Ducey’s decision to give the state authority over nursing home managers raises staffing concerns

With Governor Doug Ducey’s veto of SB 1282, the Arizona Department of Health Services (ADHS) is set to take over the licensing of managers for nursing homes and assisted living facilities. Ducey’s push to transfer jurisdiction over these managers to the state creates several concerning obstacles with worrying implications for seniors, according to the executive director of the Arizona Healthcare Association (AzHCA), David Voepel.

SB 1282, sponsored by Sen. Tyler Pace, would have reinstituted the Board of Examiners of Nursing Care Institution Administrators and Assisted Living Facility Managers (NCIA) for another eight years.


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According to Voepel, there’s only so much time for the state to implement a system in which it oversees the licensure process. With Pace’s bill off the table, current NCIA operations are set to end in June. In other words, Arizona needs to produce an alternative to NCIA oversight in less than two months.

“CMS mandates that states do licensure of nursing home administrators, so the operations of the NCIA board will need to continue even if the board doesn’t. If, after June 30 when the NCIA is dissolved, ADHS is not ready to go or there’s not another mechanism in place, then we’ll have a much larger staffing crisis on our hands.”

Voepel said license issuances and renewals would “grind to a halt” if the state doesn’t have a legitimate replacement for NCIA’s responsibilities once the board is dissolved. Without any administrators, he said, nursing homes and assisted living facilities could face significant workforce shortages.

Ducey said he’s calling for the change after a report from the Arizona Republic showed questionable oversight on the part of the board. The investigation revealed the board recently granted a license to a convicted felon. And in 2019, a facility staff member was accused of sexually assaulting an incapacitated female resident — who later became pregnant.

Ducey said he has spoken with lawmakers regarding the change of direction and plans to work with the Legislature to shift responsibility to ADHS.

“With this new information, we need something more than continuation. My office has spoken to the sponsor and other key members of the legislature on a path to not just continue the status quo but to improve the oversight of administrators of long-term care facilities.”

Voepel said AzHCA believes there should always be some degree of “peer review” concerning long-term care operations. In other words, individuals other than the state who have experience with the operations of these facilities should have at least some oversight of the process.

He added that ADHS’s new authority over licensure of these individuals could result in an overreach of government authority..

“Our fear with having ADHS do licensure of administrators is that they will become judge, jury and executioner. Meaning: they survey facilities and go on complaint surveys… if they are also doing licensure investigations, will subjectivity carry over? So a major firewall will need to be in place in order to allow administrators and AL [assisted living] managers a proper hearing.”

NCIA didn’t respond to State of Reform’s request for comment.