Posts Tagged ‘Long-term Care’

Hitting Our Mark at Showtime

February 28th, 2013

Last Saturday our Licensing team hit the mark at Showtime- when it matters most.  After hearing that the Fountain Retirement Hotel had put residents on notice it was closing, we immediately became concerned that staff would stop showing up, food and medication would not be given out, and the residents would be turned out into the streets to live. Many of the residents have significant medical and behavioral health needs, and need a caregiver to assist them with things like taking medication and preparing food.  

Our licensing team arrived at the facility immediately after hearing of the situation from the Sheriff’s Office…  and our licensing team pretty much right away called an “immediate jeopardy” (meaning that there was the potential for a real threat to health and safety of the residents).  Our team stayed all afternoon and into the night, working with the facility’s owner and manager to ensure all residents would be safe.  We maintained a strong presence at the facility throughout the weekend, making sure there were proper caregivers, enough food, and that residents were receiving their medication. 

We’re still sending surveyors out twice a day and are working with many other agencies, including AHCCCS, the VA, Adult Protective Services, Magellan, Partners in Recovery, and the Long Term Care Ombudsman’s Program to make sure the residents are finding new homes that will be able to meet their needs.  A huge thanks to Dr. Cara Christ, Kathy McCanna, Richard Young, Ellie Strang, and Jim Tiffany, for responding so effectively and ensuring the Health and Wellness of these Arizonans.  Thanks!

Evidence-Based Decision-Making: A Key Regulatory Benchmark

November 19th, 2012

The role of a surveyor can be a difficult one. Our team of licensing surveyors need to maintain neutrality as regulators and be able to apply the Arizona Administrative Code (otherwise known as “the rules”) to a wide variety of facilities within the healthcare system.  Part of our surveillance includes investigating complaints- which can be generated from an array of internal and external sources.  When the complaints come because of TV or other media coverage- it can pose unique challenges for our team.  But…  no matter where the complaint comes from, our job is to use facts and evidence to drive our investigation, decision-making, and interventions. 

There are 3 forms of evidence that we use to substantiate an allegation made in a complaint: 1) observation; 2) documentation; and 3) interviews. Two of these forms of evidence need to be present before we find that a complaint is “substantiated”.  By using these tried and true evidence-based tools we put ourselves in the best position to identify real health and safety problems without jumping to conclusions.

Focusing on facts and evidence (and not allowing one’s self to be driven by media coverage) is a good start…  but there are a few things that both surveyors and healthcare professionals can do to keep focus on providing a healthy and safe environment. Keep good records, document, sign and store up to date data, maintain consistent supervision for those that require it, follow your agency’s policies and procedures without fail, report what’s required, be proactive (not reactive), and seek out ongoing education in your field.  Don’t cut corners when it comes to care… and don’t be afraid to admit a mistake or that you do not have all the answers. 

So, if you happen to hear or see a TV story about a facility, keep in perspective that the story might focus on anecdotes and what the reporter thinks they know or even just their opinion- not necessarily what the evidence demonstrates.  In a time when information is disseminated second by second rather than day by day, let’s remember that we all share the same goal, to promote Health and Wellness for all Arizonans, which includes providing surveyors, community, clients and staff accurate and factual information.

Curious about the real scoop on how all of our licensed facilities are doing?  Check out our AZ Care Check website which has the details about our evidence-based investigations and surveys.

Interim AD for Licensing

May 10th, 2012

 Colby Bower will serve as our Interim Assistant Director for Licensing while we recruit and hire a permanent Assistant Director.  Colby has been serving as our Legislative Affairs chief for the last couple of years.

Colby fills several of the criteria that we needed for the interim post: 1) He’s a good risk manager and has a good understanding of the importance of Stakeholder relations; 2) He understands the matrix of our statutes and rules- and knows that we need to exercise our authority through the prism of public health; 3) He’s good with people; and 4) Now that the legislative session is over- he’ll have the time needed to invest in the program.  Our Operations folks are busy doing all of the IT, finance and legal things to get Colby the authority and tools he’ll need in his post.

We’ve already announced our recruitment for a permanent Assistant Director.  I blogged about the recruitment yesterday, including a hot link to the job announcement on ADOA’s website.  Our goal is to complete the recruitment process and hire a permanent AD this summer.


Join me in welcoming and thanking Colby for his willing to fill this important post while we go through the full recruiting process!

ADHS Looking for a Forward-thinking Assistant Director

May 8th, 2012

Promoting Health and Wellness for all Arizonans” is the motto of the Arizona Department of Health Services.  We promote and protect the health of Arizona’s children and adults and set the standard for personal and community health through direct care, science, public policy and leadership.  Want a piece of the action? 

We’re looking for an experienced and proactive leader to become our new Assistant Director for Licensing Services. This key position reports directly to me and manages six different state and federal licensing units including Long Term Care, Medical Facilities, Child Care, Assisted Living, Behavioral Health, and Special Licensing.  The job oversees about 200 employees and a budget of $17M.  But- what makes the job exciting is that you’ll have a unique opportunity to lead a dynamic team and use your talents and skills to make Arizona a healthier place- “Promoting Health and Wellness for All Arizonans”.

A Look in the Mirror

September 15th, 2011

Many folks don’t know that our Licensing division undergoes a periodic audit (survey) to look at compliance to our Federal contract with the Centers for Medicare Medicaid Services (CMS). This past week, 3 surveyors from the regional office of CMS came to review our Long Term Care and Medical Facilities areas. This survey centered on complaint surveys and their prioritization, initiation and investigation. This audit is much like the surveys the Division of Licensing performs on our licensees. There’s an “entrance” whereby the Surveyors explain why they’re here, what they’re going to look at and items that they’ll need in order to help them with their survey. Then there are a few days of what can be intensive record review, interviews with staff and other associated investigatory activity. 

Then the Surveyors compile their information and hold an “exit” with the staff to review what they did, found and suggestions from the survey. During this, exit the staff finds out areas the Surveyor reviewed and if there are any areas they will need to improve upon (findings).  CMS asks for a plan of correction where we would provide a description of how the issue(s) will be resolved, when they’ll be resolved and how we’ll maintain and monitor things.  

Lots of hard work goes into preparing for these CMS visits. Thank you’s go to everyone who work in the Bureaus of Long Term Care Licensing and Bureau of Medical Facilities Licensing. It is truly a team effort as CMS looks at the field work/documentation of the Surveyors, the reviews of the Team Leaders and Bureau Chiefs and the documentation files etc. the Program Project Specialists and the Support Staff maintain.  We don’t have our report back yet- but all indications are that we did well on our assessment.

ADHS Status

July 21st, 2010

We’ve got a lot to be proud of over the last year and an half.  It’s been hard, I know because of all of the budget reductions and the lower staffing level.  On the other hand, we’ve got an incredible mission and we’re doing a good job.  I often tell people that we work in the most interesting agency in state government.  Why?  Because we touch the lives of Arizonans in dozens of different ways everyday.  We:


  • Make sure that Arizonans are healthy and protected from infectious diseases like the flu and foodborne illnesses- and prevent diseases in the first place through our Vaccine for Children Program  


  • Provide families with young kids access to nutritious blend of foods


  • Make sure that the kids at Child Care facilities are safe and sound and that they get some exercise thanks to our Empower Pack program.



  • Help save lives by doing things like developing Cardiac Arrest Centers and Primary Stroke
    Centers across the state that are dramatically improving outcomes for folks that have a cardiac arrest or a stroke and are leading the national shift to continuous chest compression CPR from the old compression/breathing method .


  • Are building a new Trauma System from the ground up- which saves lives every day.


  • Are leading the state’s anti tobacco efforts like the prevention activities in our youth tobacco campaign (called Venomocity)  and helping thousands of Arizonan’s Kick the Habit through our services.


  • Are improving the performance of the state’s mental health system by giving choice and voice to folks with mental health and substance abuse needs- improving their ability to better participate in their path to Recovery from  Mental illnesses.  Over this past year, we have developed the new Nine Adult Guiding Principles to compliment our Children’s 12 Principles. We developed an RFP, went out for bid, and issued awards for all Geographic Service Areas outside of Maricopa County. We also planned for and implemented the most severe budget reductions in the behavioral health system in Arizona’s history.


  • Make a difference in hundreds of peoples lives at the Arizona State Hospital-  by helping them in their road to recovery by treating them with dignity, care and respect.


  • Run one of the state’s most well respected public health laboratories- providing the backbone for Arizona’s public health system.  For example, we find hundreds of kids with metabolic disorders and hearing and helped their doctors conduct interventions to help them avoid serious complications from their condition through our newborn screening program. 


  • Administer the Office of Children with Special Healthcare Needs (OCSHCN) program, which includes the Children’s Rehabilitative Services (CRS) program.  CRS provides family-centered medical treatment, rehabilitation, and related support services for children under age 21 with qualifying chronic and disabling conditions such as congenital heart disease,  neuromuscular conditions, spina bifida, cleft lip, cerebral palsy, and many others.


  • Test 1000s of biological samples for all kinds of viruses and bacteria including H1N1, tuberculosis, West Nile virus, rabies, and literally dozens of other diseases so that counties and doctors can help slow the spread of disease and help people get better in our Public Health Microbiology program.



  • Ensure that hundreds of clinical and environmental laboratories across the state are doing things right and providing good results through our Laboratory Licensure & Certification program.



And that’s just a fraction of the incredibly interesting and important things that we do.  Do you have any doubt now that this is the most fascinating place to work in state government?


We’re successful at all of these things because of your commitment to the folks of Arizona and to each other.  It takes a wide range of help from everyone including our IT, Human Resources, Rules, Procurement, Auditing, Financial Services and other Operations Teams to make these things happen.


Thank you all for rowing in the same direction.  I really appreciate your can-do attitude.  Thanks…  and make sure that you take the time to thank the folks around you from operations that make this place tick.