Argentum CEO: Phase 4 PRF Payment Plan ‘Slap in the Face’ for Industry

Senior living industry association Argentum is calling out the Biden Administration’s plan for determining Covid relief payments for assisted living communities.

The association on Wednesday took aim at the methodology for Provider Relief Fund (PRF) Phase 4 payments from the Health Resources and Services Administration, which is an agency of the Department of Health and Human Services (HHS). A day earlier, HHS had announced the release of $9 billion in Phase 4 Provider Relief Fund payments to health care providers, including assisted living operators.

According to the industry association, the methodology is “unconscionable, amounting to a slap in the face” for senior living operators.

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“The Biden Administration has had ample opportunity and the resources provided by Congress to do the right thing and prioritize senior living for Covid relief dollars,” Argentum President and CEO James Balda said in a press release. “We strongly believe that the Administration is not listening to the needs of seniors, nor the results of national polls which show widespread support across party lines for supporting senior living with adequate Covid relief.”

At the heart of Argentum’s issue with the new payment methodology is the fact that some operators stand to gain relatively little in reimbursed losses and expenses, compared to what they had received in the previous round.

In this round of relief funding, HHS plans to pay operators a percentage of their loss caused by a change in quarterly operating revenues and expenses. Operators with annual net patient care revenues of greater than or equal to $100 million stand to get reimbursed up to 20% of their losses, while operators with between $10 million and $100 million in annual net patient care revenues can get reimbursed for 25% of their losses. For operators with less than $10 million in annual care revenues, 45% of their losses are eligible for reimbursement.

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But that is far less than Provider Relief Fund (PRF) Phase 3 payments, when operators could get reimbursement for up to 88% of their losses, according to Argentum. At the same time, Argentum believes that assisted living operators have incurred greater losses during the Phase 4 quarters than during the Phase 3 quarters.

Furthermore, relatively few assisted living providers will be eligible for “bonus” payments available to providers who are reimbursed through Medicare, Medicaid and CHIP.

“Not only has HHS/HRSA not targeted relief for those caring for the aging and chronically ill who live in senior living communities, it is lowballing the payments that will be made,” Balda said.

When counting higher expenses and lost revenue, Argentum estimates the senior living industry has lost $30 billion in revenue during the Covid-19 pandemic.

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