The COVID-19 pandemic will leave a lasting mark on the ASC field, as many administrators are pivoting their strategy for growth in the coming months.
Here, 15 ASC administrators discuss how the pandemic has affected their plans for the next six to 12 months.
Raghu Reddy. Executive Administrator of SurgCenter of Western Maryland (Cumberland, Md.): This pandemic has impacted us just as it did most of the ASCs in the country. We have about 400 case backlog to make up whenever we resume normal operations with our usual case volume. If the spread does not slow down, we anticipate losing the case volume as we will be constrained to how many cases we can perform each day, which will, in turn, impact our growth plan.
Due to our recent affiliation with UPMC Western Maryland Health System, we have plans to expand the current specialties and to add new ones over the next six to 12 month period. This pandemic, unless it's contained and/or until we meet the gating criteria, will significantly slow down our expansion plan this year while impacting our overall financial projections if we cannot resume normal operations at our center within a month or sooner.
We are cautiously optimistic and are already noticing some job losses which might impact the elective procedures due to loss of insurance coverage. However, we firmly believe that in the long run, the future remains healthy for us and the fact that we are the only free-standing multispecialty ASC in a 65-mile radius.
Matthew Ewasko. Administrator of Physicians Alliance Surgery Center (Cape Girardeau, Mo.): We anticipate it taking around three to six months before all of our specialties resume normal operating levels. With physicians' offices being closed, or having reduced hours for the past two months, the referral base is very low. The backlogs of each surgeon will be done first, but once that volume is reduced it will take some time for patients to be seen in their respective offices. Another factor we are looking at is the number of people who continue to put their procedure off until they feel safe to do so. Even though our facility is open and is scheduling cases, we have heard from several patients who are choosing to wait another few weeks before they consider moving forward.
Rick Liwang, RN. Administrator of Gulf Coast Outpatient Surgery Center (Biloxi, Miss.): We expect to increase purchase of disinfectants and PPE. Also, we look at our schedule with a microscope. We have to be vigilant with the start time and the time the patients can come in to register. We have lost some business with our GI docs because they felt that we did not accommodate them during the pandemic but we were on lock down. We now have to reevaluate our procedures, our costs, our equipment and supplies.
Bonnie Brady Lavoie, RN. Vice President of Operations for West Morris Surgery Center (Succasunna, N.J.): Our plan for growth was put on the back burner as we now need to concentrate on becoming financially solvent before we take on any new plans.
Bobbi Freeman, RN. Gastroenterology Endoscopy & GI Lab Manager of Harbin Clinic Endoscopy Center (Rome, Ga.): We are a very busy center running about as efficiently as we can. We do not have much room for growth. Our surgery center is at capacity for pre/post op and procedure rooms. The only thing we could do to grow would be to offer extended hours and weekend services. As of right now, we do not have an immediate plan for that. If the COVID-19 crisis continues or we have a resurgence, we may have to consider that option in an effort to remain open.
Michelle Eilander, RN. Administrator of Ankeny (Iowa) Park Surgery Center: Our facility was in the implementation stages of a total joint replacement program to hopefully begin by the end of 2020. At this time, we are looking at implementing the program hopefully in 2021.
Catherine Retzbach, RN, BSN. Administrator of Memorial Ambulatory Surgery Center (Mount Holly, N.J.): The pandemic has placed us in a financial hole, which will restrict our capital equipment purchasing. Also the start-up will be slow so our case volume will continue to be behind the normal levels.
Tracey Tylicki, RN, BSN. Administrator of Carolina Coast Surgery Center (Murrells Inlet, S.C.): Though we are ready for cases to resume at full capacity, we are aware that our patients may still be reluctant to have surgery during the next few months, which will affect volume. We still have two new surgeons coming on board at the end of May though again their volume may not be at peak. I will say, [we have already experienced a few weeks] over capacity. Days are long and volume is high due to the backlog.
John Lewis. CEO of Semmes Murphey Clinic (Memphis, Tenn.): Our volumes have been significantly reduced over the last few weeks. We will remain hopeful for the future; however, there are still many unknowns. As a result, we are being very cautious, especially given the possibility that we could see an uptick in COVID cases. It's clear that in one way or another, we will feel the impact of this through the remainder of this year and possibly into next year.
Patricia Frendak, RN, BSN. Administrative Director of New Britain Surgery Center: We are not expecting to see any growth for 2020 at this time, we are hopeful to remain flat in comparison to 2019.
Debra Hagendorn. Administrator of East Hills Surgery Center (Greenvale, N.Y.): Too soon to tell but our plan for growth has changed and will continue to change as we move forward. Everything related to the coronavirus has required us to be flexible within all areas since CDC recommendations and guidelines, as well as state department of health guidelines, have been ever changing.
Alfonso del Granado. Administrator of Covenant High Plains Surgery Center (Lubbock, Texas): Although the impact is measurable, we're reasonably confident for the mid-term. We have a great number of active surgeon partners whose patients have waited out the quarantine and are now backlogged, and we expect this to take months to catch up. The greatest impact for us will be on cash collections, as we expect more patients will qualify for financing their deductibles and coinsurance than before, and the finance terms will likely be longer as well. That said, our worst-case models have us down but still profitable for 2020, normalizing caseloads by May of next year, and revenues returning to par for 2021.
Leticia Ramirez, RN, BSN. Administrator of MidAmerica Orthopaedics (Palos Hills, Ill.): The pandemic has drastically affected our plan for growth considering we just completed an expansion project on our facility. COVID testing is not realistic for standalone ASCs and testing supplies are nowhere to be found. Swabs and viral transport medium are in short supply and while the CDC offers a 'recipe' to create your own VTM, we do not have a laminar flow hood or biological safety hood within a sterile environment to fill vials.
Polly Ladd. Administrator of Crowne Point Endoscopy & Surgery Center (Flint, Mich.): It has affected it tremendously as we are mainly GI/endoscopy, we also do minor surgeries of the hand, GYN-urology and podiatry. We will not resume our surgeries until much later.
Todd Currier. Administrator of Northern Wyoming Surgical Center (Cody): Expected growth and changes have been postponed until we can be assured that volumes have returned and risk of future closure or limitations have ceased.
Barbara Smith. Administrator of a Multispecialty Surgery Center in Virginia: Our growth may be hampered by lack of critical supplies. It is difficult to judge at this time. Plus patients' economic situation remains to be seen.
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