THE WEEK OF DECEMBER 19, 2022

The Pulse will be taking a break the weeks of

December 26, 2022, and January 2, 2023.

Please look for the first issue of the New Year on January 9th.

Happy Holidays to All!

NJAASC JANUARY GENERAL MEMBERSHIP MEETING

Wednesday, January 25, 2023

8am-2:00pm

Galloping Hill Golf Course

3 Golf Drive Kenilworth, NJ

"Getting Down to Business"

The Business Aspects of Running Your ASC

 We'll cover the LEGAL, HR, BILLING KPIs and Regulatory Compliance aspects of running an ASC in today's environment to help you succeed.

Doors open at 8am- for registration.

Content begins at 9am.

Come early and visit our vendors.

There will be over three dozen in attendance and displaying.

This is a great opportunity to network. Renew old acquaintances and make new friends!

Member Centers register your employees to attend for Free.

Vendor Members attend for Free as well as participate in the vendor exhibit! Attendees can visit the booths, participate in the prize giveaways, demonstrations, chat, view products and services!

Don’t miss the PRIZES! Besides the vendor give-a-ways, NJAASC is offering prizes to all registered ASC attendees! Visit the vendor booths to be automatically enrolled in the Grand Prize Drawing!

IT’S TIME TO RENEW YOUR NJAASC MEMBERSHIP!

Please be aware that 2023 NJAASC dues renewal letters have gone out to the membership. Your 2022 membership runs out January 2023, so make sure you renew in order to attend the events we have scheduled for 2023.

January 25, 2023 - Quarterly Membership Meeting - Galloping Hills Country Club in Kenilworth, NJ: ONLY FOR NJAASC CENTER AND VENDOR MEMBERS.

February 15, 2023 - Infection Control Conference, in cooperation with NJDOH - Galloping Hills Country Club in Kenilworth, NJ: ONLY FOR NJAASC CENTER AND VENDOR MEMBERS

NJAASC would like to thank all of you for your support this past year. As you can see, we have even bigger plans for 2023, including the 13th Annual ASC Conference, April 18 & 19, 2023.

VENDORS

Your renewal invoice includes an option to ‘lock in’ your discounted table for the 13th Annual ASC Conference.

It is optional, but this offer is only extended in conjunction with your 2023 dues renewal.

If you have any questions about your membership renewal or have not received an invoice, please contact Kelly Biddle: kbiddle@njpsi.com

Language is the currency of commerce; 

stories its means of exchange. 

This is why all business leaders need to think like a media company. 

This is why stories are so important in growing and succeeding today. 

The best stories are memorable because they are clear, concise, consistent and credible.

The best stories are made up of words that paint pictures because pictures convey emotion. 

The best stories act as mental fulcrums: balancing expectation with empathy, ambition with purpose, and capitalism with compassion.

The best stories are those that reflect and capture the soul and spirit of the enterprise.

Ron Cappello | CEO

Infinia Group LLC

RCAPELLO@INFINIAGROUP.COM

PR Planning for 2023- Tip #1

Use social media to bypass or supplement traditional media coverage. The opportunity to publish long-form content on LinkedIn about some new technology you are using, for example, or share your Center’s recent new hire news or Holiday photo on Facebook are great ways to share your expertise or Center’s news in a timely manner. Of course, the channel should fit the message and the target audience, but your marketing point person can help you tailor the content appropriately. The parameters continue to change about content length and format for these channels, but it’s easy to look up those guidelines, which tend to be updated annually.

Nina Dietrich

Public Relations and Marketing Communications

nina@ninadietrich.com

I know what you are thinking – is she crazy? Here’s the thing; it is not only required under the HIPAA Rule(s), but also absolutely essential to safeguarding your organization’s privacy of patient data and protecting its environment from the vulnerabilities of hackers, ransomware attackers, and security incidents that may ultimately lead to a HIPAA Breach.

How do we get through to our workforce?

If you are conducting training in-house make it fun. Have games around the questions and answers; reward the first “winners” of the answers.

When annual online training is required, reward the first workforce members who complete HIPAA training.

Try to add “HIPAA Humor” whenever possible with comics or videos.

Be creative – use crosswords, puzzles, and questions that challenge the staff.

As a reminder, always document training which confirms HIPAA training is completed for ALL your workforce.

HHS/OCR offers HIPAA training materials.  

HHS 405(d) Aligning Health Care Industry Security Approaches Resources

Dawn Meglino

HIPAA Compliance Specialist, CHPSE, CCSA, CCAP

ANATOMY

dawn.meglino@anatomyit.com

A fire occurred in one of my clients medical gas rooms. At the time of the fire the ASC had three rooms going, one patient was in the middle of a case and had to be removed from the center while manually ventilated. Luckily the other room was just about to start, and the last just closed. When speaking with management the words that rang out the most were, you think it won’t happen to you, and, it was the scariest day of my

day of my career.” Both statements I’m sure are accurate. This is exactly why we train, why drills have a degree of redundancy and are performed as frequently as they are. Think about what your center would have done. Take into consideration the location of your medical gas room: is it housed on a floor below the center or in the ASC itself, or possibly off the public hall, or in one of the primary means of egress?

Additionally, on the facility side, many of my clients have wood on the walls of the medical gas room, which is installed erroneously in order to mount the manifolds, and the code doesn’t allow it. In fact, there shouldn’t be any combustibles in the room. This includes manuals, trash cans, storage, or even the plastic baseboard molding. The plywood backing was the primary cause of fire spread in this incident. Because the fire is very recent the cause has yet to be determined.  

Stay safe. 

Anthony Riehl, CFI, CESI

Healthcare Life Safety Consultants, Inc.

anthony@hlsconsultantsllc.com

From centers:

Smoke and fire dampers must be inspected one year after installed, and then every four years subsequently.

Make sure you get a discharge summary from the hospital for any transfer you do.

Janitor closets and medical gas rooms must have self-closing doors.

Blood Glucose Monitors

Blood Glucose Monitors are commonly used at surgical centers. It is important to follow the instructions for use (IFU) to avoid potential issues. Some important things to remember:

• The glucometer in use must be specifically designated for multi-person use.
• Calibrate Blood Glucometer Monitor per IFU using testing reagents.
• Upon first use, date and accordingly dispose testing reagents and fingersticks per the package insert/IFU. Both of these items when used past expiration may give inaccurate readings.
• Wear gloves before and after glucose monitoring.
• Follow hand hygiene.
• Change gloves between patient contacts.
• Use single-use self-retracting lancets which should be disposed of in the Sharps container after use.
• Thoroughly clean all visible soil or organic materials prior to disinfection.
• Use the appropriate disinfectant following each use. (See IFU).

Amit Gupta RPh, Pharm. D, CCP

Consultant Pharmacist

amit@amitguptaconsulting.com

Q: Is there a guide on how many Defibs/AEDs an ASC needs?

A: Refer to 8:43A-12.18

Q: Are centers required to register and pay annual renewal for a weights and measures (scale) license?

A: § 8:43A-6.10 Calibration of instruments

All instruments of measurement shall be calibrated in accordance with manufacturers' instructions. A record of instrument calibration shall be maintained.

Each county has its own office, the main location is:

Weights & Measures

Po Box 490

Avenel, NJ 07001

732-815-7826

Stefani Mozgai

NJDOH

Each county has its own office, the main location is:

Q: We have new owners and are making a lot of changes. They are telling me that the COVID requirements have changed. Is there something I missed?

A: NOTHING has changed! You abide by ED 20-016 revised. NJDOH told NJAASC that they were working on them, but nothing yet, and no time frame.

My opinion only: I think they (NJDOH) are waiting to see what COVID season looks like this winter before making any far-reaching changes.

It is a determination by a fiscal intermediary or carrier under Part A/B with respect to whether or not a particular item or service is covered.

Q:  If a radiology tech that holds a license (ARRT) assists the physician in scrubbing cases in an ASC, do they need to be scrub tech-certified?

A: A radiology tech has nothing to do with scrubbing and is not a scrub tech! A scrub tech needs to be certified unless grandfathered in prior to the 2011 law.

Q: Can a GI center use an oxygen concentrator instead of oxygen tanks?

I have seen oxygen concentrators used in GI centers in NY. It is so much cheaper than buying oxygen tanks. However, when I have asked for the manufacturer’s instructions for use and cleaning, the machines are described as single patient use. There is a filter in it that is supposed to be changed between patients. These concentrators are used for patients on home oxygen. When the patient is finished with it, it is returned and thoroughly cleaned before reusing with another person. So, my answer about whether it can be used in GI is: confirm and verify the manufacturer’s instructions that the machine can be used for a health care setting on multiple patients. I never was able to get the manufacturer to provide me the information I needed in writing, so I made my NY GI centers remove them.  

Debbie Comerford, RN, CNOR, CASC, CLSS-HC

DEBBIE@ASCQS.COM

ASC Staffing Success

In this job market, you're always walking a fine line between

moving too quickly and moving too slowly. When you seek

candidates for your staff you need to be ready with:

• A competitive salary. You don't have to offer the highest salary in the area, but it must be competitive. You can find out what local health care facilities are offering just by looking at online ads, talking to HR people at the local hospital, and talking with officers of the local nurses' association.
• Good benefits. One big benefit most ASCs offer is day shift with no weekends or on call requirements. You should be offering health insurance, vacation, and sick pay comparable to the local hospital. Try your best to develop a work schedule that accommodates individual needs, such as later starting times for parents with kids in school, or a four-day workweek.
• A positive environment. Ask staff members what really matters to them.
• When interviewing candidates, think about how each person will fit into the total team. You're looking for team players who will complement and support each other. Once you have identified this person, don't wait too long to make an offer. You can lose good candidates because of hesitation. Now, for someone who appears to be a perfect fit, we make an offer that same day or the next day. The offer is always made pending full reference and background checks.

Nancy Goldstein , MA, RNC

Horizon Healthcare Staffing

nancy@hhstaff.com

To develop stronger, long-term relationships with payers, don’t go into meetings and negotiations focused on coming out victorious.

Successful relationships do not have individual winners; everyone should win. Ask for fair reimbursement rates. Be prepared to discuss matters such as admission criteria and what payers expect for their members. Come to the negotiating table open minded and ready to give up a little of what you want in one area if you can get what you want in another.

Kathryn Boylan

SISfirst

kboylan@sisfirst.com

Does Your Sterile Processing Area Have Instrument Air for Processing Medical Devices ?

ANSI/ AAMI ST-79 : Steam Sterilization and Sterility Assurance in Healthcare Facilities (2017) recommends that instruments and devices should be dried for steam and low temperature sterilization processes (e.g., Sterrad). In addition, flexible endoscopes

should be completely dried after high-level disinfection and prior to storage (unless placed in a drying cabinet).

AAMI only recommends instrument air for drying. Instrument air (previously called compressed air or medical air) is defined as a medical gas that falls under the general requirements for medical gasses as defined by the NFPA 99: Health Care Facilities Code, is not respired, is

compliant with the ANSI/ISA S-7.0.01, Quality Standard for Instrument Air, and is filtered to 0.01 micron, free of liquids and hydrocarbon vapors, and dry to a dew point of -40º F (-40º C). 

NFPA 99 Code states “Central supply systems for oxygen, medical air, nitrous oxide, carbon dioxide and all other patient medical gases shall not be piped to, or used for, any purpose except patient care application.” Therefore, the use of compressed air is not recommended.

Instrument air may be supplied from cylinders, bulk containers and/or medical air compressors. The definition of a medical air compressor (per NFPA) is a compressor that is designed to exclude oil from the air stream and compression chamber and that does not, under normal operating conditions or any single fault, add toxic or flammable contaminants to the compressed air.

Instrument air is ultra-pure and toxin-free, which ensures the instruments/devices are not re-contaminated after cleaning. Staff should not use computer “air” (canned air to clean computer keyboards) or Nitrogen. 

You should have Instrument air in the Decontamination area at the 3rd (last) basin of the manual cleaning sink. This is to permit drying of manually- cleaned items or to “blow out” residue from lumened devices. Instrument air should also be available in the clean prep area to dry instruments prior to packaging for steam and/or low temperature sterilization.

Your medical gas supplier should be able to accommodate your facility with instrument air since this recommendation dates back to 2017.

Nancy Chobin, RN, AAS, CSPM, CFER

President

nancy@spdceus.com

414 River View Plaza Trenton, N.J. 08611 •  (609) 503-7696  • info@njaasc.org

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