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Preventing Nursing Homes Closures and Protecting Patients' Access to Care

The COVID pandemic has taken an enormous toll on our health care providers, particularly long-term care facilities and rural hospitals.  Four Maine nursing homes announced in September that they would be shutting their doors, displacing more than 100 residents, and many other long-term care facilities are struggling to stay open.


Over the course of the pandemic, I have heard from numerous Maine health care providers about the difficulty and expense of paying for additional staff, along with COVID-related facility improvements, personal protective equipment, and other financial challenges.  These same demands are stressing health care providers across the country, especially in rural areas.  When the pandemic began, an estimated 70 percent of rural hospitals’ income dried up when patients avoided doctor’s appointments and states halted elective procedures.  Almost half —17 out of 36—of Maine hospitals finished last year with a negative operating margin.  


To address this crisis, Congress appropriated $178 billion for the Provider Relief Fund last year. The PRF is designed to be a lifeline for hospitals, nursing homes, assisted living centers, and physician practices that have sustained significant losses.  Congress also provided an additional $8.5 billion for rural providers. 


I have worked across the aisle to protect this funding and ensure that it is available for providers that desperately need it.  Earlier this year, a bipartisan amendment I authored with Senator Joe Manchin of West Virginia to strengthen the PRF was adopted by a near-unanimous vote of 99-1.  In addition, as lead negotiators of the bipartisan infrastructure package, New Hampshire Senator Jeanne Shaheen and I successfully opposed attempts to slash funding from the PRF.


Despite the financial challenges created by the pandemic, however, this critical relief has been slow in reaching providers.  A report by the Government Accountability Office in June criticized HHS for its lack of transparency in distributing funding and revealed that 25 percent of the PRF remained unspent.


I spoke with Department of Health and Human Services Secretary Xavier Becerra on multiple occasions about this issue.  I also joined New Hampshire Senator Jeanne Shaheen in leading a bipartisan group of 50 Senators sending a letter calling for the quick distribution of the remaining money in the PRF.  In response, HHS announced the release of $25.5 billion from the fund in September.  This includes $8.5 billion set aside specifically for rural providers and $17 billion for providers that can document revenue losses and expenses associated with the pandemic.


            The release of this funding comes at a crucial time for health care providers.  A new law Senator Shaheen and I authored earlier this year is providing additional financial help for frontline health care providers by preventing a two percent cut in Medicare payments from taking effect during the public health emergency.


Nursing home closures can have a significant impact on rural communities as well as families.  A lack of available beds can make it a serious challenge to ensure older adults receive the care that they need.  Additionally—when residents are forced to move away from their families—spouses, children, and grandchildren are unable to visit their loved ones as frequently. 


As the ongoing public health crisis continues to cause such harm, the release of this vital funding will help to prevent more health care facilities from closing their doors and protect patients’ access to care.