Provider Relief Funding – $2 Billion Incentive Payment Distribution

As part of the additional $5 billion provider relief funding for nursing homes, the U.S. Department of Health and Human Services (HHS) announced its plans on how they will distribute the funding.

• Late August, HHS distributed $2.5 billion to nursing homes for support to increase testing, personal protective equipment (PPE), and staffing
• $2 billion will be distributed during a four month period based on measured performance to a facility’s respective location, as detailed below
• The allocation of the remaining $500 million is to be determined

Similar to the August distribution of the $2.5 billion, nursing homes do not need to apply to receive a share of the $2 billion distribution. Providers are qualified if they are Medicare certified and actively certified by the state they are located in. In addition, providers must report to one of the following data systems:

• Certification and Survey Provider Enhanced Reports (CASPER)
• Nursing Home Compare (NHC)
• Provider of Services (POS)

Providers will be removed if they are terminated, expired, or have revoked certifications in the Provider Enrollment, Chain and Ownership System (PECOS).

HHS is using the Community Profile Reports (CPRs) collected by the Centers for Disease Control and Prevention (CDC) to evaluate the baseline level of infection for each county. Nursing homes are measured against the baseline level of their respective location.

The two performance indicators measured are the following:

• Provider’s ability to keep new COVID infection rates low among residents
• Provider’s ability to keep COVID mortality low among residents

Data from the National Healthcare Safety Network (NHSN) LTCF COVID-19 module is used to measure the infection and mortality rates to evaluate performance and determine subsequent payment.

The remaining four months of the year are divided into performance periods starting from September through December. Each month (performance period) has $500 million available for distribution to nursing homes. A nursing home will receive its payment the following month after HHS assesses and audits the previous month’s data.

Marcum will continue to provide updates when more details are available for the provider relief funding plans. Please reach out to your Marcum Healthcare Advisor with any questions you may have.