Podcasts about surveyors

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

Quaranteam-Northwest: Part 3 Change of Pace, Change of Place. Based on a post by Break The Bar. Listen to the ► Podcast at Explicit Novels.   I'm pretty sure it was only for a moment, but it could have been a couple minutes. When I came to, I was still inside Erica, and still mostly hard. I pulled out and was quickly followed by our leaking mess spilling onto the sheets. Erica didn't move, except for heavy breathing. Then she rolled onto her side, legs coming up into a fetal position, ass pointed back at me. Her messy, cummy twat peeked at me between her legs and butt cheeks. Sitting back on my ass, I blinked a few times and tried to re-center myself until I gave up and fell backwards, breathing hard and looking up at the ceiling. "God damn, E," I said. "That was something fucking else." No response. I rolled over, dragging myself up to lay next to her. "Erica?" Her eyes were closed and she was looking comfortable, if a little cold laying over the sheets. Her lips were moving, and when I got close enough it sounded like she was whispering, "Imprinting," over and over. "That's kinda fucked up," I said quietly, looking at her otherwise still face. She sounded like a computer program reporting on a status. The only thing that kept me from freaking out was the big, contented smile on her lips. I kissed her forehead, trying not to think about quite how fucked up things were, and then I rolled off the bed and stood up. Underwear and pants went back on, and I crossed the hall to the bathroom where I got a wet, warm washcloth and a towel. I returned to the room and carefully wiped down Erica's twat and ass of our mixed fluids, then wrapped her in a towel and picked her up. I carried her down the hall to my room and managed to get her under the covers. I'll admit, I also gave her tits another soft grope, just to convince myself this was all real. God, they're awesome. Leo was out of the house, which on second thought made me realize what I'd just done. I'd fucked his sister, and we hadn't really held back at all. If he and I had been hearing the 'biz' and soft moans of Erica masturbating I can only imagine the sounds that had been coming down through the old wooden timbers of the house. "Fuck," I sighed. Hopefully he had gone out to the workshop before we'd gotten started. It was still the middle of the afternoon so I went back to packing. It was weird, sorting through everything in the house. Also fucking annoying because I didn't even have many boxes to pack with, and I couldn't exactly just run out to the liquor or hardware store to get some. It was strange; I'd lived in the house for much of my life, and I'd lived in it with Leo for the past five years, but I still found traces of my parents and grandparents I hadn't thought about in ages. It had to have been an hour or two later when Leo came back into the house. He had rings of sweat on his t-shirt and looked like he was ready to punch something. "Hey," I said. I was kneeling down in the living room, busy scooping old VHS tapes out from the back of one of the big cupboards. They hadn't seen the light of day in probably twenty years, but I also felt like it was a waste to throw them out. Leo just looked at me from the doorway, kicking off his boots. "That was fucked up," I said. "Yeah, it was," he said. "You know I wouldn't just pump and dump her," I said. Leo twisted up his face in revulsion. "Fucking of course not. Jesus, Harrison. You're not an animal." "So why the fuck would you make her hold on to a high school agreement when she and I might have been good for each other, Leo?" "She told you that?" Leo's face dropped. "Yeah. She did," I said. "She shouldn't have. Not talking about it was part of the deal, too," Leo grunted. He peeled off his sweaty shirt and threw it towards the stairs, then headed towards the back of the house. "Where is she now?" "Upstairs. That's another thing we need to talk about, but I'm not done with this." Leo was pouring himself a drink from the tap. My father had gotten a new well drilled a couple of years before I was born, and then when I hit high school we'd gotten a pump system; I still couldn't believe we'd lived on hand-pumped well water until I was fourteen. Now, with a whole filtration system set up in the back shed we - It doesn't matter. It's all going away. That realization almost shook me out of the conversation. "What's left to talk about?" Leo asked me, leaning on the doorsill from the kitchen. "Leo, I've always liked your sister. This whole thing just... forced the issue. You get that, right? She's not betraying you. I'm not betraying you." Leo didn't answer at first, buying time by taking a drink from his glass before sighing. "Yeah. I know." "So what are you pissed about?" "Dude, she's still my sister. And you're my best friend. That's not how this is supposed to go! She's supposed to meet some guy that I don't really like, but I learn to tolerate him, and we make fun of him together behind their backs and talk about how she could do so much better." "Why is that how it's supposed to go?" I asked. "I don't know, man. That's just; That's how it was with my parents and aunts and uncles. My dad was an only child, but all my mom's sisters settled for mediocre guys. My parents tolerated them, and I got to hear all the family gossip and that's just how it was." "Leo," I said. "That's kind of fucked up that you would want that for Erica." "I don't want it for her, it was just... Look, I hear how stupid and dickish it is, as it's coming out of my mouth, Okay? But now it's going to be you two. He-man and... I don't know. Who's the lady in He-man?" "Dude, I have never watched He-man," I laughed. "Well, whatever. You're you. She's her," Leo said. "By the end of this quarantine bullshit you'll be together and I'll be out." "Leo. You're thinking glass-half-empty here," I said. "Erica and I get together, what else does that mean?" "I dunno," Leo said. "What?" "What does that make us?" Leo blinked. "Brothers-in-law?" He rolled his eyes, but I could see the smirk growing. "Brothers, Leo. Even better than best friends. Better than best friend roommates!" "Fine, fine," Leo sighed. "Okay, there's an upside. Just don't expect me to just... be Okay with you two getting frisky everywhere or something. You can be happy or whatever, just not right in my face, alright?" The sound of a car pulling up outside on the newly-widened gravel driveway crackled through the house. I stood up and headed for the door. "What was the other thing?" Leo asked me. "Something about Erica being upstairs?" "Yeah, yeah," I said, slipping on my sneakers. "She's in my room right now, kinda sleeping but not? This whole Vaccine thing has more to it, dude. Let me figure out what this is first." He grunted, giving me a questioning eyebrow raise and turned back to the kitchen to refill his water. Outside I found the same blacked-out, now dust-covered, town car that had dropped off Erica. The door opened and I blinked hard as a woman I could only describe as a cross between an elf and an angel stepped out of the back seat. She had long, wavy brunette hair and a face that I could only guess had matched up with Helen of Troy, with soft, full lips and wide eyes with a playful spark. She was wearing a simple, baggy white t-shirt that looked like it belonged to a guy my size, and with her slight frame she was practically swimming in it but somehow she made it look like a diaphanous dress. I couldn't even tell if she had anything else underneath it since the t-shirt came down low on her bare thighs. "Hey there," she said, grabbing what looked like a solid camper's backpack from inside the car and walking over to me. When she got closer she only somehow got more beautiful, but I also saw... something. That look in her eye. The way her lips were slightly parted, and she was breathing a little more shallow. "You're Leo?" she asked. She had an accent, but I couldn't place it. "No. Harrison. Leo's inside," I said. She eye fucked me for a moment, took in a breath and breathed it out through pursed lips, then headed past me into the house without another word. "God damn," I said. "Yeah, she's running a little hot," Agent Sourpuss said. She'd gotten out of the driver's seat of the car and came around. "Got the shot at the same time as Miss Lacoste, but it turned out the guy she was originally going to be paired with got infected sometime in the past few days. We found him dead in his penthouse when we tried to drop her off." "Fuck," I said. And not because of the story. The woman had walked up the front steps of the porch, slung her bag onto it and had been stripping off her shirt as she walked into the house. I didn't see anything but bare back and a pair of tight booty shorts painted onto a slim, perky ass, but I was fucking jealous. "How is Miss Lacoste?" The agent asked. "Did the bonding process work?" "Um," I said, shaking my head and turning to the woman. "Uh, yeah. If you mean she didn't really tell us much but made it clear she needed sex, and now she's upstairs asleep in my bed muttering 'Imprinting' over and over." "Good, good," the Agent said. "Working as intended, then." "No," I said, shaking my head. "Not good. I said she's muttering 'imprinting' over and over. What the fuck is up with that?" "Look, Mr. Black, it's a long fucking story. And one you're not cleared for," the Agent said. "I'm sure one day you'll read a book about it or something. For now, just get out of my face. Alright?" "You can't seriously expect people to just go along with this. It sounds like... like,” "Brainwashing?" The Agent asked. Then snorted and started heading back to her car. "I don't have time to hold your hand through this. Like I said, just do what they say and enjoy your new fucking world. We'll be in touch." She slammed the door, the engine turned over, and she peeled out and drove back down the driveway. "What the fuck," I said. "What the fuck? What. The fuck?" I headed back into the house and stopped before kicking off my shoes. "Oh, fuck yes!" the woman shouted. "Oh my God, oh my God, oh my God," Leo yelled. They were upstairs. It hadn't been more than two minutes. I could hear them clearly. Fuck. Doesn't have a problem when it's not his sister, I thought, shaking my head. I went for a walk. I made dinner an hour later, and Leo managed to come downstairs to eat. He mumbled something about getting struck by lightning, but once he'd gotten some food in him he'd shrugged. "I dunno, man. She just walked up to me, holding her shirt, and said, 'Take me up to your room and fuck me.' I didn't even get her name. Now she's doing that 'imprinting' thing and it's freaking me out a bit." "Yeah," I nodded. "Yeah. Erica was doing that too. That lady agent dropped off your girl, didn't want to talk about it, and just said we should do what the ladies tell us." "Hey, that's all fine with me," Leo said. "She can tell me anything she wants. I mean... Harrison. God damn!" We called it an early night and I found myself climbing into bed next to Erica. She was still out of it, but at least she wasn't murmuring anymore. It felt weird, and kind of creepy, to try snuggling up next to her. She was still naked under my sheets, and totally out of it. I ended up putting on an undershirt and gym shorts and managed not to feel like a perv for long enough to fall asleep. The rumble of trucks woke me up, and I met Leo at the stairs as we headed down. He went to start making coffee while I checked outside. Two big trucks were hauling in a pair of trailers onto what had once been my front lawn and workers in bright fluorescent vests were directing them as others set up some concrete blocks. The trailers looked like they were the start of whatever construction HQ was going to get set up. "So it begins," I sighed. We brought out the coffee; it was an entirely different crew of guys, but they didn't have any new information for us. They appreciated the coffee, but when I went in to make more I realized we were running out quickly. Hopefully one of those trailers was going to be a break room for those guys because they were going to drink my wallet dry if it was on me to feed their caffeine addictions. The trailers were quickly set up, and the workers were gone, but a 14-seater van arrived so quickly that I figured they must have passed each other on the driveway. Inside were a solid dozen Surveyors, along with boxes of topographical maps and all sorts of equipment. I couldn't offer them coffee, but they'd come with their own travel mugs. They weren't much for conversation, though they weren't bad men and women; they just had a very large job to do. "We've done what we can ahead of time with the satellite imaging," the Head Surveyor said to me. "But we've got to plan out the development of this entire area in the most efficient building plan possible. They want houses built and livable ASAP." And that was where I came in. That promise I'd made to Agents Grierson and Walters had included my help with the surveying. Now it was time to give the grand tour. "I'll head out with them this morning," I told Leo. "I'll start with the front loop trails down to the highway and back. You want to show them the Arrowhead trail after lunch, and I'll take them up the ridge after that?" "Yeah, works for me," Leo said. "I'll go check on Erica." "Um... maybe I should do that," I said. "Why? Is something wrong?" Leo asked. "No, dude... she's just, uh..." I stammered. Leo's eyes went wide and he clapped his hand over his ears. "Nana nana" he sang, heading back out of the house towards the barn. I checked in on Erica; still asleep. I hesitated a moment, leaning over her in the bed, but went for it and pressed my lips to her forehead in a soft kiss. She mumbled something, pulling the sheets closer to her, and she smiled. It almost kicked my adrenaline, and I could hear my heart in my ears as I walked back down the hallway. When I passed Leo's room I realized that his door was cracked open, and I could see a shapely and naked leg and foot sticking out from his own sheets. I was tempted to peek further, but that feeling of creepiness from last night struck me again and I closed the door instead. I was kicking myself an hour later, deep into the trails with a half dozen surveyors following along and taking notes as I pointed things out and they asked me questions. It was the slowest I think I'd ever walked the trails, and the question kept flaring up in the back of my mind of what I'd missed out on seeing. Leo's girl was living in my head rent-free right alongside Erica, but now I knew what Erica was like; the mystery of what I hadn't seen was tantalizing fodder for a brain that didn't want to think about the overwhelming weirdness of the whole situation. We were back to the house around 1pm, and by the time we'd been gone a third trailer had been set up and there were two more of those big passenger vans, along with a couple of pickups, lined up in a makeshift parking lot. I didn't notice any of it, or the people working, and I didn't even answer the last question one of the surveyors was asking me because I was jogging for the house. Erica was standing there on the porch in low hip-hugging jeans and a tight band t-shirt under one of my unbuttoned flannel shirts. She had a beer in each hand, one opened and half empty, the other cold and sealed. I could see the emotions play across her face for a moment as I walked up quickly, and she opened her mouth to say something but I didn't want to hear a smart remark or a question. I wrapped my arms around her and I kissed her. She kissed me back, her arms crossing behind my neck as she pulled me deeper to her. Her tongue and mine met and teased for a long moment, and I reveled in the feeling of her in my arms. Her chest crushed against me, soft and firm, and her belt buckle pressed into my crotch as she melded herself to me. A whistle, sharp and catcalling, sounded from somewhere behind me and I could feel Erica shift both beer bottles to one hand. I had no doubt she was flashing them the finger with her free hand, and the laughter from the construction workers confirmed it. Eventually we had to stop, and I held her by the waist as our faces pulled away. "Well, I guess that answers most of my questions," Erica smirked at me. "I've got a few of my own, but you're not slapping me so that answers most of mine," I said. She pursed her lips and brought her beer hand down between us. "Leo said you've had a long morning. Up for a nooner?" "God yes," I said. "But I've always had a different definition of 'nooner.'" "What, you think I mean the beer?" Erica asked. "No, baby. I want you to,” "Ahem," a voice interrupted, and I turned to see who had approached us. "Sorry to interrupt." The girl, and I couldn't call her more than that because she looked like she couldn't have been more than twenty-three despite the tattoo across her neck, was wearing a rough sweater and one of those orange construction vests, along with a dinged-up blue hardhat with about dozen peeling stickers on it and her jeans tucked into her steel-toed work boots. She had some vaguely Latina features, mostly in the lips, but was pale where she wasn't tattooed. Erica's arm immediately went around my waist, and I lowered mine to hers as we held each other. "No problem," Erica said. "What can we do for you?" "I'm Vanessa," the girl said. "Are you Harrison Black?" "Yeah, you found me," I nodded. "Alright, cool," she said, looking me up and down. Erica's hand at my waist scratched my side playfully, and I lowered my own from her hip down to her ass, slipping my fingers into the back pocket of her jeans and cupping it firmly. "Well," Vanessa continued, "I'm the Foreman for the general laborers on site right now, and we've already gotten a laundry list of our daily jobs done so I need to start getting my guys into the house." "I'm sorry?" I asked. Vanessa sighed and then smiled in a knowing sort of way. "No one's talked to you about the day or week plans, have they?" "Not really," I said. "I've been out with the surveyors all morning." "Yeah, that sounds about right for this clusterfuck," Vanessa shook her head. "Well, orders are that everything that's currently in this house, and that barn, and anything else on the property that needs to, is hitting those sea cans in the backyard by sundown tomorrow. Demo on this place hits bright and early the next morning and everything not packed up is getting carted the fuck off." Vanessa, it turned out, was a straight shooter. It just took me a second to wrap my head around everything. Erica took charge while I followed along. I'd figured I had weeks, maybe months, before demolition. This wasn't the hurry-up and wait I'd been expecting. This was all hurry, all the time. Leo went out with the surveyors, and I started answering a million questions for Vanessa while she directed five big, burly guys as they began unloading my house into boxes, and hauling those boxes out to a pair of storage containers that had been brought in on trucks and plopped down near the back of the wide clearing that had been the 'backyard' for generations. Erica, I realized, was helping manage me more than anything else. Keeping me on task, keeping me focused. She helped me reminisce quickly a couple of times, helped me make decisions about what actually needed storing and what could get thrown out. I was getting a brand new house, fully furnished, courtesy of my contract. Did I really need the shitty TV stand or the ratty couch sitting on the back porch? No. Did I want to keep my grandmother's freestanding jam cupboard? I couldn't picture it anywhere else other than where it was in the house, I'd never even seen a piece of furniture like it in another house before. But it was an heirloom piece. Was I supposed to keep that? Yes, Erica helped me. Yes, keep the heirlooms, even if they seem odd or silly. Just know what's an actual heirloom and what's not. "You're doing well," she told me, stopping me at the foot of the stairs. "You're a good boss," I smiled, reaching my free hand around to hug her to me. I was carrying a pair of bedside lamps in the other. She frowned and shook her head. "I'm not your boss. And I don't want you to think I'm being bossy, and I definitely don't want you to start thinking of me as some nagging mother figure." I laughed and shook my head. "Never. E, you're just a natural manager. Of people, or situations. I needed a minute, not an hour, and you helped me get on track way faster than I would have without you. Plus," I grinned, and let my hand slide up from around her waist to softly take her tit in my hand and squeeze playfully, "Ain't nothing of a 'nagging mother' about you." She smirked and bit her lip as I squeezed her braless tit a little more firmly. "Well, good," she said, and rubbed the front of my pants. "And thanks for the very weird compliment from my b,” She stopped short, eyes going a little wide. I chuckled and leaned down to kiss her cheek, then her lips. "You can say it. I'd be happy to." "I've never said that so fast before. It hasn't even been a day," she said. "Not officially," I countered. "But we've also been living together for a couple of months. And before that we went on casual group dates. We just didn't know it at the time." She rolled her eyes but her grin was everything to me. "Well, if you put it that way..." I kissed her again. "God, I want to fuck you," I said. "Yes, please," she hummed back. We separated. I watched her walking away, the way her ass moved. The way my shirt hung on her. An hour or so later we'd gotten a lot of the preliminary stuff cleared up, and after a quick conference with Vanessa, we decided that the big guys on her team were probably going to be most useful getting all of Leo's woodworking equipment safely moved out to the storage containers from the barn. I'd helped Leo move all of those heavier tools into the barn over the past five years and each one was a son of a bitch, and we didn't have any forklifts to make it easier. The guys hadn't been out of the house for more than fifteen minutes when I was busy taking old pictures off the walls of the living room while Erica was getting to the ones in the front hall. "Hmm, morning," a warm, honeyed voice said from Erica's direction. "Uh.... hi," Erica said, her tone of voice a little shocked but with a weird cadence. I turned to see who was in the house and nearly dropped a glass picture frame holding a collage of photos my mother had put together of my sister and me. The elf/angel girl, Leo's imprint-person, was wandering into the living room and looking around curiously. She was as beautiful as the first time I'd seen her, and I figured she must have taken a minute to touch up her makeup. She had beautiful, pale porcelain skin, and her wavy chestnut brown hair still had a bit of a messy 'just got fucked' look. She also happened to be completely naked except for a pair of sheer panties that left it very obvious she was shaved to the wood down below. Her tits were so perfect and perky, big enough on her thin frame to look almost fake but somehow still natural; either the best boob job ever or the perfect genetic lottery. Her areolas and stubby nipples, puffed and firm in the cool spring air even in the house, were the same soft shade of pink as her lips. "Hey there," she said, giving me a little smile and a wave. "I think I almost fucked you yesterday, yeah?" I coughed. "Um, no. Definitely not that close." "Hmm," she smiled, looking around the chaos of the house. "Well, maybe not, but I definitely remember wanting to jump your bones. Where can I get some water?" "Through there," I pointed her towards the kitchen. "Hey, we didn't actually meet. I'm Harrison, Leo's roommate." "Oh, right," the woman said, then stepped forward and pulled me into a hug. A naked-lady hug. While I was looking over her shoulder at Erica, who was staring from the hallway door with an expression between utter confusion and the kind of stare I could only imagine a 13-year-old boy would have when looking at this same sight. I made a 'what am I supposed to do?' face at Erica, and slowly hugged the naked woman back with one arm, trying not to think about those perfect tits pressing into my side and chest. "I'm Danielle," the woman said. I was struck again by that strange accent that I couldn't place, elongating some of the vowels and with just a touch of different intonation. "I got told all about you and Leo by that government lady on the way here. I guess I didn't realize you wouldn't have gotten the full story." "Yeah, no. She isn't really one of our biggest fans," I said. Danielle stepped back from the hug, with a warm smile. "This is Erica, Leo's twin sister and my, ah" "Girlfriend," Erica said, stepping forward. She opened her arms and Danielle happily stepped in for a hug with Erica as well. Erica looked at me over Danielle's shoulder and mouthed, 'Oh my God!' "And vaccine partner." "Oh, god," Danielle said, leaning away. "Fuck, I wasn't even thinking about that. Are we supposed to still be careful? We're all vaccinated, right?" "Very vaccinated," Erica said, then looked at me again and smirked. "Very, very vaccinated." "You too, huh?" Danielle asked. "Those orgasms,” "Out of this fucking world," Erica nodded. "Let me get you that water," I said. I left the two in the living room and went to the kitchen, taking a moment to adjust my cock in my pants before fetching a cup. Erica was attractive as all hell, and while I might not have been in love with her yet, I knew I was going to get there and fast. The physical and the personality just synced with us like that. But this girl. Woof. She was that unattainable attractive tier that you saw in movies, or on Instagram. When I was coming back, Danielle was slipping on my flannel shirt. "I'm really fine with it," she was saying. "I like being naked, and I'm a stripper so I'm used to it. Honestly, it kind of turns me on." "Yeah, well there's about twenty construction workers outside right now and I don't think anything is going to get done if they catch a look at you, Dani," Erica said. Danielle laughed and shrugged while she brought the sides of the flannel shirt up and tied them between her tits. I don't think my shirt had ever looked better, and somehow she just effortlessly made it a perfect, teasing shape that hugged her cleavage and slim torso. "You're a stripper?" I asked, offering her the water. "I thought most women in that business preferred 'dancer' or something like that "Hmm, only the ones who are embarrassed about it deep down," Danielle said. She took a sip from her glass. "But I made $300k American last year as a stripper, so why should I care what other people think of me? I'm a businesswoman and entrepreneur, and I work hard to make sure my product is amazing. And my product happens to be stripping off my clothes and making guys cream their pants." I almost choked on my own spit as Danielle casually dropped her tax bracket. "You made that much?" "Oh, you must not be a strip club boy, are you?" Danielle smiled at me. "He will be," Erica said, chuckling. "I will?" "Oh yeah, baby," Erica said. "Half of my best clients are strippers. I'm a tattoo artist, by the way," she said to Danielle, then smirked at me again. "Once the world opens back up, I know some babes who are going to rock your world. I can't wait to see the look on your face!" "Well, it's always nice to find a discerning lady-fan of the art," Danielle said. "Honestly, women always make the best fans. Guys shell out more cash, but women just appreciate us more." The front door of the house opened and Vanessa walked in, stopping as she saw Danielle standing between Erica and me in nothing but my shirt and her panties. "Fuck, sorry," she said, and she looked like she was going to head right back out the door, then re-thought that and stayed where she was. "Um, Harrison, we could use your help out in the barn. Any shot we can get that old tractor running to move the planer?" "We can try," I said. "I didn't need it to plough the past couple of winters since the ATVs did the trick. I'll see if it'll turn over." I left Danielle in Erica's hands; something which both brought chub-inducing pictures to mind, but also just a touch of jealousy considering the open lust my now-girlfriend was showing for her twin's vaccine-fuck-friend. We really need to figure out some terms and definitions, I sighed. The tractor, in fact, did not turn over. It was deader than a doornail. With enough leverage and muscle power, we managed to get Leo's big planer; which he had thankfully already prepped for moving; onto a trailer we used with the ATVs and carefully towed the sucker with two guys on either side to keep it balanced and upright. Vanessa shooed me away after that, telling me to go keep packing up the valuables and let her paid gorillas do the heavy lifting. The big laborers all grumbled good-naturedly at her name-calling, and as I was leaving them I heard one trying, "Me Tarzan, you Jane." "Yeah, and I'll Jane you right in the mouth if you start trying to hit on me, Tarzan," she replied. "I don't shit where I eat, unlike you goddamned animals." Back in the house, Erica was helping Danielle start packing Leo's things up in his bedroom, so I went back to work cleaning out all the corners of the house. The one thing I realized was that I didn't actually need to be neat about anything. The last time I'd moved, when Leo and I had left our place back in Portland and come up to the homestead, half of the bother was cleaning everything up to make sure we got our security deposits back. This place was gonna get knocked over in two days, so what was the point of cleaning? I'd been trying to find time to sneak Erica to somewhere private, and maybe to fool around a bit now that that was part of our relationship, but Danielle was too full of questions. If she wasn't chatting with Erica, she was asking me all sorts of questions about the house, my family, and the deal with the land and the vaccine. I was happy to chat with her as we packed up the kitchen, or while she helped me as I handed her things out from the little root cellar under the house, but that smile and those eyes were hard not to get distracted by. Not to mention the braless cleavage in my shirt and her toned, bare midriff and legs since she only bothered to slip on a pair of booty shorts to complete her outfit. It turned out that Danielle had known about the vaccine longer than any of us by about a day and a half. The Government, whichever agency was running the whole thing, had gotten her contact information from a couple of the strip clubs in Portland where she'd been scheduled to work before the lockdown. Danielle was the kind of girl who took risks, so she immediately signed up to be a Phase 2 tester for the vaccine; Portland was one of three secondary trial locations across the country in 'Phase 2.' She'd asked around once she got tested and entered the Quarantine Hotel, and it turned out most of the women who'd been contacted had been sex workers of one sort or another; strippers, dancers, Only Fans models, high-end call girls, even a few honest to god porn stars. Danielle figured whoever was in charge had decided the sexual nature of the vaccine lent itself more easily to openly sexual people. It seemed... Well, it seemed weirdly logical to me, but also shady as hell. She'd received the same briefing Erica had, which she said had felt more like a meeting selling timeshares in Boca than anything else, had done the questionnaire and then picked a guy out of a list of twenty photos of her top 'matches'. She remembered seeing Leo on that first list but didn't remember why she picked the guy she did. They drove her to a big building in downtown Portland, but she never got out of the car. Her escorts came back about twenty minutes later and told her the guy wasn't a valid partner anymore, and she had to pick again. She got a new list, and Leo was on it. "I can't help but notice you aren't asking about him," I said to her as we were carrying the dining room table across the backyard towards the storage containers, each of us on an end. "You've gotten half my life story at this point. You're not curious about the guy you're, well, imprinted on?" Danielle smiled and shook her head. "Naw, I had my guy pegged the minute I saw him. I have all the time in the world to learn the details, I know what I need to know. He's sweet and boyish, and honest. You should have seen him blush when I walked up and kissed him. Hah! He didn't know what hit him." "Neither would I," I said. "You're quite the woman, Danielle. Leo's a lucky guy." "Well thanks, hun. But I have a feeling you'd know just what to do with me. I could see it in the way you were standing when I got out of that car yesterday." "The way I stand?" I asked. "Oh, for sure. You're a big guy. Muscly, but not a bodybuilder. You have that mountain-man vibe with the longer hair and the beard, but even after a couple of months of quarantine you still keep it trimmed and neat. And your eyes were looking at everything all at once. My Dad had eyes like yours, and he was Australian military back home. A man like you, if he isn't a prick, well... let's just say I've known a couple of gals with guys like you, and they are quite happy." We'd set the table down outside the storage containers and were headed back for the chairs now. "Well, thanks I guess. Hopefully Erica feels the same." "Oh, she does," Danielle smirked. "She may not realize it completely yet, but the way she's grinning to herself when she didn't think I was looking? She does." That little nugget of information made my heart sing. "Sorry if it's a button, but I noticed you said your Dad had eyes like mine. He's gone now?" I asked. "Hmm," Danielle nodded. "Years ago, so don't worry about it. Cancer. I was fifteen and it hit me hard. Mum got a boyfriend the next summer and within six months of that she moved us to California and I finished high school in the Valley. I hated the new guy, and then the guy after that, so I moved back to Sydney as soon as I could and was planning to go to school there. But then I took a job at a strip club to pay the bills, and the rest is history. I've been doing it for five years and did a tour up the east coast of the US last year, so I figured I'd do the west coast this year." "Oh, well, I'm still sorry to hear that. It all sounds tough," I said. "But I guess it's good you found your... calling?" "Hah," she laughed. "Something like that. I'm not like other girls who have specific ambitions. I've just been banking as much money as I can, while I can, and having fun doing it. I'm not looking to go to med school, or become a lawyer or something." We were carrying the last of the chairs, and Danielle was telling me a story about her senior year in high school when Leo came back. It turned out Danielle's accent, a bastard amalgamation of Aussie twang and Valley girl, was the one thing she disliked about herself but she was just plain terrible at trying to fix it and it was because of some traumatic bullying while she'd lived in the Valley. As soon as Leo came out of the mouth of one of the trails, the chair Danielle was carrying was forgotten as she dropped it in the middle of the yard and began sauntering over towards Leo and the surveyors. She looked like a lioness on the prowl, and Leo stopped when he saw her coming. The surveyors, about two-thirds of whom were men, all moved aside to let her past them, watching with big eyes as she stalked up, knocked Leo's baseball cap off his head and molded herself to him as she planted a kiss on him that I could feel searing from across the yard. And she didn't stop. They were kissing a solid thirty seconds, hands wrapped around each other, before the surveyors backed away and came towards me, shaking their heads and grinning. "We need fifteen minutes, then are you ready to head out again?" one of them asked as they got near me. "Sure, sure," I said. "How many are coming out?" "All of us," one of the ladies said. "About... fifteen?" "Jesus Christ," I said, shaking my head. "Hey, big project at speed. Most of the time you pick quality, quantity, or speed. The government wants all three, and they are throwing around the kind of money needed to make it happen right now," the first guy said. "We'll be working like crazy for the next two weeks getting all the info, then another two handing it all off to the developer team, then back on site again to make sure everything is being built in the right place." I headed back to the house to get my hiking gear back on. Danielle and Leo had stopped making out and were talking now, but I could see Leo was holding Danielle's hand while she had her other on his chest, and he was grinning and nodding along with whatever she was saying. I smiled, happy for my friend, and went inside. "Hey," I said when I found Erica upstairs, cleaning out my closets. "I need to head out in about ten minutes on another tour." "Oh yeah?" Erica asked, turning to face me. She was still wearing that tight t-shirt, her sweat from hard work making it stick to her a little more. It cupped under her tits, making them stand out just that touch more, and I could see the bumps of her nipples in the black fabric. "Yeah," I said lowly, and stepped beside her, offering her a hand to help her up. "And Danielle and Leo are out in the backyard talking right now." Erica's eyes lit up as she let me help her up. "Well why didn't you say so?" she asked, and I pulled her in to kiss her, feeling her tits press against my chest. She hummed happily into my lips and slid her tongue across mine. I picked her up without breaking the kiss and brought her over to the bed, and she lifted her legs up to circle my waist and cling to me as I laid her on her back. I was leaning over her and she wrapped her arms around my neck, keeping me close as we made out. "Hmm, I want you," she whispered between kisses. "Yeah?" I asked. "Good. I want you, too." "How bad do you want me?" Erica asked me. "Utterly. Totally. Bad to the bone." She snickered and pulled up her top over her tits, freeing them, and I shifted to quickly mouth over them, kissing as much of them as I could all at once and as quickly as I could. "Ooh, baby, baby," Erica crooned. "God, you make me feel so sexy." "You are sexy," I said, pulling away from her tits and mauling them with my hands as I lifted my lips back to her. "Deadly sexy. Femme fatale. Boss bitch." "You say the nicest things," she laughed. "I'm glad you aren't freaked out by all of this." "Oh, I'm freaked out more than enough," I said to her, pausing our kisses to press my forehead to hers and looking down, meeting her eyes. "The entire world stopped, and now it's going faster than it ever has before, but you Erica Lacoste are enough to make me not care about any of it." She cupped my cheeks with her hands, then ran her fingers through my beard and pulled me down to her, kissing me hard as she kept her eyes open, looking at me through the soulful, hungry kiss. There was a bang downstairs, the back door opening and closing, and we could just hear the muffled sounds of Leo talking with Danielle. "Fuck," I said, as Erica let go of my beard and our kiss ended. "Fuck," Erica groaned. "Fucking Leo." Erica straightened herself out, getting her shirt back on properly and standing back up, while I straightened my hair a moment and pulled it back and then changed into a new shirt. I caught Erica eyeing me up from across the room while I was shirtless, and she didn't even blush or look away. "Yummy," she said and winked. "You're trouble like this," I said with a smirk. "You don't know the half of it," Erica said. "I feel like I've been set free. The only thing keeping me from tearing your pants off is the thought of my brother being in the next room." That made me laugh, and as I got myself together and was ready to head out I kissed her one more time, one hand squeezing her ass and pulling her into me as I held the back of her head with the other. "Ugh, you bastard," she said when we separated. "You keep getting better at kissing me." "Just taking your cues," I said. "Fuck you like I hate you, right?" "Did I say that?" Erica thought. "God, everything yesterday went so fast." "Actually, I think you said you wanted someone to love you, but who fucks you like they don't. I figured that went for steamy kisses, too." "Oh, it certainly does," Erica said, one finger tracing down her boob and nipple over her shirt. "But now I'm going to need to change panties, you bastard. God, you're leaving me here soaking wet." "I prefer to think of you as simmering for later," I smirked, and she scoffed and threw a sock at me as I left the room. The tour with the Surveyors was slow going, but it was late in spring and we had plenty of light left to us. Leo had taken them along a bunch of the lowlands areas, so I took them up the other side of the property, pointing out some of the ponds and a couple of old growth copses of trees. There was a solitary Redwood on the property which they all agreed would be a shame to lose, and I pointed out some other big, ancient trees that served as landmarks. Deep into the hike we reached the Spring Pond, high on one of the rolling hills near the back of the property, and I showed them where I wanted mine, my sisters and Leo's houses to be built. I didn't much care how they organized the lots, but the Spring Pond fed down as a stream into the Nehalem River that bordered the property, and it had sweet, pure water that had been a swimming hole for my family for generations. Other than the old House itself, this was where the Black family had made their mark. It helped convince the Surveyors when I pointed out that my family graveyard, dating back more than a hundred and fifty years, was an acre up the slope overlooking the pond. At the mention of a Native burial ground I could almost see all of them shudder, not in fear of spiritual consequences but of Red Tape. I had a feeling this particular project wouldn't actually care one shit if they came across potential burial grounds, but all of these folks had horror stories of major projects getting stalled for months, or even years, by old bones in the ground. The sun was setting over the hills when I led them back down, having reached the very far edge of the property and pointing out the markers my great-great-grandfather had erected prior to the first World War. It was twilight during the last few minutes of the hike, and despite being veterans of their work I could tell the long day of heavy walking, questions, and note-taking on the move had drained them all. As they left, trudging around the house back to their work trailers to file away their notes, I saw Vanessa just shutting off the light in the barn. "Hey, how'd it go today?" I asked. "Good. Better than I hoped, actually," she said, grinning widely. "How's it going in the house with your wife and... who was that?" "Erica's my girlfriend, and that's kinda new, and Danielle is; well, it's a long story. How's a beer sound?" I asked. "That sounds fucking great, actually," Vanessa said. She checked her watch and then nodded. "I've got some time. I'm technically off shift already, we just don't have any time clocks or anything set up yet. I sent the boys back in the van about fifteen minutes ago, I'll take my truck back to the motel when we're done." I fetche

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!

Our guest: Hossam Gamal, PharmD, BCPS, MBAWelcome to Drug Diversion Insights. In today's episode, we're diving into a critical conversation about hospital drug diversion programs and the evolving landscape of regulatory oversight. I'm joined by Dr. Hossam Gamal, an experienced Pharmacy Director who brings valuable insights into how surveyors are increasingly scrutinizing diversion mitigation efforts.Recent trends suggest a significant shift in how facilities are being evaluated - moving beyond simply checking boxes to requiring truly meaningful diversion programs. Dr. Gamal will share his firsthand experiences with recent surveys, discussing how regulators are examining program effectiveness, the role of monitoring software, and the essential components of a robust diversion response strategy.We'll explore whether surveyors are equipped with the necessary technical knowledge to evaluate these programs effectively, drawing parallels to similar challenges faced in other areas of healthcare compliance. Of particular interest is Dr. Gamal's perspective on establishing clear criteria for activating diversion response teams - a critical yet often overlooked aspect of comprehensive diversion mitigation.This conversation comes at a crucial time when healthcare facilities nationwide are reevaluating their approach to diversion mitigation. Whether you're a healthcare administrator, pharmacy professional, or compliance officer, today's discussion will provide valuable insights into creating and maintaining effective diversion programs that meet increasingly rigorous regulatory expectations.Thanks to our sponsor, MIDAS Healthcare SolutionsLearn more about V.I.E.W. Waste and Return System: https://midashs.com/products/For more information on Drug Diversion mitigation and resources, visit: https://www.rxpert.solutions/#drugdiversion #hospitalpharmacy #opioidcrisis #hospitalworker

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 

In this episode of the ASC Podcast with John Goehle, we cover the latest updates from the ASC industry, including an update on the Corporate Transparency Act, a survey about Gen Z workers, a review of the requirements of RN Administered This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: Non-Opioid Pain Medication FDA Approved: https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain Update on Corporate Transparency Act: https://fincen.gov/boi-faqs https://fincen.gov/boi/small-entity-compliance-guide Intelligent.com Articles about Gen Z Workers https://www.intelligent.com/1-in-5-managers-have-considered-quitting-due-to-stress-of-overseeing-gen-z-employees/ https://www.intelligent.com/1-in-6-companies-are-hesitant-to-hire-recent-college-graduates/ ASC Quality.org http://ascquality.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 

Hannah Howard Jones is the Director of Asset Management for Home Group, a housing association with over 58,000 rented and home ownership properties, combining integrated housing, health and social care in supporting their customers to fulfill their aspirations and live independently. Hannah's a chartered residential management surveyor with over 15 years experience in agency and client-side roles, across both the public and private sector. In this episode, we talk about Hanna's career journey and how her life experience affected her trajectory as a surveyor. We discuss the importance of understanding the built environment and people inhabiting it, the role of emotional intelligence in dealing with the challenges of housing repair and disrepair claims, how utilising the date can ensure compliance and quality in property management, and the significance of visibility, inclusivity and fairness in the housing sector and property professions. What is Covered: (00:00) The role of a chartered residential management surveyor (05:15) Hannah's experiences prior to becoming a surveyor (09:33) Her current role at Home Group (14:00) The significance of property and asset management (17:00) Surveyors' detective work and dealing with repairs and disrepair claims (21:00) The need for education on how to be a responsible tenant or landlord (23:39) The fundamental significance of access to quality housing (31:00) Hannah's experience of co-chairing a conference and representing the sector (38:18) The importance of creating an inclusive environment in the housing sector (44:05) The need for emotional intelligence in dealing with customers and colleagues (53:30) Addressing biases in property professions (57:56) The importance of listening and understanding the needs of customers (01:03:04) How to utilise data to improve compliance and quality in property management Resources: Home Group https://www.homegroup.org.uk/ Connect with Hannah Howard-Jones on LinkedIn https://www.linkedin.com/in/hannah-howard-jones-mrics-05584465/ Learn more about Awaab's Law https://www.housing.org.uk/resources/awaabs-law/ Tina Paillet “Why we need a built environment GCSE to inspire the next generation of professionals” https://www.bdonline.co.uk/opinion/why-we-need-a-built-environment-gcse-to-inspire-the-next-generation-of-professionals/5131605.article Samantha McClary “Male, pale and privileged: welcome to real estate” https://www.egi.co.uk/news/male-pale-and-privileged-welcome-to-real-estate/ Ryan Parke - The Science of Men's Mental Health https://www.lovesurveying.com/podcasts/the-surveyor-hub-podcast/episodes/2148287598 Buy me a Coffee https://www.buymeacoffee.com/thesurveyorhub The Surveyor Hub Community - Facebook https://www.facebook.com/groups/the.surveyor.hub.love.surveying/

In this episode of the ASC Podcast with John Goehle, we cover the latest updates from the ASC industry, including an update on the dockworkers settlement, a discussion of recent HIPAA issues, free toolkits from the ASC Quality Collaboration.  We also discuss recent experiences including infection control issues, on-boarding less experienced clinical staff and regulatory requirements related to research.  In our focus segment, we discuss how to handle flooding emergencies, and temperature and humidity issues.     This episode is sponsored by Surgical Information Systems, RFX Solutions,  triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: HIPAA Updates: https://www.hipaajournal.com/hapy-bear-surgery-center-data-breach-settlement/ https://www.axios.com/2025/01/13/hospitals-cyber-security-rule-upgrade ASC Quality Collaboration Toolkits:  https://ascquality.org/toolkits/ Becker's Article about Specialties Shifting toward ASCs https://www.beckersasc.com/asc-news/5-emerging-specialties-among-ascs.html?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=0573H1191845C8E 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.

This week's episode of "Surveyor Says! The NSPS Podcast" takes on the serious subject of surveyors and their role dealing with wildfires. Our guest, Carl C.de Baca, a professional land surveyor with R.E.Y. Engineers, Inc. from Folsom, CA. Carl and Tim recently sat down to discuss conditions of performing parcel tracement in post-disaster condition, biohazards to consider, and compilation of records research and data collection processes. A can't miss conversation so check it out today! NSPS Foundation Disaster Relief Help Available! The Foundation is a tax deductible 501(c)(3) organization. DONATE NOW to the NSPS Foundation Disaster Relief Fund here: https://nsps.us.com/page/DisasterRelief

Episode 205 of the series covers the A Russian Struggle Thread, Two Disabled Men in the Free State and a Surge in Surveyors. Sprinkled with tales of Hoffman. That would be Johannes Hoffman commonly known as Sias Hoffman, the first president of the Orange Free State who signed the Bloemfontein Convention with the British in February 1854. Regarded as a shrewd and able merchant, he had been disabled in an accident, but that didn't stop Hoffmann from wielding political power. He was also a fundamentalist voortrekker, hard core. Hoffman was one of the representatives of the Smithfield District in the Orange River Sovereignty during the negotiations between Boers and British. Both Hoffman and his State Secretary Jacobus Groenendal were disabled and their government to quickly gained the nickname 'the crippled government' which is not only wicked, but wouldn't fly in today's equitable lexicon. Groenendaal had been born in Holland then travelled to South Africa as a teacher in 1849. Hoffman was a friend of Moshoeshoe of the Basotho, conciliatory towards the Griqua who lived in the transOrangia, and pretty distrustful of Pretorius' more militant Boers. His friendships with the black and coloured people living around the Free State caused deep mistrust amongst his fellow Boers. Hoffman's term in office was also short-lived, just under one year, thus the crippled government epithet. As a gesture of good faith, Hoffman had given a present of a keg of gunpowder to king Moshoeshoe. His fellow burghers found this an unwise move, over-friendly and potentially dangerous for the survival of the new state. Relations between the Boers and the Basotho were less than cordial with the border dispute unresolved. What sealed Hoffman's fate, however, was not the gift itself so much as the fact that he tried to hide his actions from the Volksraad and the Orange Free State parliament. Living in the Caledon Valley and Orange River confluence areas were the Thlaping - a combination of Tswana peoples who had gathered in the area during the Difaqane, loosely led by Adam Kok but ostensibly under their chief Lephoi. French missionary Jean Pierre Pellissier set up his station at a place called Bethulie and by 1854 more than 3 000 Tswana, Thlaping and others lived there. They were a pretty mixed community, escaped Rolong, Sotho, Tswana and a number of Bastaards as they were known, Khoi and freed slaves — and many of these with special skills. Ironically, many of the former slaves were literate, which made them influential members of the community. Inside this sprawling Free State land of 80 000 square kilometres lived 10 000 Boers and English along with about 30 000 Griquas, Rolong and Thlaping. While Hoffman focused on local diplomacy, Treasurer Jacob Groenendaal and a 26 year-old Irish land surveyor called Joseph Orpen wrote the Free States' first constitution. And this was far more sophisticated than the Transvaal Constitution which was based on the Trekker 33 point manifesto and the Old Testament. In the Cape, the growing density of farm settlement had led to the post of Surveyor General way back in 1826. This officer would oversee surveys within the colony, promote a trigonometrical survey and then produce a map of the Cape and if possible, beyond. Charles Cornwallis Michel who was an energetic colonel of the Royal Engineers set about his task. He also had a perchant for sketch and watercolour. Unfortunately for everyone, except for greedy speculators, he could not complete his task effectively. An enormous backlog of farm and town plot diagrams awaited approval and by mid-1830s, the task was deemed impossible for Michel and his two assistants.

In this episode of the ASC Podcast with John Goehle, we cover the latest updates from the ASC industry, discuss possible supply chain issues in the new year, review the stalled Corporate Transparency Act and how it would affect ASCs, and in our focus segment, provide tips for preparing for a possible survey in 2025.   This episode is sponsored by Surgical Information Systems, RFX Solutions,  triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: ASC News- The Critical role of ASC's during national emergencies: https://ascnews.com/2024/11/the-critical-role-of-ascs-during-national-emergencies/?spMailingID=132653&puid=3910766&E=3910766&utm_source=newsletter&utm_medium=email&utm_campaign=132653 The Hill - New Report from CDC on Vaccination Rates: https://thehill.com/policy/healthcare/5003450-cdc-report-covid-flu-vaccination/ CDC estimates of hospitalizations and deaths Resources for Survey Preparedness: 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 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 Conditions for Coverage Conference https://conferences.asc-central.com/211-2/ Credentialing and Peer Review Conference: https://conferences.asc-central.com/176-2/   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://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 

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

Canada Immigration CEC Express Entry selection since 2015 for NOC 21203 Land surveyors for New Brunswick Good day ladies and gentlemen, this is IRC news, and I am Joy Stephen, an authorized Canadian Immigration practitioner bringing out this data analysis on the number of applicants approved for Canadian Permanent Residence for multiple years Under the Express Entry CEC selection based on your NOC code. I am coming to you from the Polinsys studios in Cambridge, Ontario The number of individuals selected under the old 4 digit NOC code 2154 or the new Specific 5 digit NOC code 21203 Land surveyors through the Federal Express Entry CEC for Canadian Residents in the express entry program is listed on your screen as a chart. These Permanent Residents were destined for the province of New Brunswick. The figures for each year from 2015 to 2023 are shown as a chart on your screen. Years without any selection for this category destinated for New Brunswick are shown as a blank. | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | - | - | 5 | - | - | - | 5 | - | - If you have an interest in gaining assistance with Work Permits based on your country of Citizenship, or should you require guidance post-selection, we extend a warm invitation to connect with us via https://myar.me/c. We strongly recommend attending our complimentary Zoom resource meetings conducted every Thursday. We kindly request you to carefully review the available resources. Subsequently, should any queries arise, our team of Canadian Authorized Representatives is readily available to address your concerns during the weekly AR's Q&A session held on Fridays. You can find the details for both these meetings at https://myar.me/zoom. Our dedicated team is committed to providing you with professional assistance in navigating the immigration process. Additionally, IRCNews offers valuable insights on selecting a qualified representative to advocate on your behalf with the Canadian Federal or Provincial governments, accessible at

Canada Immigration CEC Express Entry selection since 2015 for NOC 21203 Land surveyors for New Brunswick Good day ladies and gentlemen, this is IRC news, and I am Joy Stephen, an authorized Canadian Immigration practitioner bringing out this data analysis on the number of applicants approved for Canadian Permanent Residence for multiple years Under the Express Entry CEC selection based on your NOC code. I am coming to you from the Polinsys studios in Cambridge, Ontario The number of individuals selected under the old 4 digit NOC code 2154 or the new Specific 5 digit NOC code 21203 Land surveyors through the Federal Express Entry CEC for Canadian Residents in the express entry program is listed on your screen as a chart. These Permanent Residents were destined for the province of New Brunswick. The figures for each year from 2015 to 2023 are shown as a chart on your screen. Years without any selection for this category destinated for New Brunswick are shown as a blank.  | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | - | - | 5 | - | - | - | 5 | - | - If you have an interest in gaining assistance with Work Permits based on your country of Citizenship, or should you require guidance post-selection, we extend a warm invitation to connect with us via https://myar.me/c. We strongly recommend attending our complimentary Zoom resource meetings conducted every Thursday. We kindly request you to carefully review the available resources. Subsequently, should any queries arise, our team of Canadian Authorized Representatives is readily available to address your concerns during the weekly AR's Q&A session held on Fridays. You can find the details for both these meetings at https://myar.me/zoom. Our dedicated team is committed to providing you with professional assistance in navigating the immigration process. Additionally, IRCNews offers valuable insights on selecting a qualified representative to advocate on your behalf with the Canadian Federal or Provincial governments, accessible at

In this episode of the ASC Podcast with John Goehle, we cover the latest updates from the ASC industry, review requirements for annual governing body meeting requirements and in our focus segment interview Jamie Miller, with SCA HEALTH about Cultivating a Safety-First Culture: Leadership's Role in Patient Safety and Employee Retention.   This episode is sponsored by Surgical Information Systems, RFX Solutions,  triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: Johns Hopkins Article about Glowing Gel https://engineering.jhu.edu/news/scientists-engineer-glowing-gel-to-improve-eye-surgery/ OR Manager GLP 1 Guidance https://www.ormanager.com/briefs/new-guidance-preoperative-glp-1s-safe-for-surgical-patients/?oly_enc_id=3914G8504789C8H Quality, Safety & Oversight Memo Ref: QSO-25-09-ALL  DATE: November 21, 2024 SUBJECT: REVISED: Revisions to Appendix Q, Guidance on Immediate Jeopardy LINK: https://www.cms.gov/files/document/qso-25-09-all.pdf AEUs/IPCHs for the End of the Year If you need AEU or IPCH Credits for 2024 - make sure you visit: 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! http://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 

Get ready to fill your NSPS Young Surveyors Network (YSN) ballot for new officers! How? Listen to this episode of "Surveyor Says! The NSPS Podcast" for a terrific conversation with the two candidates for Secretary, Stacy Pollock (Michigan) and Adam Thayer (Idaho). Lots of great insights on the collaboration within this exciting group, so check it out today! YSN members are eligible to vote, so make sure you are signed up today. Elections close on December 31st!

Get ready to fill your NSPS Young Surveyors Network (YSN) ballot for new officers! How? Listen to this episode of "Surveyor Says! The NSPS Podcast" for a terrific conversation with the two candidates for Vice President, Farrah Etcheverry (Arizona) and Jon Geffre (South Dakota). Lots of great insights to the collaboration of this exciting group, so check it out today! YSN members are eligible to vote, so make sure you are signed up today. Elections close on December 31st!

In this episode we explore the fascinating history of Europeans working in the complex maritime world of China in the late nineteenth and early twentieth centuries. In particular we find out about ship surveyors working for the classification society Lloyd's Register, and how those employees influenced the global perception of maritime safety and risk management. This group has never previously been studied so everything you hear in this episode is 'new' history that helps us understand not only the functioning of ship surveyors in China at that time but more broadly the encounter and connections between Imperial Britain and China, a meeting that was rapidly intensifying, socially, culturally and economically. To find out more Dr Sam Willis spoke with Corey Watson, from the Centre for Port Cities and Maritime Cultures at the University of Portsmouth. Hosted on Acast. See acast.com/privacy for more information.

In this Special Episode of the ASC Podcast with John Goehle recorded live Live from the Washington Ambulatory Surgery Center Association 2024 Annual Education Conference & Trade Show 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,  triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: Main Website for WASCA: https://wasca.net/ Become a member of the WASCA: 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! 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 cover the latest updates from the ASC industry, discuss out-sourced Sterilization, explore recent changes in the accreditation industry, and examine the top CMS citation areas. For our focus segment, we feature an exclusive interview with Bill Prentice at the 2024 Washington State Association Meeting, discussing the implications of the 2024 election results, the 2025 Final HOPD/ASC Payment Rule, and updates to Medicare Quality Reporting requirements.   This episode is sponsored by Surgical Information Systems, RFX Solutions,  triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: Report by Mercer presented in MedCity: https://medcitynews.com/2024/09/nursing-healthcare-workforce/ AXIOS Article Nov 13th https://www.axios.com/2024/11/13/nasal-swab-test-covid-severity Offsite Sterilization Article in AORN from 2022: https://www.aorn.org/outpatient-surgery/article/2022-April-care-offsite 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://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 Your Drone Questions Answered, David Young, founder of Drone Launch Academy, sits down with Rut Patel, a mapping expert who works with survey firms to integrate drone technology into their workflow. They dive deep into how drones are revolutionizing the surveying industry by reducing project timelines, improving data accuracy, and offering cost-effective solutions compared to traditional methods.Root shares insights from his hands-on experience, explaining the step-by-step process of using drones for surveys—from project planning and flight execution to data processing and deliverables. He also highlights the types of drones and software commonly used, such as the Mavic 3 Enterprise with a DRTK station and photogrammetry tools like Pix4D.Whether you're curious about how drones are being used in geomatics, the benefits they offer for surveying, or what the future holds for this field, this episode is packed with practical knowledge and expert advice.Learn how drones are becoming an essential tool for surveyors and discover why this technology is reshaping the industry!

It is well known that Washington D.C. was carved out of parts of Virginia and parts of Maryland, but do you know how this was done? Today's episode goes through the legislation that created the District of Columbia as well as the individual surveyors who “layed out Washington D.C.” and how they did it. You can see us on YouTube, your favorite podcast application, Instagram, X, Facebook, and our website (fastfunhistory.com). We are the podcast from the Sons of the American Revolution.   Show Notes: https://boundarystones.org/  A. Morton Thomas and Associates, Inc.: The Hunt for Southeast 8 (Apr. 29, 1991). Alexander, Mrs. Sally Kennedy: "A Sketch of the Life of Major Andrew Ellicott," Records of the Columbia Historical Society, Vol. 2, pp. 170-182 (1899). Baker, Marcus: "The Boundary Monuments of the District of Columbia," Records of the Columbia Historical Society, Vol. 1, pp. 215-224 (1897). Chase, Louise Coflin: Boundary Stones of the District of Columbia (1930) [unpublished manuscript in the Washingtoniana Collection of the District of Columbia Public Library], later reprinted (minus one paragraph) in Records and History of the Boundary Stones of the District of Columbia (no date) [unpublished manuscript in the Kiplinger Research Library of the Historical Society of Washington, D.C.]. DCDAR: Records and History of the Boundary Stones of the District of Columbia (no date) [unpublished manuscript in the Kiplinger Research Library of the Historical Society of Washington, D.C.]. DCDAR: Biographies of the Boundary Stones (2001) [unpublished manuscript in the Kiplinger Research Library of the Historical Society of Washington, D.C.]. Miller, Mrs. Charles S., State Historian, DCDAR: Correspondence with National Park Service regarding the disappearance and replacement of SE8 (1962). National Capital Planning Commission: Boundary Markers of the Nation's Capital: A Proposal for Their Preservation & Protection (Summer 1976). National Park Service: National Register of Historic Places Inventory - Nomination Form: Jones Point Lighthouse and District of Columbia South Cornerstone (Mar. 1980). Northern Virginia Boundary Stones Committee: 1994-1995 Findings and Recommendations of the Northern Virginia Boundary Stones Committee (Sep. 1995). Nye, Edwin Darby: "Revisiting Washington's Forty Boundary Stones, 1972," Records of the Columbia Historical Society, Vol. 48, pp. 740-751 (1973). Robinson, June: "The Arlington Boundary Stones," The Arlington Historical Magazine, Vol. 9, pp. 5-19 (Oct. 1989). Shuster, Ernest A.: The Original Boundary Stones of the District of Columbia (1908). Shuster, Ernest A.: "The Original Boundary Stones of the District of Columbia," National Geographic, pp. 356-359 (Apr. 1909). Stewart, John: "Early Maps and Surveyors of the City of Washington, D. C.," Records of the Columbia Historical Society, Vol. 2, pp. 48-61 (1895). Woodward, Fred E.: Chart Showing The Original Boundary Milestones of The District of Columbia (1906). Woodward, Fred E.: "A Ramble Along the Boundary Stones of the District of Columbia With a Camera," Records of the Columbia Historical Society, Vol. 10, pp. 63-87 (1907). Woodward, Fred E.: "With A Camera Over the Old District Boundary Lines," Records of the Columbia Historical Society, Vol. 11, pp. 1-15 (1908). Woodward, Fred E.: "The Recovery of the Southern Corner Stone of the District," Records of the Columbia Historical Society, Vol. 18, pp. 16-24 (1915). Woodward, Fred E.: "Boundary Mile Stones" (1916) in Records and History of the Boundary Stones of the District of Columbia (no date) [unpublished manuscript in the Kiplinger Research Library of the Historical Society of Washington, D.C.].

On this Episode of the ASC Podcast with John Goehle we discuss the latest news in the ASC Industry, review the final 2025 ASC/HOPD Payment Rule and Update to the ASC Quality Reporting Measures, provide an update on developments in the IV Fluid Shortage and in our focus segment speak with Mary Ryan about developing the next generation of ASC Leaders.   This episode is sponsored by Surgical Information Systems, RFX Solutions,  triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: Baxter IV Fluid Updateshttps://meded.baxter.com/sites/g/files/ebysai4096/files/2024-10/ExtendedExpDatesIVSolutions%20v2.pdf?mkt_tok=NzEwLVpMTC02NTEAAAGWc_r9SzfYVWxtY036SKWAXOOizycFbDsQMgvHx8DbkmC7Ibef7ZiAchJT7IANNeOx6_tKoyg13ZIRHShmdrJTpRvvBdQ2Vlm3zHWq5HN394FmpUQ https://www.baxter.com/baxter-newsroom/hurricane-helene-updates https://meded.baxter.com/hurricane-helene-clinical-resources Outpatient Surgery Magazine article about Colored Additives in Wipeshttps://digital.outpatientsurgery.net/view/493385375/10/ Becker's Spine Review - ASC Suing Architectshttps://www.beckersspine.com/orthopedic-spine-practices-improving-profits/60890-orthopedic-practice-suing-over-opening-delays.html?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=0573H1191845C8E 2025 Final HOPD/ASC Payment Rulehttps://public-inspection.federalregister.gov/2024-25521.pdf https://www.cms.gov/newsroom/fact-sheets/cy-2025-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center-0 ASCA Focus Article:https://www.ascfocus.org/ascfocus/content/articles-content/articles/2024/digital-debut/asca-survey-provides-insight-into-reporting-ascqr-measures?_gl=1*s08qa6*_ga*NDY3NTAxNzk1LjE3MTE2NzQzODE.*_ga_5DE4L5HXFY*MTcyNTM3Njk1MS41Mi4wLjE3MjUzNzY5NTIuNTkuMC4w 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://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 RegionsCMS 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

Not everyone in the industry is on board with the Government's proposed building consents scheme. Businesses with a track record of delivering bigger projects, will be able to access streamlined consenting. Qualified tradespeople will be able to forego inspections for low risk builds through the opt in 'self-certification scheme'. Institute of Building Surveyors President David Clifton told Mike Hosking consents are there for a reason, as not all builders are perfect and there's still a high failure rate with consents. Clifton told Hosking we need to get our foundation right before moving forward on this. He says if we get our education, building and consenting processes right, then this can happen. LISTEN ABOVE See omnystudio.com/listener for privacy information.

On this Episode of the ASC Podcast with John Goehle we discuss the latest news in the ASC Industry including updates on Supply Chain Disruptions, a discussion of how employees can ease the transition from the Hospital to the ASC Setting and in our focus segment, do a deep dive into OAS-CAHPS and the pending implementation in January 2025.     This episode is sponsored by Surgical Information Systems   Notes and Resources from this Episode: HIDA Clips - Tentative Strike Agreement https://thehill.com/business/4915046-port-strike-deal-reached/?email=b3427831f1ca31e5cc12adbeaf25599c6d57e870&emaila=a00ba7927366ae9a1c9cb105a5fbfb6f&emailb=ddfdf9519da78d05b0a4dc5f8e76691a1849dbbec74f804949979add0b419019&utm_source=Sailthru&utm_medium=email&utm_campaign=10.03.24-Breaking%20News-Strike%20deal AHVAP supply chain disruption resource centerhttps://www.ahvap.org/ahvap-aorn-resource-center?mkt_tok=NTQ1LUtDUC0xNjMAAAGV6MH8jpU8dqpPZ0mH7Jh01Q5YFOaNTMmYuKo2ahIEYmiOn_nGAHp_hF3SFAS3Cnd2Rmc9CMfjadnUgJ87Glxux9oZAYuj63ASlm00t3cYPgsF AORN - Periop Today- 8/26/24 - Hospital to ASC: How to Make the Move https://www.aorn.org/about-aorn/aorn-newsroom/periop-today-newsletter/periop-today-newsletter/hospital-to-asc--how-to-make-the-move?utm_campaign=periop_today&utm_medium=promotional&utm_source=email&utm_content=ambulatory_mpl_240828&mkt_tok=NTQ1LUtDUC0xNjMAAAGVOfoVhES1yIvN5z7jzxOJdon4xPRpE-5bZJcNs693Dc-Sl59A3sB3Ry-zRC3WnfZzd59liOfYmj5mCXR5HhZZPQ_HI9FHXVlm2ZmbcGE2hluq Surgical Information Systems - This week's sponsor!Surgical Information Systems 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://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 RegionsCMS 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: On this Episode of the ASC Podcast with John Goehle we discuss the latest news in the ASC Industry including updates on Supply Chain Disruptions, a discussion of how employees can ease the transition from the Hospital to the ASC Setting and in our focus segment, do a deep dive into OAS-CAHPS and the pending implementation in January 2025.       This episode is sponsored by Surgical Information Systems   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!

On this Special Episode of the ASC Podcast with John Goehle recorded live at the 2024 New York State Association of Ambulatory Surgery Center's Annual Conference 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, triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: New York State Association of Ambulatory Surgery Centers:Membership Application: https://www.nysaasc.org/benefits-of-membership Web Site: http://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://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 RegionsCMS 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

On this Episode of the ASC Podcast with John Goehle we discuss the latest news in the ASC Industry, review some recent experiences with accreditation and CMS surveys, discuss some interesting statistics between HOPDs and ASCs and in our focus segment, talk to Kara Newbury, Chief Advocacy Officer for ASCA about the 2025 HOPD/ASC Proposed Payment Rule.     This episode is sponsored by Surgical Information Systems, triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: Beckers ASC Review Comparing ASC's and HOPD'shttps://www.beckersasc.com/asc-news/ascs-vs-hopds-in-5-numbers.html?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=0573H1191845C8E Article in CNBC from September 19th about the pending Longshoremen's Strikehttps://www.cnbc.com/2024/09/19/largest-port-on-east-coast-begins-preparations-for-a-strike.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! http://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 RegionsCMS 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 

On this Episode of the ASC Podcast with John Goehle we discuss the latest news in the ASC Industry, Review issues with the 2025 Medicare Quality Reporting Measures, discuss the future of staff shortages and review recent litigation.  In our focus segment we will discuss Life Safety with Ruben Garcia - a life safety surveyor with AAAHC and a life safety consultant   This episode is sponsored by Surgical Information Systems, triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: Beckers hospital review deficits and surplus of healthcare workers by 2028https://www.beckershospitalreview.com/workforce/healthcare-faces-deficit-of-100-000-workers-by-2028.html?origin=WomensE&utm_source=WomensE&utm_medium=email&utm_content=newsletter&oly_enc_id=0573H1191845C8E https://www.mercer.com/en-us/insights/talent-and-transformation/attracting-and-retaining-talent/future-of-the-us-healthcare-industry/ Press Ganey Patient Satisfaction Rates Uphttps://info.pressganey.com/e-books-research/patient-experience-2024 CNBC news about the potential longshoremen's strike:https://www-cnbc-com.cdn.ampproject.org/c/s/www.cnbc.com/amp/2024/09/04/east-coast-port-strike-fears-grow-as-key-labor-union-meetings-begin.html Outpatient Surgery Article on Supply Shortages:https://digital.outpatientsurgery.net/view/473472688/26/?mkt_tok=NTQ1LUtDUC0xNjMAAAGU0lcWS90dlVVolT5a4MP9vZ-mc7o6qU-K0sUrNLm9nDWALZV5p2kAqKLbclkrkJWDbT5VRkFBNXLzKCIzpi-bmM0uONppLIsQFqxZm7xoM1he 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://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 RegionsCMS 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 

On this Episode of the ASC Podcast with John Goehle recorded live at the 2024 Illinois Ambulatory Surgery Center Association Annual Conference in Chicago Illinois we interview some of the speakers and discuss the benefits of membership in the  Association.   This episode is sponsored by Surgical Information Systems, triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: Illinois Ambulatory Surgery Center AssociationMembership Application: https://wjweis.association-service.org/securesite/iasca/app.aspx Web Site: https://il-asca.org/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! http://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 RegionsCMS 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

Today's episode of "Surveyor Says! The NSPS Podcast" finds us talking with one of the legends in social media for surveyors, Justin Farrow, Founder of Land Surveyors United. Justin, along with collaborator Christopher Lucas and Texas RPLS Deward Bowles, joined Tim Burch to discuss the radical overhaul of the famous website. They spoke of providing educational resources and tools for every facet of surveying, so join us for a great conversation about how the future of sharing surveying knowledge is evolving. For more information about the website: https://landsurveyorsunited.com/rebirth

On this Episode of the ASC Podcast with John Goehle we discuss the latest news in the ASC Industry, provide an update on health care data breaches, discuss methods to create and update your policy manual and in our focus segment, we discuss revenue cycle metrics with Jessica Nelson from Surgical Information Systems.   This episode is sponsored by Surgical Information Systems,.   Notes and Resources from this Episode: Healthcare data breacheshttps://digital.outpatientsurgery.net/view/302017647/14/#zoom=true https://www.axios.com/2024/07/08/health-care-cyberattack-cybersecurity-cisa-pushback Cyber Incident Reporting for Critical Infrastructure Act of 2022 HIPAA journal July 24 referenced an IBM articlehttps://www.hipaajournal.com/2023-cost-healthcare-data-breach/ HIPAA journal July 17 2024 CYBER fire drillshttps://www.hipaajournal.com/cyber-fire-drills-for-healthcare/ Beckers ASC review- ASC leader pay soarshttps://www.beckersasc.com/leadership/asc-leader-pay-soars.html?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=5567B4088734C3Z 2024 Multi-State Conference:https://www.eventbrite.com/e/2024-multi-state-asc-conference-tickets-966457188467 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://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 RegionsCMS 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

On this Episode of the ASC Podcast with John Goehle we discuss the latest news in the ASC Industry, Celebrate ASC Month, Review Upcoming ASC Central Conferences including the 2024 2 day Virtual Multi-State Conference in November, Provide more information on the proposed 2025 ASC/HOPD Payment rule including the new ASC Quality Reporting proposals, Remind listeners on the requirements for malignant hyperthermia drugs and in our focus segment, discuss Cardiology Procedures in the ASC Setting.    This episode is sponsored by Surgical Information Systems, triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: DOCbuddy interview with John Goehle https://www.linkedin.com/posts/docbuddy_surgerycenter-outpatientsurgery-ambulatorysurgery-activity-7224791546217328642-sJ6S?utm_source=share&utm_medium=member_desktop Upcoming ASC Conferences:2024 Multi-State Conferencehttps://www.eventbrite.com/e/2024-multi-state-asc-conference-tickets-966457188467?aff=oddtdtcreator Infection Control 101https://conferences.asc-central.com/asc-infection-control-coordinator-training-101/ Infection Control 201https://www.eventbrite.com/e/asc-infection-control-coordinator-training-infection-control-oversight-201-tickets-945304429997?aff=oddtdtcreator OR Manager - Article about Recallshttps://www.ormanager.com/briefs/fda-announces-class-1-recalls-of-ventilator-eye-injection-kits/?oly_enc_id=3914G8504789C8H Recalled Items:Bausch + Lomb I-Pack Injection Kit, UDI/DI 20841305107544; Lot Number P62764979R. Bausch +Lomb I-Pack Injection Kit with drape, UDI/DI 20841305107551, Lot Number P63044983R. Bausch +Lomb I Pack Injection Kit, UDI/DI 20841305107605, Lot Number P62764965R. Bausch+Lomb I-Pack Injection Kit UDI/DI 20841305107612, Lot Number P627664970R. Beckers ASC Review Article about increasing stark law violation enforcement:https://www.beckersasc.com/asc-coding-billing-and-collections/10-things-to-know-about-rise-of-stark-law-violations.html?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=5567B4088734C3Z GCaptain Article about looming supply chain issue:https://gcaptain.com/potential-coast-wide-strike-inches-closer/ 2024 Payment Rule Resources:CMS 2025 proposed payment rulehttps://www.cms.gov/newsroom/fact-sheets/cy-2025-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center Proposed List of Qualifying Non-Opioid Drugs for Separate ReimbursementExparel  Omidria  Dextenza  Xaracoll Zynrelef Effective April 1, 2025  Ketorolac  ON-Q Pump  ASCQR:Current List of Required Elements:ASC 1 Patient Burn Asc 2 Patient Fall ASC 3 Wrong site, wrong side, wrong patient, wrong procedure wrong implant ASC 4 - All Cause Hospital Transfer or Admission ASC-12 - Facility 7-Day Risk-Standardized Hospital Visit Rate after Outpatient Colonoscopy ASC-13 Normothermia Outcome ASC-14 Unplanned Anterior Vitrectomy ASC-15a-e OAS CAHPS Measures ASC-17 Hospital Visits after Orthopedic Ambulatory Surgical Center Procedures ASC-20 COVID-19 Vaccination Coverage Among Health Care Personnel Proposed Additions:Screening for Social Drivers of Health (SDOH) Voluntary (Mandatory starting in 2026) Screen Positive for Social Drivers of Health (SDOH) Voluntary (Mandatory starting in 2026) Facility Commitment to Health Equity (FCHE) Mandatoryhttps://qualitynet.cms.gov/files/659c609eca7fd3001b35edab?filename=AttstGdnceHCHEMeas_v1.2.pdf Malignant Hyperthermia Resources:http://mhaus.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://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 RegionsCMS 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 

On this Episode of the ASC Podcast with John Goehle we discuss the latest news in the ASC Industry, take a preliminary look at the proposed CMS 2025 HOPD/ASC Payment Rule, Discuss our upcoming conferences and in our focus segment talk about Time Outs including an interview with Bill Duffy - who has been referred to as the “Father” of the Time-Out.    This episode is sponsored by Surgical Information Systems, triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: CMS 2025 proposed payment rulehttps://www.cms.gov/newsroom/fact-sheets/cy-2025-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center SEATTLE Plastic Surgeon Fined 5 million for falsifying reviews(Beckers ASC Review):https://www.beckersasc.com/asc-news/cosmetic-asc-fined-5m-for-falsifying-reviews-intimidating-patients.html?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=0573H1191845C8E Gastroenterology & Endoscopy News about smoke exposure in GI endoscopy:https://www.gastroendonews.com/Endoscopy-Suite/Article/05-24/endoscopy-suite-smoke-inhalation-risks-healthcare-workplace-safety/73824 Beckers ASC Review June 25th Post Procedure Clawbackshttps://www.beckersasc.com/asc-coding-billing-and-collections/ascs-see-post-procedure-payer-clawbacks-intensify.html?origin=ASCE&utm_source=ASCE&utm_medium=email&utm_content=newsletter&oly_enc_id=0573H1191845C8E   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://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 RegionsCMS 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

On this Episode of the ASC Podcast with John Goehle we discuss the latest news in the ASC Industry including a discussion of OSHA 300 Reporting, reviewing the difference between a policy and a protocol, a discussion about the Medical Advisory or Executive Committee and in our focus segment, we discuss Credentialing and Privileging and interview Amanda Penrod with RFX Solutions about Credentialing documentation pitfalls.    This episode is sponsored by Surgical Information Systems, triValence, Medserve and  Ambulatory Healthcare Strategies.     Notes and Resources from this Episode: ShiftKey Results of its study looking into what influenced newer nurses, or those who considered becoming nurses but decided not to, in making their decisions.https://www.shiftkey.com/resources/news/shiftkey-report-social-media-gen-z-and-the-future-of-nursing Becker's Health IT from May 16th- Nurses are becoming concerned about AI in healthcare.https://www.beckershospitalreview.com/healthcare-information-technology/nurses-call-for-pause-on-healthcare-ai.html?origin=BHRE&utm_source=BHRE&utm_medium=email&utm_content=newsletter&oly_enc_id=0573H1191845C8E Amanda Pendrod - RFX Solutions:https://www.rfxsolutions.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! http://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 RegionsCMS 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 

Our final episode in our series featuring chats with FIG Young Surveyors from the recent FIG Working Week 2024 in Accra, Ghana is Angela Anykora from Nigeria and Roshni Sharma from Australia. They joined Tim Burch to chat about the Working Week and how the FIG Young Surveyors are engaging with the profession around the world. We were joined by Rosario Casanova, a surveying professor from Uruguay and Kwabena Asiama, former Chair of the FIG YSN and current Commission 8 Chair from Ghana. A lively conversation that features lots of topics yet captures the overall comradery of the Young Surveyors. This was a great way to wrap up our trip to Ghana, so check out our conversations from all our episodes today!

On this Episode of the ASC Podcast with John Goehle we discuss the latest news in the ASC Industry including recent regulatory changes in Kentucky related to medical errors, a discussion about a recent survey and governing body reporting of QAPI activities and in our focus segment we talk about managing drug costs with john Karwoski with JDJ Consulting.    This episode is sponsored by Surgical Information Systems, triValence, Medserve and  Ambulatory Healthcare Strategies.   Notes and Resources from this Episode: Science.Org Article on SSIshttps://www.science.org/doi/10.1126/scitranslmed.adk8222 OR Manager Article on Nasal Decolonization:https://www.ormanager.com/antiseptic-nasal-decolonization-noses-ahead/ Drug Diversion Article:https://mailchi.mp/5aea19dd3756/alert-missing-fentanyl-leads-to-surgery-center-license-suspension-12936095?e=b2b6f4d67c Kentucky First State to Decriminalize Medical Mistakeshttps://www.wkyt.com/2024/04/30/kentucky-become-first-state-decriminalize-medical-mistakes/ JDJ Consulting:John Karwoski JDJ Consulting https://www.jdjconsulting.net/ 609-313-7572 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://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 RegionsCMS 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 

On 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 we interview some of the speakers and discuss the benefits of membership in the  Association.    This episode is sponsored by Surgical Information Systems, triValence, 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! http://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 RegionsCMS 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 

On today's show we are talking about the importance of hiring a surveyor for every step of the building process.  The first case study is of a property located in Hawaii on the island of Puna.  A construction company has reportedly built a half-million-dollar house on the wrong property. The second example is a public road that was built 20 feet off center and is encroaching on the neighbor's property. ---------------- Host: Victor Menasce email: podcast@victorjm.com