On April 19, 2020, Governor Lamont announced additional financial benefits to support nursing homes during the COVID-19 crisis.

Medicaid Payments Increase

Medicaid payments for non-COVID nursing home beds will be increased 10% retroactive to March 1. An additional 5% increase for non-COVID beds will be in effect from April 1 through June 30. The daily reimbursement rate for COVID-positive residents in non-COVID recovery facilities will be $400 per day up to a maximum of 30 days per bed. For those facilities being re-opened to serve residents with COVID-19, the State will assist with start-up costs and make payments of $600 per day.

These additional payments are to be applied as follows:

  1. Employee wages, including staff retention bonuses, overtime, and shift incentive;
  2. New costs related to screening of visitors, PPE, and cleaning and housekeeping supplies; and
  3. Other COVID-related costs.

Nursing homes are expected to track expenditures and enhanced income from all sources. The State will require an enhanced level of reporting to confirm COVID-related costs. The income tracking should include all sources of revenue, including direct federal stimulus, state funding, and additional Medicare reimbursements available.

State Provider Tax

At this time, the State has elected not to delay or forbear the provider tax to nursing homes across the board. However, individual facilities can receive an extension if they can prove financial hardship as evaluated by the Department of Revenue Services. Requests will also be reviewed by the Office of Policy and Management and the Department of Social Services to determine the fiscal impact to the state and the level of financial hardship documented in the request.

In the next 7-10 days you should also expect an in-person visit from the Department of Public Health to conduct infection control surveys. The DPH representatives have all been fit-tested for N95 respirators.

Federal Waivers from CMS

CMS has waived the requirement for a 3-day prior hospitalization for Medicare coverage of a skilled nursing facility stay. This will allow dislocated residents and other people affected by COVID-19 to be admitted to SNFs without a qualifying hospital stay. Additionally, CMS has authorized renewed SNF coverage for residents who exhausted their SNF benefits without first having to start a new benefit period. As such, certain COVID-positive residents will now be able to obtain coverage at the Medicare per diem, which is higher than the Medicaid per diem.

Federal Provider Relief Payments

The CARES Act provides $100 billion in relief funds to hospitals and other healthcare providers on the front lines of the coronavirus response. Beginning April 10, 2020, $30 billion payments began arriving to eligible providers by direct deposit or check. These are payments, not loans, to healthcare providers, and will not need to be repaid if the terms and conditions are met.

Large Organizations will receive relief payments for each of their billing TINs that bill Medicare. Each organization should look to the part of their organization that bills Medicare to identify details on Medicare payments for 2019 or to identify the accounts where they should expect relief payments.

For more information on provider relief payments, please see our updates here and here.

Mariella LaRosa
(203) 575-2454; [email protected]

Leah M. Nollenberger
(203) 575-2685; [email protected]

Tamara M. Nyce
(203) 578-4275; [email protected]