revenue cycles

Nursing Homes Pivot to Meet New PRF Requirements

As coronavirus descended upon the healthcare industry in the early part of 2020, long-term care facilities like nursing homes and skilled nursing centers bore the brunt of the pandemic. Caregivers and residents were at higher risk of infection, resulting in severe economic challenges. As the pandemic continues to affect nursing home operations, risk management tools like nursing home insurance remain at the forefront of importance. Now, funding to provide economic relief has become available for senior centers. In this guide, we will explore the details your clients need to know in order to claim Provider Relief Funds (PRF).

The CARES Act Provider Relief Fund

Signed into law in March 2020, the Coronavirus Aid, Relief, and Economic Security (CARES) Act contained a $178 billion provision administered by the U.S. Department of Health and Human Services known as the Provider Relief Fund (PRF). The money is designed to support healthcare providers on the front lines of the coronavirus pandemic and their families. Qualified healthcare providers may receive payments from the PRF for healthcare-related expenses or lost revenue due to COVID-19. As with any federal program, there are certain terms and conditions providers must abide by to receive distributions.

Changes in Reporting to the PRF

The Health Resources and Services Administration (HRSA) launched a PRF portal in 2021 to facilitate reporting by healthcare providers. Since the CARES Act was first passed, reporting requirements have evolved. Now, nursing advocacy groups and care industry consultants are scrambling to help providers navigate the complex reporting process. This complexity is especially true of healthcare operations that experienced changes in ownership during the covered period. Healthcare organizations have advocated on behalf of providers, spurring the HRSA to issue rule clarifications periodically throughout 2021.

One of the most crucial changes to PRF reporting is related to the timeline of funds usage. Before the HRSA made changes, PRF payments at or exceeding $10,000 needed to be used by June 30 or returned to HHS no matter when the payments were disbursed. Under the rule change, the timeline is tied to when payments were received by the provider filing the report and only for payments of $10,000 or more in aggregate.

Failure to complete reports accurately or outside required timelines may result in administrative delays, audits, or rejection of reimbursement claims. For nursing homes operating on thin margins, these delays can be costly, potentially resulting in higher-than-expected claims against nursing home insurance policies.

Tips for Nursing Home Owners

National long-term care industry advocacy organizations know that reporting requirements under PRF are complex, resulting in confusion, processing delays, or rejection of claims. To facilitate accurate reporting, these organizations are encouraging nursing home operators to become familiar with the PRF portal and its reporting deadlines. They also stress to nursing home owners to maintain accurate documents for a three-year period to meet documentation requirements for federal grant funds. Some nursing homes have moved to a quarterly reporting period for lost revenue due to COVID-19; industry analysts suggest that these more frequent periods are easier to justify than longer timeframes.

For now, nursing home owners and managers must stay abreast of PRF reporting requirements in order to receive reimbursements in a timely manner. Reviewing and updating nursing home insurance policies is also a smart risk management step to ensure these policies reflect the changing risk landscape faced by long-term healthcare facilities. With these tools, nursing homes can continue to deliver quality care to America’s seniors without the financial hardships brought on by the coronavirus pandemic.

About Caitlin Morgan

Caitlin Morgan specializes in insuring assisted living facilities and nursing homes and can assist you in providing insurance and risk management services for this niche market. Give us a call to learn more about our programs at (877) 226-1027.