Covid relief file folder
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Although the COVID-19 pandemic led to increased costs, decreased revenue and exacerbated staffing shortages across the healthcare continuum, assisted living providers weathered those challenges with fewer resources than their counterparts, provider groups told members of the House of Representatives on Wednesday.

The Provider Relief Fund offered a “lifeline” to healthcare providers that experienced financial losses created by the pandemic, Carole Johnson, administrator of the US Department of Health and Human Services’ Health Resources and Services Administration, testified Wednesday during a House subcommittee hearing on the Provider Relief Fund and healthcare workforce shortages.

Johnson told members of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies that the PRF has made more than 800,000 payments to more than 440,000 providers across the country. But she also acknowledged that 2,000 Phase 4 PRF reconsideration requests remain under review.

Those reconsiderations could be in jeopardy, given calls for repealing unused PRF funds, the American Seniors Housing Association told McKnight’s Senior Living . The association is seeking assurances that all outstanding payments to senior living providers are made before PRF funds are reprogrammed or repealed.

“While ASHA has been incredibly grateful to gain access to the PRF to help with the significant costs and revenue loss associated with the pandemic, we have been disappointed with the pace at which some providers were allocated payment,” ASHA Vice President of Government Affairs Jeanne McGlynn Delgado said. 

In comments submitted to the House subcommittee, Argentum argued that providers of senior living — independent living, assisted living and memory care — did not receive nearly the same level of financial relief as other healthcare providers through the PRF.

“Senior living providers, collectively, have incurred more than $30 billion in COVID-related loss to protect the most vulnerable populations to COVID, yet received extraordinarily little federal relief,” Argentum Senior Vice President of Public Affairs Maggie Elehwany said. “In fact, despite caring for roughly the same number of seniors as nursing homes, assisted living caregivers received only one-twelfth of the federal relief.”

Policymakers, Elehwany said, largely either forgot senior living caregivers or confused them with nursing home workers. Assisted living first was recognized during Phase 2 PRF distributions.

“The sustained losses, coupled with increasing strain on the workforce, has left the majority of senior living providers operating at a financial loss, reducing new admissions and relying on overtime shifts and pricey agency hires to maintain operations,” she said.

Workforce challenges linger

Argentum also called on the federal government to address the lingering workforce challenges facing the healthcare sector, and particularly senior living, which lost almost 110,000 positions between February 2020 and November 2021.

Elehwany cited a 2022 study by the National Center for Assisted Living that found that 48% of assisted living communities were concerned that they may have to close if workforce challenges persist. In addition, 37% of assisted living providers reported that they could sustain the current operating pace for more than a year, and 24% said they were reducing new admissions due to workforce shortages.

“As the need for senior care broadly — and assisted living, specifically — continues its dramatic growth, the current and future workforce is simply not keeping pace,” Elehwany said.

In a previously released workforce report, Argentum reported that total employment in the long-term care industry is projected to reach 8.3 million by 2040 — a 42.1% increase from 2021 employment levels. In addition to new jobs that will be created, there will be an additional 18 million job openings that result from employees either exiting the labor force or transferring to different occupations.

“Given the scope of the workforce shortage in every segment of our healthcare system, it is my hope that the committee will continue to explore this issue and pursue policies to expand and retain the caregiving workforce so that all Ameicans can continue to access this critical care,” Elehwany said.

Johnson told the House subcommittee that HRSA administers more than 50 programs aimed at strengthening the healthcare workforce and has made expanding that workforce a priority.

“We recognize that there are many challenges facing the healthcare workforce, which is why our budget prioritizes training more medical residents, alleviating bottlenecks in the nurse training pipeline, investing in growing the behavioral health workforce, prioritizing the health and well-being of the current workforce, and spurring innovation in health workforce training,” Johnson said.

ASHA asked HRSA to identify workforce training programs that can be expanded to allow access to all in-demand, frontline positions in short supply in senior living communities.

“We need an all-of-the-above approach when making policies to address the workforce shortage,” Delgado said. “And so, it is important that any programs administered by the government to assist with training and development should be accessible to the broader healthcare community — including senior living.”