Healthcare payment concept with stethoscope and big money US dollar.
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An announcement about the distribution of $413 million in Phase 4 Provider Relief Fund payments this week is welcome news, but it did little to quell the “extreme frustration” senior living providers are experiencing waiting for COVID-19 relief funds.

The Health Resources and Services Administration announced the fourth round of Phase 4 payments on Tuesday. Almost $12 billion in payments have gone out to more than 82,000 providers since November. An additional $7.5 billion in American Rescue Plan payments to more than 44,000 rural providers also has been distributed in the past four months.

The distribution does not provide the targeted funding sought by the senior living and care industry, however. A LeadingAge spokeswoman told McKnight’s Senior Living that the Phase 4 relief dollars only cover expenses incurred through the first quarter of 2021, well before the spring 2021 case surge from the delta and omicron variants.

“Many providers, including assisted living, have spent millions over the past 12 months to cover a multitude of pandemic-related costs, from skyrocketing fees for temporary staff to continued outlays for tests and personal protective equipment,” the spokeswoman said. “There is no plan for how providers get relief for coronavirus expenses and lost revenues incurred since April 1 of last year.”

Without additional support, providers are at risk of having to scale back services or close their doors, something LeadingAge called “a devastating blow” to older adults and their families.

In a letter to Senate and House leaders last week, LeadingAge President and CEO Katie Smith Sloan said that aging services providers need additional, targeted relief to get through the public health emergency. She also asked that Congress restore the $23 billion siphoned from the Provider Relief Fund for other coronavirus expenses that did not include provider relief. 

American Seniors Housing Association President and CEO David Schless said he expressed the organization’s “extreme frustration” that the industry is experiencing while waiting for Phase 4 Provider Relief Fund payments. With the $413 million distribution this week, he said, HRSA still has to act on approximately 11,000 applications.

“This process has taken far longer than it should to make these payments, especially given that these funds are for lost revenue and expenses from third quarter 2020 through fourth quarter 2021,” Schless said. “More than a year of uncompensated losses have not yet been addressed by Congress.”

Schless said that ASHA continues to advocate for additional COVID-19 relief on Capitol Hill, and he encouraged states to allocate some of their ARPA funds to assisted living.

Argentum President and CEO James Balda said HRSA announcements “are not offering relief to senior living.” Argentum estimates that assisted living and memory care communities were losing nearly $41 million per day over the course of the Provider Relief Fund Phases 2-4 — losses that continue to accumulate.

“Unfortunately, for most senior living caregivers, COVID relief remains AWOL as these providers continue to protect their residents from the pandemic, and in doing so accumulate enormous financial losses that have thus far been largely ignored by the administration,” Balda told McKnight’s Senior Living. “While the administration and Congress are trying to put the COVID nightmare to rest, caregivers in senior living communities across the country see no end in sight to the struggle in ensuring residents’ safety.”

Balda said the senior living industry needs real relief in the form of actual targeted monetary distributions, as well as a game plan for what will be an upcoming fourth round of vaccine clinics for residents.

The American Health Care Association / National Center for Assisted Living recently asked for an extension of the public health emergency, as well as prioritization of long-term care for access to COVID-19 testing and treatments. 

AHCA / NCAL, ASHA and LeadingAge joined Argentum, AMDA – The Society for Post-Acute and Long-Term Care Medicine and other organizations asking for the release of any remaining Provider Relief Funds to operators. They also relayed their support for the Provider Relief Fund Improvement Act, which would delay PRF reporting requirements until after the public health emergency is over and allow operators to use those dollars to enhance workplace safety.

The Department of Health and Human Services opened applications for $25.5 billion in Phase 4 COVID-19 provider relief funding in September 2021. Phase 4 payments are meant to reimburse smaller providers for a higher percentage of losses during the pandemic. It includes payments to providers who service Medicaid, Medicare and Children’s Health Insurance Program beneficiaries.

This week’s announcement comes after HHS in late February announced that it was distributing $560 million in PRF money to COVID-affected healthcare providers. With this week’s payments, approximately 89% of all Phase 4 applications have been processed. 

HRSA said it is working to review all remaining applications and anticipates another round of Phase 4 distributions to be released in late April or early May. PRF payments received in the first half of 2022 can be used until June 30, 2023.