Additional Details on Nursing Home Incentive Payment Program Released

COVID-19; Research and Data

​​​​Today, HHS released additional information on how $2 billion in incentive payments will be distributed to nursing homes under the CARES Act. Here is a summary of those details. 


Two Gateway Criteria for Incentive Payments 

For a facility to be eligible for an incentive payment, they must pass both criteria:  

  • Facility COVID infection rate below the rate in the county they are located in. 
  • Facility COVID death rate below a nationally establish performance threshold. 


Incentive Payment Schedule and Performance Period 

The $2 billion in incentive payments will be split into five distributions of up to $400 million. Four of the distribution will be based on month long performance periods from September 2020 through December 2020. The fifth distribution will be an aggregated four-month performance period of September 2020 through December 2020. 


Performance Period 

Tentative Payment Date 

Tentative Audit Date 

Incentive Pool 

September 2020 

October 2020 

November 2020 

$400 million 

October 2020 

November 2020 

December 2020 

$400 million 

November 2020 

December 2020 

January 2021 

$400 million 

December 2020 

January 2021 

February 2021 

$400 million 

Aggregate  
(Sep – Dec 2020) 

February 2021 

March 2021 

$400 million 

 

Incentive Payment Calculation 

For each performance period and incentive distribution, the first 80% of the pool ($320 million) will be based on rate of infection. The other 20% of the pool ($80 million) will be based on mortality. 


Infection Measure Calculation  

A facility’s COVID infection performance will be measured on two factors. The first is the amount by which their rate is lower than their county’s. The second is their total patient volume. Patients admitted to the facility with COVID will not be counted against the facility.  


Mortality Measure Calculation 

A facility’s mortality measure will be adjusted to account for facility-level characteristics and resident-level health and demographic characteristics.  

Additionally, direct outreach will be made to facilities with at least one death in the performance period and a mixture of COVID admissions and in-facility infections. This outreach will be used to determine how many of their reported COVID deaths were due to in-facility infections versus COVID admissions. 

NHSN data will be used as the primary source of identifying COVID deaths. 


More Details to Come 

AHCA is inquiring for more details about the performance measure calculations and thresholds. We will share additional information as it becomes available. In the meantime, maintaining efforts to prevent COVID from entering a building and spreading among residents remains to be the most effective means for success under this incentive program.