HEROES Act Supports Nursing Homes; But More Is Needed To Support the Aging Services Field

Legislation | May 14, 2020 | by Marsha R. Greenfield

On May 12, Speaker Nancy Pelosi (D-CA) released the ‘‘Health and Economic Recovery Omnibus Emergency Solutions Act’’, the HEROES Act, as part of the continuing legislative effort to address the coronavirus pandemic. The Act contains new programs for nursing homes, some of which include elements of proposals from LeadingAge, and addresses other healthcare-specific issues.

On May 12, Speaker Nancy Pelosi (D-CA) released the ‘‘Health and Economic Recovery Omnibus Emergency Solutions Act’’, the HEROES Act, as part of the continuing legislative effort to address the coronavirus pandemic. The Act contains new programs for nursing homes, some of which include elements of proposals from LeadingAge, and addresses other healthcare-specific issues. Next step is a vote in the House of Representatives, which will set the stage for negotiations with the Senate and the Administration.

So what’s new for nursing homes?

  • The bill authorizes $500M to be appropriated to states to set up “strike teams” to assist nursing homes with residents or staff with diagnosed or suspected cases of COVID-19, with clinical care, infection control, or staffing. While LeadingAge has not taken a position on strike teams, we strongly support providing additional support and assistance to nursing homes to address the never-ending need for staff and proper protective equipment.
  • The bill creates an incentive program for 4- and 5-star nursing homes to create COVID specific units. This is similar to LeadingAge’s recommendation that COVID be considered a skilled need for payment purposes, and that Congress appropriate funds specifically for specialized settings. We certainly support this and other similar efforts.
  • CMS is mandated to report, on Nursing Home Compare, demographic information on residents with suspected or confirmed cases of OVID-19, including age, race/ethnicity, and preferred language (taken from the data already provided by nursing homes). LeadingAge has supported collection of demographic data to better understand this new disease and its impact. While this provision requires reporting deaths, we also believe that it would be critical to report on recovery, which is equally important in understanding the trajectory of the disease and how to respond.
  • CMS is mandated to contract with at least one Quality Improvement Organization to provide infection control support.
  • Finally, CMS is required to issue guidance to nursing homes on how to provide access to visitation for residents, at least by phone. LeadingAge members are working diligently to provide virtual visitation and contact with family, which is critical for the health and wellbeing of our residents. We will be happy to share our experiences with CMS, but urge that Congress include funding for the additional technology needed to enhance and improve communications.

Anything else of interest?

  • The provider relief program gets a make-over, specifically mandating that funds be distributed by a grant program, setting up the way the program is to be implemented. We are reviewing carefully to see how this will affect our members.
  • A variety of commissions and task forces are created to address the federal response to testing, equipment distribution, a cohesive and coherent plan for distributing funds authorized for COVID and the like.
  • A “HEROES Fund” is created to provide premium support for essential workers, which would include nursing home, home health, social workers, and other identified workers. LeadingAge has strongly advocated for increased funds for frontline staff in all our communities and home-based settings.

What big issues are missing?

  • Setting aside $100B specifically for aging services providers, recognizing that aging services is its own ecosystem and is more than nursing homes. We still strongly advocate for a separate fund.
  • Uniform and unified federal reporting remains a top priority. Reporting requirements are scattered throughout the bill, and for nursing homes at least, the states and sometimes localities have their own reporting requirements. The CDC reporting that CMS mandated has proven to be difficult to implement and would not create a uniform system.
  • Recognizing, in line with our request for a separate fund, that we need to look ahead – not just to how to react to the crisis but the impact the crisis will have on our field in the future. This is the Bipartisan Congressional Commission on the Future of Aging Services that we recommend in our May 5 letter to Congress, and that is one of our top priorities.

How do we advance the issues we support and the issues still outstanding? Your advocacy is critical here, your members of Congress must hear from you to understand what life is like “on the ground” and what support you need to provide the highest quality housing, care and services. Please join your colleagues and send your message to Congress through our Advocacy Alert.