Doug Ducey headshot
Arizona Gov. Doug Ducey

Calling Arizona’s June 50% increase in COVID-19 cases “brutal,” Gov. Doug Ducey for the first time has pulled assisted living communities into the mix of potentially accepting transfers from hospitals of COVID-19 patients.

With inpatient and intensive care unit beds at 90% capacity statewide, Arizona is looking at its options in transferring more COVID-19 patients from hospitals to long-term care settings, including nursing homes and assisted living communities. 

Ducey’s July 9 executive order issued an “Enhanced Surveillance Advisory” requiring daily reporting by assisted living communities, nursing homes, hospice care facilities, home health agencies and facilities that care for developmentally disabled of the following:

  • The number of positive COVID-19 cases that require isolation.
  • The facility’s ability to accept new COVID-19 admissions on a given day.
  • The number of beds available overall. 
  • The number of beds available for active or previous cases of COVID-19.

The order does not force facilities to accept patients, according to published reports. Rather, the intent was to gauge the availability of beds on any given day and identify which facilities are willing to “accept and transfer patients as directed by the Arizona Surge Line.”

According to the Arizona Public Health Association, the percentage of patients testing positive in the state continues to increase, from a low of 4.9% in mid-May to a new high of 23.4% this past week. From a May 22 plateau, total COVID-19 hospitalizations increased 301% from 1,093 to 4,384 occupied beds. 

Arizona nursing homes have been providing most of the information requested in the July 9 directive from the governor — and accepting patient transfers — since April under a previous executive order. The new order represents the first time assisted living communities have been asked to report their data and consider accepting transfers.

Assisted living communities have been struggling to access personal protective equipment and testing on their own. The state has indicated that it will provide funding for staffing, supplies, equipment, rapid turnaround testing for staff, training and technical assistance to facilities that participate in transfers and care of hospital COVID-19 patients. 

The American Health Care Association / National Center for Assisted Living and AMDA – The Society for Post-Acute and Long-Term Care Medicine released a joint statement in March blasting statewide orders impacting COVID-19 admissions to long-term care facilities. The statement specifically addressed a New York state order requiring nursing homes and assisted living communities to accept hospital discharges and admissions, regardless of COVID-19 status. New York’s policy is being blamed for worsening outbreaks at nursing homes.

In other coronavirus-related news:

  • July 20 is the deadline for participants in the Medicaid program that have not received a payment from the Provider Relief Fund General Distribution to submit applications for a piece of the $15 billion to be distributed from the CARES Act Provider Relief Fund. AHCA / NCAL has posted resources here.
  • Next week, Sen. Mitch McConnell (R-KY) is expected to share his plans to shield long-term care providers and other businesses from coronavirus-related lawsuits. A provision is expected to be included in the next coronavirus relief legislation. McConnell already has said that granting immunity is a top goal.
  • Universal testing of assisted living and nursing home residents is critical to identifying asymptomatic cases of COVID-19 and curbing virus transmission, according to an analysis published by JAMA Internal Medicine. The report comes on the heels of a warning from AHCA / NCAL of imminent outbreaks at such settings. 
  • AARP California has come out in “strong opposition” against state legislation, AB 1035, that would grant immunity from liability related to COVID-19 for small businesses with 25 or fewer employees, which includes residential care facilities for the elderly.
  • New York is now allowing indoor and outdoor visitation in assisted living communities across the state. Operators must have protocol plans approved by the health department, no coronavirus cases and pass infection control inspections. Visitors will undergo screening, and must wear masks and social distance. 
  • Only seven states — Connecticut, Maryland, Louisiana, New Hampshire, New Mexico and New York  — require ongoing COVID-19 testing of long-term care residents, staff or both, according to an analysis. 
  • Vermont has issued a framework for phased-in reopenings to allow some group activities and more visitation in assisted living, where testing will be optional.
  • Beginning Wednesday, Kentucky began allowing limited visitation at long-term care facilities through guidelines established by the state. Visits must wear face masks, submit to temperature checks, practice social distancing and wash their hands.
  • The Pennsylvania Department of Human Services is launching a Regional Response Health Collaboration Program to directly support COVID-19 continued readiness and response planning in assisted living communities, personal care homes and skilled nursing facilities. The program aims to improve quality of care related to infection prevention, expand COVID-19 testing to include asymptomatic staff and residents, and facilitate continuity of care and services provided in an attempt to mitigate the risk of spread of COVID-19.
  • California has announced new COVID-19 testing guidelines that include a tiered system for recipients. Workers and residents of assisted living communities and nursing homes are in Tier 2. Under the new guidelines, people without symptoms and not in essential jobs won’t be prioritized for testing until results can be turned around in less than 48 hours.
  • The South Carolina Department of Health and Environmental Control reports that the pandemic is taking a toll on staff members in elder care facilities. The department published new COVID-19 case numbers for assisted living communities and nursing homes showing 1,148 COVID-19 cases and eight deaths among eldercare staffers.
  • LeadingAge Illinois President Karen Messer is warning against complacency during the coronavirus pandemic. Messer said that although the rate of infections has flattened in Illinois, the danger to older adults has not passed. She reiterated the national organization’s call to Congress to allocate $100 billion to help aging services providers protect older adults.
  • Nine Pennsylvania hospitals and health systems will receive $175 million as part of the Regional Response Health Collaboration Program to help their local long-term care facilities protect residents from the spread of COVID-19. The money will be used to help nursing homes, personal care and assisted living facilities expand their testing capability and use proven best practices for preventing and tracing infections.

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