Contributor: Kailey Riskowski CPA from Bland and Associates, the reimbursement consulting contractor for LeadingAge Kansas.
On August 27, 2020, $2.5 billion of the Health and Human Services (HHS) CARES Act Provider Relief Fund was distributed to nursing facilities. Facilities with 6 or more beds received $10,000 plus $1,450 per bed. According to HHS, Nursing Home Infection Control FAQs, the distributed funds must be spent on –
- costs associated with administering COVID-19 testing for both staff and residents;
- reporting COVID-19 test results to local, state, or federal governments;
- hiring staff to provide patient care or administrative support;
- incurring expenses to improve infection control, including activities such as implementing infection control “mentorship” programs with subject matter experts, or changes made to physical facilities; and
- providing additional services to residents, such as technology that permits residents to connect with their families if the families are not able to visit in person.
These same criteria will apply for the incentive payments issued November 2, 2020 and subsequent payments occurring monthly through February 2021. Providers have until June 30, 2021 to spend these funds.
Many are wondering if further clarification will be provided by HHS regarding specific allowable uses of the funds, and unfortunately, we have been told, this likely will not occur.
LeadingAge Kansas has been in frequent communication with LeadingAge National, who has successfully submitted questions to HHS on our Association’s behalf. Based on a response received to our member’s questions, it appears HHS will intentionally not be providing specific guidance to avoid unintentionally omitting qualifying expenses. HHS’ message is if the expense relates to infection control efforts enacted to prevent or treat COVID-19, the expense will qualify.
Despite their response, HHS did provide further clarification (through FAQ) on the hiring of staff noted above, and whether qualifying expenses must relate solely to new staff:
“Payments from the Nursing Home Infection Control Distribution may be used to cover “hiring” expenses related to both recruiting new hires and the continued payment and retention of existing staff to provide patient care or administrative support.”
Further, the Association received a question from a member that was shared with LeadingAge National. We wanted to share the question and follow-up in our efforts to further assist your evaluation of qualifying expenses –
Question: “Does the requirement “Expenses incurred to improve infection control, including activities such as implementing infection control “mentorship” programs with subject matter experts or changes made to physical facilities” include wage expenses for maintenance employees that made physical facility changes?”
Follow-up: This has not been specifically addressed by HHS, however per discussion with LeadingAge National, one might conclude that if the work performed was covered by normal wages for these employees, HHS will likely consider those wages to be covered by reimbursements from another source (e.g. Medicaid, Medicare revenue, etc.); however, if overtime was necessary to make the physical facility changes, then one could infer this was a coronavirus expense related to physical facility changes required for infection control.
LeadingAge National provided this explanation as an example of how one might evaluate allowable expenses in the absence of explicit guidance. Our contact at LeadingAge National will try to solicit further clarification on this inquiry, as well as others, from HHS, and we will keep everyone updated if additional guidance is provided.
The FAQs issued by HHS on the topics discussed in this article can be found here –
