While the pandemic has led to a nursing shortage, it also reminded people of the importance of ambulatory surgery centers.

Two associates of the Ambulatory Surgery Center Association spoke to TASCS members about healthcare legislation, surgery centers during the pandemic and nationwide nursing shortages.

Kara Newbury, the regulatory counsel and director of government affairs, and Stephen Abresch, the associate director of government affairs, talked about the significance of the Hospitals Without Walls program, which allowed ambulatory surgery centers to take on a greater role during the pandemic. “This is really how the Hospital Without Walls program came to be,” Newbury said. “Because we were pushing back from day one from any [federal encouragement] for COVID patients to come to ASCs.”

Centers that enrolled in this program could bill as hospitals and provide hospital services. “More than 50% of ASCs nationwide only have one to two ORs,” Newbury added. “It doesn’t really make sense to spread out COVID patients across our ASCs like that.”

About 100 facilities nationwide participated, and one spine facility in Arkansas that enrolled early on was able to collect some beneficial data. The facility was able to show that there were two in-patient codes that could be done safely as ASC procedures, Newbury said.

As ASCs began to take on a more critical role during the pandemic, Abresch noted that government officials seemed to get a crash course in surgery centers and realized how crucial they are. Shutting centers down wasn’t doing a whole lot of good for retaining hospital capacity and actually inflicted more pain on non-COVID patients. “[The patients] have elective surgeries scheduled — Sure, they’re elective, but that doesn’t mean they can wait six months to have it done.”

As time has progressed, Abresch has noticed a more nuanced approach where states only dial back elective surgeries as needed. By educating legislators on what elective surgery really means, it will continue to help guide the policy on these procedures. “This pandemic has opened up some state government officials' eyes,” Abresch said.

During the pandemic, another problem swept the nation: the nursing workforce shortage. The federal government has acknowledged this issue, Newbury said, and several major nursing groups put out memos about this staffing emergency, but there’s no clear-cut solution on the table right now.

Some members of the healthcare industry have emphasized the idea of calling out-of-state nurses into the U.S. to help with the crisis, but traveling nurses are costly to surgery centers and not a good long-term solution. “Making sure legislators understand that this isn’t just a ‘right now’ problem [is important],” Abresch said. “This is going to persist if they don’t take steps to increase the amount of healthcare staff.”

Some possible incentives could be tuition reimbursement or targeted scholarships, but Abresch emphasized that legislators need to understand this is a problem that could be around for a long time if there’s no stimulus to the workforce soon.

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