3. Complying with Medicare’s Conditions for Coverage (CFCs)
CMS establishes requirements, called Conditions for Coverage that ASCs must meet in order to be certified. The requirements cover all aspects of an ASC from operational organization to facility design and patient care. It is important to note that the CFCs must be met for all patients and not just Medicare patients.
CMS also produces a State Operations Manual which includes guidance for surveyors, often referred to as the Interpretive Guidelines. The guidance specific to ASCs can be found in Appendix L: Interpretive Guidelines for ASCs. In addition to reiterating the text of the Conditions for Coverage, this document provides guidance on the meaning of the rules and further advice on how ASCs should comply.
It is important to note, however, that two other appendices also apply to ASCs. ASCs are required to comply with Appendix I: Survey Procedures and Interpretive Guidelines for Life Safety Code Surveys, which addresses the Life Safety Code, and Appendix Q: Guidelines for Determining Immediate Jeopardy.
ASCs are also required to maintain a compliant emergency preparedness (EP) plan, which must be reviewed and updated at least every other year. CMS eliminated the requirement that ASCs maintain a written transfer agreement with a local hospital, as well as the requirement that each patient have a medical history and physical (H&P) assessment prior to surgery. Additional information on the regulatory changes is available on the 2019 Omnibus Burden Reduction Rule webpage.