Hard-hit Georgia nursing home industry seeks $347 million in COVID-19 relief

Sisters Clarece Jones, right, and Betty Crowder, third from right, visit their brother Johnny Simmons, left, with their mother, Lucille Simmons, earlier this year at Westbury Medical Care and Rehab in Jackson.(Alyssa Pointer / Alyssa.Pointer@ajc.com)

Credit: Alyssa Pointer / Alyssa.Pointer@ajc.com

Credit: Alyssa Pointer / Alyssa.Pointer@ajc.com

Sisters Clarece Jones, right, and Betty Crowder, third from right, visit their brother Johnny Simmons, left, with their mother, Lucille Simmons, earlier this year at Westbury Medical Care and Rehab in Jackson.(Alyssa Pointer / Alyssa.Pointer@ajc.com)

With more than 3,500 COVID-19 deaths, a big drop-off in occupancy and rising costs, nursing home officials say their industry has been financially hammered by the pandemic, and they’re looking for federally funded relief.

The Georgia Health Care Association is requesting nearly $347 million from the state’s $4.8 billion portion of the COVID-19 relief fund Congress approved in March.

The Atlanta Journal-Constitution reported Wednesday that the state has delayed announcing which businesses, governments and nonprofits will be awarded grants from the fund until early next year to give them more time to apply.

Nursing homes and other care facilities have received hundreds of millions of dollars in state and federal help since COVID-19 hit the state in March 2020, but officials say they need more.

“Long-term care providers across the state have responded to this crisis heroically, all while facing significant operational challenges and financial losses,” said Tony Marshall, president and CEO of the Georgia Health Care Association.

“The current financial conditions are simply not sustainable for our state’s long-term care communities, and a number of providers are facing difficult operational decisions that include limiting admissions and even closure at a time when Georgia’s senior population is set to grow exponentially,” Marshall said.

The COVID-19 recovery bill President Joe Biden signed in March was designed to help states — and the economies of those states — hard hit by the coronavirus.

Gov. Brian Kemp has set up committees to review applications to spend the state’s share of the money in three areas: expanding high-speed internet services to areas that lack them; improving water and sewer infrastructure; and providing relief to people and businesses impacted by COVID-19.

The money could be used to make direct payments to Georgians, provide aid to small businesses, give extra pay to “essential workers,” fund job training and placement services, or assist hard-hit areas of the economy such as the hospitality and travel industries.

For instance, Kemp, who gets to make the final decision on how the money is spent, announced Thursday that he was giving the state’s tourism division $5.8 million to promote the industry.

Georgia has received half of the $4.8 billion it is expected to get. It is scheduled to receive the second half next year.

The first round of applications would allocate about $875 million of the $2.4 billion the state has received so far, according to the Office of Planning and Budget.

The $347 million request from the nursing home industry would eat up a sizable chunk of the fund.

When asked whether one industry will wind up getting that much, House Appropriations Chairman Terry England, R-Auburn, a member of the committees, said: ”I have no idea. But I think they are building a pretty good case.”

The nursing home industry said the COVID-19 grants would help financially stabilize their business and could end when occupancy rates match or surpass pre-pandemic levels for two consecutive months.

It said occupancy in homes dropped from an average of 84.5% in December 2019 to just below 70% in February. While the occupancy rate improved to 72.2% in July, more than one-quarter of the homes are less than two-thirds full. Some, much less. There were about 28,500 people residing in nursing homes in Georgia in July, down from just under 34,000 in December 2019.

England said, “A lot of folks are saying, ‘We are going to keep granny at home.’ ”

Marshall said the drop in occupancy in homes has resulted “in a devastating loss of revenue.”

“Revenue losses of $31 million or more per month, as seen during the second half of 2020, continue to this day,” Marshall said.

Deborah Meade, CEO of Health Management in Warner Robins, the third generation of her family to operate a small nursing home company, said her average occupancy at her facilities is 59% as the delta variant outbreak hits Middle Georgia hard this summer.

“We are taking admissions, and five days after they are admitted, they are testing positive,” she said. “And they were fully vaccinated.

“The additional strain on the staff to see this all over again after seeing this during 2020 is unimaginable,” she said, noting that she has lost workers because of it.

Meade, who is also chairwoman of the American Health Care Association, said her father died of COVID-19. She had hoped her daughter would follow her in running the company, but “I am for the first time afraid that she is not going to have that opportunity — it is that dire.”

Industry officials said they have seen greatly increased costs for things such as COVID-19 prevention and mitigation, and for staffing. Often workers are only available through staffing agencies.

Some of those higher costs were picked up by taxpayers.

The state sent in National Guard troops to help the homes, and $113 million in CARES Act COVID-19 funding approved at the beginning of the pandemic paid for staffing and pandemic response.

The industry is heavily reliant on payments from Medicaid and Medicare, the taxpayer-funded health care programs for the poor, disabled and elderly. For some facilities, that reliance has only increased since the pandemic began.

But the fact that so much of its revenue is tied to state and federal funding means the industry is also by necessity politically active, which puts it in a strong position to lobby for more COVID-19 relief.

The Health Care Association and nursing home giant PruittHealth have well-connected lobbyists at the Capitol.

The association has contributed more than $400,000 to state leaders, lawmakers and partisan state political action committees in the past five years. The Pruitt family and its companies have donated at least $950,000 in that time, including about $107,000 to Kemp’s campaigns and $250,000 to Republican caucus funds and the state GOP.

But beyond the money and lobbying, the General Assembly is run by lawmakers from rural Georgia, which is a key voter base for Kemp and the Republican majority. Rural lawmakers say while the nursing home giants may be able to hang on through the pandemic, small local facilities in their areas may not make it without further aid.

“With these small, independent homes ... the cash flow has disappeared,” England said. “It’s really putting them in a quandary.”