AHCA UPDATE | March 16, 2021
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Staff Shortages and Additional Funding Request
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Hopefully you’ve seen our recent Alerts on this issue. In order to comply with the Governor’s office request for this information, we continue to distribute a brief staffing survey to all member facilities. Take the survey below. This will be every two weeks until mid-April. We are collecting data in two week increments, so complete the survey with your data for the weeks (February 27 – March 12) ending March 12, 2021.
Whether or not you filled out the first survey over the last two weeks, this survey and future surveys must also be done in order to show the need. We know asking for another survey to be completed is difficult when you’re short staffed, but this is the only way we will be able to fund this problem. If we don’t receive enough responses, then we won’t be able to ask for additional dollars.
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AHCA NCAL Unveils Care for Our Seniors Initiative in DC
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AHCA NCAL unveiled the new SNF initiative called Care for Our Seniors Act. This is intended to provide payment reform while improving America’s nursing homes by learning from the COVID pandemic tragedy. Click here
to see some of the bold solutions put forth for the future. Keep in mind that this is the initial outreach and has a long way to go before being fully implemented.
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National Skilled Nursing Week Set for May 9-15 |
This year's theme, "Together Through the Seasons," will honor the collaborative commitment of skilled nursing care facilities and their staff in providing compassionate care to their residents during this unprecedented time. The NSNW Planning Guide and Product Catalog is now available online. Be sure to browse through the guide for activity ideas and explore the selection of special products to help you celebrate May 9-15.
Visit ahcancal.org/NSNCW to download the new guide and to access promotional graphics and a proclamation template. Don't forget to use the hashtag #NSNCW on social media and "like" us on the NSNCW Facebook page. Thank you for your continued dedication to the residents you serve and protect. We also thank this year’s official sponsor of NSNCW, Essity, for its generous support.
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New Federal Stimulus Passed
Last week Congress passed a sweeping $1.9 trillion stimulus bill that contains a little support (very little) for long term care.
Basically, the new stimulus includes $200 million to support COVID-19 vaccination efforts and infection control improvements in nursing homes through contracts with the QIOs, along with an additional $250 million for states to fund dedicated "strike teams" to help facilities combat outbreaks for up to a year after the end of the formal coronavirus emergency. Plus, a total of $8.5b was allocated towards rural healthcare (hospitals, docs, AL, SNF, etc.) providers. The details of this portion are still sketchy.
Although this most recent stimulus package includes a host of provisions that could eventually trickle down to the post-acute and long-term care sector - including billions for testing, personal protective equipment (PPE), workforce development, and hazard-pay grants for employers of essential workers – the specific nursing home provisions fall far short the $20 billion in additional aid requested by AHCA NCAL.
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President Biden Signs Executive Order on National
Emergency Declaration
President Biden on February 24 signed an order continuing the national emergency declaration for the COVID-19 pandemic which was initially set by former President Trump on March 13, 2020. The formal continuation of the national emergency declaration, along with the recently renewed public health emergency, allows the Department of Health and Human Services to continue Section 1135 waivers and other flexibilities to ensure sufficient healthcare services and items to respond to the pandemic. Please don’t be confused by all of this… as of this writing, the PHE under this national emergency declaration currently runs out on March 21, 2021. The HHS administrator is given the authority to extend the PHE another 90 days but has not done so yet.
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STATE / PUBLIC POLICY NEWS |
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SNF Provider Assessment Dollars Are Back on Track
Click here to see the payment information for the period of 10/1/20 through 12/31/20. In the last newsletter we indicated that the dollars would be late in arriving to you, but now they are back on track thanks to AHCCCS! So, you should have received them or will receive them in the next week or two. Please contact us if you have not received any dollars by the end of the month. As far as the amount of dollars sent in by providers, there are about 10 buildings that AHCCCS has been in touch with to confirm they are paying the tax. So once that is solved, we should be getting close to our typical 98% payment rate from providers.
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Assisted Living: Current AHCCCS DAP Program
(Oct. 1, 2020 – Sept. 30, 2021)
AHCCCS has confirmed the list of assisted living providers that should be receiving the Home and Community Based Services (HCBS) Differential Adjusted Payment (DAP) this year.
You can find the list at this link: click here. If you are on the list then your center should currently be receiving an additional .5% on top of your base rate as of October 1, 2020 ending September 30, 2021. If you’re on the list and not receiving these dollars, please reach out to your MCO partners. Remember, the DAP is not cumulative and is newly calculated each year. If you have questions, please contact me at dvoepel@azhca.org.
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SNF: AHCCCS DAP Program (Oct. 1, 2021 – Sept. 30, 2022) and HIE Requirements
Remember… in order to participate in next year’s Health Information Exchange (HIE) Differential Adjusted Payment (DAP) skilled nursing facilities must submit a Letter of Intent (LOI) by April 1, 2021. AHCCCS established the DAP program to recognize SNFs that have committed to participate in Arizona’s state-wide HIE, operated by Health Current. The goal of this participation is to improve patient health, resident care and reduce costs. AHCA supports this technology related DAP and is working with AHCCCS and Health Current to ensure its implementation. To receive this 1% DAP in next fiscal year, certain milestones must be met, including submission of this signed Letter of Intent (LOI) to AHCCCS and Health Current by April 1, 2021. Please contact Jayme Pina at Health Current to confirm you’ve submitted your LOI at jayme.pina@healthcurrent.org.
The other 1% of the DAP is focused on UTIs, which is similar to the current DAP. That data will be pulled by AHCCCS on March 15. Once it is confirmed which facilities will receive the DAP, we will send an update in this newsletter.
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Arizona Legislature Session Update
Leaders in both the Arizona Senate and House of Representatives have begun working on the fiscal year 2022 state budget as committees continue to work on passing legislation. Recent developments show one of the many proposals to terminate the current state of emergency declared by Governor Ducey on March 11, 2020, is likely to pass. No fewer than 10 bills and ballot referrals attempting to end the current state of emergency or limit the governor’s ability to declare a state of emergency have been introduced.
To date, nearly 700 bills are progressing through the legislative process while 44 have been signed into law by Governor Ducey. Committees have until March 26 to hear all bills. Those not heard by the deadline will be effectively dead, although they can be resurrected in one form or fashion. Here are some that we’re still working on:
SB 1034 included a ‘strike-everything’ amendment and changed the bill to be an Assisted Living referral agency change. Referral agencies shall disclose to any prospect their fees. Awaits Senate vote.
SB1377: GOOD FAITH LIABILITY PROTECTION. Passed the Senate. Awaits House committee work. AHCA supports.
SB 1373: HEALTH FACILITIES; RESUSCITATION; EMERGENCY CARE
All licensed health care institutions that provide residential care are required to provide CPR and first aid training for all staff as prescribed in rule by ADHS. Facility staff who are certified in CPR must be available at all times. AHCA opposes. SB 1373 is on hold for further work.
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Assisted Living: Questions About Ostomies
The United Ostomy Associations of America (UOAA) and the Wound Ostomy and Continence Nurses Society have joined forces to promote solutions to barriers that people with ostomies experience as they age and require assistance.
Just as states have a wide variance of regulations and approaches to care, there is also a variety of challenges that people with ostomies face. It is a sad day when couples with a lifetime together are separated when their assistance needs differ; or when people are sent to SNFs prematurely.
UOAA and the WOCN Society are approaching all fifty (50) states to learn what problems exist and discover ways to improve the situation for people with ostomies, who seek assisted care. They are asking Arizona providers to answer a few questions to help understand your experiences, and to know what challenges and solutions you have found.
Please fill out the questionnaire below and email your answers to dvoepel@azhca.org. Thank you for taking the time to answer these questions.
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CMS Revises Memo on Nursing
Home Visitations
The latest guidance calls on facilities to allow “responsible” indoor visitation at all times for residents, regardless of their or their visitor’s vaccination status, unless certain scenarios arise that would limit it. Those limitations should be put in place for:
- Unvaccinated residents if the COVID-19 county positivity rate is greater than 10% and less than 70% of residents in the facility are fully vaccinated;
- Residents with confirmed COVID-19, regardless of vaccination status, until they’ve met criteria to discontinue transmission-based precautions; and
- Residents in quarantine until they’ve met criteria to be released.
The guidance calls for continued compassionate care visits, as they must be allowed at all times for any residents, regardless of vaccination status. Ombudsmen also should be provided with immediate access to any resident the QSO memo states. Additionally, providers cannot require visitors to provide proof of vaccination or submit to a coronavirus test as a prerequisite for entering a facility, though CMS is encouraging family and friends to roll up their sleeves when they have the opportunity. Federal and state surveyors also do not need to be vaccinated to perform their duties, though they can be denied access if they actively display COVID symptoms.
The guidelines also call on providers to continue to adhere to CMS rules for COVID-19 testing, including routine staff testing, testing of individuals with symptoms and outbreak testing. Facilities should not restrict visitation for all residents as long as there is evidence that the transmission of COVID-19 is contained to a single area of the facility says CMS.
Please review the QSO memo. While there are differences between this guidance, what ADHS is saying and the new CDC guidance that was also released today, providers must follow CMS guidance and/or state and local guidance, whichever is more strict!
The Governor’s Task Force on Long Term Care that recommends guidance for Assisted Living and SNFs to reopen and allow visitations was scheduled to meet last Friday. In light of this new guidance from CMS, that meeting has been delayed until March 19 to allow time to review it. AHCA will continue to seek clarity from ADHS, CMS or CDC on any inconsistencies. We will provide updates as we have more information. If you are uncertain about whether visitation is allowed in a particular circumstance, contact AHCA’s Kay Huff and document your process.
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Provider Magazine Articles
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Here are some new articles from AHCA NCAL’s Provider magazine:
AHCA/NCAL President and CEO Mark Parkinson tells Provider that recovery is around the corner. When exactly census starts to build back up to pre-COVID levels revolves around the success of vaccination programs with residents and staff and recreating the trust between facilities and the communities they serve.
In this second piece, NIC Chief Economist Beth Burnham Mace says while the pandemic shuffled the deck beyond anyone’s expectation and will have an impact for months to come, the basics remain clear: Nursing homes and assisted living communities are here to stay, and there will be a clear start to the return to normalcy in 2021.
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COVID-19 Cases Down in SNFs
Well, of course they are, you say, but we think it’s good to see the numbers. According to the latest federal research from the National Investment Center (NIC), data showed that 93% of SNFs overall reported no new cases among residents during the week of Feb. 21 — a 28% increase from the week of Dec. 20 when just 65% of facilities reported no new cases.
Breaking the numbers down by facility size, data showed that 13% of SNFs with more than 150 units reported confirmed cases among residents. Just 7% of facilities with between 100 and 150 units reported new cases, while the number was 5% for SNFs with 50 to 100 units and 2% for providers with fewer than 50 units.
The average vaccination rate in the U.S has recently picked up to two million per day and will likely continue to increase, suggesting that 100 million Americans who are most vulnerable to the coronavirus will likely be fully vaccinated in the next month or two. Overall, newly confirmed cases among SNF residents are down 94% since the launch of the Pharmacy Partnership for Long Term Care Program nine weeks ago.
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Please Send Us Contact Information for Your Infection Preventionists and Directors of Nursing
The Disaster Ready Emergency Preparedness Infection Control (EPIC) program needs your assistance to update our database with the contact information for your DONs and Infection Preventionists. We will use this information to provide new and helpful information regarding emergency preparedness, infection control, and information about the new monthly Infection Preventionist calls. These IP calls will provide guidance to new and seasoned Ips, help answer questions and will provide infection control updates. Please take a moment and click on this link to provide your contact information, so we can help you and your team stay informed.
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Registration is Open for AzCHER’s First virtual Conference
AzCHER’s premiere conference is April 15, and 16, 2021. The two-day event (9 a.m. to 12 p.m. each day) features a packed agenda with keynote speakers addressing the recent Estes Park, Colorado wildfire and the 2017 mass shooting in Las Vegas. Eight break-out sessions will also be offered.
There is no fee to participate and the conference is open to all members and partners of AzCHER.
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DR EPIC Video Resource Library
The DR EPIC team has developed a video resource library with videos on various infection control and prevention topics. These videos are short informational resources to help guide you with your infection control programs. If you have any questions, please contact us at EPIC@azhca.org.
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AHCA PAC Fundraiser – Soccer Golf
Join us on April 30, 2021 at the Wigwam in the west valley for a twilight golf game – we’re changing it up as it’ll be with your feet and a soccer ball!
For $99 per person, $199 per family (up to three 16 year old or younger) or $349 per foursome you’ll be able to participate in this AHCA PAC fundraiser and have a ton of fun! We’ll provide the food, drinks and fun and you provide the foot and the smiles!
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Arizona Gives Day is Tuesday,
April 6, 2021
The Arizona Health Care Foundation is once again 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.
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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 goal is to raise $25,000 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!
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Arizona Health Care Foundation Scholarship Applications
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Look for your scholarship applications in the mail! Please note that the absolute deadline to apply for an education scholarship through the Arizona Health Care Foundation is Noon on Wednesday, March 24, 2021. Applications were sent to all AHCA member skilled nursing and assisted living facilities last week. Awardees will be selected in mid-May. Click here for the application. The Foundation has awarded thousands of dollars in scholarship funds over the years with the average award between $1,200 and $1,400. Applicants must work in an AHCA member skilled nursing facility or assisted living community in good standing.
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For more information
please contact
or 602-265-5331
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Reserve Your 2021 Expo Booth Today!
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The 2021 AHCA Convention & Expo will be held from July 26-28 at the Talking Stick Resort in Scottsdale. Although Early Bird registration has ended, you can still reserve a booth at the member rate of $1450.
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March 17 | Webinar
Standards of Care (3 of 12):
Reducing Infections in LTC Facilities
(1.0 CEUs)
Presenter:
Shelly Maffia
Director of Regulatory Services
Proactive Medical Review
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April 8 | Seminar
Strengthening Person-Centered Care for Residents with Dementia
(5.0 CEUs)
Join us for an in-person event with limited,
socially-distanced seating.
Marriott Phoenix Airport
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April 21 | Webinar
Standards of Care (4 of 12):
Care of the Dialysis Recipient
(1.0 CEUs)
Presenter:
Eleisha Wilkes, RN, RAC-CT, RAC-CTA
Clinical Consultant
Proactive Medical Review
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Virtual Education | 24/7
Need more CEUs?
Check out AHCA’s On-Demand Course Library Portal
Earn continuing education credits
anytime, anywhere.
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Preceptor Certification Zoom Training
All Administrators-In Training (AIT) in Arizona must be trained by a Certified preceptor and have their program approved by the ACHCA AIT Program Advisory Committee PRIOR to the training program start date. Certification/Recertification Training will be held on March 26, 2021 via Zoom.
For registration information, contact: Susan Bender, Chair, AIT Program Advisory Committee and Instructor for the AIT Preceptor course, 623-824-1207 or Bender9@cox.net.
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or ideas for future educational programming.
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April 1 | 10:00 am
DON with Kay Huff
866-839-6133
799 395 9020
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April 8 | 12:30 pm
Social Work with Paige Hector
712-770-4700
968760
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Arizona Health Care Association | 1440 East Missouri Avenue, Suite C-102 | Phoenix, AZ 85014
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