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'!B}T_t)K1/O!>OF}|!0G>OFO9'ЄxB!B1!B_=8BҔK ! m”O0'җ=—ӥ)J_)KRӸ/u).oOС VO8(  ` :beth.pickens@dshs.state.tx.usHmailto:beth.pickens@dshs.state.tx.us>derek.jakovich@dshs.state.tx.usLmailto:derek.jakovich@dshs.state.tx.us/ 0DArialNew Romanpp83F0DWingdingsRomanpp83F0 DTimes New Romanpp83F0@ .  @n?" dd@  @@`` \T\0 ,R$d!6sT^IAz 0AA@8w ʚ;1 q8ʚ;g4KdKd|[F0ppp@ <4dddd<@0p3 <4!d!d<(A0p80___PPT10 ?  %.2`Texas Ambulatory Surgery Center Society State of the State Conference Monday, February 1, 2010Va(Beth Pickens, RN-BC, MHA Derek Jakovich, JD., MBA., MHA Regulatory Services Division Texas Department of State Health Services February 1, 2010P ASC Rules mThe proposed draft rules were posted on the DSHS website and an email announcement was sent to stakeholders on December 23, 2009 to advise them of the proposed changes to the licensing rules that incorporate legislation and to request comments. The proposed rules specifically address: Health and Safety Code, Chapter 259, added by House Bill 643. This is patient safety legislation relating to employment and qualifications of surgical technologists. This rule change should increase patient safety by requiring ambulatory surgical centers to employ only appropriately educated and certified as surgical technologists.2PPxPn ASC Rules !Ambulatory surgical centers may continue to employ surgical technologists that are not certified if they were employed in that capacity before September 1, 2009. The amendment to the rule is by reference and states that hospitals shall adopt, implement and enforce policies and procedures to comply with Health and Safety Code, Chapter 259, relating to Surgical Technologists at Health Care Facilities. The proposed rules also address Health and Safety Code, Chapter 98, amended by Senate Bill 203, requires reporting of health care-associated infections and preventable adverse events in ambulatory surgical centers. This legislation allows DSHS to make ambulatory surgical center patient safety information publicly available in a format that is easy to read and available on an internet website. @"P~ ASC Rules JThe amendment to the rule is by reference, and states that ambulatory surgical centers will submit reports to the department in accordance with the reporting requirements in Health & Safety Code 98.103 98.1045 (relating to Reportable Infections, Alternative for Reportable Surgical Site Infections, and Reporting of Preventable Adverse Events). 25 TAC, Chapter 135.26 Reporting Requirements amends the rule and requires ambulatory surgical centers to submit reports to the department in accordance 25 TAC, Chapter 97, Subchapter A (relating to Communicable Diseases) and in accordance with the reporting requirements in Health & Safety Code Sections 98.103 98.1045 (relating to Reportable Infections, Alternative for Reportable Surgical Site Infections, and Reporting of Preventable Adverse Events). 2\PPP&Surgical Technologists2The recently enacted surgical technologist credentialing legislation (now codified in TX Health & Safety Code Subtitle B, Title 4, Ch. 259)was intended by Rep. Zerwas, M.D., the sponsor, and was drafted as patient safety legislation requiring health care facilities (hospitals and ambulatory surgical centers) to employ only appropriately educated and certified individuals as surgical technologists. The bill is not a professional licensure bill, nor does it define or delineate a profession subject to regulatory oversight and discipline. The description of a surgical technologist in the legislation is intended to identify the class of employees to which the education and credentialing requirements apply. It is not intended to itemize or circumscribe the practice of surgical technologists in an OR setting. "30  Surgical TechnologistsThe question of whether a surgical technologist, or other non-physician surgical personnel, can perform suturing is addressed and answered in the Texas Medical Practice Act, at Section 157.001(a) of the Occupations Code ( Authority of Physician to Delegate Certain Medical Acts ), which provides, in pertinent part:  (a) A physician may delegate to a qualified and properly trained person acting under the physician s supervision any medical act that a reasonable and prudent physician would find within the scope of sound medical judgment to delegate if, in the opinion of the delegating physician: (1) the act (A) can be properly and safely performed by the person to whom the medical act is delegated; (B)is performed in its customary manner; and (C)is not in violation of any other statute 2<PPEP  Surgical TechnologistsFurther, Texas Medical Board Rules (Texas Administrative Code, Title 22, Part 9 Chapter 193, Standing Delegation Orders) specifically allow physicians to delegate to surgical technologists:  193.1 & (b) Likewise, nothing in this chapter shall be construed as to prohibit a physician from instructing a technician, assistant or nurse to perform delegated tasks so long as the physician retains supervision and control of the technician, assistant, or employee. Nothing in this chapter should be construed to relieve the supervising physician of the professional or legal responsibility for the care and treatment of those persons with whom the delegating physician has established a physician-patient relationship& . 2P#PP  ASC Surveys Texas Department of State Health Services (DSHS) regulates ASCs pursuant to our authority in Texas Health and Safety Code Chapter 243 and Title 25 Texas Administrative Code Chapter 135 Centers for Medicare and Medicaid Services (CMS). Federal regulations are the Conditions of Coverage in Part 416 42 CFR CMS Mission and Priority document establishes workload priorities for DSHS  Tier 1- 4 Tier 1- IJs, Validations, Full Surveys if Condition Out Tier 2 - 2010  10 % (26 surveys); ARRA Funding additional 23% (62.3%) for 33.3 % (88 surveys) of facilities ASC - ~ 358 licensed facilities; 91 deemed by CMS and 267 non-deemed facilities 2ZZZ ASC Surveys FY 10 Survey Requirements: For fiscal year (FY) 2010, all State Survey Agencies (SAs) will be required to survey a substantial number (as specified in the Mission and Priority Document (MPD)) of their non-deemed ASCs using the new ASC survey process, and may receive Recovery Act funding to cover the additional costs entailed. Volunteer SAs receiving FY 2009 Recovery Act funding are already implementing the new process. Deemed vs. Non-deemed Survey Samples: To implement a Government Accountability Office (GAO) recommendation, the Centers for Medicare & Medicaid Services (CMS) is requiring SAs to include a five percent randomly selected sample of non-deemed ASCs that must be surveyed no later than September 30, 2010. CMS will also be requiring FY 2010 ASC validation surveys to be conducted on a random sample (up to seven percent) of deemed ASCs. Distribution of Survey Lists: Regional Offices (ROs) will be distributing confidential lists of ASCs to be surveyed to each SA, to facilitate efficient scheduling. CMS Admin. Info. Letter 09-37ZP& ASC Surveys Tier 4 - CMS Medicare Initial Surveys Accreditation by AO vs Access to Care Requests approved by CMS State and Federal Deficiencies  Governing Body, QA, Pharmaceutical Services, and Medical Records State  may be a 3 year survey frequency; Federal  6 year interval New CMS Survey Process  Admin Info Letter 09-37 May 15, 2009 and new Appendix L of SOM; Tracer Methodology "yz:> State Budget >HHSC Hiring Freeze 5% cuts & & & ? Questions Beth Pickens Phone: 512/834-6752 beth.pickens@dshs.state.tx.us Derek Jakovich Phone: 512/834-6700 x 2374 derek.jakovich@dshs.state.tx.us c0"?c0l  0` MMM̙` fy3` f.f̙` jg3mof` e MMMfff` Po` yyOOw]]f` MMMr~` NfD+f3>?" dd@,?dd@   @ ` n?" dd@   @@``PR    @ ` ` p>> |0L(  L L 6؆ "  T Click to edit Master title style! !$ L 0ĉ "   RClick to edit Master text styles Second level Third level Fourth level Fifth level!     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MMM̙80___PPT10.ƢrL@H'KMIPR eUWZ]_8Bfd:b# f1 9(  ` :beth.pickens@dshs.state.tx.usHmailto:beth.pickens@dshs.state.tx.usOh+'0ح hp  < H T`hdTexas Ambulatory Surgery Center Society State of the State Conference Monday, February 1, 2010DSHSCloudsDSHS38Microsoft Office PowerPoint@P##9@%֩@15`"Ghg  ,V'&" WMFCx <8nץPicturesAzCurrent UserSSummaryInformation(rPowerPoint Document(>1DocumentSummaryInformation8t>derek.jakovich@dshs.state.tx.usLmailto:derek.jakovich@dshs.state.tx.us/ 0DArialNew RomanPP OؖF0ؖDWingdingsRomanPP OؖF0ؖ DTimes New RomanPP OؖF0ؖ@ .  @n?" dd@  @@`` \T\0 ,R$d!6sT^IAz 0AA@8w ʚ;1 q8ʚ;g4KdKdhOF0ppp@ <4dddd@0P O <4!d!d(A0P80___PPT10 ?  %x2`Texas Ambulatory Surgery Center Society State of the State Conference Monday, February 1, 2010Va(~Beth Pickens, RN-BC, MHA Derek Jakovich, JD., MBA., MHA Regulatory Services Division Texas Department of State Health ServicesZ ASC Rules nThe proposed draft rules were posted on the DSHS website and an email announcement was sent to stakeholders on December 23, 2009 to advise them of the proposed changes to the licensing rules that incorporate legislation and to request comments. The proposed rules specifically address: Health and Safety Code, Chapter 259, added by House Bill 643. This is patient safety legislation relating to employment and qualifications of surgical technologists. This rule change should increase patient safety by requiring ambulatory surgical centers to employ only appropriately educated and certified as surgical technologists.LPP)P?PPo ASC Rules !Ambulatory surgical centers may continue to employ surgical technologists that are not certified if they were employed in that capacity before September 1, 2009. The amendment to the rule is by reference and states that hospitals shall adopt, implement and enforce policies and procedures to comply with Health and Safety Code, Chapter 259, relating to Surgical Technologists at Health Care Facilities. The proposed rules also address Health and Safety Code, Chapter 98, amended by Senate Bill 203, requires reporting of health care-associated infections and preventable adverse events in ambulatory surgical centers. This legislation allows DSHS to make ambulatory surgical center patient safety information publicly available in a format that is easy to read and available on an internet website. @"P~ ASC Rules JThe amendment to the rule is by reference, and states that ambulatory surgical centers will submit reports to the department in accordance with the reporting requirements in Health & Safety Code 98.103 98.1045 (relating to Reportable Infections, Alternative for Reportable Surgical Site Infections, and Reporting of Preventable Adverse Events). 25 TAC, Chapter 135.26 Reporting Requirements amends the rule and requires ambulatory surgical centers to submit reports to the department in accordance 25 TAC, Chapter 97, Subchapter A (relating to Communicable Diseases) and in accordance with the reporting requirements in Health & Safety Code Sections 98.103 98.1045 (relating to Reportable Infections, Alternative for Reportable Surgical Site Infections, and Reporting of Preventable Adverse Events). 2\PPP&Surgical Technologists2The recently enacted surgical technologist credentialing legislation (now codified in TX Health & Safety Code Subtitle B, Title 4, Ch. 259)was intended by Rep. Zerwas, M.D., the sponsor, and was drafted as patient safety legislation requiring health care facilities (hospitals and ambulatory surgical centers) to employ only appropriately educated and certified individuals as surgical technologists. The bill is not a professional licensure bill, nor does it define or delineate a profession subject to regulatory oversight and discipline. The description of a surgical technologist in the legislation is intended to identify the class of employees to which the education and credentialing requirements apply. It is not intended to itemize or circumscribe the practice of surgical technologists in an OR setting. "30  Surgical TechnologistsThe question of whether a surgical technologist, or other non-physician surgical personnel, can perform suturing is addressed and answered in the Texas Medical Practice Act, at Section 157.001(a) of the Occupations Code ( Authority of Physician to Delegate Certain Medical Acts ), which provides, in pertinent part:  (a) A physician may delegate to a qualified and properly trained person acting under the physician s supervision any medical act that a reasonable and prudent physician would find within the scope of sound medical judgment to delegate if, in the opinion of the delegating physician: (1) the act (A) can be properly and safely performed by the person to whom the medical act is delegated; (B)is performed in its customary manner; and (C)is not in violation of any other statute &<PIP  Surgical TechnologistsFurther, Texas Medical Board Rules (Texas Administrative Code, Title 22, Part 9 Chapter 193, Standing Delegation Orders) specifically allow physicians to delegate to surgical technologists:  193.1 & (b) Likewise, nothing in this chapter shall be construed as to prohibit a physician from instructing a technician, assistant or nurse to perform delegated tasks so long as the physician retains supervision and control of the technician, assistant, or employee. Nothing in this chapter should be construed to relieve the supervising physician of the professional or legal responsibility for the care and treatment of those persons with whom the delegating physician has established a physician-patient relationship& . 2P#PP  ASC Surveys Texas Department of State Health Services (DSHS) regulates ASCs pursuant to our authority in Texas Health and Safety Code Chapter 243 and Title 25 Texas Administrative Code Chapter 135 Centers for Medicare and Medicaid Services (CMS). Federal regulations are the Conditions of Coverage in Part 416 42 CFR CMS Mission and Priority document establishes workload priorities for DSHS  Tier 1- 4 Tier 1- IJs, Validations, Full Surveys if Condition Out Tier 2 - 2010  10 % (26 surveys); ARRA Funding additional 23% (62.3%) for 33.3 % (88 surveys) of facilities ASC - ~ 358 licensed facilities; 91 deemed by CMS and 267 non-deemed facilities 2ZZZ ASC Surveys FY 10 Survey Requirements: For fiscal year (FY) 2010, all State Survey Agencies (SAs) will be required to survey a substantial number (as specified in the Mission and Priority Document (MPD)) of their non-deemed ASCs using the new ASC survey process, and may receive Recovery Act funding to cover the additional costs entailed. Volunteer SAs receiving FY 2009 Recovery Act funding are already implementing the new process. Deemed vs. Non-deemed Survey Samples: To implement a Government Accountability Office (GAO) recommendation, the Centers for Medicare & Medicaid Services (CMS) is requiring SAs to include a five percent randomly selected sample of non-deemed ASCs that must be surveyed no later than September 30, 2010. CMS will also be requiring FY 2010 ASC validation surveys to be conducted on a random sample (up to seven percent) of deemed ASCs. Distribution of Survey Lists: Regional Offices (ROs) will be distributing confidential lists of ASCs to be surveyed to each SA, to facilitate efficient scheduling. CMS Admin. Info. Letter 09-37ZP& ASC Surveys Tier 4 - CMS Medicare Initial Surveys Accreditation by AO vs Access to Care Requests approved by CMS State and Federal Deficiencies  Governing Body, QA, Pharmaceutical Services, and Medical Records State  may be a 3 year survey frequency; Federal  6 year interval New CMS Survey Process  Admin Info Letter 09-37 May 15, 2009 and new Appendix L of SOM; Tracer Methodology d&?c~;A State Budget >HHSC Hiring Freeze 5% cuts & & & ? Questions Beth Pickens Phone: 512/834-6752 beth.pickens@dshs.state.tx.us Derek Jakovich Phone: 512/834-6700 x 2374 derek.jakovich@dshs.state.tx.us c0"?c0l}0  $(  r  S RP R r  S RP `   R H  0޽h ? 33___PPT10i.߸+D=' O= @B + 0 0 0(   x  c $,ZRL  R x  c $[RLOI  R H  0޽h ? 33___PPT10i.V +D=' O= @B + 0 40(  4x 4 c $`ARL  R x 4 c $GRL  R H 4 0޽h ? 33___PPT10i.+D=' O= @B + 0 D0(  Dx D c $(L   x D c $ЗL`  H D 0޽h ? 33___PPT10i.Ģp_+D=' O= @B +r$ g  3ħ# fU1 9(  ` :beth.pickens@dshs.state.tx.usHmailto:beth.pickens@dshs.state.tx.us>derek.jakovich@dshs.state.tx.usLmail      !"#$%&'()*+,-./01234567 ՜.+,D՜.+,$    ~On-screen ShowDSHS1F ' Arial WingdingsTimes New RomanCloudsaTexas Ambulatory Surgery Center Society State of the State Conference Monday, February 1, 2010 ASC Rules ASC Rules ASC RulesSurgical TechnologistsSurgical TechnologistsSurgical Technologists ASC Surveys ASC Surveys ASC Surveys State Budget Questions  Fonts UsedDesign Template Slide Titles P 8@ _PID_HLINKSA %mailto:beth.pickens@dshs.state.tx.us'mailto:derek.jakovich@dshs.state.tx.us)_1Robert E. HillertRobert E. Hillertn of any other statute &<PIP  Surgical TechnologistsFurther, Texas Medical Board Rules (Texas Administrative Code, Title 22, Part 9 Chapter 193, Standing Delegation Orders) specifically allow physicians to delegate to surgical technologists:  193.1 & (b) Likewise, nothing in this chapter shall be construed as to prohibit a physician from instructing a technician, assistant or nurse to perform delegated tasks so long as the physician retains supervision and control of the technician, assistant, or employee. Nothing in this chapter should be construed to relieve the supervising physician of the professional or legal responsibility for the care and treatment of those persons with whom the delegating physician has established a physician-patient relationship& . 2P#PP  ASC Surveys Texas Department of State Health Services (DSHS) regulates ASCs pursuant to our authority in Texas Health and Safety Code Chapter 243 and Title 25 Texas Administrative Code Chapter 135 Centers for Medicare and Medicaid Services (CMS). Federal regulations are the Conditions of Coverage in Part 416 42 CFR CMS Mission and Priority document establishes workload priorities for DSHS  Tier 1- 4 Tier 1- IJs, Validations, Full Surveys if Condition Out Tier 2 - 2010  10 % (26 surveys); ARRA Funding additional 23% (62.3%) for 33.3 % (88 surveys) of facilities ASC - ~ 358 licensed facilities; 91 deemed by CMS and 267 non-deemed facilities 2ZZZ ASC Surveys FY 10 Survey Requirements: For fiscal year (FY) 2010, all State Survey Agencies (SAs) will be required to survey a substantial number (as specified in the Mission and Priority Document (MPD)) of their non-deemed ASCs using the new ASC survey process, and may receive Recovery Act funding to cover the additional costs entailed. Volunteer SAs receiving FY 2009 Recovery Act funding are already implementing the new process. Deemed vs. Non-deemed Survey Samples: To implement a Government Accountability Office (GAO) recommendation, the Centers for Medicare & Medicaid Services (CMS) is requiring SAs to include a five percent randomly selected sample of non-deemed ASCs that must be surveyed no later than September 30, 2010. CMS will also be requiring FY 2010 ASC validation surveys to be conducted on a random sample (up to seven percent) of deemed ASCs. Distribution of Survey Lists: Regional Offices (ROs) will be distributing confidential lists of ASCs to be surveyed to each SA, to facilitate efficient scheduling. CMS Admin. Info. Letter 09-37ZP& ASC Surveys Tier 4 - CMS Medicare Initial Surveys Accreditation by AO vs Access to Care Requests approved by CMS State and Federal Deficiencies  Governing Body, QA, Pharmaceutical Services, and Medical Records State  may be a 3 year survey frequency; Federal  6 year interval New CMS Survey Process  Admin Info Letter 09-37 May 15, 2009 and new Appendix L of SOM; Tracer Methodology d&?c~;A State Budget >HHSC Hiring Freeze 5% cuts & & & ? Questions Beth Pickens Phone: 512/834-6752 beth.pickens@dshs.state.tx.us Derek Jakovich Phone: 512/834-6700 x 2374 derek.jakovich@dshs.state.tx.us c0"?c0lr# 19(  ` :beth.pickens@dshs.state.tx.usHmailto:beth.pickens@dshs.state.tx.us>derek.jakovich@dshs.state.tx.usLmailto:derek.jakovich@dshs.state.tx.us/ 0DArialNew RomanPP$6ؖF0ؖDWingdingsRomanPP$6ؖF0ؖ DTimes New RomanPP$6ؖF0ؖ@ .  @n?" dd@  @@``  #E  !,R$d!6sT^IAz 0AA@8w ʚ;1 q8ʚ;g4ddddUF0ppp@ <4dddd@0P6 <4!d!d(A0P80___PPT10 ?  %O  =x2`Texas Ambulatory Surgery Center Society State of the State Conference Monday, February 1, 2010Va(~Beth Pickens, RN-BC, MHA Derek Jakovich, JD., MBA., MHA Regulatory Services Division Texas Department of State Health ServicesZ ASC Rules nThe proposed draft rules were posted on the DSHS website and an email announcement was sent to stakeholders on December 23, 2009 to advise them of the proposed changes to the licensing rules that incorporate legislation and to request comments. The proposed rules specifically address: Health and Safety Code, Chapter 259, added by House Bill 643. This is patient safety legislation relating to employment and qualifications of surgical technologists. This rule change should increase patient safety by requiring ambulatory surgical centers to employ only appropriately educated and certified as surgical technologists.LPP)P?PPo ASC Rules !Ambulatory surgical centers may continue to employ surgical technologists that are not certified if they were employed in that capacity before September 1, 2009. The amendment to the rule is by reference and states that hospitals shall adopt, implement and enforce policies and procedures to comply with Health and Safety Code, Chapter 259, relating to Surgical Technologists at Health Care Facilities. The proposed rules also address Health and Safety Code, Chapter 98, amended by Senate Bill 203, requires reporting of health care-associated infections and preventable adverse events in ambulatory surgical centers. This legislation allows DSHS to make ambulatory surgical center patient safety information publicly available in a format that is easy to read and available on an internet website. @"P~ ASC Rules JThe amendment to the rule is by reference, and states that ambulatory surgical centers will submit reports to the department in accordance with the reporting requirements in Health & Safety Code 98.103 98.1045 (relating to Reportable Infections, Alternative for Reportable Surgical Site Infections, and Reporting of Preventable Adverse Events). 25 TAC, Chapter 135.26 Reporting Requirements amends the rule and requires ambulatory surgical centers to submit reports to the department in accordance 25 TAC, Chapter 97, Subchapter A (relating to Communicable Diseases) and in accordance with the reporting requirements in Health & Safety Code Sections 98.103 98.1045 (relating to Reportable Infections, Alternative for Reportable Surgical Site Infections, and Reporting of Preventable Adverse Events). 2\PPP&Surgical Technologists2The recently enacted surgical technologist credentialing legislation (now codified in TX Health & Safety Code Subtitle B, Title 4, Ch. 259)was intended by Rep. Zerwas, M.D., the sponsor, and was drafted as patient safety legislation requiring health care facilities (hospitals and ambulatory surgical centers) to employ only appropriately educated and certified individuals as surgical technologists. The bill is not a professional licensure bill, nor does it define or delineate a profession subject to regulatory oversight and discipline. The description of a surgical technologist in the legislation is intended to identify the class of employees to which the education and credentialing requirements apply. It is not intended to itemize or circumscribe the practice of surgical technologists in an OR setting. "30  Surgical TechnologistsThe question of whether a surgical technologist, or other non-physician surgical personnel, can perform suturing is addressed and answered in the Texas Medical Practice Act, at Section 157.001(a) of the Occupations Code ( Authority of Physician to Delegate Certain Medical Acts ), which provides, in pertinent part:  (a) A physician may delegate to a qualified and properly trained person acting under the physician s supervision any medical act that a reasonable and prudent physician would find within the scope of sound medical judgment to delegate if, in the opinion of the delegating physician: (1) the act (A) can be properly and safely performed by the person to whom the medical act is delegated; (B)is performed in its customary manner; and (C)is not in violation of any other statute &<PIP  Surgical TechnologistsFurther, Texas Medical Board Rules (Texas Administrative Code, Title 22, Part 9 Chapter 193, Standing Delegation Orders) specifically allow physicians to delegate to surgical technologists:  193.1 & (b) Likewise, nothing in this chapter shall be construed as to prohibit a physician from instructing a technician, assistant or nurse to perform delegated tasks so long as the physician retains supervision and control of the technician, assistant, or employee. Nothing in this chapter should be construed to relieve the supervising physician of the professional or legal responsibility for the care and treatment of those persons with whom the delegating physician has established a physician-patient relationship& . 2P#PP  ASC Surveys Texas Department of State Health Services (DSHS) regulates ASCs pursuant to our authority in Texas Health and Safety Code Chapter 243 and Title 25 Texas Administrative Code Chapter 135 Centers for Medicare and Medicaid Services (CMS). Federal regulations are the Conditions of Coverage in Part 416 42 CFR CMS Mission and Priority document establishes workload priorities for DSHS  Tier 1- 4 Tier 1- IJs, Validations, Full Surveys if Condition Out Tier 2 - 2010  10 % (26 surveys); ARRA Funding additional 23% (62.3%) for 33.3 % (88 surveys) of facilities ASC - ~ 358 licensed facilities; 91 deemed by CMS and 267 non-deemed facilities 2ZZZ ASC Surveys FY 10 Survey Requirements: For fiscal year (FY) 2010, all State Survey Agencies (SAs) will be required to survey a substantial number (as specified in the Mission and Priority Document (MPD)) of their non-deemed ASCs using the new ASC survey process, and may receive Recovery Act funding to cover the additional costs entailed. Volunteer SAs receiving FY 2009 Recovery Act funding are already implementing the new process. Deemed vs. Non-deemed Survey Samples: To implement a Government Accountability Office (GAO) recommendation, the Centers for Medicare & Medicaid Services (CMS) is requiring SAs to include a five percent randomly selected sample of non-deemed ASCs that must be surveyed no later than September 30, 2010. CMS will also be requiring FY 2010 ASC validation surveys to be conducted on a random sample (up to seven percent) of deemed ASCs. Distribution of Survey Lists: Regional Offices (ROs) will be distributing confidential lists of ASCs to be surveyed to each SA, to facilitate efficient scheduling. CMS Admin. Info. Letter 09-37ZP& ASC Surveys Tier 4 - CMS Medicare Initial Surveys Accreditation by AO vs Access to Care Requests approved by CMS State and Federal Deficiencies  Governing Body, QA, Pharmaceutical Services, and Medical Records State  may be a 3 year survey frequency; Federal  6 year interval New CMS Survey Process  Admin Info Letter 09-37 May 15, 2009 and new Appendix L of SOM; Tracer Methodology d&?c~;A State Budget >HHSC Hiring Freeze 5% cuts & & & ? Questions Beth Pickens Phone: 512/834-6752 beth.pickens@dshs.state.tx.us Derek Jakovich Phone: 512/834-6700 x 2374 derek.jakovich@dshs.state.tx.us c0"?c0l/80 zr (    0P  P     P*    0P       R*  d  c $ ?     0P   0   RClick to edit Master text styles Second level Third level Fourth level Fifth level!     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