Clif Porter II, AHCA’s senior vice president of government relations

Nursing home operators and the rest of the country may soon know the key components in a fourth, and likely final, coronavirus relief package from the federal government.

Some observers think Senate Majority Leader Mitch McConnell (R-KY) might have a proposal ready to unveil by the time his chamber returns from recess in 11 days. This week, he predicted that lawsuit protections and further stimulus checks for lesser wage earners could be in the offing, which would please long-term care operators and frontline workers, respectively.

“McConnell is taking the position that he wants to focus on the ‘big rocks,’ and we agree that immunity is an incredibly important component in this next package,” Clif Porter, senior president of governmental affairs for the American Health Care Association, told McKnight’s Long-Term Care News on Wednesday. “Immunity is potentially the sort of brick that will destroy everything if the trial lawyers have their way and get open access to sue over every COVID case in America. That’s a gigantic ‘rock’ for us.”

Porter said long-term care providers and others also will be lobbying for delayed paybacks for a Medicare advance payment program. “I think the assumptions were a little more rosey when they first came out … we have to get some terms extended to help cash flow,” Porter said. “We feel good about our chances there.”

Due to uncertainties looming in the fall and extending into the flu season and first quarter of next year, providers also will be pushing for increased funding in any further relief packages, Porter said. He expects Democrats to quickly pan any proposal brought by the Republican-controlled Senate and that negotiations would start in earnest around the end of the month, when the big “inflection” points will be known.

Lawmakers will have just a few weeks before another recess kicks in and attention shifts to the fall elections. So there won’t be much time to waste, he and others pointed out.

“I think they’ll get a deal done, but it’s not 100% probably. It could fall apart. That’s a real possibility,” Porter said. “I’m cautiously optimistic we’ll get a deal. The real question is whether it’s big, small or in the middle.”

Cynthia Morton
Cynthia Morton

Any liability protection that can be put into a fourth stimulus package would be “very helpful for providers,” agreed Cynthia Morton, the executive vice president of National Association for the Support of Long-Term Care. The most interesting part will be what the Democrats want in return at the bargaining table, she added. That and whether long-term care stakeholders get any more aid, particularly ancillary services providers who are looking for their first round of extra coronavirus funding.

“Whether it’s rehab or X-rays or labs, we have the same [personal protective equipment] costs, and in some cases, those companies are burning through PPE a little faster,” Morton told McKnight’s. “The second area we’d want is would there be anything in this package for help with testing. Testing for residents has been paid for by CMS, which has done a pretty nice job, but testing for staff is murkier. CMS stopped short of requiring it, so when they don’t require it, they don’t fund it.”

Money is at the root of all concerns, she concedes.

“Will there be dollars given to the whole sector? How about assisted living too? They have similar vulnerabilities. Congress has some funding fatigue, but I would argue that our parents and residents in the long-term care sector are just as vulnerable today as they were a couple of months ago,” she said.

LeadingAge Senior Vice President for Policy Ruth Katz said there will surely be concerns in the months ahead, too.

“I don’t think [a fourth virus relief package] can be the final deal,” Katz said. “This is going to go on for a while.”