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Overnight Status for Outpatients in MD Raises Safety Concerns

John Commins, for HealthLeaders Media, January 10, 2014

Offering patients extended recovery time by keeping them overnight in an ambulatory surgery center may comply with CMS regulations, but Maryland's Office of Health Care Quality and the Maryland Hospital Association are voicing concerns about patient safety.

An ambulatory surgery center in suburban Washington, D.C., is taking federal regulations down to the final minute.

The Massachusetts Avenue Surgery Center, LLC, in Bethesda, MD, says it will fall within Centers for Medicare and Medicaid guidelines when it hold patients overnight because the stays will be no longer than 24 hours.

"Under CMS rules a surgery center may keep a patient for no more than 23:59," says Randall Gross, executive director at MASC, which provides mostly orthopedic, GYN, and general surgery services.

"There are a lot of procedures our docs have not been able to do, [such as] total knees and total hips, that are done at the hospital and then the patients are either sent home or sent to a rehab center and sent home the next morning. All we are really doing is extending the recovery time and creating an environment where our patients can spend 12 more hours here approximately."

Gross says he requested clarification from the state of Maryland and was assured that any recovery periods within the 24-hour window were acceptable under CMS regulations. MASC is negotiating with payers now and hopes to begin offering procedures that may require extended recovery times by March.

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