Can ASCs operate as timeshare properties? Yes, thanks to a little-known CMS ruling that lets multiple ambulatory surgery centers use the same physical space, including the same operating rooms, on separate days of the week. Timeshare ASCs must be dually licensed by the states in which they operate and they can't have concurrent or overlapping hours of operation.
These condo or "entity within an entity" arrangements let surgeons lease staff and equipment as needed without the multimillion-dollar burden of land acquisition, construction, equipment and staffing. Although some states, including Florida, won't license multiple ASCs for the same address, timeshare centers are popping up across the country.
"Leasing outpatient operating room space is a cost-effective way for single-specialty physicians to acquire ASC space," says Beverly Kirchner, RN, BSN, CNOR, CASC, founder of Texas-based SurgeryDirect, which teamed with a local hospital and a neurosurgeon to develop a dual-licensed ASC that opened last month in Littleton, Colo.
Keeping odd hours
Believed to be Colorado's first dual-licensed ASC, the Functional Neurosurgical Ambulatory Surgical Center hosted its first case on April 15. It's open on the first and third Friday of the month. It occupies the same space as the host center lessor, the Highline South Surgical Center, which is open for all but the first and third Friday of the month.
How can a surgery center subsist when it's only open 2 days a month? Neurosurgeon David VanSickle, MD, PhD, performs highly profitable deep brain stimulation for patients with Parkinson's disease, dystonia, essential tremor and severe obsessive-compulsive disorder. He begins the two-part surgical procedure at Littleton Adventist Hospital, a 51% partner in the joint venture. There, patients are anesthetized while a CT scan and robotic guidance identify where to place 2 electrical devices to slow too-rapid brain activity. One week later, the patient undergoes a brief — 1 hour or less — procedure at the ASC to insert a small battery-powered generator similar to a pacemaker into his chest. Dr. VanSickle needs to do only 8 cases to recoup his investment, which he expects to do after 3 months.