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Author: Punch Robinson

The Application for Provider Relief Fund & American Rescue Plan Rural Payments Closes Oct. 26

October 19, 2021

BY: Christopher Findlay

The U.S. Department of Health and Human Services (HHS) has announced $25.5 billion in new funding for health care providers impacted by the COVID-19 pandemic. This includes $17 billion in Provider Relief Fund Phase 4 funding for providers who have experienced changes in operating revenues and expenses, as well as $8.5 billion in American Rescue Plan Rural funding for providers who provide Medicare, Medicaid, or Children’s Health Insurance Program (CHIP) services to rural beneficiaries.

PRF Phase 4 payments will be based on providers’ lost revenues and expenditures between July 1, 2020, and March 31, 2021.  ARP rural payments will be made to providers based on the amount of Medicaid, CHIP and/or Medicare services they provide to patients who live in rural areas as defined by the HHS Federal Office of Rural Health Policy.

Providers may apply for both programs via a single application on the Provider Relief Fund Application and Attestation Portal through the final deadline of October 26, 2021.

  • Eligibility:  
    • PRF: Providers or suppliers who bill Medicare fee-for-service (Parts A and/or B) or Medicare Advantage, Medicaid (fee-for service or managed care) or CHIP
      • Phase 4 will also include new elements specifically focused on equity, including reimbursing smaller providers for their changes in operating revenues and expenses at a higher rate compared to larger providers, and bonus payments based on the amount of services providers furnish to Medicaid/CHIP and Medicare patient.
    • Rural payments: Providers who serve Medicaid, CHIP, and Medicare patients who live in rural communities are eligible for the ARP Rural payments
      • HRSA will price payments at the generally higher Medicare rates for Medicaid/CHIP patients.
  • Required documentation:
    • Applicant TIN and TINs for any subsidiaries included in the applicant TINs IRS tax filing.
    • Internally-generated financial statements that substantiate operating revenues and expenses from patient care in 2019 Q1, Q3, and Q4; 2020 Q3 and Q4; and 2021 Q1.
    • Form 990

More information is available from HRSA.

CMS Vaccine Mandate Temporarily Halted Nationwide by Courts

December 1, 2021

BY: Christopher Findlay

On Tuesday, November 30, the U.S. District Court for the Western District of Louisiana granted a preliminary injunction effectively preventing the Centers for Medicare & Medicaid Services (CMS) from enforcing its vaccine mandate rule nationwide.  While the Court’s ruling was based on a lawsuit brought by only 14 states, given the scope of the mandate and the previous injunction granted Monday, November 29, by another District Court preventing enforcement in 10 other states, the Louisiana court indicated that its ruling would cover all remaining states not already under the previous injunction “due to the need for uniformity.”

While the Biden Administration has indicated that it plans to appeal the rulings, as of now, CMS is prevented from requiring compliance with the vaccination mandate’s Dec. 6 deadline for most healthcare workers to have first round shots completed. The final deadline for full vaccinations was set at Jan. 4.

This court ruling follows a three-state (Kentucky, Ohio, and Tennessee) injunction against enforcement of a vaccine mandate for federal contractors and a nationwide injunction on enforcement of the similar mandate issued by The Occupational Safety and Health Administration (OSHA.)  Lutheran Services in America has submitted comments on the OSHA mandate.  Lutheran Services in America has prepared a summary of the CMS rule, and will be submitting comments to CMS sharing questions and concerns from our network members.

Please contact Sarah Dobson, Senior Director of Public Policy and Advocacy, at sdobson@lutheranservices.org to share your input as we prepare our official comments on the CMS mandate.

For further information, please contact Sarah Dobson, Senior Director of Public Policy and Advocacy, at sdobson@lutheranservices.org or Josh Dubensky, Director of Public Policy and Advocacy, LSA-DN, at jdubensky@lutheranservices.org.

America’s Silent Heroes

June 10, 2020

BY: Joey Hess

A dark cloud of fear and uncertainty looms over our nation as our friends, family, and neighbors lose their income, their food security, and are forced to self-isolate in an attempt to avoid illness. We turn on the news, and day after day the same message is echoed. An invisible, virulent, and deadly virus is circulating the country and while precautions are in place, people are still being affected in vast numbers. Instead of hearing about any of the good that is happening in the country, our attention seems to be directed toward the negative. But there is good news! Hundreds of faithful people at Lutheran social ministry organizations across the nation are still going to work every day to help.

While the enemy we fight is invisible, these heroes are not. Presence in our communities is needed now more than ever, and LSA and our member organizations recognize that and are answering the call. As part of our mission to bring awareness to all the great work that our members have been doing amidst the COVID-19 pandemic, LSA has been publishing daily stories highlighting the unsung Front Line Heroes who are selflessly serving their communities. Our senior care nurses, social workers, physical therapists, case managers and so many more who, despite receiving little to no praise, are on the front lines fighting to protect and serve our most vulnerable populations.

If you take the time to read through all of the stories posted on the LSA blog you would be baffled by all of the amazing work these organizations are doing and the impact they are making throughout the country. What is even more shocking is how difficult it is to find a single story that highlights any of their great work in the mainstream media. Despite receiving little recognition, these organizations are sacrificing themselves for the greater good of the people they serve.

Lutheran Social Services of South Dakota is providing translation services at COVID-19 testing sites to remove the language barrier and ensure everyone has access to care. Luther Home of Mercy is streaming religious services for their residents as a way for them to grow and heal spiritually. Lutheran Social Services of North Dakota is providing daily dial-in support groups as a resource to fight social isolation. Lutheran Senior Life delivered over 10,000 meals to their community in the span of five weeks and Lutheran Social Services of Nevada expanded its DigiMart food pantry from 750 square feet to 3,058 square feet to help the growing number of people in their community who are facing food insecurity. These are just 5 out of the 50+ stories we have shared over the past few months and there are many more to come.

So, we ask you to take the time to thank those working in senior services who are putting themselves and their families at risk in order to protect the older adult population. We ask you to share the stories of those serving our children, youth and families who are working tirelessly to ensure that every child they serve is safe, healthy, and able to reach their full potential. Lastly, we ask that, if you are able to, donate some of your time, funds or food to those providing shelter and nourishment for the people who are struggling through these troubling times.

At LSA, we plan to continue our effort to recognize these heroes and show appreciation for all the amazing work they do. If you believe in the brave work that these front line workers are providing, we ask you to join us as we continue to work toward our vision of transforming the lives of the people and communities that our members so selflessly serve.

President Biden Announces Framework for $1.75 Trillion “Human Infrastructure Package”

October 29, 2021

BY: Christopher Findlay

Disagreements between progressive and moderate factions of the Democratic party must be resolved before final vote can take place.

The White House released a $1.75 trillion framework Thursday for the “Human Infrastructure Plan,” also known as the Build Back Better Act. The framework marks a significant reduction from the originally anticipated $3.5 trillion package, but still represents one of the largest federal investments in social spending programs in history. However, timeline for final passage remains unclear. Legislative text is still in draft form, and key moderates Sens. Manchin and Sinema have still not committed to voting for the bill. Progressives in the House remain united against advancing the Senate’s bipartisan infrastructure bill until they receive more details and a guarantee of passage of the Build Back Better Act. It is likely the bills will move together in the House to ensure both factions are satisfied.

The President’s framework notably included $150 billion for home and community-based services. This money would set up a permanent FMAP increase for states if they agree to expand HCBS eligibility and services and improve wages for direct care workers. This represents an historic investment in HCBS, but until the Build Back Better Act is passed nothing is final. That is why Lutheran Services in America continues to advocate for key provisions that would help address the acute workforce shortage and expand access to home and community-based services. Specifically, we are advocating for a final package that includes:

  • $150 billion to incentivize states to deliver or improve home- and community-based service programs, including through increasing wages and benefits for direct care workers;
  • $1.48 billion for a grant program funding strategies to recruit and retain direct care workers; and
  • the provisions of the WORK NOW Act to create a $50 billion grant program supporting nonprofits in paying wages and benefits.
    Please join us in this effort through our advocacy alert.

Honoring Juneteenth

June 17, 2022

BY: Christopher Findlay

Positive Impact of iN2L Tablets on Senior Living Residents and Staff

April 26, 2022

BY: Christopher Findlay

At iN2L, the leading provider of person-centered engagement technology for older adults, we have been conducting research to better understand the impact of our technology on the lives of those we serve. In this blog post, I will share some of the key results from our work on the first two phases of Project VITAL (Virtual Inclusive Technology for ALl), a project in partnership with the Alzheimer’s Association and Florida Department of Elder Affairs, which examined how technology and community resources could be leveraged to combat social isolation and loneliness during the COVID-19 pandemic.

 

Across the first two phases of Project VITAL, 600 iN2L tablets were distributed to 300 senior care communities, including assisted living, skilled nursing, memory care, and adult family-care homes. Staff members were asked to complete online surveys approximately six months after the iN2L tablets were implemented in their community in order to gauge staff perceptions of residents’ feelings of social isolation and mood.

 

Across all community types, staff agreed that residents were struggling with loneliness and that their mood had declined since the implementation of COVID-19 precautionary measures. However, there was strong agreement among staff that the iN2L tablets were useful in both reducing residents’ loneliness and improving residents’ mood. Feedback from staff help demonstrate the different ways in which the tablets could have a positive impact on these metrics, including being a good source of distraction and engagement.

 

“The tablets have been a great tool for distractions from COVID.”

“We have very much enjoyed [the tablets]. Each month we celebrate a different country, and we use iN2L for music from the country we are celebrating. We also use them for bed-bound residents to play relaxation music.”

“I have used iN2L in my memory care unit. The sing-alongs, the old programs (Lone Ranger, etc.) are fabulous…It makes a HUGE difference in my residents suffering with sun downers.”

“The residents have truly enjoyed all of the features.”

 

Staff also agreed that the tablets made it easier for residents to stay in touch with family and friends, which could help alleviate feelings of social isolation and loneliness. One key way that residents could connect with family and friends using the tablet was through video chat. A staff member noted that not only did residents enjoy video chats, but that “the families enjoyed the video chatting.”

 

You can read more about Project VITAL 1 and 2 in our study published in Frontiers in Public Health.

 

iN2L has been creating possibilities, enjoyment, and connection for older adults through content-driven engagement since 1999. iN2L’s expansive content library promotes wellness, empowerment, and engagement among older adults and is the foundation for activities that facilitate social interaction, cognitive and physical exercise and therapy, education, reminiscing, areas of interest, and memory support engagement. iN2L is a critical part of the resident experience in more than 3,700 nursing homes, assisted and independent living communities, memory care settings, and adult day programs across the U.S. and Canada.

 

To learn more about iN2L and its senior living program, please join us for an informative webinar on Thursday, May 5, at 2 p.m. ET.

Carroll Lutheran Village Restarts Ministry Program Offering Help, Hope and Healing

June 1, 2022

BY: Christopher Findlay

Two years ago, the pandemic put the Stephen Ministry program at the Lutheran Social Ministries of Maryland community Carroll Lutheran Village (CLV) in Westminster, Maryland, on hold for safety reasons. Now, a team of four residents and an associate chaplain has returned to manage the program and resume its work with CLV residents on depression, loneliness, family loss, loss of faith, health, end-of-life and other challenging issues and are grateful to be providing caregiving again.

Stephen Ministry trains lay people to provide one-to-one Christian care to those experiencing grief, illness, hospitalization, life transitions, or another life challenge. Bob Nicoll, the program’s class administrator, provides oversight with two other CLV Stephen leaders: Connie Kidder and Jay King. CLV’s associate chaplain Charles Marshall and Spiritual Life Committee chair James Boesler round out the leadership team. Each team member received 50 hours of specialized training to be a Stephen minister before working with residents.

While the reasons for volunteering vary for each, they all share an understanding of the program’s importance and necessity. Kidder became interested in caring ministries early in life. As a young adult, she received support from her church, family and others. Since then, she has had a passion for helping others.

King’s interest in assisting older adults came from his interactions with a pastor while in high school. He stated, “Now I am one,” yet he still enjoys befriending residents who are close in age. He saw an ad about Stephen Ministries at CLV and immediately applied. He feels lucky to have been in the right place at the right time. Stephen Ministries allows him to do what he loves—empowering others.

Boesler faced many challenges and at one time thought, “God can’t love me.” It took time, but he now believes, despite everything, God loves him. He wants others going through a difficult time to know God is with them all the time. This desire led Boesler to complete the Stephen Ministry training so he can support CLV residents.

After a long career in management where Nicoll spent most of his time with lots of people and organizations, he said, “I wanted to find something different—something to experience one-on-one relationships.” As a Stephen minister, he’s been able to experience those relationships.

Nicholl said, “We routinely remind our team that we are caregivers, not cure givers—the latter is in God’s hands.” CLV’s eight Stephen Ministers are careful to remember they are not therapists and avoid trying to fix care receivers’ problems. If care receivers need more support than a minister can offer, a referral is made to an outside professional or mental health specialist.

The leadership team plans to expand the program to include reaching those who may need support but do not require the full program. For example, some residents may benefit from simply having a conversation with a Minister rather than meeting for multiple sessions.

Considering the challenges many are facing since the pandemic started, CLV’s residents and team members are happy to have Stephen Ministers and Leaders in the community to provide caring support.

Lutheran Social Ministries of Maryland is a member of Lutheran Services in America, a national network of 300 Lutheran health and human services organizations that reaches one in 50 people in America each year. Carroll Lutheran Village, a community of Lutheran Social Ministries of Maryland, is an accredited, not-for-profit continuing care retirement community that supports nearly 700 residents in 397 homes and apartments, 50 assisted living suites and 103 skilled care beds.

Learn more about Lutheran Social Ministries of Maryland.

Bipartisan Report Recognizes Importance of Nonprofits in Public Health

May 31, 2022

BY: Christopher Findlay

The Bipartisan Policy Center released a report in December 2021 that outlines a five-year plan for building a more equitable and sustainable public health system in the United States. Lutheran Services in America president and CEO Charlotte Haberaecker served as a member of a 14-person task force that shaped the report’s recommendations.

The report, “Public Health Forward: Modernizing the U.S. Public Health System,” recognizes the important role community-based organizations play within underserved communities and encourages policymakers and health departments to build long-term partnerships with nonprofits to advance health equity in these areas.
The report sets a vision for the United States that can respond effectively to public health challenges while ensuring the well-being of every person in America.

Watch the release event for the report.

Will You Join Me?

May 27, 2022

BY: Christopher Findlay

Together, we can advance programs that improve equitable outcomes for children and families, fill significant gaps in care for low-income older adults and empower local health and human services leaders with additional skills and opportunity to drive transformational change for people and communities across the country. Hear from five Lutheran Services in America board members who were called to meet these momentous challenges we face.

WATCH NOW

Lutheran Services in America Meets with CMS Administrator, Continues Driving Home the Impact of the Direct Care Workforce Crisis

June 14, 2022

BY: Sarah Dobson

We are continuing our work to raise awareness of the impact on access to care as a result of the ongoing workforce shortage crisis in direct care—and drive action in the Biden Administration that will help address the problem.

Making the Case for Change

In March, the Centers for Medicare and Medicaid Services (CMS) announced a sweeping Skilled Nursing Facility (SNF) initiative that includes more than 20 proposed actions, including implementing a minimum staffing requirement, increasing frequency of compliance surveys and dramatically increasing penalties for deficiencies.  No funding is provided for additional staff required by nursing homes.

In response, Lutheran Services in America wrote a letter to CMS administrator Chiquita Brooks-LaSure outlining our concern about the lack of understanding of the workforce shortages facing skilled nursing providers and the result that older adults will not have access to the care they need. We also invited our members and their networks to participate in our advocacy campaign to Brooks-LaSure and members of Congress and conducted a survey of our SNF providers to collect hard data to strengthen our messages.

Strength in Numbers

Illustrating the strength in numbers when we come together as the voice of a $23 billion faith-based network, we secured a meeting with CMS Administrator Brooks-LaSure on May 26 with four of our member CEOs:

During this meeting, we shared that we’ve already reduced services for older adults because of workforce shortages—for example, 1 percent of the population of Lindsborg, Kansas, is waiting to be admitted to a skilled nursing facility and over 100 older adults in one Minneapolis hospital alone can’t be discharged because there are no skilled nursing beds available.

We highlighted the limited options for older adults who are frail and need higher level skilled care today because of workforce shortages—and that an unfunded mandate to expand staffing requirements would mean we would have to turn away more people.

We talked about the dedicated caregivers—the frontline heroes—and the extensive efforts our members make to recruit and retain staff in this competitive environment. But with Medicaid reimbursement rates that don’t fully meet the costs of care (e.g., losing $90/day on 70 percent of the population served), even the prison commissary in one rural community pays staff more than Medicaid provides.

We also shared the exorbitant fees paid to staffing agencies to secure additional workers to continue to empower older adults. For example, outside staffing agencies were 27 percent of the nursing budget for one member—where two years ago they were $0. Another cited paying staffing agencies $90/hour for a Certified Nursing Assistant, clearly not sustainable.

Next Steps

We recommended bringing our provider voice into CMS’s plans and that CMS should focus on helping expand the workforce through immigration and other levers to expand the pipeline and expand Medicaid reimbursement to cover the cost of care.

Now, CMS is also seeking public comments on the minimum staffing requirement, and we’ve shared our message with them there as well.

Our advocacy work isn’t over, and we still need your help and your voice to continue making progress, but we know our message is beginning to break through and for that, we thank you for your continued support.

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