Ortmann Healthcare Consultants is taking today to remember our Veterans. Thank you for your dedication and commitment to making this country and our world a better place.

Sorry for the recent lack of postings. It’s been a week of computer failings and traveling for the Ortmann team, but we are back on track and excited for this weekend! Ortmann Healthcare Consultants will be at Becker’s ASC Review’s 16th Annual Improving Profitability, and Business and Legal Issues for ASCs Conference. Come and visit us at booth space 28 where we will have information regarding our company and projects, and of course, CANDY! Key members of our consulting team will be there to answer your questions as well, including Chris McMenemy, VP of Administration, and Jessica Miller, Director of Regulatory Affairs. The conference runs October 8-10 at the Westin Hotel and Conference Center in Chicago, Illinois. More information can be found at Becker’s ASC Review.Please stop by our booth and say hello-we hope to see you there!

You are a dedicated GI physician who has just completed construction on a single specialty ambulatory surgery center. You’ve got your equipment, staff, and certifications in place and already have a list of patients eager to have their procedures at your beautiful, brand new facility. After months of working with a development team, you are ready to cut the cord and start running your facility. And then the question comes from the head of the consulting team: “Are you thinking about retaining us further for management services of your facility?” And you’re thinking-No way! Spend more money? Have even more hands involved?

Well, here are a few reasons to re-think what a management company can, and should, be doing for you. Finding a management company with these traits can put even more money back in your hands!

1. Expertise-Obviously the most important reason to use a management company is that they have experience and credibility in the ASC industry. This isn’t their first rodeo and good management companies will know how to handle any issue that may arise, whether its related to keeping on top of licensure and credentialing paperwork or preparing the budget.
2. Negotiation skills-Expertise in this area will directly affect the bottom line. A management company can help you save money on contracted services, or collect more when it comes to managed care. A management company can periodically review your managed care contracts and negotiate for new rates based on their experience in the marketplace. They can also review your service contracts and negotiate for better terms based on market conditions.
3. Vigilance- You already have your Center Director playing two roles: administrator and nurse. Don’t add financial ovesight to her already growing list of responsibilities. A management company with access to billing software can provide direct oversight of the billing and collecting process, tracking how much and when reimbursements are applied, and allowing them to react when problems arise.

Ortmann Healthcare Consultants provides management and consulting services to new and existing ASCs. If you are interested in learning more, you can reach us at 803-252-7979.

Submitted by Jessica Miller, Director of Regulatory Affairs

In early September 2001, Fred W. Ortmann III, founded Ortmann Healthcare Consultants. Fred had retired as a colonel from the Air Force in the late eighties, and spent his career with the military in hospital administration. Fred then helped found AMSURG in 1991 and served as the Vice President for Center Development, overseeing the development of over 100 facilities. When he retired from AMSURG, Fred decided to move closer to his home town and started his business in Columbia, South Carolina.

The company has grown in the past eight years from a small consulting firm to a major player in the ambulatory surgery center development business. Ortmann Healthcare Consultants (OHC) started its business by developing two large surgery centers in South Carolina. A year later, OLYMPUS America, Inc., conducted a national search and selected Fred as the consultant to develop a new service line for the company. This line includes a sophisticated pro forma development tool called the EndoPlanner, for which Fred is a co-patent holder. The Olympus project gave OHC a good start in the ambulatory surgery center development business. Today the company has a number of development projects across the country, ranging from Kona, Hawaii, in the west, to Goldsboro, North Carolina, in the east, to Fort Lauderdale, Florida, in the south, and North Dartmouth, Massachusetts, in the north. OHC has developed physician-owned ASCs, hospital/physician joint venture ASCs, and is currently working on two hospital outpatient surgery departments that will use physician management to run the departments.

The company is based on three rather simple principles: honesty, integrity, and excellence in all we do. To our knowledge, every ambulatory surgery center we have developed is open and successful. We believe the key to this success is that we know and understand the core concepts that yield successful ambulatory surgery centers.

Since our start in 2001, we have added staff and moved into management and ownership of centers, but continue to stand firmly on our basic principles.
We provide:

• Full, turn key development services for ambulatory surgery centers, regardless of ownership position
• Economic analysis, which we call a Proforma, for those considering development of ambulatory surgery centers
• Consulting studies for existing surgery centers
• Management of ambulatory surgery centers
• Ownership participation interest in ambulatory surgery centers

As a full service development company, we provide in-depth consulting in all aspects of ambulatory surgery development. Our strengths include physician/hospital relationships, ASC negotiation skills, development of financial Proformas, clinical services, managed care contracting, equipment planning and regulatory management.

We have extensive experience in both single and multi-specialty ambulatory surgery center development and have worked on centers featuring all of the medical specialties: orthopedics, ophthalmology, GI endoscopy, urology, ENT, GYN, plastic surgery, podiatry, bariatric surgery, pain management, and general surgery.

We have not had deficiencies on any state, Medicare, or accreditation inspection of the centers we develop. This means these centers open on time, cases begin and budgets are met. This is primarily due to our superb clinical staff that is in almost daily contact with our centers. The quality of our work has been acknowledged in a number of national publications, and our pro-formas have been recognized by many CPAs and financial institutions for their accuracy, honesty and conservative projections. Our greatest strength, however, is our people and their absolute dedication to our clients and our principles.

We also owe many thanks to the clients and business associates who have made the past 8 years such a success. Cheers to the future of Ortmann Healthcare Consultants!

Ortmann Healthcare Consultants will be at Becker’s ASC Review’s 16th Annual Improving Profitability, and Business and Legal Issues for ASCs Conference. Come and visit us at booth space 28 where we will have information regarding our company and projects, and of course, CANDY! Key members of our consulting team will be there to answer your questions as well, including Chris McMenemy and Jessica Miller. The conference runs October 8-10 at the Westin Hotel and Conference Center in Chicago, Illinois. More information can be found at Becker’s ASC Review.

York County Endoscopy Center, a recently completed Ortmann Healthcare Consultants project, is hosting an Open House tomorrow, Wednesday, September 2, from 4-7pm. This will be the official unveiling of the new facility and the event is open to the community! We hope to see you there!

In late June, the Massachusetts Department of Health began sending letters to ambulatory surgery centers across the state notifying them of the changes to licensure requirements for clinics under the new Chapter 305 regulations. According to the new regulations, ambulatory surgery centers are no longer exempt from licensure requirements. All ambulatory surgery centers will be required to seek licensure status by December 12, 2009.
For facilities that are Medicare certified or accredited, there is a deemed-by-accreditation licensure option. This option is available to Medicare certified and accredited ambulatory surgery centers that were in operation on August 10, 2008, or an ASC that was under construction on August 10, 2008 and that is in operation on December 12, 2009.

Furthermore, the Department expects that those ASCs planning to take advantage of the grandfathering provisions in chapter 305 will be applying for licensure as substantially the same entity that was in operation in August of 2008. The grandfathering provision does not apply to, for exmaple, a surgery center with one physician and one OR that in the interim has added two more physicians or another operating room. The Department would find that the newly-configured ASC was not in operation on August 10, 2008 and the ASC would be required to obtain a Determination of Need (DoN) prior to licensure. Similarly, if an ASC that operated as a single-specialty practice on August 10, 2008 seeks clinic licensure as a multi-specialty practice, the Department would find that the multi-specialty practice was not in operation on August 10 and therefore would need DoN approval prior to licensure. You can seek an advisory opinion from DoN if you have specific questions regarding changes in your facilities operation.

If you need more information, here is a copy of the updated regulations 105 CMR 140.000: Licensure of Clinics. Copies of the circular letters and required forms can be found at the DOH ASC Licensure website.

If you are an ambulatory surgery center in the state of Massachusetts and your facility needs assistance becoming compliant with the new regulations, contact Ortmann Healthcare Consultants. We have worked in Massachusetts, are familiar with the changes, and can assist your facility in completing the required paperwork for licensure. And as always, the sooner you complete this paperwork, the better!

Submitted by Jessica Miller, Director of Regulatory Affairs

Surgery centers undergo a number of inspections for everything from the certificate of occupancy, medicare certification and accreditation. The fire safety survey, also known as the NFPA 101 Life Safety Code, is an important survey that you will have to complete as part of medicare certification. Typically the State Agency for certification assists in setting up the fire safety survey, but due to budget cuts, they often defer to the accrediting agency. It is preferable that if your state will still provide the fire safety survey that you go with them because otherwise the accrediting agency will charge an additional fee for this survey.

Each state survey process varies but to prepare for this survey there are a few things you should have on hand. Ortmann Healthcare Consultants likes to prepare and organize our facilities paperwork into a binder system. Two binders are specifically helpful for the fire safety survey: construction documents, and ancillary agreements. In these binders you should have records regarding the fire alarm system, sprinkler system, and generators if applicable. The inspector will also ask to see fire drill records, depending on how long the facility has been open, and will review the policy and procedure for staff training.

It is also helpful to have handy a set of plans showing fire rated doors and walls. The inspector may want to use a ladder to physically inspect these partitions. Also make sure your medical gas, electrical, and mechanical rooms are free of any clutter. These spaces cannot be used for storage and nothing should be on the floor or around the major equipment.

There is a template available for the fire safety survey and we ask our architects to assist in completing the form so the surveyor may use it as a guide. If your facility is expecting a fire safety inspection, contact Ortmann Healthcare Consultants today to see how we can help!

A news story recently ran on MSN.com that is further proof of how important proper credentialing procedures are for physicians, nurses and other providers. According to the report, Betty Lichtenstien, 56, has been charged with pretending to be a nurse at a doctors office. Lichtenstien also held a dinner party in her own honor for being named ‘Nurse of the Year’ by a nursing association authorities say does not exist. Authorities began investigating Lichtenstien after a patient complaint.

There are several safe guards in place that, when done properly during the credentialing process, can prevent the hiring of unqualified, illegal, or troubled personnel. Some tools available to employers are state registries of licensed nurses and practitioners. With the appropriate information you can verify a license online. You can also do this for professional associations the provider might belong to. Many states also have requirements for background checks of all health care providers in a facility. Employing these tools can protect you and your patients.

If your ambulatory surgery center needs assistance with credentialing or selecting individuals for employment, Ortmann Healthcare Consultants can help. Contact us at (803) 252-7979 to learn about our credentialing, and center director and staff training services.

American Recovery and Reinvestment Act of 2009 (Recovery Act) Ambulatory Surgical Center Healthcare-Associated Infection (ASC-HAI) Prevention Initiative

Federal funds have recently become available for 12 states to survey ambulatory surgery centers. Kathleen Sebelius, Secretary for HHS, announced on July 31st that funding would be available for 12 states to survey more than 125 ambulatory surgery centers. The funding comes from the American Recovery and Reinvestment Act of 2009 (ARRA) and will be administered by CMS in the amount of $9.95 million.

The first 12 states to volunteer, and the amounts they were awarded are listed below:

• Arkansas- $14,000
• Florida- $16,250
• Indiana- $62,500
• Kansas- $53,500
• Maine- $13,500
• Maryland- $73,000
• Michigan- $53,000
• New Jersey- $125,000
• North Carolina- $34,000
• Oregon- $53,500
• Utah- $62,500
• Wyoming- $11,500
• Total for States & DC- $572,250

CMS believes the additional funding will assist in reducing the number of health care associated infections (HAI). The surveys will also ensure that facilities are following Medicare’s guidelines for infection control. The initiative includes the use of a new survey process and tool developed with the CDC. The tool is the infection control survey that is available at the end of the new Interpretive Guidelines issued by CMS.

The surveys should be completed by September 30, 2009. An additional $9 million in funding will be available in October for the remaining states to survey their ambulatory surgery centers. The CDC has also promised to make available an additional $40 million for states to create or expand their HAI prevention and surveillance efforts.
Additional information can be found at the following links:
Medicare Press Release
HHS’ 2009 Action Plan to Prevent Health care-Associated Infections

If you operate an ambulatory surgery center in one of the first 12 volunteer states and want to make sure your facility is prepared for a survey, contact Ortmann Healthcare Consultants at (803) 252-7979. We have the tools to help you prepare and a record of “No Deficiencies” for every licensure, accreditation, and certification survey we have participated in.