The technique, profession, and science of determining the positions of points and the distances and angles between them
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In this episode of the ASC Podcast with John Goehle, we discuss the latest news and information, review the regulatory impact over the past year on ASCs, discuss required Department of Transportation Training related to Regulated Medical Waste and in our focus segment, continue our Accreditation Organization Series with an interview with Noel Adachi, Chief Executive Officer for the Accreditation Association for Ambulatory Health Care (AAAHC). This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Beckers ASC Review 10 Biggest Disruptions to ASC's https://www.beckersasc.com/asc-news/the-10-biggest-disruptions-to-ascs-to-prepare-for-in-2026/?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=5567B4088734C3Z From Beckers ASC Review - The ASC Policy Whiplash https://www.beckersasc.com/asc-coding-billing-and-collections/the-asc-policy-whiplash/?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=5567B4088734C3Z The Accreditation Association for Ambulatory Healthcare (AAAHC) https://www.aaahc.org/ Announcing our upcoming Bootcamps! Director of Nursing Bootcamp April 7-10 Administrator's bootcamp - May 26-29 For More Information, go to: https://conferences.asc-central.com/bootcamps/ INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
This week's episode of “Surveyor Says! The NSPS Podcast” is the next installment of “From the Director's Desk” with your host, NSPS Executive Director Tim Burch and features stories about National Surveyors Week. Tim shares the origin story of how the third week of March became a fixture on the surveyor's calendar as well as current events happening for 2026. A very informational episode you don't want to miss so check it out today!
The Surveyors and their crew find themselves at a house party for Yarrow's Eve. Can they find Nix, what can the learn about the city, and (most importantly) who's taking the main stage?
In this episode of the ASC Podcast with John Goehle, we discuss the impact of recent weather events, provide an update on the New York City Nurses strike and how it could impact ASCs, introduce our upcoming Director of Nursing and Administrators Bootcamps, and in our focus segment begin our year-long deep dive into artificial intelligence with Mat Giladi from Ambusun. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Announcing our upcoming Bootcamps! Director of Nursing Bootcamp April 7-10 Administrator's bootcamp - May 26-29 For More Information, go to: https://conferences.asc-central.com/bootcamps/ ASC Central: ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this episode of the ASC Podcast with John Goehle, we discuss the latest news in the industry, recent survey experiences, including a reminder about expiration dates, review 2025's profitability breakthroughs and in our focus segment we discuss Malignant Hyperthermia with Dr. Andrew Herlich This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Beckers ASC review-- Most Profitable Breakthroughs in 2025: https://www.beckersasc.com/asc-transactions-and-valuation-issues/ascs-most-profitable-breakthroughs-in-2025/?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=5567B4088734C3Z Boston Bowel Prep Scale: https://www.endoscopy-campus.com/en/classifications/boston-bowel-preparation-scale/ INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
As a building surveyor you may still be called on to represent landlords or tenants, so attaining the relevant competency can help you manage the relationship between the two parties.
In this episode of the ASC Podcast with John Goehle, we cover the latest on hospital industry strikes, the need for non-generator-backed outlets in the OR, off-site sterilization, deemed vs. non-deemed status surveys, and in our focus segment, an interview with Rommie Johnson from ACHC as part of our accreditation organizations series. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: ACHC Website: https://achc.org/ Prepare for the CAIP Exam with our 2 day On-Demand Virtual Conference: Infection Control 101 – Training for Infection Control Coordinators in ASCs (September 2024 Recording) Infection Control 201 – Advanced Training for Infection Control Coordinators (September 2024 Recording) INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this podcast, Ecologist Sebastian Hoefer talks to Methods in Ecology and Evolution assistant editor Harriet Rhodes about his article ‘Sensors versus surveyors: Comparing passive acoustic monitoring, camera trapping and observer-based monitoring for terrestrial mammals'. The paper compared different methods of monitoring, focusing on passive acoustic monitoring and observer based monitoring like camera trapping over several years in Eastern Australia, and they discuss some of the challenges involved in remote ecology. Read the full article here: https://besjournals.onlinelibrary.wiley.com/doi/10.1111/2041-210X.70169
Episode Description: What happens when half of an entire profession retires within a few years? Dustin Gardner, a fourth-generation surveyor, is facing that reality head-on. The average licensed land surveyor is now in their early 60s, and the industry is racing against time to train the next generation before decades of expertise walks out the door. In this conversation, Dustin pulls back the curtain on a profession that touches every construction project, property transaction, and development—yet remains deeply misunderstood. From the hidden work that happens before anyone steps foot on a site, to lifetime liability that follows every stamp, to why vampire folklore matters to modern surveying, this episode reveals why attracting new talent means changing how we tell the story. Whether you’re in civil engineering, construction, or leadership, you’ll walk away with fresh perspective on workforce development, cross-generational knowledge transfer, and how family businesses can be a retention advantage rather than a limitation. Key Takeaways: The surveying profession is losing half its licensed professionals to retirement in the next few years, with the average license holder now in their early 60s—creating an urgent need to train the next generation while mentorship is still available. Surveyors carry lifetime liability for every job they stamp—meaning they can be sued for their very first project at their retirement party—yet the profession hasn’t kept pace with inflation on pricing since 2000. The biggest misconception about surveying is that the fieldwork is the work, when in reality, days of courthouse research, calculations, and post-field analysis happen before and after the visible hour on site. Family businesses offer a competitive advantage in retention because people who feel like family at work are more likely to stay, creating natural pathways for the next generation to enter the profession. Reframing surveying from “working in the dirt” to “solving complex problems outdoors with history, math, and law” can attract a new generation who wants intellectual challenge without being desk-bound. Timestamps: [00:24] Introduction – The talent shortage across engineering industries[01:16] The aging crisis in surveying – Half the profession retiring soon[02:17] What surveyors actually do (beyond boundary lines)[06:10] Misconceptions about surveying work and pricing[11:30] Strategies for attracting the next generation[16:45] Why family businesses can be a retention advantage[25:23] Surveying folklore – The boundary pusher vampire[28:07] Leadership advice for introverts in technical professions[29:57] Coach in Your Corner – You are bound by what you define Guest Information: Name: Dustin Gardner, Fourth-Generation Land Surveyor Connect: LinkedIn: https://www.linkedin.com/in/dustin-gardner-rls-292781220/ Instagram: @the_superstitious_surveyor About the Host: Dr. James Bryant is an engineering leadership coach and host of the Engineer Your Success podcast. He works with engineering and technical leaders who want to win at work and win at home. James helps leaders make intentional decisions about how they lead, work, and live, so success in one domain strengthens the other over time. His approach emphasizes clarity, responsibility, and long-term integrity—acknowledging the effort and trade-offs leadership requires while rejecting the assumption that success must come at the expense of family, health, or presence. Connect with James on LinkedIn or visit www.eysnow.com
In this episode of the ASC Podcast with John Goehle we discuss the latest news in the industry. Instrument Decontamination and in our focus segment we discuss Balancing Physician Satisfaction with Patient Safety Through EHR Hard Stop Optimization This episode is sponsored by Surgical Information Systems, Notes and Resources from this Episode: VMG health survey AAC Leader Expectations for 2026 https://1863187.fs1.hubspotusercontent-na1.net/hubfs/1863187/VMG%20Health%20ASC%20Leader%20Expectations%20for%202026%20Survey.pdf Beckers- Red flags in Hospital/ASC Joint Ventures https://www.beckersasc.com/asc-transactions-and-valuation-issues/red-flags-to-watch-in-asc-hospital-joint-ventures/?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=0573H1191845C8E Prepare for the CAIP Exam with our 2 day On-Demand Virtual Conference: Infection Control 101 – Training for Infection Control Coordinators in ASCs (September 2024 Recording) Infection Control 201 – Advanced Training for Infection Control Coordinators (September 2024 Recording) INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this episode of the ASC Podcast with John Goehle we discuss the latest news in the industry, including the nurses strike in New York City, look back on major ASC events in 2025 and in our focus segment, discuss the activities that need to be done as you begin the year, especially focusing on governing body activities. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Prepare for the CAIP Exam with our 2 day On-Demand Virtual Conference: Infection Control 101 – Training for Infection Control Coordinators in ASCs (September 2024 Recording) Infection Control 201 – Advanced Training for Infection Control Coordinators (September 2024 Recording) INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this episode of the ASC Podcast with John Goehle we discuss the current state of ASC Accreditation and the value of Accreditation and in our focus segment, Interview Tom Terranova with QuadA. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: QuadA Website: https://www.quada.org/ INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this episode of the ASC Podcast with John Goehle we discuss the latest news, review common infection control and sanitary environment issues in ASCs and in our focus segment, discuss Navigating the Complexities of ASC Billing and Coding with Bob Lathrop from SIS. This episode is sponsored by Surgical Information Systems, Notes and Resources from this Episode: Cost pressures that battered ASCs in 2025: https://www.beckersasc.com/asc-transactions-and-valuation-issues/the-cost-pressures-that-battered-ascs-in-2025/?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=5567B4088734C3Z Focus on Sanitary Environment and Infection Prevention & Control (IPC) in ASC Surveys Sanitary environment and IPC issues consistently rank among the top deficiencies in ambulatory surgery center (ASC) accreditation and certification surveys, making this a critical "hot issue" for 2025 and beyond. These citations directly impact patient safety by increasing risks of healthcare-associated infections (HAIs), and they appear frequently across major accreditors like CMS, AAAHC, and ACHC. For context: In AAAHC's 2025 Quality Roadmap (released September 2025), IPC remains a persistent top challenge, with deficiencies cited in nearly 90% of surveys for ASCs and office-based surgery settings. ACHC's November 2025 survey data highlights sanitary environment lapses (e.g., sanitation issues, incomplete policies) as a leading deficiency, often tied to inconsistent implementation of hand hygiene, glove techniques, and environmental cleaning. Historical CMS data shows patterns holding into recent years, with "Sanitary Environment" and "Infection Control Program" among the most cited, stemming from failures in basic practices like cleaning, sterilization, and safe injection protocols. These issues often arise from documentation gaps, staff inconsistencies, or overlooked details during busy operations, even in high-performing centers. Key Regulatory Requirements The foundation for sanitary environment and IPC in ASCs is CMS Conditions for Coverage (CfC) at 42 CFR § 416.51, which applies to Medicare-certified ASCs and influences other accreditors (deemed status via AAAHC, ACHC, etc.). Standard: Sanitary Environment (§ 416.51(a)): The ASC must provide a functional and sanitary environment for surgical services, avoiding sources and transmission of infections by adhering to professionally accepted standards (e.g., CDC, AORN, APIC guidelines). Standard: Infection Control Program (§ 416.51(b)): Maintain an ongoing, coordinated program to prevent, control, and investigate infections/communicable diseases. This includes: Designation of a qualified professional (e.g., infection preventionist) to oversee the program. Annual risk assessment to identify infection risks. Integration of nationally recognized guidelines (CDC core practices are mandatory if no other evidence-based standards apply). Policies for hand hygiene, environmental cleaning, sterilization/high-level disinfection (HLD), safe injection practices, and point-of-care devices. INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
Check out these highlights from Day 2 of this year's awesome event!!! 00:10 - Kristie Achee, Sr. Project Manager @ QK & Kathy Nitayangkul, Land Surveyor and Partner @ Polaris Land Surveying 14:00 - Carol Morman, Owner @ CLM Surveying & Engineering and Program Chair, Professor Land Surveying @ Cincinnati State Technical and Community College & Cara Tryling, Professional Land Surveyor @ Brandstetter Carroll Inc. 28:45 - Isabella Totra, Student @ Saint Louis University & Iris Saldana-Zapata, Senior CAD Technician @ Sabak, Wilson & Lingo, Inc and Student @ Vincennes University AND 2026 Geoholics WSS Scholarship WINNERS!! 45:10 - Kaitlin Constantine, Professional Land Surveyor @ DOWL and YOUNGEST female licensed land surveyor in NV & Rita Lumos quite possibly the OLDEST female licensed land surveyor in NV!!! 1:01:20 - Evi De La Rosa Ricciardi, Professor Land Surveying Engineering @ University of Puerto Rico-Mayaguez & Genesis Feliciano, Student @ University of Puerto Rico-Mayaguez & Yanielyz Paola, Student @ University of Puerto Rico-Mayaguez
Check out these highlights from Day 1 of this year's awesome event!!! 04:00 - Heather Markley, Vice President @ Future Surveyors Foundation and Sr Vice President @ LJA Surveying, Inc. 16:00 - Natalie Martinez-Vega, Land Surveyor @ US Army Corp of Engineers & Jade Castillo, Topography Technician @ V. Seda & Associates PSC 37:00 - Trisha Lund, Owner of WLG Surveying Solutions 51:00 - Jeanette Harley, Owner of Harley Surveying & DeeDee Frasure, Surveyor @ Timmons Group 1:02:15 - Schuyler Sears, Survey Field Technician @ IMEG Corp 1:17:00 - Marissa Almiron, Phase Manager @ SAM & Ruth Trujillo Rodriguez, President & CEO @ Ruth L. Trujillo Rodriguez Professional Land Surveyors, PSC 1:33:00 - Alicia Tabachnick, Land Surveyor @ Timmons Group & Tiana Marbuery, Project Surveyor @ McKim & Creed, Inc.
In this episode of the ASC Podcast with John Goehle we discuss the latest news, including the delay in the Pre-authorization pilot and Anthem's new policy on out-of-network providers. In our focus segment we discuss the final 2026 CMS ASC/HOPD Payment Rule This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Final Rule: https://public-inspection.federalregister.gov/2025-20907.pdf Press Release about Final Rule: https://www.cms.gov/newsroom/press-releases/cms-empowers-patients-boosts-transparency-modernizing-hospital-payments Fact Sheet about Final Rule: https://www.cms.gov/newsroom/fact-sheets/calendar-year-2026-hospital-outpatient-prospective-payment-system-opps-ambulatory-surgical-center Downloads for the Final Rule: https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient/regulations-notices/cms-1834-fc ASC Quality Reporting web site: https://www.qualityreportingcenter.com/en/ascqr-program/ ASC Association Web Site (Join to get more information): http://ascassociation.org INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this Special Episode of the ASC Podcast with John Goehle recorded live from the Colorado Ambulatory Surgery Center Association 2025 Annual Conference and Trade Show in Golden, Colorado, we interview some of the attendees, speakers and discuss recent activities for the association and the benefits of membership in the Association. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Link to the Colorado Ambulatory Surgery Center Association Website: https://coloradoasc.org/ INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! http://conferences.asc-central.com Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this Episode of the ASC Podcast with John Goehle we discuss the latest news about the ASC Industry, prepare for the 2025 Multi-State Virtual ASC Conference on Thursday and Friday November 20-21, 2025 and in our focus segment discuss survey preparation and mock surveys with Katie Pierson with Ambulatory Healthcare Strategies. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: ASC News Article by Shelby Grebbin About the importance of patient selection https://ascnews.com/2025/08/as-the-surgical-shift-accelerates-ascs-must-sharpen-their-patient-selection-strategies/?spMailingID=166677&puid=3910766&E=3910766&utm_source=newsletter&utm_medium=email&utm_campaign=166677 AAAHC Quality Roadmap Press Release https://www.aaahc.org/uploads/2025/09/AAAHC_2025-Quality-Roadmap-Press-Release_FINAL.pdf ACHC Top Citations https://achc.org/top-asc-deficiencies-highlight-opportunities-for-improvement/ AORN Article about reducing first case start time delays: https://www.aorn.org/article/reducing-first-case-start-time-delays INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
Measuring Snow: Citizen Science in the CatskillsSummary: Winter in the Catskills isn't just about skiing, sledding, or shoveling. Snowpack plays a critical role in our water resources, local economies, and even global climate regulation. In this episode, Brett Barry speaks with Dr. Marco Tedesco of Columbia University's Lamont‑Doherty Earth Observatory, about the NASA‑funded X‑Snow Project — a citizen science initiative inviting volunteers to measure, photograph, and collect snow data across the region.Together, they explore how local observations help validate satellite models, improve climate predictions, and build community engagement around environmental stewardship.
In this Special Episode of the ASC Podcast with John Goehle recorded live from the Washington Ambulatory Surgery Center Association Annual Education Conference in Tulalip WA we interview some of the speakers and discuss recent activities for the association and the benefits of membership in the Association. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Washington Ambulatory Surgery Center Association Website: https://wasca.net/ Membership Benefits: https://wasca.net/join/benefits-of-membership/ INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this Episode of the ASC Podcast with John Goehle we discuss the latest news and information in the ASC Industry, discuss the effect of the Government Shutdown on CMS Surveys, review the recent Amazon Web Services issues and its impact on ASC Computer Systems and celebrate Cybersecurity Month with Paul Alcock from Surgical Information Systems. This episode is sponsored by Surgical Information Systems, Notes and Resources from this Episode: Memo #QSO-26-01-ALL REVISED REVISED: Contingency Plans – State Survey & Certification Activities in the Event of Federal Government Shutdown https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos/policy-memos-states-regions/revised-contingency-plans-state-survey-certification-activities-event-federal-government-shutdown ASCA Survey on EMR Adoption in ASCs https://www.ascfocus.org/ascfocus/content/articles-content/articles/2025/digital-debut/asca-survey-shows-continued-growth-of-ehr-usage-by-ascs?_gl=1*skvj45*_ga*Mjg5MjgyMjUzLjE3NDk1NTUzOTk.*_ga_5DE4L5HXFY*czE3NTYxNzM2ODckbzQwJGcwJHQxNzU2MTczNjg4JGo1OSRsMCRoMA.. INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this Special Episode of the ASC Podcast with John Goehle recorded live from the New York State Association of Ambulatory Surgery Centers 2025 Annual Conference in Albany, New York we interview some of the speakers and discuss recent activities for the association and the benefits of membership in the Association. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Link to the New York State Association Website: https://www.nysaasc.org/ INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! http://conferences.asc-central.com Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this Special Episode of the ASC Podcast with John Goehle recorded live from the Oregon Ambulatory Surgery Center Association Annual Conference in Portland, Oregon we interview some of the speakers and discuss recent activities for the association and the benefits of membership in the Association. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Membership Information for the Oregon Association: https://ascoregon.org/ INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
What do Joint Commission surveyors really look for when assessing your diversion prevention program?In this episode of Rxpert Solutions, I'm joined by Marianne Sevcik, RN, MSN, of Partnership Consulting International LLC, and Meggan McGraw, MSN, CNS, RNC — both former surveyors for The Joint Commission — to share insider insights from years of conducting hospital and compliance surveys.We explore:- How surveyors evaluate diversion prevention program effectiveness- The red flags and key phrases that trigger deeper review- Balancing regulatory compliance with real-world practicality- How to respond when you disagree with survey findings- What surveyors think about emerging tools like AI-powered diversion monitoringWhether you're preparing for accreditation or refining your controlled substance diversion program, this episode gives you a rare surveyors' perspective on how to build programs that go beyond compliance—and truly protect patients, staff, and controlled substances.More from Rxpert Solutions: https://www.rxpert.solutions/?utm_source=spotify&utm_medium=insights&utm_campaign=surveyor
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Top Stories for October 7th Publish Date: October 7th From The BG AD Group Studio, Welcome to the Gwinnett Daily Post Podcast. Today is Tuesday, October 7th and Happy Birthday to John Mellencamp I’m Peyton Spurlock and here are your top stories presented by KIA Mall of Georgia Fox Theatre continues Coca-Cola Film Series with screening of 'The Phantom of the Opera' Iconic Italian tenor Andrea Bocelli reflects on 30 years of music ahead of Gwinnett concert Gwinnett honors Jimmy Carter's life on his 101st birthday All of this and more is coming up on the Gwinnett Daily Post podcast, and if you are looking for community news, we encourage you to listen and subscribe! Break 1: Kia MOG STORY 1: Fox Theatre continues Coca-Cola Film Series with screening of 'The Phantom of the Opera' The Fox Theatre is bringing a little magic—and a lot of nostalgia—to its Coca-Cola Film Series with a special screening of the 1925 silent classic The Phantom of the Opera on Oct. 29. Here’s the twist: the film will be accompanied live by organist Ken Double on the Mighty Mo, the Fox’s legendary 1929 Möller pipe organ. If you’ve never heard it, you’re in for a treat—it’s massive, intricate, and honestly, a masterpiece in itself. But that’s not all. Expect Phantom-inspired photo ops, a peek into the Fox’s own history with the film, and, for Marquee Club guests, custom watercolor portraits by Lexi Brite’s team. Exclusive, artsy, and unforgettable. Tickets? Head to foxtheatre.org. STORY 2: Iconic Italian tenor Andrea Bocelli reflects on 30 years of music ahead of Gwinnett concert For over three decades, Andrea Bocelli has been enchanting audiences worldwide with his voice—one that feels like it was made to stir souls. At 67, the legendary tenor from Italy, has sold over 90 million albums, but it’s his live performances that truly leave people breathless. On Saturday, Oct. 11, Bocelli will bring his magic to Gas South Arena in Duluth, performing a mix of operatic arias, crossover hits, and selections from his album A Family Christmas. With Maestro Steven Mercurio conducting and surprises promised, it’s a night not to miss. STORY 3: Gwinnett honors Jimmy Carter's life on his 101st birthday Even though former President Jimmy Carter wasn’t there in person last Wednesday, Tiffany Parks felt his presence everywhere. As volunteers hammered and sawed away at what will soon be her new home in Lilburn, she couldn’t help but think of the man who championed Habitat for Humanity for decades. “This is special—for him, his family, his legacy,” Parks said. Wednesday would’ve been Carter’s 101st birthday, and Gwinnett County honored him in every way imaginable: a Habitat build, a mural at Best Friend Park, blue lights on Jimmy Carter Boulevard, and heartfelt tributes. “He showed the world that everyone deserves a home,” said Habitat’s Eric Miller. We have opportunities for sponsors to get great engagement on these shows. Call 770.874.3200 for more info. We’ll be right back Break 2: CITY OF SUGAR HILL STORY 4: Gwinnett road closures Oct. 4-10 Here’s what’s happening with Gwinnett road closures for Oct. 4-10, courtesy of the Department of Transportation: Albion Farm Rd: Lane closures through October for utility work. Ballpark Ln: Closed until November for construction. Detour via Rock Springs Rd and Buford Dr. Beaver Ruin Rd over I-85: Lane closures through April 2026 for bridge work. Buford Dam Rd: Lane closures for improvements. Info: 678.231.3190. Lakeview Rd: Closed for bridge replacement. Detour via Grayson Pkwy. For the full list or questions, email DOT Community Relations at dotcommunityrelations@gwinnettcounty.com. Stay safe out there! STORY 5: EXPLORING GWINNETT'S HISTORY: Your Parcel ID and the 1820 Land Lottery Ever wonder where your property’s parcel ID comes from? Turns out, it’s not random—it’s rooted in history, all the way back to Georgia’s 1820 Land Lottery. Back then, the state divided up land taken from Native Americans through treaties and forced removal, creating opportunities for white settlers to claim plots. Gwinnett County, established in 1818, was part of this process. Surveyors carved the county into districts and 250-acre lots. The first digit of your parcel ID? That’s your lottery district. The next three? Your original land lot. The last three? Your slice of that lot today. Curious who won your land? Visit the Gwinnett Historical Society in Lawrenceville! We’ll be right back. Break: LILBURN DAZE STORY 6: The Lights Fest coming to Lanier Islands Resort On Oct. 25, the night sky over Lake Lanier will come alive with thousands of glowing lanterns as The Lights Fest makes its Atlanta-area debut at Lanier Islands Resort. Picture it: a lakeside evening filled with music, dancing, and the quiet magic of lanterns drifting into the dark. Hosted at PineIsle, the event invites people to release biodegradable lanterns—simple rice paper, bamboo, and string—symbolizing hope, remembrance, or just letting go. Some come to honor loved ones, others to dream, and some just to soak in the beauty. A portion of proceeds supports the Georgia Mountain Food Bank. Want to stay the night? Lanier Islands is offering a special package with tickets and accommodations. Details at lanierislands.com. STORY 7: Georgia Tech Switching to Under Armour from Adidas for Uniforms, Apparel Big news for Georgia Tech fans: starting July 1, 2026, Under Armour will officially take over as the Yellow Jackets’ provider for uniforms, apparel, footwear, and accessories. Yep, the same brand outfitting Notre Dame, Maryland, and Wisconsin is coming to Atlanta. This partnership isn’t just about gear—it’s about innovation. Under Armour’s investment includes NIL opportunities for student-athletes and even hands-on roles in product design. Fans? Expect more Tech merch hitting stores soon. Fun fact: Georgia Tech was Under Armour’s first collegiate client back in 1996. Now, nearly 30 years later, they’re reuniting. Full-circle moment, right? Stay tuned for uniform reveals! We’ll have closing comments after this. Break 4: Ingles Markets Signoff – Thanks again for hanging out with us on today’s Gwinnett Daily Post Podcast. If you enjoy these shows, we encourage you to check out our other offerings, like the Cherokee Tribune Ledger Podcast, the Marietta Daily Journal, or the Community Podcast for Rockdale Newton and Morgan Counties. Read more about all our stories and get other great content at www.gwinnettdailypost.com Did you know over 50% of Americans listen to podcasts weekly? Giving you important news about our community and telling great stories are what we do. 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In this Special Episode of the ASC Podcast with John Goehle recorded live from the Ohio Association of Ambulatory Surgery Centers Annual Conference in Columbus Ohio we interview some of the speakers and discuss recent activities for the association and the benefits of membership in the Association. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Membership Information for the Ohio Association: http://www.oaasc.net/aws/OAASC/pt/sp/join ASCA Membership Information: https://www.ascassociation.org/asca/membership/join-renew Dinsmore https://www.dinsmore.com/ INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
This week, we feature a special surveyor who is more than doing her part to promote the profession and help educate our future surveyors! "Surveyor Says! The NSPS Podcast" finds us chatting with Kimberly Odom, PSM and owner of Delta Land Surveyors in Monticello, FL. She leads the way with the multi-generational business (learning the biz from her father!) and having family around her every step of the way. Tim Burch recently caught up with Kim to talk about her promotion of the profession at public events and parades as well as "planting the seeds" within elementary school kids about the wonderful career of surveying. You can't help but being impressed after this episode, so check it out today!
In this episode of the ASC Podcast with John Goehle, we discuss the latest news and trends in the ASC industry, discuss the Annual Report to Congress by CMS on the Program Oversight of Accrediting Organizations and in our focus segment, we interview Kara Newbury from ASCA about the 2026 Proposed CMS ASC Payment Rule. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Anesthesia Time Limit Laws (From Beckers): https://www.beckersasc.com/anesthesia/anesthesia-time-limit-laws-where-3-bills-stand/?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=0573H1191845C8E CMS Prior Authorization: https://ascnews.com/2025/09/ascs-still-struggling-with-prior-authorization-despite-payer-pledges/ QSO-25-25-AO/CLIA - FY 2022 Report to Congress (RTC): Review of Medicare's Program Oversight of Accrediting Organizations (AOs) and the Clinical Laboratory Improvement Amendments of 1988 (CLIA) Validation Program: https://www.cms.gov/files/document/qso-25-25-ao/clia.pdf INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this Special Episode of the ASC Podcast with John Goehle recorded live from the California Ambulatory Surgery Center Association 2025 Conference in San Diego, California we interview some of the speakers and discuss recent activities for the association and the benefits of membership in the Association. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Link to the California Association Website: https://casurgery.org/aws/CASA/pt/sp/home_page Link to Join CASA: https://casurgery.org/aws/CASA/pt/sp/membership INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! http://conferences.asc-central.com Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this inspiring episode of The Geoholics Podcast, Kent is joined by special guests Anna Rios and Amanda Allred to shine a spotlight on the Future Surveyors Foundation and the upcoming Women Surveyors Summit (WSS) 2025 in Las Vegas. The show kicks off with Geoholics news and happenings—INTERGEO, Trimble Dimensions, and, of course, the highly anticipated Women Surveyors Summit in October. Powered by EMLID and supported by our incredible sponsors, this episode blends industry updates with thought-provoking dialogue about the future of surveying. The guests share the origin story and mission of the Future Surveyors Foundation—creating opportunity, inspiration, and support for a diverse geospatial workforce. Listeners get an inside look at programs like PRISM+ALLIES, the Women Surveyors Summit, and mentorship partnerships designed to strengthen the profession while opening doors for underrepresented groups We dive deep into the philosophy behind the Summit—“for women, by women”—and what that means for event design and delivery. From continuing education tracks to ethics sessions, the 2025 edition promises fresh opportunities for growth, networking, and empowerment. The conversation highlights why Las Vegas was chosen as the host city and teases some standout program elements happening October 23–26, 2025 The Foundation also proudly announces the Geoholics Scholarship winners—Isabella Totra & Iris Saldana—future leaders carrying the torch for the next generation of surveyors As always, we add a cultural twist with our Song of the Week: Tim McGraw's “Humble & Kind”—a reminder of the values that guide both our personal lives and professional journeys Listeners also catch the latest GEODNET count update, proving that satellites, crypto, and surveying are more connected than ever. The episode closes with a powerful challenge: what can you do to inspire and support the next generation of surveyors? Whether it's attending the Summit, mentoring, or sponsoring initiatives, the message is clear—change starts with community and commitment. #addvalue #makefriends #beageoholic
In this Special Episode of the ASC Podcast with John Goehle recorded live Live from the Live from the Illinois Ambulatory Surgery Center Association 2025 Meeting in Rosemont, Illinois we interview some of the speakers and discuss recent activities for the association and the benefits of membership in the Association. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Link to the Illinois Association Website: https://il-asca.org/home Link to the Infection Control Worksheet Referenced in the Interview with Laurie Roderiques: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! http://conferences.asc-central.com Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this episode of the ASC Podcast with John Goehle, we discuss the latest news and trends in the ASC industry and in our focus segment, we interview Laurie Roderiques, Director of Clinical Services for Ambulatory Healthcare Strategies during the Illinois State Association Meeting and discuss the Infection Control Risk Assessment and the CMS Surveyor Infection Control Worksheet. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: ASC News- Management should be engaged with staff to avoid potential risks: https://ascnews.com/2025/07/employment-attorney-urges-ascs-to-stay-engaged-with-staff-watch-for-legal-risks/?spMailingID=164824&puid=3910766&E=3910766&utm_source=newsletter&utm_medium=email&utm_campaign=164824 Garfunkel Wild ASC $250,000 settlement emphasizes security risk analysis requirement https://garfunkelwild.com/insights/surgery-center-250000-settlement-emphasizes-security-risk-analysis-requirement/ The Office of the National Coordinator for Health Information Technology (“ONC”), in conjunction with the OCR, has published a tool that can be used by small- to medium-sized covered entities to perform the SRA internally. Here is the link to the tool: https://www.healthit.gov/topic/privacy-security-and-hipaa/security-risk-assessment-tool. Infection Control Focus Segment: Link to the Infection Control Worksheet Referenced in the Interview with Laurie: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Link to Training on Infection Control: Infection Control 101 – Training for Infection Control Coordinators in ASCs (September 2024 Recording) Infection Control 201 – Advanced Training for Infection Control Coordinators (September 2024 Recording) INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
As human-driven climate change makes winters shorter, ticks are spreading to new parts of the country. And when ticks find hospitable homes, they bring new tick-borne illnesses to the humans who live there. Now, surveyors in Montana are searching for invasive ticks to track and prepare for the diseases they can carry.
Quaranteam-Northwest: Part 5 Lab work. Based on a post by Break The Bar. Listen to the ► Podcast at Explicit Novels. Time went quickly, but also seemed to go nowhere at all; only three days after the final demise of the house we'd moved the RVs four times and I decided we needed to figure out something at least semi-permanent. Even a week in the same spot would be preferable to constant movement. The space where my house had stood was now full of stacks and pallets of supplies, and Vanessa had a crew of almost two dozen of her 'gorillas' working to erect what would become the first of a dozen temporary bunkhouses for the incoming construction workers. She still seemed to be the only foreman on site, so I went looking for Vanessa. I found her at the water truck, splashing some water onto the back of her neck as she took a quick break. It had turned even hotter over the week, spring slipping fully into summer, and we were all starting to boil when we were outside. I'd quickly abandoned the feeling of needing to 'dress up' for everyone and I was down to athletic shorts and one of my sleeveless workout shirts; one of the few that were still 'mine' considering both Erica and Ivy had taken to wearing them as well. Vanessa was the boss however and had to set the example for the rest of the crew, so she was still wearing the jeans, long-sleeved t-shirt and her reflective vest of a dutiful construction foreman. "Hey, got a second?" I asked. "Oh, hey Harrison," she said, looking up as she continued splashing water onto the back of her neck. "Sorry I haven't come to check with you and the girls today, we had three more loads this morning of barracks pilings I had to get sorted, and the fucking surveyors are still bitching about not knowing where the sewage lines are going to come onto the property, as if I can fucking answer that question for them or something." "When's your Dad supposed to finally get on site?" I asked. Her father was supposed to be the General Manager of the entire construction project, but so far I had yet to have seen him. "Fuck, a few days still at least," Vanessa sighed. "I'm getting tired as shit of the phone tag." "Well, sorry if this is a big ask and causes you more headaches; any chance we could project ahead a bit and figure out where we can stash the RVs and everything where we're not going to need to move them for a while? Moving everything around is annoying by itself, but I've also noticed some of your guys are spending a lot of time wandering by the RVs whenever the girls are outside." "Fucking gorillas," Vanessa grunted and grimaced. "I mean, on the one hand, I get it; they are either cooped up in the motel or here working. I'm not exactly thrilled with the situation either. But they could keep it in their fucking pants too, ya know?" "Look, if we can find a spot, the way I see it we can use the RVs and Containers to set up a yard for us that's blocked from view. Then we can have some privacy and not feel cooped up in the RVs, and your guys aren't tempted to let their eyes wander," I said. "I figure it's a win-win." Vanessa smiled and patted my arm. "Harri, as long as you keep the fucking indoors, I'll see what I can do about getting you guys some more privacy." "What do you mean?" I asked, suddenly a little worried that Erica and I might have gotten caught at the Willow tree after all, or that maybe a surveyor had wandered up near the Spring without us hearing. "Nothing, nothing," Vanessa said. "I just; you know we can see the RVs rocking a bit, right? And I don't know who it is, but someone over in your camp is a screamer. We can hear her when she really gets going. Once the guys even gave you a standing ovation." "Fuck," I coughed, shaking my head. "I'm sorry. I think it's something to do with the vaccine. I've had more sex in the last four days than I have in the last four years. Honestly, I don't even know how I'm doing it; I ain't old, but I'm not a teenager either." "Well, god bless the vaccine I guess," Vanessa smirked. "And good for you. Just do me a favor and keep it inside the RVs 'till we can get you that privacy. We don't need the entire site shutting down to listen to you fucking your girlfriends." I shook my head again with a self-deprecating smirk. "Um, deal. I hope." That made Vanessa chuckle, and we parted ways for the afternoon. The next day, she came back in the morning and explained the plan she had worked out with the Surveyors and one of the tree-clearing crews. By mid-afternoon, a new swathe of the back end of the hill was bare of trees, and a bulldozer scooped dirt into the holes left by ripped-up stumps. By the time Vanessa left that evening, two of the storage containers had been shifted around by the 'gorillas' and positioned in an L-shape for us in the new location, and Leo and I moved the RVs to form the other two sides of a square. When Vanessa came by the next morning we'd hung up some old, heavy blankets at the corners to maximize our privacy, busted out the lawn chairs and barbecue, and were on our way to turning the space into an outdoor living room. Leo and I even went so far as to rig up an old bell we'd salvaged from the barn on a wooden post with a metal knocker on a string to serve as a doorbell. Erica was the one to answer Vanessa's ring of the bell, and she swept aside the blanket curtain. "Welcome to Casa de Black," she declared. "Jesus," Vanessa said, walking into our new home base. "You guys didn't want to wait, did you?" "Why would we?" Leo asked. "We don't know how long we're going to be living like this, so might as well make the most of it." Leo had decided to make one last addition to our current set-up, and had pulled a loose slab of wood from the container holding all his tools and was carving 'Speak Friend and Enter' into it the makeshift sign with his handheld angle grinder. He'd already been talking about using his torch to burn the wood before giving it a clear lacquer coat. "What can we do for you, Vanessa?" I asked. "Need some breakfast?" "Actually?" Vanessa chewed on the inside of her cheek for a second and peeked back outside the yard. "Breakfast would be fucking great. They're feeding us at the motel, but it's been the same instant oatmeal every fucking morning." "Well, we've yet to have our egg hookup dry out on us," I said. Old Mrs. Branston lived about fifteen minutes down the highway and had been selling eggs to three generations of my family; through the pandemic and quarantine we'd set up a system where I called ahead and she dropped off two dozen eggs at the end of her driveway, and I left a ten dollar bill in her mailbox. "How do you like them? I think I'm getting pretty good at using the grill with a frying pan." We hosted Vanessa for about fifteen minutes as I fried her up some over-easy eggs and some toast to go with it, and she started devouring the first two so quickly that I put another two in the pan for her immediately. While I cooked, she shared the most recent gossip running through the construction crews. "So the latest group to come in said they got tested four times before even leaving the airport," she said around a mouthful. "They were basically flown into Portland, put in little hygienic pods inside the terminals until they'd tested negative all four times, then escorted to military transports. I guess the army is our taxi service or something, and there are members of the national guard currently standing watch at all of the motels. It's kind of fucked up and feels like a prison, honestly. We're not even supposed to mingle outside with each other, despite the fact that we all work together here all day." "Who's feeding you all?" Danielle asked. "Just the people already working out there seems like a lot." "Some catering service is making these prepackaged meals," Vanessa said. "The breakfasts are shit, and the lunches are whatever. The dinners are Okay though; microwavable, and waiting for us when we get off shift." "Have you heard anything else out there about the vaccine?" I asked. "Hmm-Hmm," Vanessa shook her head. "But I mean, I spend my time working." "I'm still not seeing much online," Leo said. "Little whispers on social media, but then it disappears before it gets going." "That's kinda fucked up," Erica said. "We know it's real. The government must be censoring the information or something. "Well, whenever it happens, I don't know what I'll do," Vanessa sighed. "I like working too much, being my own woman. I bring in more cash in a year than almost every other person I graduated high school with, I've been doing it for years, and I don't have any debts. I can't just get tied down to some guy." "You would be surprised, Vanessa," Ivy spoke up. "I am this way too, no? I left home to make my way, and I am happy doing it. But now I am happy here, and am also safe from the sickness. It is not how I saw my life going, but c'est la vie, non?" Vanessa shrugged, and we moved on to some other topics until her radio squawked and she had to run off back to her work. By lunchtime I'd already done another two quick guides into the hills for the surveyors and Leo had gotten his nerd-sign carved out and torched, and he was spray lacquering it outside the yard with a facemask and safety goggles on to cut the strong fumes. He stopped the sprayer when he saw me approaching and stepped away from the sign. "Hey, you able to help me out with hanging this tonight?" he asked me. "Of course," I said. "I gotta help you fly your nerd flag somehow." "Yeah, says the guy with the Lord of the Rings concept art cycling as his desktop screen," Leo rolled his eyes. "It's for my work," I said. "Top-notch inspiration." And then I realized I hadn't opened my laptop in days; not since I'd finished the questionnaire that had led to Erica choosing me. And Ivy for that matter. I hadn't checked emails, I hadn't reached out to contacts. Fuck, I hadn't even sent in my last work-for-hire backgrounds. "Whatever," Leo laughed and punched me in the arm. "Look, when you go in there, just know it wasn't my idea, Okay? I only helped them move the stuff." "What does that mean?" I asked. "You'll see," Leo said cryptically. I ducked through the blanket door and immediately saw what Leo was talking about. Space had been cleared in the center of our sheltered yard for three of the heavy Adirondack deck chairs, and laying in those chairs were Danielle, Erica and Ivy. Each of them was wearing a bikini and were glistening with sunscreen and sweat from the sun as they tanned. They had a Bluetooth speaker playing songs from their phones; I suspected Erica was trying to convince the younger two women of the virtues of mid-2000s pop punk. "Oh, good," Erica said, grinning as she saw me coming into the yard. She lifted her glass. "Um, excuse me, waiter? We could use a top-up, please." I snorted and shook my head, walking over. All three of the women were in two-piece swimsuits, though I suspected Danielle and Ivy's were possibly part of their stripping gear rather than actual bikinis. Both of their suits were more string than fabric and left little to the imagination. Erica's was a bit more conservative, though really not by that much because of her swathe of cleavage. "What are we drinking today, ladies?" I asked. "I made up a pitcher of sangria," Erica said. "It's in the fridge in our place. You would be the absolute love of my life if you were to go get it for us, please?" "I thought I already was the love of your life?" I asked with a smile. "You are," Erica smiled back. "But this will get you to the front of the line for my next life, too. How about that?" "Does that go for all of you?" I asked. "Absolutely," Ivy grinned. "I think I could definitely do worse," Danielle grinned. "But I think Leo might have something to say about that." "Harri can take my brother," Erica chuckled. "Don't worry, Danni. Just sell your future soul to Harri, what's the worst that could happen?" "Fine. My future love life for a refill of sangria," Danielle giggled. I fetched the pitcher and poured for the three women, unable to wipe the grin from my lips as I watched and listened to them bantering back and forth happily. By mid-afternoon, the tanning was over and after a quick fuck in the RV Erica and I were lounging in the Adirondacks, each of us with a sketchbook in hand. "What are you working on?" I asked. "I know you've been as frustrated as I have over the last month." "A tattoo design for Ivy," Erica said, her brow creased as she tapped her pencil against her lips thoughtfully. "Now that I have a future canvas, I feel like I can concentrate again. Plus the sex helps a lot." You laughed and nodded. "Got your creative juices flowing, huh?" "Got all my juices flowing, baby," she grinned at me. "What about you? I've got Ivy, and Danielle wants me to design something for her now, too. What's got you drawing again?" I smiled a little and shrugged. "Just figured out my muse," I said. "And what's that?" she asked. "Come on, don't be shy." I turned my sketchbook around so that Erica could see the portrait I had been sketching of her. She looked at it and blushed, biting her lower lip. "Just the most beautiful thing in the world," I told her. "You know," Erica said. "It kinda looks like you're drawing me naked." "That's cause I'm drawing you from the shoulders up," I said. "Yeah, but would you?" she asked. "Would I what? Draw you naked?" "Or Ivy?" "Are you asking me to draw you like one of my French girls?" I asked. Erica barked out a laugh at the reference and threw her pencil at me. "Yes, maybe I am," she said. "Now give me back my pencil." "You threw it at me," I said, fetching it off the ground. "Come and get it." We ended up in each other's arms and making out, me halfway to taking her back into the RV for round two, when someone rang the doorbell. "Who is it?" I shouted over the wall. "It's me," Vanessa called and ducked through the blanket door without waiting for a response. "Sorry, but we've got a problem," she said. "I think I'm going to need you down at the road again." "Fuck," I said. "Is it Kara?" "It's a lot more than that bitch," Vanessa said. I changed and this time Vanessa drove us both down in her company-branded pickup truck. Erica, having already staked her claim on me in front of Kara in her eyes, decided to hang back and let Ivy finish what I'd started. I was sure sending me away with that picture in my mind was done on purpose. As we were nearing the bottom of the driveway, I could hear the noise of the protest through the closed windows and over the engine of the truck. "Fuck me," I said. "Yeah," Vanessa nodded. The end of the driveway was packed with people, shoulder to shoulder, blocking traffic. They were three rows deep and singing a protest chant. Every single one of them was dressed in bright colors, showing their allegiance to the Band and proudly shouting for all they were worth. Opposing them, about ten feet up the drive, was a slim, single row of burly construction workers just watching the protest happen. "Those guys really can't let themselves get baited," I said. "If something happens, it doesn't matter who said what or what can hold up in court. There'll be big, scary motherfuckers showing up wanting to do some damage and I don't think your boys are ready for that." "I know, I already told them," Vanessa said. "But I'll tell them again. You'd be surprised how much threatening someone's big, fat bonus checks can keep them calm and focused." We got out of the truck and I walked down to the line of workers, rubbing at the stubble on my chin as I considered the protestors. There were easily fifty of them blocking the driveway, and there was already a backup of two flatbed trucks on the highway, plus a half dozen cars that looked more like they just wanted to get by rather than come in. Another thirty or so protestors were strung out on either side of the highway in both directions, holding up signs and doing the organizational things to keep the protestors going. "Pretty good turnout," I said offhandedly. "A lot bigger than last time." "When was the last time?" Vanessa asked. "Five years ago," I said. "Kara tried to sue for an injunction on my father's Will, and about a dozen protestors showed up to the courthouse the day she got shot down." "Any chance they'll get tired and go home?" Vanessa asked. I scanned the crowd and the vehicles parked up and down the highway. I already knew there were about thirty military-age males in the protest, and I could see people opening the backs of vans where I spotted supply caches of water and food. I could also see the determination on the faces of the crowd, and hear the declarations of a couple of different women holding loudspeakers. The rhetoric, and emotions, were ramped up more than usual. The anti-government hate was high, and now that they knew they weren't fighting Me but rather the Government it seemed to steel their resolve. "Not a shot," I said. I stepped forward and the shouting got louder. Likely every single person in that crowd knew who I was, while I had no idea who most of them were. But with every step I took, they shouted louder. Finally, halfway between the lines, they seemed to be at a fever pitch and I just stopped and waited. They kept going for a good five minutes before Kara pushed her way through and walked up to me, masked behind those bandanas again. "I told you this would happen," Kara said over the shouting and chanting. "You didn't think I could do it, but look at us. Look at us, Harrison! We will not let this happen to our land." "Kara," I said loudly. "How do you think this ends?" "Only one way," Kara shouted. "The Feds surrender to our rightful claim, and stop their colonization efforts, and we take back what's ours." "This is dangerous, Kara," I said, gesturing at the crowd. "What?" she shouted back. "I said this is dangerous, Kara," I shouted. "Every person here is in danger." "Are you threatening us?" Kara shouted, playing it up for the crowd behind her. "Going to kill us, like your family has done for generations?" "Jesus fuck," I said, shaking my head. "Kara, this doesn't end the way you think it does. I'm going to pray for you, honest to God." Kara just held up her middle finger at me, pointed her other at Vanessa behind me, and turned and walked away to the cheers of her people. I shrugged and went back to Vanessa. "Yeah, they aren't leaving," I said. "I already called my Dad," Vanessa said. "He's coming down and will want to meet with you." "Sure," I nodded. "If they let him through." About thirty minutes later the protesters were still going strong, and another three flatbeds with either supplies or heavy machinery were backed up on the highway, along with dozens of cars. Vanessa was doing as much as she could to keep her workers at least a dozen yards away from the crowd of protestors; the last thing she wanted was for them to need to get quarantined waiting on a half dozen new tests. Or worse, actually catch something. I did my best to help her juggle phones, calling various General Foremen to get incoming trucks rerouted to staging areas and to keep those that were stuck in the traffic in their cabs or else they couldn't enter the site. Eventually she got a call, spoke quickly and then hung up. "Harri, this might be a big ask, but could you do me a favor?" she asked. "The government paid me a lot of money for my land and doing favors," I said. "But you've gone out of your way plenty for me and Leo and the girls. Favors come free to you, Vee." She rolled her eyes. "Who told you my brothers call me that?" "No one, just felt natural," I chuckled. "I call Erica 'E' sometimes, and I'm sure I'll end up calling Ivy 'I've' at some point." "Alright, well, 'H,'" she said. "My dad is parked down at the edge of the property on the highway and doesn't want to get too close to the traffic. Could you hike out to him and bring him back?" "Sure," I said. I looked up at the sun and then out at the woods. "Um, from here... it's probably faster if I grab an ATV. Would he be squeamish about riding double with me?" Vanessa snorted. "He probably wouldn't be, but he's also got a gut the size of your ATVs so it would be a tight fit." "Alright, guess we're hiking. I can rough it and reach him in about twenty minutes," I said. "I'll take a smoother way back for him, so we'll get here in under an hour." "Got it, I'll let him know you're on your way. Thanks," she said, patting my arm. "Try to take it easy on him, he growls like a bear but he's still my Dad." "Hey, he's the big man in charge. Gotta keep him happy or else I'll find myself with the worst workers for my house, right?" "Very true," she laughed. I started hiking back up the driveway a little ways, and then diverted into the woods, hoping that the protestors would miss that I was skirting away from them. I was very glad I had changed from my lounging around clothes; rough jeans and my hiking boots were a lot sturdier in the rocky bush than athletic shorts and sandals. The raucousness of the protestors was quickly muffled by the forest to a dull roar, and it felt good to get away from them. It was weird. After spending months in isolation with Leo and Erica, we'd been getting used to so many people around again with the workers and adding Ivy and Danielle to our weird little family dynamic. But a crowd like that, all packed together? That was exactly what the quarantine orders were warning against. "Harrison!" My name cut through the muffle of the trees and shrubs, and I turned and saw Kara quickly jogging through the woods to catch up with me. "Kara, what the fuck are you doing? You're trespassing," I said. "So throw me off your land," Kara said, coming to a stop about ten feet from me and putting her hands on her hips. "Oh wait, that's right, it's not your land anymore." I rolled my eyes. "You can take off the bandanas if you want. We're fine this far apart." She did so, pulling them down to hang around her neck. Kara was still as beautiful as the day we'd broken up, though she'd grown up a lot. Where I was such a mix that it was hard to tell I had any Native American in my bloodstream, she had that classic warm skin tone and thick black hair. She'd been taking care of herself well, fit and a little thinner than Erica was, but with a similar strong jawline to my girlfriend. Her lips were as full as I remembered though, and I could almost feel her kissing me again like all those years ago behind the corner of the biology classroom in high school, or laying out in the back of my old beater pickup under the stars. "What's going on, Harri?" she asked me. "I thought we'd at least hit a status quo or something." "Oh, the one where you file a lawsuit against me every couple of years, and the judge shuts you down, but I keep having to rack up legal fees?" "No," she said. "Well, sort of. I thought we were keeping things above board. No games, no gimmicks. Not getting historical." I grimaced. "Well, we did," I said. "So what the fuck?" she said, throwing her arms wide. "What the fuck is all of this?" "Kara, think about it for one fucking second without your prejudice. Imagine I'm not just doing this as a 'Fuck You' from my family tree to the Band," I said. "A week ago I wouldn't have thought any of this would be happening. A week ago I was happily living my life and would have stayed that way straight through the end of the world if I had to. Do you seriously think I've done this on some whim?" "Why, then? What are they doing? What are they offering you?" she demanded. "You wouldn't believe me if I told you," I said. "And even if you did, I think you're too far into this already to walk it back with your people." "Try me," she said. "If you ever cared about me,” "Stop," I interrupted her. "You've used that line twice on me before, Kara. You used it when you broke up with me, and you used it again right after my father died. That line didn't work when I was at some of the lowest points in my life; do you seriously think I'll respond well to that here?" She grimaced, and I saw the realization in her eyes that I was right. That she had used that line before, and it had been pretty fucked up for her to do that. "I'm sorry," she said, and only partially through gritted teeth. "I shouldn't have done that." "Thank you," I said. My heart was pounding in my chest and I felt like I was in combat, just having this verbal sparring contest with her. I fucking hated her, but I also still knew she was the first girl I'd ever loved. The one that had broken my heart. The one that 'got away.' "Just explain it to me," Kara said, trying to be more even about it. "Please." I took a moment to breathe deeply. I wasn't barred from telling her anything. I'd tried to warn her when she'd shown up at the driveway before, but the thought of all those protestors at risk for the virus pushed me over the edge of trying to warn her again. "Kara, the government gave me the choice of accepting a huge payout for the land, or them kicking me out and taking it by eminent domain. Either way, they were going to take it and take it fast. I could either ride it, or die fighting it." "So what are they doing with it?" she asked. "Building homes," I said. "A whole gated community, it sounds like. Part of my payout was housing for myself, Leo and Valerie." "What the fuck? Why do they want a gated community way out here?" she asked. "Worst-case scenario shit," I said. "You mean the pandemic?" she asked. "Are you for fucking serious?" "Serious enough that my house got bulldozed a couple days ago," I said. "Gone. Like it was never even there." "This can't be real," Kara said. "This is absurd." "I told you that you wouldn't believe me," I said. "Well, if you were too much of a cunt to stop them, we will," Kara said, steeling herself again. "We'll have the local news down here by tomorrow, and if the Feds show up we'll have national news coverage by the end of the week." I had to try one more time. "Kara, this doesn't end the way you want it to. You're a dreamer, and I loved that about you when we were teens, but you know the real world doesn't just work like that." Kara narrowed her eyes. "Where are you going right now?" "What does that matter?" I asked. "Because I just followed you out into the woods after your little construction girlfriend was talking to you," she said. "She's not my girlfriend," I rolled my eyes. "Tell her that. She's flirting with you hard enough," Kara said. "I can see her doing it." "Even if she was, what does that have to do with you?" I asked. I knew I'd landed a blow because she got angry again. "Nothing," she said. "But I still want to know what you're doing." "I don't have to tell you that, Kara," I said. "I don't answer to you, I don't owe you anything, and I don't worship the ground you walk on. All I've got to say now is that you should go send all those people home, and hope that you haven't organized some super-spreader event here. For all the shit you've given me and my family, I don't want to see them all dead. I don't want to see you dead." Kara raised her bandanas again. "We're fighting the good fight. We're on the right side of this, Harrison. You're not." She turned and started walking back towards the road. "Fuck me," I sighed, shaking my head. That woman could still push my buttons almost fifteen years later. I pressed through the forest, making for the edge of the property and then diverting towards the road. When I reached it, I found a white and brown heavy pickup identical to Vanessa's idling on the gravel shoulder. The big guy in the driver's seat rolled down his window a crack. "What's up?" "I'm Harrison Black," I said. Another guy got out of the passenger seat and came around, slapping the hood. "Head on back to the motel," he said to the man in the truck. "I'll catch a ride back with my daughter." The guy in the truck nodded and waited for us both to back away before pulling a U-Turn and taking off down the highway. "So, you're the land guy, eh?" the man said, turning and offering me his hand. He was exactly as Vanessa had described; portly to the point of obese, with a gruff exterior that spoke of years handling his business in a rough industry and getting shit done. "I am," I said, taking his hand and shaking it firmly. "Your daughter has been fantastic to work with. Helpful and on task, and she keeps her guys in line." "I have no doubt," he said. "She grew up bossing her older brothers around and got the best of her mother and me. I'm Brent Peters, by the way. I'm sure we'll be speaking every once in a while through this project." "Good to meet you, sir," I said. "And I'm sure we will." I led Brent into the brush and got us through the roughest part until I could get us to one of the more used trails. It got a lot easier for him there, and once he had a chance to catch his breath he seemed to actually enjoy the chance to stretch his legs. He didn't know, or at least wasn't forthcoming, with any more information than Vanessa had been able to give about what was going on, but he did enjoy hearing about the sordid history of the land, my family and the Band. It took a little longer than I'd thought it would to get back to the driveway, Brent needing a couple of breaks, but we made it eventually. Vanessa grinned when she saw her father in a way that made me think she was going to run to him and hug him, but she never made the move. I had to assume that was a hard-trained response from her years working with the man; hugging your pops on a job site would probably lead to taking a lot of shit from your coworkers. Brent quickly got updated on the last hour of developments from Vanessa, and I saw his managerial side take over. Soon the line of construction workers were twenty yards back from the protestors, and he was stride-waddling forward with a medical mask stretched over his face. Kara met him halfway, and whatever they said seemed to go about as well as the talks I'd had with her myself. Again, she ended it by showing off for the protestors by giving him the double-birds. "Well, that went well," Brent sighed as he came back. "You were right, Harrison. They're stuck in. Wouldn't even help us get those trucks room to move or get out of the way of traffic." "She feels like she's got leverage," I guessed. "And they haven't had that on us for years now." "Well, I've officially done what I can," Brent said. "Time to do what every good GM does when shit like this happens." He took out his phone and started walking up the driveway away from Vanessa and me. "What's that?" I asked. "Call the client and tell them to un-fuck the situation," Vanessa smirked. The rest of the afternoon and evening was a long fucking day. There was no good way to get the workers on site off of it, and no good way to get new ones on, so Leo and I ended up walking several groups through the trails to get to the road in places out of sight of the protestors. And since the big crew vans were parked on site, Brent ended up getting access to school buses to come and pick up his guys. The second to last bus dropped off a dozen men who would take over watching the driveway and the protestors overnight; we'd already seen them breaking out tents and lanterns to hold their vigil; and the last bus out had Brent and Vanessa on board. "Client will be by in the morning," Brent said, and winked at me. "Don't you worry, bucko. You hold down the home front tonight, and the cavalry will be here in no time." "You got it," I said. "But whoever is coming, I suggest you make sure they know to take this seriously. The Band is riled up, and now they smell blood in the water. This isn't going away easily." "I'll pass that on to the Lieutenant Colonel," Brent nodded. He shook my hand again and stepped onto the bus. "See you tomorrow, H," Vanessa grinned at me. "Not if I see you first, Vee," I chuckled. She stepped up into the bus and I heard her voice raise immediately. "Alright, you Gorillas. Grab your fuckin' seats and stay there. I swear to Christ if one of you pisses me off, I'll confiscate your fuckin' dinner, got it?" I laughed, and could see the construction workers grinning in their seats as the bus did a three-point turn and pulled away. The sun was getting low when I finally hiked out of the bush and back into view of our little compound. Erica was waiting for me with a smile and a plate of stir fry. "What's the word, Harri?" "They're still down there," I said. "There are some workers keeping an eye on the driveway. Could you throw on a big pot of coffee for me and dig one of the thermoses out of storage?" "Harri, if they've got some of their workers down there, it's not your job to supervise. I'm sure Vanessa and her Dad left someone in charge." "They did," I said. "And I'm not going down there. I'm staying up here." I shoveled the stir fry down, relishing in the spicy kick Erica liked to cook with. Inside our little compound I gave Ivy a kiss, apologizing that I wouldn't be seeing her in bed for the night. Then I went to the storage container closest to my RV. The one with my gun safe. "What's the word?" Leo asked me when he found me. I had a lantern flashlight on and was loading rounds into my father's Model 700. "Jesus, Harri. What the fuck?" I doubted he was commenting on me loading the Remington hunting rifle. We'd used it plenty when we were hunting during deer season; it was a solid, reliable tool. No, I knew he was reacting to the other firearms I had out. My M9 was already holstered on my hip, a copy of my service sidearm that had served me so well through my tour and as an MP, and my DDM4V1 was laid out, waiting for me to do a quick check it was still in good order. "Just taking precautions," I said. I was already trying to get into the right mindset. "What does that even mean? What are you doing?" "There's about a hundred protesters down there, last I counted. More keep arriving," I told Leo, loading the last round into the 700 and checking the safety before setting it down. I fished a handful more.308's out of the ammo box in the safe and fed them into the bandolier shoulder strap for the hunting rifle. "Problem is, they're pissed off. Not just about the construction, but at all the other shit going on right now. And pissed-off people do dumb shit." "So what, you're going to go all Alamo on us?" Leo asked. "For real, Harri. Nothing's going to happen. They're down there, we're up here." "Leo," I said. "I'm not asking you to do anything you don't want to. The Bear shotgun is in my RV. Do me a favor and keep it handy tonight. If I miss something, I'd rather you have it than not." "Harri,” "Dude, just stop," I said. I'd finished with the.308s and started taking apart the DDM4V1 and giving it a quick clean. It was a budget purchase that I'd made prioritizing reliability over flashy shit, and the 'scary one' in my collection when it came to civilians. Erica hadn't even liked the idea of me owning it when we gave her the tour of my firearms and taught her the safety protocols for them. Leo had only ever fired it once. Both of the siblings had said the same thing; 'If you have the rifles and shotguns and the handgun, why do you need a machine gun?' This sort of thing was why I needed it. And it wasn't a 'machine gun.' "I'm not planning, or hoping, to kill someone tonight. If I have to use the DDM4 or my sidearm, something has gotten really fucked," I said. "But I'm also not taking any chances. Sometime tonight, there's going to be people sneaking up into the construction yard to cause mischief, and they aren't going to know the difference between the construction yard and where we're living. Maybe they hear us and they stay clear, or maybe they don't. I'm not taking that chance." Leo watched me cleaning my rifle, and glanced out at the darkening sky, and then back to me. "What should I do?" he asked. A wave of relief washed over me; it had been years since I'd served, and every instinct I had was telling me to do what I was doing, but that civilian part of my brain was second-guessing everything. Leo agreeing told me I was being logical, even if he didn't like it or I turned out to be wrong. "Just be with the girls tonight," I said. "I can handle the yard, you stay with them. Think of it like a shitty tower defense game. If I do my job, you'll never have to do anything." He nodded and left me to my work. Surprisingly, it was Danielle who came to see me next. "What can I do to help?" she asked. Her Australian accent was sounding stronger, the California valley girl part of it dropping with her serious demeanor. "Nothing, I've got it," I said. She'd caught me as I was strapping on my ghillie suit; another item that Leo and Erica had found silly to own considering we didn't need it for hunting deer. It had honestly been more of a gag item in my collection than anything until tonight. "Harrison, I'll remind you that my Dad was military, yeah?" she said. "I grew up outside the city. I know how to work a firearm." I took a breath and looked at her. Even at night, by the light of a lantern, she looked like an elven beauty despite the cutoff denim shorts and zippered knit sweater. "Can you handle a handgun?" I asked. "I've shot the head of an Eastern Brown from ten paces away when it was threatening to bite my dog," she said. "I assume that's a snake?" "A fucking poisonous one," Danielle said. "Alright," I nodded. "Under the passenger seat of my truck is a gun case with my pop's old 1911 and a couple of magazines. Hang on to it for tonight. Try not to freak out Erica or Ivy, and if you hear shots tonight don't let Leo come looking for me, let alone Erica and Ivy. If they leave the RVs it'll just make things worse." "Okay," she said with a serious nod, then stepped towards me, hugged me and gave me a kiss on the cheek. "Thanks." "For what?" I asked as she stepped back. "For being the man I figured you were," she said. "Leo's all mine and I'm happy with that, but like I told you; you remind me of all the good parts of my Dad. I'm glad I have Leo and you around." She left to fetch the pistol, and I finished strapping on the ghillie suit and slung my two rifles over my shoulders and closed the gun safe. When I was finished slamming the storage container closed, I turned around to find Ivy and Erica both looking at me with their arms crossed. "Both of you, huh?" I asked. "Yes, both of us," Erica said. "United front," Ivy said. "Look,” "Shut up, Harrison," Erica said, and then they were both hugging me while being careful around the firearms. "Just be careful." "Extra careful," Ivy said, burying her face into the strings of the ghillie suit in my chest and then immediately pulling back with a wince. "Ugh, this smells terrible." "Yeah, well it's not exactly the sort of thing you clean very often," I shrugged. "Whatever," Erica said and kissed me. Ivy kissed me as well, looking at me with those big eyes of hers with concern. "So you're not going to try and convince me this isn't necessary?" I asked. "Wouldn't do anything except lead to a fight we couldn't win," Erica said. "You're too stubborn not to do it." "And too brave," Ivy added. "That too," Erica smiled sadly. Then she handed me the big thermos of coffee. "Come back to us in one piece." "I will," I said. "Don't worry. But if you two hear anything tonight, if there's any gunfire, don't come looking for me. Just stay in the RVs and hunker down from the windows. If you come looking for me, you'll add more danger and not take it away, alright?" They both agreed, though I could tell Erica didn't like it. I could only imagine her sprinting across the construction yard, bullets flying everywhere, screaming my name as she worried I'd been shot. Hell, she'd probably pick me up and carry me to safety if it were true, but she'd also likely never get to me in the first place if things were that bad. I kissed them both again, then stalked off into the night. I ended up settling into a nook on the side of the hill to the south of the construction yard, with a clear view of about two-thirds of the yard and most importantly the RV compound. I unslung my rifles and carefully positioned myself in a comfortable prone position I was going to be able to manage for a long time. I'd never gone through Sniper training, but I'd picked up enough from my Bootcamp, talking with other soldiers and from movies to know a thing or two; not to mention years of hunting. So I cracked the thermos and took a sip of the hot, strong coffee, and started my watch. I saw them moving through the trees at around 02:30 in the morning down on the east side of the yard near the driveway. They must have skirted around the construction worker picket line and followed the driveway up, but they were still in the shadows so I couldn't tell how many there were, or what they were carrying. The only reason I spotted them early at all was because someone was flicking a flashlight up occasionally. I had the 700 cradled in my arms, and I slowly rolled into position but didn't sight down the scope yet. I didn't have any night vision gear, and while the simple Leopold scope easily gave me the range to tag anything moving down there, I wouldn't know what I was hitting. They stopped at the edge of the tree line, and I could only imagine the nerves they were feeling looking out over the open area. There were seven portables set up holding various offices now, and half a dozen big crew vans that had been left behind for the night along with some of the company pickup trucks. The pilings and supplies to erect the bigger barracks were also looming in the big, open space. "Just take a look and leave," I muttered quietly to myself, willing whoever was down there to not make this worse than it could be. Five minutes went by before a figure began to creep out of the tree line, crossing the rise of the hill and slipping towards the yard. From the distance I was at, I couldn't see them clearly enough other than to tell they were probably wearing a backpack; not a big deal in and of itself, but my training was screaming at me. 'Anything' meant anything. That backpack could hold weapons, or communications equipment, or even an I E D. I sighted in on the figure. It was a man, military age but young. I couldn't see much of his face between the black bandana over his nose and mouth and a ball cap backwards on his head. My finger tightened just a fraction on the trigger when I saw the flash of metal in his hand, but my hesitation saved his life; he was carrying a can of spray paint. He reached what he thought was the shelter of the first building; and it was shelter if he thought a guard was patrolling inside the yard. But I wasn't inside the yard, and instead I was looking at him dead on along the length of the building as he took off his backpack and then turned, motioning back towards the tree line. A half dozen more figures began quickly creeping across the hillside. I had a choice; if that backpack was full of spray-paint and that was all they were there to do, it would be annoying vandalism at worst as long
In this episode of the ASC Podcast with John Goehle, we discuss the latest news and trends in the ASC industry and review the proposed 2026 CMS Payment Rule for ASCs and HOPDs. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Ambulatory Surgery Center News - 9 Quotes that capture 2025 for ASC's: https://ascnews.com/2025/06/you-dont-have-to-play-by-hospital-rules-what-asc-leaders-are-saying-right-now/?spMailingID=161608&puid=4098726&E=4098726&utm_source=newsletter&utm_medium=email&utm_campaign=161608 Healthcare Dive Article June 23 - How health insurers are pledging to reform prior authorization: https://www.healthcaredive.com/news/health-insurers-pledge-prior-authorization-reform-trump-hhs/751309/ 2026 Proposed CMS ASC/HOPD Payment Rule: https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient/regulations-notices/cms-1834-p INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this special 250th episode of the ASC Podcast with John Goehle, we discuss HIPAA compliance in emails, cybersecurity threats, robotic surgery, surviving Department of Labor audits, and in our focus segment, Katie Pierson interviews John Goehle about the past and future of the podcast and emerging trends in the ASC Industry. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Paubox state of security report https://www.paubox.com/hubfs/Report%20Assets/2025-03-07_REPORT_StateofSecurity.pdf?utm_campaign=Demand%20Gen%20Nurture&utm_source=press_new Oregon Passes Bill to Block Corporate Takeovers of Medical Practices: https://www.healthcaredive.com/news/oregon-law-private-equity-in-healthcare-delivery/750526/ Remote Robotic Surgery! https://www.adventhealth.com/news/historic-telesurgery-connects-central-florida-and-angola-world-first-medical-breakthrough INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers Linked In Post: In this special 250th episode of the ASC Podcast with John Goehle, we discuss HIPAA compliance in emails, cybersecurity threats, robotic surgery, surviving Department of Labor audits, and in our focus segment, Katie Pierson interviews John Goehle about the past and future of the podcast and emerging trends in the ASC Industry. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Become a Patron Member of the Podcast! Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. Go to https://asc-central.com/landing/plans/247448 to Become a member today!
In this episode of the ASC Podcast with John Goehle, we explore the latest updates in the ASC industry, discuss recent challenges and survey experiences, review a new change in how CMS survey results are reported publicly, highlight National Time Out Day, and dive into best practices for peer review. Plus, in our focus segment, we do a deep dive into the requirements for a robust Infection Control Program. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Release of CMS-2567: Statement of Deficiencies and Plan of Correction https://www.cms.gov/files/document/qso-25-19-all.pdf National Time Out Day https://ortoday.com/rethinking-surgical-time-out/ Florida Men Accused of Operating without a License https://www.miamiherald.com/news/health-care/article304623151.html ASC News “A blockbuster day for ASC deals Ascension acquire Amsurg” https://ascnews.com/2025/06/ascension-to-acquire-amsurg-in-asc-blockbuster-deal/?spMailingID=159970&puid=4098726&E=4098726&utm_source=newsletter&utm_medium=email&utm_campaign=159970 Infection Control Training from ASC Central: Infection Control 101 – Training for Infection Control Coordinators in ASCs (September 2024 Recording) Infection Control 201 – Advanced Training for Infection Control Coordinators (September 2024 Recording) INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this episode of the ASC Podcast with John Goehle, we cover the latest updates from the ASC industry, discuss recent ASC issues and survey experiences, provide an update on Fraud and Abuse investigations, discuss signage in shared spaces, review rules about transporting medications, and in our focus segment, discuss patient registration, patient privacy, rights and responsibilities, and posting requirements. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: CMS Fraud Detection Operation Center Launched to Combat Fraud https://www.fiercehealthcare.com/providers/cms-sets-real-time-medical-fraud-center-doge-federal-contractor-rolls-out-commercial-tool Outpatient Surgery Magazine article about construction: https://digital.outpatientsurgery.net/view/998248182/24/ Small ASC's better off https://www.beckersasc.com/asc-transactions-and-valuation-issues/the-big-disruption-of-small-ascs/?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=0573H1191845C8E Resources from CMS to Remain Compliant with CfC (including regulations and guidance on the focus segment discussion: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this episode of the ASC Podcast with John Goehle, we cover the latest updates from the ASC industry, discuss recent ASC issues and survey experiences, review a recent survey by Avanza, discuss high level disinfection issues and in our focus segment, we interview Jennifer Cantrell with AMSURG during the New Jersey ASC Associations recent conference where she discussed Patient Engagement and how OAS-CAPHS can provide valuable information for improving patient satisfaction. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Resources from AHS, ASC Central and the ASC Podcast with John Goehle ASC Podcast website - http://ascpodcast.com ASC Central website - http://conferences.asc-central.com Ambulatory Healthcare Strategies, LLC - http://ah-strategies.com Contact John Goehle at 585-594-1167 for more information. AJIC literature review- endoscope HLD failures https://www.ajicjournal.org/article/S0196-6553(25)00290-1/fulltext 6th Annual Hospital Leadership ASC Survey: https://avanzastrategies.com/wp-content/uploads/2025/05/6th-Avanza-Intelligence-Hospital-Leadership-ASC-Survey.pdf Chemical Risk Assessment: https://www.osha.gov/chemical-hazards INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this episode of the ASC Podcast with John Goehle recorded live at the New Jersey Association of Ambulatory Surgery Centers Annual Conference at The Palace at Somerset Park in Somerset New Jersey on May 13th, we interview some of the speakers and discuss the benefits of membership in the Association. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: New Jersey Association of Ambulatory Surgery Center Membership Information: https://njaasc.org/Join-us Information from the Conference: https://njaasc.org/Events INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this episode of the ASC Podcast with John Goehle recorded live from ASCA 2025 in Denver Colorado the staff of Ambulatory Healthcare Strategies and the Podcast, and some of our clients and listeners sit down to talk about their experience here after the Second day of ASCA 2025. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: ASCA 2025: https://www.ascassociation.org/annualconference/home ASC Central http://conferences.asc-central.com INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this episode of the ASC Podcast with John Goehle recorded live from ASCA 2025 in Denver Colorado the staff of Ambulatory Healthcare Strategies and the Podcast, and some of our clients and listeners sit down to talk about their experience here after the first day of ASCA 2025. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: ASCA 2025: https://www.ascassociation.org/annualconference/home ASC Central http://conferences.asc-central.com INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this Episode of the ASC Podcast with John Goehle recorded live from ASCA 2025 in Denver Colorado the staff of Ambulatory Healthcare Strategies and the Podcast, and some of our clients and listeners sit down before the conference started to talk about the challenges we are facing and what we hope to hear while we are at ASCA 2025. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: ASCA 2025: https://www.ascassociation.org/annualconference/home ASC Central http://conferences.asc-central.com INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this episode of the ASC Podcast with John Goehle, we cover the latest updates from the ASC industry, review a recent survey about OAS-CAHPS, discuss credentialing applications, we follow-up on an earlier discussion of RN Administered Conscious Sedation and discuss our preparations for ASCA 2025 in Denver this week. In our focus segment we discuss incident reporting. Listen to Episode 242 This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: ASCA 60-Second Survey: OAS CAHPS https://www.ascfocus.org/ascfocus/content/articles-content/articles/2025/digital-debut/asca-survey-shows-majority-of-rspondents-aministering-oas-cahps ASCA 2025 https://www.ascassociation.org/annualconference/home INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In this episode of the ASC Podcast with John Goehle, we cover the latest updates from the ASC industry, discuss recent survey experiences, including a discussion of proper vaccine storage and in our focus segment, discuss governance and the governing body. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: NY Post Face Fire Article: NY post- face fire article https://nypost.com/2025/01/14/us-news/cancer-patient-was-awake-when-face-caught-fire-in-surgery-suit/ Soccer player leg infection https://www.kafourymcdougal.com/former-major-league-soccer-goalkeeper-wins-20-million-against-portland-timbers-team-doctor-jury-cites-concealment-of-negligent-surgery-2025-04-04/ OR Manager- Sleep deprived nurses at higher risk for infections https://www.ormanager.com/briefs/study-sleep-deprived-nurses-face-higher-infection-risk/ CDC Has a tool kit that you can use to make sure you follow the CDC recommendations: https://www.cdc.gov/vaccines/hcp/storage-handling/?CDC_AAref_Val=https://www.cdc.gov/vaccines/hcp/admin/storage/toolkit/index.html INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
In Episode 53, hosts Houston Blackwood and Kaliah Dozier sit down with Jake Bonds, Senior Vice President of Shoal Engineering, to dive into the workforce development challenges facing Alabama's surveying industry. Together, they discuss the growing demand for survey technicians and how the collaboration with the Innovation Center, driven by the Skills for Success Land Survey Technician course, is working to bridge that gap.Explore how technology is transforming the profession, discover the qualities of the ideal candidate, and learn about the career pathways and hands-on training that are shaping the future of surveying. Get inspired as we highlight innovative tools like 3D-printed boats and drones, showcasing how these technologies are engaging students and offering a glimpse into the bright future of surveying.This episode offers an inside look at the exciting efforts underway to tackle workforce shortages and equip Alabama's surveying industry with the skilled professionals it needs. Industry partnerships, such as this one, play a critical role in building a diverse, skilled workforce to help the industry thrive!
In this episode of the ASC Podcast with John Goehle, we cover the latest updates from the ASC industry, review recent developments with CONs, discuss the anesthesia model and the OIG, provide an update on the corporate transparency act and in our focus segment, discuss emergency preparedness. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: Certificate of Need Reform: https://www.whitefordlaw.com/news-events%2Fambulatory-surgery-center-trends-in-regulation-compliance-and-enforcement OIG Anesthesia Advisory: https://www.whitefordlaw.com/news-events%2Fambulatory-surgery-center-trends-in-regulation-compliance-and-enforcement Garfunkel Wild 3/5/25 Alert about the CTA: https://garfunkelwild.com/insights/cta-reporting-requirements-partially-suspended/ Gallup Workplace Survey: https://www.gallup.com/workplace/656906/top-four-reasons-taking-new-job.aspx?utm_source=gallup_brand&utm_medium=email&utm_campaign=gallup_at_work_february_1_02252025&utm_term=information&utm_content=image_imagelink_1 INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
We're in the midst of 1856. This is the year lung sickness took hold of the country, and it's effect was to push some people of the land over the edge. Nongqawuse living in Gxarha had prophesized about salvation which was at hand. The former Anglican now born-again Xhosa Mhlakaza had thrown himself into the messianic messaging business. You heard last episode about the causes of the Xhosa Cattle Killing, now we're going to deal with how it spread. The amaXhosa were not alone. Around the world, frontier battles had lit up the globe, the pressure of these new arrivals on indigenous people had burst into flames. In Seattle, U.S. Marines had been dispatched by ship in January 1856 to suppress a Native American uprising. The First People's were resisting pressure to cede land - they were being herded into reservations and opposed the plan. Just to set the tone, a few days before the attack on Seattle, Washington Governor Isaac Stevens had declared a "war of extermination" upon the Native American Indians. Seattle was a small, four-year-old settlement in the Washington Territory that had recently named itself after Chief Seattle - a leader of the Suquamish and Duwamish peoples of central Puget Sound. In Utah, the Tintic war had broken out in the same month between the Mormons and Ute people - it ended when the Federal Government took the Ute's land but intermittent clashes and tension continued. This went on all the way to the Second World War in the twentieth century, with the Ute's demanding compensation. In India, the Nawab of Oudh, Wajid Ali Shah, was exiled to Metiabruz and his state was annexed by the British East India Company. Following our story about Surveyors in South Africa, it is interesting to note that in March 1856 The Great Trigonometrical Survey of India officially gave 'Peak XV' the height of 29 thousand and 2 feet. We know Peak XV now as Mount Everest and its actually 29 000 and 31 feet. Also in March 1856, the Great Powers signed the Treaty of Paris, ending the Crimean War. Soon thousands of British German Legion veterans of the Crimean war would arrive in South Africa. In May 1856, Queen Victoria handed Norfolk Island to the people of Pitcairn Island — famous for being descendents of the Mutiny on the Bounty. The Pitcairners land on Norfolk Island promptly extend their Pitcairn social revolution idea - to continue with women's suffrage. David Livingstone arrived in Quelimane on the Indian Ocean having taken two years to travel from Luanda in Angola on the Atlantic Ocean across Africa. And in South Africa, since April, amaXhosa had been killing their cattle upon hearing of the Prophet Nongqwase of Gxarha, whose pronouncements were now being managed by Mhlakaza her uncle. King Sarhili had visited the mysterious River and pronounced his support for her visions which spoke of salvation through cleansing of goods and cattle. Killing cattle and throwing away goods, she warned of witchcraft destroying the Xhosa, she had been spoken to by two men in a bush. Nongqawuse and her little ally, Nombanda, were visited by Xhosa from far and wide to hear her story directly. The most privileged visitors were taken to the River and the Ocean, but most of these men and women heard nothing - no voices although Nongqawuse continued to relay the two stranger's messages to those present. A minority began to claim they heard the voices. Rumours of the happenings spread like wild fire and the official sanction of King Sarhili Ka-Hintsa of the amaGcaleka removed the last doubts from many who desperately wanted this prophecy to have power. And yet most of the amaXhosa chiefs intitially opposed the prophecies, but were ground down mentally, dragged into the worse form of cattle killing by the commoners. The believers began the comprehensive work of destruction. This back and forth went on until what is known as the First Disappointment.
Are home movies the grecian urns of the twentieth century? Today's poem says, “sort of.”Poet, editor, essayist, playwright, and lyricist Mary Jo Salter was born in Grand Rapids, Michigan. She grew up in Michigan and Maryland, and earned degrees from Harvard and Cambridge University. A former editor at the Atlantic Monthly, poetry editor at the New Republic, and co-editor of the fourth and fifth editions of the Norton Anthology of Poetry, Salter's thorough understanding of poetic tradition is clearly evident in her work. Salter is the author of many books of poetry, including A Kiss in Space (1999), Open Shutters (2003), A Phone Call to the Future (2008), Nothing by Design (2013), and The Surveyors (2017). Her second book, Unfinished Painting (1989) was a Lamont Selection for the most distinguished second volume of poetry published that year, Sunday Skaters (1994) was nominated for a National Book Critics Circle Award, and Open Shutters was a New York Times Notable Book of the Year. Salter has received fellowships from the National Endowment for the Arts and the Guggenheim Foundation and taught for many years at Mount Holyoke College. She is currently the Krieger-Eisenhower Professor in the Writing Seminars at Johns Hopkins University. Get full access to The Daily Poem Podcast at dailypoempod.substack.com/subscribe
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