HHS Inspector General Report Finds Oversight ‘Lacking’ in Ambulatory Surgery Centers
Oversight in ambulatory surgery centers that serve Medicare patients is "lacking," and information about the quality of such centers is "woefully inadequate," the HHS Office of Inspector General states in a three-part report. USA Today reports that the study found that 33% of the more than 3,000 ambulatory surgery facilities serving Medicare beneficiaries have not undergone state inspections in five or more years, and that some have not been inspected for over 10 years. The report also found that federal standards for the centers have not been updated since 1982, despite "explosive growth in the number of facilities and the types of surgical procedures performed." The report focused on free-standing facilities unconnected to hospitals or doctors' offices, which are subject to different inspection regulations. While the study acknowledged research showing that ambulatory surgery centers "usually provide good care for patients," HHS Inspector General Janet Rehnquist said, "Medicare's system of quality oversight falls short." The report stated, "While adverse events can happen in any setting, the risk of complications and the fact that more elderly patients with poorer health conditions are becoming candidates for ambulatory surgery illustrate the necessity for strong quality oversight."
The report calls for CMS to establish a "minimum standard" for ambulatory surgery center inspections, as well as a "better complaint process" and public release of inspection results. CMS said it agreed with the findings but said "scarce resources" would make it difficult to implement the recommended changes. In a written statement, the Federated Ambulatory Surgery Association said that the report could "mislead" patients to believe that such centers are unsafe. FASA said, "Nothing could be further from the truth" (Appleby, USA Today, 3/5). Summaries of part one, part two and part three are available online. Note: You must have Adobe Acrobat Reader to view the summaries.
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