If your ambulatory surgery center is in the market for a new administrator, here are 13 questions Dawn Q. McLane, RN, MSA, CASC, CNOR, regional vice president of Health Inventures, suggests you ask candidates. Administrators can use this checklist as a guide for information they might want to know before going into an interview and questions they might want to ask about the ASC.
1. Have you held previous administrator positions and, if so, how many years of experience do you have? "If they have held previous administrator positions, what type of ASC — single-specialty, multi-specialty?" says Ms. McLane. "What specialties have they worked with in the past? I think it's important to know that. If it's a heavily orthopedic center I'm recruiting for, then have they worked with orthopods before? If I'm working with a GI center, have they worked with GI physicians before?"
2. How large were the previous ASC(s) you worked in? "Was it a two-OR ASC or five-OR center?" she says. "The more ORs usually means a busier center and more responsibility" for the administrator.
3. Do you have clinical experience, business office experience or both? "I definitely want to know this," she says. "If they have clinical experience, is it in the operating room or the perioperative area? This helps me get a good feel for where they're coming from. Is their expertise in the OR or are they a PACU nurse? They think differently, they perceive the surgery center differently."
4. What kind of experience do you have with payor contracting? "Have they had someone do it for them in the past?" Ms. McLane says. "Maybe they worked at an ASC where the hospital partner did all of the contracting for the surgery center. You want to know at what level they have been involved in payor contracting."
5. Are you CASC (Certified Administrator Surgery Center) certified? "That tells me a little bit about their competency level and it tells me they're interested enough in being an administrator to get the credential," Ms. McLane says.
6. Where is the ASC(s) you previously worked at located? "You want to know what geographic area they have worked in and are they familiar with the area we're recruiting to," she says. "Have they worked in this state before? Are they familiar with the state rules and regulations for our particular state? Not that they can't learn the state rules, but if they already have a familiarity then that's a plus."
7. Do you have experience working in diverse areas? "For example, I have a [California center] with a very high Vietnamese population and many of the physicians who work there are Vietnamese," she says. While candidates for administrator at this center would not necessarily need to speak Vietnamese, "they need to have a cultural competence that demonstrates an understanding of how to manage in a culturally diverse organization with a very large international population," she says.
8. Are you familiar with our market? "This is pinpointed more toward the candidate’s knowledge of local / regional payors and competition within the market," says Ms. McLane. "Who are the payors in your market, who is the competition in your market and are they familiar with them at all?"
9. (For ASCs with a management company with expectations/requirements): Are you prepared to work in the corporate environment? "That's something that's very important to know," Ms. McLane says. "If they've never worked in a corporate culture before where there's a corporate manager or RVP, they might struggle with the expectations of a corporate entity. Some people who have never worked in that environment feel that the corporate entity is just creating more work for them and they don't always support the corporate entity or understand and appreciate the benefits
"If the person doesn't have experience working at a corporate entity, I would ask them to tell me what they think the value-adds that a corporate entity brings to this relationship," she says. "It's not for everyone. Some people much prefer a very independent way of managing and others love having the corporate entity's support."
10. (For ASCs with a hospital or health system partner with expectations/requirements): Are you prepared to work with a hospital/health system? "You want to know they can communicate effectively and how they will deal with a hospital or healthcare system partner," Ms. McLane says. "What kind of experience they have in that area?"
11. (For ASCs with a board that has expressed specific needs or expectations): Do you meet the requirements of our board? "That could be something like the ASC board wants only to interview clinical candidates and maybe they are not willing to consider candidates without an RN," she says. "I've had that happen before, where the board has only wanted to interview someone with a clinical background or financial background. I think sometimes it just has something to do with an experience in their recent history. ."
12. Can you handle the specific challenges of our center? "Every center has a unique personality. It has specific needs they desire to be a met," says Ms. McLane. "It may be a center that's in its first year of operations and will need someone who can move them successfully through the startup period. Maybe it's a mature center that's starting to decline, physicians are retiring or are moving away from the community and there hasn't been a good recruitment process in place in the past and now the center needs to recruit and to implement a succession plan.. It could be an ASC with a disengaged investor body and we need someone with the talent, experience and a personality to talk to the doctors and engage them again.
"Each center has its own individual personality," she says. "The person you're hiring as the administrator, must understand the unique challenges for that center and you must determine whether their talents and personality will be a match with the specific culture and needs of your center."
13. (For ASCs expecting a dual role for their administrator): Are you prepared to also hold the position of director or nursing or business office manager? Some small centers may not have a DON or BOM and may expect the administrator to assume dual roles," says Ms. McLane. "That all feeds into the type of qualifications and competencies you're looking for in your administrator."
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