When millions in federal COVID-19 relief dollars started rolling in, St. Charles Health System in Bend, Ore., quickly created a tiger team of administrators, accountants and revenue cycle managers to devise a compliance game plan. Now, three accountants are working part-time to tackle the issue.
Halfway across the country in rural Arkansas, Magnolia Regional Medical Center’s entire administrative team is just three people. Part of the hospital’s accounting staff was furloughed until mid-May. Magnolia CEO Rex Jones said leadership has talked about tracking funds and is gathering information, but hasn’t adopted a formal plan.
“There are so many emails from everyone and their brother about different grants, and about what’s available in the grants, and their stipulations and requirements,” Jones said. “Having it all in one place would be great.”
The federal government has in recent weeks pumped hundreds of billions of dollars into the industry in a desperate, unprecedented bid to stem providers’ bleeding balance sheets. The funds are administered through a fragmented hodgepodge of federal agencies, and each funding stream has its own requirements and restrictions. Hospitals have had to make quick decisions on applications and compliance, and some were better equipped for the challenge than others.
The most direct, wide-ranging source of hospital aid comes from a $175 billion provider grant fund Congress created to offset coronavirus-related losses and expenses. Hospital executives generally appreciate that the funding has gone out quickly, but some say it barely made a dent in their losses.
St. Charles Chief Financial Officer Jennifer Welander said the system received $14.5 million from the CARES Act's provider relief fund, but that barely covered two weeks of operations considering the system at its lowest point in late April lost between $800,000 and $1 million per day due to volume reductions.
Large, for-profit systems have been tight-lipped about how much revenue they have lost, but have disclosed some grant receipts.
“We bolstered our balance sheet and liquidity with some support from the CARES Act, but (it was) not sufficient,” Tenet Healthcare Corp. CEO Ronald Rittenmeyer told investors on May 5. Tenet publicly disclosed receiving at least $345 million in CARES Act grant funds.
The funds came with strings attached. Hospitals receiving grant money had to attest that they wouldn’t balance-bill patients for COVID-19 care, and they can’t double-dip with expenses that are reimbursed from other sources. Each tranche of grant funds has its own set of conditions to follow, and HHS has tweaked the requirements several times with little notice.