Posted in: Triangle Times Today
Volume 5 | Issue 2 | February 2026
Artificial Intelligence (AI) Leads Key Changes in v45 Standards—Public Comment Coming Soon
A substantive area of change to the proposed addition of AAAHC v45 Standards is addressing the use of artificial intelligence (AI) in ambulatory care, which must be guided by clinical oversight and ethical responsibility. Developing these Standards is a rigorous and multilayered process, and much of this work happens behind the scenes.
One of the most important steps in the Standards development process is sharing proposed new Standards—and any substantive revisions to existing ones—for public comment. Stakeholders in this process include accredited organizations, Surveyors, professional associations, and the public.
During public comment, AAAHC’s Standards Development Committee (SDC) reviews all feedback and makes revisions as needed to strengthen clarity, reduce ambiguity, and ensure the Standards are meaningful and applicable across ambulatory care settings. This process is essential to improving the quality, usability, and integrity of the Standards before they become effective. To learn more about the Standards development lifecycle, please visit the AAAHC website.
Public Comment Is Coming Soon—We Need Your Input!
The public comment period for the version 45 (v45) Standards will open soon, and AAAHC encourages all stakeholders to review the proposed updates and share their perspectives. AAAHC also urges public comment participants to share this opportunity with colleagues and professional networks to capture broad and diverse input.
A Key Area of Change: Proposed AI Standards
Our goal is to ensure organizations have core governance in place before AI becomes deeply embedded in patient care. The proposed v45 Standards emphasize foundational principles of safe AI use, including:
- Transparency and explainability
- Validation and accuracy
- Data security and privacy
- Human oversight
- Fitness for purpose
- Fairness and bias mitigation
These expectations are designed to be surveyable—clear, feasible, and measurable in real-world ambulatory care settings so both organizations and Surveyors can consistently evaluate readiness.
Building on these principles, the proposed v45 Standards seek to strengthen organizational accountability, ensure informed consent, enhance vendor oversight, and support safe, appropriate implementation—without adding unnecessary administrative burden.
Considerations When Reviewing Standards During Public Comment
As you review the proposed Standards, we encourage you to consider the RUMBA principles:
- Relevant — Is the Standard appropriate for ambulatory care settings?
- Understandable — Is the language clear, direct, and unambiguous?
- Measurable — Can Surveyors assess compliance objectively and consistently?
- Beneficial — Does the Standard meaningfully improve quality or safety?
- Achievable — Can organizations meet the requirement without undue burden?
We also welcome any additional comments or suggestions you may have beyond these criteria.
Finally, as with all version updates, v45 will include minor, non-substantive refinements and small reorganizations to improve readability and consistency across the Handbook.
Stay tuned for future communications announcing the start of the public comment period—or visit our website for the latest updates.
Advancing Cardiovascular Care Through AAAHC Accreditation
Cardiovascular centers are essential in managing heart and vascular conditions, offering life-saving diagnostics and interventions. As care delivery shifts from traditional hospital settings to more agile environments like office-based labs (OBLs), adherence to the Accreditation Association for Ambulatory Health Care (AAAHC) Standards—and the 1095 Strong philosophy—has become a cornerstone of sustainable, high-quality care.
Emergency Management (EMG) Standards are critically important in cardiology settings due to the high-risk nature of cardiovascular procedures and the potential for life-threatening complications. AAAHC EMG Standards, such as EMG.180 and EMG.170, require cardiovascular centers to maintain readily accessible emergency equipment—including defibrillators, oxygen, and resuscitation tools—and to conduct regular scenario-based drills.
These protocols ensure staff are trained and prepared to respond swiftly to cardiac emergencies like arrhythmias, myocardial infarctions, or sudden cardiac arrest. In cardiology, where seconds can determine outcomes, these Standards reinforce a proactive approach to patient safety and align with the 1095 Strong philosophy of maintaining excellence every day of the accreditation cycle.
Beyond equipment and training, EMG Standards also emphasize comprehensive emergency and disaster preparedness planning. Cardiovascular centers must have written protocols for internal and external emergencies, including patient transfer procedures and documentation requirements. This is especially vital in OBLs and outpatient cardiovascular facilities, where immediate access to hospital-level resources may be limited. By adhering to EMG Standards, cardiology practices demonstrate their commitment to safe, high-quality care and continuous readiness—ensuring every patient encounter is supported by robust emergency infrastructure and well-trained personnel. This not only fulfills AAAHC Accreditation requirements but also builds patient trust and reinforces the cardiovascular center’s reputation for clinical excellence.
OBLs are reshaping outpatient cardiovascular care by offering procedures like angiography and stent placements in physician-owned, patient-centered settings. Their appeal lies in efficiency and cost-effectiveness, but success hinges on rigorous compliance. AAAHC Standards ensure sterile environments, radiation safety, and emergency response protocols are in place. Detailed documentation, multidisciplinary collaboration, and patient education further elevate care quality.
As we recognize American Heart Month, it’s a timely reminder of the importance of cardiovascular health and the systems that support it. By integrating AAAHC Standards and the 1095 Strong, quality every day philosophy, cardiovascular centers and OBLs foster a culture of excellence, safety, and continuous improvement—ensuring every day of the 1,095-day accreditation cycle reflects the highest standards of care.
CMS Moves CLIA Fully Paperless: What AAAHC-Accredited Organizations Need to Know
Effective March 1, 2026, the Centers for Medicare & Medicaid Services (CMS) will transition the Clinical Laboratory Improvement Amendments (CLIA) program to a fully paperless process. Paper fee coupons, mailed CLIA certificates, and check payments will be discontinued in favor of electronic notifications and online payments through Pay.gov.
This modernization reinforces existing expectations within Accreditation Association for Ambulatory Health Care (AAAHC) Standards related to laboratory compliance, documentation, and continuous readiness.
Beginning March 1, CMS will issue CLIA certificates and renewal communications electronically, using email as the official channel. All CLIA certification fees must be paid online through Pay.gov; paper checks will no longer be accepted. As a result, laboratories must ensure they can reliably receive and manage digital CLIA communications and documents.
Ambulatory organizations with laboratory services are encouraged to review CMS guidance for details on required actions and timelines, available on the CMS CLIA website.
Alignment with AAAHC Standards
AAAHC Standards (LRD.140) already require organizations to maintain current laboratory licensure and certification, ensure required certificates—including CLIA—are posted or readily accessible, and demonstrate ongoing compliance rather than point-in-time readiness. With CMS eliminating paper certificates, organizations should confirm that electronic CLIA certificates are easily retrievable, appropriately posted or available during surveys, and integrated into internal compliance and document management processes.
Why This Matters
Moving to electronic-only CLIA documentation helps prevent missed renewals or compliance gaps, supports continuous readiness, and streamlines administrative processes. AAAHC encourages accredited organizations to act now—well ahead of the March 1, 2026 deadline—to ensure uninterrupted compliance and survey readiness as CMS modernizes the CLIA program.
AAAHC Standards Interpretation
CMS Compliance and Best Practices for Immediate Use Steam Sterilization (IUSS) in Health Care Settings
To offer clarification on Standards requirements and support consistent compliance across organizations, we are providing additional guidance on the appropriate use of IUSS.
IUSS is a rapid sterilization method used in health care settings when instruments are urgently needed and cannot undergo standard terminal sterilization. The Centers for Medicare & Medicaid Services (CMS) provides clear guidance to ensure IUSS is used safely and appropriately, aligning with infection control standards and patient safety goals. CMS requires that IUSS be reserved strictly for emergency situations—not for convenience or routine use. Facilities must follow nationally recognized guidelines, such as those from the Association for the Advancement of Medical Instrumentation (AAMI) and Association of periOperative Registered Nurses (AORN), and adhere to manufacturer instructions for use (IFUs). Proper cleaning, decontamination, and sterilization steps must be followed, even under time constraints. The use of validated sterilization containers is essential to maintain sterility during transport and storage.
Documentation is a critical component of CMS compliance. Facilities must track each IUSS cycle, including the reason for use, the instrument involved, and confirmation that all steps were completed correctly. Infection prevention programs must include policies that limit IUSS use and ensure staff are trained in appropriate procedures. CMS surveyors may review sterilization logs, observe practices, and assess whether IUSS is being used in accordance with regulatory expectations.
Ultimately, CMS emphasizes that patient safety must never be compromised. IUSS should be a last resort, used only when no other sterilized instrument is available and the delay would negatively impact patient care.
Specialty Corner
Driving Quality Every Day: The Next Evolution of Advanced Orthopaedic Certification
In 2018, AAAHC launched its Advanced Orthopaedic Certification (AOC) program to recognize ambulatory surgery centers (ASCs) that deliver exceptional specialty care. AAAHC-accredited ASCs performing total joint replacements and/or complex spine procedures are eligible to pursue this Certification. The program was developed with insight from an expert panel of orthopaedic surgeons, anesthesiologists, orthopaedic nurses, physical therapists, quality specialists, and payors.
AOC builds on core accreditation requirements by adding specialty-specific expectations for orthopaedic and spine care. Organizations seeking AOC undergo an onsite survey conducted by Surveyors with deep experience in ambulatory orthopaedics. Organizations who achieve AAAHC AOC demonstrate a consistently high standard of care through:
- A dedicated clinical team with focused education and expertise in orthopaedics
- Staff who hold or are actively pursuing orthopaedic specialty credentials
- Performance measures collected and submitted to a nationally recognized specialty registry
This AAAHC Certification advances the 1095 Strong, quality every day philosophy. These ASCs model excellence in patient experience and outcomes by providing comprehensive education, dedicated nurse navigation, and streamlined, standardized processes across multispecialty care pathways.
Exciting Enhancements Coming to the AOC Standards
In response to feedback from clients, AOC Surveyors, and staff, the Expert Content Committee on Orthopaedic Certification (ECC-OC) conducted a comprehensive review and refinement of the Standards. Their work focused on meaningful, practical improvements. Version 45 of the AOC Standards is designed to remove burdensome requirements, resolve common pain points, improve clarity, and introduce consistent, clinically relevant terminology. The proposed updates also offer expanded guidance to support easier, more accurate interpretation in real-world ambulatory care settings. Public Comment for the v45 Standards opens soon. AAAHC encourages public participation to help shape the next evolution of the program.
Visit AAAHC for more information about Advanced Orthopaedic Certification.
Conferences & Exhibits
- Southern College Health Association (SCHA), March 16–18, Raleigh, NC
- Association of periOperative Registered Nurses (AORN), April 11–14, New Orleans, LA
- Progressive Surgical Solutions, April 17–18, Dallas, TX
- Ambulatory Surgery Center Association (ASCA), May 13–16, Washington, D.C.
- ASCA + SAMBA 2026 Conference & Expo AAAHC Affiliate-Led Session
- Elevating Quality Outcomes in Orthopaedics and Beyond
- May 13, 4–5 PM, ET, Washington, DC
- American College Health Association (ACHA), May 26–30, Denver, CO
1095 Learn
2026 Achieving Accreditation
- March 19–20, Renaissance Orlando at SeaWorld®, Orlando, FL
- September 14–16, Virtual
- December 10–11, Red Rock Casino Resort and Spa, Las Vegas, NV
