Skilled nursing facilities gain access to $5B in stimulus funds

The Department of Health and Human Services (HHS) announced the distribution of nearly $5 billion to help skilled nursing facilities (“SNFs”) deal with the financial impacts of the COVID-19 pandemic.

These facilities have felt the brunt of the pandemic this spring. While only about 1 percent of the U.S. population lives in these facilities, residents of these facilities account for up to one-quarter of all the diagnosed cases in the country, STAT reports.  Despite that impact, this is the first dedicated tranche of funding dedicated for skilled nursing facilities.

The federal government "is providing every resource we can, from funding and direct PPE shipments to regulatory flexibility and infection control consultations, to protect seniors in nursing homes and those who care for them," HHS Secretary Alex Azar said in a statement.

According to the terms of the funding released as part of the CARES Act, each SNF in the country will get a baseline payment of $50,000, along with an additional $2,500 per bed. The money will be made available to facilities with six or more certified beds. 

SNFs receiving these targeted distribution funds must complete an attestation and agree to comply with the Terms and Conditions of the program.  The attestation must be completed within 45 days of receiving the funds.

The Terms and Conditions for the targeted SNF distributions are substantially similar to the Terms and Conditions for the General Distributions previously made available to providers. The Terms and Conditions require SNFs to:

• Certify that: (i) it provides or provided after January 1, 2020 diagnoses, testing, or care for individuals with possible or actual cases of COVID-19; (ii) it is not terminated from participation in Medicare, or excluded from participation in Medicare, Medicaid, or other federal health care programs; and (iii) its Medicare billing privileges are not revoked.
• Certify that the funds will only be used to prevent, prepare for, and respond to COVID-19 and to reimburse the recipient only for healthcare related expenses or lost revenues attributable to COVID-19.
• Certify it will not use the funds to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse.
• Submit reports to ensure compliance with payment conditions, as specified in future instructions from the Secretary of HHS.
• Consent to public disclosure of the payments received from the fund which may allow others to estimate specific financial information of the recipient.
• Certify that all information provided as part of any application for the funds, and reports relating to the funds, are true, accurate, and complete, to the best of its knowledge. Recipient must acknowledge that any deliberate omission, misrepresentation, or falsification of any information in any application or report may be punishable by criminal, civil, or administrative penalties.
• No later than 10 days after the end of each calendar quarter any recipient that receives more than $150,000 total in funds under the CARES Act, the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act or any other Act primarily making appropriations for COVID-19 response and related activities, must submit a report to the Secretary and the Pandemic Response Accountability Committee, containing certain prescribed information, including:
  • the total amount of funds received;
  • the amount of funds received that were expended or obligated for a project or activity; and
  • a detailed list of all projects or activities for which large covered funds were expended or obligated, including certain prescribed information further detailed in the Terms and Conditions.
• Maintain appropriate records and cost documentation including, as applicable, documentation required by 45 CFR § 75.302 - Financial management and 45 CFR §75.361 – 75.365 - Record Retention and Access, and any additional information required by further instructions. Copies of such records and cost documentation must be submitted upon the Secretary’s request. The recipient also agrees to cooperate in all audits the Secretary, Inspector General, or Pandemic Response Accountability Committee conducts.
• Certify that for all care for possible or actual COVID-19 cases, it will not seek to collect out-of-pocket expenses from a patient in an amount greater than the patient would have otherwise been required to pay if the care had been provided by an in-network provider.