In my state, if you want to build an ASC, the certificate of need process takes 12-18 months (or it did pre-COVID), and you can’t start building a structure until you have the CON. And you can’t get a CON if you can’t prove that not only can you not provide adequate care, but that no one in the community can. And none of that includes actually hiring an architectural firm that can make the building up to code, paying for it, buying the property, and then building it.
Your only other option would be to actually expand your hospital, which I have to imagine is even worse.
And then, as mentioned, you have to staff the ASC or new ORs, and right now no one can staff the ORs that they already have. COVID really @&$ked an already nearly @$&ked system. A lot of people who were only hanging around because it was convenient and they got benefits just retired or started doing something else when those things both became untrue.
I mentioned it on another forum, but I had a patient angry that I couldn’t get her husband in to the OR for three months who later told me that she was an OR nurse until COVID and then she retired early. And that’s why we can’t get her husband to the OR for three months.
We just broke ground on an ASC that planning started for in 2019. Which is actually pretty amazing considering the COVID delays. I have no idea where they’re going to get people to work in it.