**The current formula penalizes states like New Hampshire that have controlled the spread of COVID-19 in the community, but continue to face serious outbreaks in nursing & long-term care facilities**

**Despite 82 percent of all COVID-related deaths in New Hampshire being attributed to nursing facility residents – the highest rate in the nation – facilities only received an average of $4,909 from HHS, the third-lowest in the U.S.**

(Washington, DC) – U.S. Senators Jeanne Shaheen (D-NH) and Maggie Hassan (D-NH) and Representatives Annie Kuster (NH-02) and Chris Pappas (NH-01) sent a letter to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar, calling on the Department to update the methodology for distributing the next round of awards from the CARES Act’s $175 billion Provider Relief Fund to prioritize nursing homes and long-term care facilities in states like New Hampshire that have lower COVID-19 infection rates, but face serious issues with the spread of COVID-19 and mortality rates among residents of nursing facilities.

In New Hampshire, the pandemic has had a severe and disproportionate impact on nursing homes and long-term care facilities, with 82 percent of all COVID-related deaths in the state occurring among residents of these facilities – the highest rate in the country. Despite the urgent need for relief by these facilities, the latest round of funding from HHS for nursing homes was focused on facilities’ improvement on infection control measures relative to their surrounding communities. Considering how much lower COVID-19 spread and mortality is in New Hampshire’s surrounding communities – that are outside of these nursing facilities – it is difficult for New Hampshire nursing facilities to maintain lower infection and death rates in comparison. As a result of this methodology for calculating federal support, New Hampshire nursing facilities received significantly lower funding than what they need.

The delegation highlighted how this formula unfairly penalizes nursing facilities in New Hampshire, writing, “While we believe that it is important to reward quality improvement and performance on infection control in nursing homes, the current formula disadvantages nursing homes in states that have more effectively contained COVID-19 spread in the community but simultaneously have issues with COVID-19 infections and mortality in LTCFs.”

They noted how this disadvantage is particularly acute for New Hampshire, adding, “In total, 66 nursing facilities in New Hampshire received $324,014 in funding from this performance-based payment round, at an average of approximately $4,909 per facility. That $4,909 per-facility payment ranks third-lowest in the country, behind only Maine and Vermont. This low payment level comes despite the fact that approximately 82 percent of New Hampshire’s COVID-19 deaths come from nursing facility residents, the highest rate in the country. By comparison, the nationwide average per-facility payment from this grant round was $24,777, more than five times as much as New Hampshire facilities received.”

They continued, “…The fact that 82 percent of the COVID-19 deaths in the state come from nursing home residents shows that New Hampshire facilities need more help than ever. That is why incorporating measures of overall community spread of COVID-19 (outside of nursing facilities) into the formula is so damaging for states like New Hampshire… New Hampshire ranks third-to-last in terms of grant support from this latest round of Provider Relief Fund payments to nursing facilities.”

The delegation concluded by urging HHS to ensure that future rounds of nursing-specific grant funding from the Provider Relief Fund incorporate a more representative set of measures and statistics to ensure nursing facilities in New Hampshire and across the country get the support they need to match the scope of the crisis in these facilities, and protect the lives and health of nursing residents and caretakers.

The letter can be read in full here.

The New Hampshire delegation has fought to provide resources and support for Granite State nursing homes during the pandemic. In September, Shaheen questioned top Trump administration officials on the administration’s failure to fully distribute relief funds meant to help COVID-19 mitigation efforts at long-term care facilities. She has visited nursing facilities across New Hampshire to highlight the need to provide additional resources to providers in COVID-19 relief legislation.

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