American Health Care Association

Last updated

AHCA/NCAL
Founded1949;75 years ago (1949)
Legal statustrade association
Headquarters1201 L Street NW
Location
Membership
14,000 facilities
Official language
English
CEO/President
Clifton J. Porter, II
Website www.ahcancal.org OOjs UI icon edit-ltr-progressive.svg

The American Health Care Association (AHCA) is a non-profit federation of affiliated state health organizations that represents more than 14,000 non-profit and for-profit nursing homes, assisted living communities, [1] and facilities for individuals with disabilities. Clifton J. Porter, II became CEO on 14 October 2024. [2]

Contents

The National Center for Assisted Living (NCAL) is a part of the AHCA. AHCA was founded in 1949 and is based in Washington, D.C. AHCA/NCAL works with Congress and the federal government to advocate for long-term care services. Membership is open to health care facilities of all sizes. Employees of member facilities or companies, such as administrators, directors of nursing, certified nursing assistants, and corporate staff, have access to the association's educational and networking opportunities.

Issues

Medicare and Medicaid funding

In the United States, Medicaid is the primary payer for long-term care. Most Americans (64 percent) who live in a nursing homes depend upon Medicaid to pay for their care. Almost all people with intellectual and developmental disabilities and 19 percent of residents in assisted-living communities depend upon Medicaid. [3]

Nursing homes that are Medicare-certified are called skilled nursing facilities (SNF). Medicare Part A will cover skilled nursing care in a SNF in certain conditions on a short-term basis. Medicare Part B helps cover medically necessary and/or preventive outpatient services, including physical, occupational and speech therapy treatment, which can be offered in a SNF. Medicare does not cover custodial care, or personal care like help with activities of daily living (bathing, dressing, using the bathroom, and eating). [4] [5]

In July 2020, CMS issued a final rule establishing a 2.2 percent net increase in Medicare reimbursements for nursing homes for Fiscal Year 2021 with total reimbursements increasing $750 million. The final rule will take effect on October 1, 2020. [6]

AHCA supports changes in Medicaid reimbursement that link payments to quality or efficiency and believes reforms should take into account different kinds of providers and the various populations they serve. The group believes that improvements in efficiency should heavily emphasize ensuring funding is used only for high-quality services that are medically necessary. AHCA supports making any changes to Medicaid reimbursement gradual to allow for iterative patient and provider input to improve implementation. [7]

AHCA opposes any Medicaid reform that would shift the burden of funding to state and local governments or medical providers. [7]

In January 2020, AHCA stated its opposition to the Medicaid Fiscal Accountability Regulation (MFAR). MFAR would effectively implement new Medicaid taxes by ending long-standing exemptions and discounts that apply to some facilities and other healthcare organizations. [8]

According to AHCA/NCAL, the typical nursing home operates on low or negative profit margins due to Medicaid reimbursements only covering 70 percent to 80 percent of costs. It is common for nursing homes to continue operations by using reimbursements from short-term Medicare post-acute care to subsidize the care of Medicaid patients. Due to the dramatic decrease in surgical procedures that would necessitate post-acute care during the COVID-19 pandemic, this model is becoming increasingly untenable. [9]

COVID-19

In April 2020, Vice President Mike Pence announced that skilled nursing facilities would receive a higher priority for PPE and other resources from the federal government. Pence announced that the Federal Emergency Management Agency would soon start sending PPE to every nursing home in the United States. The same month the Centers for Disease Control and Prevention (CDC) changed its priority classifications for COVID-19 testing related to long-term care. Under the new rules, health care workers and residents with symptoms would be high priority, and health care workers who contact people known or suspected to have COVID-19 would be rated priority. Before, the CDC identified three priority levels for tests. Symptomatic health care workers were rated as priority one, symptomatic residents were rated as priority two, and asymptomatic health care workers as priority three. This action came after two months of urgent requests from AHCA/NCAL. [10]

In May 2020, AHCA/NCAL called for additional help from state and local governments for skilled nursing facilities. The group released a “Long Term Care Workforce Roadmap for Governors and States” to help protect caregivers and other staff. The roadmap asked for improved access to PPE for caregivers and other skilled nursing facility staff, helping workers with childcare and bonus pay, relaxing regulations to bring in additional staff across state lines, and the establishment of “strike teams,” including the National Guard, to assist at facilities with virus outbreaks. [11]

The CMS released recommendations on May 18, 2020 that in addition to an initial test, long-term care and assisted living facility residents should be tested if they have symptoms or if a staff member in their facility tests positive. The Centers suggested all staff should be tested weekly. The costs associated with following these recommendations caused severe alarm in the industry. AHCA stated that testing every staff member and resident in the United States only once would cost about $444 million, thus making repeated testing “unsustainable” without government subsidies. [12]

AHCA has identified the length of time it takes to get test results back as a major problem for its members. 90% of the facilities surveyed said it took more than two days to get COVID-19 test results. About 25% said it took five or more days. [13] In July 2020, AHCA/NCAL sent a letter to the Secretary of Health and Human Services Alex Azar arguing that long-term care residents and providers should receive top priority for receiving a vaccine when it becomes available, as these groups face the highest risk from the virus. [14]

The letter asked for the federal government to extend the COVID-19 public health emergency beyond its expiration date of July 26, 2020 and to keep waivers of Section 1135 and Section 1812(f) of the Social Security Act in place until certain goals, such as developing a vaccine, provision of personal protective equipment in sufficient quantities, and nursing homes reaching pre-pandemic staffing levels, are met. These sections allow the Centers for Medicare & Medicaid Services to issue blanket waivers to facilitate access to care during an emergency. The agency used a set of waivers in March 2020 including a temporary relaxation of Medicare’s restrictions on distance medicine. [14]

On August 11, 2020, AHCA/NCAL released a report showing a large increase in COVID-19 infections among nursing home patients due to the spread of the disease in the general population. On August 13, the association released the results of a survey showing that the majority of nursing homes would not be able to continue operations another year with losses accruing at the current rate. On August 19, the association released the results of a similar survey of long-term care facilities, which have received no federal financial assistance to deal with the pandemic; It found that half of long-term care facilities are operating at a loss and 64 percent will be unable to continuing operating for another year at their current burn rates. [15]

Following news that the federal COVID-19 pandemic emergency declaration will end in 2023, the AHCA has publicly raised concerns that nursing homes will lose money as a result. [16]

Quality improvement

In February 2012, AHCA/NCAL introduced The Quality Initiative, an effort that builds upon existing work the long-term and post-acute care field is doing by setting specific, measurable targets to further improve quality of care in American's nursing and assisted living centers. [17]

AHCA/NCAL serves skilled nursing care centers in improving the quality of care provided to residents. AHCA provides facilities with resources and solutions for quality improvement such as the Quality Award Program, LTC Trend Tracker, Gero Nurse Prep, and Nurse Assistant Training. [18]

Research and publications

AHCA develops and compiles research and data concerning the long term and post-acute care industry. Whether conducted by AHCA and research agencies or gathered from government agencies, AHCA tries to inform the public and policymakers about the state of long term care facilities. [19]

AHCA publishes a weekly email newsletter called Capitol Connection and a separate monthly magazine titled Provider. The publications include news and legislative, regulations, and other issues affecting its members. AHCA/NCAL members have access to various other publications which include: AHCA/NCAL Notes, NFP Newsletter, and DD Digest. [19]

Events

AHCA/NCAL Convention

This annual long-term care industry event includes speakers, education programs, networking opportunities, and other activities. [20]

Congressional Briefing

Members convene annually in Washington, DC to raise awareness of important issues affecting long-term and post-acute care in addition to meeting with congressional representatives. [21]

Independent Owner Leadership Conference

The AHCA/NCAL Independent Owner Leadership Conference is for independent owners and not-for-profit operators of 10 or fewer long-term care facilities. [22]

Quality Summit

This annual conference is for long-term care professionals and focuses on quality improvement. [23]

National Skilled Nursing Care Week

AHCA established National Nursing Home Week in 1967, which was renamed National Skilled Nursing Care Week in 2018. This is a week-long observance recognizing nursing homes. It is held in May and begins on Mother's Day, the second Sunday of May. [24]

National Assisted Living Week

NCAL established National Assisted Living Week in 1995. This is a week-long observance recognizing the contributions of assisted living staff and residents. It is held in September and begins on Grandparents’ Day, the Sunday after Labor Day. [25]

Leadership

Mark Parkinson, former president and CEO of AHCA MarkParkinson2019.jpg
Mark Parkinson, former president and CEO of AHCA

Mark Parkinson, a former governor of Kansas and state legislator, succeeded Bruce Yarwood as CEO and president of AHCA in 2011. [26]

In October 2024 Clifton J. Porter, II became president and CEO of AHCA/NCAL, [2] the first Black CEO. Porter, a former nursing home administrator and long-time lobbyist, had been with AHCA for more than 20 years, most recently as senior vice president of government relations. [27]

Related Research Articles

<span class="mw-page-title-main">Medicaid</span> United States social health care program for families and individuals with limited resources

In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding.

<span class="mw-page-title-main">Medicare (United States)</span> US government health insurance program

Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with end stage renal disease and amyotrophic lateral sclerosis. It was begun in 1965 under the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services (CMS).

<span class="mw-page-title-main">Home care in the United States</span>

Home care is supportive care provided in the home. Care may be provided by licensed healthcare professionals who provide medical treatment needs or by professional caregivers who provide daily assistance to ensure the activities of daily living (ADLs) are met. In-home medical care is often and more accurately referred to as home health care or formal care. Home health care is different non-medical care, custodial care, or private-duty care which refers to assistance and services provided by persons who are not nurses, doctors, or other licensed medical personnel. For patients recovering from surgery or illness, home care may include rehabilitative therapies. For terminally ill patients, home care may include hospice care.

A nursing home is a facility for the residential care of older people, senior citizens, or disabled people. Nursing homes may also be referred to as care homes, skilled nursing facilities (SNF) or long-term care facilities. Often, these terms have slightly different meanings to indicate whether the institutions are public or private, and whether they provide mostly assisted living, or nursing care and emergency medical care. Nursing homes are used by people who do not need to be in a hospital, but require care that is hard to provide in a home setting. The nursing home staff attends to the patients' medical and other needs. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day.

<span class="mw-page-title-main">Assisted living</span> Housing facility for people with disabilities

An assisted living residence or assisted living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or who choose not to live independently. The term is popular in the United States. Still, the setting is similar to a retirement home, in the sense that facilities provide a group living environment and typically cater to an older adult population. There is also Caribbean assisted living, which offers a similar service in a resort-like environment.

<span class="mw-page-title-main">Elderly care</span> Care serving the needs of old people

Elderly care, or simply eldercare, serves the needs of old adults. It encompasses assisted living, adult daycare, long-term care, nursing homes, hospice care, and home care.

<span class="mw-page-title-main">Long-term care</span> Services for the elderly or those with chronic illness or disability

Long-term care (LTC) is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. Long-term care is focused on individualized and coordinated services that promote independence, maximize patients' quality of life, and meet patients' needs over a period of time.

The Minimum Data Set (MDS) is part of the U.S. federally mandated process for clinical assessment of all residents in Medicare or Medicaid certified nursing homes and non-critical access hospitals with Medicare swing bed agreements.

<span class="mw-page-title-main">Mark Parkinson</span> American businessman and politician

Mark Vincent Parkinson is an American businessman and former politician serving as head of the American Health Care Association (AHCA) and National Center for Assisted Living (NCAL). He served as the 47th lieutenant governor of Kansas from 2007 to 2009 and the 45th governor of Kansas from 2009 until 2011. He was also a state legislator.

Jonathan 'Jon' Dolan is a trade association executive and former Missouri legislator who served in the Missouri Senate from 2003 to 2005 and served in the Missouri House of Representatives from 1997 to 2003.

Program of All-inclusive Care for the Elderly (PACE) are programs within the United States that provide comprehensive health services for individuals age 55 and over who are sufficiently frail to be categorized as "nursing home eligible" by their state's Medicaid program. The ultimate goal of PACE programs is to keep eligible older adults out of nursing homes and within their communities for as long as possible. Services include primary and specialty medical care, nursing, nutrition, social services, therapies, pharmaceuticals, day health center services, home care, health-related transportation, minor modification to the home to accommodate disabilities, and anything else the program determines is medically necessary to maximize a member's health. If you or a loved one are eligible for nursing home level care but prefer to continue living at home, a PACE program can provide expansive health care and social opportunities during the day while you retain the comfort and familiarity of your home outside of day hours.

Genesis HealthCare is a provider of short-term post-acute, rehabilitation, skilled nursing and long-term care services. According to data provided by the Centers for Medicare & Medicaid, as of November 1, 2023, Genesis owned or operated 290 skilled nursing facilities with 34,047 bed through 105 affiliates in 25 states in the United States. Genesis also supplies rehabilitation therapy to approximately 1,700 healthcare providers in 45 states and the District of Columbia. Genesis has approximately 80,000 employees. Genesis HealthCare is headquartered in Kennett Square, Pennsylvania.

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<span class="mw-page-title-main">ProMedica Senior Care</span> Healthcare organization in Perrysburg, United States

ProMedica Senior Care, formerly HCR ManorCare Inc, is a major provider in the United States of both short-term post-acute and long-term care. As of 2020, it had more than 300 skilled nursing and rehabilitation centers, assisted living facilities hospice and home health care offices, and over 45,000 employees. The company is headquartered in Toledo, Ohio. In July 2007, it agreed to a $4.9 billion buyout offer from the private equity firm Carlyle Group. In 2018, HCR ManorCare filed for bankruptcy protection and agreed to be taken over by its landlord, Quality Care Properties and in April 2018, Quality Care Properties was acquired by a joint venture between Welltower and ProMedica. In November 2022, ProMedica announced it would end its joint venture with Welltower and would cede its 15% ownership of ProMedica Senior Care. Welltower announced a partnership with Integra Health shortly after which will take over control of all but 10 skilled nursing facilities from ProMedica. ProMedica will continue to operate the assisted living facilities gained under the original agreement.

The Green House Project is an American national non-profit organization dedicated to creating alternative living environments to traditional nursing home care facilities.

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As of 2017, approximately 1.4 million Americans live in a nursing home, two-thirds of whom rely on Medicaid to pay for their care. Residential nursing facilities receive Medicaid federal funding and approvals through a state health department. These facilities may be overseen by various types of state agency.

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References

  1. ↑ Parker, William (April 2, 2010). "American Health Care Association: Assisted Living Communities". American Health Care Association. Senior Living. Retrieved October 19, 2017.
  2. 1 2 "Clifton J. Porter, II Takes the Helm of AHCA/NCAL" (Press release). AHCA/NCAL. October 14, 2024.
  3. ↑ "Long Term Services & Supports". Medicaid.gov. Centers for Medicare & Medicaid. Retrieved September 25, 2020.
  4. ↑ "Residential Facilities, Assisted Living, and Nursing Homes".
  5. ↑ "Skilled nursing facility (SNF) care". Centers for Medicare and Medicaid Services. Retrieved September 25, 2020.
  6. ↑ Staff (July 31, 2020). "Fiscal Year 2021 Payment and Policy Changes for Medicare Skilled Nursing Facilities (CMS-1737-F)". CMS.gov. Centers for Medicare & Medicaid Services. Retrieved September 25, 2020.
  7. 1 2 Staff. "A Framework for Medicaid Reform" (PDF). AHCA/NCAL. Retrieved September 25, 2020.
  8. ↑ O'Brien, Jack (August 11, 2020). "AMERICA'S ESSENTIAL HOSPITALS PUSHES FOR CMS TO WITHDRAW THE MFAR". HealthLeaders. Simplify Compliance. Retrieved September 25, 2020.
  9. ↑ Novotney, Amy (June 11, 2020). "Nursing home industry on verge of financial collapse, group claims". McKight's Senior Living. Haymarket Media. Retrieved September 25, 2020.
  10. ↑ Brown, Danielle (April 30, 2020). "LTC now has higher federal priority for PPE, testing". McKnight's Long-Term Care News. Haymarket Media, Inc. Retrieved September 22, 2020.
  11. ↑ Bonvissuto, Kimberly (May 22, 2020). "'Immediate action' needed from governors to address long-term care workforce needs during pandemic, AHCA / NCAL says". McKnight's Senior Living. Haymarket Media. Retrieved September 25, 2020.
  12. ↑ Brown, Danielle; Berger, Liza (April 30, 2020). "LTC now has higher federal priority for PPE, testing". McKnight's Long-Term Care News. Haymarket Media. Retrieved September 25, 2020.
  13. ↑ Davis, Katie (July 3, 2020). "NBC 10 I-Team: Nursing homes face testing delays". 10 WJAR. Retrieved September 25, 2020.
  14. 1 2 Brown, Danielle (July 8, 2020). "LTC residents and workers should get top priority for COVID-19 vaccine: AHCA". McKnight's Long-Term Care News. Haymarket Media. Retrieved September 25, 2020.
  15. ↑ Berlinger, Joshua; Renton, Melissa; Macaya, Renton; Wagner, Meg; Hayes, Mike (August 12, 2020). "August 11 coronavirus news". CNN. Retrieved September 25, 2020.
  16. ↑ "More than half of US nursing homes are unprofitable—and it's about to get a lot worse". Quartz. February 8, 2023. Retrieved February 14, 2023.
  17. ↑ Staff (December 19, 2019). "Kentucky recognized for progress in quality of long-term care". The Lane Report. Louisville, Kentucky. Retrieved September 25, 2020.
  18. ↑ Staff (January 23, 2020). "NCAL partners with CarePrepare to offer members state survey inspection data". McKnight's Senior Living. Retrieved September 25, 2020.
  19. 1 2 Staff. "News & Communications". AHCA/NCAL. Retrieved September 25, 2020.
  20. ↑ Berklan, James M. (September 25, 2020). "AHCA/NCAL preparing for Oct. 8-31 online annual conference". McKnight's Long-Term Care News. Haymarket Media. Retrieved September 25, 2020.
  21. ↑ Staff. "AHCA/NCAL Congressional Briefing". AHCA/NCAL. Retrieved September 25, 2020.
  22. ↑ Staff. "2021 Independent Owner Leadership Conference". AHCA/NCAL. Retrieved September 25, 2020.
  23. ↑ Ewing, John Patrick. "2020 AHCA/NCAL Quality Summit: Registration Open". Long Term Care Leader. Retrieved September 25, 2020.
  24. ↑ Mortensen, Ellen (May 7, 2020). "Saluting our skilled nursing care workers". Gothenburg Leader. Retrieved September 25, 2020.
  25. ↑ Bowers, Lois A. (September 14, 2020). "A special week during an unusual time". McKnight's Senior Living. Haymarket Media. Retrieved September 25, 2020.
  26. ↑ Berklan, James M. "McKnight's 40 for 40: Mark Parkinson". McKnight's Senior Living. Haymarket Media. Retrieved September 25, 2020.
  27. ↑ James Birklan (July 17, 2024). "Long odds for Clifton Porter as new AHCA CEO, he's been there". McKnight's Long-Term Care News.
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