Becker's ASC Review

7 ASC MANAGEMENT What hospitals raising nurse pay could mean for ASCs By Patsy Newitt Some hospitals have been raising nurse pay, which could mean ASCs will have even more difficulty recruiting staff. In November, Baltimore-based LifeBridge Health said it would raise the hourly minimum wage for many employees to $16. Also, the Oregon Nurses Association approved a contract with Providence Hood River (Ore.) Memorial Hospital in fall 2022 that includes wage increases between 14 percent and 21 percent over the next two years. Nurse salary at ASCs has remained relatively flat the last five years, according to the most recent data. Five years ago, ASC nurses made $35.93 per hour as the median average salary, according to VMG Health's 2018 Multi-Specialty ASC Benchmarking Study. By 2020, the median ASC nurse staff wage was $37.05 per hour, according to the company's updated report released in 2022 based on data reported from 2018 to February 2020. Additionally, the Ambulatory Surgery Center Association said in 2021 that most surgery centers budgeted 3 percent raises for staff in 2021, but those raises might not be enough to compete with hospitals and travel nursing agencies. ASCs have been struggling to compete with the deep pockets of hospitals and health systems amid tightening margins. According to the VMG Health report, many ASCs have to spend one- quarter or more of their net operating revenue on employees to stay ahead of shortages. Pay for ASC administrators is also rising, hitting $100,000 to $119,000 on average, according to OR Manager. "As we continue to hear about staffing and supply chain, these two aspects of healthcare operations can really be a challenge," Brenda Carter, administrator at Wilmington (N.C.) Surgcare, told Becker's in September. "ere is no way to 'cut corners' on qualified staff when candidates are limited, so ASCs must find a way to improve retention and recruitment. Qualified teams are essential for patient safety and efficient care. e cost of staff turnover is incredible." ASCs reimbursements are also historically lower than hospital outpatient departments for the same procedures, meaning low staffing costs are critical to meet margins. Many ASCs are opting for long-term retention strategies, such as fostering a positive workplace culture and providing incentives to leverage employment, instead of raises. "We are engaging our teams in meaningful ways to promote a positive culture," Amanda Sosnosky, administrator of Orthopedic Surgery Center of Green Bay (Wis.) and Orthopedic Surgery Center of the Elgin, Ill.-based Fox Valley, told Becker's in October. "We are putting our talented team members first. We are creating staffing models that will allow for greater job satisfaction and work-life balance." n The ASCs that faced opposition in 2022 By Patsy Newitt Here were seven ASCs that faced opposition in 2022: 1. In March, state regulators granted Steindler Clinic's planned $19.2 million ASC in Iowa City, Iowa, a certificate of need after a last-minute withdrawal of all opposition to the facility. Opposition to the surgery center, slated for completion in November 2023, initially included the University of Iowa Health Care, Johnson County Surgical Investors and Iowa City Ambulatory Surgical Center. 2. In April, plans for the proposed Florence (Ala.) Eye Surgery Center were approved by the Alabama Certificate of Need Review Board. The eye ASC ran into opposition from the Laser Eye Surgery Center of Florence and Florence-based Shoals Outpatient Surgery. After initially contesting the application, both competitor ASCs dropped their opposition by the end of March. 3. In May, Mobile, Ala.-based USA Health broke ground on a 25,000-square-foot surgery center in Fairhope, Ala. Mobile-based Infirmary Health, the state's largest nonprofit health system, challenged the certificate of need board's unanimous decision to approve the ASC in 2022. 4. In June, Orangeburg, S.C.-based Regional Medical Center said it would challenge plans for a $12.5 million private ASC in a hearing. The nonprofit hospital held a June 6 closed-door meeting to discuss plans for its own $2.4 million ASC in Orangeburg, but no vote or public discussion was held. 5. In July, The Heart & Vascular Institute of Alabama was cleared to build a single-specialty ASC in Montgomery after facing opposition from other health systems and ASCs in the area. The project faced more than a year of opposition from other providers, including the Healthcare Authority for Baptist Health; Prattville, Ala.- based Jackson Hospital & Clinic; and Jackson Surgery Center. 6. In August, a $67 million, 163,000-square foot medical complex under construction in Amherst, N.Y., faced criticism from the town's residents. The medical complex, which includes an ASC, is tied to UBMD Physicians' Group and Kaleida Health — both based in Buffalo, N.Y. — and is being developed by Ciminelli Real Estate Corp. 7. In September, a plan for an ASC in Alabama was granted a certificate of need despite opposition. Infirmary ASC, a planned multispecialty center in Mobile, will include four operating rooms and four procedure rooms. n

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