APEX and ACR and direct supervision

[firewicket]

Center is planning on becoming accredited by once of the ROCR approved quality programs.
Anyone offer any insight into whether these mandate direct supervision versus the lovely CMS general supervision many of us have become accustomed too
To keep the discussion relevant to the question: this is not a discussion about if CMS allows general supervision. For anyone who has investigated that it is quite clear. ASTRO has other political motives.
Thanks

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[HolySmokes]

ACR requires direct supervision but we have used some remote coverage due to MD staffing issues and during our last survey (2024) we were still reaccredited, so it doesn't seem to be make or break.

 

[Gfunk6]

ACR requires direct supervision but we have used some remote coverage due to MD staffing issues and during our last survey (2024) we were still reaccredited, so it doesn't seem to be make or break.

Exactly. The key is that you need to have a written plan or document that says direct coverage is the standard. However, ACR (at least) understands that life happens and occasionally remote coverage will be needed.

 

[RickyScott]

Exactly. The key is that you need to have a written plan or document that says direct coverage is the standard. However, ACR (at least) understands that life happens and occasionally remote coverage will be needed.

Hospital was trying to bully us into hiring a 3rd but we called acr and they were very reasonable. They basically dont want one doc hired to cover 2 centers.

 

[medgator]

Virtual direct supervision has been the law of the CMS land since early 2020

 

[CCJW]

ACR requires direct supervision but we have used some remote coverage due to MD staffing issues and during our last survey (2024) we were still reaccredited, so it doesn't seem to be make or break.

Can you elaborate on this? We were recently ACR accredited -- I have had several conversations with the ACR rad onc folks asking about their supervision policies (I am also solo), and they essentially told me that they only allow non-direct supervision in cases of unplanned emergencies. As a result, I have been shutting the clinic down/starting late to get to dentist/doctors appointments etc. How have you been managing this?

 

[HolySmokes]

Can you elaborate on this? We were recently ACR accredited -- I have had several conversations with the ACR rad onc folks asking about their supervision policies (I am also solo), and they essentially told me that they only allow non-direct supervision in cases of unplanned emergencies. As a result, I have been shutting the clinic down/starting late to get to dentist/doctors appointments etc. How have you been managing this?

Ours is a bit of a different situation - we have several locations in our market that are ACR accredited but one of them is very rural. We have had difficulty with staffing full time because most of our locums have only wanted to cover 3 days/week. We remotely supervise the other 2 days from our main locations.

 

[randomname2018]

ACR and ASTRO require direct supervision. If ASTRO discovers you lack direct supervision, your practice will be notified. That notification requires the practice to describe the situation that resulted in non-compliance and a plan to achieve compliance moving forward.

While I appreciate that the idea of accreditation is largely suspect, if one compares the two programs directly, ACR is the better program IMO.

 

[firewicket]

I like how they have now snuck this into the ROCR legislation now. You have to join! So many politics.

 

[medgator]

ACR and ASTRO require direct supervision. If ASTRO discovers you lack direct supervision, your practice will be notified. That notification requires the practice to describe the situation that resulted in non-compliance and a plan to achieve compliance moving forward.

While I appreciate that the idea of accreditation is largely suspect, if one compares the two programs directly, ACR is the better program IMO.

Virtual direct is direct. According to CMS. Does ASTRO qualify "direct" ?

 

[randomname2018]

Virtual direct is direct. According to CMS. Does ASTRO qualify "direct" ?

Per Apex, direct is in person.

 

[medgator]

Per Apex, direct is in person.

Don't think ACR/ACRO care. They even do much of the site visits virtual these days

 

[TheWallnerus]

Virtual direct is direct. According to CMS. Does ASTRO qualify "direct" ?

Per Apex, direct is in person.

I hear that ASTRO refers to virtual direct as VD.

 

[CCJW]

Don't think ACR/ACRO care. They even do much of the site visits virtual these days

Per direct conversations with the ACR staff (circa November 2024), that is not the case. I have that in writing (see attached) because i asked them this question. I just looked at their answer again -- they specify that on site direct supervision is required for ACR accreditation. Wonder if anything has changed in the meantime. Would be nice to have some flexibility.

 

[medgator]

Per direct conversations with the ACR staff (circa November 2024), that is not the case. I have that in writing (see attached) because i asked them this question. I just looked at their answer again -- they specify that on site direct supervision is required for ACR accreditation. Wonder if anything has changed in the meantime. Would be nice to have some flexibility.View attachment 403928

Direct virtual supervision isn't general supervision. Even the folks at the ACR don't know what they are talking about 🤦🏾