Thursday, February 17, 2022

Feds: Hospital Capital Projects Allowable Use of ARPA Funds

Report Highlights COVID’s Impact on Rural Hospitals

CMS Open Door Forum on Surprise Billing

REGISTER: IHA Virtual Legislative Advocacy Meetings

Illinois COVID-19 Update

Briefly Noted

Feds: Hospital Capital Projects Allowable Use of ARPA Funds

A U.S. Treasury Department final rule issued late January clarified and expanded the circumstances under which states and localities may use American Rescue Plan Act (ARPA) State and Local Fiscal Recovery Funds (SLFRF) to include general hospital construction projects.

State and local governments have wide latitude to fund programs according to their own parameters. However, the changes included in the Treasury Department’s final rule allow hospitals increased eligibility to use potential funds for capital expenditures by clarifying eligibility for non-profit hospitals to be a subrecipient, and by more clearly describing what types of capital expenditure projects are eligible.

To access a detailed memo prepared for IHA on the Treasury Department final rule click here.

Illinois hospitals interested in applying SLFRF grants may find limited guidance on the Illinois Dept. of Healthcare and Family Services ARPA Payment website. Specific inquiries and questions should be directed to HFS.CARES@illinois.gov.

Report Highlights COVID’s Impact on Rural Hospitals

The COVID-19 pandemic is deepening health disparities and health inequity in rural hospitals and communities, according to a recent study released by The Chartis Group.

The report noted “the pandemic’s impact on rural communities portends a difficult period for the rural health safety net in the aftermath of the pandemic.” This includes new and increasing disparity gaps, particularly rural hospitals’ vulnerability to closure.

According to the study, in states where more than 15% of Black residents lived in rural communities, there was a trend of “higher rates of premature death and poverty, particularly in children,” which is associated with a negative impact on general health and development.

Staffing shortages also remain a concern that could further undermine the relative stability of the rural health safety net. While the report did cite “pandemic-related burnout and retirement” as reasons for nurse departures, according to the survey the most prevalent reason was for “more financially lucrative opportunities at other hospitals.” Fifty percent of respondents reported “nurse staffing issues had either resulted in a suspension of services…or it was something being considered.”

However, the analysis of recent hospital data indicates overall rural hospital operating margins have improved slightly, suggesting they have benefited from the $12 billion distributed through the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the COVID-19 Accelerated and Advance Payment (CAAP) program, and the American Rescue Plan. The report cautioned that reimbursement cuts, including the Medicare sequester, threaten this stability.

CMS Open Door Forum on Surprise Billing

On Wednesday, Feb. 23, the Centers for Medicare & Medicaid Services (CMS) will host an open door forum on specific provisions of the No Surprises Act from 1-2 p.m. CT. The session will provide information for providers and facilities on balance billing disclosure requirements, protections for certain continuing care patients whose plan terminates a contract with a provider, and requirements to protect patients and improve the accuracy of provider directory information.

Registration is not required, and interested providers may join the conference call by dialing 1-888-455-1397 (passcode: 5109694). The presentation slides for this conference call are available here, and providers may submit questions at any time to provider_enforcement@cms.hhs.gov.

REGISTER: IHA Virtual Legislative Advocacy Meetings

Over the next several weeks, the Illinois General Assembly will focus on the Illinois budget and other high-priority policy issues—including reauthorization of the Hospital Assessment Program, additional funding support for hospitals, the non-profit hospital sales tax exemption and investor-owned tax credit, and Nurse Compact legislation.

We strongly encourage you to meet virtually with your legislators. Please RSVP by Feb. 25 by clicking here so IHA can make the appropriate arrangements. For scheduling purposes, please indicate on the RSVP form which state legislators you would like to meet with and the order of your preference.

Illinois COVID-19 Update

The Illinois Dept. of Public Health (IDPH) today reported 2,538 new confirmed and probable COVID-19 cases, including 65 additional deaths.

Most recent IDPH hospitalization data show 1,611 individuals in Illinois were reported to be in the hospital with COVID-19. Of those, 298 patients were in the ICU and 146 patients were on ventilators.

The preliminary seven-day statewide positivity for cases as a percent of total tests is 2.5%. The preliminary seven-day statewide test positivity is 3.3%.

The seven-day rolling average of vaccines administered daily in Illinois is 21,021 doses. IDPH reported that 76.2% of adults (18 years and older) have been fully vaccinated, while 85.8% have received at least one vaccination dose. For the Illinois population 12 years and older, 75% have been fully vaccinated, while 84.4% have received at least one vaccination dose. For the Illinois population five years and older, 71.2% have been fully vaccinated and 80.5% have received at least one dose.

The Associated Press is reporting that an estimated 73% of Americans are now immune to the COVID-19 Omicron variant, a figure calculated by the Institute for Health Metrics and Evaluation. That number drives optimism from health experts that even if a future surge drives an increase in cases, hospitalizations and deaths will not substantially spike.

Briefly Noted

Researchers studying blood samples from 244 patients hospitalized for COVID-19 identified “rogue antibodies” that correlate with severe illness, which may help explain mechanisms associated with severe blood clotting. As compared to those from healthy controls, the COVID-19 samples contained higher levels of the antibody IgG. This antibody works with other immune cells, such as IgM, to respond to immune threats. However, higher levels of IgG were also associated with COVID-19 disease severity, such as in patients who required breathing assistance.