Tuesday, April 5, 2022 | A weekly member publication of the Arizona Health Care Association

Arizona Gives Day - TODAY April 5, 2022

The Arizona Health Care Foundation is participating in the statewide online donation campaign -- Arizona Gives Day. This is your chance to impact the work of the Arizona Health Care Foundation by going online to www.azgives.org and donating.

Arizona Gives Day is a day for individuals to come together and make giving back a priority by donating to the nonprofit organizations they're most passionate about, such as the Arizona Health Care Foundation. It’s easy to do, just visit www.azgives.org and “Search for your nonprofit” for the Arizona Health Care Foundation. Click on the logo and then click on “Donate Now”. Our 2022 fundraising goal is to raise $20,000 to benefit the Foundation's programs, such as the Live A Dream, Academic Scholarships, Holiday grants and others. Any amount is appreciated. Would you take a moment right now and give? The Arizona Health Care Foundation thanks you for your support!

NATIONAL NEWS |

AHCA NCAL Warns of SNF Medicare Funding Cuts

SNFs may soon face disastrous Medicare funding cuts, AHCA President and CEO Mark Parkinson warned last week. CMS is expected to release its latest proposed payment rule for SNFs in the coming weeks and while the nursing home sector has successfully fought against similar cuts in the past, Parkinson indicated that this year’s effort will be different – and even more critical – than ever before. Parkinson said during a virtual event, "The tea leaves are indicating that we’ve got a real problem here. So, we’re working as hard as we can to make the best possible case that nursing homes have never been in a worse position and this would not be a good time for a cut." Parkinson also "said the industry needs to brace for ‘the very strong possibility’ that cuts are coming."

AHCA NCAL Meets with HHS/CMS Regarding Nursing Home Reform

This last week, AHCA President and CEO Mark Parkinson and several members met with HHS Secretary Bacerra and CMS Administrator Chiquita Brooks-LaSure to discuss the reforms first posed by the President during the State of the Union address. After their meeting, the HHS Secretary said that the government will "meet or exceed" the one year self-imposed deadline to implement nursing home reform.

In addition, Parkinson and team have been walking the halls of Congress and have also met with Sen. Majority Leader Chuck Schumer (D-NY) and Speaker of the House Nancy Pelosi (D-CA). This reform process will take quite a minute and involve many members, Congress and others before it’s finalized, so stay tuned.

FDA Approves Second Booster for COVID-19

A second COVID-19 booster was approved by the U.S. FDA on March 29. Both Pfizer-BioNTech and Moderna booster vaccines have been approved for adults 50+. The fourth shot (second booster) was also authorized for immunocompromised children older than 12 when receiving the Pfizer-BioNTech vaccine and the Moderna was authorized for immunocompromised adults over 18 years old. It is unknown at this point if the boosters will be mandated for long term care.

National Skilled Nursing Care Week May 8-14, 2022

The American Health Care Association is pleased to announce that National Skilled Nursing Care Week (NSNCW) will take place from Sunday, May 8 to Saturday, May 14, 2022.

This year’s theme, Creating and Nurturing Connections, celebrates the important role skilled nursing care centers and staff play in providing care and social support to their residents.

Download Planning Guide and Offers

STATE AND PUBLIC POLICY ISSUES |

AHCCCS Workgroup Meets to Discuss Key Issues Including Provider Assessment

AHCA communicates and advocates directly with AHCCCS on your behalf and we meet quarterly in a work group to discuss issues pertaining to skilled nursing and assisted living. In our most recent meeting, we discussed several issues including the successful legislative renewal of the provider assessment, as well as the change in the assessment slated for October 1, 2022, implementation.

What change is planned? Well, currently the law allows AHCCCS to assess SNFs a tax for up to 3.5% of gross revenue. This is considerably lower than the federal cap, which allows states to assess a 6% tax. As you know, with the pandemic and other factors in play, we have lost Medicaid days and this results in a lower payment to SNF providers. In order to counteract that, we have advocated for the tax assessment to be adjusted in order to ensure additional funds will be received by providers. This adjustment is planned for October 1, 2022 implementation. Going forward from that date, you’ll see an increase in the amount of tax billed to you, as well as a substantial increase in the amount of the supplemental payment received. For every provider assessment dollar sent to Washington, we receive just over $3 back in payment to you. This planned tax adjustment in October should bring an additional $37m to the SNF provider community. Please pay close attention to your quarterly provider tax billing from the Arizona Department of Revenue and pay timely. Remember, late payments can result in substantial fines and the potential loss of your Medicaid number!

Additional issues discussed with AHCCCS included the expected extension of the federal Public Health Emergency (PHE), claims, reimbursement and workforce development issues. If you have any questions or concerns you would like considered in our AHCCCS quarterly meetings, please contact Dave Voepel at AHCA.

Important! To Receive your Assisted Living Directed Payment Complete the Attestation Due April 10!

We recently reported the great news that AHCCCS will be offering a directed payment to all Medicaid assisted living providers. The guidance on this payment is now available and can be found at this link: ProviderDirectedPaymentGuidance.pdf (azahcccs.gov). Please note that in order to receive this funding… you must complete the AHCCCS attestation. The attestation for these dollars is due April 10. There are no exceptions to this deadline! Click here to complete and submit this important document.

Also, to learn more about AHCCCS directed payments across the health care sector, you can check out the webpage here . All of the directed payments are funded by the federal program known as the American Rescue Plan Act (ARPA).

You may expect to receive the funds from your managed care plan partners by May 31, 2022. Please contact me at [email protected] if you have any questions or concerns.

Governor Ducey Terminates the State’s COVID-19 Public Health Emergency

The Arizona COVID-19 public health emergency was terminated last week by Governor Ducey which took effect immediately. It’s important to note that the federal Public Health Emergency currently slated to end on April 16 (it’s widely expected to be extended) is the one that governs SNF waivers and the TNA program. Until that one is removed, all waivers and programs will continue.

AHCCCS New Provider Assessment Webpage

Check out the all new AHCCCS page on the SNF provider assessment… click here . Almost everything you need to know about the assessment is on this page including the annual payment summary by facility and the dates the assessment is due to DOR. We will continue to post information in this space regarding these items and more, but you should bookmark the AHCCCS page. AHCCCS is planning on updating the page – if you have questions regarding the information, please do not hesitate to contact the AHCA office.

Arizona Legislative Update

Appropriations Committees in the House and Senate held their final regularly scheduled meetings. With that, most of the committee work was completed for this year. Moving forward, leadership will continue to allow some bills to move through the final phases and send them to the Governor’s desk. However, it is common to slow the process down as leadership in both chambers works on the budget and courts votes from individual members. Legislative updates will be lighter as we move into the portion of session where we all wait for the negotiated budget to be revealed. With that, here are the remaining bills we continue to work on:

• Fingerprint Clearance Card (HB 2049): Passed Senate committee with an amendment to allow volunteers to either have a fingerprint clearance card or have direct visual supervision. No further updates.

• Civil Penalty Increase (SB 1641): Increases, from $500 to $1000, the maximum civil penalty assessed for violation of health care institution statutes and rules. Passed the Senate. No further updates.

• Clergy Visitation (HB 2449): Neutral. Requires a care facility to allow clergy to visit a patient if the facility allows in-person visitation. Passed the House. Passed Senate committee. No further updates.

QUALITY AND REGULATORY |

State and Federal Requirements of Reporting a Crime (F608 and 609)

Federal

F608 requires a facility to report any reasonable suspicion of a crime against a resident. Appendix One of CMS S&C: 11-30-NH includes that “a ‘crime’ is defined by law of the applicable political subdivision where a LTC facility is located. Applicable facilities must coordinate with their local law enforcement entities to determine what actions are considered crimes within their political subdivision”. Reports must made to ADHS and to one or more law enforcement entities. Reports must be made immediately but no later than 2 hours if there is serious bodily injury, and no later than 24 hours if no serious injury.

F609 requires that all alleged violations of abuse, neglect, exploitation, or mistreatment, including injuries of unknown source and misappropriation of resident property be reported to the administrator and other officials in accordance with state law and includes to ADHS and APS. Reports are to be made immediately but no later than 2 hours if it involves abuse or resulted in serious bodily injury and 24 hours if not. The complete Federal reporting requirements can be found in Appendix PP.

State

R9-10-403.E.1. and 2. If abuse, neglect, or exploitation of a resident is alleged or suspected to have occurred before the resident was admitted or while the resident is not on the premises and not receiving services, administrator shall report as follows:

For a resident 18 years of age or older, according to A.R.S. § 46-454; or

For a resident under 18 years of age, according to A.R.S. § 13-3620

R9-10-403.F.2. If an administrator has a reasonable basis, according to A.R.S. § 13-3620 or 46-454, to believe that abuse, neglect, or exploitation has occurred on the premises or while a resident is receiving services from a nursing care institution’s employee or personnel member an administrator shall report it to A.R.S. § 13-3620 or 46-454.

These two state rules require a report to be made immediately to a peace officer and APS (if 18 years or older) or DCS (if a minor).

R9-10-403.H. An administrator shall provide written notification to the Department (ADHS) of a resident’s:

Death, if the resident’s death is required to be reported according to A.R.S. § 11-593, within one working day after the resident’s death; and
Self-injury, within two working days after the resident inflicts a self-injury that requires immediate intervention by an emergency medical services provider.

The complete state rules for reportable events can be found in Article 4.

ASSOCIATION NEWS |

AHCA Directory 2023 Advertising

The Arizona Health Care Association has partnered again with E&M Consulting, Inc. to develop the annual Membership Directory. The publication will be available in both print and digital formats. E&M will be managing the project, including advertising sales and layout/graphic design.

They are extremely professional and produce a high-quality publication, and we ask that you give them a moment of your time. E&M will be contacting all members about the advertising opportunities available.

The publication will be mailed to every member – a great opportunity to promote and give your company additional exposure. If you have any questions or would like to advertise, please contact an E&M sales associate at 800-572-0011 ext.8005 or [email protected]. As always, your support is greatly appreciated!

AHCA Salary Survey 2022

Fill out the survey today!

AHCA is conducting the annual 2022 Salary Survey for both AL and SNF. All information collected in this survey is strictly confidential and no identifying characteristics will be used in the survey report. Due to the nature of the data in this survey, the results will only be sent to those that participated. We need a lot of you to participate, so the data collected is comprehensive and meaningful.

So, here’s your challenge: click on the links below, complete the survey, and five (5) SNFs and five (5) ALs will be chosen at random to win a $100 Amazon gift card!

As you’ll see, this online survey is through Survey Monkey and it will be compiled by our friends at Healthcare Systems and Services, Inc. The survey links will also be available on our "Members Only" section of the website.

Please take a moment to complete the survey – the deadline is Friday, May 13, 2022. If you have any questions, please feel free to call the AHCA office at 602-265-5331. Thank you for your participation!

Assisted Living Survey

Skilled Nursing Survey

DISASTER READY |

Wildfire Season Awareness

The overall lack of precipitation in Arizona this past winter should prompt long term care providers of all types to be acutely aware of the inevitable wildfire threat. As attendees of the 2022 Disaster Ready Summit learned during a special presentation by two providers from Colorado who experienced a fast-moving vegetation fire near Boulder in late 2021, these adverse events can occur during non-traditional times. It's time to open up your EOP and review your wildfire plans with your team. Whether you will be required to shelter-in-place or evacuate, your facility must be ready for wildfires and other adverse events that can occur with little or no warning. It is essential to ensure that your team is "Disaster Ready" all day and every day.

Two Opportunites for Tabletop Exercise Training

A tabletop exercise is designed to be an interactive activity where players are required to determine the cause of the problem and identify the actions needed to properly manage the scenario.

Flagstaff (AzCHER Northern Region)

Wednesday April 6, 2022 | 10am-2pm

Coconino County Health and Human Services Building

2625 N. King Street | Flagstaff, AZ 86004

This exercise will meet the communitywide exercise annual requirement | Lunch provided

TTX Flagstaff Registration

Phoenix

Thursday May 5, 2022 | 10am-2pm

AzHCA Office Classroom

1440 East Missouri Avenue, Suite C-102 | Phoenix, AZ 85014

Lunch provided

This unique tabletop exercise will focus on infection control protocols. It will be facilitated by the DR / EPIC Team who will present participants, also known as "players," with a simulated scenario that involves some type of condition within the built-environment of a SNF that is having an adverse effect on residents.

This exercise requires a "team approach" that utilizes all disciplines within a nursing facility. Therefore, attendees should include administrators, clinical staff, maintenance, housekeeping, dietary and others that may be responsible for emergency management. It is recommended that multiple team members from your facility register for this interactive exercise.

TTX Phoenix Registration

EDUCATION OPPORTUNITIES |

Booths Are Going Fast!

Reserve Your 2022 AHCA Convention & Expo Booth Today!

We are quickly running out of exhibit booth space, as we are down to our last 15, so you need to reserve yours today!

The 2022 AHCA Convention & Expo will be held July 18-20 at the Sheraton Phoenix Downtown.

Please check out the convention details below.

Convention Website

Available Booths

Reserve Booth

Join Us for the AHCA NCAL Congressional

Briefing in D.C. – June 6-7, 2022

Come to Washington, D.C. June 6-7, to present and discuss your needs and concerns with people in a position to make changes.

During the Congressional Briefing, you will receive updates on the latest happenings in long term and post-acute care, develop an effective and immediate plan of action with your colleagues, and meet with Representatives and their staff on Capitol Hill. It’s a unique opportunity to voice your concerns and have an impact on issues you care about most. For more information, click on the link above or contact the AHCA office.

April 5 | 1.0 CEU

Survey Webinar Series #4:

F761 Label/Store Drugs/Biologicals

Presenter:

Janine Lehman

RN, RAC-CT, CLNC

Clinical Consultant

Proactive Medical Review

April 14 | 5.0 CEUs

Quality Forum:

Workforce & Leadership Development

9:00 am – 3:30 pm

Marriott Phoenix Airport

1101 N. 44th St. | Phoenix, AZ 85008

May 3 | 1.0 CEU

Survey Webinar Series #4:

F689 Free of Accident Hazards/ Supervision/Devices

Presenter:

Shelly Maffia

MSN, MBA, RN, LNHA, QCP,

CHC, CLNC, CPC

Director of Regulatory Services

Proactive Medical Review

May 10

Tabletop Exercise:

Infectious Disease Outbreak

10:00 am – 2:00 pm

Health Services Advisory Group

3133 East Camelback Road

Phoenix, AZ 85016

May 12 | 5.0 CEUs

Quality Forum:

Strengthening Personal Centered Care and Preventing Abuse & Neglect

9:00 am – 3:30 pm

Marriott Phoenix Airport

1101 N. 44th St. | Phoenix, AZ 85008

AHCA On-Demand Webinars

You will find a spectrum of topics within long term care to support you in earning CE credits on your own time, 24/7.

Some webinars are Arizona-specific, while others are more generally focused.

On-Demand Here

Administrator-In-Training Preceptor Certification

and Re-Certification Workshop

Friday, April 8, 2022

9:00 a.m. - 3:30 p.m.

Assisted Home Health

1420 East Missouri Avenue, Suite 101

Phoenix, AZ 85014

Questions:

Call Misti Valentino at 702-273-7800 or email: [email protected].

Application and Details Here

Join our Thursday Calls

Get the latest information on

Infection Prevention | Social Work | DON

April 7 / 10:00 am

DON with Kay Huff

866-839-6133

799 395 9020

April 14 / 12:30 pm

Social Work

with Paige Hector

609-746-1155 968760

April 28 / 1:00 pm

Infection Preventionist Zoom Call

Email [email protected] for Zoom Link

QUESTION OF THE WEEK |

Q: Should our facility pause communal activities and dining during an outbreak investigation?

A: If the facility is using a contact tracing approach for an outbreak investigation, those residents who are identified as potentially being a close contact of the individual who tested positive for COVID-19 are considered to have had close contact and should not participate in communal dining or activities. Residents who are not up-to-date with all recommended COVID-19 vaccine doses and have had close contact with someone with COVID-19 infection should be placed in quarantine, even if viral testing is negative.

In general, residents who are up-to-date with all recommended COVID-19 vaccine doses and residents who had COVID-19 in the last 90 days do not need to be quarantined or restricted to their room and should wear masks when leaving their room.

When using a broad-based approach for an outbreak investigation, residents who are not up-to-date with all recommended COVID-19 vaccine doses should generally be restricted to their rooms, even if testing is negative, and should not participate in communal dining or group activities until they have met the criteria for discontinuing transmission-based precautions (quarantine). In general, residents who are up-to-date with all recommended COVID-19 vaccine doses and residents who had COVID-19 in the last 90 days do not need to be restricted to their rooms unless they develop symptoms of COVID-19, are diagnosed with COVID-19 infection, or the facility is directed to do so by the jurisdiction’s public health authority.

The answer is from the revised QSO-20-39-NH FAQs.

If you’re tired of hearing from us on Tuesday mornings and want to be removed from this mailing list, just let us know by replying directly to this email or 602-265-5331 - www.azhca.org

Arizona Health Care Association | 1440 East Missouri Avenue, Suite C-102, Phoenix, AZ 85014

[email protected] | 602-265-5331 | www.azhca.org

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