HRSA sends more PRF money, still reviewing Phase 4 applications

The Health Resources and Services Administration disbursed $60 million in Phase 4 PRF funds to 293 providers, leaving approximately $1.6 billion still to be given out.

There are still 1% of Phase 4 applicants to be reviewed, the agency noted.

HRSA, a part of the Department of Health and Human Services, added a fifth reporting period for some beneficiaries of the Provider Relief Fund to detail how they used the money. The fourth reporting period opens Jan. 1, 2023, while the fifth opens on July 1, 2023. The Sept. 9 distribution is the 10th set of funds the federal government has sent out since the program began in 2020.

It’s significant that HRSA is still reviewing applications after nearly one year, meaning HRSA wanted to take a closer look at the details, Nicole Fallon, vice president of health policy & integrated services for LeadingAge, told McKnight’s Long-Term Care News in an email.

“One of our members who just received their Phase 4 payment in July or August had a fire in their nursing home right in the middle of the pandemic,” she said, citing an example of difficult cases that take HRSA longer to review. “The good news is no one was harmed and everyone was evacuated quickly. However, because of the unusual circumstances for demonstrating losses and expenses, it took longer for HRSA to process their application.”

Fallon said a number of the other outstanding applications are from larger or multi-site organizations so their requests for funds are likely to be significantly larger in scope. She said tracking data on the number of SNFs that applied for these funds is difficult because applicants must select the care setting and provider type that represents the greatest proportion of their revenue.

“So sometimes that might be assisted living or independent living versus an 80-bed SNF,” Fallon explained. “If I had to guess, I would say most nursing homes applied for Phase 4 if they still had ongoing losses and/or coronavirus expenses. We have heard from very few that received enough PRF, plus other COVID-19 funding, to cover all their coronavirus losses and expenses. PRF rarely fills the entire financial hole created by the pandemic.”

Many SNFs would not have survived the huge burden of pandemic-related increased expenses without such help, Fallon said. Extra costs include personal protective equipment, COVID testing, retaining and hiring staff, and vaccinations. There also may have been needs like upgrading HVAC systems or setting up isolation units during outbreaks. 

Fallon added that reduced occupancy substantially cut revenues, and while nursing homes did receive targeted PRF distributions and targeted Nursing Home Infection Control funds, some of the financial support had strict requirements.

“The NHIC funds, for instance, could only be used to pay for infection control expenses, which included things like PPE, testing, staffing, technology to enable connection with families and other infection control expenses,” she noted.