The CMS state surveyor guidelines have been recently updated to provide additional instruction on how to survey ASCs regarding their policy on honoring advance directives.  ASCs should review their advance directive policy to make sure that it takes into consideration the new surveyor guidelines.  (A copy of the new guidelines is attached.)

The new guidelines (416.50(c)) indicate that an ASC should “to the maximum extent practicable” honor a patient’s advance directives.   This means that a blanket statement that an ASC does not honor any advance directives is no longer permissible.   

The new guidelines permit an ambulatory surgery center to refuse to honor certain advance directives due to moral or ethical beliefs (reason of conscience) so long as it is in compliance with state law.  An example of this would be a patient who presents a Do Not Resuscitate (DNR) advance directive.  If the ambulatory surgery center was not willing to comply with this directive, the guidelines require that it will communicate this to the patient through a statement of limitation rather than by providing a blanket statement that advance directives are not honored.

If, after the physician explains the ASCs statement of limitation and the patient refuses to accept the limitation; the law requires that the patient be transferred to a facility that will honor the patient’s advance directive. 

The statement of limitation should be communicated before the start of surgery and meet three criteria specifically set out in the surveyor guidelines.  The manual also provides an example of a sample statement of limitation.

We will have more information when actual surveys are completed to determine exactly how the new guidelines are being implemented.  This is not a new Standard, only further instruction from CMS to their surveyors on how to review ASC advance directive policy.

Supporting Documents: Surveyors Guidelines - Advance Directives

FMQAI, the support contractor for the Ambulatory Surgical Center Quality Reporting Program (ASCQR) will host a webinar presentation "Capturing the Good Stuff: Submitting Your Web Based Measures with QualityNet" for participants in the ASCQR Program.

To accommodate all interested attendees, two one hour sessions of the webinar will be held on Wednesday, June 5, 2013:

• First Session: 10 AM Eastern Time
• Second Session: 2 PM Eastern Time

This webinar will provide an overview of the ASC web-based measures, data analysis, the APU reconsideration process, and directions on submitting web-based measures data.

Attendees will need to register for the webinar in advance at http://www.oqrsupport.com/asc/education.

This is an urgent reminder from FMQAI, the Support Contractor for the Ambulatory Surgical Center Quality Reporting (ASCQR) Program on behalf of the Centers for Medicare & Medicaid Services, that ASCs must act quickly to designate a QualityNet Security Administrator to submit data for two web-based measures. Submission of web-based as well as claims-based quality measure data is required under the ASCQR; failure to meet all requirements under this program shall result in your facility receiving a two percentage point reduction in the CY 2015 annual payment update. 

For information on how your center can register a Security Administrator please view the attachment below.  Please note that the forms must be notarized and take 4-6 weeks to process.

 

Supporting Documents: SA Registration Reminder

Below you will find the Ambulatory Surgical Center Quality Reporting (ASCQR) Program Frequently Asked Questions. Since the beginning of the ASCQR Program in October 2012, FMQAI has been assisting ASCs with their quality reporting concerns. We have collected and compiled the most frequently asked questions. We hope you find this information helpful.

Additional information and reporting tools for the ASCQR Program can be found at http://www.oqrsupport.com, or contact the ASCQR Program Support Contractor at 866-800-8756.

 

Supporting Documents: Frequently Asked Question about the ASCQR Program

Clinical Specialties Compounding Pharmacy Products Recalled

Clinical Specialties is voluntarily recalling all lots of all sterile products repackaged and distributed by the pharmacy due to lack of sterility assurance. The recall of all sterile products is conducted in follow-up to concerns regarding practices at the site which cannot assure the sterility of the products.

This expanded recall follows the firm’s initial recall of Avastin on March 18, 2013, due to reports of five patients who have been diagnosed with serious eye infections associated with the use of the product. Clinical Specialties Compounding sterile products covered under this recall were distributed nationwide between October 19, 2012, and March 19, 2013.

Until further notice, health care providers should stop using all sterile products distributed by Clinical Specialties Compounding and return them to the company. Consumers or health care providers with questions regarding this recall may contact Clinical Specialties by phone at 866.880.1915 Monday through Friday between the hours of 10 am to 5 pm EST, or e-mail at clinicalrx@bellsouth.net. Patients who have received any product distributed by Clinical Specialties Compounding and have concerns should contact their healthcare provider.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

* Complete and submit the report online

* Download the form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

Click here to read the MedWatch safety alert.

 

CMS QUALITY REPORTING PROVIDER SUPPORT

The Centers for Medicare and Medicaid Services (CMS) has contracted with FMQAI to serve as the sole nationwide support and implementation specialists for ambulatory surgery center quality reporting (ASCQR) which begins October 1, 2012.  ASCs will not be able to contact CMS or the carrier to discuss the ASCQR program.

FMQAI has staff members who are familiar with the ASC environment.  They can assist with data collection strategies, reporting concerns, form locations, qualitynet.org registration and many other details that will arise as ASCs implement reporting.   FMQAI may be reached by phone at 866.800.8756 weekdays from 7 a.m. to 6 p.m. Eastern Time.

FMQAI is encouraging every ASC to register with the qualitynet.org website ASC list serve in order to receive notices on when registration opens on the qualitynet.org website.  Users will also receive notices on future FMQAI offerings.  The URL to the list serve is http://www.qualitynet.org/dcs/ContentServer?pagename=QnetPublic/ListServe/Register

Please take advantage of this great resource. 

Starting October 1, 2012, the Agency for Health Care Administration implemented a postcard renewal system instead of certified mail as the notice for licensure renewal.  The postcard will be sent approximately 90 days before the license is scheduled to expire. 

In addition, AHCA will send an email to each licensed health care provider when a postcard renewal has been mailed if the Agency has a valid email address for the provider.  If AHCA does not have this information, the licensed health care provider should follow this link http://ahca.myflorida.com/MCHQ/index.shtml#3 or contact their respective licensure unit.