Call for revision to elective surgery approach

AzHHA sent a letter to Governor Doug Ducey Thursday thanking him for his leadership on Arizona’s COVID-19 response and acknowledging his efforts to effectively flatten the curve to slow the spread of COVID-19 in our state. In the letter, AzHHA President and CEO Ann-Marie Alameddin cited a new model from the Institute for Health Metrics and Evaluation (IHME) which now predicts hospitalizations will peak on April 30 with peak hospital and ICU bed estimates with a wide safety margin—even without the 50% bed capacity increase directed by Executive Order 2020-16. Alameddin continues, “Given the success of Arizona’s control measures, and the predictive models suggesting Arizona already has adequate capacity to meet peak demand with a wide safety margin, we ask you to consider deeming the directive to be met if hospital capacity is sustained at the 25% increase.”

Arizona hospitals have experienced a financial crisis following the March 19, 2020, Executive Order calling for a halt on elective surgeries. While we supported this necessary step to protect the health of our healthcare workforce at the time, we believe it’s time to reassess the order now that we have meaningful data on the virus spread in Arizona.

Member hospitals report revenues are down 30-40% due to the cancellation of elective procedures and a reduction in emergency department visits. On a statewide basis that would equate to a revenue reduction of $430 million to $575 million per month.

Read the full letter here.

New executive order calls for increased data

Earlier this week, Governor Doug Ducey announced a new Executive Order expanding data that hospitals must report to EMResource. ADHS will submit the new data fields directly to the federal Department of Health and Human Services, which will replace the current requirement that hospitals report data individually. Additional data points required to submit per Executive Order 2020-30 include:

• Total number of total new admissions per day
• Total number of new COVID-19 positive or suspect admissions per day
• Total number of new total ICU admissions per day
• Total number of total ICU discharges per day
• Total number of COVID-19 positive or suspect ICU admissions per day
• Total number of COVID-19 positive or suspect ICU discharges per day
• Total number of extubations/ individuals weaned off of ventilators per day
• Total number of direct care staff per day
• Number of days on PPE Inventory on hand:
  • 0 days, 1-3 days, 4-14 days, 15-30 days, +30 days
• Total number of all staffed inpatient and outpatient beds in your hospital, including all overflow and surge/expansion beds used for inpatients and for outpatients (includes all ICU beds)
• Number of patients currently hospitalized in an inpatient bed with onset of suspected or confirmed COVID-19 fourteen or more days after hospital admission due to a condition other than COVID-19
• Number of patients with suspected or confirmed COVID-19 who currently are in the Emergency Department (ED) or any overflow location awaiting an inpatient bed
• Number of patients with suspected or confirmed COVID-19 who currently are in the ED or any overflow location awaiting an inpatient bed and on a mechanical ventilator
• Number of patients with suspected or confirmed COVID-19 who died in the hospital, ED, or any overflow location on the date for which you are reporting.

Temporary emergency licensure for MDs and PAs

The Arizona Medical Board recently announced temporary emergency licenses for Physicians (MDs) and Physician Assistants (PAs) to practice in Arizona and the extension of the time frame for renewal of MD licenses during the COVID-19 State of Emergency. Read more about the temporary emergency licensure for MDs here and for PAs here.

AHA announces partnership to accelerate availability of PPE; New Smart App Will Help Coordinate Efforts

The American Hospital Association (AHA) recently announced its partnership with Kaiser Permanente, consulting firm Kearney, Microsoft, Merit Solutions, Goodwill, and UPS to launch Protecting People Everywhere, powered by HealthEquip™. HealthEquip is a smart app that will match individuals and organizations donating PPE with local hospitals based on needs-criteria. The app also will track PPE donations and manage shipping through UPS to your hospital. To register, please visit www.health-equip.com. In addition, please view this video guide and frequently asked questions document for more information.

CMS Releases Guidance Implementing CARES Act Provisions

The Centers for Medicare & Medicaid Services (CMS) yesterday released new guidance implementing several provisions included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. These provisions include:

• A Medicare add-on payment of 20% for both rural and urban inpatient hospital COVID-19 patients;
• Waiver of the long-term care hospital (LTCH) site-neutral policy for COVID-19 patients;
• Waiver of the LTCH "50% Rule" for COVID-19 patients; and
• Waiver of the inpatient rehabilitation facility (IRF) "3-hour Rule" for COVID-19 patients.

Read more here.

CDC updates COVID-19 infection control guidance

The Centers for Disease Control and Prevention updated its infection prevention and control recommendations on April 13 for health care settings. Among specific changes, CDC said health care facilities should consider source control for everyone entering the facility. Actions include requiring everyone to wear a cloth face covering to address the risk of asymptomatic and pre-symptomatic transmission; screen everyone for fever and COVID-19 symptoms before they enter; and consider foregoing contract tracing for exposures and instead screen for fever and symptoms before each shift.