‘The Tide Has Shifted Significantly’ for Nursing Home Financial Support

While nursing home operators have largely relied on help from the federal government by way of the Provider Relief Fund (PRF) and other mechanisms to get through the COVID-19 pandemic, some leaders have found more success refocusing advocacy efforts to state legislatures for future funding.

“When the stimulus bill came out and passed with trillions of dollars, there was basically nothing for providers. When the first infrastructure bill was introduced, trillions of dollars nothing for providers. And so that’s when I went to our board and I said, ‘we’ve got to change our playbook,’” American Health Care Association (AHCA) President and CEO Mark Parkinson said.

Parkinson was one of three industry leaders who appeared on a panel Tuesday at the National Investment Center for Seniors Housing & Care (NIC) conference in Houston to discuss funding and policy proposals. Joining him on stage were Argentum President and CEO James Balda and David Schless, president of the American Seniors Housing Association (ASHA). Brian Jurutka, president and CEO of NIC, moderated the panel.

Parkinson said that while federal funding has and continues to remain an avenue for nursing homes, he recognizes the sheer availability of those funds is few and far between.

“We’re going to continue to get what we can at the federal level but we’re going to be scratching and clawing for a diminishing amount of money and there’s not much there,” he said.

Late last month the U.S. House of Representatives revealed a significantly trimmed down version of President Joe Biden’s Build Back Better plan, a massive economic proposal that seeks to expand the country’s social safety net. The bill lumped in some of the proposals in the Nursing Home Improvement and Accountability Act of 2021, including funding to improve nursing home surveys and ensuring staffing ratios are being monitored and adjusted accordingly.

The plan also allocated $150 billion for in-home care, specifically funding to help reduce waiting lists for in-home care services and improve low wages for workers.

The Biden administration also announced in September that $25.5 billion will be made available for health care providers, including $17 billion from phase four of the Provider Relief Fund and an additional $8.5 billion from the American Rescue Plan to assist providers who serve rural Medicaid, Children’s Health Insurance Program and Medicare.

At the state level, the Texas Health Care Association earlier this year requested $400 million to help providers staff buildings amid the skilled nursing workforce shortage. Texas lawmakers last month passed Senate Bill 8, also known as the American Rescue Plan Act (ARPA) Funds bill, which includes financial support for long-term care in the state.

The bill proposed $200 million as grants for nursing homes and $178.3 million in grants for assisted living facilities, home health agencies, community attendants and facilities that serve individuals with intellectual or developmental disabilities in an intermediate care facility. It authorizes the use of ARPA funds as a way to help these facilities recruit and retain staff.

Parkinson said AHCA and its state affiliates plan to “double down” on the state funding strategy for the remainder of this year and into 2022.

“I am optimistic that we will get significant additional money; I think it will primarily come from the states,” he said.

Parkinson touched on other ways AHCA can help advocate for nursing homes, including the need to make initiatives like the temporary nurse aide (TNA) program permanent to help facilities weather the staff shortage storm.

The program is tied to the ongoing COVID-19 public health emergency (PHE) which was extended on Oct. 15 by U.S. Department of Health and Human Services Secretary Xavier Becerra for an additional 90 days.

He also discussed the need to hold staffing agencies accountable for their pricing and speeding up the worker visa application process.

“Unfortunately there is no single silver bullet type solution. I think it’s going to be a number of things we’re going to have to fuse together,” Parkinson said.