Governor Ned Lamont today announced that he is committing an additional $31.2 million, as well as continued support for COVID-19 recovery and alternate COVID recovery facilities, to support Connecticut’s nursing homes in their ongoing response to combat the COVID-19 pandemic. Today’s announcement comes in addition to more than $150 million the state previously spent on nursing homes for COVID response. The additional aid is being delivered through increased payments that are retroactive to November and prospective through February.
“As we are dealing with a resurgence of the coronavirus statewide, we have taken action to mitigate a repeat of the first occurrence and reduce infections and spread in our nursing homes,” Governor Lamont said. “To that end, we are providing increased payments and a deferral on the recoupment of interim payments to provide more financial security as the costs of combatting the virus remain high and it is essential we give the facilities the resources they need. At the same time, we are strengthening best practices in infection control. I commend our state agencies, including the Department of Public Health, the Department of Social Services, and the Office of Policy and Management, for outstanding collaborative work in bringing this initiative forward.”
“These critical financial supports for our nursing homes will facilitate the continued ability to manage the virus until we have widespread access to a vaccine,” Office of Policy and Management Secretary Melissa McCaw said. “By combining state and federal resources, we are able to provide retroactive increases for the efforts already undertaken and the increased costs the facilities face over the winter, particularly to recognize the sacrifice and commitments made by critical staff during the course of this public health crisis. This is in addition to the more than $94 million we have spent to date for testing in nursing homes, as well as approximately $60 million to support additional staff costs, personal protective equipment, and other COVID-related costs from the Coronavirus Relief Fund. Thanks to excellent staff work, improved infection control measures, and better understanding of the virus, fewer nursing homes have had outbreaks during this resurgence and the vast majority of those with COVID-19 cases have been able to limit spread to fewer than 20 cases. Our nursing home residents, staff, and facilities need this help to continue these efforts and we are able to provide it.”
“This relief package affirms our shared commitment with the industry to continue to invest extensive technical guidance, advisory support and financial resources in preventing spread of COVID-19,” Dr. Deidre Gifford, Acting Commissioner of the Department of Public Health and Commissioner of the Department of Social Services, said. “First and foremost, the investment links additional funding for all Connecticut nursing homes to identified best practices in infection control. These include performance of supplemental antigen testing, use of on-site infection preventionists, and staff compensation incentives to reduce the incidence of staff working in more than one home. Further, homes that have rooms accommodating three and four residents will be required to reduce those to single or double rooms. Taken together, we believe these measures will make a significant impact in increasing protection of our most vulnerable family, friends and neighbors during care at skilled nursing facilities.”
The financial relief package was developed with the goal of providing comprehensive financial support across two phases of funding distribution – one to be issued immediately for the period covering November and December 2020, and the second to be issued for the period covering January and February 2021.
These conditions of funding were developed with two aims:
- To ensure continuity and quality of care to Connecticut’s most vulnerable residents, while preventing the spread of infectious disease; and
- To increase the probability that Connecticut nursing homes will quality for the remaining cycles of federal Provider Relief Fund financial assistance that are being distributed by the Centers for Medicare & Medicaid Services on the basis of infection and mortality rates.
The comprehensive financial support package announced today includes:
- Approximately $31.2 million in Coronavirus Relief Fund payments and Medicaid rate increases for nursing homes;
- Deferred recovery of $23.4 million in previously issued interim payments until FY 2022;
- Continued funding of the COVID recovery and alternate COVID recovery facilities; and
- Assistance to nursing homes that have had difficulty paying the nursing home user fees that were due for the quarter ending March 31, 2020.
Phase One funding (November and December 2020)
Phase One will provide bridge funding reflecting the equivalent of a 10 percent Medicaid rate increase for November and December 2020 using $20.8 million of funding from the federal Coronavirus Relief Fund; defer recovery of $23.4 million in previously issued interim payments until FY 2022; continue funding for testing of residents and staff through March 31, 2021 (with current terms extended through February 14, 2021); and continue funding of COVID recovery and alternate recovery facilities as needed or until the end of the federal public health emergency, whichever occurs first.
Phase One funding will be contingent on attestation by nursing facilities that they adhere to the following requirements:
- Compliance with Connecticut Department of Public Health standards regarding infection control, including but not limited to cohorting requirements and establishment of back-up testing partners;
- Performance of supplemental antigen testing;
- Provision of incentive payments to recognize all direct care staff and, at the discretion of each home, incentive payments to indirect care staff – both of which are defined below – for their service; and
- Initiation of the process of eliminating rooms with three and four beds.
As applicable, nursing homes should review orders issued by the commissioner of the Department of Public Health for further details. The following process steps will ensure accountability to these requirements:
- Nursing facilities will attest to the terms through Coronavirus Relief Fund grant agreements with the Connecticut Department of Social Services; and
- The Department of Public Health will document compliance through use of reported data and surveys.
Phase Two funding (January and February 2021)
With the goals of continuing to provide financial assistance, supporting the investments previously referenced, and emphasizing the use of funds to mitigate the spread of COVID-19 infection, nursing facilities will receive a five percent Medicaid rate increase totaling approximately $5.2 million per month for the months of January and February 2021. Funding will be authorized through a Medicaid disaster relief state plan amendment, provided other federal funding is not made available to offset the cost of these requirements.
Phase Two funding will be targeted to the following areas and will be contingent on documentation by the Department of Public Health to the Department of Social Services that nursing facilities are meeting these conditions:
- Continued adherence to all Phase One requirements;
- Implementation of incentive payments to all direct care staff as defined in Department of Social Services cost reporting requirements, including nursing staff, nursing pools and nurse aides, and, at the discretion of each home, incentive payments to indirect care staff, including in-house housekeeping, dietary, and laundry staff;
- Use of compensation arrangements (e.g., shift incentive payments, staff retention incentive payments, and extended schedules) to incentivize direct care staff to work in only one facility;
- Documentation of expenditures for personal protective equipment or other COVID-19 related costs;
- Increase in the hours of infection preventionists, as needed, to ensure they are on-site full-time;
- Use of shift coaches to monitor infection control;
- Performance on plans to eliminate three and four-bed room arrangements; and
- Adherence to any requirements of the Department of Public Health’s vaccine implementation plan that are in effect.
In addition to these, the Lamont administration will partner with nursing homes with the goals of providing short-term relief and promoting longer-term financial stability through:
- Assistance to nursing homes that have had difficulty paying the nursing home user fees that were due for the quarter ending March 31, 2020. The state recognizes that nursing homes have been and continue to be impacted by the pandemic. Any nursing home that has been granted two extensions of time to pay the nursing home user fees that were due for the quarter ending March 31, 2020, and is still unable to pay these user fees is encouraged to contact the Department of Revenue Services. Although the nursing home user fees that were due for the quarter ending March 31, 2020, cannot be waived, the Department of Revenue Services can work with nursing homes to find acceptable payment arrangements. If a nursing home and the state agency identify an acceptable payment arrangement and the nursing home complies with the terms of the arrangement, the Department of Revenue Services has the authority to waive associated penalties and adjust applicable interest. Payment arrangements are dependent on the facts and circumstances specific to each nursing home.
- Use of a new batch application process to support inter and intra-facility consolidation of facilities using transfer and certificate of need processes.