [](https://progressivesurgicalsolutions.com/forums/reply/38747/) - Hi Lexee. Thank you for this question. We would recommend you review your Infection Control policies. You may reference certain nationally recognized guidelines for handwashing or for your entire program as a whole (i.e., AORN, CDC, APIC, WHO). Then, if you'd like to post handwashing instructions or provide employee education, use that reference as a - [](https://progressivesurgicalsolutions.com/forums/reply/38741/) - Thank you, Apryl - [](https://progressivesurgicalsolutions.com/forums/reply/38740/) - Hi Valerie. Thank you for this question. This form can be found by clicking on Quality Management > QAPI and Infection Control Program Annual Assessment Guide. It is the first form when you scroll down the Overview page. - [](https://progressivesurgicalsolutions.com/forums/reply/38739/) - Hi Keyanna and Lisa! This is a great question and information. Outside of what Lisa mentioned, be sure to review your Medical Staff / Governing Body bylaws regarding fellows because there may be very specific language in there about how to onboard and credential these individuals. You'll also want to make sure you're following any - [](https://progressivesurgicalsolutions.com/forums/reply/38738/) - Hi Sharon. Thank you for this question. Yes, you're correct. You have to have a TB program (section in your Infection Control manual) but not a respiratory protection program. This would be warranted if you had a high-risk center and/or if you required fit testing for your staff for respirators. Some centers may have had - [](https://progressivesurgicalsolutions.com/forums/reply/38732/) - I have had to develop policy and procedure and other documentation around surgical fellowship. I am happy to help. Does your practice/facility have credentials for an approved fellowship program? I went to the fellowship website and found documentation that our company is approved fellowship program and also got the documentation evidence that we are fully - [](https://progressivesurgicalsolutions.com/forums/reply/38621/) - Hi Mike. Thank you for this question. You should follow the MIFUs for your instruments when processing them. If you don't have them, request a copy from the manufacturer or look them up online. Ophthalmic instrument MIFUs often call for the use of an ultrasonic machine. The AORN guidelines for ophthalmic instrument processing also mention - [](https://progressivesurgicalsolutions.com/forums/reply/38585/) - Hi Missy. We would recommend you use the same letter you use to grant privileges but change the language to not approved and then replace the offering of the medical staff bylaws / rules and regulations with a sentence providing the information for contacting the MAC/GB regarding their decision. Remember, you need to stick to - [](https://progressivesurgicalsolutions.com/forums/reply/38572/) - Thanks April. Does anyone have an example of a letter that is sent to a provider notifying them that their reappointment of privileges has not been granted? - [](https://progressivesurgicalsolutions.com/forums/reply/38570/) - Hi Missy. Thank you for this question. A great amount of detail isn't necessary. Review your medical staff bylaws for specifics on this. A simple, "Provider X applied and the decision was made by the GB to not approve an appointment at this time." This would only be if the provider officially applied via written - [](https://progressivesurgicalsolutions.com/forums/reply/38569/) - Hi Nicole. Thank you for this question. If you have PSS Books then the policy that states you comply with state reporting can be found in your Infection Control manual, section 1, Communicable Disease Reporting. - [](https://progressivesurgicalsolutions.com/forums/reply/38557/) - Hi Amy. Thank you for this question. This is definitely something that has been occurring in the ophthalmology world for sometime. I would suggest you post your question on the Facebook page. You may get some good feedback there! https://www.facebook.com/groups/ascmanagers/ - [](https://progressivesurgicalsolutions.com/forums/reply/38556/) - Hi Annette. Thanks for the question. Here's the link to verify this: https://mcweb.apps.prd.cammis.medi-cal.ca.gov/references/sandi - [](https://progressivesurgicalsolutions.com/forums/reply/38523/) - Thank you for the feedback Apryl. Sharon - [](https://progressivesurgicalsolutions.com/forums/reply/38521/) - Hi Andi. Thank you for this question. Texas has NHSN and TxHSN reporting requirements for ASCs. There is SSI reporting and PAE reporting. However, last time Progressive checked into this, ASCs were exempt from the NHSN and TX SSI reporting requirement. Although an SSI falls into the category of a PAE, the PAE has to - [](https://progressivesurgicalsolutions.com/forums/reply/38519/) - Hi Missy. Thank you for this question. Perhaps a fellow eSupport member may have something to share. I would also encourage you to put this on the Facebook page. You may also want to check with your state regulation agency to obtain a sample of this as it will be specific to your state's requirements. - [](https://progressivesurgicalsolutions.com/forums/reply/38516/) - Hi Sharon. Thank you for this question. Biologicals are typically ran at the beginning of each day with a results in one hour. Biologicals should be ran in accordance with your sterilizer's MIFU. While a chemical indicator should be on the inside and outside of each wrapped / closed container load, it is not traditional - [](https://progressivesurgicalsolutions.com/forums/reply/38509/) - Yes, if you're QUAD A you still need to follow this. No, we do not have a form that meets this QUAD A standard but perhaps another member does! - [](https://progressivesurgicalsolutions.com/forums/reply/38501/) - Hello, It was a QUADA standard. Historically, we have been able to allow the staff to complete themselves. The standard and I quote - Section 11 SubSection H item 4 "Each personnel record contains any health problems of individuals which may be hazardous to the employee, other employees, or patients, and a plan of action - [](https://progressivesurgicalsolutions.com/forums/reply/38500/) - Hi Leslie. Thank you for this question. It is unlikely this is still recommended. However, please see this page from the CDC: https://www.cdc.gov/quarantine/vhf/interim-guidance-risk-assessment.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fquarantine%2Finterim-guidance-risk-assessment-ebola.html and then contact your local health department. - [](https://progressivesurgicalsolutions.com/forums/reply/38499/) - Hi Jazmine. Thank you for this question. Do you require a health screening prior to employment or annual health screenings? If so, do you require the employee visit their PCP for this? Or, do you allow them to complete this on their own? - [](https://progressivesurgicalsolutions.com/forums/reply/38498/) - Hi Michelle. Thank you for this question! No, there is not a consent that is required for the patients to participate in the OAS CAHPS survey. This does not require patient consent. You can make mention of protecting the patient's privacy in the BAA but everyone involved is a covered entity. You can learn more - [](https://progressivesurgicalsolutions.com/forums/reply/38491/) - Hi Jazmine, Medical Assistants (MAs) are unlicensed and cannot administer medications in the ASC due to the CMS CfC and they cannot establish IV access. This is a major difference from the LVN's scope. You can use an MA in the ASC but again, they must work within their scope, which is provided by the - [](https://progressivesurgicalsolutions.com/forums/reply/38490/) - Hi Michelle. Thank you for this question. Because the MIFUs state to only clean the containers if in the OR with a patient or if visibly soiled, you should address this in policy and reference the MIFU. Because the manufacturer allows you to make the call regarding cleaning under normal conditions (taken from OR prior - [](https://progressivesurgicalsolutions.com/forums/reply/38489/) - Hello Thank you for your response, what about Medical Assistance? - [](https://progressivesurgicalsolutions.com/forums/reply/38481/) - Hi Missy. Thank you for this question. I hope one our members is able to assist you! You may want to consider posting your question on our Facebook page, too. Here's the link to join if you haven't yet: https://www.facebook.com/groups/ascmanagers/ - [](https://progressivesurgicalsolutions.com/forums/reply/38480/) - HI Jazmine. Thank you for this question. Yes. LVNs can work in the ASC setting. However, they do need to practice within their scope and there are certain tasks that LVNs cannot perform. The scope of practice is dictated by the state and the board issuing the licensure. An example of a limitation would be: - [](https://progressivesurgicalsolutions.com/forums/reply/38469/) - Hi Nicole. Thank you for your question. Please navigate to Life Safety Code > HVAC Maintenance for a video regarding air balancing. This discusses TJC requirement. Progressive recommends ASC follow the AORN guidelines for this topic. AORN references ANSI/ ASHRAE/ ASHE and the FGI guidelines. The decontamination/dirty room(s) should be negative pressure compared to adjacent - [](https://progressivesurgicalsolutions.com/forums/reply/38468/) - Yes, Nicole. We do plan to have another benchmarking study in 2024. Do you have an area of interest to suggest? - [](https://progressivesurgicalsolutions.com/forums/reply/38463/) - Will there be another one for 2024? - [](https://progressivesurgicalsolutions.com/forums/reply/38450/) - Thank you, Apryl Sharon - [](https://progressivesurgicalsolutions.com/forums/reply/38437/) - Hi Michelle. Thank you for this question. If you're state licensed, you will need to contact your state licensure department regarding this question. Changing your patient population may require notification to both your state and accrediting organization, if you're accredited. If you're admitting a pediatric patient to your center, it may not necessarily matter that - [](https://progressivesurgicalsolutions.com/forums/reply/38436/) - Hi Sharon. Thank you for this question. Goals and thresholds for follow up are different. In example, your goal may be 100% compliance but just because you're at 98% doesn't mean follow up action is warranted. Your center can use a recognized source to revise established goals and thresholds and you do not have to - [](https://progressivesurgicalsolutions.com/forums/reply/38425/) - Hi Donna. Thank you for this question. Smoke evacuation requirements vary by state. The sample policy is to help you get started with meeting these requirements but customization may be required. Smoke evacuation education, training, and inservicing will vary depending upon your unique setting (i.e., procedures requiring smoke evacuation, state laws, equipment involved, etc.). However, - [](https://progressivesurgicalsolutions.com/forums/reply/38424/) - Hi Lisa. Thank you for this question. All patient's admitted to the ASC, regardless of the level of anesthesia or complexity of the planned procedure, are subject to CMS §416.52 Condition for coverage – Patient Admission, Assessment and Discharge. The patient's post-surgical assessment shouldn't be deferred and the chart wouldn't include the required components in - [](https://progressivesurgicalsolutions.com/forums/reply/38423/) - Thank you for the question, Emily. You will need to add Fentanyl to your facility formulary. The formulary is reviewed and approved by your Governing Body. You will also want to confirm you have Naloxone available in the event too much Fentanyl is administered or any additional emergency equipment you may need to help support - [](https://progressivesurgicalsolutions.com/forums/reply/38415/) - Hi Sharon. Thank you for this question. No, physician satisfaction is not a required measure. If you don't wish to collect this data then you can delete it or replace with another measure. Some ideas for your survey, if you opted to collect this date, would be: ease of scheduling cases, adequacy of block time - [](https://progressivesurgicalsolutions.com/forums/reply/38390/) - Hi Susan. Thank you for this question. No, your clerical personnel aren't required to have BLS per CMS or accrediting organizations. However, you should check your state regulations, too. You should have a policy to outline which staff are required to have BLS, ACLS, and PALS (as applicable). BLS training for all staff has an - [](https://progressivesurgicalsolutions.com/forums/reply/38376/) - Hi Jessica. Thank you for this question. Yes, this just occurred last month and has made verifying DEAs more difficult. Please see this notice: https://www.deadiversion.usdoj.gov/Dear_Registrant.pdf We have just started asking clients to navigate this new process. Feel free to message us back to let us know if you're successful with the Registrant Datasets Access (RDA) - [](https://progressivesurgicalsolutions.com/forums/reply/38375/) - Hi John. Thank you for this question. Be sure to review your Operating Agreement and/or Governing Body / Medical Staff bylaws about this. You may find this is outlined there. Typically, in the ASC we see $1M / $3M but your bylaws may be different. You could also speak with your liability carrier to discuss - [](https://progressivesurgicalsolutions.com/forums/reply/38374/) - Hi Nicole. Thank you for this question. Yes! We just did an efficiency benchmarking study in Dec 2023 if you haven't seen that yet. But yes, we will. Do you have suggestions for topics? We discuss this on our Facebooks page, too. If you'd like to join, here's the link: https://www.facebook.com/groups/ascmanagers/ Have you registered for - [](https://progressivesurgicalsolutions.com/forums/reply/38373/) - Hi Tabatha. Thank you for this question. This comes up during AAAHC surveys quite often. We recommend you outline all the specific considerations you take for your pediatric patients in this policy. In example 1.) stocking pediatric-sized emergency equipment in the crash cart, 2.) pediatric medications and dosing, 3.) staff education specific to pediatrics (PALS), - [](https://progressivesurgicalsolutions.com/forums/reply/38352/) - Following - [](https://progressivesurgicalsolutions.com/forums/reply/38327/) - Hi Emily. Thank you for this question. We would recommend you abide by the 10-year ruling from the WA State Medical Association because Title 70, Public Health & Safety doesn't address this for ASCs, only for hospitals. There is no required method in which you retain records (paper or electronic) only that they are retrievable - [](https://progressivesurgicalsolutions.com/forums/reply/38319/) - Thanks so much! - [](https://progressivesurgicalsolutions.com/forums/reply/38318/) - Hi Andi. Thank you for this question. The external physician peer reviewer should sign a confidentiality agreement. Removing patient identifiers is a great first step but doesn't protect the practice and physicians entirely. You can either include confidentiality language in the agreement you have with the reviewer, ask him to sign a BAA, or modify - [](https://progressivesurgicalsolutions.com/forums/reply/38317/) - Hi Anna. Thank you for this question. Heated ultrasonics are required when a high level disinfectant or other solution that you're using to process your instruments needs to remain at a certain temperature according to the MIFU. This will depend upon the instruments you're processing and the solutions you're using in the instrument processing department. - [](https://progressivesurgicalsolutions.com/forums/reply/38316/) - Hi Emily. Thank you for this question. Unlike some organizational changes, a change in hours isn't reportable to TJC. Yes, you'll need to update your HOH in policy and then also what is posted on your building and your phone system. Be sure to check your state and TJC portals to see if you provided - [](https://progressivesurgicalsolutions.com/forums/reply/38315/) - Hi Andi. Thank you for this question. The staff member conducting post-op calls does not need to be a nurse. However, there should be a procedure for when the call may need handed off to a nurse for additional phone assessment. In example, if the patient reports pain, bleeding or questions about medications, an RN - [](https://progressivesurgicalsolutions.com/forums/reply/38314/) - Hi Anna. Thank you for this question. Here is a checklist resource: https://www.asra.com/docs/default-source/guidelines-articles/local-anesthetic-systemic-toxicity-rgb.pdf?sfvrsn=33b348e_2 Here is a link for a podcast and additional information to help build your protocol and support staff training: https://www.apsf.org/article/local-anesthetic-systemic-toxicity-last-revisited-a-paradigm-in-evolution/ Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you there! - [](https://progressivesurgicalsolutions.com/forums/reply/38313/) - Diana. Thank you for this question. Yes, this is fine. Just be sure that the cryoablation tank is secured, stored, and transported in accordance with NFPA guidelines. The ASC should document the tank level to ensure there is always adequate supply and your staff should be educated regarding safe handling and storage of the gas. - [](https://progressivesurgicalsolutions.com/forums/reply/38312/) - Hi Sharon. Thank you for this question. Yes, medical staff should be included in your mandatory annual education and training program. Use the "Competency Assessment - Annual" in your PSS HR manual to document this. We wouldn't recommend omitting anything from this list. Review the Mandatory Inservice and Education Requirements Summary under CE Management to - [](https://progressivesurgicalsolutions.com/forums/reply/38302/) - Do you know if they are preloaded? - [](https://progressivesurgicalsolutions.com/forums/reply/38293/) - I think FCI and I believe JnJ just launched one - [](https://progressivesurgicalsolutions.com/forums/reply/38280/) - Hi Nicole. Thank you for this question. The accrediting organizations (AOs) may review your compliance with ST108 during survey as an extension of the CMS CfC standard that requires ASCs to select nationally recognized guidelines for their infection control program. Typically, ANSI / AAMI is the standard selected by centers when it comes to instrument - [](https://progressivesurgicalsolutions.com/forums/reply/38279/) - Hi Alexis. Thank you for this question. Yes, there are weekly sprinkler inspections that need to occur. They will vary based upon the manufacturer's recommendations for your unique system. We suggest you work with the sprinkler vendor to determine what these are. In the interim, be sure to review the eSupport > Life Safety Code - [](https://progressivesurgicalsolutions.com/forums/reply/38278/) - Hi Kathy. Thank you for this question. Here is a link from the AMA that may be helpful: https://www.asahq.org/quality-and-practice-management/managing-your-practice/timely-topics-in-payment-and-practice-management/anesthesia-payment-basics-series-3-payment-conversion-factors-modifiers We would also suggest that you contact your MAC and/or other payers. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you there! - [](https://progressivesurgicalsolutions.com/forums/reply/38277/) - Hi Jazmine. Thank you for this question. Yes, the same protocols for beginning and end of day counts would apply. The clinic and the physician's DEA would be held liable for diversion or mishandling. You should refer to California's Board of Pharmacy requirements for controlled substance handling. Have you registered for the NLC yet? Here’s - [](https://progressivesurgicalsolutions.com/forums/reply/38243/) - Hi Keyanna. Thank you for this question. We hope you get some good responses. There has been a great deal of discussion about this on our Facebook page. You may want to check there if you haven't yet. Here is the link: https://www.facebook.com/groups/ascmanagers/ Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We - [](https://progressivesurgicalsolutions.com/forums/reply/38242/) - Hi Amy. Thank you for this question. This would be in your state's ASC regulations. Your state may automatically defer to the CMS conditions for coverage as their adopted regulations. In this case, you would follow as provided above. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you - [](https://progressivesurgicalsolutions.com/forums/reply/38241/) - Hi Missy. Thank you for this question. Because you aren't able to verify the reliability of the patient's device, you should use your ASC's glucometer that undergoes quality control testing per the MIFU for documentation and patient care purposes. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you - [](https://progressivesurgicalsolutions.com/forums/reply/38239/) - Hi Jessica. Thank you for this question. Your patients can wear street clothes into the OR but it is recommended their clothing be covered by a blanket. Their shoes and hair should be covered, too. Housekeeping should change into OR scrubs that are professionally laundered or wear a bunny suit. Have you registered for the - [](https://progressivesurgicalsolutions.com/forums/reply/38237/) - Hi Alexis. Thank you for this question. You do not need to have the cabinet labeled. A cabinet with a glass door is a great idea for visibility. However, your staff must know where to locate the SDS manual and this should be in policy, too. Be sure to label the manual SDS on the - [](https://progressivesurgicalsolutions.com/forums/reply/38236/) - Hi Gabrielle. Thank you for this question. Correct, you cannot mix more than 3 medications in the ASC due to USP 797. It is a CMS and AAAHC requirement that you follow USP 797. You will need to use a compounding pharmacy to be in compliance or change the mixture to only 3 solutions. Have - [](https://progressivesurgicalsolutions.com/forums/reply/38235/) - Andi - if you're administering this to patients within the ASC then it should be on your formulary. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you there! - [](https://progressivesurgicalsolutions.com/forums/reply/38234/) - Hi Nicole. Thank you for this question. We hope you get some good responses from the group. If not, I would recommend you reach out on the Facebook group. There has been some recent discussion about the ST108 on there as well. Here is the link for the FB group if you haven't joined yet: - [](https://progressivesurgicalsolutions.com/forums/reply/38217/) - Follow-up question on this subject - where would we find out if our state still requires a transfer agreement? - [](https://progressivesurgicalsolutions.com/forums/reply/38178/) - Thank you! Do artificial tears need to be listed in the med rec as well? I lot of our patients use them, but I am not sure if it qualifies as a medication. - [](https://progressivesurgicalsolutions.com/forums/reply/38176/) - Hi Amy. Thank you for this question. If you're making the distilled water then this needs to be tested and then the steam from your Statim needs to be tested. Please see the eSupport > Infection Control > Water Quality page to find the testing specifications and frequencies for critical and steam water. It sounds - [](https://progressivesurgicalsolutions.com/forums/reply/38175/) - Hi Alexis. Thank you for this question. You can document that medication reconciliation was done via EHR. You do not need to document this on paper. Just make sure you capture the requirements of med rec in your documentation. This includes completing a list of medications, vitamins, nutritional supplements, and over-the-counter drugs at the start - [](https://progressivesurgicalsolutions.com/forums/reply/38174/) - Hi Emily. Thank you for this question. Yes, you can do this but then the staff won't receive credit for the quiz. The online quiz needs to be completed for the system to issue a certificate and for the course to be reflected as completed on their transcript. We suggest you have the staff read - [](https://progressivesurgicalsolutions.com/forums/reply/38172/) - Hi Connie. Thank you for this question. Patients who report pain but decline intervention wouldn't be included in the reporting because this is the patient's right to refuse. For this indicator, which is currently "Number of patients with pain being treated as effectively as possible", the numerator would be how many patients with pain that - [](https://progressivesurgicalsolutions.com/forums/reply/38171/) - Hi Carson. Thank you for this question. The risk assessment called for in the NFPA 99 code is the Facility Building and Category risk assessment found under eSupport > Risk Assessments. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you there! - [](https://progressivesurgicalsolutions.com/forums/reply/38170/) - Hi Alexis! Thank you for this question. This may be a great question for our Facebook group! Here is the link if you haven't joined yet: https://www.facebook.com/groups/ascmanagers/ Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you there! - [](https://progressivesurgicalsolutions.com/forums/reply/38151/) - Perfect. Thank you. I think I was over thinking it. Thanks - [](https://progressivesurgicalsolutions.com/forums/reply/38149/) - I have two questions related to the QAPI performance indicator on patients “being treated as effectively as possible for pain”. We assess all patients for pain as per best practice, but when obtaining the QAPI tracking data should we just include patients treated for pain and exclude patients who have c/o pain but refused treatment.? - [](https://progressivesurgicalsolutions.com/forums/reply/38146/) - Hi Anna. Thank you for this question. Core principle #7 applies when you are an office-based surgery center and is provided in the standards. It reads: AMA Core Principal #7—Physicians performing office based surgery must be currently board certified/qualified by one of the boards recognized by the American Board of Medical Specialties, American Osteopathic Association, - [](https://progressivesurgicalsolutions.com/forums/reply/38144/) - Hi ladies! We realize sterile water can be difficult to get, especially in large quantities but just be sure this follows the instrument MIFUs! Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you there! - [](https://progressivesurgicalsolutions.com/forums/reply/38143/) - Hi Erin. Thank you for this question. If using a standalone consent for this, it should be signed following the incident and prior to the blood draw. You can add this language to your facility consent for the patient to sign ahead of the surgery but you would still want to have a documented conversation - [](https://progressivesurgicalsolutions.com/forums/reply/38142/) - Hi Jennifer. Thank you for this question. Yes, sharps bins should be secured from tampering. This means that your sharps bins should be in a locking device that is secured to a cart or wall. They shouldn't be kept in a way that someone could walk off with the bin or accidentally knock it over. - [](https://progressivesurgicalsolutions.com/forums/reply/38141/) - Hi Renee! Thank you for this question. Please see Quality Management > Overview for this. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you there! - [](https://progressivesurgicalsolutions.com/forums/reply/38123/) - Thank you, I will look into this! - [](https://progressivesurgicalsolutions.com/forums/reply/38120/) - We use a product called SalJet - available from Henry Shein- to dilute our betadine scrub. Saline works for this and for sterile field use, we no longer use sterile water on the field, instead, Scrubs wipe instruments with instrument wipe moistened with saline and these are immediately processed. - [](https://progressivesurgicalsolutions.com/forums/reply/38101/) - Does the consent need to be acquired prior to surgery? For example add to our Consent for Surgery since the patients receive anesthesia for procedures? - [](https://progressivesurgicalsolutions.com/forums/reply/38100/) - Hi Tabatha. Thank you for this question. It is a CMS CfC and a AAAHC standard that you select nationally recognized guidelines for your infection control program, which includes your instrument cleaning, disinfection, and sterilization program. ANSI / AAMI is the nationally recognized guideline for instrument processing. AORN and the CDC both reference reference ANSI - [](https://progressivesurgicalsolutions.com/forums/reply/38098/) - Hello, Does this apply to all ASCs? We follow AAAHC standards, as well our our state regulations. I hadn't seen anything about this prior to now so I'm wondering if we need to work on this? We use a water system in our decontamination area but our sterilizers use our building water. Would appreciate any - [](https://progressivesurgicalsolutions.com/forums/reply/38088/) - Hi Jazmine. Thank you for this question. The MH policy is available on eSupport, which includes an outline of the algorithm. This is under Policies and Procedures > Anesthesia / Medical Management. You can also find additional resources, including the MH staff training and protocol on the MHAUS website, which is the official resource for - [](https://progressivesurgicalsolutions.com/forums/reply/38087/) - Hi Susan. If your instruments are never exposed to the water coming from your building; utility, critical, or steam (including your ultrasonic / washer / autoclave, if applicable) then the ST108 wouldn't be applicable. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you there! The $90 off sale - [](https://progressivesurgicalsolutions.com/forums/reply/38086/) - Hi Keri. Thank you for this question. We don't have the policy that addresses the wet room risk assessment on eSupport but you can include the following language in an existing policy regarding risk assessments or OR environment safety: An operating room “wet” area risk assessment will be developed initially and reviewed/revised as needed. This - [](https://progressivesurgicalsolutions.com/forums/reply/38085/) - Hi Leslie. Thank you for this question. What occurs with a retiring surgeon's privileges depends upon your medical staff bylaws. In example, your bylaws may have a minimum number of cases the surgeon must perform annually to remain active or there may be other medical staff membership levels (i.e., honorary). Instead of ending his privileges, - [](https://progressivesurgicalsolutions.com/forums/reply/38084/) - Hi Michelle. Thank you for this question. Ophthalmic instruments should be cleaned with a neutral, low sud, non-enzymatic detergent. Please see the position statement from ASCRS and keep on file as some of the instrument MIFUs may call for the use of an enzymatic detergent, which can increase the risk for TASS. https://ascrs.org/-/media/files/advocacy/recommendations-re-enzyme-final.pdf McKesson and - [](https://progressivesurgicalsolutions.com/forums/reply/38065/) - Hi Apryl, We only use bottled distilled water in our autoclaves so again, the ST108 would not apply? - [](https://progressivesurgicalsolutions.com/forums/reply/38060/) - Hi Sharon. Thank you for this question. Yes, you are using this tool correctly. However, it does not need to be conducted each surgical day and quarterly is adequate. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you there! - [](https://progressivesurgicalsolutions.com/forums/reply/38059/) - Hi Jazmine. Thank you for this question. Expanding anesthesia services requires review and revision of your formulary, including the potential expansion of what medications you're going to have on your crash cart. In example, you'll require malignant hyperthermia rescue drugs and supplies. You will require an anesthesia machine / gases and additional monitoring equipment if - [](https://progressivesurgicalsolutions.com/forums/reply/38058/) - Hi Susan. Thank you for this question. The ANSI / AAMI ST108 only addresses the utility, critical, and steam water quality that comes from your building's water supply. Therefore, if your instruments are never in contact with this water, the ST108 wouldn't apply in your case. If you use an autoclave, the steam quality guidelines - [](https://progressivesurgicalsolutions.com/forums/reply/38025/) - Hi Carson - the rating of occupancy separation walls varies depending upon the adjacent occupancy definition or use as found in NFPA 101 - 2012. At a minimum, unless noted otherwise by Table 6.1 (NFPA 101), the occupancy separation wall shall be rated for one-hour. Regarding interior walls for rooms containing a slightly higher degree - [](https://progressivesurgicalsolutions.com/forums/reply/38024/) - Hi Alexis. Thank you for this question. No, you can't use an IV bag for multiple patients because IV bags are a single patient / single use item. You may want to ask your question on the Facebook page if you're a member. We also recommend you reach out to your local ASCs and hospitals - [](https://progressivesurgicalsolutions.com/forums/reply/38023/) - Hi Nicole. Thank you for this question. Evoqua Water Technologies | Xylem is a national company and may have a local rep. You may also want to check with Vert Environmental. They serve Orange, Los Angeles, Riverside & San Bernardino Counties. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to - [](https://progressivesurgicalsolutions.com/forums/reply/38022/) - Hi Keri. Thank you for the question. This depends entirely upon the nurse to patient ratio, the patient population, the floor plan, and the level of anesthesia services. Patients should be assessed by an RN upon admission and then need to be assessed by an RN prior to discharge, in addition to the post-anesthesia assessment - [](https://progressivesurgicalsolutions.com/forums/reply/38021/) - Hi Sharon. Thank you for this question. Chart review can be conducted at the conclusion of your day. It does not need to occur prior to the patient being discharged. You can adjust your policy to your current practice. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you - [](https://progressivesurgicalsolutions.com/forums/reply/37976/) - Apryl, thank you for your response, I'm struggling to find a company that does this, do you have any referrals or recommendations for SO-CAL? Thank you! - [](https://progressivesurgicalsolutions.com/forums/reply/37970/) - Hi Jazmine. Thank you for this question. I will attach a sample of this form to this thread. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you there! - [](https://progressivesurgicalsolutions.com/forums/reply/37969/) - Hi Alexis. Thank you for this question. Yes, the AORN guideline is to clean and maintain your ice maker in accordance with the manufacturer's recommendations due to the potential for contamination. Your facility policy should reflect the procedure and frequency for ice maker cleaning and this should be documented on a log. If you don't - [](https://progressivesurgicalsolutions.com/forums/reply/37330/) - Hi Jazmine. Thank you for this question. Progressive has a set of policies and procedures for Radiation Services that require customization for your facility. Please contact me via email to learn more. apryl@pss4asc.com Also, in the state of CA, you'll want to check out the information posted on the Radiologic Health Branch's website, if you - [](https://progressivesurgicalsolutions.com/forums/reply/37329/) - Hi Jazmine. Thank you for this question. Medical Assistants are limited in their scope and what functions they can perform without supervision. Using an MA in the ASC is permitted but they need to perform functions that are within their scope. This is set by the state and the certifying board and this should be - [](https://progressivesurgicalsolutions.com/forums/reply/37324/) - Hi Susan. Thank you for this question. The required components of an H&P is determined by your facility policy and state regulations. Since CMS no longer requires H&Ps (see CMS CfC §416.52(a): Standard: Patient assessment and admission for requirements) it is recommended you begin with your state regulations regarding history and physicals to determine what - [](https://progressivesurgicalsolutions.com/forums/reply/37321/) - Thank you, Apryl. This is very helpful. Sharon Bour, Clinical Director - St Lukes - [](https://progressivesurgicalsolutions.com/forums/reply/37320/) - Hi Gabrielle. Thank you for this question. Informing AAAHC is enough as CMS doesn't track the number of ORs you have. Remember to notify your state licensing board (as applicable) if you haven't already. There may be additional requirements in that regard. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope - [](https://progressivesurgicalsolutions.com/forums/reply/37317/) - Thank you for this question, Beverly. This would depend upon the reason for their concern. Is there a concern for loss/theft, infection, airway obstruction, reflection risks due to lasers, accidental injury, or thermal injury/burns during electrocautery? In example, in the event of thermal injury risk due to electrocautery use, we only need to concern ourselves - [](https://progressivesurgicalsolutions.com/forums/reply/37316/) - Hi Annette. Thank you for this question. Right on! Logs should be kept for the duration of your accreditation cycle. If you're not accredited, we recommend three years. Have you registered for the NLC yet? Here’s the link! https://ascnurseleadership.com/ We hope to see you there! - [](https://progressivesurgicalsolutions.com/forums/reply/37315/) - Hi Nicole. Thank you for this question. The specific water testing requirements for your facility begin with partnering with a water quality specialist that is familiar with the water in your area and you water treatment system. Yes, some tests do include a dipstick and others require the sample being sent to a lab. No, - [](https://progressivesurgicalsolutions.com/forums/reply/37314/) - Hi Sharon. Thank you for the question. Yes, there are specific policies you need to follow when receiving and handling tissue. While you may not find this in regulation, there are best practices. Examples include examining and loggings outer box, tissue, and temperature integrity upon delivery, storage temperatures and logging (we recommend continuous temp monitoring), - [](https://progressivesurgicalsolutions.com/forums/reply/37270/) - Hi Stacy. Thank you for this question. We don't have the entire set of Medical Records policies and procedures available on eSupport. These policies often require some degree of customization, depending upon your facility and of course, whether you're EHR or paper. If you'd like assistance in switching your medical records policies over to EHR, - [](https://progressivesurgicalsolutions.com/forums/reply/37269/) - Hi Jessica. DOT training is required at hire and every 3 years, if applicable to the staff member's job. You can find the cadence of required education, training, inservice, and competencies under Human Resources > Orientation & Education. - [](https://progressivesurgicalsolutions.com/forums/reply/37266/) - does anyone know how often staff need DOT training? is it annually or just on hire? - [](https://progressivesurgicalsolutions.com/forums/reply/37248/) - Hi Connie. Thank you for this question! We suggest you contact waste disposal company first. Explain your concerns. They may have solutions, especially considering the damage the truck is causing to your property. You may also be able to contract with a private carrier to take your trash to the processing center / dump. Finally, - [](https://progressivesurgicalsolutions.com/forums/reply/37247/) - Hi Beverly. Thank you for this question. Great timing! We'll be publishing this to eSupport very soon. You will be able to find the 2024 data under Business Ops > Medicare Fee Schedule. - [](https://progressivesurgicalsolutions.com/forums/reply/37237/) - Hi Michelle - in addition, the codes adopted by CMS are the standard nationwide. It is upsetting to know that things may have been missed or interpreted differently by various surveyors in the past. I know that some surveyors have more experience in certain areas than others. In any event, all deeming agencies acting on - [](https://progressivesurgicalsolutions.com/forums/reply/37236/) - Hi Michelle - in addition, the codes adopted by CMS are the standard nationwide. It is upsetting to know that things may have been missed or interpreted differently by various surveyors in the past. I know that some surveyors have more experience in certain areas than others. In any event, all deeming agencies acting on - [](https://progressivesurgicalsolutions.com/forums/reply/37235/) - Hi Keri. Thank you for this question. No, a CMS-certified ASC in the state of CA doesn't need to be accredited. However, some insurance companies do require accreditation. CA ASCs must be state licensed (which many cannot be due to CA law), OR accredited, OR CMS-certified if administering anesthesia. Have you registered for the NLC - [](https://progressivesurgicalsolutions.com/forums/reply/37234/) - Hi Keri. Thank you for this question. While this protocol doesn't necessarily violate any CMS CfC, there may be room for improvement in terms of best practice and patient safety. Patients that have received sedation and then a RBB are susceptible to low BP, lightheadedness, and/or syncope. Ambulating back to the OR does pose a - [](https://progressivesurgicalsolutions.com/forums/reply/37233/) - Hi Annette. Thank you for the question. Yes, it is true that CMS no longer requires a transfer agreement. However, some states still require this. If you no longer maintain a transfer agreement then you do not need to collect this information any longer. We do have a sample periodic written notice and additional explanation - [](https://progressivesurgicalsolutions.com/forums/reply/37186/) - Hi Heather. Thank you for this question. The requirements for SB 809/Rider 143 expired as of August 31, 2023. Please see this link for more information : https://pfd.hhs.texas.gov/provider-finance-communications#SB809Rider143COVID19ReportingHealthcareInstitutionListUpdated10032023 - [](https://progressivesurgicalsolutions.com/forums/reply/37185/) - Hi Michelle. Thank you for this question. We work with both organizations and both organizations have adapted to the ever-changing CMS CfC for ASCs and the stipulations placed on them by CMS as a deeming authority. We suggest you develop a list of questions regarding the items of concern and importance to you and contact - [](https://progressivesurgicalsolutions.com/forums/reply/37073/) - Hi Lisa. Thank you for this question. The NFPA 101 21.7.8 states portable space-heating devices shall be prohibited in all ambulatory health care occupancies, unless both of the following criteria are met: (1) Such devices are used only in nonsleeping staff and employee areas and (2) The heating elements of such devices do not exceed - [](https://progressivesurgicalsolutions.com/forums/reply/37071/) - Hi Keyanna. Thank you for this question. First, you'll want to review your state requirements, if any, for the use of lasers in a medical setting (registration, Laser Safety Officer registration, etc.). If you're accredited, you should review the standards, too. Next, in certain applications, a laser may be considered a heat-producing device so look - [](https://progressivesurgicalsolutions.com/forums/reply/37070/) - Hi Debra. Thank you for this question. We do have a sample privilege request form on eSupport for an ophthalmologist. You could use it to get started. This is under Medical Staff Credentialing > Privileges. For a CRNA, you would want to include all the forms of anesthesia they provide (IV sedation, local, topical, regional, - [](https://progressivesurgicalsolutions.com/forums/reply/37069/) - Hi Susan. Thank you for this question. Smoke detectors are installed for varying reasons such as to active a device to halt smoke spread, such as a door or damper, or due to the location / content of the room that is combustible in nature. This is a question you'd want to review with your - [](https://progressivesurgicalsolutions.com/forums/reply/37068/) - Hi Annette. Thank you for the question. Review your medical staff bylaws to determine if there is language in there regarding how to recredential a provider that has no internal peer review or case review items. Also, determine if he's met the threshold to maintain active medical staff membership. Review this with your Medical Director - [](https://progressivesurgicalsolutions.com/forums/reply/37051/) - My reception area is directly in front of the front door (very poor design) we are not allowed space heaters, but she uses a heated throw over her lap which helps. Lisa - [](https://progressivesurgicalsolutions.com/forums/reply/37036/) - Hi Thelma. Thank you for this question. Yes. If the surgeon has signed off on the patient's discharge from the facility, you just need to have an ACLS provider available until the patient has been discharged. This doesn't even necessarily need to be a CRNA, it can be an RN with ACLS, too. However, you - [](https://progressivesurgicalsolutions.com/forums/reply/37016/) - Hi Susan. Thank you for this question. This answer can vary by MAC and payer. We highly recommend you check with them prior to submitting the claim for complex cataract surgery due to the use of a dye. Here is an article from CMS but please keep in mind this is a Local Coverage Article: - [](https://progressivesurgicalsolutions.com/forums/reply/37010/) - Hi Jazmine, thank you for the question. AORN recommends you monitor patients intraoperatively, even when only providing local anesthesia. You, along with the Medical Director / Governing Body can determine what will be monitored (BP, RR, HR, SpO2, etc.) and how often you will cycle the monitor and document (every 5, 8, 10 minutes). The - [](https://progressivesurgicalsolutions.com/forums/reply/36992/) - Hi Emily, Opening syringes and needles the day before you use them is not a best practice and is an infection control risk. Because you're using these syringes and needles to handle medications, the USP for sterile preparations and the CDC's safe injection practices apply. We recommend you work with a consulting pharmacist to - [](https://progressivesurgicalsolutions.com/forums/reply/36991/) - Hi Stacy, You do not need two RNs in the OR when anesthesia isn't administered. You only need 2 RNs in the room (one to circulate and one to monitor) when there isn't an anesthesia provider (CRNA, anesthesiologist) in the OR and the patient has been sedated. No, an IV is not required, this is - [](https://progressivesurgicalsolutions.com/forums/reply/36990/) - Hi Megan, As far as we know, splitting single dose vials is not permitted in the ASC under any circumstances. Our suggestion would be to network with local ASCs and/or hospitals to work through a backorder and also check out the Medication Management: Overview > Medication Shortages section, which provides the link for the FDA's - [](https://progressivesurgicalsolutions.com/forums/reply/36989/) - Su-Ann, You should onboard your agency staff with the same facility orientation as your hired staff. Create a file for your agency nurses, just like you could for a traditional employee with a signed job description. Fortunately, the agency should have a great deal of the documentation (licensure verification, vaccination records) so you can just - [](https://progressivesurgicalsolutions.com/forums/reply/36988/) - Hi Connie, Influenza vaccination and prevention is a best practice and a CDC recommendation. However, your facility can make its own determination regarding influenza vaccination and/or declination for staff based upon your setting, services, and patient population. Hospitals will often require flu vaccination, badge staff, and require masking for those who declined due to the - [](https://progressivesurgicalsolutions.com/forums/reply/36987/) - Hi Michelle, According to the CMS CfC, the operative note must include the findings and techniques of the operation, including a pathologist’s report on all tissues removed during surgery, except those exempted by the governing body, and any complications, allergies or adverse drug reactions that occurred. While the detail of the operative note may vary - [](https://progressivesurgicalsolutions.com/forums/reply/36985/) - Hi Tiffany, This is something that has come up quite a few times with our clients and on our Facebook page. We have a policy drafted and it should be available soon! I will keep you posted. - [](https://progressivesurgicalsolutions.com/forums/reply/36984/) - Hi Laura, You don't need a specific policy regarding the ORA, however it should be part of your OR nurse's initial training and annual competencies. It can be on the orientation list you use just as ORA, or have some additional items (powering on, connecting to scope, monitor set-up, navigation, troubleshooting, etc) listed, too. You - [](https://progressivesurgicalsolutions.com/forums/reply/36978/) - Thank you for the question, Susan. We recommend you contact your MAC and/or third party payers because this could vary by contract. - [](https://progressivesurgicalsolutions.com/forums/reply/36975/) - The docs we work for have always told us that the HVF testing is good for a year. We only have one surgeon who does blephs and she is typically booked at least 3 months out. On average we usually do the surgery within 3-4 months of the testing. When we have a patient scheduled - [](https://progressivesurgicalsolutions.com/forums/reply/36957/) - Hi Jazmine. This question has two threads. Unfortunately, CMS denied Emily's challenge to this citation. Please see thread "CMS and over processing instruments" from Oct 9th. We haven't had any addition responses on this topic. - [](https://progressivesurgicalsolutions.com/forums/reply/36956/) - Hi Jazmine. Thank you for this question. Medical records are required to be retained in accordance with state law. This is typically 7 to 10 years. If the surgery center is out of business and no longer subject to state licensure, medicare, or accreditation surveys, then the QA documentation wouldn't need to be retained. However, - [](https://progressivesurgicalsolutions.com/forums/reply/36954/) - Any additional response. In curious - [](https://progressivesurgicalsolutions.com/forums/reply/36953/) - Closed, as in out of business. - [](https://progressivesurgicalsolutions.com/forums/reply/36922/) - Hi Bradley. Thank you for this question. The updates are available on eSupport, including a competency. Please see Medication Management > Compounding under eSupport. - [](https://progressivesurgicalsolutions.com/forums/reply/36921/) - Thank you for this question, Riley. This will depend upon your state regulations and accrediting organization standards. At a minimum, this is something that should be tracked and trended within your organization through your QAPI program. Depending on your state and accrediting organization, you may need to report this event because it occurred within hours - [](https://progressivesurgicalsolutions.com/forums/reply/36920/) - Hi Kathy. Thank you for this question. This would be at the point where your decontamination area HVAC system ends and vents to the outside (due to the negative air pressures in this space). This may be on your rooftop or on the side of your building. The sign would include that the exhaust is - [](https://progressivesurgicalsolutions.com/forums/reply/36914/) - Thank you so much! - [](https://progressivesurgicalsolutions.com/forums/reply/36913/) - Michelle, Not necessarily. If the RN is administering Fentanyl for the purposes of analgesia and not for sedation, then this would be different. However, if this is being administered in conjunction with a sedative or for the purposes of sedation, then yes, this would fall under the IVCS program. It would be highly recommended that - [](https://progressivesurgicalsolutions.com/forums/reply/36912/) - Dia, You can number your trays on the outside of the sterilization tray. There are autoclave/sterilization resistant markers and tags available for this purpose. - [](https://progressivesurgicalsolutions.com/forums/reply/36900/) - How do you number your trays? - [](https://progressivesurgicalsolutions.com/forums/reply/36899/) - Does the same apply to Fentanyl IV? - [](https://progressivesurgicalsolutions.com/forums/reply/36898/) - Hi Susan. Thank you for this question. This is a sample form for a diesel generator and reflects the NFPA requirements for this type of generator. When developing your weekly, monthly, qtrly, biannual, and annual inspection, testing, and maintenance schedule for your generator, this should be done with your generator vendor to ensure the manufacturer - [](https://progressivesurgicalsolutions.com/forums/reply/36893/) - Thank you for this question, Michelle. It is not a requirement that the patient's tray# be documented on their chart. Verification of the chemical indicators should be conducted by your OR staff when the sterilized items are brought into the OR to be opened. Your sterilization log with the printout is enough to verify that - [](https://progressivesurgicalsolutions.com/forums/reply/36890/) - Sure. In the AAAHC v42, Chapter 10, letter T. "The findings and techniques of a procedure are accurately and completely documented immediately after the procedure." Numbers 1 and 2: The health care professional who performed the procedure documents the findings and techniques. The documentation is immediately available for patient care. - [](https://progressivesurgicalsolutions.com/forums/reply/36889/) - Thank you for this question, Michelle. What you're referring to is an RN IV Conscious Sedation (IVCS) program. Yes, ACLS would be a requirement for the RN to administer the sedation. The RN should also have specific education, training, and competency documented to perform this. Yes, the MD must provide the order and is responsible - [](https://progressivesurgicalsolutions.com/forums/reply/36888/) - We are accredited by AAAHC MDS, however I've looked through the chapters and couldn't find any specific requirements regarding the operative note. Do you know in which chapter and/or section I might find the information? Thanks! - [](https://progressivesurgicalsolutions.com/forums/reply/36883/) - Hi Michelle. Thank you for this question. The important part is that the education is documented. However, AAAHC's Personnel Records Worksheet doesn't state these need to be IN the file. These items don't begin with "File contains ..." they are in their own section that state, "Documentation of initial orientation and training indicates that 3.D.1-6 - [](https://progressivesurgicalsolutions.com/forums/reply/36882/) - Thank you for this question, Annette. The form should provide the timeframe in which the provider is referring to. He should have marked "yes" if the form says "have you ever ...". You may want to ask him about this. Also, be sure to pull the NPDB to validate his responses or verify that you - [](https://progressivesurgicalsolutions.com/forums/reply/36881/) - Hi Gabrielle. Thank you for this question. Yes, this is a best practice and in some cases, a requirement. You may find this written in your state regulations. Also, are you accredited? AAAHC and TJC have specific requirements for a note entered into the chart when the operative note isn't immediately provided following the surgery. - [](https://progressivesurgicalsolutions.com/forums/reply/36862/) - Thank you for this question, Jessica. This isn't a requirement however, you should follow your facility policy. You may opt to keep the strips and attach to your crash cart log or document on the log that the machine was checked by verifying the strip but not necessarily keeping the strip as evidence. - [](https://progressivesurgicalsolutions.com/forums/reply/36837/) - Katherine, Your surgeons are more than likely already familiar with the risks of enzymatic cleaner and ophthalmic instruments. You could bring this joint position statement to the Governing Body of your facility and together make the formal decision to to implement non-enzymatic cleaner for those instruments in which the MIFU specifically calls for enzymatic cleaner - [](https://progressivesurgicalsolutions.com/forums/reply/36836/) - Hi Lisa. Thank you for this question. This is entirely up to your facility policy, the level of surgical services and anesthesia you provide, and your patient population. As Nicole stated, some facilities take each patient out in wheelchairs for their safety. Some centers may allow the family members to assist the patients out to - [](https://progressivesurgicalsolutions.com/forums/reply/36835/) - Hi Nicole. Thank you for this question! Navigate to eSupport > Policies and Procedures > Human Resources. There you will find the available sample job descriptions. - [](https://progressivesurgicalsolutions.com/forums/reply/36834/) - Hi Anna. Thank you for this. Cal-OSHA doesn't align with the CDC's recommendations for TB testing. However, centers have the flexibility to not adhere to Cal-OSHA and follow the CDC's guidelines through their flexibility program. We recommend you review this notice from the state when the CDC updated their guidelines and also contact your regional - [](https://progressivesurgicalsolutions.com/forums/reply/36832/) - in our facility in california we wheel every patients to their cars with their rides with us. - [](https://progressivesurgicalsolutions.com/forums/reply/36830/) - We are single special ophthalmology. We track trays. We document lot numbers only of compounded medications by our policy. This has proved useful in recalls. - [](https://progressivesurgicalsolutions.com/forums/reply/36829/) - How do you document the decision that we will not use detergents which goes against the IFU? - [](https://progressivesurgicalsolutions.com/forums/reply/36828/) - Thank you for this question, Susan. No, the medical record reviewer doesn't need to be an RN. However, it should be someone who is familiar with the required components and contents of the medical record so they can properly evaluate them. - [](https://progressivesurgicalsolutions.com/forums/reply/36827/) - Thank you for this question, Susan. This depends on that manufacturer's instructions for use (MIFU) that came with the dispenser. Some manufacturers may instruct you to check for a red light, for clogged tubing, cleanliness, freely-leaking ABHR, dead batteries, properly latched, not damaged, dispensing the appropriate amount, etc. - [](https://progressivesurgicalsolutions.com/forums/reply/36822/) - Hi! I have a follow up to this. It was my understanding that although the CDC had changed its guidleines, that Cal OSHA did not adopt these recommendations, and thus annual TB was still required in California Has this changed? - [](https://progressivesurgicalsolutions.com/forums/reply/36811/) - Thanks for the question, Tiffany. For the current exam, you may utilize either the CS Technical Manual, 8th Ed (2016) or the SP Technical Manual, 9th Ed (2023). These, along with ANSI/AAMI’s ST79 (2017), and AORN’s Guidelines for Perioperative Practice (2023) were used for reference in creating the CRCST exam. You can order these publications - [](https://progressivesurgicalsolutions.com/forums/reply/36810/) - Hi Jazmine. Thank you for the question. Enzymatic cleaners can cause TASS, which is why non-enzymatic cleaners should be used for ophthalmic instruments. Typically instruments that are entering the anterior segment do not get much blood on them. However, if the determination is made that an enzymatic is necessary, the rinsing protocol must be adhered - [](https://progressivesurgicalsolutions.com/forums/reply/36808/) - Hi Michelle. Thank you for your questions. Yes, if you identify a hazard that is likely to occur or to have devastating effects on your facility or life then you should have a policy and train your staff accordingly. You may want to specify the weather event, even if you include all in one policy. - [](https://progressivesurgicalsolutions.com/forums/reply/36754/) - I am going to answer my original question with another question... We completed the hazard vulnerability analysis for our facility and determined that an ice storm/snow are potential hazards as far as weather. Since we identified these events, and a couple of others, do we now have to have a policy pertaining to that event? - [](https://progressivesurgicalsolutions.com/forums/reply/36739/) - Emily, we're going to send out a Sharing is Caring to see what additional responses you receive. - [](https://progressivesurgicalsolutions.com/forums/reply/36729/) - Hello, I clarified with CMS as advised and was denied the challenge to the citation. We need to follow exactly the instrument IFU, despite ST79 and our sterilizer manual. What other nationally recognized sterilizer guidelines other than AAMI 79 are other ASCs using? We sterilize trays with instruments. How do other ASCs do this? - [](https://progressivesurgicalsolutions.com/forums/reply/36728/) - Thank you for that very helpful information. Sharon Bour - [](https://progressivesurgicalsolutions.com/forums/reply/36727/) - Thank you for clarifying. Sharon Bour - [](https://progressivesurgicalsolutions.com/forums/reply/36725/) - Hi Sharon. Thanks for reaching out. As you stated, this is a CDC recommendation for healthcare workers. Not all facilities collect vaccination records / titers for these diseases. Be sure that your policy is aligned with what you are collecting from staff at hire. TJC does have specific standards concerning influenza, OSHA has requirements concerning - [](https://progressivesurgicalsolutions.com/forums/reply/36724/) - Thank you, Sharon. We appreciate this feedback. Each state varies in regards to the workplace violence training. When there is a requirement, it is often for government employees and not for private organizations. That being said, we appreciate the feedback regarding the orientation and education checklist. - [](https://progressivesurgicalsolutions.com/forums/reply/36719/) - Apryl, I have a question related to Annette's question. Not all of our staff at St Luke's has documentation of MMR, Varicella vaccines, boosters, or titers. we only have proof of Hepatitis, Flu, and Covid. This is all we have had in employee files since we went through state and TJC surveys and we were - [](https://progressivesurgicalsolutions.com/forums/reply/36716/) - Thank you, Apryl. That is what is in one of our policies, but it was stated differently on a different page of the P&P manual. I will make the adjustment. Thanks again. Sharon Bour - [](https://progressivesurgicalsolutions.com/forums/reply/36715/) - Thank you for this question, Sharon. Conducting crash cart checks are only necessary on the days you're operational and you have patients in the facility. - [](https://progressivesurgicalsolutions.com/forums/reply/36704/) - Thank you for the question, Jazmine. Temperatures this cold place your patients at risk for hypothermia and hypothermia leads to an increased risk of multiple complications. When documenting these temperatures, a corrective/follow-up action should be documented to reflect the steps taken to correct this situation (contact HVAC company, turn thermostat up and check back in - [](https://progressivesurgicalsolutions.com/forums/reply/36703/) - Hi Emily. Thank you for this question. While it is best practice to have an RN Circulator in the OR, the state of WA has these two regulations regarding RNs: WAC 246-330-220 Recovery care. (3) Assure a registered nurse trained and current in advanced cardiac life support measures is immediately available for patients recovering from - [](https://progressivesurgicalsolutions.com/forums/reply/36696/) - Surgery Centers can only bill for the the facility fee. The expenses you listed are covered under the complex Cataract code, which unfortunately is the exact same reimbursement as a normal cataract. Drugs such as Dextenza can be reimbursed (under certain plans with the right authorization). You can check the ASC approved list of J - [](https://progressivesurgicalsolutions.com/forums/reply/36663/) - Thanks, do you have any literature to support. Your response was my understanding Gratitude! - [](https://progressivesurgicalsolutions.com/forums/reply/36654/) - Thank you for the question, Jazmine. If the ASC sent the pathology out then it is responsible for ensuring the physician receives the results. Specimen reports must be signed, dated and timed by the surgeon and placed in the patient’s medical record. This should be done regardless of the results. - [](https://progressivesurgicalsolutions.com/forums/reply/36653/) - Thank you for the question, Denise. Yes, succinylcholine is a triggering agent of malignant hyperthermia. If this medication is in your facility you must have the appropriate measures in place to rescue a patient in crisis. Your anesthesia personnel will more than likely wish to keep a muscle relaxant on the formulary should they need - [](https://progressivesurgicalsolutions.com/forums/reply/36652/) - Hi Emily. Thank you for this question. Unfortunately, citing ASCs for anything that remotely strays from the manufacturer's instructions for use for instrument processing is becoming commonplace for CMS. We recommend you follow the advise of the sterilizer technicians with the AAMI standard as evidence. further, the MIFU for the instrument refers to the 270F/4 - [](https://progressivesurgicalsolutions.com/forums/reply/36623/) - Hi Michelle. Thank you for this question. Yes, ST108 will most likely impact your policies and procedures. According to AAMI, the new standard identifies the categories of water quality that should be used during each stage of sterile processing, provides a risk analysis and establishes roles and responsibilities for processing facilities, assesses water quality based - [](https://progressivesurgicalsolutions.com/forums/reply/36609/) - Hi Megan. Thank you for the question. The reason that licensed nurses are used in pre-op and in the laser room is often due to the administration of drugs. The CMS CfC includes §416.48(a) Standard: Administration of Drugs that includes the language that the administration of the drugs or biologicals must be by, or under - [](https://progressivesurgicalsolutions.com/forums/reply/36604/) - Hi Emily. Thank you for the question. You'll want to review that manufacturer instructions for use (MIFU) for point of care use prior to decontamination. This will vary by instrument and by manufacturer. In the absence of MIFUs, then you move to nationally recognized guidelines, we suggest AORN. AORN recommends enzymatic pretreatment or a water-soaked - [](https://progressivesurgicalsolutions.com/forums/reply/36603/) - Hi Tabatha. Yes, 3 years is correct. Check out this link from the CDC: https://www.cdc.gov/infectioncontrol/guidelines/disinfection/sterilization/sterilizing-practices.html#:~:text=Sterilization%20records%20(mechanical%2C%20chemical%2C,and%20state%20and%20federal%20regulations. Just be sure your state doesn't have requirements that longer. - [](https://progressivesurgicalsolutions.com/forums/reply/36602/) - Hi Jessica. Thank you for this question. You may not find guidelines for this specific situation. Our suggestion would be to ensure the temp/humidity is appropriate in the storage facility and have procedures in place to ensure that the supplies do not get wet and/or exposed to temperature extremes for an extended time during transport. - [](https://progressivesurgicalsolutions.com/forums/reply/36595/) - Hi Emily. Thank you for your question. The implantation of an ICL needs to be reflected on your approved procedure list by the Governing Body. If the surgeon is competent in this procedure, then the board should also grant him privileges to conduct this procedure. So, make sure this procedure is also reflected on his - [](https://progressivesurgicalsolutions.com/forums/reply/36594/) - We use temp stick as well and you can set days and times of when you want it to notify you when it is outside of a certain range - [](https://progressivesurgicalsolutions.com/forums/reply/36588/) - great idea thank you so much!! - [](https://progressivesurgicalsolutions.com/forums/reply/36587/) - Hi Jessica. Thank you for the question. The crash cart and corresponding emergency supplies/equipment should be immediately available to the OR. These supplies do not need to be in the OR but must be accessible to the OR. Depending on the way your center is designed, you may determine that more than one set of - [](https://progressivesurgicalsolutions.com/forums/reply/36579/) - We use TempStick. - [](https://progressivesurgicalsolutions.com/forums/reply/36572/) - Hi Michelle. You may want to speak with a AAAHC representative before completing your application as such. Sometimes if centers are far apart geographically, the surveyors may opt for separate surveys, even if one or more is listed as a satellite. The PTAN will be different for each site but the tax IDs may be - [](https://progressivesurgicalsolutions.com/forums/reply/36571/) - Hi Emily. Thank you for your question. You should contact TJC ASAP. If you're deemed status through TJC, you may not be able to care for Medicare patients if your accreditation lapses. However, there is a 45 day window. To ensure adequate time is allowed for scheduling and for a survey to be conducted within - [](https://progressivesurgicalsolutions.com/forums/reply/36558/) - Hi Susan. Thank you for your question. Please review the Medical Record Audit Tool under Policies & Procedures > Nursing. We use this tool for centers that have both paper and electronic medical records. You can modify it to meet your needs. - [](https://progressivesurgicalsolutions.com/forums/reply/36552/) - We are a single specialty ophthalmology center and we document the instrument tray numbers directly on the sterilizer strip which then gets attached to our intraoperative report for the patient. We also document the BSS bags and provisc lot#s on our intraoperative report (circulator fills out). We then keep a log in the OR per - [](https://progressivesurgicalsolutions.com/forums/reply/36551/) - Hi Dia. Thank you for your question. Regarding the lot# tracking, this is a best practice but it isn't necessarily a requirement and is typically done with implants and medications, more so than supplies. If your staff are finding it difficult to document lot#s with limited time, you may opt to track lot#s on a - [](https://progressivesurgicalsolutions.com/forums/reply/36549/) - Thank you, Candas. OK. I understand what you're looking for. We do not have a sample policy for annual electrical panel testing / fire wall penetration checks. We suggest you work with your contractor and/or an electrician to determine what your policies should state for your facility. If you'd like to contact our Life Safety - [](https://progressivesurgicalsolutions.com/forums/reply/36546/) - We already complete all of these things and they are documented annually/biennially. The state is asking for a policy that reflects these requirements. The Receptacle Policy will suffice for polarity and tension testing but I can not find anything to cover annual scheduled electrical panel infrared testing or fire wall penetration checks. I need help - [](https://progressivesurgicalsolutions.com/forums/reply/36541/) - Hi Candas. Yes. Your receptacles should be tested for polarity and tension on an annual basis. Please see eSupport > Life Safety Code > Forms, Logs, and ITM Tools > Receptacle Testing Log. The Life Safety Code section on eSupport may help you find exactly what you're looking for. Our LSC engineer did confirm that - [](https://progressivesurgicalsolutions.com/forums/reply/36540/) - Hi Michelle. Thank you for this question. There are chairs available on Amazon that are up to a 500lb weight limit that are height adjustable, with a back, and armless. Here is an example: https://a.co/d/eDRnEge - [](https://progressivesurgicalsolutions.com/forums/reply/36539/) - Hi Leslie. Thank you for this question. 24 hours may be too long due to contamination concerns- not for the flush alone but also for the extension tubing. However, we suggest you check the manufacturer's instructions for use and then also discuss with your consulting pharmacist. - [](https://progressivesurgicalsolutions.com/forums/reply/36538/) - We use SensoScientific Temp/Humidity Monitoring that uses wifi to track and send data and alert when out of range. With it, we can create graphs and look at trends. Even when it appears to be offline, it is still tracking and sending data so that nothing is missed. Surgery Center of Northern California, Shasta Eye - [](https://progressivesurgicalsolutions.com/forums/reply/36522/) - Hi Emily. Thank you for this question. Donning gloves prior to eye drop administration is a recommendation and what we consider best practice. No, it is not a requirement and therefore, your staff should abide by your facility policy and procedure for eye drop administration. - [](https://progressivesurgicalsolutions.com/forums/reply/36520/) - My apologies. You are correct. The code is actually Q0108 under building safety. - [](https://progressivesurgicalsolutions.com/forums/reply/36519/) - Hi Candas. Thank you for your question. I want to make sure I understand what you're asking. Q0042 Hospitalization in Appendix L, the CMS CfC refers to §416.41(b) Standard: Hospitalization, which has to do with handling emergencies in the ASC via hospital transfer. The items in your question are NFPA Life Safety Code requirements. I'm - [](https://progressivesurgicalsolutions.com/forums/reply/36513/) - Hi Emily. Thank you for this question! Please visit Patient Safety > Culture of Safety under eSupport to learn about this topic. Here is a link to the SOPS survey for the ASC to evaluate you culture of safety: https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patientsafetyculture/asc/resources/asc-survey.pdf You can also use data on outcomes of care, performance on safety and quality initiatives, - [](https://progressivesurgicalsolutions.com/forums/reply/36496/) - Thank you for the question, Emily. Please see the attached document. - [](https://progressivesurgicalsolutions.com/forums/reply/36492/) - Hi Annette. Thank you for this question. This depends on your policy. If your policy reads that this is required for all staff as a condition for employment, then this would include non-clinical personnel. However, if you policy outlines a risk determination, where your clerical staff are considered to be at no risk, then this - [](https://progressivesurgicalsolutions.com/forums/reply/36490/) - Hi Michelle. Thank you for this question. First, let me say this would be a great QAPI study! Determine why patients cancel, why they don't reschedule, and develop some corrective actions. We suggest you track and trend this data to determine why your patients are being cancelled and prevent those cancellations to the best of - [](https://progressivesurgicalsolutions.com/forums/reply/36487/) - Hi Ashley. Thank you for your question. When a patient signs your facility consent, they are verifying that they were provided the opportunity to engage in the informed consent process with their surgeon. While informed consent is the physician's responsibility, this process is not a well-executed if the patient isn't afforded the opportunity to meet - [](https://progressivesurgicalsolutions.com/forums/reply/36483/) - Thank you for this question, Sharon. We recommend you establish an agreement with an occupational health program/facility/department to manage exposures such as this. The determination if an employee requires prophylactic treatment is best left to an expert in that field that handles exposures frequently. The source of the injury (source patient, type/use/status of the instrument, - [](https://progressivesurgicalsolutions.com/forums/reply/36462/) - Hi Tabatha. Thank you for this question. Please navigate to Infection Control > Surgical Eye Prep and then scroll down to Betadine Allergy Management to learn more about this topic. - [](https://progressivesurgicalsolutions.com/forums/reply/36461/) - Hi Alissa. Thank you for this question! The purpose of risk assessments is to identify risks and their probability/impact, determine your preparedness for them, and then develop mitigation measures accordingly. Part of identifying risk and their probability is reviewing historical data. Therefore, while the tool itself is proactive, the data you use (patient demographics, literature, - [](https://progressivesurgicalsolutions.com/forums/reply/36458/) - Thank you for the reply! - [](https://progressivesurgicalsolutions.com/forums/reply/36446/) - We use Govee monitors for our refrigerators. Outside of range sends an alert to key people.We can pull reports PRN. For our room temps/humidity, there's a system that our HVAC company has that sends alerts (via email) to key people. They also monitor it. We can also pull data (real-time and historical PRN) - [](https://progressivesurgicalsolutions.com/forums/reply/36439/) - Thank you for this question, Su-Ann and thank you, Amber! This is the exact resource I was going to share with Su-Ann. It would be best to have your Medical Director and/or anesthesia provider(s) review this ASA press release and update your policies accordingly if they determine they'd like to align with the recommendations. - [](https://progressivesurgicalsolutions.com/forums/reply/36437/) - Thank you for the question, Caroline. While it is best practice to operate within your published business hours, occasionally operating earlier/later in the day shouldn't pose an issue. If it becomes a trend, you may want to modify your hours. Hours of operation are considered "basic characteristics" of your ASC by CMS and define you - [](https://progressivesurgicalsolutions.com/forums/reply/36436/) - Hi Su-Ann. Thank you for this question. The operating room RN should be solely dedicated to the purpose of circulating. Therefore, in cases where an anesthesiologist/anesthetist is not present, an additional RN is required to monitor the patient. - [](https://progressivesurgicalsolutions.com/forums/reply/36435/) - We also have a program called I-Vu - [](https://progressivesurgicalsolutions.com/forums/reply/36434/) - We have a program through our HVAC company called Metasys. It sends daily temperature/humidity to my emails as well as text/email for highs and lows. We love it, especially during high humidity season. Jeannine Arcuri Cleveland Eye and Laser Surgery Center - [](https://progressivesurgicalsolutions.com/forums/reply/36431/) - We are following the guidelines put out by The American Society of Anesthesiologists.. Day or week prior to the procedure: Hold GLP-1 agonists on the day of the procedure/surgery for patients who take the medication daily. Hold GLP-1 agonists a week prior to the procedure/surgery for patients who take the medication weekly. Consider consulting with - [](https://progressivesurgicalsolutions.com/forums/reply/36426/) - Hi Dia. Thank you for this question. Because ASCs aren't state licensed and CMS-certified only in the state of Idaho, finding state regulations surrounding linen processing in the ASC would be highly unlikely. The CMS CfC don't require you contract with a linen company. AORN recommends that you either a. contract with a linen company, - [](https://progressivesurgicalsolutions.com/forums/reply/36425/) - Hi David. Thank you for this question. We can send out a ‘Sharing is Caring’ to see what responses you receive. - [](https://progressivesurgicalsolutions.com/forums/reply/36424/) - Hi Tabatha. Thank you for this question. Yes. Reporting through the NHSN for the ASCQR ASC-20 is still a requirement and will continue through 2024. - [](https://progressivesurgicalsolutions.com/forums/reply/36410/) - MST Accutome - [](https://progressivesurgicalsolutions.com/forums/reply/36401/) - SIS MAGNUM DIAMOND MST - [](https://progressivesurgicalsolutions.com/forums/reply/36399/) - We are using SIS complete and have the billing and booking included. It is easy to use once you build it. The reporting is amazing. Any report you need is easily accessible. Turnover time, room utilization and cost per case are just a few of the many. - [](https://progressivesurgicalsolutions.com/forums/reply/36390/) - Thanks you so much for the information. - [](https://progressivesurgicalsolutions.com/forums/reply/36379/) - Thank you for the question, Jazmine. I'm not sure if you're referring to general information about the ASC environment, or if you mean staff education and training materials (infection control, OSHA, etc.). ASCA has some general ASC materials on their website that you may find helpful. - [](https://progressivesurgicalsolutions.com/forums/reply/36375/) - Hi Susan. Thank you for this question. No, you do not need to keep individual tags. However, you do need to have a log of all the information you provided for each patient (tray#/item, load number, etc.). So, you can continue to use the tags or create a log to write this information down instead. - [](https://progressivesurgicalsolutions.com/forums/reply/36368/) - Hi Pam. Thank you for this question. Gloves should be worn during eye drop instillation. Fresh gloves should be used for each task, followed by hand hygiene. It would be acceptable for the nurse to perform hand hygiene, don gloves, administer eye drops, doff gloves, perform hand hygiene, don gloves to establish IV access, doff - [](https://progressivesurgicalsolutions.com/forums/reply/36325/) - I checked with our LSC Consultant......They can be stored in a closet that is smoke tight and sprinklered. They cannot be stored in a room with a high degree of hazard such as a med gas room, biohazard or boiler room. Also, electrical panels require a free 36” clear space around them to a height - [](https://progressivesurgicalsolutions.com/forums/reply/36307/) - Thank you for the question, Su-Ann. No, portable squeeze bottles will not meet the standards. Here is a recommendation for a new unit that our LSC consultant suggests if you're unable to have the existing plumbed unit repaired. https://www.uline.com/Product/Detail/H-5457/Eyewash-Station-and-Supplies/Wall-Mount-Eyewash-Station-Plastic - [](https://progressivesurgicalsolutions.com/forums/reply/36305/) - Hi Jessica. Did you mean to ask something different in this thread? Something about tissue testing? - [](https://progressivesurgicalsolutions.com/forums/reply/36304/) - Thank you, Sara. Yes, this is a new requirement and something the Progressive team has developed and once finalized, we will be happy to share! Stay tuned for updates on this. - [](https://progressivesurgicalsolutions.com/forums/reply/36303/) - Hi Jessica. Thank you for this question. The directional flow of air should be checked in your ORs, procedure rooms, sterile storage, clean utility, and SPD monthly. The purpose of directional flow testing is to make sure you're not bringing contaminated air into the OR from adjacent spaces. Dirty rooms should have negative pressures, while - [](https://progressivesurgicalsolutions.com/forums/reply/36283/) - You don't have to report anything regarding that to CMS or TJC, but you may have to with your State. You need to look at the state licensing requirements and maybe reach out to their office to see if there are any standards you have to follow with construction. - [](https://progressivesurgicalsolutions.com/forums/reply/36282/) - Looking into it and will respond! - [](https://progressivesurgicalsolutions.com/forums/reply/36281/) - If you don't do the blood draw at the facility, then you should have a facility that you would send them. Like an urgent care or occupational health. You don't necessarily need an official agreement, but ensure that you have communicated with them, that sharps injury blood draw and follow-up would start with them. - [](https://progressivesurgicalsolutions.com/forums/reply/36279/) - We have been using SIS for over 3 years. Very simple to use with excellent customer support. We are multispecialty ASC. Our CRNA's love the anesthesia module. Highly recommend SIS complete. - [](https://progressivesurgicalsolutions.com/forums/reply/36273/) - Hi Jessica. Thank you for this question. Unfortunately, using two different EHRs in which one system holds critical information (such as the H&P) and this isn't scanned or imported into your primary EHR where everything else is documented would be in violation of the CMS CfC, section §416.47 Condition for Coverage: Medical Records. The reason - [](https://progressivesurgicalsolutions.com/forums/reply/36260/) - Hi Julie. Thank you for this question. Progressive Surgical Solutions is an approved CASC (BASC) AEU credit provider for our live webinar series and our in-person ASC Nurse Leadership Conference (NLC). The webinars can be accessed through the Education > Webinars. The CE courses under the Education heading are not CASC-approved AEUs. Please contact Courtney - [](https://progressivesurgicalsolutions.com/forums/reply/36259/) - Thank you for the question, Sharon. For reference, here is the link for the Association of Surgical Technologists (AST) that tracks which states require STs to be certified. Yes, on the job training with your experienced ST is a great first step. You'll want to develop a training schedule to help guide the new STs - [](https://progressivesurgicalsolutions.com/forums/reply/36251/) - So- the way our practice works, is that the physicians offices are on the second floor, and the ASC is on the first floor. The patients are booked through ECW- (that we at the ASC also use) but we generally use another system (MD reports) for when the patient is here for their actual procedure - [](https://progressivesurgicalsolutions.com/forums/reply/36231/) - Hi Michelle. Thank you for this question. The factors you listed from §416.52(a)(1) are referring to your H&P policy that must address certain patient characteristics that may necessitate the need for examination and testing prior to surgery. At a minimum, your H&P policy must include the above-mentioned factors, include a timeframe for H&Ps (when required - [](https://progressivesurgicalsolutions.com/forums/reply/36227/) - Thank you for the question, Gabrielle. You may want to consider the possibility of an answering service that will collect the information and then contact the appropriate provider. You could also have an "on call" rotation schedule for the surgeons. Meaning, one surgeon takes call each week and then notifies the appropriate provider when an - [](https://progressivesurgicalsolutions.com/forums/reply/36197/) - We implemented SIS in October 2021 and have been happy with it. It's a fairly new product and they make useful updates regularly, but it still lacks a few features that we would like to see eventually. If you choose SIS, my advice is to make sure you have a skilled, experienced implementation consultant. Pros: - [](https://progressivesurgicalsolutions.com/forums/reply/36196/) - We just implemented SIS in December of 2022. We really like it its very easy to use and not terribly hard to build. I was told by another ASC nurse manager who has experience building SIS and HST that she would choose SIS hands down. The reporting is really nice and you have the ability - [](https://progressivesurgicalsolutions.com/forums/reply/36195/) - We have HST and we love it. We have been using it since 2017. I have used other EMR's and this is by far the easiest and most user friendly EMR I've seen. Most importantly, the service is on point. They are extremely responsive and adaptive. You won't be disappointed. I have used SIS and - [](https://progressivesurgicalsolutions.com/forums/reply/36194/) - We currently only use paper. Sorry I can't help you. - [](https://progressivesurgicalsolutions.com/forums/reply/36193/) - We have been using HST since 2018 and love it!! - [](https://progressivesurgicalsolutions.com/forums/reply/36189/) - Hi Angela, We would love to help you. I will send you an email to coordinate a call. - [](https://progressivesurgicalsolutions.com/forums/reply/36188/) - Hi Jeannine. We're going to send out a Sharing is Caring to see what responses you get! - [](https://progressivesurgicalsolutions.com/forums/reply/36187/) - Hi Sharon. Thank you for the question! The personnel that perform housekeeping would need to complete the same annual training requirements as all the other staff members. Please see HR > Orientation and Education > Mandatory Annual Inservices and Education. In addition to this, the training and education you mentioned is adequate. However, you may - [](https://progressivesurgicalsolutions.com/forums/reply/36181/) - Hi Nancy, We are considering hiring a revenue cycle biller and coder consultant and gathering information as we start to explore this option. Thank you, Angela Potter, MBA Administrator Kootenai Outpatient Surgery 707 Ironwood Dr. Coeur d' Alene, ID 83814 Phone 208-625-6428 Fax 208-625-6401 Angela.Potter@kh.org kh.org - [](https://progressivesurgicalsolutions.com/forums/reply/36171/) - Hi Su-Ann. Thank you for the question. Inservicing and education requirements come from multiple sources; your state, accrediting organization, and federal programs (CMS, OSHA). CMS does provide standards regarding training your staff for emergency equipment/supplies and BLS/ACLS in §416.44(e), privacy procedures and HIPAA in §416.50(g), infection control for designated personnel for the program in §416.51 - [](https://progressivesurgicalsolutions.com/forums/reply/36139/) - Thanks! - [](https://progressivesurgicalsolutions.com/forums/reply/36138/) - Hi Shana. Great question. CMS and AAAHC don't state one hour specifically in regards to beyond use dates/time (BUD). The CMS CfC state, "Any pre-filled syringes must be initialed by the person who draws it, dated and timed to indicate when they were drawn, and labeled as to both content and expiration date." AAAHC states - [](https://progressivesurgicalsolutions.com/forums/reply/36137/) - Hi Shana and Amber. Just as an additional note, the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) Survey-based measures (ASC-15a-e) are mandatory under the ASC Quality Reporting Program beginning with the CY 2025 reporting period/CY 2027 payment determination and for subsequent years. Here is a list of approved vendors - [](https://progressivesurgicalsolutions.com/forums/reply/36136/) - We switched to ASCWebQI when SPH sold to Press Ganey. I don't think the reporting feature is as detailed as SPH's was but it has worked well for what we need. - [](https://progressivesurgicalsolutions.com/forums/reply/36131/) - Hi Michelle. Thank you for this question. We recommend you follow AORN guidelines for this. We also have the link for the CDC's Environmental Guidelines on the Infection Control > Environmental Sanitation page on eSupport. According to AORN, your facility should determine a cleaning schedule (eg, weekly, monthly) for areas and equipment that are not - [](https://progressivesurgicalsolutions.com/forums/reply/36108/) - Thank you so much for your response. - [](https://progressivesurgicalsolutions.com/forums/reply/36105/) - Thank you for the question, Anna. You should have a policy that defines your patient population and ages in your Governance policies and procedures (scope of surgical services, medical staff credentialing) and in your surgical scheduling exclusion criteria, too. In example, you may admit 12-17 year olds as long as they are a certain weight - [](https://progressivesurgicalsolutions.com/forums/reply/36099/) - Hi Leslie. Thank you for the question. We highly recommend you keep laundry services as a contracted service. However, we do have a policy sample I will email to you for facility laundry. - [](https://progressivesurgicalsolutions.com/forums/reply/36060/) - Hi Michelle. Thank you for this question. Before beginning this service, we suggest you contact your state licensing board. Some states require different licensure for infusion therapies and these may not always be considered "surgical services" for the ASC. - [](https://progressivesurgicalsolutions.com/forums/reply/36047/) - Hi Michelle. Thank you for this question. Take a look at the Vendor Credentialing and Visitors policies under Policies & Procedures > Administration. You can also add language to the Visitors policy to state that only those persons with a just and bona fide reason for being in the operating and/or procedure room will be - [](https://progressivesurgicalsolutions.com/forums/reply/36046/) - Hi Cortni. Thank you for the question. Since this is such a specific request, we will send out a Sharing is Caring. Also, I would suggest you post your question to our Facebook group: ASC Nurse Managers and Administrators. - [](https://progressivesurgicalsolutions.com/forums/reply/36045/) - Hi Elayne. Thank you for the question. I hope you get some good feedback. I would suggest you try Accutome or Ambler, if you haven't already. - [](https://progressivesurgicalsolutions.com/forums/reply/36033/) - Hi Susan. Thank you for the question. Please see Medication Management > Controlled Substances > Perpetual Inventory Sheet. There are also some other helpful tools on this page. You may also want to visit the Medication Management section of the P&P section. For the quarterly audit, please see this section and review Controlled Substance Inventory - [](https://progressivesurgicalsolutions.com/forums/reply/36037/) - Yes - [](https://progressivesurgicalsolutions.com/forums/reply/36036/) - Hi Diana. Thank you for this question. We have samples of YAG documentation available on eSupport. Please see Form Samples > Laser Procedures (Ophthalmology). - [](https://progressivesurgicalsolutions.com/forums/reply/36035/) - Jazmine, please reach out to Vanessa for this information. She will be happy to assist you with this. - [](https://progressivesurgicalsolutions.com/forums/reply/36034/) - Hi Cortni. Thank you for this question. We would recommend the patient keep their controlled substances at home. Unless the center is the one responsible for the safe keeping and administration of these drugs, then you do not need to be involved in the handing or storage of these medications. - [](https://progressivesurgicalsolutions.com/forums/reply/36015/) - Can you email me too - [](https://progressivesurgicalsolutions.com/forums/reply/36014/) - Can you please email me the information. - [](https://progressivesurgicalsolutions.com/forums/reply/36010/) - Hi Jessica. Thank you for this question. Typically, when a patient presents to your facility for surgery, they are implicitly providing their permission for you to gain access to their records. A consent should not necessary as the pharmacy and your center are covered entities. However, due to the nature of the EHR notice, we - [](https://progressivesurgicalsolutions.com/forums/reply/36009/) - Hi Melanie. Thank you for this question! Yes, as long as this is what your operating agreement states. Your bylaws should align with your operating agreement. - [](https://progressivesurgicalsolutions.com/forums/reply/36005/) - Leslie, we heard back from TJC. Their response: The new NPSG.16.01.01 addressing health care equity applies to ambulatory health care organizations providing primary care within the "Medical Centers" service in the ambulatory health care program. The requirements are not applicable to organizations providing episodic care, dental services, or surgical services (which includes ambulatory surgical centers). - [](https://progressivesurgicalsolutions.com/forums/reply/36004/) - Hi Leslie. Thank you for this question. We are confirming the applicability of NPSG 16.01.01 to the ASC and not other "ambulatory" settings as categorized by TJC. - [](https://progressivesurgicalsolutions.com/forums/reply/36003/) - Hi Jazmine. Thank you for reaching out. Radiology services program policies and procedures are available through Progressive Surgical Solutions for purchase. - [](https://progressivesurgicalsolutions.com/forums/reply/35997/) - Thank you for this question, Amy. Yes, you should have a policy and procedure in place for this. The policy should cover the documentation required when this occurs, incident report, peer review, mandatory reporting (if applicable), the consent process, additional patient follow-up, billing practices, etc. How you consent the patient for this return to OR - [](https://progressivesurgicalsolutions.com/forums/reply/35992/) - Hi Thelma, I will email you with this information. This is for clients with the PSS manuals. - [](https://progressivesurgicalsolutions.com/forums/reply/35953/) - Hi Su-Ann, Prescription pads, while less popular due to e-prescribing, are still able to be used. They should be stored in a locked cabinet and only those with permission should be permitted to access them. If you discard them, ensure they're properly destroyed to ensure they don't end up in the wrong hands. Make sure - [](https://progressivesurgicalsolutions.com/forums/reply/35949/) - Hi Carol. Thank you for this question. The No Surprise requirements includes restricting surprise billing for patients in job-based and individual health plans who get emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. Then the following were later added: Establishing an independent dispute resolution (IDR) process - [](https://progressivesurgicalsolutions.com/forums/reply/35937/) - Hi Carol. Thank you for this question. It is both a CMS and AAAHC requirement that when services are provided by an outside resource via contract that the ASC must assure that these services are provided in a safe and effective manner. The compliance and quality of your pathology agreement(s) should be evaluated through your - [](https://progressivesurgicalsolutions.com/forums/reply/35934/) - Thank you for this question, Jazmine. As long as the patient's street shoes/clothing are covered when going back to the OR, your practice is appropriate. You can remove heavily soiled shoes, or shoes that are too big to cover and then either cover the patient's feet/socks with a blanket or shoe covers. Yes, the patient's - [](https://progressivesurgicalsolutions.com/forums/reply/35932/) - Hi Su-Ann. Thank you for this question. No, individual chemical indicators do not need to go on patient charts or in a log book. The chemical indicators should be read by your staff and verified per your policy at the proper times per the manufacturer instructions. However, they can be discarded once this occurs. The - [](https://progressivesurgicalsolutions.com/forums/reply/35928/) - Hi Su-Ann! Thank you for reaching out. We will email you with some information. Talk soon! - [](https://progressivesurgicalsolutions.com/forums/reply/35927/) - Yes, I"d like to know too. - [](https://progressivesurgicalsolutions.com/forums/reply/35926/) - Hi Ashley. Thank you for the question. It is not necessary to document the lot number and expiration date on administration records. However, it would be best practice to document this information on a medication log when your receive medications shipments. This way, in the event of a recall, you'll be able to quickly identify - [](https://progressivesurgicalsolutions.com/forums/reply/35925/) - Jazmine, This is entirely up to the make / model of your laser and the manner in which you're using it. The pertinent information should be documented regarding the use of the machine (settings, techniques, incisions, procedures performed, etc.) just like any other piece of equipment used surgically on a patient. - [](https://progressivesurgicalsolutions.com/forums/reply/35923/) - Hi Jazmine. Thank you for the question. Yes. When a patient is involved in a reportable or adverse event within your facility, the event should be documented in their medical record, including their status, that the MD was notified, and any care they received as a result of their fall (ambulance, first aid, extended monitoring, - [](https://progressivesurgicalsolutions.com/forums/reply/35919/) - Great, Su-Ann. Do you provide them with a postage-paid envelope to mail back? You may want to consider an electronic version of the survey and include a QR code to the bottom of the survey. This way, your patients can scan the QR code and access the survey, instead of using the paper survey. - [](https://progressivesurgicalsolutions.com/forums/reply/35918/) - Ours is pretty straight forward. Only about 6 questions. We tell the pt about the survey in the pre-op and pacu areas. We also included it in their eye kit, which they have to open to get their eye drops and sunglasses out. - [](https://progressivesurgicalsolutions.com/forums/reply/35917/) - Thank you for the question, Su-Ann. You may want to consider asking patients during preop phone calls or registration how they'd like to be surveyed following their surgery. Some patients may prefer to be contacted via phone, mail, or electronically. Reaching patients in a manner they want to be contacted will help. Take a look - [](https://progressivesurgicalsolutions.com/forums/reply/35901/) - Hi Kim. Thank you for the question. No, a signature is not required per regulation. The CMS CfC require that discharge instructions are provided to the patient and/or their responsible adult in writing and copy of the discharge instructions provided to the patient must be in the patient’s medical record. Obtaining a signature is a - [](https://progressivesurgicalsolutions.com/forums/reply/35900/) - Hi Jazmine. Thank you for this question. Expanding your scope of anesthesia services may require that your state and/or accrediting body be notified. A follow-up visit to your center may be scheduled, based upon those variables. Your anesthesia providers and medical director will determine the required expansion in your formulary to provide GA, along with - [](https://progressivesurgicalsolutions.com/forums/reply/35899/) - Jazmine, Yes. Your QAPI committee should have a data set of quality indicators to be reviewed by the committee each quarter. I provided some examples of these above. Your center may even opt to review the percentage of patients receiving a follow-up communication from your center as an indicator. Indicators should have a goal. In - [](https://progressivesurgicalsolutions.com/forums/reply/35893/) - When you say "must be documented in the patient’s chart and reported back to your QAPI committee." What exactly needs to be documented and reported? No adverse and infection control forms and data? - [](https://progressivesurgicalsolutions.com/forums/reply/35890/) - Hi Su-Ann. Thank you for this question. Temperature checks at facility entrances have been off the CDC recommendations for sometime. Until this month, May 2023, the recommendations hadn't been updated since September 2022 and then February 2022 before that. That being said, some facilities still require temperature screening at the entrance (or for employees prior - [](https://progressivesurgicalsolutions.com/forums/reply/35889/) - Thank you for the question, Jazmine. Implanting an expired lens would definitely fall into the category of an incident report. You may consider conducting and documenting an investigation to determine the root cause of this error. The manufacturer of the IOL should be contacted to determine next steps for your facility and for the patient's - [](https://progressivesurgicalsolutions.com/forums/reply/35884/) - Hi Anna. Thank you for the question. You're correct. Annual TB testing is only required when indicated by your state or when the local health department or other authority requires this. This may occur if you lived in an area with higher TB prevalence or if you were treating active or higher risk for TB - [](https://progressivesurgicalsolutions.com/forums/reply/35881/) - We utilize Grainger for SDS web-based look up. http://complyplus.grainger.com/grainger/ - [](https://progressivesurgicalsolutions.com/forums/reply/35877/) - Hi Jamie. Thank you for this question. This will depend entirely upon the state your center is in. Before you begin training, please visit the Association of Surgical Technologist's website to view which states have regulations concerning the educational and licensure/certification requirements of Surgical Technologists: https://www.ast.org/Public_Policy/Legislative_Overview/ You may also want to research your state's pending - [](https://progressivesurgicalsolutions.com/forums/reply/35849/) - Thanks, Kayla. This will depend upon the specific language in your operating agreement and bylaws. These documents may need updated if you plan to make changes in officials/titles. The owner more than likely can hold either title, or hold a particular title in the operating agreement, and hold another title in the Medical Staff bylaws. - [](https://progressivesurgicalsolutions.com/forums/reply/35846/) - The ownership has not changed, because our podiatry surgeon is still the Owner (DPM). We just have him as medical director and then our anesthesiologist listed as chief executive officer since he is an MD. Does our podiatrist that is the owner need to be listed as executive officer rather than medical director? - [](https://progressivesurgicalsolutions.com/forums/reply/35845/) - Hi Joy. Thank you for this question. The manufacturer of the hazardous substance should provide an SDS. You can also download them from the manufacturer's website or request them via email or by phone. There are online databases, none specifically for the ASC that we're aware of. However, you often need to subscribe and/or pay - [](https://progressivesurgicalsolutions.com/forums/reply/35800/) - Hi Kayla. Thank you for the question. I assume the Anesthesiologist became an owner? If you're changing your reporting structure, your Organizational Chart and HR policies and procedures, including Job Descriptions will need updated, if any exist for these roles. If you've had an ownership/interest change, you should also report this to your state and - [](https://progressivesurgicalsolutions.com/forums/reply/35792/) - Hi Cindy. CMS provides recommendations for this in §416.52(a): Standard: Patient assessment and admission of the CMS CfCs. The recommendations include the American College of Surgeons, the American Society of Anesthesiologists, the American College of Cardiology, and the American Academy of Ophthalmology. These societies have best practice guidelines or recommendations for preoperative care. Just be - [](https://progressivesurgicalsolutions.com/forums/reply/35791/) - Where can I find nationally recognized guidelines for extending H&P's beyond the 30 day mark? Since AAAHC recently updated their standards to mimic CMS on the timeline for H&P's I am searching for literature/guidelines to validate an extension to our current 30 day timeline H&P policy is acceptable. - [](https://progressivesurgicalsolutions.com/forums/reply/35790/) - Hi Quinanna. Thank you for this question! There aren't any specific guidelines regarding fake eyelashes in the OR for scrubbed or circulating personnel. In fact, there isn't any evidence that demonstrates that fake eyelashes pose a risk or don't pose a risk to our patients. For this reason, this will be entirely up to your - [](https://progressivesurgicalsolutions.com/forums/reply/35789/) - Carol, The GA ASC regs don't state three days. However, they do state: Each center will have effective policies and procedures for handling infection control and for recording complications which occur during or after surgery, which includes a reporting mechanism for patients who develop infections or postoperative complications after discharge and a system shall be - [](https://progressivesurgicalsolutions.com/forums/reply/35788/) - I have been told it is a Ga. state reg. To contact them within 3 days but I can’t figure out how to find that reg. On line. Do you have any suggestions how I can verify that reg.? - [](https://progressivesurgicalsolutions.com/forums/reply/35787/) - Hi Carol. Thanks for the question. There is not a regulation that requires postop phone calls. However, you, as a facility, are required to capture data to validate postop outcomes. This is an integral part of your QAPI program. Therefore, if you want to work with the physicians that see your patients at the 1-day - [](https://progressivesurgicalsolutions.com/forums/reply/35775/) - Hi Amy. Thank you for the question. The CDC updated their guidance regarding universal masking on May 8, 2023 in response to the ending of the public health emergency on May 11, 2023. Yes, the CDC community transmission tracking has ended meaning masking will not be dictated by this metric any longer. We will be - [](https://progressivesurgicalsolutions.com/forums/reply/35773/) - Hi Jazmine. Thank you for the question. No. Your surgeons do not need to be ACLS certified. In fact, no one is required to have ACLS by CMS regulations. However, everyone should be BLS certified and then depending on the services you provide and the population you serve, you’re well advised to have ACLS providers, - [](https://progressivesurgicalsolutions.com/forums/reply/35708/) - Thank you for the question, Michelle. CMS doesn't use the term "medical assessment" but you may be referring to one of the the two pre-surgical assessments; the first one is the H&P, which your facility must have a policy concerning which patients require an H&P, the timeframe in which they should be completed, and be - [](https://progressivesurgicalsolutions.com/forums/reply/35707/) - Hi Diana. Thank you for the question. No, per AAAHC and CMS, your surgeons are not required to have active privileges at the hospital. However, the following standards and requirements must be met: The ASC must have an effective procedure for the immediate transfer, to a hospital, of patients requiring emergency medical care beyond the - [](https://progressivesurgicalsolutions.com/forums/reply/35693/) - Hi Emily. Thank you for this question. There is no specific BMI limit called out in regulation or standards. Determining if and how a BMI limit needs set for your facility should be based upon your patient population, the surgical and anesthesia services you provide, and equipment limitations. We suggest you work with your anesthesia - [](https://progressivesurgicalsolutions.com/forums/reply/35692/) - Hi Tracy. Thank you for the question. Your entire staff have access to all the courses available on eSupport. Courses are not electronically "assignable" per department or role. You can communicate assignments to your staff using the CE Course Employee Assignment Sheet under Account > CE Management > Instructions. Or, you can communicate the courses - [](https://progressivesurgicalsolutions.com/forums/reply/35689/) - Hi Kari. Thank you for the question. We don't currently offer continuing education concerning pain assessment or management. However, we're always adding new content and this is a great suggestion! Providing the practitioner with your pain management policies and procedures that provide their specific responsibilities related to pain meets this specific requirement. Be sure to - [](https://progressivesurgicalsolutions.com/forums/reply/35687/) - Hi Amy. Thank you for this question. Mandatory reporting for incident reports and patient deaths are sent to the Medical Board of CA and transfer reporting (Part B) are sent to the HCAI, if medical treatment exceeded 24 hours. You are no longer required to report to the CDPH. This does require some changes to - [](https://progressivesurgicalsolutions.com/forums/reply/35686/) - Hi Jessica D. and Jessica L! All correspondences with a patient must be documented in their medical record. Postop follow-up calls are not a CMS requirement. However, the ASC is required to ensure the patient is informed of the contact information for the physician that is responsible for their follow-up care. In addition to this, - [](https://progressivesurgicalsolutions.com/forums/reply/35685/) - Thank you for the feedback, Jessica. Is the Fire Marshall concerned this would result in a false alarm? Your monitoring center and/or local dispatch center should be informed of when you plan to pull the fire alarm to prevent this. The Life Safety Code doesn't require that you pull the fire pull to result in - [](https://progressivesurgicalsolutions.com/forums/reply/35678/) - Well, I can tell you I had my AAAHC survey two weeks ago, and when we did chart audits, I had to show her that each patient had a pre call and post call done. - [](https://progressivesurgicalsolutions.com/forums/reply/35675/) - I asked our Fire Marshall about this and he said we aren't allowed to pull the alarm. - [](https://progressivesurgicalsolutions.com/forums/reply/35672/) - Hi Missy. Sorry to hear this has been a trouble for you. We suggest you reach out to our Facebook group: ASC Nurse Managers and Administrators. We can also send out a message to fellow eSupport members to help you get some suggestions. - [](https://progressivesurgicalsolutions.com/forums/reply/35671/) - Hi Jessica. Thank you for this question. Yes, a compliant fire drill includes audible alarm activation. You aren’t required to have the fire drills when the vendor comes to test the system, this can be silenced or disregarded by your staff. However, when you’re holding a fire drill the transmission of a fire alarm signal - [](https://progressivesurgicalsolutions.com/forums/reply/35666/) - One more thing - the revised transfer form now states that reports go to the Department of Healthcare Access and Information (HCAI) instead of OSHPD. Updated patient death reporting form also. So maybe the policy needs updating as well? - [](https://progressivesurgicalsolutions.com/forums/reply/35665/) - In reviewing the Mandatory Reporting for CA, the policy (11/2015) states at the beginning that adverse events need to be reported to CDPH, but after adverse events are described, it references the Adverse Event form that is used to report to the CA Medical Board only with no mention of how to report to CDPH. - [](https://progressivesurgicalsolutions.com/forums/reply/35664/) - Hi Leslie. Thank you for the question. You can use a reverse distributor or Rx Destroyer for controlled substance disposal. The method of destruction must render the controlled substance to a state of non-retrievable and meet all applicable destruction requirements but the DEA doesn’t specify a specific method for destruction. If you opt to destroy - [](https://progressivesurgicalsolutions.com/forums/reply/35613/) - Can anyone reference where the standard is about post op calls? - [](https://progressivesurgicalsolutions.com/forums/reply/35610/) - Sure, Dia. You have the option to wrap your instruments and then the non-sterile individual unwraps for the sterile tech and then the sterile tech collects their instruments after unwrapped, or you can purchase rigid instrument containers. Aesculap, Miltex, Medline, Innovia Medical, and Steris have rigid containers. There are others available. You'll want to measure - [](https://progressivesurgicalsolutions.com/forums/reply/35609/) - Do you have any suggestions on a container that would be "acceptable" & fit our cataract instrument tray for transfer from Autoclave to OR? - [](https://progressivesurgicalsolutions.com/forums/reply/35606/) - Thank you for the question, Dia. A sterile field and instruments must always be supervised to ensure sterility is maintained. Setting up the sterile field in the clean room is not best practice, this should occur in the OR. Sterile instruments should be transported to the OR in a sealed peel pack or container by - [](https://progressivesurgicalsolutions.com/forums/reply/35605/) - Hi Annette. Thank you for the question. You’re correct about the AHA info. Adolescents aged 14+ would not require a PALS nurse, especially at 120+ lbs because pediatric medication dosing wouldn’t apply. Just be sure to never admit a patient outside of your age and weight parameters, when a PALS protocol could potentially apply. The - [](https://progressivesurgicalsolutions.com/forums/reply/35603/) - Hi Amy. Thank you for the question and sorry for the delay! If you're Medicare certified, your facility is still required to adhere to the federal COVID-19 vaccine mandate, including documentation of the vaccination status of all staff. No, you do not need to have exemption documentation on file for those who are not up - [](https://progressivesurgicalsolutions.com/forums/reply/35590/) - PSS - Just following up on any guidance/response to these questions? Thanks! - [](https://progressivesurgicalsolutions.com/forums/reply/35575/) - Hi Susan. Thank you for the question. All correspondences with a patient must be documented in their medical record. Postop follow-up calls are not a CMS requirement. However, the ASC is required to ensure the patient is informed of the contact information for the physician that is responsible for their follow-up care. In addition to - [](https://progressivesurgicalsolutions.com/forums/reply/35569/) - Thanks for the previous response, but have a couple follow-up questions. First, California has now removed the required masking in healthcare facilities and healthcare vaccine requirements. We are following those updates, but CMS still has the healthcare vaccine requirement and reporting. When I am completing the updated NHSN spreadsheet for reporting, anyone who has not - [](https://progressivesurgicalsolutions.com/forums/reply/35565/) - Hi Leslie. Thank you for the question. The temperature setting for your ice maker should be set according to the manufacturer recommendations. These may be posted on the machine itself or available in the information that came with the machine. You may also be able to find the specific manufacturer instructions online or by contacting - [](https://progressivesurgicalsolutions.com/forums/reply/35561/) - Hi Jazmine, We recommend you verify whether your state requires a state application to be used for these providers. - [](https://progressivesurgicalsolutions.com/forums/reply/35553/) - An allied healthcare appointment application - [](https://progressivesurgicalsolutions.com/forums/reply/35549/) - Hi Michelle, We apologize for the delay in responding to your question! We encourage you to reach out to your consulting pharmacist or a pharmacist you work with to address your question and the individual preps your referenced. If you do decide to reuse opened bottles/containers for multiple patients, be sure the nursing staff is - [](https://progressivesurgicalsolutions.com/forums/reply/35548/) - Thank you for the question, Laura. A wrist rest is a horseshoe shaped device that attaches to the head of the stretcher that helps the surgeon stabilize his/her hands during surgery. Check with the manufacturer of your stretchers to determine a compatible model. Keeler, Steris, and Stryker all manufacturer wrist rests but you will find - [](https://progressivesurgicalsolutions.com/forums/reply/35547/) - Does anyone know the answer to this??? Do things like Rubbing alcohol and Hibiclens have to be labeled with a date opened and then disposed of by 28 days later?? - [](https://progressivesurgicalsolutions.com/forums/reply/35466/) - I know these are not "medications" but can be used as multi-patient and somewhere along the way we were under the impression they had to be tagged, dated and disposed of 28 days after opening????? - [](https://progressivesurgicalsolutions.com/forums/reply/35463/) - Hi Emily. Thank you for the question. Yes. This is true. However, you must conduct medical staff reappointment in accordance with your state regulations and per your Governing Body bylaws. So, if you do opt to move to a 3 year reappointment, just be sure this is permissible in your state and that your Governing - [](https://progressivesurgicalsolutions.com/forums/reply/35435/) - Thank you for your response. That's my take on it. - [](https://progressivesurgicalsolutions.com/forums/reply/35434/) - Hi Amy. Thank you for the question. You can use your Medical Director's license to order medications for your ASC. However, those medications (especially controlled substances) should only be administered to the Medical Director's patients. If you have more than one provider in your center, you need to apply for a facility license because you're - [](https://progressivesurgicalsolutions.com/forums/reply/35433/) - Hi Sara. Thank you for the question. Pharmaceutical waste management is dictated by your local and state agencies so always check for your state’s regulations concerning this first. You also have the option of a reverse distributor for incineration. Contacting your local diversion field office may also be helpful. Here’s the link to find yours: - [](https://progressivesurgicalsolutions.com/forums/reply/35432/) - I would say no because the person was not admitted. My rationale would be that at this point they are no different than a guest and you wouldn't consider a quest a transfer. I hope others agree. - [](https://progressivesurgicalsolutions.com/forums/reply/35430/) - Are CA ASC's now required to have a pharmacy license? If so, when did that change? I know it was an option in the past but did not think it was a requirement. Do we have the option to not be licensed and use our Medical Director's DEA to order meds? - [](https://progressivesurgicalsolutions.com/forums/reply/35428/) - We utilize Survey Monkey and find it works well for our accreditation needs. - [](https://progressivesurgicalsolutions.com/forums/reply/35322/) - Thank you for the question, Danielle. New equipment should be checked and labeled for safety by your biomedical vendor prior to use. Also, your staff must have documented training on the equipment prior to use. Are you registered for Progressive Surgical Solution’s ASC Nurse Leadership Conference in April? Here’s the link to register. https://ascnurseleadership.com/ I - [](https://progressivesurgicalsolutions.com/forums/reply/35305/) - Lisa, the consent signed between the patient and the surgeon in the surgeon's office is not the same as the facility consent. You cannot use the consent signed in surgeon's office for your ASC's consent. The facility consent should be specific to your center, and reflect that the patient has been given the opportunity to - [](https://progressivesurgicalsolutions.com/forums/reply/35304/) - Amy, you won't find this language in regulation. ASC patients are to be, as the name implies, ambulatory and well enough to walk in and out of the facility. ASCs are not equipped or staffed to safety lift patients out of a wheelchair. Doing so places both the patients and your staff at risk of - [](https://progressivesurgicalsolutions.com/forums/reply/35303/) - Ashley, there are no additional required licenses or certifications for a surgeon to order medications for IV sedation. That being said, the ordering physician should have experience with ordering these medications and this should be outlined on their delineation of privileges (ie: "supervision of sedation administered by non-physician staff"). You may consider developing a competency - [](https://progressivesurgicalsolutions.com/forums/reply/35302/) - Thank you for the question, Sara. Yes, you are permitted to do this but not without properly trained and certified staff and a well designed and implemented IV conscious sedation program, policies and procedures. Your surgeons need to be properly credentialed and privileged to order these medications. Documentation of licensure, training, and certification must be - [](https://progressivesurgicalsolutions.com/forums/reply/35299/) - Thank you, April! What kinds of certifications or licensures are required for our Surgeons? Our nursing staff is all ACLS certified and have taken the steps for education and training. Our orders have to come from the surgeons and there is discrepency as to what certifications etc. are required for our doctors to hold in - [](https://progressivesurgicalsolutions.com/forums/reply/35285/) - Thank you for your response. In regard to the question and answer, 1. Our facility in ONLY Medicare Certified not accredited by any agency. Do we need to contact CMS? 2. California (state) doesn't require a license for the facility. 3. When you say LSC department- we are having an individual as our safety officer - [](https://progressivesurgicalsolutions.com/forums/reply/35283/) - Can you show us the regulation so we can share with the surgeon's? - [](https://progressivesurgicalsolutions.com/forums/reply/35279/) - If the EMR is shared with the surgeon office do you need a additional consent if the consent meets all the requirements/components of informed consent? We share the EMR with the office and consents are signed electronically in the medical record at pre op visit. - [](https://progressivesurgicalsolutions.com/forums/reply/35278/) - Thank you for the question, Jazmine. This depends on your state and accrediting organizations. Adding beds typically means you're adding bays or patient care areas. If construction is involved, your life safety department will most likely require an Infection Control Risk Assessment prior to work starting. This may also require notification to your state licensing - [](https://progressivesurgicalsolutions.com/forums/reply/35277/) - Thank you for the question, Jazmine. We suggest you contact your state department on aging and reach out to local transportation services within your community. They may be able to provide additional information concerning insurance coverage, rates for patient transportation, and potential agreements. You should contact your liability carrier concerning starting your own transportation service. - [](https://progressivesurgicalsolutions.com/forums/reply/35276/) - Jazmine, spiking and IV bag and priming IV tubing is within an RN's scope of practice. Technicians are not trained regarding these skills and is not within their scope of practice. - [](https://progressivesurgicalsolutions.com/forums/reply/35275/) - Thank you, Amy. We appreciate your question. To be an appropriate patient for the ASC, the patient should be ambulatory. If a patient is capable of standing and transferring to the bed independently and safely, then this patient would be appropriate for the ASC setting. Patients who cannot stand up/transfer for the wheelchair independently and - [](https://progressivesurgicalsolutions.com/forums/reply/35274/) - Hi, Ashley. Thank you for this question. Yes, you are permitted to have an RN IV Conscious Sedation program in your facility. You will need to have education, training, and competencies on file for the nursing staff. Also, there must be well established and comprehensive policies and procedures concerning this program. An important concept is - [](https://progressivesurgicalsolutions.com/forums/reply/35259/) - Why does the RN need to be the one to spike the BSS bags for the Phaco machine? Can a technician assisting in the turn over/set up assist? - [](https://progressivesurgicalsolutions.com/forums/reply/35158/) - Hi Jazmine. Thank you for the question. There aren't specific regulations regarding the frequency of staff meetings. Staff meetings should be held at he frequency that is appropriate for your center. Monthly inservices could be used to also share any staff meeting agenda items, if you'd like to combine the two. Updating your staff regarding - [](https://progressivesurgicalsolutions.com/forums/reply/35144/) - Hi Jazmine. Thank you for the question. No, it is not mandatory that you obtain a copy of the consent the patient signs with the surgeon in clinic. This is not a required component of the ASC medical record. However, you must have a facility consent on file, in which the patient is attesting to - [](https://progressivesurgicalsolutions.com/forums/reply/35128/) - Thank you for the question, Ashley. Health care personnel with a documented history of a prior positive TB test should receive an individual TB risk assessment and TB symptom screen upon hire. Additionally, individuals with a prior positive TB test should receive a chest x-ray or provide documentation of a normal chest x-ray. Requirements regarding - [](https://progressivesurgicalsolutions.com/forums/reply/35127/) - Thank you for the question, Danielle. AAAHC requires that interpretation services be "available" under the patient rights and responsibilities section. Please note that CMS states under §416.50(a) Standard: Notice of Rights that the patient has the choice of using an interpreter of his or her own, or one supplied by the ASC. Therefore, it is - [](https://progressivesurgicalsolutions.com/forums/reply/35126/) - Thank you for this question, Ashley. CMS recommends marking of the intended procedure site by the physician who will perform the procedure or another member of the surgical team so that it is unambiguously clear. Best practices dictate that the patient be involved in the process of surgical site verification, prior to the administration of - [](https://progressivesurgicalsolutions.com/forums/reply/35123/) - I just learned that discovisc, provisc,duo visc etc.. are not considered drugs. They were approved under surgical device not pharmacy. - [](https://progressivesurgicalsolutions.com/forums/reply/35095/) - Thank you for the question, Donna. CMS requires that the informed consent includes a description of the proposed surgery, including the anesthesia to be used. Therefore, the description needs to be accurate, including what is most likely to occur and also what may occur, based upon the surgeon's professional judgement. The consent would not need - [](https://progressivesurgicalsolutions.com/forums/reply/35094/) - Hi Erin. Thank you for the question. Patient should be prepped in the OR because the OR is a controlled environment that prevents the potential for surgical site contamination following prep. Positive airflow and pressure, limited traffic patterns, respiratory precautions, complete air exchanges prevent the surgical site from contamination and these precautions aren't available in - [](https://progressivesurgicalsolutions.com/forums/reply/35093/) - Hi Leslie. Thank you for the question. The information you're looking for is in CMS's Appendix Z, §416.54(d)(2). If you have determined that a full-scale community exercise is not accessible, document your efforts and conduct a facility-based exercise. Remember, if you experience an actual event that requires the activation of your emergency plan, then you're - [](https://progressivesurgicalsolutions.com/forums/reply/35071/) - Hi, Erin. Thank you for the follow-up question. We have an Infection Control Risk Assessment (ICRA) for Construction and Renovation on eSupport. Please navigate to eSupport > Risk Assessments > Infection Control RA | Matrix Precautions for Construction & Renovation. Are you registered for Progressive Surgical Solution’s ASC Nurse Leadership Conference in April? Here’s the - [](https://progressivesurgicalsolutions.com/forums/reply/35070/) - Hi, Anna. Thank you for the question. If you're keeping a complete electronic copy of the paper charts when you scan them then you do not need to keep the paper records for any specified timeframe. After they're scanned into your system, they can be shredded as soon as it is confirmed they're properly filed - [](https://progressivesurgicalsolutions.com/forums/reply/35069/) - Did anyone happen to respond to this thread? I'm also looking for an example if someone is willing to share. Thanks, - [](https://progressivesurgicalsolutions.com/forums/reply/35038/) - We totally agree and are going to try and fight this. Thank you so much for your help. - [](https://progressivesurgicalsolutions.com/forums/reply/35037/) - Thank you for the question, Tracy. There is a Research policy sample available on eSupport under Policies and Procedures > Administration. Are you registered for Progressive Surgical Solution’s ASC Nurse Leadership Conference in April? Here’s the link to register. https://ascnurseleadership.com/ I hope to see you there! - [](https://progressivesurgicalsolutions.com/forums/reply/35036/) - The manufacturers are not referring to laser procedures as surgery. Lasers utilizing these lens are often done in an office setting and not in the ASC. The MIFU are written for all settings, not just the ASC. Your ability to bill for the surgery doesn't necessarily impact the manufacturer's definition of surgery. Unless you're introducing - [](https://progressivesurgicalsolutions.com/forums/reply/35034/) - I feel pretty confident that the MIFUs for Ocular are pretty clear in that the only time sterilization is required is if used on an ulcerated cornea. See very top of page 2 of MIFUs for Ocular Instruments: It says Caution: If used on an ulcerated cornea, lens must be STERILIZED before next procedure. It - [](https://progressivesurgicalsolutions.com/forums/reply/35027/) - Hi, Jazmine. The ASC does not have documentation requirements for the patient to be scheduled. However, there are required documents that should be in the patient's medical record prior to surgery (any testing, H&P), then added to the patient's chart on the day of their surgery (nursing documentation, operative and anesthesia records), and then any - [](https://progressivesurgicalsolutions.com/forums/reply/35026/) - Thank you for the question, Jazmine. CMS states that the facility must provide the patient or the patient’s representative, as appropriate, the following information in writing, prior to the start of the surgical procedure: Information on the ASC’s policies on advance directives, a description of the applicable State health and safety laws, and if requested, - [](https://progressivesurgicalsolutions.com/forums/reply/35025/) - Hi Jazmine. Thank you for the question. No. The surgeons do not need to be ACLS certified, unless this is your facility policy. CMS states, under §416.44(e) Standard: Emergency Personnel that personnel trained in the use of emergency equipment and in cardiopulmonary resuscitation must be available whenever there is a patient in the ASC. There - [](https://progressivesurgicalsolutions.com/forums/reply/35024/) - Hi Kathy. Thank you for the question. A preop phone call is not a regulatory requirement. However, the components typically performed during the preop phone call are required and/or recommended. In example, the patients must understand that a driver is required (if receiving anesthesia) and depending on your state and/or accrediting organization, you my still - [](https://progressivesurgicalsolutions.com/forums/reply/35018/) - Hi Michelle. Thank you for the question. Laser lenses must be cleaned and disinfected per the manufacturer's instructions for use (MIFU). Therefore, it would be best to read the MIFU that came with your lenses. However, two common laser lens manufacturers are Volk and Ocular Instruments. Sterilization is not necessary unless you're introducing the lens - [](https://progressivesurgicalsolutions.com/forums/reply/35017/) - Thank you for the question, Michelle. It is unlikely that you need to culture the grafts. However, you should contact the manufacturer of this particular amniotic graft to confirm that it is not necessary to culture prior to use. Amniotic grafts should be supplied by an accredited/certified supplier. Amniotic grafts for ophthalmic surgery should be - [](https://progressivesurgicalsolutions.com/forums/reply/35003/) - Hi Amanda. Thank you for the question. According to the Office of Statewide Health Planning and Development (OSHPD), which was adopted and amended to the California Building Standards Code, flooring must be coved at least 5" in patient restrooms and waste holding rooms with resilient floors and in the OR the flooring must be monolithic - [](https://progressivesurgicalsolutions.com/forums/reply/35000/) - Sure. This is the link for the CMS CfC Appendix L https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf. From there, you will want to search for this particular section. The specific CfC is §416.44 Environment and then then navigate to 416.44(d). - [](https://progressivesurgicalsolutions.com/forums/reply/34998/) - Can you send a link to CMS requirements, see the CfC §416.44(d) Standard: Emergency Equipment Which you mentioned? I can’t seem to find it, thanks. - [](https://progressivesurgicalsolutions.com/forums/reply/34976/) - Thank you for the question, Leslie. Multidose vials (MDVs) that have entered an immediate patient care area (OR, anesthesia cart) can no longer be used for multiple patients. You can use the vial for that patient only and then discard the rest. If the portable metal box is entering the OR, then your MDV can - [](https://progressivesurgicalsolutions.com/forums/reply/34975/) - Hi, Candice. Thank you for the question. Your accrediting organization (AO), state, and CMS require you stock the appropriate medications and supplies for emergency management. It is your medical staff and Governing Body's responsibility to determine exactly how your ASC should be equipped which is entirely dependent upon your patient population and the surgical and - [](https://progressivesurgicalsolutions.com/forums/reply/34964/) - Hi, Danielle. Thank you for the question. AAAHC feels that patient pre-screening is critical but also requires that you follow local and state guidelines. Make sure you are following any pre-screening/testing requirements your state may have. Select infection prevention and control (IPC) measures are influenced by levels of SARS-CoV-2 transmission in the community. Currently, the - [](https://progressivesurgicalsolutions.com/forums/reply/34963/) - Hi, Jessica. Thank you for the question. No. There are no regulatory requirements that you receive notification that your facility has experienced a power outage. However, a consideration would be your temperature-sensitive medications and other inventory that require refrigeration or freezing. If your generator failed to turn on, your frozen/refrigerated items may become compromised. Continuous - [](https://progressivesurgicalsolutions.com/forums/reply/34953/) - Thank you for the reply. I will look there again. Our state updated theirs to 90 days awhile back but we've been tied to the 30 days through AAAHC. Great news! - [](https://progressivesurgicalsolutions.com/forums/reply/34952/) - Thank you so much. Also, we are trying to decrease the number of forms the patients need to sign on admission. We have 2 that are totally Covid related. One that is informing the pt to notify us if they should get Covid and the other which acknowledging that we are not responsible if they - [](https://progressivesurgicalsolutions.com/forums/reply/34946/) - Hi Carol. Thank you for the question. You need four (quarterly) scenario-based drills of the internal and external emergency and disaster preparedness plan per year AND one of these drills must include CPR techniques. You need one malignant hyperthermia (MH) drill (if you stock triggering agents) per year. Four fire drills (conducted quarterly at expected - [](https://progressivesurgicalsolutions.com/forums/reply/34945/) - Thank you for the question, Tabatha. The AAAHC standards regarding H&Ps can be found in the AAAHC Accreditation Handbook for Medicare Deemed Status, v42. This is available for PDF download from the AAAHC store. This is in Chapter 10, Section I, letter D. Also, AAAHC's H&P standard mirrors the CMS CfC §416.52(a): Standard: Patient assessment - [](https://progressivesurgicalsolutions.com/forums/reply/34941/) - Can you tell me where I can find this updated standard? I'm having trouble finding it. We are currently AAAHC accredited and this would be a welcomed change! Thank you. - [](https://progressivesurgicalsolutions.com/forums/reply/34934/) - Thank you for the question, Thelma. CMS requires that the ASC is a “distinct entity” must be physically and administratively distinct from any other entity. See section 416.2 of the CMS CfC for additional information about being a distinct entity. This means that you must have your own ASC EHR system and it must be - [](https://progressivesurgicalsolutions.com/forums/reply/34724/) - Hi Michelle. Thank you for the question. Yes, AAAHC recently aligned with CMS's 2019 changes regarding H&Ps. However, you must still develop a policy that identifies when an H&P is required, the timeframe it must be completed within, patient age groups, diagnosis, procedures to be performed and how many, comorbidities, and the planned anesthesia level. - [](https://progressivesurgicalsolutions.com/forums/reply/34701/) - Thank you for your question, Jazmine. It sounds like we need some additional information from you to best answer your question. We will contact you soon. In the meantime, information concerning NPIs can be found on the NPPES website: https://nppes.cms.hhs.gov/#/ - [](https://progressivesurgicalsolutions.com/forums/reply/34700/) - Thank you for your question, Jazmine. The ASCQR ASC-20 COVID-19 Vaccination Coverage Among HCP measure is reported through the NHSN, not the NPDB. We will reach out to you to collect more information regarding your question. - [](https://progressivesurgicalsolutions.com/forums/reply/34579/) - Hi Donna. Thank you for the question. CMS states that you must provide the patient with written discharge instructions either before the surgery or before discharge. A copy of the discharge instructions you provided to the patient must be in their medical record. Your patient should also be provided with information regarding prescriptions and contact - [](https://progressivesurgicalsolutions.com/forums/reply/34576/) - Hi Anna. Thank you for the question. The necessary documentation will depend upon the reasons for the dismissal and what your medical staff bylaws dictate concerning dismissal. You must adhere to the bylaws. If this was a dismissal secondary to an amicable, benign, or mutual change or agreement that didn't relate to a patient safety - [](https://progressivesurgicalsolutions.com/forums/reply/34574/) - Hi, Jenni. Thank you for the question. This all depends on where you are opening the medications and the labeling on the medications. Medications that are approved for multiple patient use cannot be opened/accessed in an immediate patient care area. Examples of immediate patient treatment areas include operating and procedure rooms, anesthesia and procedure carts, - [](https://progressivesurgicalsolutions.com/forums/reply/34573/) - Thank you for the question, Kimberly. Hospital privs aren't always necessary as long as your facility maintains a transfer agreement. This is quite common in ophthalmology because ophthalmologists don't often keep hospital appointments. You must adhere to your accrediting organization's (AO) standards regarding credentialing and privileging within your facility. Even if the AO mentions hospital - [](https://progressivesurgicalsolutions.com/forums/reply/34572/) - Thank you for the question, Anna. You should have a policy and procedure regarding safe extubation of your patients. We suggest you work with your anesthesia providers to determine what this procedure should say regarding the role your staff will take during this process. This policy should reflect the patient's required status prior to extubation - [](https://progressivesurgicalsolutions.com/forums/reply/34571/) - Hi, Donna. Thank you for the question. Your high risk fire protocol should be specific to your facility and outlined in your policies and procedures. Examples of these considerations and subsequent protocols would include the management of the environment/items found in your surgical environment that cause OR fires, also referred to as the fire triangle: - [](https://progressivesurgicalsolutions.com/forums/reply/34558/) - Thank you, Susan. Almost all of the education and competencies conducted at hire are also required on an annual basis as well. In example, OSHA training should occur at hire and then annually. For your nursing staff, a competency assessment should also be conducted at hire, at 90 days, and then annually thereafter. This competency - [](https://progressivesurgicalsolutions.com/forums/reply/34556/) - Thank you for the question, Michael. Yes. Samples of a Quality Improvement Incident Report, Incident Report Follow-Up form, Incident Report Log, and Near Miss Log are available on eSupport under Quality Management > Risk Management. - [](https://progressivesurgicalsolutions.com/forums/reply/34496/) - @alyssa-jones I am going to reach out to you to discuss. - [](https://progressivesurgicalsolutions.com/forums/reply/34491/) - @amy-fox we are so sorry for the delayed response to this question!! The CDC actually doesn't require a booster to meet the 'fully vaccinated' definition. There are some States that do require the booster to meet the 'fully vaccinated' definition. See link below, fifth question down. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html - [](https://progressivesurgicalsolutions.com/forums/reply/34488/) - Thank you for the question, Susan. IV catheters without needles (just the plastic catheter), IV tubing, and IV bags are not sharps and should not be discarded in sharps bins. OSHA's Bloodborne Pathogens Standard discusses the protection of employees during the containment, storage, and transport of regulated waste other than contaminated sharps. Regulated waste is - [](https://progressivesurgicalsolutions.com/forums/reply/34487/) - Hi Annette. Thank you for the question. Education and evaluation of new safety devices and engineering controls are an ongoing practice of the Exposure Control Plan (ECP). OSHA requirements under the ECP state that you must review/update this plan annually and that this annual review reflects changes in technology that eliminate or reduce exposure to - [](https://progressivesurgicalsolutions.com/forums/reply/34486/) - Hi Leslie. Thank you for the question. Documented sharps counts would be warranted in oculoplastic cases. Sponge counts most likely won't apply here because the "cavity" created in blepharoplasties isn't typically large enough to hide a sponge. Your needles, suture needles, and blades should be counted for oculoplastic cases, documented prior to the case beginning, - [](https://progressivesurgicalsolutions.com/forums/reply/34416/) - Hi Jessica - Yes since no patients "should" be in these areas you do not need listed hospital grade receptacles in that room. Testing shall be monthly for all Ground Fault Circuit Interrupter (GFCI) receptacles and annually for all others in the facility. Thank you. John L. Crowder, Jr. - [](https://progressivesurgicalsolutions.com/forums/reply/34415/) - Thank you so much John. Can I take that to mean that our scope reprocessing room does not have to have hospital grade outlets? And what about the yearly testing of the outlets? Thank you again. - [](https://progressivesurgicalsolutions.com/forums/reply/34414/) - Hi Jessica - Pursuant to NFPA 99: 6.3.2.2.6, 6.3.2.3 & NFPA 70: 210.8, 517.18 - all receptacles located in patient care areas shall be listed hospital grade. The definition for patient care areas is a follows: A space within a location intended for the examination and treatment of patients, extending 1.8 m (6 ft) beyond - [](https://progressivesurgicalsolutions.com/forums/reply/34397/) - Thank you for your question, Michelle. Unfortunately, there are not specific standards regarding this, but we definitely recommend ASC personnel records remain within your building because you will need frequent access to these files for entries and to ensure compliance with the contents. These files must be readily available during survey, which they may not - [](https://progressivesurgicalsolutions.com/forums/reply/34390/) - McKesson shows in stock - would need an item# to de sure Also try Surgical Product Solutions.com - [](https://progressivesurgicalsolutions.com/forums/reply/34352/) - We did not go with Press Ganey either. We are now using ASC WebQI for our electronic surveys and have been happy. Currently their program won't be OAS CAHPS compliant but since that is still voluntary at this point, we will cross that bridge when we have to. - [](https://progressivesurgicalsolutions.com/forums/reply/34339/) - Hi Sarah. Thank you for your question. AAAHC permits the use of an automated external defibrillator (AED) or manual defibrillator. The important part is that your staff have documented education and training that demonstrates their competency with the emergency equipment and your facility's policies and procedures concerning emergency management. Remember, because you have AAAHC accreditation, - [](https://progressivesurgicalsolutions.com/forums/reply/34338/) - Hi Lata. Thank you for your question. Please review the eSupport OSHA: Injury and Illness Prevention page for information on this topic to assist you in policy development. eSupport also offers a Workplace Violence CE course. Finally, be sure to check out Workplace Violence and Prevention Program P&P sample, available under OSHA in the P&P - [](https://progressivesurgicalsolutions.com/forums/reply/34323/) - Does anyone have a financial hardship policy they would share? - [](https://progressivesurgicalsolutions.com/forums/reply/34321/) - I found that the danger in using an online platform is that they ask for input on that day, which is not bad other than when you need to see the week or the month at one time to see if there has been in decrease or increase in values. For example, your humidity % - [](https://progressivesurgicalsolutions.com/forums/reply/34308/) - Thank you for your question, Thelma. Monitored anesthesia care, or MAC, is not a level of anesthesia. It is the pre/intra/post anesthesia services provided to the patient. When an anesthesia provider plans to provide MAC, the potential for converting to general is included. Total intravenous anesthesia (TIVA) is an anesthesia technique which may or may - [](https://progressivesurgicalsolutions.com/forums/reply/34307/) - Thank you for your question, Leslie. The term "non condensing" is referring to your YAG laser specifically. This means that your machine isn't at risk of experiencing condensation as long as the temp and humidity remain within the ranges provided. Once outside of those ranges, the manufacturer cannot guarantee that the laser will function as - [](https://progressivesurgicalsolutions.com/forums/reply/34306/) - Thank you for your question, Cathy. The Life Safety surveyor is more than likely referring to your policy that refers to your compliance with section 416.44 of the CMS CfC: Environment. This states, "The ASC must have a safe and sanitary environment, properly constructed, equipped, and maintained to protect the health and safety of patients. - [](https://progressivesurgicalsolutions.com/forums/reply/34305/) - Thank you for your question, Jodi. CMS does not specify what format your logs need to be in (print or electronic). They just need to be current, readily available, reflect what is provided in your policy, and demonstrate compliance. We recommend you reach out to your current EHR and medical/surgical supply vendors. They may have - [](https://progressivesurgicalsolutions.com/forums/reply/34263/) - Sorry, another question - the updated PSS policy also states weekly testing is required for non-vaccinated staff in California, but the state rescinded that requirement on 9/13/22, so we can remove that from the P&P update, correct? - [](https://progressivesurgicalsolutions.com/forums/reply/34259/) - Does anyone have a QAPI coordinator job description for ASC - [](https://progressivesurgicalsolutions.com/forums/reply/34258/) - Hello, Before each fire drill we place the fire alarm in "test mode" buy logging into the website of the company we use or call dispatch directly they can do it for you. We document the date time and the name of the person we spoke with on the fire drill log. Use the key - [](https://progressivesurgicalsolutions.com/forums/reply/34209/) - Hi Jessica, thank you for your question. Yes, you do need to include the fire alarm. This is an NFPA requirement. "Fire drills include the transmission of a fire alarm signal and simulation of emergency fire conditions. Fire drills are held at expected and unexpected times under varying conditions, at least quarterly on each shift. - [](https://progressivesurgicalsolutions.com/forums/reply/34196/) - Thank you for your question, Jamie. I want to make sure I understand your question. You are referring to an individual that has graduated nursing school, correct? Not a nursing student. If so, a graduate nurse (GN) must be under the supervision of a licensed nurse when providing patient care and providing that care within - [](https://progressivesurgicalsolutions.com/forums/reply/34195/) - Thank you for your question, Katherine. There is no standardized documentation/assessment tool for determining if a patient is stable for transitioning from Phase I to Phase II, or for discharge. The most common are the Aldrete, Modified Aldrete, and the Post Anesthetic Discharge Scoring System, PADSS, Modified PADSS, and Postanesthesia Recovery Score for Ambulatory Patients - [](https://progressivesurgicalsolutions.com/forums/reply/34184/) - Does anyone know if it is a requirement to pull the fire alarm as part of the drill? I spoke to our fire marshall and he says they don't want us touching that. I'm not sure what requirement this is under. - [](https://progressivesurgicalsolutions.com/forums/reply/34183/) - Thank you for your question, Michael. There is no set number of minutes and/or timeframe for when surgical items should/can be opened prior to surgery. It is important to confirm that the previous patient has been transferred from the OR and that thorough OR cleaning/disinfection turnover has occurred. Surgical items should be opened as close - [](https://progressivesurgicalsolutions.com/forums/reply/34170/) - Thank you! - [](https://progressivesurgicalsolutions.com/forums/reply/34058/) - Thank you for the question, Kim. The FDA provides a website that allows you to search for drugs with “extended use dates” that assists with drug shortages. This website can be found here: https://www.fda.gov/drugs/drug-shortages/search-list-extended-use-dates-assist-drug-shortages. The FDA also provides an additional database that allows you to search for medications to determine if there’s a known shortage, - [](https://progressivesurgicalsolutions.com/forums/reply/34057/) - Thank you for the question, Elizabeth. There are other tools for DVT assessment available that can be adopted into your VTE/DVT policy and procedure. AAAHC has a Patient Safety Toolkit for VTE and this is $10 through their website: https://store.aaahc.org/Ambulatory-Surgery-and-Venous-Thromboembolism-Toolkit. There is also the Autar DVT risk assessment: https://www.semanticscholar.org/paper/The-management-of-deep-vein-thrombosis%3A-the-Autar-Autar/b0e393c0546e68f978cffd326cd58487e6a2d22c. There is this tool from the - [](https://progressivesurgicalsolutions.com/forums/reply/34030/) - He should reapply for privileges to the medical staff. His role was different as a fellow so he will now be applying for active medical staff privileges per the medical staff bylaws. - [](https://progressivesurgicalsolutions.com/forums/reply/34029/) - Thank you for your question, Jenni! Letter J of the CMS ASC IC Surveyor Worksheet states, "Multi-dose medication vials used for more than one patient are stored appropriately and do not enter the immediate patient care area (e.g., operating room, anesthesia carts). NOTE: If multi-dose vials enter the immediate patient care area, they must be - [](https://progressivesurgicalsolutions.com/forums/reply/34022/) - Is there an expiration date on preprinted orders coming from physician offices? For example, if a physician sends an order that is timed and dated 60 days prior to scheduled date of surgery, is that an issue? - [](https://progressivesurgicalsolutions.com/forums/reply/34021/) - No policy needed, our protocol is to report to the manufacturer, the removal of the expired IOL from our consignment inventory, then order a replacement. some companies ask you to destroy them and document it. Some require you to send them back. - [](https://progressivesurgicalsolutions.com/forums/reply/34019/) - Thank you for your question, Megan. CMS allows non-clinical/common space (check-in desk, waiting room, restrooms) within an ASC to be shared with an adjacent physician's office but never at the same time. Meaning, you cannot be admitting or caring for ASC patients and LASIK patients in the same space within the ASC. If the ASC - [](https://progressivesurgicalsolutions.com/forums/reply/34018/) - Thank you for your question, Michelle. Your education for waste anesthetic gases (WAG) should be included in your annual OSHA training, because this is an occupational hazard. QUAD A states that all medical hazardous wastes are to be stored in OSHA acceptable containers and separated from general refuse for special collection and handling and there - [](https://progressivesurgicalsolutions.com/forums/reply/34014/) - How are you documenting if the doctor has ok'd the patient to drive? Is it done on the doctors orders or nurses notes? Our current process is that the patient documents on their health history if they have a driver or not. Curious if we need to change our process. - [](https://progressivesurgicalsolutions.com/forums/reply/33966/) - If your pre-op orders include medication administration, these orders should be executed by a licensed nurse, functioning within her scope of practice within your given state. An additional consideration is the appropriate pre-operative assessment data collection, which may be used in the surgeon's pre-surgical assessment conducted prior to surgery. It would be unlikely that an - [](https://progressivesurgicalsolutions.com/forums/reply/33965/) - Thank you for your question, Annette. To manage this, first, refer to your facility's Respiratory Protection Program (RPP). Review the plan to ensure there is language in there regarding fit testing and the use of N95s within your facility. If the nurses are working in environments in which there is a potential for an airborne - [](https://progressivesurgicalsolutions.com/forums/reply/33948/) - Please clarify, does this mean that all RN's should have an annual competency checkoff? - [](https://progressivesurgicalsolutions.com/forums/reply/33947/) - Can anyone confirm whether or not an RN must perform preop and post op/discharge on YAG or SLT laser patients? We are currently using a person that has been trained to assist the physician but is not a nurse. Our administration insists that this is ok but now I am questioning this policy. - [](https://progressivesurgicalsolutions.com/forums/reply/33944/) - OSHA does not give an option for declination of the initial two-step. They could do the QUANTI-feron blood test instead. Or if you want to change your facility policy to allow people to decline, that would be a decision internally. - [](https://progressivesurgicalsolutions.com/forums/reply/33942/) - A job description is not necessary for medical staff members. They should receive a copy of the Medical Staff Bylaws and sign an acknowledgement. Then they will be credentialed and granted privileges for procedures they are qualified to perform - this needs to be approved by the Governing Body. - [](https://progressivesurgicalsolutions.com/forums/reply/33917/) - No, just the medical director. I guess I assumed I needed one. We are on boarding a new surgeon, so getting everything ready :) - [](https://progressivesurgicalsolutions.com/forums/reply/33912/) - It is not required to have a job description for a surgeon. Is someone suggesting that you need to have one? - [](https://progressivesurgicalsolutions.com/forums/reply/33911/) - You really just need to have a protocol for your process of discarding expired lenses. You don't need to have a policy. If you would like I can post this on "Sharing is Caring" to reach a broader audience. Please let me know if you would be interested. You can also post it on the - [](https://progressivesurgicalsolutions.com/forums/reply/33898/) - Yes we used SPH as well. Not impressed with Press Ganey but what other company? The center does over 7500 cases per yr and need surveys to be sent electronically - [](https://progressivesurgicalsolutions.com/forums/reply/33897/) - We were using SPH analytics, but they were recently bought by Press Ganey. We have found that Press Ganey is designed for huge hospital systems with multiple departments. It has also been difficult to interpret reports from their data. We are looking at another company Arbor, which seems to be more geared toward smaller centers - [](https://progressivesurgicalsolutions.com/forums/reply/33896/) - We built a patient satisfaction survey in Microsoft Forms and attached a QR code to the form. We include a brightly colored piece of paper with the QR code and instructions with a thank you note from all our staff when we discharge a patient. When our patient's use the QR code and fill out - [](https://progressivesurgicalsolutions.com/forums/reply/33891/) - @cristina-hallgren Gregory is not on here, but his email is listed in his response above so you can reach out to him directly. Sorry for the inconvenience. - [](https://progressivesurgicalsolutions.com/forums/reply/33890/) - We will send out on sharing is caring to get other feedback, but it would also probably be helpful to post on the facebook page!! - [](https://progressivesurgicalsolutions.com/forums/reply/33889/) - There really aren't specific policies to those procedures that you need to add except policies for accepting and reporting tissue. Usually you don't store tissue, just receive day of, but there would be additional policies for that as well. - [](https://progressivesurgicalsolutions.com/forums/reply/33888/) - Yes this is correct. If you do a procedure in your ASC and are billing a facility fee for it, you need to follow all the same rules - RN pre and postop assessments, H&P, presurgical assessment, operative report, physician orders, etc. There are sample medical record forms for ophthalmology laser procedures on eSupport under - [](https://progressivesurgicalsolutions.com/forums/reply/33887/) - There has been no official response from Medicare. You can follow CDC recommendations as long as your State or Local Department of Health doesn't state otherwise. It also largely depends on case rates where you are geographically located. Medicare never actually 'mandated' masks but were expecting that everyone was following CDC recommendations. - [](https://progressivesurgicalsolutions.com/forums/reply/33886/) - Hello Gregory, I am located in California. I would like to transfer Narcotics from one center to another. I have had a heck of a time reaching a live person at the DEA office of diversion since they've changed their phone system. I'm only able to leave a voicemail and I've left many in the - [](https://progressivesurgicalsolutions.com/forums/reply/33884/) - Hello Michelle, We do clinical trials here at our facility. I will email! -Kim - [](https://progressivesurgicalsolutions.com/forums/reply/33883/) - @Amber- So helpful thank you ! Do you have an example of your policy and documentation you might be willing to share? - [](https://progressivesurgicalsolutions.com/forums/reply/33879/) - We are eyes only, about 16 - 20 cataracts a day right now. We have 12 trays and one person with 4 Tabletop Autoclaves. I am looking to hire a part time person to help as we add Cornea cases to the mix and also have back up for our one tech. - [](https://progressivesurgicalsolutions.com/forums/reply/33878/) - CMS doesn't differentiate between a procedure done in the OR versus a procedure room. For our yags, we do a set of vitals, pain rating, verify allergies, and go through patient's med list and discharge instructions, then dilate patient. Before the procedure takes plac,e a time out is done. Afterwards, the doc documents the number - [](https://progressivesurgicalsolutions.com/forums/reply/33862/) - It does depend on the State you are living in. You can look on eSupport under Resources_Certifications for some states. They are passing legislation that requires CST. Most of the legislation has grandfather rules that allow for individuals to work at surgical techs if they have been doing so for a particular amount of time - [](https://progressivesurgicalsolutions.com/forums/reply/33861/) - There is no 'certification' for this. ASCs can do research cases, but depending on what it is, it can be pretty involved, We will add a Research policy to eSupport so check back later this week. It will need to be approved by the Governing Body, procedures will need to be added to your Approved - [](https://progressivesurgicalsolutions.com/forums/reply/33859/) - @kimberly_malchow this is something a little too involved to answer through the Forum. I will send you an email to set up a quick phone call. - [](https://progressivesurgicalsolutions.com/forums/reply/33858/) - We are also an ophthalmic ASC and perform 30-40 cases out of 2-3 ORs depending on the day. We staff 2 positions in our CS department, one for each side (decontamination/rinsing vs "clean" side for wrapping, etc). Some days we'll get by with 1 person if needed but have found it's not sustainable over time - [](https://progressivesurgicalsolutions.com/forums/reply/33857/) - I'm pretty sure this varies by state. I know our scrub technician finished the school but I don't think she ever did the exam. She has been a scrub tech in Maryland for almost 30 years. Hope this helps! Elizabeth - [](https://progressivesurgicalsolutions.com/forums/reply/33838/) - ASCs are no longer required to report flu vaccination data to CMS. - [](https://progressivesurgicalsolutions.com/forums/reply/33830/) - Yes you can do minor procedures without anesthesia on site. The procedures need to be listed on your scope of care and the providers will need to request privileges (if they haven't already) to be able to perform such procedures. Meaning, it will need to be listed on their delineation of privileges request form and - [](https://progressivesurgicalsolutions.com/forums/reply/33827/) - Yes, ma'am. - [](https://progressivesurgicalsolutions.com/forums/reply/33821/) - We utilize 2 operating rooms. The instrument tech is only doing instruments. Cases are around 10-15 minutes each. - [](https://progressivesurgicalsolutions.com/forums/reply/33818/) - There is nothing in the regulations that doesn't allow this. It is obviously a risk management issue to allow a family member back into the OR, just in case there are any complications. But as long as they are in appropriate attire, there are no regulations against it. - [](https://progressivesurgicalsolutions.com/forums/reply/33816/) - Does this also go for Staff? thank you! - [](https://progressivesurgicalsolutions.com/forums/reply/33815/) - There are no regulations regarding this unless you are in a State that requires certified SPD techs to process instruments (there are not that many). This is a very typical model - but some f/u questions....how many ORs are those 25 cases being performed in and is the instrument tech only doing instruments or are - [](https://progressivesurgicalsolutions.com/forums/reply/33814/) - It is something the CDC recommends but there is no requirement. Unless there is a separate requirement by the State. https://www.cdc.gov/vaccines/hcp/admin/admin-protocols.html - [](https://progressivesurgicalsolutions.com/forums/reply/33813/) - An LVN could be the QAPI Coordinator with involvement from the RN Clinical Director. The ICC just has to be licensed so an LVN could do it, but you would need to show the appropriate IC training. - [](https://progressivesurgicalsolutions.com/forums/reply/33809/) - Unfortunately, there is no regulatory requirement, other than the requirement to have one ACLS nurse in the facility at all times. It is definitely a standard that all clinical personnel have, at a minimum, BLS certification. If you are doing RN conscious sedation, your RN monitors should be ACLS certified. - [](https://progressivesurgicalsolutions.com/forums/reply/33806/) - AORN is a hard stop on rings and wrist jewelry when scrubbed in. AORN has left it up to facilities with necklaces and earrings. - [](https://progressivesurgicalsolutions.com/forums/reply/33805/) - The purpose of the Driver's License is to verify the providers identity during appointment. Once it is verified it It should be either notated on a checklist or you need to keep a copy of it on file if you are not utilizing a checklist. Asking for updated Driver's License after it has expired is - [](https://progressivesurgicalsolutions.com/forums/reply/33803/) - Are there any state regulations for Texas code that would prohibit a family member from being back in surgery with the patient if the operating doctor gave the green light ? Is this up to the facility and doctors discretion or could we be cited for this scenario? - [](https://progressivesurgicalsolutions.com/forums/reply/33802/) - Thank you! - [](https://progressivesurgicalsolutions.com/forums/reply/33800/) - Hello - See attached (page 10). Hope that helps! - [](https://progressivesurgicalsolutions.com/forums/reply/33792/) - AORN doesn't have a specific recommendation when it comes to wearing necklaces but they do say that it does pose a risk that the necklace could fall into the sterile field if it is visible on a scrubbed in individual. Otherwise, you are correct, it really is something that your Infection Control team evaluates and - [](https://progressivesurgicalsolutions.com/forums/reply/33791/) - thank you! - [](https://progressivesurgicalsolutions.com/forums/reply/33785/) - Each patient needs a history and physical examination. The links below are the VA State regulations regarding that. There is no specific time frame, so you need to determine what that time frame is and ensure that is included in the policy. https://law.lis.virginia.gov/admincode/title12/agency5/chapter410/section1260/ https://law.lis.virginia.gov/admincode/title12/agency5/chapter410/section1270/ The CMS requirement you can find on eSupport under CMS Regulations_CfC - [](https://progressivesurgicalsolutions.com/forums/reply/33782/) - An AED is acceptable for emergency use on your crash cart. If your scope of services includes general anesthesia and bigger procedures, a defibrillator would be appropriate. But bottom line you need something on your crash cart and if you can't get a defibrillator you need to at least have an AED. - [](https://progressivesurgicalsolutions.com/forums/reply/33781/) - Hi there, thanks for responding. We are in Virginia. We are not accredited at this time. - [](https://progressivesurgicalsolutions.com/forums/reply/33780/) - @Erin-VanLoon what State are you located in? And are you accredited also? - [](https://progressivesurgicalsolutions.com/forums/reply/33779/) - No we don't have a specific policy regarding this. Because recommendations frequently change and it varies depending on where you are located. If you have someone test positive for COVID it is best to just check recommendations with CDC and/or local health department. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html - [](https://progressivesurgicalsolutions.com/forums/reply/33755/) - It would be good to have a statement in the policies that other contrasts may be used when shortages occur with GB approval. And also put it in your meeting minutes to demonstrate GB approval. - [](https://progressivesurgicalsolutions.com/forums/reply/33753/) - A signature at the bottom is fine, just make sure it is authenticated and dated/timed prior to the nurse carrying out the orders. - [](https://progressivesurgicalsolutions.com/forums/reply/33748/) - You can absolutely change your policy to meet the IFU for the product. And per CMS/State/AAAHC/AAAASF (IFU - Vendor Guideline Settings) - Max Blanket: 200° F / Max Fluid: 110° F) - [](https://progressivesurgicalsolutions.com/forums/reply/33744/) - Great! thank you - [](https://progressivesurgicalsolutions.com/forums/reply/33743/) - Apologize for the delayed response! Peer review is only required for medical staff (surgeons, anesthesia personnel). Annual performance appraisals, including competency checks are required for all facility staff members (clinical and business ops) on an annual basis. There are some examples of competencies for annual performance appraisals on eSupport under Policies and Procedures_Human Resources. - [](https://progressivesurgicalsolutions.com/forums/reply/33742/) - No those orders would be fine. You just need to ensure that the surgeon who performed the procedure is on the consent form signed by the patient. - [](https://progressivesurgicalsolutions.com/forums/reply/33740/) - It should be event related shelf life. We will add a policy to eSupport under Policies and Procedures_Infection Control called Event Related Shelf Life and Sterile Packaging. Check back later this week. - [](https://progressivesurgicalsolutions.com/forums/reply/33739/) - Unfortunately, no. You still need to have a complete file on the provider being credentialed including peer references. - [](https://progressivesurgicalsolutions.com/forums/reply/33727/) - You are not required to do COVID testing for non vaccinated staff. You are required to have a policy for accommodations for non vaccinated staff which could include weekly testing, but it is up to the facility on what accommodation you want to have in place (ie. testing, masking, separate lunch breaks, etc). - [](https://progressivesurgicalsolutions.com/forums/reply/33726/) - Yes, AAAHC utilizes the CMS infection control surveyor worksheet which has been updated with the new requirement for multidose eye drops. - [](https://progressivesurgicalsolutions.com/forums/reply/33725/) - Due to the anesthesiologist shortage in our area, we are preparing to use CRNA's when there is no anesthesiologist to cover. - [](https://progressivesurgicalsolutions.com/forums/reply/33679/) - For unused vials, we check with the manufacturer to see if we can get a credit. For opened or syringe waste, we use Rx Destroyer you can order jugs (charcoal) online. - [](https://progressivesurgicalsolutions.com/forums/reply/33678/) - We use RXRS.com. We box up our expired Controlled substances, print off shipping labels and mail them in. It is a very easy process. - [](https://progressivesurgicalsolutions.com/forums/reply/33666/) - We waste small amounts of expired IV medications into a cactus container. Large amounts or pills are wasted using a product called RX Destroyer that you can order online. With Rx Destroyer you just put the medication into the bottle gently shake and place in the regular trash. We have an expired medication log where - [](https://progressivesurgicalsolutions.com/forums/reply/33665/) - We send our unopened expired medications, both controlled and non-controlled, back to National Pharmaceutical Returns company. For opened controlled meds that need to be wasted, we squirt them in the RX Destroyer bottle and both nurses sign the narcotic waste log. For opened non-controlled meds, we squirt them in the sharps container which gets picked - [](https://progressivesurgicalsolutions.com/forums/reply/33661/) - OK thank you both very much! - [](https://progressivesurgicalsolutions.com/forums/reply/33660/) - We use a CRNA for our cataract cases. - [](https://progressivesurgicalsolutions.com/forums/reply/33659/) - Are there any outpatient surgery centers in California that are not using an anesthesiologist for local and topical cataract surgery? We are in the Bay area and would love to talk to you! - [](https://progressivesurgicalsolutions.com/forums/reply/33651/) - @heather-jeffers it really isn't per the American Heart Association. You can have people take an online portion, but the AHA specifically says, "After completing the online portion of this course, you must complete a hands-on session with an AHA Training Center to obtain a course completion card." They need the practicum portion of the course. - [](https://progressivesurgicalsolutions.com/forums/reply/33650/) - Yes, it is okay to document patient states "unknown" as long as something is documented to show it has been addressed. - [](https://progressivesurgicalsolutions.com/forums/reply/33649/) - With the reaction it is ok to document unknown if patient doesn't know BTW, many patients don't but just make sure something is documented. - [](https://progressivesurgicalsolutions.com/forums/reply/33648/) - Look at your state regulations and your accreditation agency. I am in NJ and state doesn't specify (surprisingly) but AAAHC specifies it must be in person. - [](https://progressivesurgicalsolutions.com/forums/reply/33637/) - as - [](https://progressivesurgicalsolutions.com/forums/reply/33634/) - Attached is our Pre-op nurses note for reference - [](https://progressivesurgicalsolutions.com/forums/reply/33631/) - We only have intra-op orders that state "administer to sterile field". The surgeon documents the medications he injected on his operative note. We do not have an intra-operative MAR because signing these would indicate the circulating nurse administered them. Does that make sense? So when you say "Nursing Record" what are you specifically referring to? - [](https://progressivesurgicalsolutions.com/forums/reply/33630/) - There are a lot of products on the market for use as a cleaner/ disinfectant for OR floors. Here is the EPA website and this link is to products from List N recommended by the CDC and CMS for cleaning and disinfecting during the pandemic. Your local distributor could also give you suggestions on what - [](https://progressivesurgicalsolutions.com/forums/reply/33628/) - Got it. My answers are applicable. Let me know if you have any other questions. Thanks! - [](https://progressivesurgicalsolutions.com/forums/reply/33626/) - It should be documented on the Nursing Record, the same way that a circulator would document medications administered in the OR by the surgeon. - [](https://progressivesurgicalsolutions.com/forums/reply/33623/) - Hello, These requirements came from AAAASF. They recently came out with an updated CMS ASC Covid-19 worksheet. I posted the worksheet on the FORUM a while back thank you for the information! - [](https://progressivesurgicalsolutions.com/forums/reply/33622/) - We don't have an example of Medical Staff Bylaws on eSupport. I will email you to discuss. - [](https://progressivesurgicalsolutions.com/forums/reply/33621/) - @kimberly-malchow where are you getting these requirements from? Just want to ensure I am giving you correct information. We don't have specific training related to COVID-19. It really is going to vary depending on your location and facility requirements so you should just document an inservice with your staff. You should have cleanable furniture throughout - [](https://progressivesurgicalsolutions.com/forums/reply/33619/) - Using an outside transcription company is not required. There are some facilities that use templates for procedures and fill in required data based on the OR Record and then have surgeons authenticate. As long as there is an accurate Operative Report that is authenticated by the surgeon, that is what matters. - [](https://progressivesurgicalsolutions.com/forums/reply/33610/) - 1. You need to document the allergy and the reaction, you do not have to document the severity. 2. Yes, you should be asking specifically about latex allergies as well as their reaction. If the patient has a latex allergy or sensitivity you would want to be proactive and ensure the supplies you have are - [](https://progressivesurgicalsolutions.com/forums/reply/33605/) - There are policies and procedures on esupport-P&P-Covid-19 for Visitors, Universal Masking, Social Distancing and in Infection Control- Hand Hygiene. - [](https://progressivesurgicalsolutions.com/forums/reply/33604/) - 36 vials (6 boxes) of Dantrolene should be available. The nanocrystalline suspension of RYANODEX® is 150 times more concentrated than standard dantrolene, therefore not as much is required to be available for an MH crisis. https://www.mhaus.org/healthcare-professionals/be-prepared/what-should-be-on-an-mh-cart/ - [](https://progressivesurgicalsolutions.com/forums/reply/33602/) - You can revise your policy to read a 'Y' for yes will be placed at the surgical site. The marking of the intended procedure site must be at or near the procedure site, unambiguously clear, and the method of marking must be consistent throughout the organization. - [](https://progressivesurgicalsolutions.com/forums/reply/33601/) - Hi Robin, There is a great document on eSupport that gives an overview on requirements for LSC. Please refer to eSupport_Life Safety Code_LSC Overview and then scroll all the way down. There is a document that is called Life Safety Code Overview 2017. Please let me know if you have additional questions after you have - [](https://progressivesurgicalsolutions.com/forums/reply/33598/) - In researching this, I've come up with several different answers. I haven't seen anything that said they are one time use though. Most say they can be cleaned with soap and water, or some say autoclave. Some say used up to 30 times. Where is this 'guidance' coming from?? - [](https://progressivesurgicalsolutions.com/forums/reply/33595/) - requirement is six boxes - 36 viles on the crash cart at all times - [](https://progressivesurgicalsolutions.com/forums/reply/33594/) - Just to clarify....3 vials of dantrolene is sufficient? or should that be 3 boxes? I was always under the impression we were required to have 6 boxes. - [](https://progressivesurgicalsolutions.com/forums/reply/33593/) - The original post on this thread is from Feb 20, 2017. Are the standard "Christmas tree" adapters still considered a single use item? Thanks. - [](https://progressivesurgicalsolutions.com/forums/reply/33590/) - Three vials of Ryanodex should be available in your MH cart. - [](https://progressivesurgicalsolutions.com/forums/reply/33588/) - Yes, all staff working inside the facility are included, regardless of clinical responsibility or patient contact. - [](https://progressivesurgicalsolutions.com/forums/reply/33560/) - There is not a standard for how many RNs you need. The CfCs state "There must be sufficient nursing staff with the appropriate qualifications to assure the nursing needs of all ASC patients are met." - [](https://progressivesurgicalsolutions.com/forums/reply/33558/) - Crissy, you may have made my day, week, month!!!! Would you mind to point me in the right direction to show this wild MD? He said, oh this will be self pay and VERY profitable. I do NOT want to do these for many reasons!!! Thank you very much for your help & if I - [](https://progressivesurgicalsolutions.com/forums/reply/33555/) - We use the nipple and nut adaptors. Says there is 50 per box which makes me think they are disposable. But is there a work around? We connect long connector tubing that stays in place attached to the adaptor, that connects to an oxygen tubing connector, then the nasal cannula connects to that... https://www.medline.com/product/Nipple-and-Nut-Adapters/Z05-PF33080 - [](https://progressivesurgicalsolutions.com/forums/reply/33544/) - Hi Michelle, No, you are not missing a step. If you are unable to see your data input, I would recommend contacting the help desk. - [](https://progressivesurgicalsolutions.com/forums/reply/33543/) - Ok, do you have any kind of P&P regarding patients that test positive for Covid during their in-office H&P with the surgeon would cancel the procedure and make the patient wait 21 days before they can reschedule surgery We have a AAAASF survey coming up don't have a Policy for this - [](https://progressivesurgicalsolutions.com/forums/reply/33542/) - We would recommend to follow CDC guidelines. If you test positive for COVID it is really just 5-10 days depending on different circumstances. https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html - [](https://progressivesurgicalsolutions.com/forums/reply/33541/) - The anesthesia provider can be the witness signature since it should be signed after informed consent is provided. You don't need an additional witness signature. - [](https://progressivesurgicalsolutions.com/forums/reply/33540/) - You can't do that in a surgery center. It is not an approved procedure for ASCs. - [](https://progressivesurgicalsolutions.com/forums/reply/33537/) - @katherine-spencer we can help drive this so I will email you to find out more about what exactly you are looking for. Thanks. - [](https://progressivesurgicalsolutions.com/forums/reply/33536/) - There is no state licensing in the state of Idaho for ambulatory surgery centers in Idaho so no other specific regulations to follow besides Medicare and your accreditation requirements. - [](https://progressivesurgicalsolutions.com/forums/reply/33522/) - I am located in Idaho and we are accredited through AAAHC and CMS. Can you help point me in the direction of where I can find these regulations for H&P that are specific to idaho? - [](https://progressivesurgicalsolutions.com/forums/reply/33521/) - I completed the reporting for one week each month for the first quarter. I just received a notice that I have not submitted any vaccination data for any of the months. Am I missing a step? - [](https://progressivesurgicalsolutions.com/forums/reply/33514/) - Hi Jazmine, There are no AAMI/AORN recommendations that state you must double peel pack or not, but they do recommend you follow your manufacturer IFU's. There are many peel packs that have not been validated to be double pouched. Important to look at your MIFUs to see if yours can be or not. - [](https://progressivesurgicalsolutions.com/forums/reply/33511/) - Hi Dia, We have an Infection Control Risk Assessment on eSupport under Risk Assessments. There are two of them. One is a spreadsheet stating the probability, risk, and readiness. It is a scoring system like you mentioned. The other one based on the issue, what your current status is, what is your desired status, what - [](https://progressivesurgicalsolutions.com/forums/reply/33506/) - Mckesson (and similar vendors) offer an inventory product that can be free based on spending dollars per month. IOS envy is also a good product and relatively inexpensive. - [](https://progressivesurgicalsolutions.com/forums/reply/33504/) - HI Jodi, I would recommend posting on the Facebook group also. You are on the right track...Ultimately you would want to treat it as two separate surgeries, meaning both surgical sites would be marked, two separate surgical preps, different lot numbers (if possible), two time outs and the room turned over in between eyes. I - [](https://progressivesurgicalsolutions.com/forums/reply/33503/) - Hi Amanda, Annually, PSS holds an amazing leadership conference called the NLC (Nurse Leadership Conference). This conference is specifically for clinical directors and administrators focusing on leadership, compliance, QAPI, staffing, infection control, financial, and much more. Progressive holds this conference every year in the Spring and the next one will be April 27th and 28th - [](https://progressivesurgicalsolutions.com/forums/reply/33502/) - Thank you, this is so helpful! - [](https://progressivesurgicalsolutions.com/forums/reply/33497/) - This attachment was given to me by my pharmacy consultant. - [](https://progressivesurgicalsolutions.com/forums/reply/33479/) - There is a really great webinar on eSupport under Education_Webinars_Progressive Huddle_ 2022 ASC Quality Reporting by Gina Throneberry that goes over all of the 2022 Quality Reporting specifically the ASC 20. I highly recommend watching the webinar first and then let me know if you have any questions. The reporting of the ASC 20 is - [](https://progressivesurgicalsolutions.com/forums/reply/33478/) - To add to this, apparently effective June 27, 2022, we need to report HCP that are 'up to date' (booster within the past 5 months) on the vaccinations. Are we going to get 'dinged' if they are not up to date ?? - [](https://progressivesurgicalsolutions.com/forums/reply/33467/) - Hi Leslie, I will post on Sharing is Caring, but I would also recommend for you to post on the Facebook group. I will touch base with via email also to make sure you are all set on a policy. - [](https://progressivesurgicalsolutions.com/forums/reply/33466/) - Hi Tammy, I will post this in Sharing is Caring, but I would also recommend you posting on the Facebook group. We have Florida based leaders that would have some great suggestions. Also, if you haven't already, I would recommend looking on Floridahealth.gov they have training specific to Human Trafficking. - [](https://progressivesurgicalsolutions.com/forums/reply/33465/) - Hi Lynn, We are not aware of any new regulations that require you to regularly test your water quality. You just need to ensure that critical water is being used for decontamination and sterilization, and also that you are following the manufacturer's instructions for use for both instruments and equipment. I would also check with - [](https://progressivesurgicalsolutions.com/forums/reply/33464/) - Hi Michelle, I apologize for the delayed response. There are no current federal requirements for screening, but I would check with your local/State health department. This is a facility decision. If you decide to screen and utilize a questionnaire, just be sure you have a policy for it. - [](https://progressivesurgicalsolutions.com/forums/reply/33462/) - Anyone at PSS know the answer????? - [](https://progressivesurgicalsolutions.com/forums/reply/33461/) - Is screening (Covid S&S and temp check) of anyone entering the facility still required? - [](https://progressivesurgicalsolutions.com/forums/reply/33453/) - So how is it being documented that the physician is doing this? - [](https://progressivesurgicalsolutions.com/forums/reply/33425/) - This is really confusing the way CMS did this, but really nothing has changed. - The Anesthetic Risk and Evaluation changed to include an anesthetist being able to examine the patient for risk of anesthesia (instead of just a physician). - The Anesthetic Risk and Evaluation 416.42a(1)(i) also now includes that a physician has to - [](https://progressivesurgicalsolutions.com/forums/reply/33423/) - Hi Scott, There are only five states (California, Connecticut, New Mexico, New York, and New Jersey) that mandated a booster in order to be "fully" vaccinated. If you are not located in one of the states listed then they would not have to test weekly. If you are in one of the states listed, and - [](https://progressivesurgicalsolutions.com/forums/reply/33421/) - Thank you I will do just that. - [](https://progressivesurgicalsolutions.com/forums/reply/33420/) - Hi Lynn, I will post this on Sharing is Caring. Also, this would be a great question for you to post on the Facebook group. - [](https://progressivesurgicalsolutions.com/forums/reply/33419/) - Hi Jazmine, Here's the website for the final rule in 2019, scroll down to ambulatory surgery center. It speaks on the transfer agreement. Despite this change, many states have their own requirements surrounding transfer agreements and/or hospital privileges, so be sure to check your state requirements also. https://www.cms.gov/newsroom/fact-sheets/omnibus-burden-reduction-conditions-participation-final-rule-cms-3346-f - [](https://progressivesurgicalsolutions.com/forums/reply/33416/) - We are and ophthalmic ASC and are trying to develop more straightforward guidelines for patient blood sugars. We test all diabetics and notify the CRNA if the results are outside of range but with us contracting with an anesthesia group, each provider has different feelings or are concerned about their decision causing conflict with surgeons. - [](https://progressivesurgicalsolutions.com/forums/reply/33407/) - I automatically add them to PEER review, for evaluation of the complication. I also have a monthly tracking for benchmarking that I include it on. - [](https://progressivesurgicalsolutions.com/forums/reply/33406/) - Thank you, I just remeasured our data in April of 2022, and found that we have backslid to 58%. I have implemented a new measure by updating our patient assignment cards to have a space for pre-op RN to write their name, but none of the staff are following this, even our team leaders. I - [](https://progressivesurgicalsolutions.com/forums/reply/33393/) - Hi Victoria, It's not advisable to use a portable dehumidifier in your facility. This would be an infection control issue. I'm sure you have already had your units serviced, but I would question whether the humidification units are the correct size to adequately manage the humidity? I would also consult with Alcon to advise on - [](https://progressivesurgicalsolutions.com/forums/reply/33380/) - The confusing part is testing unvaccinated employees when we just had a fully vaccinated employee test positive for Covid. That employee has not been here. We have two "exempt" employees who are maybe only here once a month. Some staff we don't see for months. We are not their primary employer they all have FT - [](https://progressivesurgicalsolutions.com/forums/reply/33376/) - Can you please provide in writing that an ASC no longer needs a transfer agreement. - [](https://progressivesurgicalsolutions.com/forums/reply/33374/) - What five states are the booster required for? ## Courses - [OBSC Orientation / Annual Education & Training](https://progressivesurgicalsolutions.com/courses/obsc-orientation-annual/) - OBSC Orientation / Annual Education & Training DISCLAIMER: This education program provides general orientation and annual education for personnel working in the OBSC and does not replace facility-specific training, competency validation, or in servicing. Additional education may be required based on the facility’s policies, procedures, equipment, specialty services, emergency protocols, and applicable state or regulatory - [ASC Annual Education & Training](https://progressivesurgicalsolutions.com/courses/annual-training/) - ASC Annual Education & Training DISCLAIMER: While VMG Health makes every effort to capture traditional mandatory annual training requirements in this course, facility and role-specific training and competencies are still required. Examples of this may include and are not limited to: emergency shut-off locations, waived testing, CEMP policies and procedures, etc. Please see the following - [Infection Control Coordinator / Preventionist Training Program](https://progressivesurgicalsolutions.com/courses/infection-control-coordination-preventionist-training-program/) - Infection Control Coordinator / Preventionist Training Program Course Description This course provides a comprehensive foundation for the Infection Control Coordinator (ICC) or Infection Preventionist (IP) responsible for developing, implementing, and overseeing the facility’s Infection Prevention and Control (IPC) Program. This course is designed to strengthen regulatory understanding, reinforce evidence-based practices, and build the practical skills - [QAPI Program](https://progressivesurgicalsolutions.com/courses/qapi-program/) - QAPI Program Course Description A well-developed Quality Assessment and Performance Improvement (QAPI) program is essential to an ASC. Not only is it a requirement (state and federal regulations as well as accreditation standards), it assures and documents the safety and quality of the services provided in your facility. A QAPI program includes ongoing evaluation of - [Bloodborne Pathogen Exposure Control](https://progressivesurgicalsolutions.com/courses/bloodborne-pathogen-exposure-control/) - Bloodborne Pathogen Exposure Control Course Description The purpose of a Bloodborne Pathogen Control Program is to minimize or limit occupational exposure to blood and other potentially infectious materials, since any exposure could result in the transmission of bloodborne pathogens, such as Hepatitis B virus (HBV), Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV), which could - [IV Conscious Sedation](https://progressivesurgicalsolutions.com/courses/iv-conscious-sedation/) - IV Conscious Sedation Course Description This course is designed to review the fundamental concepts associated with the safe administration and management of conscious sedation by a Registered Nurse (“RN”). The term conscious sedation is also known as moderate sedation/analgesia or procedural sedation/analgesia in various professional publications, agency websites, and interdisciplinary guidelines for non-anesthesia practitioners. Learning - [Workplace Violence](https://progressivesurgicalsolutions.com/courses/workplace-violence/) - Workplace Violence Course Description This course is designed to educate nurses and other healthcare professionals who are involved with the care of patients regarding identification and response during violent situations in the workplace. Before completion of this learning module, the participant should have a basic understanding in the identification of workplace violence and appropriate response. - [USP <800> Handling of Hazardous Drugs](https://progressivesurgicalsolutions.com/courses/usp800-handling-of-hazardous-drugs/) - USP Handling of Hazardous Drugs Course Description USP provides standards for the safe handling of hazardous drugs from the ordering process to use in the clinical space. This course will review the standards in detail and provide specific guidance on how to implement these standards in your facility. Learning Objectives Describe what USP - [TASS and Endophthalmitis](https://progressivesurgicalsolutions.com/courses/tass-and-endophthalmitis/) - TASS and Endophthalmitis Course Description This course was designed to inform and educate you about the differences between TASS and endophthalmitis after cataract or refractive surgery. Topics will include signs and symptoms, diagnosis and common treatments for these diseases. We will also review recommendations and guidelines set forth to prevent TASS and endophthalmitis. This course - [Sterilization Best Practices in the ASC](https://progressivesurgicalsolutions.com/courses/sterilization-best-practices-in-the-asc/) - Sterilization Best Practices in the ASC Course Description Instrument decontamination and sterilization is under increased scrutiny and for good reason. As part of a strong Infection Control Program, it is important that all healthcare professionals and ancillary staff involved receive adequate education. This course is intended for staff working in the ASC arena involved with - [Steam Sterilization](https://progressivesurgicalsolutions.com/courses/steam-sterilization/) - Steam Sterilization Course Description Sterilization is the complete destruction of all microbial life using physical or chemical procedures. In this course, you will learn why steam sterilization is often the method of choice, details about basic types of steam sterilization equipment, and procedures to monitor sterilization cycles, properly maintain sterilizers, and abort loads. This course - [Radiation Safety](https://progressivesurgicalsolutions.com/courses/radiation-safety/) - Radiation Safety Course Description This course is designed to present information about radiation safety practices for healthcare providers who are involved with the care of patients undergoing radiographic imaging in the O.R. Learning Objectives Identify the 3 categories of radiation sued in healthcare Name the 3 basic principles of radiation protection Discuss the effects of - [Pain Assessment & Management in the ASC](https://progressivesurgicalsolutions.com/courses/pain-assessment-and-management-asc/) - Pain Assessment & Management in the ASC NOTE: This course is educational and does not replace staff training and/or competency regarding facility-specific pain assessment and management policies and procedures. This course may not be accepted by your state board of nursing for required pain management continuing education units. Course Description Not all surgical procedures - [OSHA Overview](https://progressivesurgicalsolutions.com/courses/osha-overview/) - OSHA Overview Course Description This module is designed to present an overview of a compliant OSHA program for all clinical and non-clinical personnel working in an ambulatory surgery center. Learning Objectives Identify major bloodborne pathogens and symptoms Define personal protective equipment and its appropriate use Understand the Hazard Communication Program Course Material Once you have - [Medication Safety in the ASC](https://progressivesurgicalsolutions.com/courses/medication-safety-in-the-asc/) - Medication Safety in the ASC Course Description This course is designed to educate nurses on the importance of proper medication management, medication error prevention strategies, and safety considerations in the often repetitive and fast-paced ASC environment. Before completion of this course, the participant should have a basic understanding their scope of practice, of patient - [Medical Record Documentation](https://progressivesurgicalsolutions.com/courses/medical-record-documentation/) - Medical Record Documentation Best Practices Course Description This course is designed to review the fundamental concepts associated with the best practices of documentation as a Registered Nurse (RN) to ensure your medical record documentation meets basic standards of practice and regulatory requirements. Learning Objectives Describe the purpose of accurate documentation Identify five documentation requirements in - [Malignant Hyperthermia](https://progressivesurgicalsolutions.com/courses/malignant-hyperthermia/) - Malignant Hyperthermia Course Description The goal of this learning module is to review the key signs and symptoms of Malignant Hyperthermia (MH), to enhance early recognition, and to help each healthcare professional working in the operating room understand the role he or she may have to play in treating an MH episode. Learning Objectives Discuss - [Leadership and Nurse Burnout](https://progressivesurgicalsolutions.com/courses/leadership-and-nurse-burnout/) - Leadership and Nurse Burnout Course Description This course is designed to educate the ASC leader, nurse leader, or nurse about burnout in the healthcare industry. The definitions, risk factors, signs and symptoms, prevention, and treatment of both leadership and nurse burnout are addressed. Additional resources for burnout assessment and identification, self-help, and awareness are provided. - [Latex Sensitivity](https://progressivesurgicalsolutions.com/courses/latex-sensitivity/) - Latex Sensitivity Course Description This course is designed to train nurses and other healthcare professionals who are involved with the care of patients who are sensitive or allergic to latex. Before completion of this learning course, the participant should have a basic understanding to care for the patient with latex sensitivity/allergy. Learning Objectives Recognize the - [Laser Safety](https://progressivesurgicalsolutions.com/courses/laser-safety/) - Laser Safety Course Description This course is designed to educate staff regarding the importance of laser safety to the healthcare providers involved with the care of patients receiving laser treatment in the ambulatory surgery center. At the completion of this CEU course, the participant should have a basic understanding of the importance of laser safety. - [Intro to Endoscopy](https://progressivesurgicalsolutions.com/courses/intro-to-endoscopy/) - Intro to Endoscopy Course Description This course was designed to introduce the most routine endoscopic procedures and infection prevention and control practices at an Ambulatory Surgery Center (ASC) that specializes in endoscopy. Topics addressed include gastrointestinal diagnoses and their associated signs and symptoms, which warrant an endoscopic procedure. This course applies to anyone who has - [Infection Control 2 | In the ASC](https://progressivesurgicalsolutions.com/courses/infection-control-2-in-the-asc/) - Infection Control in the ASC (2) Course Description This course is designed to educate nurses and other healthcare professionals (HCP) who are involved in infection control in the ambulatory surgery center (ASC) setting. The principles discussed in this course will increase knowledge base regarding standard precautions, safe medication handling and injections practices, and providing a - [Infection Control 1 | The Basics](https://progressivesurgicalsolutions.com/courses/infection-control-1-the-basics/) - Infection Control: The Basics (1) Course Description This course is designed to educate nurses and other healthcare professionals (HCP) who are involved in infection control in the ambulatory surgery center (ASC) setting. The principles discussed in this course will increase knowledge base regarding the current status of healthcare acquired infections in the United States (US) - [Human Trafficking: Recognition and Reporting 2 Hour](https://progressivesurgicalsolutions.com/courses/human-trafficking-2hour/) - Human Trafficking: Recognition and Reporting (2 Hour) Course Description The purpose of this course is to bring awareness to the crime of human trafficking among the healthcare community, provide education to those healthcare providers who may play an integral role in the recognition and reporting of human trafficking activity, and to provide a framework for - [Human Trafficking: Recognition and Reporting 1 Hour](https://progressivesurgicalsolutions.com/courses/human-trafficking/) - Human Trafficking: Recognition and Reporting (1 Hour) Course Description The purpose of this course is to bring awareness to the crime of human trafficking among the healthcare community, provide education to those healthcare workers who may play an integral role in the recognition and reporting of human trafficking activity, and to provide a framework for - [Housekeeping in the ASC](https://progressivesurgicalsolutions.com/courses/housekeeping-in-the-asc/) - Housekeeping in the ASC Course Description This course is designed for housekeeping/environmental services staff, clinical support personnel, and ASC leaders responsible for infection prevention and quality oversight. The content emphasizes the critical role of environmental cleaning in patient safety, regulatory compliance and alignment with nationally recognized guidelines. By the end of the course, participants will - [HIPAA](https://progressivesurgicalsolutions.com/courses/hipaa/) - HIPAA Course Description The purpose of this learning course is to provide a platform to understand the law known as HIPAA and its relevance to the ASC. Learning Objectives Define HIPAA Differentiate between the Privacy Rule and the Security Rule List 5 HIPAA requirements for ASCs Define how HIPAA is enforced Course Material Once you - [Hazard Communication](https://progressivesurgicalsolutions.com/courses/hazard-communication/) - Hazard Communication Course Description This course will focus on the responsibilities of the employer in establishing and implementing an effective hazard communication program. The target audience is all employees in the ambulatory surgical facility. Learning Objectives List the primary Hazard Communications Standard responsibilities for manufacturers, distributors, importers, and employers. Discuss the nature of chemical hazards - [Hand Hygiene](https://progressivesurgicalsolutions.com/courses/hand-hygiene/) - Hand Hygiene Course Description Hand Hygiene is one of the most important parts of your facility infection control program and it definitely remains to be one of the most consistently cited deficiencies. This course is designed to educate all ASC staff to the importance of hand hygiene and is appropriate for everyone in the healthcare - [Fraud, Waste, and Abuse](https://progressivesurgicalsolutions.com/courses/fraud-waste-and-abuse/) - Fraud, Waste and Abuse Course Description As an ambulatory surgery center (ASC) employee, it is important that you are able to recognize and understand a situation that may involve fraud, waste, or abuse of resources. Such activity costs taxpayers billions of dollars each year. To mitigate this loss, your employer is required to educate and - [Fluoroscopic Imaging in the OR](https://progressivesurgicalsolutions.com/courses/fluoroscopic-imaging-in-the-or/) - Fluoroscopic Imaging in the OR Course Description This course is designed to introduce nurses and other healthcare professionals who are involved with the care of patients receiving procedures utilizing x-ray and fluoroscopic imaging. Before completion of this learning course, the participant should have a basic understanding of the application and principles of x-ray and fluoroscopic - [Fire Safety](https://progressivesurgicalsolutions.com/courses/fire-safety/) - Fire Safety Course Description This course is designed to present information about fire safety and prevention practices for healthcare providers in the ambulatory surgery center (ASC). Learning Objectives Identify areas of concern in the elimination or prevention of fires Define meaning of the acronym “ARACE” Define meaning of the acronym “PASS” Identify the 3 elements - [Emergency Preparedness](https://progressivesurgicalsolutions.com/courses/emergency-preparedness/) - Emergency Preparedness Course Description Every health care facility must have a plan in place to assure the safety of its employees, visitors and patients in the case of a disaster, natural or otherwise. A well-developed emergency preparedness program is required for Medicare certified ASCs. This learning course will cover what needs to be included in - [Department of Transportation](https://progressivesurgicalsolutions.com/courses/department-of-transportation/) - Department of Transportation Training Course Description This course is designed to educate ambulatory surgery center (ASC) personnel, who are involved in performing functions related to handling, packaging, storing, moving, loading and unloading of hazardous waste. Certain medical waste is considered hazardous. The principles discussed in the course will increase knowledge regarding the Department of Transportation’s - [Customer Service](https://progressivesurgicalsolutions.com/courses/customer-service/) - Customer Service Course Description This course is designed to provide nurses and other healthcare professionals a better understanding of the value and importance of good customer service both internally and as it relates to the patient experience. The quality of professionalism and customer service has tremendous impact on patient satisfaction, organizational culture, and ultimately the - [Cultural Sensitivity](https://progressivesurgicalsolutions.com/courses/cultural-sensitivity/) - Cultural Sensitivity Course Description Ambulatory surgery has become a cornerstone of healthcare delivery that provides safe, efficient, quality care to patients without the stress and cost of undergoing surgery in a large hospital setting. With the evolution of the ambulatory surgery center (ASC), dynamic and engaged teams are imperative to the delivery of quality care. - [Cardiac Rhythm Monitoring in the ASC](https://progressivesurgicalsolutions.com/courses/cardiac-rhythm-monitoring-in-the-asc/) - Cardiac Rhythm Monitoring in the ASC Course Description This course provides ASC nurses with the knowledge and skills to monitor heart rhythms safely perioperatively. It covers the basics of how EKG monitoring works, proper placement of three- and five-lead systems, and recognition of normal sinus rhythm. Nurses will learn how to identify common arrhythmias, distinguish - [Advance Directives](https://progressivesurgicalsolutions.com/courses/advance-directives/) - Advance Directives in the ASC Course Description This course is designed to present information about advance directives for healthcare providers who are involved with the care of patients in the ASC setting. Before completion of this learning course, the participant should have a basic understanding of what an advance directive is and the CMS requirements - [Abuse Identification](https://progressivesurgicalsolutions.com/courses/abuse-identification/) - Abuse Identification Course Description This course is designed to educate nurses and other healthcare professionals who are involved with the care of patients to identify, document, and report suspected abuse/neglect. Before completion of this learning course, the participant should have a basic understanding of the responsibilities of the healthcare professional when an abusive situation is - [Medical Staff Education](https://progressivesurgicalsolutions.com/courses/medical-staff-education/) - Medical Staff Education Course Description This education is designed for medical staff working in the ASC. It is required at the time of initial appointment and serves as an annual refresher. The course covers compliance, patient safety, infection prevention, emergency preparedness, and professionalism. The goal is to ensure medical staff understand their responsibilities, support a ## Lessons - [Infection Control Coordinator / Preventionist Training Program](https://progressivesurgicalsolutions.com/lessons/infection-control-coordinator-preventionist-training-program/) - [1 | Role Overview, Governance, Credentialing, & Customer Service](https://progressivesurgicalsolutions.com/lessons/1-role-overview-governance-credentialing-customer-service/) - [10 | Patient Safety Culture](https://progressivesurgicalsolutions.com/lessons/10-patient-safety-culture/) - [9 | Professional Development & Leadership](https://progressivesurgicalsolutions.com/lessons/9-professional-development-leadership/) - [6 | Pharmaceutical, Laboratory, & Radiology Services](https://progressivesurgicalsolutions.com/lessons/6-pharmaceutical-laboratory-radiology-services/) - [8 | Administration Part II: Medical Records & Patient Rights](https://progressivesurgicalsolutions.com/lessons/8-administration-part-ii-medical-records-patient-rights/) - [7 | Administration Part I: Financial Management & Human Resources](https://progressivesurgicalsolutions.com/lessons/7-administration-part-i-financial-management-human-resources/) - [5 | Infection Control](https://progressivesurgicalsolutions.com/lessons/5-infection-control/) - [4 | QAPI](https://progressivesurgicalsolutions.com/lessons/4-qapi/) - [3 | Surgical & Anesthesia Services](https://progressivesurgicalsolutions.com/lessons/3-surgical-anesthesia-services/) - [2 | Emergency Preparedness](https://progressivesurgicalsolutions.com/lessons/2-emergency-preparedness/) ## COURSE EXAMINATION - [CE Course Examination | OBSC Orientation / Annual Education & Training](https://progressivesurgicalsolutions.com/quizzes/ce-course-examination-asc-annual-education-training/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | ASC Annual Education & Training](https://progressivesurgicalsolutions.com/quizzes/annual-training-unlicensed/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | ICC / IP Training Program](https://progressivesurgicalsolutions.com/quizzes/ce-course-examination-icc-ip-training-program/) - Complete the following quiz evaluation based on your knowledge from the Course. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Medical Staff Education](https://progressivesurgicalsolutions.com/quizzes/medical-staff-education/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Housekeeping in the ASC](https://progressivesurgicalsolutions.com/quizzes/housekeeping-in-the-asc/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Human Trafficking 2 Hour](https://progressivesurgicalsolutions.com/quizzes/human-trafficking-2/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Human Trafficking 1 Hour](https://progressivesurgicalsolutions.com/quizzes/human-trafficking/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Abuse Identification](https://progressivesurgicalsolutions.com/quizzes/abuse-identification/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Bloodborne Pathogen Exposure Control](https://progressivesurgicalsolutions.com/quizzes/bloodborne-pathogen/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Emergency Preparedness](https://progressivesurgicalsolutions.com/quizzes/emergency-preparedness/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Fluoroscopic Imaging in the OR](https://progressivesurgicalsolutions.com/quizzes/fluoroscopic-imaging-in-the-or/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Hand Hygiene](https://progressivesurgicalsolutions.com/quizzes/hand-hygiene/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Hazard Communication Quiz](https://progressivesurgicalsolutions.com/quizzes/hazard-communication/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | HIPAA](https://progressivesurgicalsolutions.com/quizzes/hipaa/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Infection Control 1 | The Basics](https://progressivesurgicalsolutions.com/quizzes/infection-control-1/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Infection Control 2 | In the ASC](https://progressivesurgicalsolutions.com/quizzes/infection-control-2/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Laser Safety](https://progressivesurgicalsolutions.com/quizzes/laser-safety/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Latex Sensitivity](https://progressivesurgicalsolutions.com/quizzes/latex-sensitivity/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | OSHA Overview](https://progressivesurgicalsolutions.com/quizzes/osha-overview/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Radiation Safety](https://progressivesurgicalsolutions.com/quizzes/radiation-safety/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Steam Sterilization](https://progressivesurgicalsolutions.com/quizzes/steam-sterilization-post-test/) - [CE Course Examination | Sterilization Best Practices in the ASC](https://progressivesurgicalsolutions.com/quizzes/sterilization-best-practices-in-the-asc/) - [CE Course Examination | TASS and Endophthalmitis](https://progressivesurgicalsolutions.com/quizzes/tass-and-endophthalmitis/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Workplace Violence](https://progressivesurgicalsolutions.com/quizzes/workplace-violence/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Advance Directive](https://progressivesurgicalsolutions.com/quizzes/advance-directive/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Malignant Hyperthermia](https://progressivesurgicalsolutions.com/quizzes/malignant-hyperthermia/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | QAPI](https://progressivesurgicalsolutions.com/quizzes/qapi/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Fire Safety](https://progressivesurgicalsolutions.com/quizzes/fire-safety/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | IV Conscious Sedation](https://progressivesurgicalsolutions.com/quizzes/iv-conscious-sedation/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Medical Record Documentation](https://progressivesurgicalsolutions.com/quizzes/medical-record-documentation/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Fraud, Waste, and Abuse](https://progressivesurgicalsolutions.com/quizzes/fraud-waste-and-abuse/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Department of Transportation](https://progressivesurgicalsolutions.com/quizzes/department-of-transportation/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Cultural Sensitivity](https://progressivesurgicalsolutions.com/quizzes/cultural-sensitivity/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Customer Service](https://progressivesurgicalsolutions.com/quizzes/customer-service/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | USP <800> Handling of Hazardous Drugs](https://progressivesurgicalsolutions.com/quizzes/usp-handling-of-hazardous-drugs/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Intro to Endoscopy](https://progressivesurgicalsolutions.com/quizzes/into-to-endoscopy/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Medication Safety in the ASC](https://progressivesurgicalsolutions.com/quizzes/medication-safety-in-the-asc/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Leadership and Nurse Burnout](https://progressivesurgicalsolutions.com/quizzes/leadership-and-nurse-burnout/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Pain Assessment & Management in the ASC](https://progressivesurgicalsolutions.com/quizzes/pain-assessment-and-management-asc/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. - [CE Course Examination | Cardiac Rhythm Monitoring in the ASC](https://progressivesurgicalsolutions.com/quizzes/cardiac-rhythm-monitoring-in-the-asc/) - Complete the following quiz evaluation based on your knowledge from the Course PDF. You must get 80% correct in order to receive a certificate. ## Certificates - [VMG Certificate (3 Hour)](https://progressivesurgicalsolutions.com/certificates/vmg-certificate-3-hour/) - [VMG Quiz Certificate](https://progressivesurgicalsolutions.com/certificates/vmg-quiz-certificate/) - [VMG Quiz Certificate (2 Hour)](https://progressivesurgicalsolutions.com/certificates/vmg-quiz-certificate-2/) - [VMG Quiz Certificate (3 Hour)](https://progressivesurgicalsolutions.com/certificates/vmg-quiz-certificate-3-hour/) - [VMG Certificate (2 Hour)](https://progressivesurgicalsolutions.com/certificates/vmg-certificate-2/) - [VMG Certificate](https://progressivesurgicalsolutions.com/certificates/vmg-certificate/) - [Cultural Sensitivity (Licensed)](https://progressivesurgicalsolutions.com/certificates/cultural-sensitivity-licensed/) - License #:, - [Cultural Sensitivity (Unlicensed)](https://progressivesurgicalsolutions.com/certificates/cultural-sensitivity-unlicensed/) - License #:, - [Abuse Identification](https://progressivesurgicalsolutions.com/certificates/abuse-identification/) - [Bloodborne Pathogen Exposure Control](https://progressivesurgicalsolutions.com/certificates/bloodborne-pathogen-exposure-control/) - [Emergency Preparedness](https://progressivesurgicalsolutions.com/certificates/emergency-preparedness/) - [Fluoroscopic Imaging in the OR](https://progressivesurgicalsolutions.com/certificates/fluoroscopic-imaging-in-the-or/) - [Hand Hygiene](https://progressivesurgicalsolutions.com/certificates/hand-hygiene/) - [Hazard Communication](https://progressivesurgicalsolutions.com/certificates/hazard-communication/) - [HIPAA](https://progressivesurgicalsolutions.com/certificates/hipaa/) - [Infection Control – 1](https://progressivesurgicalsolutions.com/certificates/infection-control-1/) - [Infection Control – 2](https://progressivesurgicalsolutions.com/certificates/infection-control-2/) - [Laser Safety](https://progressivesurgicalsolutions.com/certificates/laser-safety/) - [Latex Sensitivity](https://progressivesurgicalsolutions.com/certificates/latex-sensitivity/) - [OSHA Overview](https://progressivesurgicalsolutions.com/certificates/osha-overview/) - [QAPI Program](https://progressivesurgicalsolutions.com/certificates/qapi-program/) - [Radiation Safety](https://progressivesurgicalsolutions.com/certificates/radiation-safety/) - [Steam Sterilization](https://progressivesurgicalsolutions.com/certificates/steam-sterilization/) - [Sterilization Best Practices in the ASC](https://progressivesurgicalsolutions.com/certificates/sterilization-best-practices-in-the-asc/) - [TASS and Endophthalmitis](https://progressivesurgicalsolutions.com/certificates/tass-and-endophthalmitis/) - [Workplace Violence](https://progressivesurgicalsolutions.com/certificates/workplace-violence/) - [Bloodborne Pathogen Exposure Control (Licensed)](https://progressivesurgicalsolutions.com/certificates/bloodborne-pathogen-exposure-control-licensed/) - License #:, - [Emergency Preparedness (Licensed)](https://progressivesurgicalsolutions.com/certificates/emergency-preparedness-licensed/) - License #:, - [Fluoroscopic Imaging in the OR (Licensed)](https://progressivesurgicalsolutions.com/certificates/fluoroscopic-imaging-in-the-or-licensed/) - License #:, - [Hand Hygiene (Licensed)](https://progressivesurgicalsolutions.com/certificates/hand-hygiene-licensed/) - License #:, - [Hazard Communication (Licensed)](https://progressivesurgicalsolutions.com/certificates/hazard-communication-licensed/) - License #:, - [HIPAA (Licensed)](https://progressivesurgicalsolutions.com/certificates/hipaa-licensed/) - License #:, - [Infection Control – 1 (Licensed)](https://progressivesurgicalsolutions.com/certificates/infection-control-1-licensed/) - License #:, - [Infection Control – 2 (Licensed)](https://progressivesurgicalsolutions.com/certificates/infection-control-2-licensed/) - License #:, - [Laser Safety (Licensed)](https://progressivesurgicalsolutions.com/certificates/laser-safety-licensed/) - License #:, - [Latex Sensitivity (Licensed)](https://progressivesurgicalsolutions.com/certificates/latex-sensitivity-licensed/) - License #:, - [OSHA Overview (Licensed)](https://progressivesurgicalsolutions.com/certificates/osha-overview-licensed/) - License #:, - [QAPI Program (Licensed)](https://progressivesurgicalsolutions.com/certificates/qapi-program-licensed/) - License #:, - [Radiation Safety (Licensed)](https://progressivesurgicalsolutions.com/certificates/radiation-safety-licensed/) - License #:, - [Steam Sterilization (Licensed)](https://progressivesurgicalsolutions.com/certificates/steam-sterilization-licensed/) - License #:, - [Sterilization Best Practices in the ASC (Licensed)](https://progressivesurgicalsolutions.com/certificates/sterilization-best-practices-in-the-asc-licensed/) - License #:, - [TASS and Endophthalmitis (Licensed)](https://progressivesurgicalsolutions.com/certificates/tass-and-endophthalmitis-licensed/) - License #:, - [Workplace Violence (Licensed)](https://progressivesurgicalsolutions.com/certificates/workplace-violence-licensed/) - License #:, - [Advance Directives (Licensed)](https://progressivesurgicalsolutions.com/certificates/advance-directives-licensed/) - License #:, - [Advance Directives](https://progressivesurgicalsolutions.com/certificates/advance-directives/) - [Malignant Hyperthermia (Licensed)](https://progressivesurgicalsolutions.com/certificates/malignant-hyperthermia-licensed/) - License #:, - [Malignant Hyperthermia](https://progressivesurgicalsolutions.com/certificates/malignant-hyperthermia/) - [Fire Safety (Licensed)](https://progressivesurgicalsolutions.com/certificates/fire-safety-licensed/) - License #:, - [Fire Safety](https://progressivesurgicalsolutions.com/certificates/fire-safety/) - [IV Conscious Sedation (Licensed)](https://progressivesurgicalsolutions.com/certificates/iv-conscious-sedation-licensed/) - License #:, - [IV Conscious Sedation](https://progressivesurgicalsolutions.com/certificates/iv-conscious-sedation/) - [Annual Training (Licensed)](https://progressivesurgicalsolutions.com/certificates/annual-training-licensed/) - License #:, - [Annual Training](https://progressivesurgicalsolutions.com/certificates/annual-training/) - [Medical Record Documentation (Unlicensed)](https://progressivesurgicalsolutions.com/certificates/medical-record-documentation-unlicensed/) - [Medical Record Documentation (Licensed)](https://progressivesurgicalsolutions.com/certificates/medical-record-documentation-licensed/) - License #:, - [Fraud Waste and Abuse (Licensed)](https://progressivesurgicalsolutions.com/certificates/fraud-waste-and-abuse-licensed/) - License #:, - [Fraud Waste and Abuse (Unlicensed)](https://progressivesurgicalsolutions.com/certificates/fraud-waste-and-abuse-unlicensed/) - License #:, - [Department of Transportation (Licensed)](https://progressivesurgicalsolutions.com/certificates/department-of-transportation-licensed/) - License #:, - [Department of Transportation (Unlicensed)](https://progressivesurgicalsolutions.com/certificates/department-of-transportation-unlicensed/) - License #:, - [Abuse Identification (Licensed)](https://progressivesurgicalsolutions.com/certificates/abuse-identification-licensed/) - License #:, ## xAPI Content - [ICC / IP Training Program - Course](https://progressivesurgicalsolutions.com/gb_xapi_content/icc-ip-training-program-course/) - [Infection Control Coordinator / Preventionist Training Program](https://progressivesurgicalsolutions.com/gb_xapi_content/43620/) ## Webinars - [Physical Environment Compliance Checklist: How to Talk to an Engineer](https://progressivesurgicalsolutions.com/webinars/physical-environment-compliance-checklist-how-to-talk-to-an-engineer/) - Accreditation and Licensure Surveys conducted by CMS agencies are becoming more difficult than in the past due to the increase of personnel specifically trained in Life Safety Code Requirements. Considering such, it is imperative that facilities take the time to perform tours of the physical environment on a predetermined basis in order to assess compliance. - [Nursing Scope of Practice](https://progressivesurgicalsolutions.com/webinars/nursing-scope-of-practice/) - Have you ever felt uncomfortable doing a nursing task that you did not feel qualified to do? Do you know the full scope of your RN license? After this webinar, you will be able to define the RN scope of practice in the ASC setting, understand the role of the circulating RN and ensure your - [USP <797> and USP <800>: What You Need to Know](https://progressivesurgicalsolutions.com/webinars/usp-and-usp-what-you-need-to-know/) - The USP has announced new standards will take effect on November 1, 2023. Implementation of the new USP will also trigger the enforcement of USP Hazardous Drugs – Handling in Healthcare Settings. In this webinar, we will cover changes to the immediate use provision, frequent misinterpretations, and best practices. We will provide an - [Turnover to Terminal: Housekeeping Done Right](https://progressivesurgicalsolutions.com/webinars/turnover-to-terminal-housekeeping-done-right/) - This session provides a focused review of environmental cleaning practices in the ASC, from turnover to terminal cleaning. Participants will learn how to apply nationally recognized guidelines and best practices to support a safe, clean environment and reduce the risk of infection. Designed for Infection Preventionists/Control Coordinators and environmental/housekeeping staff, this training emphasizes both oversight - [Making QAPI Manageable: Document What You’re Already Doing](https://progressivesurgicalsolutions.com/webinars/making-qapi-manageable-document-what-youre-already-doing/) - If QAPI feels like something extra you have to do...this webinar will demonstrate how to document the quality activities you are already performing every day. Attendees will learn how to properly capture QAPI efforts and understand the critical role medical record documentation plays in demonstrating compliance. The session will break down core QAPI components and - [Staff Utilization: How to Track Data and Improve Benchmarks](https://progressivesurgicalsolutions.com/webinars/staff-utilization-how-to-take-data-and-improve-benchmarks/) - Tracking staff utilization is essential in today’s cost-conscious Ambulatory Surgery Center environment. Effective monitoring of these metrics drives operational efficiency, strengthens cost management, and enhances patient safety and quality of care, all while improving staff satisfaction and retention. In this session, VMG will share the results of our comprehensive analysis of your ASC’s staffing data. - [Blueprint for ASC Staff Education](https://progressivesurgicalsolutions.com/webinars/blueprint-for-asc-staff-education/) - This webinar provides a streamlined overview of how ASCs build and maintain a compliant staff education, training, competency, and orientation program. Participants will learn how to integrate CMS and accrediting body requirements with eSupport resources, internal policies, and facility-specific needs to create a clear, sustainable education plan. The session will cover essential regulatory expectations, documentation - [Life Safety Code Survey Deficiencies and Compliance Strategies](https://progressivesurgicalsolutions.com/webinars/life-safety-code-survey-deficiencies-and-compliance-strategies/) - Explore critical life safety issues across the United States, focusing on common deficiencies found during the Life Safety Code survey and how to proactively address them. Participants will gain a comprehensive understanding of risk assessments, including how to conduct them effectively and why they are essential for mitigating potential hazards. Additionally, attendees will learn about - [2026 ASC Quality Reporting Update](https://progressivesurgicalsolutions.com/webinars/2026-asc-quality-reporting-update/) - CMS requirements and quality reporting can be challenging for perioperative leaders in the ASC setting. Participants will receive current information on the quality program with updates on the 2026 final rule, what reporting is required, and the definitions/frequently asked questions for the indicators. Gina Throneberry, RN, MBA, CASC, CNORDirector of Education and Clinical AffairsAmbulatory Surgery - [Hot Topics in Pharmacy Compliance for the ASC](https://progressivesurgicalsolutions.com/webinars/hot-topics-in-pharmacy-compliance-for-the-asc/) - This webinar will explore the critical pharmacy-related regulatory and compliance challenges faced by Ambulatory Surgical Centers (ASCs). Attendees will learn how to develop and implement robust medication processes, including Look-Alike Sound-Alike (LASA) and High Alert medication protocols, aimed at improving patient safety and minimizing errors. The session will cover best practices for managing medication waste, - [Annual ASC Survey Watch Report 2025](https://progressivesurgicalsolutions.com/webinars/annual-asc-survey-watch-report-2025/) - Navigating the complexities of state licensing, accreditation, and Medicare certification can be challenging. Our expert consulting team has had the privilege of working with numerous ASC facilities nationwide, helping them successfully pass a wide range of regulatory surveys. Join us for an informative webinar as we share the most frequently cited deficiencies from the past - [Inventory Management: Key Strategies for Enhancing ASC Financial Health and Profitability](https://progressivesurgicalsolutions.com/webinars/inventory-management/) - This webinar will explore essential inventory management and control strategies within an ASC’s supply chain, a key factor impacting the ASC’s financial health and profitability. Participants will gain valuable insights into effective inventory controls, case costing, accounting best practices, inventory planning, accurate reporting, and key performance indicators (KPIs) related to inventory management. Vanessa Sindell, MSN, - [Streamlining Communication from ASC to Clinic, Part 2: Improving Postoperative Communication](https://progressivesurgicalsolutions.com/webinars/streamlining-communication-from-asc-to-clinic-postop-communication/) - Building on the 2023 webinar Streamlining Communication from Clinic to ASC, this webinar will focus on the postoperative phase of the surgical scheduling journey. While the patient's surgical date may have passed and discharge has occurred, the scheduling process doesn’t end there. Explore the critical next steps in effective communication, emphasizing the importance of post-discharge - [Incident Reporting: From Documentation to Prevention](https://progressivesurgicalsolutions.com/webinars/incident-reporting-from-documentation-to-prevention/) - Incident reporting plays a critical role in healthcare compliance and patient safety. While it's easy to recognize when things go as planned—such as patient admission, care, or discharge—it is equally important to handle unexpected events. Documenting deviations in patient care is essential, but it’s just the first step in analyzing and preventing future occurrences. This - [Ensuring Staff Safety: A Comprehensive Guide to ASC Employee Health Programs and Infection Control](https://progressivesurgicalsolutions.com/webinars/ensuring-staff-safety-a-comprehensive-guide/) - This webinar offers a comprehensive overview of the ASC Employee Health Program, covering essential topics such as staff vaccination initiatives, COVID-19 protocols, and current tuberculosis requirements. It also addresses fundamental infection control practices and policies crucial for maintaining a safe and healthy workplace for all staff. Designed to equip attendees with the knowledge and tools - [Navigating Patient Complaints and Grievances: Enhancing Your QAPI Program](https://progressivesurgicalsolutions.com/webinars/navigating-patient-complaints-and-grievances/) - Understanding patient complaints and grievances is crucial for upholding Patient Rights and strengthening a facility's QAPI program, including effective risk management. In this webinar, participants will learn to distinguish between a complaint and a grievance and will explore effective strategies for addressing both within the QAPI process, empowering them to reduce incidents and resolve concerns - [Before the OR: Presurgical & Preanesthesia Assessments](https://progressivesurgicalsolutions.com/webinars/presurgical-preanesthesia-assessments/) - The ASC CMS Conditions for Coverage are updated infrequently, but the changes made in June 2022 to Standards 416.42 (Anesthetic Risk and Evaluation) and 416.52 (Patient Assessment and Admission) have caused ongoing confusion. In this session, participants will gain a clear understanding of the key components of these standards and learn how to demonstrate compliance, - [Sweeping the Nation: Surgical Smoke Legislation](https://progressivesurgicalsolutions.com/webinars/surgical-smoke-legislation/) - Surgical smoke is a well-documented hazard, yet no national regulations mandating smoke safety in operating rooms exist. Despite warnings from OSHA and NIOSH since 1988, the lack of federal standards underscores the need for increased awareness and state-level legislation to protect both surgical teams and patients. Nurses play a key role in advocating for change - [Demystifying RCM: A Practical Guide to Terminology, Financial Insights, & Effective Board Presentations](https://progressivesurgicalsolutions.com/webinars/demystifying-rcm-a-practical-guide-to-terminology-financial-insights-effective-board-presentations/) - This dynamic webinar is designed to deepen the understanding of Revenue Cycle Management (RCM) and equip attendees with practical tools to improve financial performance. The session will provide a comprehensive overview of essential RCM terminology, including a glossary of key acronyms, to ensure consistent language is used. Participants will also gain a deeper understanding of - [A Comprehensive Review of the ASC QAPI Program](https://progressivesurgicalsolutions.com/webinars/a-comprehensive-review-of-the-asc-qapi-program/) - Disclaimer: In 2024, AAAHC released the v43 Accreditation Standards. Prior to this, under the v42 Standards, facilities were required to conduct a 10-step QI study template. Under the v43, these steps have been consolidated into six (6) steps. Therefore, webinars presented prior to implementation of this update will discuss the 10-step QI study template. A - [Progressive Huddle: QAPI Making it Meaningful](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-qapi-making-it-meaningful/) - Disclaimer: In 2024, AAAHC released the v43 Accreditation Standards. Prior to this, under the v42 Standards, facilities were required to conduct a 10-step QI study template. Under the v43, these steps have been consolidated into six (6) steps. Therefore, webinars presented prior to implementation of this update will discuss the 10-step QI study template. You - [Meaningful Hand Hygiene Surveillance](https://progressivesurgicalsolutions.com/webinars/meaningful-hand-hygiene-surveillance/) - Disclaimer: In 2024, AAAHC released the v43 Accreditation Standards. Prior to this, under the v42 Standards, facilities were required to conduct a 10-step QI study template. Under the v43, these steps have been consolidated into six (6) steps. Therefore, webinars presented prior to implementation of this update will discuss the 10-step QI study template. Hand - [How To Run a QAPI/Governance Meeting](https://progressivesurgicalsolutions.com/webinars/how-to-run-a-qapi-governance-meeting/) - Disclaimer: In 2024, AAAHC released the v43 Accreditation Standards. Prior to this, under the v42 Standards, facilities were required to conduct a 10-step QI study template. Under the v43, these steps have been consolidated into six (6) steps. Therefore, webinars presented prior to implementation of this update will discuss the 10-step QI study template. Do - [Progressive Huddle: QI Study Review](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-qi-study-review/) - Disclaimer: In 2024, AAAHC released the v43 Accreditation Standards. Prior to this, under the v42 Standards, facilities were required to conduct a 10-step QI study template. Under the v43, these steps have been consolidated into six (6) steps. Therefore, webinars presented prior to implementation of this update will discuss the 10-step QI study template. A - [Progressive Huddle: Meaningful Quality Assurance/Risk Management Activities and Performance Improvement Studies](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-meaningful-quality-assurancerisk-management-activities-and-performance-improvement-studies/) - Disclaimer: In 2024, AAAHC released the v43 Accreditation Standards. Prior to this, under the v42 Standards, facilities were required to conduct a 10-step QI study template. Under the v43, these steps have been consolidated into six (6) steps. Therefore, webinars presented prior to implementation of this update will discuss the 10-step QI study template. QAPI/Risk - [2025 ASC Quality Reporting Update](https://progressivesurgicalsolutions.com/webinars/2025-asc-quality-reporting-update/) - CMS requirements and quality reporting can be challenging for perioperative leaders in the ASC setting. Participants will receive current information on the quality program with updates on the 2025 final rule, what reporting is required, and the definitions/frequently asked questions for the indicators. Video link: Gina Throneberry, RN, MBA, CASC, CNORDirector of Education and Clinical - [Infection Control Risk Assessment](https://progressivesurgicalsolutions.com/webinars/infection-control-risk-assessment/) - Recognizing and understanding infection control risks within our ASC is crucial, as much of our ASC activities are determined by comprehensive risk assessment. Completing the assessment, translating it onto paper in a meaningful way can be challenging. Join us for a walkthrough of an infection control risk assessment to address these challenges. Video link: CRISSY - [Annual Survey Watch Report 2024](https://progressivesurgicalsolutions.com/webinars/annual-survey-watch-report-2024/) - Our consulting team has the advantage of working with scores of facilities across the country going through a variety of different surveys including state licensing, accreditation, and Medicare certification. Take advantage of our expertise! Join us for an overview of the most common deficiencies identified in the past year. Video link: APRYL MCELHENY joined VMG - [Before It's Mandatory: Understanding OAS CAHPS](https://progressivesurgicalsolutions.com/webinars/before-its-mandatory-understanding-oas-cahps/) - The CMS ASC Quality Reporting (ASCQR) measure, ASC-15 Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS), collects information about patients’ experiences of care in ambulatory surgery centers (ASCs). This currently voluntary measure will become mandatory in 2025 for all ASCs with noncompliant facilities subjected to a 2% reduction in - [A Culture of Security: Preventing DEA Scheduled Medication Diversion in the ASC](https://progressivesurgicalsolutions.com/webinars/a-culture-of-security-preventing-dea-scheduled-medication-diversion-in-the-asc/) - People generally believe that DEA Controlled Medication Diversion is something that won’t affect them. However, in the role of a Pharmacist Consultant, one encounters signs of diversion routinely at a client. Sometimes, it’s a new client with imprecise paperwork, while other times, it’s a long-time client with constant vigilance experiencing unusual incidents. Often, it involves - [HOW TO DELIVER EXCELLENT CUSTOMER SERVICE IN YOUR ASC](https://progressivesurgicalsolutions.com/webinars/how-to-deliver-excellent-customer-service-in-your-asc/) - Customer service is not only about satisfying the needs and expectations of the patients, but also about creating a positive and professional environment for the staff and stakeholders. In this webinar, you will learn how to apply the principles and practices of customer service in an Ambulatory Surgery Center (ASC), where the patients are often - [ST108 in ASCs: A Clear Guide for Understanding and Implementation](https://progressivesurgicalsolutions.com/webinars/st108-in-ascs-a-clear-guide-for-understanding-and-implementation/) - Water and steam quality are critical considerations during the cleaning, rinsing, disinfection, and sterilization of surgical instruments. In August 2023, the ANSI / AAMI published 'ST108: 2023 Water for the Processing of Medical Devices’ standard. This new standard, applicable to new and existing ASCs, addresses how the multidisciplinary team will develop a Water Management Program - [Building Your Financial Acumen](https://progressivesurgicalsolutions.com/webinars/building-your-financial-acumen/) - ASC revenue is largely determined by the terms defined in third-party payer contracts. ASCs that carefully and regularly review contract terms tend be more profitable than those that do not. If you don't know where your contracts are or have not reviewed them in the last year or more, this webinar will help you get - [Competency Assessment in Healthcare](https://progressivesurgicalsolutions.com/webinars/competency-assessment-in-healthcare/) - As staff shortages continue, the competency of each healthcare professional is of vital importance for the safe and efficient function of surgical services. There is a general lack of understanding today regarding nursing competency and successful measurement of competency has proven elusive. This webinar will discuss widely accepted definitions of clinical competency and explore a - [2024 ASC Quality Reporting Update](https://progressivesurgicalsolutions.com/webinars/2024-asc-quality-reporting-update/) - CMS requirements and quality reporting can be challenging for perioperative leaders in the ASC setting. Participants will receive current information on the quality program with updates on the 2024 final rule, what reporting is required, and the definitions / frequently asked questions for the indicators. Video link: Gina Throneberry, RN, MBA, CASC, CNOR is the - [Annual Survey Watch Report 2023](https://progressivesurgicalsolutions.com/webinars/annual-survey-watch-report-2023/) - Our consulting team has the advantage of working with scores of facilities across the country, going through a variety of different types of surveys, including State licensing, accreditation, and Medicare certification. You can benefit from our experience! Join us for a summary of deficiencies cited over the past year. Video link: Apryl McElheny, MBA, MSN, - [ASC Billing 101](https://progressivesurgicalsolutions.com/webinars/asc-billing-101/) - Clinical leaders are often asked to oversee business aspects of their ASC with little to no experience. Managing billing and collections is a huge responsibility that impacts the overall health of your business. This webinar will walk you through the full ASC billing process and identify the top 5 critical functions of RCM to focus - [Credentialing Review](https://progressivesurgicalsolutions.com/webinars/credentialing-review/) - Medical staff credentialing remains one of the top 10 cited deficiencies for CMS and accrediting organizations. Ensuring you have all required documentation can feel like an onerous task without a formal process in place. This webinar will provide a better understanding of the specific requirements for credentialing and how to implement them effectively. Video link: - [MANAGING YOUR ASC’S ANCILLARY SERVICE CONTRACTS](https://progressivesurgicalsolutions.com/webinars/managing-your-ascs-ancillary-service-contracts/) - In addition to the regulatory requirements, there are financial and logistical considerations at play when managing your ancillary service contracts. This webinar will provide the essential tools and best practices to effectively manage your service contracts, remain compliant, improve organization, and ensure you are only paying for what you need. Video link: VANESSA SINDELL, - [ASC Budgeting](https://progressivesurgicalsolutions.com/webinars/asc-budgeting/) - ASCs are required by Medicare to have a budget. While not necessarily involved in day-to-day operations, the governing body is ultimately responsible for the overall quality of service. Numbers tell a story. Fiscal control and financial oversight are a primary point of scrutiny for surveyors. The financial health of an ASC can be a direct - [Streamlining Communication From Clinic TO ASC](https://progressivesurgicalsolutions.com/webinars/streamlining-communication-from-clinic-to-asc/) - Effective healthcare communication must be ongoing, transparent, patient-centered, concise, and relevant. Establishing these best practices between a surgeon’s clinic and the ASC supports improved patient outcomes; however, it can be difficult between separate clinical settings. With patient safety and satisfaction on the line, as well as ASC and surgeon reputation and profitability, this webinar will - [Current Trends in HIPAA and Cybersecurity](https://progressivesurgicalsolutions.com/webinars/current-trends-in-hipaa-and-cybersecurity/) - This webinar covers recent trends and increased breach reporting for healthcare providers. Kurt Bratten will review recent guidance from HHS’s Office for Civil Rights (OCR) regarding Managing Malicious Insider Threats, Direct Liability of Business Associates and OCR’s recent revision to the limits on Civil Monetary Penalties for HIPAA Violations. Join us to gain practical guidance - [Annual Survey Watch Report 2020](https://progressivesurgicalsolutions.com/webinars/annual-survey-watch-report-2020/) - Progressive Surgical Solutions has the advantage of working with scores of facilities across the country, going through a variety of different types of surveys, including State licensing, accreditation, and Medicare certification. You can benefit from our experience! Join us for a summary of deficiencies cited over the past year. VANESSA SINDELL, MSN, BSN, RN Vanessa - [2021 CMS Quality Reporting Update for ASCs](https://progressivesurgicalsolutions.com/webinars/2021-cms-quality-reporting-update-for-ascs/) - CMS requirements and quality reporting can be challenging for perioperative leaders in the ASC setting. Participants will receive current information on the quality program, what reporting is required, and the definitions/frequently asked questions for the indicators. GINA THRONEBERRY, RN, MBA, CASC, CNOR Gina is the Director of Education and Clinical Affairs for the Ambulatory Surgery - [How To Rightsize Your Anesthesia Team: Efficiency and Functionality in Staffing](https://progressivesurgicalsolutions.com/webinars/how-to-rightsize-your-anesthesia-team-efficiency-and-functionality-in-staffing/) - Anesthesia plays an important role in the ASC setting. It also presents challenges: overhead, staffing inflexibility, and a lack of team commitment/ownership. Learn from real examples how Anesthesia services can contribute more than just anesthesia delivery and how to handle common issues. CHRIS CALDWELL, CRNA Chris is the Vice President of Clinical Operations for Care - [ANNUAL ASC SURVEY WATCH 2021](https://progressivesurgicalsolutions.com/webinars/annual-asc-survey-watch-2021/) - Our team of consultants has the advantage of working with scores of ASC facilities across the country, going through a variety of different types of surveys, including State licensing, accreditation, and Medicare certification. You can benefit from our experience! Join us for a summary of deficiencies cited over the past year. VANESSA SINDELL, MSN, BSN, - [USP <800>: WHAT YOU NEED TO KNOW](https://progressivesurgicalsolutions.com/webinars/usp-what-you-need-to-know/) - As healthcare providers and with recent changes to USP , it is important to ensure protection of both our patients and staff when it comes to handling hazardous drugs. In this webinar we will dissect the new guidelines and standards so that you can implement best practices appropriately and safely. LINDA KALATA RN, BSN, CNOR - [Annual Survey Watch Report 2019](https://progressivesurgicalsolutions.com/webinars/annual-survey-watch-report-2019/) - Progressive Surgical Solutions has the advantage of working with scores of facilities across the country, going through a variety of different types of surveys, including State licensing, accreditation, and Medicare certification. You can benefit from our experience! Here is a summary of deficiencies cited over the past year. LEANNE GALLEGOS, BSN, RN has 25 years - [Documentation Best Practices in the ASC](https://progressivesurgicalsolutions.com/webinars/documentation-best-practices-in-the-asc/) - Medical record documentation is so important! Regular audits should be performed on a quarterly basis with a compliance goal of 100%. This course is designed to review the fundamental concepts associated with the best practices of documentation to ensure your medical record documentation meets basic standards of practice and regulatory requirements. CRISSY BENZE, MSN, BSN, - [Medication Shortages and How to Handle Them](https://progressivesurgicalsolutions.com/webinars/medication-shortages-and-how-to-handle-them/) - Medication shortages are now an ongoing part of business. These medications shortages can be difficult, time consuming, and occasionally dangerous. Unfortunately, your consultant pharmacist can’t make the shortages go away, but there are techniques to prevent these shortages from affecting patients. We’ll consider some common pitfalls and proactive strategies in medication ordering, stocking, and using - [Informed Consent in the ASC](https://progressivesurgicalsolutions.com/webinars/informed-consent-in-the-asc/) - What constitutes an informed consent? Can a non-parental family member sign the consent form for a minor? patient? What is the difference between a facility consent and a physician office consent? Learn the legal and practical issues related to informed consent in your ASC. DEBRA STINCHCOMB, MBA, BSN, RN Debra has 36 years of health - [ALLIED HEALTH WORKERS IN THE ASC](https://progressivesurgicalsolutions.com/webinars/allied-health-workers-in-the-asc/) - Do you have Private Scrubs or neurophysiological intraoperative monitoring technicians accompany your surgeons? These are two examples of “allied health workers”, not to be confused with an Allied Health Professional (such as a PA). Learn what differentiates these practitioners and how to maintain appropriate credentialing documentation for this category. DEBRA STINCHCOMB, MBA, BSN, RN, CASC - [Benchmarking Made Simple](https://progressivesurgicalsolutions.com/webinars/benchmarking-made-simple/) - When done well, a benchmarking study can provide valuable insight into your ASC operation, how your metrics and outcomes compare to the same in the past or to other similar organizations. It is an opportunity to systematically establish goals, collect data, measure performance, analyze findings and take action in order to effect improvement. If you - [2022 ASC Quality Reporting Update](https://progressivesurgicalsolutions.com/webinars/2022-asc-quality-reporting-update/) - CMS requirements and quality reporting can be challenging for perioperative leaders in the ASC setting. Participants will receive current information on the quality program in light of the 2022 final rule, what reporting is required, and the definitions/frequently asked questions for the indicators. Important Information Regarding Measure ASC-20 GINA THRONEBERRY, RN, MBA, CASC, CNOR Gina - [PROBLEM EMPLOYEES | HOW TO MANAGE, HOW TO WIN](https://progressivesurgicalsolutions.com/webinars/problem-employees-how-to-manage-how-to-win/) - Do you have a “problem” employee who has monopolized the attention of HR for far too long? This webinar will present real life, timely scenarios and how to handle them. We will discuss strategies for defining success with these employees, outline best practices for sticky situations, and most importantly, offer advice on how to stay - [How To Deliver An Effective Performance Appraisal](https://progressivesurgicalsolutions.com/webinars/how-to-deliver-an-effective-performance-appraisal/) - Do you dread performance appraisals as much as your staff does? Do you struggle to document specific behavioral examples to support your scores and make the process objective? Are the performance goals you set for your employees, truly aimed at improving their performance and professional development? Employee evaluations do not have to be a chore - [Infection Investigation | A Case Study](https://progressivesurgicalsolutions.com/webinars/infection-investigation-a-case-study/) - We do everything we can to avoid infection, but we should also be prepared for when they do occur. What steps do you take? How thorough should the investigation be to determine the cause? Are you ever able to rule out the facility as responsible? Join us as we walk you through an infection investigation - [Medical Record Audit Walkthrough](https://progressivesurgicalsolutions.com/webinars/medical-record-audit-walkthrough/) - CMS tells us we must use our medical records in our QAPI program. But, how do you do that in a standardized, effective and beneficial way? Learn what to audit and how to make this process more robust than merely checking for dates and signatures. Be able to identify opportunities for improvement and how to make - [ASC Leadership LIVE Panel](https://progressivesurgicalsolutions.com/webinars/asc-leadership-live-panel/) - Three guest panelists share their challenges and successes in ASC leadership. Are you a busy Administrator or Clinical Director at an ambulatory surgery center? Do you wear what seems like a ridiculous amount of hats? Are you responsible for QAPI, Infection Control, Policies and Procedures, Medical Staff Credentialing, Human Resources, Inservice Training, etc.? Are you - [ASC Quality Reporting Update](https://progressivesurgicalsolutions.com/webinars/asc-quality-reporting-update/) - CMS requirements and quality reporting can be challenging for perioperative leaders in the ambulatory surgery center setting. Participants will learn what quality reporting is required and the definitions and frequently asked questions for the indicators. Also, participants will receive current information on the quality program. GINA THRONEBERRY, RN, MBA, CASC, CNOR Gina Throneberry is the - [Accounts Receivable Benchmarking Study](https://progressivesurgicalsolutions.com/webinars/accounts-receivable-benchmarking-study/) - Have you ever wondered how long it takes other ASCs to receive payment from the top payers? PSS has partnered with Waystar* to complete an A/R Benchmarking study. Compare your ASC to the rest of the industry and find out the tools you need to get paid faster. *Waystar Clearinghouse helps healthcare organizations see their - [Customer Service In The ASC | Enhancing The Patient Experience](https://progressivesurgicalsolutions.com/webinars/customer-service-in-the-asc-enhancing-the-patient-experience/) - As ASC leaders it is our responsibility to ensure we are providing a positive experience for our patients. The way our patients perceive our centers can have a direct impact on our centers. This webinar will focus on how to provide the best experience for our patients, tools to use in your centers, and implementation - [Understanding Medical Staff Credentialing](https://progressivesurgicalsolutions.com/webinars/understanding-medical-staff-credentialing/) - Medical staff Credentialing has consistently been one of the top ten most frequently cited deficiencies in recent history, on every type of survey. Meeting the documentation requirements requires great attention to detail and can feel like a tedious paper shuffle. We have developed a comprehensive and scripted Credentialing Guide that takes the guess work out - [What’s Your Pulse? Connecting With And Understanding Your Staff](https://progressivesurgicalsolutions.com/webinars/whats-your-pulse-connecting-with-and-understanding-your-staff/) - Considering today’s post-COVID staffing challenges, this session will explore the importance of soliciting employee feedback in maintaining strong staff engagement. Participants will learn strategies to connect with team members to help drive retention. Topics will include management techniques, employee satisfaction surveys, and case studies based on employee comments. ELIZABETH MONROE, COE, CPSS, PHR Ms. Monroe - [Revenue Cycle Management: Improving the Bottom Line](https://progressivesurgicalsolutions.com/webinars/revenue-cycle-management-improving-the-bottom-line/) - All too often the clinical manager of an ASC is unaware of how their day-to-day operation can affect the bottom line. In this webinar we will discuss how scheduling, knowing revenue per case, case costing awareness, and fee schedules can all affect the profitability of your surgery center. KYLIE KACZOR, MSN-RN, CASC, CMPE, CPHRM, ACHE - [Annual Survey Watch Report 2022](https://progressivesurgicalsolutions.com/webinars/annual-survey-watch-report-2022/) - Our consulting team has the advantage of working with scores of facilities across the country, going through a variety of different types of surveys, including State licensing, accreditation, and Medicare certification. You can benefit from our experience! Join us for a summary of deficiencies cited over the past year. CYNDI KRAUSE, BSN, RN, CRNO Prior - [Life Safety Risk Assessment: What is it and What is Required](https://progressivesurgicalsolutions.com/webinars/life-safety-risk-assessment-what-is-it-and-what-is-required/) - The purpose of Life Safety Risk Assessments is to identify and manage all risks associated with maintaining a safe, functional, and supportive environment. The risk assessments focus on the building or space and the special features and equipment that are designed to protect patients, visitors and staff: safety and security, hazardous materials and waste, fire - [2023 ASC Quality Reporting Update](https://progressivesurgicalsolutions.com/webinars/2023-asc-quality-reporting-update/) - CMS requirements and quality reporting can be challenging for perioperative leaders in the ASC setting. Participants will receive current information on the quality program with updates on the 2023 final rule, what reporting is required, and the definitions/frequently asked questions for the indicators. GINA THRONEBERRY, MBA, BSN, RN, CASC, CNOR Gina Throneberry is the Director - [EXCEL FOR NURSE LEADERS](https://progressivesurgicalsolutions.com/webinars/excel-for-nurse-leaders/) - Excel skills can be a powerful tool in managing time and compiling important data. In this webinar we will create a practical spreadsheet tool and review basic functions and formulas that can help ASC nurse leaders collect, organize and analyze their data in a useful way. NANCY STEPHENS, SENIOR CONSULTANT Nancy Stephens is a senior - [Progressive Half Time: Risk Assessment 101, How to Avoid a Data Breach](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-risk-assessment-101-how-to-avoid-a-data-breach/) - Art Gross and Karen Conduragis - HIPAA Secure Now Nancy Stephens - Progressive Surgical Solutions 2016 was a record year for data breaches...It can happen to you! Data breaches are a painful event and can cost an ASC between $50,000 and $75,000 Does your ASC Security Officer know their job duties? Risk Assessments have been - [Progressive Half Time: Anesthesia - Young and Old](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-anesthesia-young-and-old/) - Thomas Wherry, MD Total Anesthesia Solutions The Extremes: the very young and the very old - presenting for Ambulatory Surgery What makes a patient a pediatric patient? How young is too young for surgery in an office setting? What are some particular unique concerns? How should you be equipped? Pediatric: accreditation, standards & training? How - [Progressive Half Time: Compounding Problems](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-compounding-problems/) - Regina Boore, MS, BSN, RN, CASC Progressive Surgical Solutions Mark Livingston & Anthony Dziabo Prima Pharma Inc. Highly publicized instances of patient complications associated with CSPs has resulted in increased scrutiny of safe medication practices in the ASC. Citations are being issued related to medication preparation and administration, There is confusion, even among surveyors, on - [Progressive Half Time: Ask the Clinical Director Panel](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-ask-the-clinical-director-panel/) - Facilitated by: Crissy Benze, MSN, BSN, RN Guest Clinical Directors: Denise Carpenter, BSN, RN, Alison Galloway, BSN, RN, & Jenn Sargent, RN Are you a busy Clinical Director at an ambulatory surgery center? Do you wear what seems like a ridiculous amount of hats? Are you responsible for QAPI, Infection Control, Policies and Procedures, Medical - [Progressive Half Time: Emergency Preparedness Update](https://progressivesurgicalsolutions.com/webinars/emergency-preparedness-update/) - Rob Sills, MBA Sills Healthcare Solutions Rob Sills is responsible for oversight of daily operations, strategic planning, physician relations, capital equipment, budgets, supplies, compliance, staffing, recruitment, policy and procedures, education of staff and management, patient relations, and scheduling and evaluating the administration of medical services at a multi-specialty clinic. Rob is the Disaster Preparedness Officer - [Progressive Half Time: Excel for Nurses](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-excel-for-nurses/) - Learn how to use Excel to track Key Performance Indicators and forecast staffing expenses – add an extra day to the OR schedule and see the impact on the bottom line. Nancy Stephens will walk you through the formulas using our Excel tool and Amy Fox, Outpatient Surgery Director at Advanced Eye Surgery Center, will - [Progressive Half Time: Got Compliance? A Pharmacist's Insights for Success](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-got-compliance-a-pharmacists-insights-for-success/) - The regulations that cover medication usage, tracking and waste can be very confusing. This program will present guidance that will assist your facility to comply with the basics in pharmacy regulations, and many of the ways your pharmacist consultant can assist you. Key topics include Pharmaceutical Waste, DEA Regulations, Compounding Pharmacies, and what to expect - [Progressive Half Time: Infection Control Risk Assessment](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-infection-control-risk-assessment/) - The risk assessment addresses the facility's responsibility in defining areas of actual and possible failure of "best practices" that could potentially put patients and employees at risk for infection. This presentation will discuss the specific components of the risk assessment and how to ensure that each risk is well documented and prioritized in order of - [Progressive Half Time: Ask the Clinical Director and Administrator LIVE Panel](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-ask-the-clinical-director-and-administrator-live-panel/) - Moderator: Crissy Benze, MSN, BSN, RN Panel Clinical Directors: Apryl McElheny, BSN RN, CASC and Minda Soria, MHA, BSN, RN Panel Administrators: Jared Abel and Joan Conine, BSN, RN, CNOR Are you a busy Administrator or Clinical Director at an ambulatory surgery center? Do you wear what seems like a ridiculous amount of hats? Are - [Progressive Half Time: Leading From The Middle](https://progressivesurgicalsolutions.com/webinars/leading-from-the-middle/) - Flat organizations tend to empower managers. ASC Clinical Directors who command the respect and support of their facility staff are able to shine in their management role. However their effectiveness as an organizational leader can be diminished by disengagement and a lack of leadership at the Governing Body level. You know the challenges; refusal to - [Progressive Half Time: Life Safety Code Compliance Blueprint](https://progressivesurgicalsolutions.com/webinars/life-safety-code-compliance-blueprint/) - Life Safety Code compliance is imperative for your ASC. John discusses life safety issues and gives a guide to achieving compliance for your survey, what you need to know for maintaining compliance, and a life safety blueprint with keys to success for upcoming surveys. Get practical guidance on the meeting inspection, testing and maintenance requirements. - [Progressive Half Time: Developing the Leader Within, Part I](https://progressivesurgicalsolutions.com/webinars/developing-the-leader-within-1/) - Today's complex healthcare environment requires effective leadership to support the goals and business outcomes of the organization, and most importantly, support excellent patient care. Join us to learn more about important core pillars of leadership and how these characteristic contribute to professional growth and organizational success. Laura Baldwin, RN is a senior consultant and certified - [Developing the Leader Within Part II](https://progressivesurgicalsolutions.com/webinars/developing-the-leader-within-part-ii/) - Bringing greater awareness to our individual energy allows people to more effectively inspire, motivate and influence themselves and others. Learn how each of us has the power to identify and shift our own energies to better serve our patients and co-workers, and achieve greater satisfaction. Laura Baldwin, RN Laura Baldwin is a senior consultant and - [Sterilization Best Practices in the ASC](https://progressivesurgicalsolutions.com/webinars/sterilization-best-practices-in-the-asc/) - Effective reprocessing of medical devices including instruments in the surgery setting is a key factor in prevention of transmission of infections. Over the course of the past several years, outbreaks of infections including the deadly “superbugs” as a result of inappropriate high-level disinfection of duodenoscopes has increased the requirements for following nationally recognized guidelines and - [Progressive Huddle: CMS Quality Reporting Update for ASCs 2019](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-cms-quality-reporting-update-for-ascs-2019/) - CMS requirements and quality reporting can be challenging for perioperative leaders in the ambulatory surgery center setting. Participants will learn what quality reporting is required and the definitions and frequently asked questions for the indicators. Also, participants will receive current information on the quality program. Gina Throneberry, RN, MBA, CASC, CNOR Gina Throneberry is the - [Progressive Huddle: How To Talk To ASC Surveyors](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-how-to-talk-to-surveyors/) - Communicating with Surveyors can have an effect on the outcome of your survey. Knowing what and how they are going to ask you to meet regulations can help you better prepare for they way you will respond and communicate with them. Join us as we give you some real-life examples and tips for communicating effectively - [Progressive Huddle: Culture of Safety in the ASC](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-culture-of-safety/) - Patient safety is paramount and should be priority number one in all facilities. Improving the culture of safety within health care is an essential component of preventing or reducing errors and improving overall health care quality. The Agency for Healthcare Research and Quality (AHRQ) says that safety culture is generally measured by surveys of providers - [Progressive Huddle: Cultural Sensitivity in the ASC](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-cultural-sensitivity/) - Cultural Sensitivity refers to a set of skills that you have to understand and learn about other people who may not have the same cultural ideals as you. Learn how cultural sensitivity has an impact on employee’s awareness and patient satisfaction in your ASC and how you can ensure addressing this issue. DEBRA STINCHCOMB, MBA, - [Progressive Huddle: Working Effectively With Your Medical Staff](https://progressivesurgicalsolutions.com/webinars/working-effectively-with-your-medical-staff/) - Working effectively with your medical staff is imperative for a top-performing surgery center. Engaged governing body leadership is the ultimate goal. Does your medical staff know about your current QAPI activities? Do they thank your staff at the end of a long day? Do they contribute to a better clinical operation? Vanessa has firsthand experience - [Progressive Huddle: Annual Survey Watch Report 2018](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-annual-survey-watch-report-2018/) - Progressive Surgical Solutions has the advantage of working with scores of facilities across the country, going through a variety of different types of surveys, including State licensing, accreditation, and Medicare certification. You can benefit from our experience! Join us for a summary of deficiencies cited over the past year. LEANNE GALLEGOS BSN, RN, graduated from - [Progressive Huddle: Life Safety Code Survey Watch](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-life-safety-code-survey-watch/) - All deemed status surveys now include a separate Life Safety Code engineer and over the past couple years we have seen an increase in citations. In addition, Medicare adopted the 2012 version of Life Safety Code in 2016, which created increased scrutiny. This webinar will go over some recent common deficiencies during surveys and it - [Progressive Huddle: DEA Controlled Substances - Tracking and Diversion Prevention](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-dea-controlled-substances-tracking-and-diversion-prevention/) - Gregory Tertes, R.Ph. Pharmacist Consultant ASC Pharmacist Consultants, Inc. Do you have a controlled substance diversion issue at your facility? Every facility says emphatically, “No.” The thing about diversion is that if we new about it, we’d stop it. The best way to ensure you do not have an issue is to track these medications - [Progressive Huddle: CMS Quality Reporting Update for ASCs 2018](https://progressivesurgicalsolutions.com/webinars/cms-quality-reporting-update-for-ascs-2018/) - Gina Throneberry, RN, MBA, CASC, CNOR Director of Education and Clinical Affairs Ambulatory Surgery Center Association CMS requirements and quality reporting can be challenging for perioperative leaders in the ambulatory surgery center setting. Participants will learn what quality reporting is required and the definitions and frequently asked questions for the indicators. Also, participants will receive - [Progressive Huddle: Annual Survey Watch Report](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-annual-survey-watch-report/) - Crissy Benze, MSN, BSN, RN Progressive Surgical Solutions We have the benefit of working with dozens of surgery centers across the country as they prepare for and go through surveys. Join us for a 20 minute review on the most common deficiencies in 2016 from CMS, Joint Commission and AAAHC surveys. We will also point - [Progressive Huddle: Minimizing the Risk of Legal Claims and Liability Through Effective Communications](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-minimizing-the-risk-of-legal-claims-and-liability-through-effective-communications/) - Will Miller Higgs, Fletcher & Mack, LLC Minimizing the Risk of Legal Claims/Liability Through Effective Patient/Patient Representative Communications. This webinar will identify scenarios frequently giving rise to liability claims in the ASC setting, and provide practical solutions to minimize the risk of claims. Download the Slides - [Progressive Half Time: Documentation in the ASC](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-documentation-in-the-asc/) - Crissy Benze, BSN, RN Progressive Surgical Solutions Make sure your medical record documentation meets basic standards of practice and regulatory requirements. This webinar discusses the purpose of accurate documentation, requirements in an ASC medical record and some legal issues associated with medical record documentation. Download the slides Progressive Half Time is a quarterly 60 minute webinar series - [Progressive Half Time: CMS Regulatory Update & Survey Trends - Life Safety Code](https://progressivesurgicalsolutions.com/webinars/halftime-life-safety-code/) - Bill Lindeman, AIA WEL Designs CMS Physical Environment Requirements and Considerations. The 2000 "NFPA 101 code set" and CMS SoM Appendix L. Download the slides Progressive Half Time is a quarterly 60 minute webinar series on industry hot topics that offers continued education credit to licensed participants. Brought to you by Progressive eSupport. Reminder: Regulations - [Progressive Half Time: Infection Control Case Study](https://progressivesurgicalsolutions.com/webinars/half-time-infection-control-case-study/) - Regina Boore, MS, BSN, RN, CASC Learning Objectives: Distinguish between endophthalmitis and TASS, Describe the steps of a postop infection investigation, Describe the considerations important to a postop infection investigation and analysis Download the slides Download Case Study Samples Progressive Half Time is a quarterly 60 minute webinar series on industry hot topics that offers continued education - [Progressive Half Time: The Scope of Infection Prevention in the GI Suite](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-the-scope-of-infection-prevention-in-the-gi-suite/) - Christie Chapman, BSN, RN, CIC UCSD Health Systems Objectives: Discuss why infection prevention is so important in GI suites Identify Standard Precautions and their application in the GI suite Review updates in endoscopy reprocessing, guidelines and standards List the decontamination and disinfection steps of a flexible endoscope from bedside to storage Name at least 2 - [Progressive Half Time: The Ambulatory Healthcare Life Safety Chapter](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-the-ambulatory-healthcare-life-safety-chapter/) - Anne M. Guglielmo Department of Engineering The Joint Commission An engineer from The Joint Commission provides an overview of Life Safety Code requirements and recent deficiencies from a survey perspective. Download the slides Progressive Half Time is a quarterly 60 minute webinar series on industry hot topics that offers continued education credit to licensed participants. - [Progressive Half Time: Roles of Clinical Staff in the ASC](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-roles-of-clinical-staff-in-the-asc/) - Debra Stinchcomb, MBA, BSN, RN, CASC You will be able to Identify issues that can affect clinical staffing levels and understand the scope of practice of clinical staff in your ASC. Can your MA administer eye drops? What level of supervision do your LVNs/LPNs require? What can your Nursing Assistant do in the pre op - [Progressive Half Time: Preventing Harassment in the Workplace](https://progressivesurgicalsolutions.com/webinars/progressive-half-time/) - Katy Raytis Worklogic HR If you don't think you are going to get sued for harassment, discrimination, or retaliation, you better think again! According to a 2015 Hiscox study, small to mid-size companies in California have a 40% chance of being hit with an employee complaint, and other states have even higher percentages! Making matters worse, harassment - [Progressive Half Time: ASC Survey Preparation](https://progressivesurgicalsolutions.com/webinars/progressive-half-time-asc-survey-preparation/) - Crissy Benze, BSN, RN Progressive Surgical Solutions Is your facility always "survey ready"?? Have all of the deficiencies from your last survey been corrected? If a surveyor walked into your facility tomorrow, would you be ready to pass with flying colors? If you answered 'no' or even 'I don't know' to any of these questions, - [Progressive Huddle: Purchasing and Supply Chain](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-purchasing-and-supply-chain/) - Brian Valley McKesson This webinar will provide a better understanding of best practices when it comes to purchasing and overall supply chain management while also highlighting the McKesson services and technology that can help create greater efficiency at the surgery center while reducing costs. Download the Slides - [Progressive Huddle: How to Effectively Respond to a Data Breach](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-how-to-effectively-respond-to-a-data-breach/) - Kurt Bratten, Esq O'Connell and Aronowitz This Webinar will address how to properly respond to a data breach under HIPAA and state law. While the program will review the legal requirements and OCR investigation process, the speaker will also offer real-world advice about how to prepare your practice for a breach and how best to - [Progressive Huddle: Hazard Vulnerability Analysis and Risk Assessments](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-hazard-vulnerability-analysis-and-risk-assessments/) - Debra Stinchcomb, MBA, BSN, RN, CASC Progressive Surgical Solutions Learn how to assess the risks in your facility to meet CMS, AAAHC and TJC requirements. See how to integrate your HVA into a focused assessment that includes mitigation, preparation, response and recovery. Have you developed your HVA? If you have an HVA, have you reviewed - [Progressive Huddle: CMS Quality Reporting for ASCs](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-cms-quality-reporting-for-ascs/) - Gina Throneberry, RN, MBA, CASC, CNOR Ambulatory Surgery Center Association CMS requirements and quality reporting can be challenging for perioperative leaders in the ambulatory surgery center setting. Participants will learn what quality reporting is required and the definitions and frequently asked questions for the indicators. Also, participants will receive current information on the quality program. - [Progressive Huddle: Annual Survey Watch Report 2016](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-annual-survey-watch-report-2016/) - Leanne Gallegos, BSN, RN Progressive Surgical Solutions We have the benefit of working with dozens of surgery centers across the country as they prepare for and go through surveys. Join us for a 20 minute review on the most common deficiencies in 2016 from CMS, Joint Commission and AAAHC surveys. We will also point you - [Progressive Huddle: Narcotic Diversion Prevention](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-narcotic-diversion-prevention/) - John Karwoski JDJ Consulting Get educated on the national epidemic of illegal narcotic use, federal regulations addressing the issue, and the impact on the local community and ASC Get training on the importance of diversion prevention Learn ways to identify potential diversion within the ASC and will have an understanding of their legal and ethical duty to - [Progressive Huddle: CMS Regulatory Update at a Glance](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-cms-regulatory-update-at-a-glance/) - Debra Stinchcomb, MBS, BSN, RN, CASC Progressive Surgical Solutions Learn about recent CMS changes affecting: Advance Directives Emergency Equipment Patient Rights Infection Control Download the slides Download follow up Q&A Progressive Huddle is a webinar series brought to you by Progressive eSupport to help you stay in the know. These 20 minute webinars are short - [Progressive Huddle: Compliance Made Simple](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-compliance-made-simple/) - Crissy Benze, BSN, RN Progressive Surgical Solutions Assuring compliance requires ongoing diligence...daily, weekly, monthly, quarterly, annually. It's all about making a plan and working your plan. This Huddle reviews a facility compliance calendar plan for success. "You don't have to plan to fail...you just have to fail to plan." Download the Slides Progressive Huddle is a webinar series brought - [Progressive Huddle: Business Operations 101](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-business-operations-101/) - Nancy Stephens Progressive Surgical Solutions Our Business Operations guru discusses: How to use the annual budget tool in Excel Using Excel to track Key Performance Indicators Short and to the point Quarterly Board Packages Business Ops tools on eSupport Download the slides Progressive Huddle is a webinar series brought to you by Progressive - [Progressive Huddle: TB Control Without Annual Testing](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-tb-control-without-annual-testing/) - Leanne Gallegos, BSN, RB Progressive Surgical Solutions Consider revising your approach to TB exposure control. This webinar discusses how. Download the slides Progressive Huddle is a webinar series brought to you by Progressive eSupport to help you stay in the know. These 20 minute webinars are short and sweet and to the point. They will give you - [Progressive Huddle: Current Issues in the Ambulatory Infection Surveillance for SSIs](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-current-issues-in-the-ambulatory-infection-surveillance-for-ssis/) - Kelly L. Podgorny, DNP, MS, RN Project Director The Joint Commission This webinar addresses: History of NHSN and the recent change in surgical site infection (SSI) implant monitoring Removal of implant monitoring requirements NHSN requirements for ambulatory SSI monitoring Revision to National Patient Safety Goal(NPSG) Resources from The Joint Commission Enterprise Download the Slides Download the follow - [Progressive Huddle: Credentialing Pearls](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-credentialing-pearls/) - Debra Stinchcomb, MBA, BSN, RN, CASC Progressive Surgical Solutions Download the slides Progressive Huddle is a webinar series brought to you by Progressive eSupport to help you stay in the know. These 20 minute webinars are short and sweet and to the point. They will give you the critical information and point you to the resources - [Progressive Huddle: Controlled Substances Management](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-controll-substances-management/) - John Karwoski, RPh, MBA JDJ Consulting Download the slides Progressive Huddle is a webinar series brought to you by Progressive eSupport to help you stay in the know. These 20 minute webinars are short and sweet and to the point. They will give you the critical information and point you to the resources you need to adapt your operation. - [Progressive Huddle: Informed Consent in the ASC](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-informed-consent-in-the-asc/) - Debra Stinchcomb, MBA, BSN, RN, CASC Progressive Surgical Solutions Download the slides Progressive Huddle is a webinar series brought to you by Progressive eSupport to help you stay in the know. These 20 minute webinars are short and sweet and to the point. They will give you the critical information and point you to the resources you - [Progressive Huddle: The "contemporary" Life Safety Code Survey](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-the-contemporary-life-safety-code-survey/) - Bill Lindeman, AIA, NCARB WEL Designs Are you under the impression that NFPA 101® Life Safety Code® (LSC) requirements are getting more stringent, and CMS is requiring things they never have before? If so, you are both right and wrong. Download the slides Progressive Huddle is a webinar series brought to you by Progressive eSupport to help - [Progressive Huddle: HIPAA](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-hipaa/) - Nancy Stephens Progressive Surgical Solutions In this Webinar: Overview of HIPAA leadership Unacceptable uses of information or electronic devices Definition of a Breach HIPAA and cash paying patients HIPAA Risk Assessment Tool Kit Download the slides Progressive Huddle is a webinar series brought to you by Progressive eSupport to help you stay in the - [Progressive Huddle: Quality Net Reporting](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-quality-net-reporting/) - Sarah Martin, MBA, RN, CASC All entities subject to the ASC Fee Schedule are required to participate in Quality Reporting. This Huddle gives you an overview of the requirements, how to report and offers practical resources to stay on track. Download the slides Progressive Huddle is a webinar series brought to you by Progressive eSupport to - [Progressive Huddle: Inservices & Employee Education](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-inservices-employee-education/) - Leanne Gallegos, BSN, RN The World Health Report 2000/Health Systems: Improving Performance states that human resources is the most important contribution to the quality of health care because "the performance of health care systems depends ultimately on the knowledge, skills, and motivation of the people responsible for delivering services. This Huddle goes over pre-employment, orientation, - [Progressive Huddle: Track & Trace](https://progressivesurgicalsolutions.com/webinars/8770-2/) - John Karwoski, RPh, MBA JDJ Consulting Track & Trace: 2015 changes to the food, drug, and cosmetic act: The Drug Supply Chain Security Act. Download the slides Progressive Huddle is a webinar series brought to you by Progressive eSupport to help you stay in the know. These 20 minute webinars are short and sweet and to the point. - [Progressive Huddle: Social Media in the Workplace](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-social-media-in-the-workplace/) - Edwin Boniske, Esq Higgs, Fletcher & Mack LLP Everyone is on Social Media these days, even at work! Do you know how to handle this modern phenomenon with your employees? Our guest speaker has important and practical tips for employers in the digital age. Download the slides Progressive Huddle is a webinar series brought to you - [Progressive Huddle: Ask the Administrator Panel](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-ask-the-administrator-panel/) - The Panel: Debra Stinchcomb, MBA, BSN, RN, CASC Kimberly Price, RN Pam Hopper, BSN, RN Are you a busy Administrator or Clinical Director at an ambulatory surgery center? Do you wear what seems like a ridiculous amount of hats? Are you responsible for QAPI, Infection Control, Policies and Procedures, Medical Staff Credentialing, Human Resources, Inservice - [Progressive Huddle: Top 10 Supervisor Slip Ups](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-top-10-supervisor-slip-ups/) - Katy Raytis, Esq Work Logic HR Supervisor mistakes lead to costly lawsuits. This session will explore the most common missteps that lead to litigation including topics such as performance management, leaves of absence, policy enforcement, and harassment. Supervisors are every company's front-line when it comes to compliance with employment laws. Don't let your front-line leave - [Progressive Huddle: Annual Survey Watch 2015](https://progressivesurgicalsolutions.com/webinars/progressive-huddle-annual-survey-watch-2015/) - Leanne Gallegos, BSN, RN Progressive Surgical Solutions has the advantage of working with scores of facilities across the country, in multiple states, with all the deemed status agencies. Periodically we post summaries of deficiencies sited on various types of surveys to the eSupport website. This Huddle provides a review of the past year. Download the slides ## Categories - [Blog Post](https://progressivesurgicalsolutions.com/category/blog-post/) - [ASC Industry News](https://progressivesurgicalsolutions.com/category/asc-industry-news/) ## Topic Tags - [TASS](https://progressivesurgicalsolutions.com/forums/topic-tag/tass/) - [biological](https://progressivesurgicalsolutions.com/forums/topic-tag/biological/) - [sterilization](https://progressivesurgicalsolutions.com/forums/topic-tag/sterilization/) - [Safety](https://progressivesurgicalsolutions.com/forums/topic-tag/safety/) - [service animal](https://progressivesurgicalsolutions.com/forums/topic-tag/service-animal/) - [new procedure](https://progressivesurgicalsolutions.com/forums/topic-tag/new-procedure/) - [Summary List](https://progressivesurgicalsolutions.com/forums/topic-tag/summary-list/) - [Anti-Discrimination; Translation services](https://progressivesurgicalsolutions.com/forums/topic-tag/anti-discrimination-translation-services/) - [infusion pumps necessary/req?](https://progressivesurgicalsolutions.com/forums/topic-tag/infusion-pumps-necessaryreq/) - 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[performance review](https://progressivesurgicalsolutions.com/forums/topic-tag/performance-review/) - [Employee safety](https://progressivesurgicalsolutions.com/forums/topic-tag/employee-safety/) - [Endoscopy](https://progressivesurgicalsolutions.com/forums/topic-tag/endoscopy/) - [Masks](https://progressivesurgicalsolutions.com/forums/topic-tag/masks/) - [Death Policy & Procedure](https://progressivesurgicalsolutions.com/forums/topic-tag/death-policy-procedure/) - [Patient Satisfaction Survey; Survey Return Rate; Patient Satisfaction](https://progressivesurgicalsolutions.com/forums/topic-tag/patient-satisfaction-survey-survey-return-rate-patient-satisfaction/) - [Physician Annual Education; Infection Control In-service for physicians](https://progressivesurgicalsolutions.com/forums/topic-tag/physician-annual-education-infection-control-in-service-for-physicians/) - [Air exchanges and endo procedures during COVID](https://progressivesurgicalsolutions.com/forums/topic-tag/air-exchanges-and-endo-procedures-during-covid/) - [COVID-19](https://progressivesurgicalsolutions.com/forums/topic-tag/covid-19/) - [Phase I](https://progressivesurgicalsolutions.com/forums/topic-tag/phase-i/) - [Phase II level of care](https://progressivesurgicalsolutions.com/forums/topic-tag/phase-ii-level-of-care/) - [covid](https://progressivesurgicalsolutions.com/forums/topic-tag/covid/) - [Corona Virus](https://progressivesurgicalsolutions.com/forums/topic-tag/corona-virus/) - [CMS; H&P; Admitting Privileges for Physicians](https://progressivesurgicalsolutions.com/forums/topic-tag/cms-hp-admitting-privileges-for-physicians/) - [Surgical Hat](https://progressivesurgicalsolutions.com/forums/topic-tag/surgical-hat/) - [Cloth Hat](https://progressivesurgicalsolutions.com/forums/topic-tag/cloth-hat/) - [Coronavirus; COVID-19; Screening](https://progressivesurgicalsolutions.com/forums/topic-tag/coronavirus-covid-19-screening/) - [Covid-19 policies](https://progressivesurgicalsolutions.com/forums/topic-tag/covid-19-policies/) - [Narcotic Book Ledger](https://progressivesurgicalsolutions.com/forums/topic-tag/narcotic-book-ledger/) - [Mitomycin C](https://progressivesurgicalsolutions.com/forums/topic-tag/mitomycin-c/) - [Requirement for H&P prior to surgery](https://progressivesurgicalsolutions.com/forums/topic-tag/requirement-for-hp-prior-to-surgery/) - [N95](https://progressivesurgicalsolutions.com/forums/topic-tag/n95/) - [Arterial Pressure Line use in Outpatient Surgery Centers](https://progressivesurgicalsolutions.com/forums/topic-tag/arterial-pressure-line-use-in-outpatient-surgery-centers/) - [Patient Screening](https://progressivesurgicalsolutions.com/forums/topic-tag/patient-screening/) - [bouffant shortage](https://progressivesurgicalsolutions.com/forums/topic-tag/bouffant-shortage/) - [employee covid exposure](https://progressivesurgicalsolutions.com/forums/topic-tag/employee-covid-exposure/) - [OR Air Exchange](https://progressivesurgicalsolutions.com/forums/topic-tag/or-air-exchange/) - [#CSR](https://progressivesurgicalsolutions.com/forums/topic-tag/csr/) - [#Billing](https://progressivesurgicalsolutions.com/forums/topic-tag/billing/) - [Ophthalmology instrument detergent](https://progressivesurgicalsolutions.com/forums/topic-tag/ophthalmology-instrument-detergent/) - [COVID P&P](https://progressivesurgicalsolutions.com/forums/topic-tag/covid-pp/) - [LPN; RN; Documentation](https://progressivesurgicalsolutions.com/forums/topic-tag/lpn-rn-documentation/) - [COVID testing](https://progressivesurgicalsolutions.com/forums/topic-tag/covid-testing/) - [Pre surgical testing](https://progressivesurgicalsolutions.com/forums/topic-tag/pre-surgical-testing/) - [AAAHC](https://progressivesurgicalsolutions.com/forums/topic-tag/aaahc/) - [Disaster preparedness](https://progressivesurgicalsolutions.com/forums/topic-tag/disaster-preparedness/) - [Staffing Shortage](https://progressivesurgicalsolutions.com/forums/topic-tag/staffing-shortage/) - [Temp medical help](https://progressivesurgicalsolutions.com/forums/topic-tag/temp-medical-help/) - [Agency work](https://progressivesurgicalsolutions.com/forums/topic-tag/agency-work/) - [Air balance](https://progressivesurgicalsolutions.com/forums/topic-tag/air-balance/) - [OR Cost](https://progressivesurgicalsolutions.com/forums/topic-tag/or-cost/) - [Legal guradian](https://progressivesurgicalsolutions.com/forums/topic-tag/legal-guradian/) - [blepharoplasty eyelid surgery ophthalmology](https://progressivesurgicalsolutions.com/forums/topic-tag/blepharoplasty-eyelid-surgery-ophthalmology/) - [Pathology P&P](https://progressivesurgicalsolutions.com/forums/topic-tag/pathology-pp/) - [Generator Load Transfer](https://progressivesurgicalsolutions.com/forums/topic-tag/generator-load-transfer/) - [Monthly receptacle documentation](https://progressivesurgicalsolutions.com/forums/topic-tag/monthly-receptacle-documentation/) - [Privilege request](https://progressivesurgicalsolutions.com/forums/topic-tag/privilege-request/) - [Combining Malignant Hyperthermia Cart/ Emergency Crash Cart](https://progressivesurgicalsolutions.com/forums/topic-tag/combining-malignant-hyperthermia-cart-emergency-crash-cart/) - [Quality improvement](https://progressivesurgicalsolutions.com/forums/topic-tag/quality-improvement/) - [Who can legally sign consent](https://progressivesurgicalsolutions.com/forums/topic-tag/who-can-legally-sign-consent/) - [Extended Stay](https://progressivesurgicalsolutions.com/forums/topic-tag/extended-stay/) - [Positive Drug Screen d/t Vyvanse](https://progressivesurgicalsolutions.com/forums/topic-tag/positive-drug-screen-d-t-vyvanse/) - [patient transfers](https://progressivesurgicalsolutions.com/forums/topic-tag/patient-transfers/) - [hospital transfers](https://progressivesurgicalsolutions.com/forums/topic-tag/hospital-transfers/) - [Human Resources](https://progressivesurgicalsolutions.com/forums/topic-tag/human-resources/) - [Patient Transfer Reproting form](https://progressivesurgicalsolutions.com/forums/topic-tag/patient-transfer-reproting-form/) - [Thermometer](https://progressivesurgicalsolutions.com/forums/topic-tag/thermometer/) - [Fire Alarm System testing](https://progressivesurgicalsolutions.com/forums/topic-tag/fire-alarm-system-testing/) - [BMI requirement for surgery](https://progressivesurgicalsolutions.com/forums/topic-tag/bmi-requirement-for-surgery/) - [External Benchmarking](https://progressivesurgicalsolutions.com/forums/topic-tag/external-benchmarking/) - [Employees](https://progressivesurgicalsolutions.com/forums/topic-tag/employees/) - [Electrostatic disinfecting](https://progressivesurgicalsolutions.com/forums/topic-tag/electrostatic-disinfecting/) - [Staffing question](https://progressivesurgicalsolutions.com/forums/topic-tag/staffing-question/) - [generator life safety code emergency preparedness](https://progressivesurgicalsolutions.com/forums/topic-tag/generator-life-safety-code-emergency-preparedness/) - [Surgical Attire](https://progressivesurgicalsolutions.com/forums/topic-tag/surgical-attire/) - [Surgical Scrub](https://progressivesurgicalsolutions.com/forums/topic-tag/surgical-scrub/) - [operating room equipment](https://progressivesurgicalsolutions.com/forums/topic-tag/operating-room-equipment/) - [nursing home](https://progressivesurgicalsolutions.com/forums/topic-tag/nursing-home/) - [congregate setting](https://progressivesurgicalsolutions.com/forums/topic-tag/congregate-setting/) - [Terminal Cleaning](https://progressivesurgicalsolutions.com/forums/topic-tag/terminal-cleaning/) - [Compliance and Accreditation Consultant Pharmacist](https://progressivesurgicalsolutions.com/forums/topic-tag/compliance-and-accreditation-consultant-pharmacist/) - [Lot numbers](https://progressivesurgicalsolutions.com/forums/topic-tag/lot-numbers/) - [IV Infusion in ASC](https://progressivesurgicalsolutions.com/forums/topic-tag/iv-infusion-in-asc/) - [Risk Assessment](https://progressivesurgicalsolutions.com/forums/topic-tag/risk-assessment/) - [Antibiotic Stewardship Program](https://progressivesurgicalsolutions.com/forums/topic-tag/antibiotic-stewardship-program/) - [IOL insertion issues](https://progressivesurgicalsolutions.com/forums/topic-tag/iol-insertion-issues/) - [Emergency prepareness](https://progressivesurgicalsolutions.com/forums/topic-tag/emergency-prepareness/) - [TB skin test](https://progressivesurgicalsolutions.com/forums/topic-tag/tb-skin-test/) - [Procedure room](https://progressivesurgicalsolutions.com/forums/topic-tag/procedure-room/) - [CEMP](https://progressivesurgicalsolutions.com/forums/topic-tag/cemp/) - [ASC covid screenings](https://progressivesurgicalsolutions.com/forums/topic-tag/asc-covid-screenings/) - [CMS certification proof](https://progressivesurgicalsolutions.com/forums/topic-tag/cms-certification-proof/) - [How long is a surgery consent good for at an ASC?](https://progressivesurgicalsolutions.com/forums/topic-tag/how-long-is-a-surgery-consent-good-for-at-an-asc/) - [Medical Director](https://progressivesurgicalsolutions.com/forums/topic-tag/medical-director/) - [Retirement](https://progressivesurgicalsolutions.com/forums/topic-tag/retirement/) - [Attestation form](https://progressivesurgicalsolutions.com/forums/topic-tag/attestation-form/) - [Clearance](https://progressivesurgicalsolutions.com/forums/topic-tag/clearance/) - [credentialing forms](https://progressivesurgicalsolutions.com/forums/topic-tag/credentialing-forms/) - [Pharmacy Inspection](https://progressivesurgicalsolutions.com/forums/topic-tag/pharmacy-inspection/) - [Policy & procedures](https://progressivesurgicalsolutions.com/forums/topic-tag/policy-procedures/) - [Human Resourses](https://progressivesurgicalsolutions.com/forums/topic-tag/human-resourses/) - [Medical record](https://progressivesurgicalsolutions.com/forums/topic-tag/medical-record/) - [Personal vs Work Email Addresses](https://progressivesurgicalsolutions.com/forums/topic-tag/personal-vs-work-email-addresses/) - [Accreditation](https://progressivesurgicalsolutions.com/forums/topic-tag/accreditation/) - [Employer Mandated COVID Vaccines](https://progressivesurgicalsolutions.com/forums/topic-tag/employer-mandated-covid-vaccines/) - [compliance calendar](https://progressivesurgicalsolutions.com/forums/topic-tag/compliance-calendar/) - [OSHA compliance/ docs](https://progressivesurgicalsolutions.com/forums/topic-tag/osha-compliance-docs/) - [building manager](https://progressivesurgicalsolutions.com/forums/topic-tag/building-manager/) - [Credit card merchant service provider](https://progressivesurgicalsolutions.com/forums/topic-tag/credit-card-merchant-service-provider/) - [Use of Volunteers](https://progressivesurgicalsolutions.com/forums/topic-tag/use-of-volunteers/) - [Physician verification](https://progressivesurgicalsolutions.com/forums/topic-tag/physician-verification/) - [Return to the OR paperwork](https://progressivesurgicalsolutions.com/forums/topic-tag/return-to-the-or-paperwork/) - [Biomed PM nspections](https://progressivesurgicalsolutions.com/forums/topic-tag/biomed-pm-nspections/) - [OR Floor](https://progressivesurgicalsolutions.com/forums/topic-tag/or-floor/) - [Satellite phones](https://progressivesurgicalsolutions.com/forums/topic-tag/satellite-phones/) - [Disaster Plan](https://progressivesurgicalsolutions.com/forums/topic-tag/disaster-plan/) - [Document retention](https://progressivesurgicalsolutions.com/forums/topic-tag/document-retention/) - [#laser #lasersafety #lso](https://progressivesurgicalsolutions.com/forums/topic-tag/laser-lasersafety-lso/) - [Employee handbook](https://progressivesurgicalsolutions.com/forums/topic-tag/employee-handbook/) - [Crentialing and priviliges](https://progressivesurgicalsolutions.com/forums/topic-tag/crentialing-and-priviliges/) - [priviliges](https://progressivesurgicalsolutions.com/forums/topic-tag/priviliges/) - [Customer Service Quiz](https://progressivesurgicalsolutions.com/forums/topic-tag/customer-service-quiz/) - [application](https://progressivesurgicalsolutions.com/forums/topic-tag/application/) - [Mandate](https://progressivesurgicalsolutions.com/forums/topic-tag/mandate/) - [COVID surgery rescheduling](https://progressivesurgicalsolutions.com/forums/topic-tag/covid-surgery-rescheduling/) - [COVID staff testing on site](https://progressivesurgicalsolutions.com/forums/topic-tag/covid-staff-testing-on-site/) - [Tracking COVID positive employees](https://progressivesurgicalsolutions.com/forums/topic-tag/tracking-covid-positive-employees/) - [Should Docs Pay for their Credentialing](https://progressivesurgicalsolutions.com/forums/topic-tag/should-docs-pay-for-their-credentialing/) - [med gas training](https://progressivesurgicalsolutions.com/forums/topic-tag/med-gas-training/) - [Compounding](https://progressivesurgicalsolutions.com/forums/topic-tag/compounding/) - [Covid vacination](https://progressivesurgicalsolutions.com/forums/topic-tag/covid-vacination/) - [credentialing fee](https://progressivesurgicalsolutions.com/forums/topic-tag/credentialing-fee/) - [Vendor Evaluations](https://progressivesurgicalsolutions.com/forums/topic-tag/vendor-evaluations/) - [Monitoring of vitals](https://progressivesurgicalsolutions.com/forums/topic-tag/monitoring-of-vitals/) - [clinical director](https://progressivesurgicalsolutions.com/forums/topic-tag/clinical-director/) - [ACLS requirement for Physician Assistants](https://progressivesurgicalsolutions.com/forums/topic-tag/acls-requirement-for-physician-assistants/) - [Guidelines for policies](https://progressivesurgicalsolutions.com/forums/topic-tag/guidelines-for-policies/) - [Patient Surveys](https://progressivesurgicalsolutions.com/forums/topic-tag/patient-surveys/) - [forms](https://progressivesurgicalsolutions.com/forums/topic-tag/forms/) - [Instrument Lubrication](https://progressivesurgicalsolutions.com/forums/topic-tag/instrument-lubrication/) - [Social Distancing COVID](https://progressivesurgicalsolutions.com/forums/topic-tag/social-distancing-covid/) - [E024 (ID Prefix tag)](https://progressivesurgicalsolutions.com/forums/topic-tag/e024-id-prefix-tag/) - [accreditation CMS](https://progressivesurgicalsolutions.com/forums/topic-tag/accreditation-cms/) - [Membership Administrator Change](https://progressivesurgicalsolutions.com/forums/topic-tag/membership-administrator-change/) - [appointment](https://progressivesurgicalsolutions.com/forums/topic-tag/appointment/) - [Labeling Chemicals in the Workplace](https://progressivesurgicalsolutions.com/forums/topic-tag/labeling-chemicals-in-the-workplace/) - [aldrete score](https://progressivesurgicalsolutions.com/forums/topic-tag/aldrete-score/) - [Supply shortage](https://progressivesurgicalsolutions.com/forums/topic-tag/supply-shortage/) - [Quality Project](https://progressivesurgicalsolutions.com/forums/topic-tag/quality-project/) - [Employee education training](https://progressivesurgicalsolutions.com/forums/topic-tag/employee-education-training/) - [transfer agreement](https://progressivesurgicalsolutions.com/forums/topic-tag/transfer-agreement/) - [Joint Commission Survey](https://progressivesurgicalsolutions.com/forums/topic-tag/joint-commission-survey/) - [Water Quality Testing Regulations](https://progressivesurgicalsolutions.com/forums/topic-tag/water-quality-testing-regulations/) - [Cost Tracking](https://progressivesurgicalsolutions.com/forums/topic-tag/cost-tracking/) - [infection](https://progressivesurgicalsolutions.com/forums/topic-tag/infection/) - [Ketamine](https://progressivesurgicalsolutions.com/forums/topic-tag/ketamine/) - [Annual Performance Review](https://progressivesurgicalsolutions.com/forums/topic-tag/annual-performance-review/) - [MH Cart](https://progressivesurgicalsolutions.com/forums/topic-tag/mh-cart/) - [As a very small ASC](https://progressivesurgicalsolutions.com/forums/topic-tag/as-a-very-small-asc/) - [we have some Versed that has expired. We've been instructed by the manufacturer to waste it](https://progressivesurgicalsolutions.com/forums/topic-tag/we-have-some-versed-that-has-expired-weve-been-instructed-by-the-manufacturer-to-waste-it/) - [with the usual witnesses and document. But would like to ask if others have a different method of disposing an expired controlled substances?](https://progressivesurgicalsolutions.com/forums/topic-tag/with-the-usual-witnesses-and-document-but-would-like-to-ask-if-others-have-a-different-method-of-disposing-an-expired-controlled-substances/) - [RN for topical or Versed anesthesia](https://progressivesurgicalsolutions.com/forums/topic-tag/rn-for-topical-or-versed-anesthesia/) - [blanket warmer](https://progressivesurgicalsolutions.com/forums/topic-tag/blanket-warmer/) - [Necklaces](https://progressivesurgicalsolutions.com/forums/topic-tag/necklaces/) - [Jewelry](https://progressivesurgicalsolutions.com/forums/topic-tag/jewelry/) - [Eye Drops](https://progressivesurgicalsolutions.com/forums/topic-tag/eye-drops/) - [ACLS/BLS AAHC/MCR ACCREDITATION](https://progressivesurgicalsolutions.com/forums/topic-tag/acls-bls-aahc-mcr-accreditation/) - [Infection Control; Masking](https://progressivesurgicalsolutions.com/forums/topic-tag/infection-control-masking/) - [expired medication](https://progressivesurgicalsolutions.com/forums/topic-tag/expired-medication/) - [anesthesia forms](https://progressivesurgicalsolutions.com/forums/topic-tag/anesthesia-forms/) - [EOC Plan](https://progressivesurgicalsolutions.com/forums/topic-tag/eoc-plan/) - [electroniclogs](https://progressivesurgicalsolutions.com/forums/topic-tag/electroniclogs/) - [ehr](https://progressivesurgicalsolutions.com/forums/topic-tag/ehr/) - [ascehr](https://progressivesurgicalsolutions.com/forums/topic-tag/ascehr/) - [Workplace Violence Policy](https://progressivesurgicalsolutions.com/forums/topic-tag/workplace-violence-policy/) - [AED vs Defibrillator](https://progressivesurgicalsolutions.com/forums/topic-tag/aed-vs-defibrillator/) - [Employee Records](https://progressivesurgicalsolutions.com/forums/topic-tag/employee-records/) - [Sharps Count](https://progressivesurgicalsolutions.com/forums/topic-tag/sharps-count/) - [Medications-28 day expiration rule](https://progressivesurgicalsolutions.com/forums/topic-tag/medications-28-day-expiration-rule/) - [NPI](https://progressivesurgicalsolutions.com/forums/topic-tag/npi/) - [EMR](https://progressivesurgicalsolutions.com/forums/topic-tag/emr/) - [Floor replacement](https://progressivesurgicalsolutions.com/forums/topic-tag/floor-replacement/) - [Pre-OP](https://progressivesurgicalsolutions.com/forums/topic-tag/pre-op/) - [Surgeon Provided Anesthesia](https://progressivesurgicalsolutions.com/forums/topic-tag/surgeon-provided-anesthesia/) - [how to handle non ambulatory patients](https://progressivesurgicalsolutions.com/forums/topic-tag/how-to-handle-non-ambulatory-patients/) - [Reappointment](https://progressivesurgicalsolutions.com/forums/topic-tag/reappointment/) - [surgery table 'writst rest'](https://progressivesurgicalsolutions.com/forums/topic-tag/surgery-table-writst-rest/) - [infection; cms](https://progressivesurgicalsolutions.com/forums/topic-tag/infection-cms/) - [fire drills](https://progressivesurgicalsolutions.com/forums/topic-tag/fire-drills/) - [Pain Education](https://progressivesurgicalsolutions.com/forums/topic-tag/pain-education/) - [Courtesy staff requirements](https://progressivesurgicalsolutions.com/forums/topic-tag/courtesy-staff-requirements/) - [History & Physical/Medical Assessments](https://progressivesurgicalsolutions.com/forums/topic-tag/history-physical-medical-assessments/) - [Post op calls](https://progressivesurgicalsolutions.com/forums/topic-tag/post-op-calls/) - [Safety Data Sheets](https://progressivesurgicalsolutions.com/forums/topic-tag/safety-data-sheets/) - [Gcode](https://progressivesurgicalsolutions.com/forums/topic-tag/gcode/) - [COVID-19 Temperature Monitoring ----I'm new to the ASC Nurse Manager Role. The position was vacant for about 6 months prior to me starting . Basically](https://progressivesurgicalsolutions.com/forums/topic-tag/covid-19-temperature-monitoring-im-new-to-the-asc-nurse-manager-role-the-position-was-vacant-for-about-6-months-prior-to-me-starting-basically/) - [not much was being done with temp checks](https://progressivesurgicalsolutions.com/forums/topic-tag/not-much-was-being-done-with-temp-checks/) - [etc. Does anyone know when the CDC stopped requiring them?](https://progressivesurgicalsolutions.com/forums/topic-tag/etc-does-anyone-know-when-the-cdc-stopped-requiring-them/) - [Discharge documentation](https://progressivesurgicalsolutions.com/forums/topic-tag/discharge-documentation/) - [Pt Satisfaction Surveys](https://progressivesurgicalsolutions.com/forums/topic-tag/pt-satisfaction-surveys/) - [Prescription Pads](https://progressivesurgicalsolutions.com/forums/topic-tag/prescription-pads/) - [Safety NPSG 16](https://progressivesurgicalsolutions.com/forums/topic-tag/safety-npsg-16/) - [Policy and Procedure Attestation Form](https://progressivesurgicalsolutions.com/forums/topic-tag/policy-and-procedure-attestation-form/) - [Return to OR](https://progressivesurgicalsolutions.com/forums/topic-tag/return-to-or/) - [YAG LAser](https://progressivesurgicalsolutions.com/forums/topic-tag/yag-laser/) - [Ultrasound-Assisted Gluteal Fat Grafting](https://progressivesurgicalsolutions.com/forums/topic-tag/ultrasound-assisted-gluteal-fat-grafting/) - [Patient Survey](https://progressivesurgicalsolutions.com/forums/topic-tag/patient-survey/) - [Inservices](https://progressivesurgicalsolutions.com/forums/topic-tag/inservices/) - [Scrub Technician OTJ training - educational requirement](https://progressivesurgicalsolutions.com/forums/topic-tag/scrub-technician-otj-training-educational-requirement/) - [Emergency construction in ASC](https://progressivesurgicalsolutions.com/forums/topic-tag/emergency-construction-in-asc/) - [Eye Wash Stations](https://progressivesurgicalsolutions.com/forums/topic-tag/eye-wash-stations/) - [ASC Eduction](https://progressivesurgicalsolutions.com/forums/topic-tag/asc-eduction/) - [Temperature Monitoring](https://progressivesurgicalsolutions.com/forums/topic-tag/temperature-monitoring/) - [Ozempic](https://progressivesurgicalsolutions.com/forums/topic-tag/ozempic/) - [Conscious Sedation](https://progressivesurgicalsolutions.com/forums/topic-tag/conscious-sedation/) - [Betadine Allergy](https://progressivesurgicalsolutions.com/forums/topic-tag/betadine-allergy/) - [Surgical Prep](https://progressivesurgicalsolutions.com/forums/topic-tag/surgical-prep/) - [Employee Sharps Injury](https://progressivesurgicalsolutions.com/forums/topic-tag/employee-sharps-injury/) - [ASC INFECTION CONTROL SURVEYOR WORKSHEET](https://progressivesurgicalsolutions.com/forums/topic-tag/asc-infection-control-surveyor-worksheet/) - [The Joint Commission](https://progressivesurgicalsolutions.com/forums/topic-tag/the-joint-commission/) - [Bariatric patient chairs/stools for ophthalmic lasers](https://progressivesurgicalsolutions.com/forums/topic-tag/bariatric-patient-chairs-stools-for-ophthalmic-lasers/) - [lot number](https://progressivesurgicalsolutions.com/forums/topic-tag/lot-number/) - [tray](https://progressivesurgicalsolutions.com/forums/topic-tag/tray/) - [The Joint Commission / CMS](https://progressivesurgicalsolutions.com/forums/topic-tag/the-joint-commission-cms/) - [New procedure in ASC](https://progressivesurgicalsolutions.com/forums/topic-tag/new-procedure-in-asc/) - [Central Supply](https://progressivesurgicalsolutions.com/forums/topic-tag/central-supply/) - [CMS Regulations re: Laser Room Staffing](https://progressivesurgicalsolutions.com/forums/topic-tag/cms-regulations-re-laser-room-staffing/) - [The Joint Commission / CMS / Sterilizing](https://progressivesurgicalsolutions.com/forums/topic-tag/the-joint-commission-cms-sterilizing/) - [budget](https://progressivesurgicalsolutions.com/forums/topic-tag/budget/) - [OR staffing](https://progressivesurgicalsolutions.com/forums/topic-tag/or-staffing/) - [Annual Training - Education Requirements](https://progressivesurgicalsolutions.com/forums/topic-tag/annual-training-education-requirements/) - [Sterilizing](https://progressivesurgicalsolutions.com/forums/topic-tag/sterilizing/) - [CRCST](https://progressivesurgicalsolutions.com/forums/topic-tag/crcst/) - 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Best Practices for Ophthlamology](https://progressivesurgicalsolutions.com/forums/topic-tag/scope-of-practice-best-practices-for-ophthlamology/) - [Phenylephrine](https://progressivesurgicalsolutions.com/forums/topic-tag/phenylephrine/) - [Generator](https://progressivesurgicalsolutions.com/forums/topic-tag/generator/) - [UPS battery](https://progressivesurgicalsolutions.com/forums/topic-tag/ups-battery/) - [ASA Status](https://progressivesurgicalsolutions.com/forums/topic-tag/asa-status/) - [Pain Management](https://progressivesurgicalsolutions.com/forums/topic-tag/pain-management/) - [off label medication usage](https://progressivesurgicalsolutions.com/forums/topic-tag/off-label-medication-usage/) - [Change in ownership](https://progressivesurgicalsolutions.com/forums/topic-tag/change-in-ownership/) - [new specialty](https://progressivesurgicalsolutions.com/forums/topic-tag/new-specialty/) - [CRASH CART LARYNGOSCOPE](https://progressivesurgicalsolutions.com/forums/topic-tag/crash-cart-laryngoscope/) - [Consent form for controlled substance](https://progressivesurgicalsolutions.com/forums/topic-tag/consent-form-for-controlled-substance/) - [Consent Forms](https://progressivesurgicalsolutions.com/forums/topic-tag/consent-forms/) - [Patient Transfer; Transfer](https://progressivesurgicalsolutions.com/forums/topic-tag/patient-transfer-transfer/) - [Ownership](https://progressivesurgicalsolutions.com/forums/topic-tag/ownership/) - [PF Kenalog](https://progressivesurgicalsolutions.com/forums/topic-tag/pf-kenalog/) - [OAS CAHPS vendor security issue](https://progressivesurgicalsolutions.com/forums/topic-tag/oas-cahps-vendor-security-issue/) - [Risk Assessments](https://progressivesurgicalsolutions.com/forums/topic-tag/risk-assessments/) - [Medication ordering](https://progressivesurgicalsolutions.com/forums/topic-tag/medication-ordering/) - [Pain Management Education Licensed Practitioner](https://progressivesurgicalsolutions.com/forums/topic-tag/pain-management-education-licensed-practitioner/) - [LOCAL ANESTHESIA](https://progressivesurgicalsolutions.com/forums/topic-tag/local-anesthesia/) - [Temperature](https://progressivesurgicalsolutions.com/forums/topic-tag/temperature/) - [Humidity](https://progressivesurgicalsolutions.com/forums/topic-tag/humidity/) - [Intra-Op Patient Temperature Documentation](https://progressivesurgicalsolutions.com/forums/topic-tag/intra-op-patient-temperature-documentation/) - [Boil Water Notice](https://progressivesurgicalsolutions.com/forums/topic-tag/boil-water-notice/) - [SDS](https://progressivesurgicalsolutions.com/forums/topic-tag/sds/) - [cleaning](https://progressivesurgicalsolutions.com/forums/topic-tag/cleaning/) - [clean](https://progressivesurgicalsolutions.com/forums/topic-tag/clean/) - [instruments](https://progressivesurgicalsolutions.com/forums/topic-tag/instruments/) - [contamination](https://progressivesurgicalsolutions.com/forums/topic-tag/contamination/) - [sterile](https://progressivesurgicalsolutions.com/forums/topic-tag/sterile/) - [decontamination](https://progressivesurgicalsolutions.com/forums/topic-tag/decontamination/) - [vancomycin eye surgery USP 797](https://progressivesurgicalsolutions.com/forums/topic-tag/vancomycin-eye-surgery-usp-797/) - [EKG Monitoring](https://progressivesurgicalsolutions.com/forums/topic-tag/ekg-monitoring/) - [Crash Cart Trach Kit](https://progressivesurgicalsolutions.com/forums/topic-tag/crash-cart-trach-kit/) - [OSHA Training](https://progressivesurgicalsolutions.com/forums/topic-tag/osha-training/) - [Sharing OR](https://progressivesurgicalsolutions.com/forums/topic-tag/sharing-or/) - [23 Hour Stays](https://progressivesurgicalsolutions.com/forums/topic-tag/23-hour-stays/) - [Local Anesthesia Policy](https://progressivesurgicalsolutions.com/forums/topic-tag/local-anesthesia-policy/) - [ASC Quality](https://progressivesurgicalsolutions.com/forums/topic-tag/asc-quality/) - [Syringe Labeling](https://progressivesurgicalsolutions.com/forums/topic-tag/syringe-labeling/) - [Policy Updates](https://progressivesurgicalsolutions.com/forums/topic-tag/policy-updates/) - [AMA](https://progressivesurgicalsolutions.com/forums/topic-tag/ama/) - [Refusal for treatment](https://progressivesurgicalsolutions.com/forums/topic-tag/refusal-for-treatment/) - [Life Safety - OR](https://progressivesurgicalsolutions.com/forums/topic-tag/life-safety-or/) - [Fall risk assessment](https://progressivesurgicalsolutions.com/forums/topic-tag/fall-risk-assessment/) - [QUAD A](https://progressivesurgicalsolutions.com/forums/topic-tag/quad-a/) - [Budget by percentage](https://progressivesurgicalsolutions.com/forums/topic-tag/budget-by-percentage/) - [AAAHC Accreditation Types](https://progressivesurgicalsolutions.com/forums/topic-tag/aaahc-accreditation-types/) - [Record Retention](https://progressivesurgicalsolutions.com/forums/topic-tag/record-retention/) - [Post Exposure Forms](https://progressivesurgicalsolutions.com/forums/topic-tag/post-exposure-forms/) - [Oxygen](https://progressivesurgicalsolutions.com/forums/topic-tag/oxygen/) - [competenecy](https://progressivesurgicalsolutions.com/forums/topic-tag/competenecy/) - [Scheduling](https://progressivesurgicalsolutions.com/forums/topic-tag/scheduling/) - [Used Syringe Disposal](https://progressivesurgicalsolutions.com/forums/topic-tag/used-syringe-disposal/) - [Chart Notes](https://progressivesurgicalsolutions.com/forums/topic-tag/chart-notes/) - [controlled substance logs](https://progressivesurgicalsolutions.com/forums/topic-tag/controlled-substance-logs/) - [enzymatic cleaners](https://progressivesurgicalsolutions.com/forums/topic-tag/enzymatic-cleaners/) ## Webinar Series - [20 Minute](https://progressivesurgicalsolutions.com/webinar-series/20-minute/) - Progressive Huddle webinar series. - [60 Minute](https://progressivesurgicalsolutions.com/webinar-series/60-minute/) - Progressive Half Time webinar series. ## Course Categories - [Required Upon Hire – All ASC Staff](https://progressivesurgicalsolutions.com/course-category/upon-hire/) - Courses required upon hire for all ASC Staff - [Required Annual – All ASC Staff](https://progressivesurgicalsolutions.com/course-category/annual/) - Courses required annually for all ASC staff - [Required – If Applicable](https://progressivesurgicalsolutions.com/course-category/if-applicable/) - Courses required if applicable based on specialty, equipment, state or accrediting organization. - [Optional / Recommended](https://progressivesurgicalsolutions.com/course-category/optional/) - Courses recommended but optional based on job/role, specialty, equipment, state or accrediting organization. - [Required – MD](https://progressivesurgicalsolutions.com/course-category/md/) - [Required - All OBSC Staff](https://progressivesurgicalsolutions.com/course-category/required-all-obsc-staff/) - Course required upon hire and annually for all OBSC staff.