Source data
v1 of the Anesthesia Shadow Registry surfaces the CMS Ambulatory Surgical Center Quality Reporting Program (ASCQR) dataset — the canonical federal publication of facility-level quality measures for every Medicare-certified ASC. ASCs perform the majority of U.S. anesthesia procedures (outpatient surgery, endoscopy, ophthalmologic, orthopedic, and pain procedures), so ASCQR is the cleanest facility-level anesthesia-adjacent data substrate that's publicly downloadable.
What v1 reports
For every Medicare-certified ASC (5708 facilities at last refresh):
- ASC-1 Patient Burn — rate of patient burns; anesthesia care contributes to thermal-injury prevention
- ASC-2 Patient Fall — rate of patient falls in the ASC; anesthesia-related sedation contributes to fall risk during recovery
- ASC-3 Wrong Site / Side / Patient / Procedure / Implant — never-events; anesthesia provider time-out is part of prevention
- ASC-4 Hospital Transfer / Admission — all-cause rate of unplanned post-procedure hospital admissions
- ASC-13 Normothermia Outcome — the percentage of patients who maintain normothermia (temperature ≥ 96.8°F at PACU arrival); anesthesia care is the primary determinant
- ASC-12, 17, 18, 19 — risk-standardized post-procedure hospital-visit rates for colonoscopy, orthopedic, urologic, and general-surgery ASC procedures, with CMS Better/Same/Worse comparison
Branmoor's signal aggregation
- Elevated safety / outcome signal — 2 or more "Worse than National Rate" comparisons, or 1 comparison + at least 1 reported safety event (burn, fall, or wrong-site)
- Mixed signal — 1 worse-than-national comparison or at least 1 reported safety event
- Performance at or above national — at least 1 better-than-national comparison and no worse
- Neutral — otherwise
What v1 is not
v1 is the facility-level operating substrate. It does not attribute the anesthesia-specific contribution to outcomes. The full Anesthesia Shadow Registry v2 adds:
- NPDB (National Practitioner Data Bank) cross-reference — provider-level malpractice and licensure-action history. NPDB is restricted; the cross-reference is for the paid product subscriber's own queries
- State malpractice disclosure — per-state, varies. MA, NY, FL among others publish provider-level claims history
- CMS Medicare claims cross-reference — anesthesia procedure volume, case mix, and complications, joined to NPI (DUA-gated for full claims)
- FDA MAUDE for anesthesia equipment — equipment-related adverse events at the facility
- Joint Commission accreditation and survey findings — supplementary facility-level safety context
- AQI NACOR cross-reference — the canonical voluntary anesthesia outcomes registry; private and consented, but signal-direction can be inferred from publicly-published aggregate trends
- Provider-level reporting where state law permits — the differentiating layer for anesthesia staffing companies and malpractice carriers
See the product page for the v2 layer and the ASC / staffing company / malpractice carrier sales motion.
Update cadence
CMS refreshes ASCQR annually. Branmoor re-ingests on each site deploy.
Limits
- Hospital-based anesthesia not covered — v1 covers ASCs only; anesthesia delivered in hospital operating rooms is in a separate CMS dataset and is not yet ingested
- Self-reported safety events — patient burn/fall/wrong-site rates are sourced from facility self-report. The data is subject to under-reporting, particularly at facilities with weak safety culture
- Anesthesia-specific attribution requires the paid layer — v1 does not isolate the anesthesia-specific contribution to the surfaced metrics. Surgeons, nursing, facility infrastructure, and case mix all contribute. The shadow-registry methodology in v2 attributes the anesthesia-specific component