Today's SurgiCenter - CASC Credential Matures

CASC Credential Matures, Enhances Administrators’ Skill Sets

By Kathy Dix

A year ago, the Board of Ambulatory Surgery Certification (BASC) began offering the Certified Administrator Surgery Center (CASC) credential. How has the credential matured over the last 12 months?

The CASC credential was created to affirm an administrator’s skills. Running an ASC is a tall order, and involves finance, human resources, quality and regulatory issues. The CASC test examines each of these areas, and requires critical thinking skills from the test-takers.

“I’m not sure the CASC credential itself has changed,” says Betty Bozzuto, RN, MBA, CASC, test development coordinator, a FASA board member and executive director of Naugatuck Valley Surgical Center in Waterbury, Conn. “We started out with an idea, and we’ve developed it into a meaningful credential. If you can pass the test, it shows you have a good understanding of what the job of surgical center administrator is.”

Bozzuto became involved with the test because she is active in FASA. “It was something to me that had a lot of value, because I’m also a surveyor for AAAHC, and I’m out on the road a lot. I go to these smaller places that don’t have the corporate groups for support. These administrators are out there on their own and don’t often even know that there are these regulations or new Medicare stuff,” she says. “When they talked about credentialing administrators, I said this would be perfect, especially for the smaller groups, because it gives them a way to enhance what they know and to expand it because it’s just not in a book anywhere,” adds Bozzuto.

“It was a wonderful experience,” she recalls. “It really is incredible when you see how a test is put together. And writing questions is one of the hardest things I’ve ever done in my life. We’re working on trying to put together some reference material so it’ll be a little easier to study for it, but it’s really experience that makes you even qualified to take it.”

The CASC credential has great room for growth. “We haven’t marketed it as much as we could; it’s spread by word of mouth and people tell their friends,” Bozzuto observes. “I think as employers find out that the person they’re getting is so well-rounded, they’ll demand it as a prerequisite for the job.”

“Over the last almost three years, the test was developed and has been administered three times,” clarifies Joe Jordan, president of BASC and president of Practice Management Services in Durham, N.C. “When it was originally developed, a group of questions were created, debated and ultimately, 400 was the number that was approved. 200 are used in an exam, so we have an initial reservoir of another 200 questions, which are used in addition to the original 200 to come up with each test, so the test is not the same every time.”

These questions will evolve over time, he adds. “We ask various people to suggest questions that can be added to the pool, and as we administer the test, questions that are unclear or answers or that seem to suggest different things to different people will either be modified or dropped, because if they confuse or don’t give us the ability to say ‘This is the right answer,’ that doesn’t help anybody.”

There is no fixed interval for administering the test; it depends on demand. “We will look at the demand for the test as well as review the geographic response if we’re getting more people from the west coast than the east,” Jordan explains. “If there seems to be a somewhat equal demand across the country, then perhaps we can give it just once a year at a central location. It would be my wish that we administer it at least annually, because there is certainly enough demand and enough new people in the industry that we ought to offer them that opportunity.”

The intent behind the certification was to allow qualified people to be recognized both by their peers as well as employers, says Jordan. “It should be a good thing for them career-wise, because they can hold themselves out as being certified. I think there are over 3,600 ASCs in the country; if there are only 148 CASC holders, then there are not a whole lot of people out there who have that credential if considered for a position. The reverse is also true; if I am an owner, it gives me some comfort to know the person I’m prospectively going to hire has completed this examination and demonstrated their mastery of the areas it seems to take to successfully run a surgery center.”

When asked why she was among the first to take the test, “I thought it would make me more valuable,” says Ruth May, director of ambulatory surgical services at Indian Wells Valley Surgery Center, Ridgecrest, Calif., and one of the early CASC credential holders. “It was a concrete way to verify that I had some of the skills that I thought I did.”

The next three dates for the CASC test are as follows:

May observes, “You have to have a pretty broad body of knowledge in both experience and education before you can even sit for the exam. It felt really good to be able to pass an exam like that. It made me feel like I was a more valuable employee.”

As for how it changed the environment of her workplace, May says, “I thought it would have more of an impact on the people above me, but it tended to have more of an impact on the people below me. I think the people above me felt if they recognize that, they would have to pay me more,” she jokes.

“I hadn’t been at this facility all that long, but I think it helped me to settle in a little bit better, because people respected that I knew what I was doing. I think there was a respect for that credential. I’m not sure they had a problem coming to me before with questions, but I think they were more confident in that if I didn’t have an answer, I could at least find one, because I had a lot of resources,” she says.

“It’s not really a static credential; it’s kind of a living, growing thing,” May continues. “Every year, you have to submit your continuing education in each of the five areas. It’s made known to you almost on a daily basis how much things are changing, and how important it is to keep up-to-date.”

However, she says, “at the same time I was surprised that there weren’t more people who took it after the first time. I’m wondering if there’s still some hesitancy or fear about taking it. I think anybody in an administrative position is already in a challenging environment, and the exam reflects that, but they shouldn’t be intimidated by that. They’re already able to handle challenging situations because they’re doing that job.”

Many people, she points out, still do not know what the CASC credential is. “Most people intimately involved in the ASC industry recognize the credential. There are people out there paying attention to that. To be perfectly honest, I have gotten a lot of job offers. I don’t have a problem with [the job offers, but] I haven’t found anything yet that makes me want to leave here!” she says. “It’s kind of reassuring. It also lets you know that there are other people in the industry who appreciate the fact that this credential means something.”

When asked if the credential has affected her work environment in tangible ways, May responds, “I’m the same person I was before I took the credential. The credential is a very good thing, but your daily job performance is just as important — how you function on a daily basis.”

The real question is whether the test was a good measure of ability. “I thought the exam was very fair,” May affirms. “It was a little bit daunting to prepare for, because you couldn’t go out and buy a book. They just gave you the subject matter and said ‘study these five areas.’ So that was a little bit intimidating. It wasn’t tremendously difficult; it was appropriately challenging.”

In a videotaped interview with FASA, Margaret Orman of United Surgical Partners International adds, “I think that has been a very important credential for us to be able to offer. It achieves a stamp of approval or a sense of security particularly for us and our company. When we hire someone who has that credential, we know that they have the knowledge and the ability to run a surgery center.”