Becker's ASC Review

ASC Turnarounds: Ideas to Improve Performance 13 would have eventually led to the expiration of their state license, so they reached out to Ambula- tory Surgical Centers of America for help. In re- sponse, ASCOA sent an operations team to deter- mine the next steps necessary to reopen the center as quickly and as safely as possible. After the initial operations assessment, ASCOA placed Marlene Bell, RN, MN, CASC, CNOR, se- nior vice president of operations at ASCOA, with the Surgery Center of Northeast Texas to spear- head turnaround efforts in June 2012. "It took a while to do this turnaround. It's a small commu- nity, and the center had gained a reputation. But we figured it out, and now we're able to distribute on a regular basis." The barriers to success were numerous. The center serves many Medicare and Medicaid pa- tients, which means a portion of its cases have consistently lower reimbursements. In addition, when Ms. Bell arrived, administrative and staff- ing problems at the center had led several issues, including: • An to an inability send out and collect bills in a timely manner • Expired supplies and medications collecting in back rooms • Staff members showing little dedication to following policy Ms. Bell recounts instance after instance of incon- sistent billing, staff complacency and poor billing policies: "They weren't following up on bills on a regular basis. Their A/R days were in the 50s," she says. Their previous management situation wasn't helping. "They had had several different manage- ment companies, a physician told me, which had been collecting fees but not directing daily activi- ties necessary for the success of the center. Those companies were not holding the staff accountable to job descriptions designed to optimize efficien- cy," she adds. Working under the philosophy that the right peo- ple make the center, Ms. Bell set to work finding the individuals who would allow the center to thrive. Between Ms. Bell and several other ASCOA per- sonnel, they recruited a new administrator, a new suite of business office employees and a trio of re- cruited physicians. "We did end up letting some of the clinical staff go. We're strict about following the way ASCOA does it, because we know it works. If staff is not willing to follow the policies, they're not a good fit for us," says Ms. Bell. With staff on board, the center was back on its feet. Robin Walter, RN, the Surgery Center of North- east Texas's administrator, really helped bring things together, according to Ms. Bell. "She helped the center totally gel — she's highly valued in our company," Ms. Bell adds. Ms. Walter joined the center as clinical coordinator. Six months in to the job, the turnover of the admin- istrator position occurred. With her two decades of ASC nursing experience and having worked with Ms. Walter for half a year, Ms. Bell felt she would make a great administrator for the center. "When I arrived the problems were mostly failure to follow policies and protocols, little account- ability and infrequent follow-ups. But ASCOA has an excellent framework for anyone who wants to succeed," says Ms. Walter, echoing Ms. Bell's comments about the necessity of the disciplined follow-through in every arena for ASC success. "The staff here is great — they were just lacking in leadership. Once the staffing changes were made, everyone stepped up and showed they have what it takes to make a successful center," adds Ms. Walter. "The surgeons are extremely happy, pa- tient reviews are wonderful, and it's great to see everything come together." n From Debt to Profitability: Surgery Center of Northeast Texas (continued from cover) Becker's ASC 21st Annual Meeting - The Business and Operations of ASCs October 23-25, 2014 • Chicago Keynotes: Terry Bradshaw, Co-Host and Analyst, FOX NFL Sunday and NFL Legend; Bill Taylor, Founding Editor, Fast Company and Best-Selling Author; Lolo Jones, 2-Time Olympic Hurdler and World Champion, 2014 Olympic Bobsledder For more information, call (800) 417-2035 30 Great Surgeons, 36 Leading Administrators and 80 Surgery Center Speakers in Total "It took a while to do this turnaround. It's a small community and the center had gained a reputation. But we figured it out and now we're able to distribute on a regular basis." – Marlene Bell, Senior Vice President of Operations at ASCOA

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