Proposed legislation before the Arizona Legislature, if passed, would privatize annual inspections of skilled nursing facilities and assisted living communities by creating a third-party entity to make assessments. Long-term care provider advocacy groups oppose the measure, however.
If the bill passes, by July 1, 2024, the Arizona Department of Health Services would contract with a third party to conduct all inspections, complaint investigations and survey duties for long-term care facilities in the state. It also would increase state inspections to twice a year.
“There is no other state that requires two inspections annually. In fact, there’s no other state that totally privatizes surveys,” David Voepel, CEO of the Arizona Health Care Association, told the McKnight’s Business Daily.
The proposal comes with a high price tag, he added, when one considers the training, staffing, contract management and accountability required by outsourcing the state’s investigative responsibility to a third party. As it stands, the federal government contracts with the ADHS to perform federal surveys. Third-party contracts would not be covered by the feds.
For nursing homes, he said, the “frequency, duration and focus are all dictated by [the Centers for Medicare & Medicaid Services], and standard surveys by federal statute must occur between nine and 15 months.”
Most states accept the federal standard survey as meeting the requirements of state annual inspections, because CMS pays states approximately 60% of the cost of conducting a federal survey, Voepel said. “Few people truly understand how much the state relies on the CMS Medicare inspections process and funding, because generally states do not have the resources to do it on their own,” he added.
Will Humble, executive director of the Arizona Public Health Association, said that group also is opposed to the legislation.
“Complaint investigations (which often provide valuable information to identify poor or dangerous care) have always been the responsibility of ADHS — and those complaint investigations can’t be outsourced to third parties,” he said in a blog post Tuesday. “It’s unclear to what standard the third party would hold the facility to (state licensing rules?). ADHS would use their licensing fees to hire the third party.”
