able profit margin, we'll still take the case," says Jennifer Arellano,
CASC, the director of operations at Pinnacle 3, which manages the
Orthopedic & Spine Center of Southern Colorado. "Without the ASC
convalescence center, our surgeons would have to perform these pro-
cedures in a hospital."
Speaking of hospitals, they should be concerned about surgery cen-
ter sleepovers. If the recovery center model catches on, it could only
lead to more high-acuity winding up in ASCs.
"The real value in a convalescence center is not insurance reim-
bursement," says Ms. Arellano. "It lets us see those types of patients
that would typically be seen in a hospital setting. "
Medicare limits ASCs to patients whose "expected duration of serv-
ices would not exceed 24 hours following an admission," (Note: the
guidelines don't specify that they must be discharged on the same cal-
endar day). Medicare also prohibits planned overnight stays in an ASC
for Medicare patients.
Even without a change in law, ASCs across the country have devel-
oped increasingly elaborate workarounds for patients who need an
extended stay to recover. An orthopedic center near Buffalo, N.Y., con-
siders the 2-bedroom condominium it owns in the building across the
street to be its "recovery suite." And an ASC in Bloomington, Minn.,
runs a hotel recovery program for total joint patients: 1 night for total
hips, 2 nights for total knees.
Not everyone's in favor of ASCs trying to broaden their turf. More
than half of the nearly 500 hospital and ASC leaders we surveyed
recently don't think ASCs should be able to keep their patients
overnight. But where there' a will, there's a way.
OSM
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