​​COVID-19 and the recent explosion of the Delta variant continue to impact thousands of skilled nursing and assisted living facilities across the country, the American Health Care Association/National Center for Assisted Living told Department of Health and Human Services (HHS) Secretary Xavier Becerra in a letter this week. The association is requesting that remaining resources in the Provider Relief Fund (PRF) be released immediately to health care providers, including long term care facilities. 

In 2020, nursing homes received $13 billion of the $178 billion of the PRF, which for many providers made the difference between keeping their doors open or shutting them for good, AHCA/NCAL said. Currently, approximately $44 billion remains in the fund; however, nothing has been distributed in 2021. In the face of mounting new cases due to Delta, the association urged the administration to prioritize its residents and frontline health care workers before the situation gets worse. 

During the pandemic, nursing homes have faced increased expenses for personal protective equipment (PPE), testing, and additional staffing to ensure residents and caregivers remain protected from COVID-19. In 2020, providers spent $30 billion on PPE and staffing alone. But as the pandemic continues, these costs will remain constant, the association said. By the end of 2021, providers are projected to spend $60 billion on pandemic-related costs in the span of two years. 

These additional costs are causing a major strain on facilities that have long struggled to break even. Medicaid—the primary payer for nursing homes residents—has been historically underfunded. The amount that providers are reimbursed only covers between 70 and 80 percent of the total cost of care, AHCA/NCAL said. This chronic gap in funding has left many providers operating on shoestring budgets year after year. 

Providers across the country are seeking to hire more staff, but many lack the financial resources to offer competitive wages. In a recent AHCA/NCAL survey, 81 percent of nursing home providers and 75 percent of assisted living communities said higher Medicaid reimbursement to offer staff better pay and benefits would help improve their ability to recruit and retain staff members.

In addition to bolstering the long term care workforce, proper financial support will help prevent widespread closures. AHCA/NCAL estimates that nearly 2,000 nursing homes could permanently close their doors over a two-year period (2020-2021).

In the letter, AHCA/NCAL President and Chief Executive Officer Mark Parkinson said, “The staff and residents in skilled nursing facilities around the country desperately need ongoing support in facilities most affected by the virus. Ensuring that this funding is delivered to long term care providers immediately is critical to our primary role of caring for and protecting our nation's seniors and most vulnerable."