Existing ambulatory surgery centers that share a waiting area with other building occupants may be exempt from a Medicare requirement that they designate a separate waiting room if they meet certain conditions, the Centers for Medicare and Medicaid Services announced in a letter to state survey agencies last week.

Under existing CMS requirements, ASCs must have a distinct waiting area for patients and families that meets Life Safety Code (LSC) requirements for ambulatory healthcare occupancies. Existing ASCs that have been cited for violations of this requirement are eligible for waivers if they can show that designating a distinct waiting area would "result in unreasonable hardship" for the facility, and that their existing waiting room arrangements do "not adversely affect the health and safety of the patients."

ASCs that are granted waivers must assure that the shared waiting area has appropriate fire protection; that it includes a temporary partition separating ASC patients and visitors from other occupants; that the partition does not block the visibility of exits, is flame resistant and is located at least 18 inches below sprinkler deflectors; and that posted signs clearly identify the distinct ASC waiting area.

The CMS letter outlines the process for obtaining a waiver, which is the same as the standard process for requesting any LSC waiver. New ASCs applying for Medicare certification will not be eligible for a waiver, nor will existing ASCs that currently have a distinct waiting room but modify their arrangements to include a shared waiting area.

ASCs that are granted continuing waivers must still work to bring their buildings into compliance with the separate waiting room requirement, says CMS. "Once a waiver is approved for an ASC waiting area, the continuing waiver will be part of the POC and will remain in effect until such time that a renovation, alteration, or modernization will allow for the implementation of the LSC requirements."

Irene Tsikitas

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