During the month of August, DHEC would like to recognize the 68 Ambulatory Surgery Centers across the state for National Ambulatory Surgery Center Month.  As COVID-19 has introduced new challenges to our healthcare system and patients, these facilities and their staff have shown great flexibility and commitment to providing solutions. 

The agency’s Healthcare Quality provides state and federal oversight of surgery centers. Ambulatory surgery centers must be licensed and can also be certified. 

Ambulatory surgery, also known as outpatient surgery, does not require an overnight hospital stay. Ambulatory Surgery Centers (ASCs), sometimes referred to as Ambulatory Surgical Facilities, specialize in this type of care and keep hospitals uncrowded and available for more invasive procedures and longer recovery times.  

ASCs also provide flexibility and a solution to scheduling issues and long wait times for what are considered common surgeries. Procedures occurring in these facilities cost significantly less when compared to hospitals, which saves the patient, insurance companies, and employers money.  

COVID-19 response 

In response to the coronavirus outbreak, three of South Carolina’s ASCs have converted into hospitals, while others have closed because of the restrictions on elective surgeries. These conversions help hospital capacity, assist with backlogs of procedures, and expand resources.  

An ASC must meet the Centers for Medicare and Medicaid Services’ (CMS) Conditions of Participation when converting to a hospital and, while operating as a hospital, it will temporarily no longer operate as an ASC. DHEC is proud of South Carolina’s ASCs and all they have done in order to comply with federal and state standards and waivers.  

The three ASCs that have converted to hospitals during the COVID pandemic are the Surgery Center at Edgewater in Fort Mill, Charleston ENT & Allergy, and Center for Colon & Digestive Diseases in Aiken.  

“ASCs provide high quality surgical care that is safe and cost-effective,” said Amanda Atkinson, Administrator of the Surgery Center at Edgewater. “They have a reduced risk of infection and patients have the convenience of receiving care in a smaller and more intimate setting.” 

Responding to COVID-19 at present, the facility is required to test all patients prior to their surgical procedure, adding extra steps to their pre-operation process. Additional staff were brought in to assist with the testing, but supply costs have risen for the facility.  

Many local hospitals have suspended elective surgeries to focus on providing care to COVID-19 cases, creating a backlog of procedures and patients on standby. By converting to a hospital, the ASC has been able to work on the backlog of surgeries waiting to be performed, improving the patient’s quality of life, and in many cases allowing them to return to work or normal daily activities.  

In addition to the extra duties and safety precautions within the facility, staff have also been dedicating time to testing the public.  

“Staff who are affiliated with MUSC have been staffing COVID 19 testing sites since the beginning,” Atkinson said. “Many of our staff continue doing so to ensure that we are doing our part to help with this pandemic. They have all been willing to work jobs outside their normal work duties as nurses and surgical technicians to help the greater good. These healthcare professionals have selflessly and courageously continued to provide excellent care to our patients and our community.” 

DHEC thanks all of our ASCs for their continued commitment to Promoting Teamwork and Service and Accessibility. Later this month, we will publish a second part in this Dashboard series to highlight our work with another ASC and how our staff is helping to protect patient care during this time.  

DHEC Applauds Ambulatory Surgery Centers for Adjusting During Pandemic

DHEC’s Healthcare Quality provides state and federal oversight of surgery centers. Ambulatory surgery centers must be licensed and can also be certified. August is National Ambulatory Surgery Center Month. 

Since the coronavirus pandemic began, hospitals have been reaching out to Ambulatory Surgery Centers (ASCs) in search of space, staff, intensive care unit (ICU) beds, operating rooms, overflow care, equipment, and more.  

When CMS released Hospital Without Walls, Charleston ENT & Allergy was quick to jump at the opportunity. CMS’s Hospital Without Walls essentially removes any regulatory barriers and allows ASCs to operate as a hospital outpatient department (HOPD). 

The facility has now performed several procedures it had never performed before, all without complications. Submitted claims have not been reimbursed, reporting requirements have changed, and regulations that did not previously apply are now in place.  

Despite these hardships, Mandy Hawkins, Director of the surgery center at Charleston ENT & Allergy, said the benefit outweighed the inconveniences.  

“During this crisis we have been able to take on higher acuity cases freeing up valuable hospital space,” she said. “We have been able to proceed with cases that were being postponed within hospital systems preventing the possibility of worsening the prognosis for the patient.”  

They also test their physicians and staff daily as well as patients and families both on the day before and of the operating procedure date. Staffing and obtaining personal protective equipment PPE have been a challenge at times, but Hawkins says that the pandemic’s obstacles have improved the teamwork among her staff.  

“Our team has grown closer, working together through difficult times,” she said. “I absolutely love being part of my ASC. Working closely with the Governing Board of Ambulatory Surgery Center Association (ASCA), the Lowcountry Healthcare Coalition, DHEC, the South Carolina Emergency Management Division (SCEMD), and a myriad of ASC leaders throughout the state and  country, I have built relationships with healthcare providers, public service workers and people I never knew I would need at an ASC.” 

DHEC encourages the public to learn about the importance of ASCs, their mission, and their commitment to providing reliable and safe options to South Carolina’s communities. We value the staff, stakeholders, and constituents that continue advocating for these important assets to the great state of South Carolina and its people.