THE WEEK OF JANUARY 16, 2023

ONLY ONE WEEK LEFT TO REGISTER FOR THE NJAASC JANUARY GENERAL MEMBERSHIP MEETING

Wednesday, January 25, 2023

8am-2:00pm

Galloping Hill Golf Course

3 Golf Drive Kenilworth, NJ

Registration closes Sunday 1/22

"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!

Disclaimer for quarterly meeting registrants: 

We had an inordinate number of no shows for our last Quarterly Membership Meeting in October.

Any registrant that is unable to attend for any reason at all MUST notify NJAASC at least 7 days in advance of the meeting date. This will allow us to avoid expenses associated with no-shows. Failure to notify NJAASC of a cancellation within the time frame specified, will result in a charge of $25.00 for the registrant(s). You will attest to this when you click on the attendance button when registering.

Please email Meagan at mrosina@njpsi.com with any cancellation requests.

We appreciate your cooperation.

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, including:

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

NJAASC WOULD LIKE TO WELCOME RETURNING MEMBERS

NJAASC would like to welcome back the following centers who re-joined with us for 2023 (after not renewing for 2022)

New Jersey Interventional Associates, Union, NJ

Shore Surgical Pavilion, Lakewood, NJ

Alliance Surgery Center, Hainesport, NJ

First GI Endoscopy and Surgery Center, Riverdale, NJ

Welcome Back!

Marketing and PR Planning for 2023 – Tip #2

As your ASC considers its marketing priorities for the New Year, we’ll provide a few tips for your planning purposes in the next few issues of The Pulse. Here is Tip #2:

Video for your social media pages is in the spotlight right now. Post them. Here’s why:

• Video gets and holds your viewers’ attention quickly and allows you to share information in a digestible format.
• Videos get more exposure and engagement (people are more apt to like them, comment and share them).
• Video across all channels has become more popular. Videos on Instagram generate the most engagement, and some say that TikTok is the one to watch in 2023.
• Video has a long shelf life and can be repurposed across myriad channels.
• It is a more “personal” way to connect with your followers. And, it lets them “see” the people behind your ASC.
• In our next Marketing Column. We’ll talk about the kinds of content that make for great videos for your ASC.

Nina Dietrich, L.L.C., PR and Marketing Communications

nina@ninadietrich.com

ENCRYPTION

To encrypt or not to encrypt, that is the question. CFR Part 164.312(e)(2)(ii) of the HIPAA Security Rule states: “Have you implemented a mechanism to encrypt EPHI whenever deemed appropriate?” This is an “addressable” safeguard – does this mean encryption is optional ?  Absolutely not!

An “addressable” safeguard under the HIPAA Security Rule means Covered Entities and Business Associates have flexibility when implementing the safeguard. If there is an alternate form of reaching the standard, this can be implemented.

As an example, if you are emailing electronic Protected Health Information (ePHI) how are you securing this information covered under the HIPAA Rule (for patient privacy) if not through encryption? Encryption must be used if transmitting ePHI over the internet, to restrict access, protect the integrity of, and guard against unauthorized access to the ePHI.

When using portable devices, i.e., laptops, tablets, install or enable encryption on these devices, especially if they are traveling out of the organization (home or satellite offices, hospitals, surgery centers). Should a portable device with encryption enabled become lost or stolen, the information contained on the laptop will be unreadable and indecipherable. Proper encryption allows Covered Entities and Business Associates to avoid HIPAA breaches – the Breach Notification Rule only applies to the breach of “unsecured Protected Health Information” (45 CFR Part 164.404(a)).

Dawn Meglino

HIPAA Compliance Specialist, CHPSE, CCSA, CCAP

dawn.meglino@anatomyit.com

YOU CAN VISIT THEM AT THE 1/25 QUARTERLY MEMBERSHIP MEETING

Medical Records Storage

Medical records must be kept according to the facility’s policies. These policies should be based on state regulations, CMS Conditions for Coverage, and the Accreditation Organization’s (AO’s) standards.

A frequent question from centers that have been open for several years, and which have lots of paper charts, concerns scanning. Scanning is a viable method for maintaining access to the charts. It’s much cheaper than sending them to storage, and retrieving charts from storage facilities is often a long process.

When records are scanned, consider the scanner that will be used. If the chart pages are 2-sided, it will take someone a long time to scan, unless your scanner is equipped to handle this easily. It also requires an employee to do the work and to ensure that there are no issues and that all the information is scanned. Once the pages are scanned, the paper is no longer required. Check the state regulations, as record retention policies apply, but remember, once scanned, if the records are stored in the Cloud, they are available indefinitely.

AAAHC standard Ch. 6.B.5 states – The policies ensure timely access to individual records. It is usually very easy to retrieve a scanned medical record. Test this function prior to starting down this road.

AAAHC standard 6.C.4 states that all clinical information relevant to a patient is readily available to authorized personnel any time the organization is open to patients. Scanning makes this easy.

Consider hiring someone temporarily to tackle this project if you don’t want to use regular staff. You must ensure that they comply with confidentiality policies. Start with the older charts and keep on scanning until they are all

Ann Geier, MS, RN, CNOR(E), CASC

Ambulatory Healthcare Strategies

AGeier@AH-Strategies.com

From a center:

AAAASF asked for a form to document treatment for MH. She said she would use the code record, but that wasn’t accepted. MHAUS does have a form The surveyor also wanted to see a statement in the policy that the anesthesiologist would travel with the patient in he ambulance.

Although wholesalers provide updates of recalls, due to shortages, we have noted that many ASC are buying medications amongst themselves. The following are two recent recalls which may affect some centers.  Please do not hesitate to reach out to your consultant pharmacist for the proper procedures of handling recalled medications.

Vancomycin Hydrochloride Injection, USP 1.5g/vial: Recall - Due to The Presence of Visible Glass Particulates

Hospira, a Pfizer company, is recalling one lot of Vancomycin Hydrochloride Injection, USP, 1.5 g/vial Single Dose Fliptop Vial, lot 33045BA, 

to the user level due to two visible glass particles observed in a single vial.

Click Here to read more.

Daptomycin for Injection 500 mg/vial and Daptomycin for Injection 350 mg/vial Lot by Accord Healthcare: Recall - Due to Product Mix-Up

LOT - R2200232 Exp:01/2025 is being recalled because A product complaint report from a hospital pharmacy that vials labeled as “Daptomycin for Injection 500 mg/vial” were found in cartons labeled as “Daptomycin for Injection 350 mg/vial”. Click Here to read more.

Amit Gupta RPh, Pharm. D, CCP

Consultant Pharmacist/Owner

amit@amitguptaconsulting.com

Read Amit Gupta’s newsletter Here

YOU CAN VISIT THEM AT THE 1/25 QUARTERLY MEMBERSHIP MEETING

Q: This is regarding having residents in an ASC environment. A doctor would like to have her residents here at our center and I am not sure what the rules are on this.

A: State licensure regulations do not specifically speak to residents in an ASC. The facility will need to establish policies and procedures and ensure that the residents are following all the requirements as any other employee/physician. For example, this includes appropriate orientation and employee health, and being fully-vaccinated or testing negative.

Q: Must we keep a physical copy of the vaccination card on file as proof of the patient being fully vaccinated, or can we note in the chart that we visualized it?

A: Facilities may keep a copy of the card or note vaccination status in the patient chart.  We expect they are doing one or the other.  The ED permits both.

NJDOH

Q: My anesthesia director brought me a statement from ASA & APSF from 12/21 recommending not testing asymptomatic patients for COVID. Has something changed?

A: Absolutely nothing! Disregard when an ASA or anyone else says. You go by what the state of New Jersey - NJDOH and Governor - instruct you to do.

NJAASC will of course let all centers know if and when changes are made. ED 20-016 revised is still in effect.

Shed Weight For The New Year

For those of you who like going to the gym, you know January is a busy month. Everyone wants to lose those extra pounds from the year before. However, after a few weeks, life gets in the way and they can no longer find time for the gym and the weight piles on.

Your bad debt is that extra weight. If you manage it by sending your accounts to a collection agency on a regular basis then you're in good shape. If you let it add up for a little while, then it becomes a project. If you let it add up for too long, it becomes a burden.

Make a commitment to keep your AR in good shape for the new year, and if you need a personal trainer, I can help.

Happy New Year!

Jonasz Knapik

SAVIT

jonaszknapik@gmail.com

YOU CAN VISIT THEM AT THE 1/25 QUARTERLY MEMBERSHIP MEETING

Having problems with aged accounts receivable (A/R)? The longest A/R remains open, the more likely it is that you will encounter collections issues. One of the secrets of keeping A/R days low is access to and frequent review of A/R and accounts payable data, but there’s a crucial human factor as well. A/R representatives should proactively communicate with payers when A/R hits a predetermined number of days to help keep claims moving forward toward payment.

Kathryn Boylan

SISFirst

kboylan@sisfirst.com

YOU CAN VISIT THEM AT THE 1/25 QUARTERLY MEMBERSHIP MEETING

Busy surgery centers need software solutions to improve charting, RCM and other processes that are critical for a profitable ASC. Patient encounter and collecting that information accurately - not just at the ASC but also at the physician’s office - is important. Doctors need to have access to technologies that are easy to use, secure, are cost-effective and save time. A smartphone app is one such option available today. Many providers like to use an app to dictate instead of a traditional phone in the system. Some still prefer an option where they can create their procedure report on the fly with just a few clicks without having to dictate. Both options are good tools for busy surgeons to manage their dictations, edit and e-sign them on a device of their choice.

Sanjay Kaul

MedOfficePro

skaul@medofficepro.com

YOU CAN VISIT THEM AT THE 1/25 QUARTERLY MEMBERSHIP MEETING

Training, Education and Consulting for Sterile Processing and GI/Endo

TIDBIT FOR JANUARY 2023

Are you testing your IUSS cycle(s) correctly?

The routine biological monitoring process challenge device (PCD) or test pack for immediate-use steam sterilizers falls under the same testing methods as for routine biological monitoring of sterilizers larger than two cubic feet.

In previous versions of ANSI/AAMI ST79, sterilizers used for immediate-use steam sterilization (IUSS) required a different type of PCD than the PCD used for the sterilizers in the SPD area. This change was based on the way sterilization was historically performed in surgery. At that time, open pans were acceptable for IUSS sterilization. BI testing consisted of placing 1-2 BI vials and a chemical indicator in a pan of instruments run on either a 3-minute pre-vacuum cycle or a 10-minute gravity cycle.

With the enactment of IUSS, the sterilization cycles used in surgery are the same as those used in SPD; therefore, the sterilization challenge is the same. The major change occurred when AAMI and AORN recommended that all IUSS be performed in a closed, rigid container, validated for IUSS cycles.

• Use a PCD pack such as used in SPD for wrapped
• Place in the chamber over the drain line on a rack in an empty chamber.
• A normal cycle should be run, according to the sterilizer, container and device manufacturers’ written IFUs.
• Upon completion of the sterilization cycle and cooling of the PCD, the BI(s) and CI(s) should be removed from the PCD and their identification recorded.
• The CI manufacturer’s written IFU for interpretation of CI results should be followed.
• BI Monitoring.
• There is no BI PCD for gravity IUSS cycles.
• Contact your IUSS container mfr for guidance on BI testing of gravity IUSS cycles using their container.
• May need to place 1-2 BI vials and CIs in the immediate use container.
• Process on gravity IUSS cycle.
• Frequency of Use of Bis.
• Initial installation testing.
• After any major repairs
• Perform at least weekly, but preferably daily (or as designated by the facility)
• Any loads containing implantable devices.
• Each type of cycle used (gravity/pre-vac).
• At end of cycle, interpret printout, initial if all parameters met.

Documentation

• Load records should contain (minimum)
• General contents of the load
• Duration and temperature of the exposure phase of the cycle
• The initials or other identification of the sterilizer operator
• The number or other identification of the sterilizer
• Date and time of cycle
• Chemical Monitoring
• A Type 5 chemical integrator shall be used with each IUSS cycle.
• Devices/sets shall not be used unless the result of the CIs is in the ACCEPT range.

IMPORTANT

• Must obtain and comply with all device manufacturer’s instructions before any IUSS sterilization is attempted.
• Compile list of devices with cleaning and sterilization requirements.

Ask yourself –

• Can I clean the device according to the instructions?
• Can I replicate the sterilization cycle type/time?
• Contraindications for IUSS
• Implants, except in a documented emergency situation when no other option is available.
• Post-procedure decontamination of instruments used on patients who may have Creutzfeldt–Jakob disease (CJD) or similar disorders.
• Devices or loads that have not been validated with the specific cycle employed.
• Devices that are sold sterile and intended for single-use only.

Nancy Chobin, RN, AAS, CSPM, CFER

nancy@spdceus.com

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

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