Congress has appropriated $2.6 trillion in CARES Act Provider Relief Funds to help the country deal with COVID-19 hardships. Almost half, $1.2 trillion, has gone to individuals, businesses, health care providers and state and local governments, according to an analysis by the Government Accountability Office ending May 31, 2020.
The data indicate that nursing homes have received about one-third of 1% of that funding. Assisted-living facilities — nothing.
Yet Ohio Department of Health figures show long-term care facilities, which include assisted-living, have suffered more than two-thirds of the state's COVID-19 deaths.
Ohio's 950 nursing homes are most vulnerable to outbreaks, with critical care and elderly patients, close-quarter staffing and frequent visits from specialists treating patients and potentially spreading virus.
Nursing homes in Ohio have each received $50,000 in CARES Act funds plus $2,500 per licensed bed. An additional fund of $25 million will be distributed based on results of infection control surveys.
By contrast, the 765 licensed assisted-living facilities in Ohio, from which about 5-10% of the state's COVID-19 cases have originated, have gotten nothing, said Jean Thompson, executive director of the Ohio Assisted Living Association.
"Even if you don't have any active cases in your building, you have to purchase personal protection equipment (PPE) ... because you want it to stay that way," said Thompson.
Costs to prevent and contain spread have been a financial burden and may jeopardize a facility's survival, she said. The vast majority of residents are "private pay," meanng that they're not using Medicare and Medicaid assistance, for which much of the assistance is directed.
"It's impossible to just pass on these costs to our residents. There would be substantial hikes the providers can't afford to absorb."
Thompson said cost hikes would force staffing layoffs and other cuts to service. "People weren't dying to work in long-term care before this happened," she added.
Profit margins are slim at Wallick Communities' seven properties, including two memory-care centers in Ohio, said Stephanie Hess, vice president of operations.
"We're asked to do a lot with very little," said Hess. "We're (long-term care) the most vulnerable population. But when it comes to getting PPE, it feels like we're the last on the list."
Without federal stockpile aid, her staff has been forced to buy supplies online, often at high prices and dubious quality.
A large shipment of hand sanitizer arrived but had a strong bleach smell.
"We didn't know what it was. We threw it out," Hess said. "You're desperate and you keep your fingers crossed."
With rising infection rates, some worry that funding shortages will force facilities to close, said Peter Van Runkle, executive director of the Ohio Health Care Association.
"We just don't see the end of it," said Van Runkle. "Is there going to be continued and sustained relief?"
A representative for U.S. Sen. Rob Portman's office said, "We don't know why the money hasn't been doled out." Questions were referred to the U.S. Department of Health and Human Services.
A spokesman for HHS disputed the GAO data and said that additional distributions are planned.
Mark Parkinson, president and CEO of the American Health Care Association and the National Center for Assisted Living, called COVID-19 "the perfect killing machine."
Testing remains one of the biggest challenges, as many are unable to conduct widespread, ongoing testing or to get results quickly — a key to preventing spread.
A national survey of 375 assisted-living communities showed that more than half have less than a two-week supply of PPE. Seven of 10 facilities reported they had sought aid from their state and local health departments and nearly half had been forced to seek donations from the public.
On Tuesday, the long-term care associations sent the National Governors Association a request for faster testing, more PPE and better coordinaton when re-opening facilities. Late Tuesday, the Ohio Controlling Board approved an additional $91 mllion for skilled nursing, but not assisted living, facilities, say Sen. Jay Hottinger, who said lawmakers must use the federal money in specific areas.
Last month, the national associations sent a letter to Health and Human Services and the Federal Emergency Management Agency seeking $5 billion in funding on behalf of assisted living communities to help with testing, PPE and staffing. And this week the association sent governors
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