Owners
The owner's of Brighton Surgery Center are 18 of the leading ophthalmologic and gastroentrology specialists in Rochester.  Combined, these physicians perform over 10,000 procedures per year.

Organizational Structure
The operating corporation (Brighton Surgery Center, LLC) is a Limited Liability Corporation (LLC) with 18 members.  The Corporation is managed by 3 "managers", each elected for a one-year term.  This Company manages the operation and is responsible for the establishment of policies and procedures that ensure the facility meets all applicable regulations.   The Corporation leases the facility from a related Real Estate Partnership (See below).  Day to day operations are managed by the Chief Operating Officer and Clinical Manager.

Real Estate
The real estate corporation that owns the land is called RGW, LLC.

Service Area
As stated earlier, the population served includes residents of Monroe, Livingston, Wayne, Ontario, Genesee, and Orleans counties.  The aforementioned area has a population in excess of 1.1 million residents.

Program Need
The Center provides approximately 10,000 surgeries per year. The Owner’s practices are growing and with the anticipated growth in the over 55 year old population (and the propensity of this population to utilize the Owner’s surgical services) it is expected that the surgical procedures they perform will increase at a 5% rate.  

Access to Care/Financial Access
The facility is conveniently located on Westfall Road near a wide range of other medical services.  This location is within 3 miles of the main north-south expressway (Interstate 390) for the Rochester area.  This expressway connects with the major east-west highway (Interstate 490) for the Rochester Area.

Services are available to all persons, regardless of race, physical capability, religion, gender, age, sponsor, referral source or diagnosis.  The Owner’s are deeply committed to providing access to all patients in the service area regardless of payment source.   All major insurance carriers are accepted.  In addition, charity care is accepted and a sliding fee schedule has been established for those individuals without medical insurance.  

The facility is located within a half mile of a bus stop providing access to the facility for both patients for preoperative visits and for potential employees without any other means of transportation.   Patients who do not have their own transportation on the day of surgery have access to several services in Rochester that will provide transportation to and from the facility.

Program Services and Utilization
Hours of Operation – Operating Hours for the Facility are from 7:00 am to 6:00 pm.   

Emergency Coverage – During operating hours, emergency coverage is provided through the office staff.   When the office is closed, the facility’s phones are forwarded to a telephone answering service that will contact the physician on-call for the patient to address the emergency.  If the physician is unable to be contacted, the Chief Operating Officer or the Clinical Manager will be contacted to follow-up.  All patients are given post-operative instructions that will list the telephone numbers of both their surgeons and the facility.

Anesthesia Coverage – The facility has developed a relationship with an anesthesia group to perform all of the anesthesia services in the facility.   Anesthesia services are under the direction of a board certified anesthesiologist whose responsibility includes assurance that anesthesia is administered in accordance with the standards of professional practice only by persons qualified to do so and that a physician examines each patient immediately prior to surgery to evaluate the risk to anesthesia and the procedure to be performed.

Hospital Affiliation – The Owner’s currently have a transfer agreement with Strong Memorial Hospital  to provide transfer arrangements in the event of an adverse event at the facility.  The Rochester Regional Hospital Association has established a “Community-Wide Transfer Agreement” through which all Article 28 Facilities located in Monroe County and some of the surrounding Counties agree to the accept transfers from any of the other facilities that have signed the agreement.  This agreement sets for the terms under which such a transfer shall occur.  It is anticipated that upon approval of this application, the Facility will contact the RRHA to assure it is included in the next revision to the list of facilities participating in the Agreement.

Procedures Performed - The Owner’s provides services in the area of Ophthalmologic Surgery, Orthopedics, Gastroenterology, Podiatry, Pain Management,  Ear, Nose and Throat Surgery, and General Surgery.  

Credentialing - Specific surgical procedures to be performed by each practitioner are delineated and reviewed on an on-going basis by the medical staff.   The medical staff develops and reviews the surgical procedures permitted to be performed on an annual basis.  Each member of the medical staff are required to have a staff appointment and be board certified.  Formal procedures have been adopted by the medical staff for evaluating and approving the credentials of physicians and affiliated health professionals.  

Rules and Regulations - All procedures performed at the facility are performed in conformance with the standards of professional practice.  Nursing services are under the responsibility of a registered professional nurse.  The program complies with all requirements of the New York State Code of Rules and Regulations.  The program’s policies and procedures have been developed within the Code’s guidelines demonstrating the willingness and ability of the Owner’s to safely serve ambulatory surgery patients with appropriate infection control, quality assessment and improvement, patient transfer, emergency care, credentialing, and medical recordkeeping protocols.   

Quality
The Owners are deeply committed to providing quality care in a safe environment.  As part of that commitment, the Owners have developed and maintain a Quality Improvement program that assesses the quality of the services it provides, evaluate changes that are appropriate to enhance that quality, and implement changes to assure the facility is continuously improving the quality of its services.  .

In order to assure that the facility continues to improve the quality of the services it provides, all patients are asked to provide feedback upon discharge.  They can complete a short “satisfaction survey” and mail it postage-free back to the facility or complete an Internet-based survey form.  In addition, each patient is phoned post-discharge to determine that all post operative questions and issues have been addressed.  This phone call also solicits feedback on the quality of services provided.   

The Quality Improvement Program reviews all incidents identified by the facility, review the results of Quality Improvement Studies, and investigate all reportable incidents.   A database has been established to track various statistical indicators within the operation to determine trends that need investigation.  Medical Records are reviewed on a regular basis to assure that they are completed appropriately and provide sufficient documentation of the surgical procedure.

The facility has established a Corporate Compliance Program to assure that all owners, employees and staff physicians act in a ethical manner and in compliance with all laws and regulations.  Regular audits are performed under the program to assure that the facility does not deviate from its established standards.

Staffing
The majority of the employees of the facility are nurses.  The Owners are committed to maintaining a safe environment for the patients and employees.  Registered Nurses and qualified Surgical Technicians or their equivalent will be hired to staff the operating rooms at appropriate staffing levels.  The Rochester Community continues to experience a shortage of nurses in the surgical area.   Since most of the procedures will be drawn from local hospitals and one of the local freestanding ASC’s, it is expected that staff from those facilities will be drawn to the proposed facility.   The proposed facility will offer competitive salary schedules and benefits, more flexible work schedules, less overtime.  It is anticipated that the facility will only employ experienced nurses and technicians due to the lack of resources that hospitals have to train new graduates.

Employees are provided with extensive on the job training, as well as periodic on-going continuing education.  Resources are provided to assist all employees to keep their skills current.   Regular training is provided in all areas required by the Department of Health and the Medicare Program.  Additional training is provided in areas such as Corporate Compliance, computer skills, communications, use of equipment, new procedures, legal issues, and health care finance.

Program Benefits/Impact to the Community

The benefits to the community for this facility are as follows: