Legislative budget negotiations are ongoing as we approach day 120

Legislative Update 

The House and Senate came in for some brief business on Wednesday, May 3 and then adjourned again until Monday, May 8. The critical business that brought the chambers into work on Wednesday was to grant Arizona Health Care Cost Containment System (AHCCCS) expenditure authority to draw down federal dollars (HB2432). Without this authority, AHCCCS would not be able to make May payments to their contracted health plans, which could have delayed payment to providers. The Senate has had the bill in their chamber since February, and finally on Wednesday voted to pass it by a vote of 26-3. The House concurred in the amendments and it was transmitted to the Governor. Budget negotiations are ongoing as we rapidly approach day 120, when members per diem stipend gets significantly reduced.

National Nurses Month reminds nurses “You Make a Difference”

Every May, the American Nurses Association (ANA) turns the focus back on healthcare providers with a month-long celebration to promote understanding and appreciation of the invaluable contributions of nurses. This year the theme is aptly, You Make a Difference, to honor the varying nursing roles and positive impact nurses have on everyone's lives. It’s no secret Arizona is facing a nursing shortage, despite the number of nursing graduates entering the workforce. The pandemic has taken a toll on existing nursing staff due to workforce shortages, employee burnout and retirement. Which makes it the perfect time to remind our nurses how much we depend on them and how much we care. The ANA has a complete toolkit to help you celebrate throughout the month. It has a breakdown of the weekly themes and how to make the most of them, suggestions on how to recognize your nurses and how to promote the nursing profession to the public. This month let’s put nurses back in the spotlight!

CMS releases updated guidance for the expiration of COVID-19 PHE

The public health emergency (PHE) for COVID-19 will end at midnight on May 11. The Centers for Medicare & Medicaid Services (CMS) published guidelines outlining the regulatory requirements set to be reinstated when the PHE ends. Some of the emergency provisions expiring include vaccination requirements, waivers for the Emergency Medical Treatment and Active Labor Act, discharge planning and nursing care plans, certain critical access hospital requirements, quality and performance improvement programs and flexibilities for expansion sites and swing beds. You can download all the guidelines on the CMS website: Guidance for the Expiration of the COVID-19 Public Health Emergency.

CDC to streamline COVID-19 data reporting requirements for hospitals

After May 11, the COVID-19 PHE will conclude, the Centers for Disease Control and Prevention (CDC) will streamline hospital reporting requirements. The CDC will reduce the number of data elements that hospitals must report and the reporting frequency. Below are some components that will be affected:

• The CDC will reduce the number of required COVID-19 data elements from 62 to 44.
• All data elements will be submitted once weekly on Tuesdays.
• The compliance enforcement period will be lengthened from 14 days to 28 days.

The CDC will provide updated guidance and confirm the date for the reporting transition in the weeks ahead. Until then, hospitals should continue following current guidance.

2022 Uniform Accounting Reports due by the end of May

Hospitals are required to submit their Uniform Accounting Report, Annual Audited Financial Statement (AFS), Medicare Cost Report, Statement of Cash Flow (unless included in the AFS), Hospital Charge Description Master and Attestation of Completeness and Accuracy to the Arizona Department of Health Services (ADHS) no later than 120 days after the end of the hospital’s fiscal year. Since a hospital’s 2022 fiscal year would have ended no later than December 31, 2022, all hospitals should submit these items no later than the end of May. ADHS has the authority to fine hospitals which submit these items late, and the AHCCCS uses these reports for several items, including for providing supplemental payments. Additional information and instructions can be found on ADHS’ website. For questions related to this process, email [email protected].

Hospitals continue to struggle with finances

On Wednesday, KaufmanHall released its report on March 2023 hospital financials which shows data from more than 900 hospitals nationwide. For the first time in a year, hospital operating margins were not negative, but they were also barely positive at 0.0% “putting hospitals in a vulnerable position should a recession or a new public health emergency materialize. While opinions vary, most experts agree that hospitals need to have operating margins of approximately 4%-6% to be able reinvest in their facilities and equipment. Hospitals continue to struggle with the increase in the cost of materials and the increased cost of labor. While outpatient volumes remain strong, hospitals continue to have issues discharging patients to post-acute care facilities in a timely manner. Arizona specific detail will be provided in the 2023 Q1 AzHHA Quarterly Financial Analysis which is scheduled to be released in less than a month.

CMS Releases Medicaid Access and Payment Managed Care, Fee-for-service Proposed Rules

On April 28, CMS released two proposed rules focused on ensuring access to services for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries in managed care and fee-for-service delivery systems. The proposals are intended to increase transparency, improve accountability, and ensure standardized data and monitoring. CMS proposes significant and extensive changes to several key Medicaid policies that would have substantial impacts on program financing and provider reimbursement. The proposals are designed to ensure access and coverage for Medicaid and CHIP populations. AzHHA will be sending a Regulatory Alert to our members in the coming days with additional information.  

Sponsorship opportunities open for the Arizona Hospital and Healthcare Foundation’s 2023 Arizona Hospital Leadership Conference

Join us at the beautiful Loews Ventana Canyon Resort in Tucson for the 2023 Arizona Hospital Leadership Conference, October 25-27. Sponsorship opportunities are now available! Please view our sponsorship prospectus to learn more about our bundled options or stand-alone sponsorships. The number of sponsors is limited to maintain the personal nature of this experience while also maximizing opportunities for sponsors to have face-time engagement with attendees. All sponsors are invited to attend a board-hosted recognition reception on Wednesday evening, lunch with healthcare leaders during Thursday’s keynote and to network at Thursday evening’s reception open to all conference participants. Only sponsoring vendors are permitted to attend the conference. Companies seeking business development opportunities may only attend as sponsors. 

Join us for a Webinar on the Salary.com Healthcare Compensation Survey

Please join AzHHA’s affiliated partner and endorsed vendor, Salary.com, for a webinar to discuss their Healthcare Compensation Survey. Topics to be covered include:

• 2023 Healthcare West Compensation Survey: Webinar will highlight the survey participation and results process, timelines and allow for Q&A with Salary.com.
• Survey Participation: Salary.com will walk you through their data methodology and provide a detailed overview of the participation templates.
• Survey Results: Salary.com will provide a detailed overview of how to access survey results and apply data filters such as facility type (hospital, rehab, critical access, etc.), bed size, teaching status, revenue and more.

Two webinars providing the same information will be presented: Thursday, May 11 at 12 p.m. CST and Wednesday, May 17 at 12 p.m. CST. Register here to participate in either offering; a Zoom link will be sent the day before each webinar. Questions can be directed to Laura Dickscheid, Vice President of Member Services at AzHHA.

UPCOMING EVENTS 

May 10 – Arizona Telemedicine Program Webinar Series: Inclusive Practices – Children with Disabilities  
The Americans with Disabilities Act identifies the need for accommodations for children with disabilities to ensure access to community services programs. The Arizona Telemedicine Program, Southwest Telehealth Resource Center and Regional Center for Border Health host a free one-hour CME webinar for creating an inclusive environment for children with disabilities. This webinar will occur on May 10 at 12 p.m. CST and registration can be found here.

May 12 - Arizona HFMA 2023 Spring Conference  
The Arizona Healthcare Financial Management Association will be holding its 2023 spring conference in Scottsdale on May 12, 2023. Learn more about the conference on their website. 

May 17 - Emergency Preparedness Webinar Series  
In partnership with Health Services Advisory Group, the Arizona Coalition for Healthcare Emergency Response (AzCHER), and others—we invite you to join the monthly emergency preparedness webinars in 2023 to discuss up-to-date information and resources for the areas of focus included in a comprehensive Emergency Preparedness Plan. This monthly series is the third Wednesday of the month from 3–3:45 p.m. PT. To register and access the recordings of previous sessions visit: https://www.hsag.com/epp-series.  

May & June – Critical Incident Stress Management Peer Team Training for Crisis Intervention  
As crises in the workplace and community disasters are becoming more frequent, the need for effective psychological crisis response capabilities becomes obvious. As a result, AzCHER will be offering Group and Individual Critical Incident Stress Management (CISM) Peer Team Training for Crisis Intervention in May and June, in the Tucson area. CISM represents a powerful, yet cost- effective approach to deal with the resultant psychological, emotional and spiritual effects from a crisis. This training will help your facility create and maintain a CISM Peer Team for both Individual and Group debriefing. Lunch will not be provided, so please plan accordingly.  

• Pima County Health Department Toole Warehouse: 350 S. Toole Ave, Tucson, Arizona, 85701 
  • May 16 & 17, 7:30 a.m. - 5 p.m. CST – capacity for 25 people 
• Abrams Public Health Center: 3950 S. Country Club Rd, Tucson, Arizona, 85714 
  • May 30-31, 7:30 a.m. - 5 p.m. CST – capacity for 25 people 
  • June 13-14, 7:30 a.m. - 5 p.m. CST – capacity for 25 people 

To register, contact Cheryl Hewlett at [email protected].  

AzHHA monthly workshops: Introduction to POLST  
Join physician orders for life-sustaining treatment paradigm (POLST) for their one-hour virtual workshops equipping healthcare professionals with knowledge and resources to begin using POLST in Arizona. The objectives are to describe what POLST is at the state and national level, explain why POLST is important, define the population for POLST, when to begin the conversation and who completes POLST, describe the process for completing, reviewing and updating POLST, and learn the process of submitting healthcare planning documents to the Arizona Healthcare Directive Registry. Upcoming workshop dates include:   

• May 9: 2 p.m. CST – Register here  
• June 8: 10 a.m.  CST – Register here 
• July 6: 10 a.m. CST – Register here   

ADDITIONAL EVENTS

May 9: Second National Health Equity Grand Rounds event, Follow the Money! Understanding the Structural Incentives for Inequity in Health Care and Beyond

IN THE NEWS 

CDC to trim hospital COVID-19 reporting rules: 2 notes (Becker’s Clinical Leadership & Infection Control)

Return of 3-Day Rule Will Stress Crowded Hospitals Further (MedPage Today)

Northern Arizona Healthcare announces selection of new CEO (Arizona Daily Sun)

HHS to drop COVID-19 vaccine rule for hospitals (Becker’s Hospital Review)

CMS targets Medicaid payment transparency, wait times in new proposed rules (Healthcare Dive)