COVID-19 Funding

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​The U.S. Department of Health and Human Services (HHS) has provided much-needed funding to many long term care facilities through the CARES Act Provider Relief Fund (PRF) and Quality Incentive Program (QIP). These funds support American families, workers, and the heroic health care providers in the battle against the COVID-19 outbreak.

AHCA/NCAL is helping our skilled nursing and assisted living​ member providers address PRF and QIP issues through work with Capitol Hill and the Administration. In partnership with our state affiliates, AHCA/NCAL is collecting outstanding funding concerns our members are facing. Contact COVID19@ahca.org with any questions.

UPDATE: HHS released​ updated reporting requirements for recipients of PRF payments. With this announcement, HHS expands the amount of time providers will have to report information, aims to reduce burdens on smaller providers, and extends key deadlines for expending PRF payments for recipients who received payments after June 30, 2020. Read More​​
 

 Provider Relief Fund
The Provider Relief Fund​ (PRF) supports health care providers in the battle against the COVID-19 pandemic. This funding is provided through the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act.​

 PRF Resources
​ Update: Provider Relief Fund FAQs
HHS recently updated the ​Provider Relief Fund (PRF) FAQs to clarify Ownership Structures and Financial Relationships between “parent” and “subsidiary” entities that received PRF funding (General and Targeted).

Provider Relief Fund Questions
There are several resources to assist with PRF questions. Contact the CARES Act Fund Hotline at (866) 569-3522 (for TTY dial 711). You can also review the HHS Frequently Asked Questions, which includes information about using the PRF for vaccine administration​.​

WebEx: Provider Relief Fund Reporting Requirements
This WebEx recording includes registration details, registration FAQs, recommended terms and conditions compliance controls, and a PRF reporting update overview.

U.S. Government Accountability Office (GAO) Report
The January 28th GAO report – Critical Vaccine Distribution, Supply Chain, Program Integrity, and Other Challenges Require Focused Federal Attention (GAO-21-265) – made several recommendations (focused around areas like COVID-19 testing, vaccines and therapeutics, and the medical supply chain) to federal agencies to improve the ongoing response and recovery efforts in the areas of public health and the economy. It is important to note that there is a summary of the PRF allocations and disbursements as of 12/31/20 on page 54.

​This document offers detail on u​se of funds for health care related expenses and transfer of funds to higher need buildings. 

 Quality Incentive Payments
AHCA/NCAL is advocating on behalf of our members to provide the necessary resources regarding the Quality Incentive Payments (QIP), as well as promoting a fairer incentive program. This step-by-step chart is available to help providers correct any previously made errors when filling out NHSN data. 

Entering this data is valuable in determining how cases are spreading throughout facilities.

With the distribution of December QIP payments on Friday, February 12, it appears that this will be the last payment that HHS will make for this program. Although HHS previously stated there would be an aggregate payment, the running total through December is $2 billion – which is the total allocated for the program.

The county population and county case rate are factored in the methodology, as well as the resident occupancy level and resident case rate. The vast majority of facilities with at least 1 infection will not receive payment. The number of facilities paid per month decreased from around 10,000 in September to 6,000 in December due to the increasing number of cases in the later months of the program. Additionally, since all of the factors varied in each month, the payment you may have received can also vary widely.

 

 

HRSA Offers New PRF Reporting Flexibilitieshttps://www.ahcancal.org/News-and-Communications/Blog/Pages/HRSA-Offers-New-PRF-Reporting-Flexibilities.aspxHRSA Offers New PRF Reporting Flexibilities4/8/2022 4:00:00 AM<p></p><div>HRSA has announced information on the opportunity to request the submission of a late Provider Relief Fund report based on extenuating circumstances for payments received between April 10 to June 30, 2020. Below is detailed information that is also located on the <a href="https://www.hrsa.gov/provider-relief/reporting-auditing/late-reporting-requests." data-feathr-click-track="true" target="_blank">HRSA PRF website</a>. </div><div> </div><div><strong>If a provider who missed Reporting Period 1 has not previously registered for the PRF Reporting Portal, the provider should proceed with registering now by visiting </strong><a href="https://prfreporting.hrsa.gov/s/" data-feathr-click-track="true" target="_blank"><strong>https://prfreporting.hrsa.gov</strong></a><strong> and click on “Register” located below “First Time User? Click on “Register” to create an account” on the left side of the page.</strong> They may call the Provider Support Line at 866-569-3522 for help with registering.</div><div><br></div><div>Starting April 11, 2022, providers that missed Reporting Period 1 due to extenuating circumstances will be able to submit their request for a late report through April 22, 2022. Then, the opportunity to complete the report will approximately start on May 9. The providers approved for late reporting will receive notification of the limited timeframe to complete the report at the email shared when they submitted their request for a late report. <strong>It will be a two-week opportunity to complete and submit the report, and there will be no option for extension to the communicated deadline.</strong> </div><div><br></div><div>Providers should not return the PRF funds per the March 2022 letter from HRSA. HRSA will contact providers in the future on the return of funds if they do not submit a request for a late report or complete the required report. Until the required report is submitted, the provider remains out of compliance with the reporting requirement for Reporting Period 1, which will impact the provider's eligibility to receive additional PRF payments.<br></div>HRSA announced the opportunity to request the submission of a late PRF report based on extenuating circumstances for payments received between April 10 to June 30, 2020.
Provider Relief Fund Updates: Phase 4 Awards Continue and Reporting Period 1 Challengeshttps://www.ahcancal.org/News-and-Communications/Blog/Pages/Provider-Relief-Fund-Updates-Phase-4-Awards-Continue-and-Reporting-Period-1-Challenges.aspxProvider Relief Fund Updates: Phase 4 Awards Continue and Reporting Period 1 Challenges3/23/2022 4:00:00 AM<div><span style="font-size:14.6667px;">​The Health Resources and Services Administration (HRSA) announced it is making more than $413 million in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 3,600 providers across the country this week. Providers would have received an email notification on March 21 if their application was among those processed in this latest batch. HRSA is working to review all remaining applications as quickly as possible and anticipates another round of Phase 4 to be released in late April or early May. </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">For more information: </span></div><div><ul><li>​The U.S. Department of Health and Human Services (HHS) updated the <a href="https://www.hrsa.gov/provider-relief/data/general-distribution/phase-4-general-distribution-payments" data-feathr-click-track="true" target="_blank">state-by-state table</a> detailing all Phase 4 payments made to date.  </li><li>As individual providers agree to the terms and conditions of Phase 4 payments, it will be reflected on the <a href="https://data.cdc.gov/Administrative/HHS-Provider-Relief-Fund/kh8y-3es6" data-feathr-click-track="true" target="_blank">public dataset</a>.  <br></li></ul></div><div><span style="font-size:11pt;">If you have neither received your Phase 4 award nor a No Pay Letter, your Phase 4 payment likely is still in manual review. </span><br></div><div><span style="font-size:14.6667px;"><br></span></div><div style="text-align:center;"><span style="font-size:14.6667px;"><strong>Reporting Period 1 Challenges</strong> </span></div><div><br></div><div>Providers began receiving failure to report notifications beginning March 14. AHCA/NCAL identified three reasons for receiving such a notification: <br> </div><div><ol><li><span style="font-size:11pt;">​SNF Targeted Allocation Filed at Parent Level: All Targeted Allocations must be reported on at the subsidiary level, not parent. </span></li><li>Omitted sections </li><li>Data entry errors </li></ol></div><div>The transmittals providers are now receiving are simply notifications that HRSA believes it has found a problem with Reporting Period 1 (RP1) submissions. The 30-day repayment notification language in these transmittals is confusing. No funds should be returned to HRSA unless a provider receives a Demand Letter. Before Demand Letters, providers will be offered the opportunity to correct reporting errors or for HRSA to determine whether the notification was sent in error. Below is a summary of points verbally shared by HRSA and suggested member action steps. <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong>What is considered non-compliance?  </strong></span></div><div>Non-compliance is defined as a failure to report funds in any reporting period. Reporting errors are not considered non-compliance. Providers who feel they received the “Failure to Report” email in error (i.e., they did complete their RP1 report), should call the Provider Support for assistance. <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><em>*ACTION ITEM</em>: Provider should check their submitted RP1 reports to ensure they included all General and Targeted Distributions received from April 10, 2020, through June 30, 2020. Stated differently, the provider should self-identify. Keep on file a copy of the submitted letter/report that shows they have completed RP1 by TIN and Funds (General and Targeted). If providers have the needed documentation, they should pursue error correction and only use the documentation if a Demand Letter is sent later. </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong>What happens if the letter was driven by data entry errors</strong><strong>?</strong> </span></div><div>If a provider believes they had typos in their report, call the Provider Support to alert them of a necessary edit. There is significant flexibility to edit. <strong>Use the term “EDIT” - not “MISSED DEADLINE” for RP1 to get in the correct response queue.</strong> If the ‘unused funds’ listed on the report is related to an error in completing the report, there may be the opportunity to revise the report.   <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong>What if I reported all awards, including SNF Targeted and Infection Control at the parent level?</strong>  </span></div><div>The parent organization may not report on a targeted distribution received by a subsidiary. HRSA has received inquiries related to a Failure to Report from entities that did not report on a Targeted distribution, which is required to be reported by the entity that received it. HRSA’s Customer Service team is finding examples of subsidiaries who failed to report on the Targeted money, though the Parent did report on their general dollars. When contacting the Support Line, providers also should ask about making these reporting corrections. <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong>What does it mean to be non-compliant?</strong>  </span></div><div>If the provider did not submit their RP1 report, they are required to return the funds received from April 10, 2020, through June 30, 2020. <strong>Only the funds not in the PR1 must be returned</strong><strong>.</strong> Payments for future distributions will not be awarded until non-compliance for RP1 is corrected. Providers who have not reported will receive a Demand Letter at a future stage with specific action steps if the federal government plans to take recovery steps or other actions outlined in the Terms and Conditions Reporting requirements.   <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><em>*ACTION ITEM</em>: Providers who received RP1 failure to report letters to determine whether the HRSA notice was generated due to an error or whether funds were not reported upon. If funds were not reported, providers should review the Terms and Conditions reporting section to assess steps and proactively monitor for HRSA Demand Letters which will contain repayment instructions. ​</span></div>HRSA announced it is making more than $413 million in PRF Phase 4 General Distribution payments to more than 3,600 providers across the country this week.
Start Now: Provider Relief Fund Reporting Period 2 Deadline March 31https://www.ahcancal.org/News-and-Communications/Blog/Pages/Start-Now-Provider-Relief-Fund-Reporting-Period-2-Deadline-March-31.aspxStart Now: Provider Relief Fund Reporting Period 2 Deadline March 313/17/2022 4:00:00 AM<p><br></p><div><span style="font-size:14.6667px;">The Health Resources and Services Administration’s (HRSA) Provider Relief Fund (PRF) <a href="https://prfreporting.hrsa.gov/s/" data-feathr-click-track="true" target="_blank">Reporting Portal</a> is open for providers who need to report the use of PRF funds in Reporting Period 2 (RP2).  </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong style="text-decoration:underline;">The deadline for RP2 is March 31, 2022.</strong> AHCA/NCAL urges members to finish RP2s before the quickly approaching deadline. The HRSA reporting website experienced technical difficulties at the end of Reporting Period 1 and shut down.  </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">Providers who fail to submit a completed report by the deadline will be subject to further enforcement actions, such as repayment or exclusion from receiving and/or retaining future PRF payments. For more details, review the <a href="https://www.hrsa.gov/sites/default/files/hrsa/provider-relief/reporting-non-compliance-fact-sheet.pdf" data-feathr-click-track="true" target="_blank">Reporting Non-Compliance Fact Sheet</a>. </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong style="text-decoration:underline;">IMPORTANT NOTE</strong>: <em>Grace periods or extensions will not be granted in RP2. HRSA encourages providers to complete their RP2 early as not to miss the deadline. </em>Should you need to make modifications to the RP2 after submitting the file, please contact HRSA’s Provider Support Line for assistance.  </span></div><div><span style="font-size:14.6667px;"><br></span></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:14.6667px;"><em>Provider Support Line</em>: (866) 569-3522, for TTY dial 711 </span></div></blockquote><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px;"><div><span style="font-size:14.6667px;"><em>Hours of operation</em>: 8 AM - 10 PM CT, Monday through Friday</span></div></blockquote></blockquote><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong>Who needs to file in Reporting Period 2?</strong> </span></div><div>Providers who received PRF payments exceeding $10,000 in the aggregate between July 1, 2020 and December 31, 2020 are required to report in RP2 and must submit a report on use of funds by March 31, 2022 at 11:59 PM ET or they will be required to return all funds to be compliant with RP2.  <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong>Next Steps</strong>  </span></div><div><ol><li>Providers should register on the <a href="https://prfreporting.hrsa.gov/s/" data-feathr-click-track="true" target="_blank">PRF Reporting Portal</a>. Providers who registered during Reporting Period 1 do not need to register again and may log into the portal with their username, TIN, and password.  </li><li>Complete all required fields in the Portal and submit a report on use of funds by the March 31, 2022 deadline.   </li></ol></div><div>After submitting a report, providers must return any unused funds within 30 days after the end of RP2. For more information on returning all or a portion of payments via ACH or check, visit the <a href="https://prfreporting.hrsa.gov/s/" data-feathr-click-track="true" target="_blank">PRF Reporting Portal</a> or refer to the <a href="https://www.hrsa.gov/sites/default/files/hrsa/provider-relief/returning-funds-fact-sheet.pdf" data-feathr-click-track="true" target="_blank">Returning Funds Fact Sheet</a> for more details and instructions on returning funds to HRSA.   <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">Please also review the <a href="https://www.hrsa.gov/provider-relief/reporting-auditing/stakeholder-toolkit/top-5-faqs" data-feathr-click-track="true" target="_blank">Frequently Asked Questions</a> page.   </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">Reporting Webinars </span></div><div><ul><li>​Nursing Home Infection Control Reporting Webinar (February 17, 2022) | <a href="https://webex.webcasts.com/starthere.jsp?ei=1529271&tp_key=32b18c2773" data-feathr-click-track="true" target="_blank">Replay the Webinar</a> | <a href="https://www.hrsa.gov/sites/default/files/hrsa/provider-relief/nursing-home-infection-control-reporting-slides.pdf" data-feathr-click-track="true" target="_blank">Download the slides</a><br></li><li>Reporting Introduction: New Reporting Entities (January 12, 2022) | <a href="https://webex.webcasts.com/starthere.jsp?ei=1519558&tp_key=8ec86d4a36" data-feathr-click-track="true" target="_blank">New Reporters</a> | <a href="https://www.hrsa.gov/sites/default/files/hrsa/provider-relief/new-reporting-entities-rp2-portal-training.pdf" data-feathr-click-track="true" target="_blank">Download the slides</a><br></li><li>Reporting Period 2 Introduction: Returning Reporters (January 13, 2022) | <a href="https://webex.webcasts.com/starthere.jsp?ei=1519562&tp_key=1c0aa8e66a" data-feathr-click-track="true" target="_blank">Returning Reporters</a> | <a href="https://www.hrsa.gov/sites/default/files/hrsa/provider-relief/returning-reporters-rp2-portal-training.pdf" data-feathr-click-track="true" target="_blank">Download the slides</a><br></li></ul></div><div>For questions on reporting or how to return unused funds, providers may call the Provider Support Line at (866) 569-3522, for TTY dial 711. Hours of operation are 8 a.m. to 10 p.m. CT, Monday through Friday.<span style="font-size:11pt;">​</span></div>The deadline for RP2 is March 31, 2022.
AHCA/NCAL-Led Workforce Coalition Endorses Provider Relief Fund Improvement Acthttps://www.ahcancal.org/News-and-Communications/Blog/Pages/AHCANCAL-Led-Workforce-Coalition-Endorses-Provider-Relief-Fund-Improvement-Act.aspxAHCA/NCAL-Led Workforce Coalition Endorses Provider Relief Fund Improvement Act3/2/2022 5:00:00 AM<p>An AHCA/NCAL-led workforce-related coalition that represents thousands of health and long term care services and supports providers and stakeholders that care for those most in need across the country recently sent letters to the members of Congress in the <a href="/Reimbursement/Documents/PRF/2.28.2022%20Coalition%20Letter%20for%20S.%203611.pdf" data-feathr-click-track="true" target="_blank">Senate</a> and <a href="/Reimbursement/Documents/PRF/2.28.2022%20Coalition%20Letter%20for%20H.R.%205963.pdf" data-feathr-click-track="true" target="_blank">House of Representatives</a> that introduced the Provider Relief Fund (PRF) Improvement Act (<a href="https://www.congress.gov/bill/117th-congress/senate-bill/3611?" data-feathr-click-track="true" target="_blank">S. 3611</a>/<a href="https://www.congress.gov/bill/117th-congress/house-bill/5963" data-feathr-click-track="true" target="_blank">H.R. 5963</a>). This legislation, among other things, extends current reporting and use-of-funds deadlines to the end of the pandemic. The coalition endorses this legislation and noted that, in addition to pushing out any remaining dollars in the PRF to providers, also urged support for a replenishment of the PRF as this pandemic and the impact of it is not over.​​</p>An AHCA/NCAL-led workforce-related coalition sent letters to the members of Congress in the Senate and House of Representatives that introduced the PRF Improvement Act.

 Questions?
Please contact us with any questions you have regarding PRF or QIP.

 Additional Resources