In an effort to assist nursing homes during the COVID-19 pandemic, the Wisconsin Department of Health Services (DHS) undertook an effort in December 2020 to provide $2,900 to those facilities for each person they directly admitted from a hospital. This program was intended to increase the number of patients facilities could accept by providing supplemental funding they were able to use to hire additional qualified staff needed to care for residents. This program was supported by funds from the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act.
Payments were calculated based on patient admission numbers beginning on October 18, 2020, drawn directly by DHS from the Long-Term Care Minimum Data Set (MDS). The program used numbers of people admitted directly from acute care hospitals through December 30, 2020. DHS made payments to facilities on a biweekly basis to the address they provided in the participation agreement.
To participate in the program, nursing homes were required to fill out a participation agreement that included uploading their federal W-9 and Wisconsin DOA-6460 forms.
Answers to questions about the program are below. Any outstanding questions can be emailed to the DHS Division of Medicaid Services COVID-19 team.
Outstanding questions? Email the DHS Division of Medicaid Services COVID-19 team.
Participating nursing homes should note that DHS increased the payment to $2,928.25 per admission (rather than a flat $2,900). This was done to make sure nursing homes received as much of the $30 million CARES funds allocated to this program as possible. Payments processed at the end of January will not only pay for new admissions from acute care hospitals, but also provide an additional $28.25 for all admissions previously processed.
Who was eligible to participate in this program?
All nursing homes in Wisconsin.
What did my facility attest to in order to participate?
The participation agreement required that the person filling out the form agreed to the following attestation:
By applying for participation in this program, the nursing home (provider) attests and agrees as follows:
That the provider accepts the Nursing Home CARES Act Payment funding provided under this program with the express intent and purpose of aiding the State in response to the on-going public health COVID-19 pandemic, by admitting new residents directly following discharge from an acute care hospital.
That the provider will admit only new residents for whom they have, or will obtain through the use of the Nursing Home CARES Act Payment funding, sufficient staff and necessary supplies to care for the new residents safely.
That the provider has exercised reasonable care and made all reasonable efforts to ensure that all MDS entry and tracking record information submitted is accurate in all respects.
That the provider will maintain, for at least 5 years, records sufficient to demonstrate that all uses of the Nursing Home CARES Act Payment funding are for direct or indirect costs of providing nursing home care to residents.
That the provider will cooperate with and provide any relevant information or records requested by DHS, its authorized representatives, or any federal or state auditing agency, and will hold DHS and the state harmless for any audit disallowance related to the Nursing Home CARES Act Payments, irrespective of whether the audit is ordered by federal or state agencies or by the courts. The provider is solely responsible for repaying to the state or federal government any amounts it receives that are later found to be ineligible under this program or the CARES Act.
That the provider agrees the state, by providing Nursing Home CARES Act Payment funding to the provider, assumes no liability for any acts or omissions of the provider or any of its officers, employees, contractors, or agents which are in any way related to the Nursing Home CARES Act Payments.
That the provider understands that CARES Act funds provided to local government entities qualify as federal assistance for purposes of the Single Audit Act and 2 C.F.R. part 200, subpart f. Further information relating to the single audit compliance is available on the Wisconsin Department of Administration website.
That the provider agrees, pursuant to 2019 Wisconsin Executive Order 1, the provider will hire only on the basis of merit and will not (and did not) discriminate against any persons performing any work on account of their military or veteran status, gender identity or expression, marital or familial status, genetic information or political affiliation.
That the provider, as required by Wis. Stat. § 16.765, will not discriminate against any employee or applicant for employment because of age, race, religion, color, handicap, sex, physical condition, developmental disability as defined in Wis. Stat. § 51.01(5), sexual orientation as defined in Wis. Stat. § 111.32(13m), or national origin, including without limitation the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. Except with respect to sexual orientation, the applicant provider will take affirmative action to ensure equal employment opportunities. The provider will post in conspicuous places, available for employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of the State of Wisconsin’s nondiscrimination law.
That the provider understands that the Nursing Home CARES Act Payment funds are federal funds and, as such, shall not discriminate against members, applicants, enrollees, and beneficiaries in programs and activities that receive federal financial assistance. Provider will comply with federal laws prohibiting discrimination including, for example, Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990, Title IX of the Educational Amendments of 1972, the Age Discrimination Act of 1975, and Section 1557 of the Patient Protection and Affordable Care Act of 2010, and prohibit recipients and subrecipients of federal financial assistance from discriminating on the basis of race, color, national origin, sex, age, disability, and, in some programs, religious creed or political affiliation or beliefs, in their service delivery, and from engaging in retaliation against those who oppose discriminatory practices protected by federal civil rights laws.
That the person submitting this request to participate in the Nursing Home CARES Act Payment Program has read this document and has the intent and legal authorization to agree to all terms and conditions on the provider’s behalf.
Did these admissions have to be for COVID-19 patients?
No. All admissions were eligible. Any admission from an acute care hospital was a qualifying admission for purposes of this payment.
Did these admissions have to be for Medicaid patients?
No. All admissions were eligible regardless of the type of health coverage the patient had.
What happened if the nursing home changed ownership between October 18 and December 30, 2020?
Each payment was made to the current owner of the facility based on the information that DHS had on record at the time of the payment. MDS Entry/Tracking records that were completed simply due to a change of ownership where the residents stayed at the same physical location were not eligible for payment.
Were there any limits on what nursing homes can use these funds for?
The funds had to be used for direct or indirect costs of providing nursing home services in Wisconsin.