A surgery center originally opened in 2006 in Littleton, Colo., is now running as a joint venture between Littleton Adventist Hospital and David VanSickle, MD. The ambulatory surgery center operates as a timeshare property with a dual license from the state.
Dr. VanSickle worked with Beverly Kirchner, BSN, RN, CNOR, CASC, who developed SurgeryDirect, to lease space at the ASC as a separate entity. CMS allows for these arrangements if the center is licensed by the state. Here are five key notes on the center:
1. Dr. VanSickle connected with Littleton Adventist Hospital CEO Brett Spenst in 2014 about the possibility of leasing space in an existing Littleton ASC near the hospital. The two devised a plan for Littleton Adventist Hospital to own 51 percent of the ASC and Dr. VanSickle to own 49 percent.
2. The host center lessor and the ASC lessee joint venture hold separate licenses from the Colorado Department of Public Health and Environment. The state law permits multiple ASCs to use the same physical space as long as they don't use concurrent or overlapping hours of operation.
"Granted, the rules are stringent and must be followed to the letter by the ability for surgeons to acquire scalability, lease staff and equipment only as needed, ensure greater patient safety in the ASC setting and cut costs for their patients and their practice is revolutionary," said Dr. VanSickle.
3. The rule requires public signage stating the separate names of each center and distinct times and days of the operation. Each licensed center must have its own policies and procedures with separate, locked patient rooms.
4. Both ASC lessees can use the same nursing and ancillary staff under a staff employer arrangement and the lessees are required to separately comply with staff utilization requirements.
5. A written agreement must establish the responsibilities for each lessee regarding:
• Services
• Supplies
• Equipment use
• Quality assurance
• Infection control
Each center is required to have a separate locking storage for its own surgical supplies and devices, medications, locked carts and other exclusive material.
Dr. VanSickle performed his first procedure at the ASC on April 15. He will only use one ASC timeshare operating room and staff on the first and third Fridays of each month.
"Thanks to the advanced technology and efficiency of an ASC, patients and/or payers can save $30,000 to more than $100,000 in medical expenses," said Dr. VanSickle. The total development cost was under $500,000 to repurpose the center and acquire appropriate capital equipment for his cases. It took 21 months to complete.
"Leasing outpatient operating room space is an easier way for young surgeons and single-specialty physicians to acquire ASC space," said Ms. Kirchner.