FAQs: Applying for HHS Assisted Living Private Pay Provider Relief Funding

The deadline to submit applications to HHS for this phase of funding has passed.

On September 1, HHS formally announced a private pay distribution from the CARES Act provider relief funds for licensed assisted living providers. As anticipated based on recent discussions, the distribution model mirrors that of the Medicaid distribution previously announced and will total 2% of annual gross revenue for private pay providers that submit an application and are validated by HHS. Private pay providers can submit an application by visiting hhs.gov/providerrelief and the deadline for applications.
These HHS resources may be helpful as your prepare to submit your application:

• Resources for applying can be found on the CARES Act Provider Relief Fund provider page. This includes information about the application process as well as a webinar on that you may find helpful.
• Instructions for completing the application form; this documentation will help answer some of your questions as you work through the application.
• HHS FAQs on the Phase 2 General Distribution will provide helpful answers to commonly asked questions.
• HHS Provider Support Line: (866) 569-3522, Option 2

Below, you’ll find FAQs prepared by Argentum on issues related to eligibility, application clarifications, change of ownership, and usage of funds. We recommend that you review the application and application process with your organization’s counsel.

IMPORTANT: If you submitted your data through the Trade Association Portal previously, you MUST ALSO complete the HHS application to be considered for funding. Your previous submission on the Trade Association Portal was necessary for HHS to validate your TIN(s) and will expedite your application, but does not take the place of the HHS application.

ELIGIBILITY INFORMATION

If I already submitted my assisted living licensure information to the Trade Association Portal, do I still need to complete this application process?
Yes, applicants must complete the Provider Relief Fund Application. However, HHS has already vetted your TIN number(s), so your application will be expedited.

If I did not provide my assisted living licensure information to the Trade Association Portal, am I still eligible to apply?
Yes, applicants that did not provide their assisted living licensure information to the Trade Association Portal are still eligible and should complete the application. It may take longer for these applicants to receive their funds because HHS will need to validate their TIN number(s).

If I applied for and received Provider Relief Funds for Medicaid, but also have private pay licensed assisted living, can I apply for these funds?
Applicants that were eligible for Phase 1 – General Distribution payments are also eligible for Phase 2 – General Distribution payments only if the applicants have not yet received payment that equals approximately 2% of revenue from patient care.

If I previously applied for Phase 2 General Distribution Medicaid Funds, but received less than 2% of gross revenue, may I apply for additional funds through the private pay portal?
No. There is a chance that additional funding could be made available in the future that these providers could apply to receive.

In my state, assisted living and memory care is certified, not licensed. Should I still submit my data?
Yes. We are using the term “licensure” generically, and it includes states that register or certify assisted living communities.

My state does not use the term “assisted living.” Should I still input my data?
Yes. We are using the term “assisted living” generically, and it includes whatever terminology your state uses for licensing “assisted living”. Check the box that says you provide assisted living.

My state has more than one licensure category for assisted living. Should providers in all those licensure categories apply?
Yes. We know some states have both personal care home and assisted living licensure categories. Both types should submit their data.

If I operate only independent living communities, am I eligible to apply?
Independent living communities that are licensed or certified in their state under assisted living facility categories are eligible to apply.

If I have licensed private pay assisted living as part of a CCRC, am I eligible to apply?
Applicants that have licensed private pay assisted living as part of a Continuing Care Retirement Community (CCRC) are eligible to apply if they did not receive payment under Phase 1 of the General Distribution that equals approximately 2% of revenue from patient care.

If my community has already applied for Phase 2 General Distribution payments according to its status as a Medicaid provider, can the community now apply again for Phase 2 General Distribution payments according to its status as an assisted living facility?
Facilities that have already applied for Phase 2 General Distribution payments may submit a second application reflecting its status as an assisted living facility, so long as the payment received under the first Phase 2 application did not exceed approximately 2% of revenue generated from patient care.

If my community has not opened yet, am I eligible to apply?
If a facility has not opened, then the facility has not yet provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19, and thus are not eligible to apply. These facilities may become eligible once they open and begin providing diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 if HHS announces a future distribution. HHS broadly views every patient as a possible case of COVID-19, therefore, care does not have to be specific to treating COVID-19. Recipients of funding must still comply with the Terms and Conditions related to permissible uses of Provider Relief Fund payments.

What limitations are placed on the use of funds received under the Provider Relief Fund General Distribution?
Provider Relief Fund payments are available to qualified providers for healthcare-related expenses or lost revenue due to the COVID-19 pandemic. HHS broadly views every patient as a possible case of COVID-19, therefore, care does not have to be specific to treating COVID-19. Retention and use of these funds are subject to certain Terms and Conditions available here.

APPLICATION CLARIFICATIONS

If I made a mistake on my application can I amend it?
Some errors will trigger a follow up from HHS for clarification.

What is an Organizational TIN?
Organizational TIN is a term used on the portal for the Parent Company’s tax-filing entity Tax ID Number. Therefore, HHS expects the same Organizational TIN to be associated with multiple Facility TINs. Ultimately, HHS will validate the Organizational TIN to a tax return.

What is the Facility TIN?
Facility TIN is the tax ID number related to the entity that was issued a license. If an applicant has multiple licenses for the same Facility Tax ID number, the applicant must provide information that would identify which license goes with which Facility TIN.

What if my Legal Entity Name is different from the name on the License?
In this scenario, the applicant will provide the Legal Entity name that is associated with the Facility TIN. The License number will be used to map the facility to the Facility TIN.

How do I present my Organizational and Facility TINs?
Organizational and Facility TINs must be presented without dashes or special characters; just numbers.

If I have independent living and skilled nursing beds consolidated in an Organizational TIN, can I still apply for these funds?
Yes, but applicants must not include any revenue associated with skilled nursing beds; they are specifically excluded, as they have received Medicare funds. Furthermore, applicants must not include any revenue associated with independent living beds if they are not associated with an assisted living license.

In Massachusetts, we don’t have license numbers. Are my communities still eligible?
Yes.

What if my Facility Tax ID Number is the number used on the federal tax return for the facility income?
Please add the number in both the Facility Tax ID and Taxpayer ID fields.

What if my facility does not have a unique Federal Tax ID number?
Include the Federal Tax ID number for the federal tax filing entity reporting the facility’s income under both the Facility Tax ID Number and Taxpayer ID Number fields.

What if my facility has a unique Federal Tax ID Number but is reporting its income in a consolidated federal tax return of a Parent Company, Partnership, etc.?
Include the facility Federal Tax ID Number under the Facility Tax ID Number field and the Federal Tax ID Number for the federal tax filing entity under the Taxpayer ID Number field.

What if my facility has a unique Federal Tax ID Number which is also the number of the Federal tax filing entity?
Include the number under both the Facility Tax ID Number and the Taxpayer ID Number fields.

If I have a facility entity(s) that is a taxpayer that is also a disregarded entity(s) for Federal taxes but files as part of a consolidated Federal return of a Parent Company or partnership, would the Taxpayer ID Number be used for the Facility ID Number field, or should the parent company or partnership Federal Taxpaying ID Number be used?
The parent company or partnership Tax ID Number should be used. For this situation, in the Facility ID Number field enter the Federal Tax ID Number of the disregarded entity and in the Taxpayer ID Number field enter the Federal Tax ID Number used on the Parent company or partnership federal return.

How should assisted living facilities calculate revenue from patient care?
“Patient care” means health care, services and supports, as provided in a medical setting, at home, or in the community to individuals who may currently have or be at risk for COVID-19, whereby HHS broadly views every patient as a possible case of COVID-19. Assisted living facilities that are applying for Phase 2 – General Distribution funds may include patient care revenue that supports residents’ nutritional, housing, activities of daily living, and medical needs, including purchased services.

CHANGE OF OWNERSHIP INFORMATION

 What happens regarding change of ownership in late 2019 or 2020?

• Will health care providers that experienced a change in ownership that disqualified them from receiving a Provider Relief Fund payment be able to receive a payment that was returned by the previous owner?
  • In order to ensure program integrity and transparency, HHS made Provider Relief Fund payments to healthcare providers based on the latest data available for a TIN. Previous owners are not permitted to transfer funds to the new owner. These previous owners are instructed to return the funds to HHS. At this time, HHS will not reissue returned payments to the new owners. Communities that have not received payments under the Provider Relief Fund due to issues related to change of ownership will be eligible to apply for future allocations. Additional information will be posted on this website.
• How should applicants that experienced a change in ownership in 2019 or 2020 (if approved by CMS as of August 10, 2020) report their revenue?
  • Any applicant with revenue adjustments, including those that experienced a change in ownership in 2019 or 2020, who enters an adjusted revenue number different from the applicable number shown on its most recent tax return must upload the Revenue Worksheet. The worksheet is provided by HHS and is available at: https://hhs.gov/sites/default/files/prf-gross-revenuesworksheet.xlsx. Applicants that experience a change in ownership should report the revenue, along with the proportion of revenue from patient care, for the acquisition or dispositions from the date of sale through the date of application in the Provider Relief Fund Application and Attestation Portal. Applicants should provide their own most recent tax return and fill out the Revenue Worksheet to reflect the change in revenue as a result of the acquisition or disposition.
  • “Applicant with revenue adjustments” means an applicant that acquired (whether as stock or asset purchase) or disposed of (whether by sale, termination, or otherwise) included subsidiaries such that its revenue as calculated in the table of Field 10 is more than 20% larger or smaller than the adjusted revenue number as calculated using the Revenues Worksheet in Field 15. For dispositions, enter revenue included in the tax return uploaded in Field 16 of included subsidiaries that were disposed of. For acquisitions, enter revenue not included in the tax return uploaded in Field 16 of included subsidiaries that were acquired.
  • In addition to completing the Revenue Worksheet for any adjustments to revenue, please include supporting documentation for any adjustments reflected on the worksheet. Examples of supporting document could include internally-generated financial statements, valuation reports that would reflect revenue, or budget-to-actual revenue comparisons.
• How should an organization currently undergoing a change in ownership to purchase a practice report revenue in its application?
  • Until the purchase is complete, the organization should only report current gross receipts in its application and should exclude the practice it is intending to purchase. Any changes in ownership that have not occurred should not be included in your revenue submission. Submissions must be based on the organization that exists at the time of application, not a projection of expected lost revenue from the practice that is being acquired.
• If a seller receives Provider Relief Fund money prior to the completion of a sale, can the seller transfer some or all of the Provider Relief Fund money to the buyer?
  •  If the transaction is a purchase of the recipient entity (e.g., a purchase of its stock or membership interests), then the Provider Relief Fund recipient may continue to use the funds, regardless of its new owner. But if the transaction is an asset purchase (whether for some or all of the Provider Relief Fund recipient’s assets), then the original recipient must use the funds for its eligible expenses and lost revenues and return any unused funds to HHS. In these circumstances, the Provider Relief Fund money does not transfer to the buyer, however, buyers in these circumstances will be eligible to apply for future Provider Relief Fund payments.
• Can a provider that purchased a TIN in 2019 accept a Provider Relief Fund payment from a previous owner and complete the attestation for the Terms and Conditions?
  • No. The new TIN owner cannot accept the payment from another entity nor attest to the Terms and Conditions on behalf of the previous owner in order to retain the Provider Relief Fund payment. However, the new TIN owner may still receive funds in other distributions.

What happens for funding of communities that opened in late 2019 or 2020?
Communities that opened in late 2019 or 2020 are still eligible to receive Provider Relief Fund payments so long as they provided on or after January 31, 2020, diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. HHS broadly views every patient as a possible case of COVID-19, therefore, care does not have to be specific to treating COVID-19. Recipients of funding must still comply with the Terms and Conditions related to permissible uses of Provider Relief Fund payments.

• If an organization neither files taxes nor has audited financial statements, what financial documents should it submit with its application?
  • If an organization does not have tax filings, nor audited financial statements, it may submit internally-generated financial statements; in the case of federal grantees, the most recent four quarters of SF-425 forms, or for eligible federal entities, the most recent annual report submitted to Unified Financial Management System (UFMS).

QUESTIONS?

Email us at [email protected]. If we are unable to answer your question(s), we will share with HHS for consideration for their FAQs.