COVID Timeline

The Centers for Disease Control and Prevention confirmed the first case of COVID-19 in the U.S.

AHCA/NCAL issued guidance to nursing homes and assisted living communities to limit all non-essential visits and screen essential personnel.

In a CNN interview, AHCA/NCAL President and CEO Mark Parkinson called on the Centers for Disease Control to provide adequate personal protective equipment (PPE) and testing for long term care communities in response to COVID-19, which he called “a perfect killing machine.”

The World Health Organization characterized COVID-19 as a pandemic.

AHCA/NCAL warned states to avoid directing nursing homes to accept all hospital patients who have not been tested for COVID-19, or without offering proper support to nursing homes with resources, such as PPE.

AHCA/NCAL called for increased support for long term care staffers who were taking bold steps to care for their residents.

Mark Parkinson conducted an interview on CNN, calling again for resources, saying “We are still fighting this incredible battle with two hands tied behind our back. On one hand is the lack of equipment…and the second hand tied behind our back is a lack of testing.”

AHCA/NCAL issued guidance to nursing homes and assisted living communities on reporting confirmed cases of COVID-19 to state officials as well as residents, family members and staff.

More than a month after AHCA/NCAL’s initial call for increased testing, Mark Parkinson was quoted by the Associated Press on testing needs.

“The country was so focused on making sure that hospitals were fully equipped and ready for a surge of admissions, we were really left behind.”

Mark Parkinson

The Centers for Disease Control revised its priority groups for testing, adding long term care residents and staff with symptoms of COVID-19 to the highest priority.

Mark Parkinson appeared on CNN again, urging that long term care residents and staff be made the priority for testing, equipment and resources.

AHCA/NCAL once again called for the prioritization of long term care providers for equipment and testing.

CMS announced the formation of an independent commission to conduct a comprehensive assessment of the long term care industry’s response to COVID-19. AHCA/NCAL applauded this decision.

In a New York Times letter to the editor, Mark Parkinson highlighted the heroic efforts of long term care staff, and called for additional resources including PPE, testing and staffing support.

Long-term care providers are facing a historic threat from COVID-19, and our caregivers are among the heroes of this fight.

Mark Parkinson

AHCA/NCAL sent a letter to HHS and FEMA requesting $10 billion in support for long term care providers. That same day, Dr. David Gifford was interviewed on C-SPAN’s Washington Journal where he talked about the desperate need for PPE in nursing homes and assisted living communities.

AHCA/NCAL sent the nation’s governors a Workforce Roadmap to offer ideas that will help provide additional staff support on the frontlines.

“Governors must take immediate action to help protect those currently on the frontlines and take proactive steps to recruit, train and deploy additional caregivers to ensure that residents continue to receive the daily care they need in our facilities. This is an ‘all hands-on deck’ situation.”

Mark Parkinson

HHS announced $4.9 billion in funding for skilled nursing facilities. AHCA/NCAL applauded this announcement, but called for additional support – especially for assisted living providers who still had not received any direct aid.

Mark Parkinson was interviewed on Fox News Sunday. He spoke about the impact of case numbers in the surrounding community on long term care providers and the need for increased testing to reopen facilities and reconnect residents with their loved ones.

An analysis conducted by AHCA/NCAL found that testing all 4.4 million long term care residents and staff only once would cost $672 million.

AHCA/NCAL sent a letter to HHS and FEMA, requesting support and funding for assisted living providers who primarily care for seniors, but have not received any federal aid.

“The price of inaction would be devastating – to our residents, to their loved ones, and to those who work in assisted living communities who see their residents as family members.”

Mark Parkinson and Scott Tittle

The Centers for Disease Control revised guidance to nursing home personnel on wearing face masks from wearing around suspected or confirmed cases to wearing a face mask at all times while they are in the facility.

AHCA/NCAL released a survey of its members, which found that 87% nursing homes and assisted living communities are having to wait two days or more for test results.

NCAL signed a letter with Argentum, LeadingAge and the American Senior Housing Association requesting Congressional leadership to provide assistance to assisted living and senior living providers in their next COVID-19 stimulus package.

“As Congress considers next steps in its response, our communities and the millions of seniors under our care must be prioritized to ensure that senior living remains a viable option for the foreseeable future.”

AHCA/NCAL called on Congress to provide funding to nursing homes and assisted living communities for testing, PPE and staffing support. Additionally, AHCA/NCAL called for long term care communities to be prioritized for vaccine distribution.

President Donald Trump announced an additional $5 billion in additional Provider Relief Funds allocated for nursing homes. AHCA/NCAL applauded the announcement, but called on Congress to prioritize additional resources and support for long term care providers in their next COVID-19 legislation.

The U.S. Department of Health and Human Services (HHS) announced a $5 billion allocation for nursing homes from the Provider Relief Fund. $2.5 billion was provided in upfront funding to support increased testing, staffing and PPE needs with additional funding available for those establishing COVID-19 isolation facilities.

AHCA/NCAL released a report showing nursing homes in the U.S. have experienced an alarming spike in new COVID-19 cases due to community spread among the general population.

AHCA/NCAL released the results of a survey of U.S. nursing homes. According to the data, providers are facing increased costs and declining revenue as a result of COVID-19, and 72% of nursing homes said they won’t be able to sustain operations another year at the current pace.

The National Center for Assisted Living released the results of a national survey of assisted living providers on their financial situation amidst growing costs and declining revenues due to COVID-19. Unlike nursing homes, assisted living providers have not received any direct federal funding or support for personal protective equipment or testing.

The Centers for Medicare & Medicaid Services (CMS) announced new testing requirements for nursing homes. The new rules required nursing homes to routinely test staff and offer tests to residents when there is an outbreak or residents show symptoms.  

The U.S. Department of Health and Human Services (HHS) announced that assisted living providers could apply for COVID-19 relief funding as provided by the CARES Act and the Paycheck Protection Program and Health Care Enhancement Act. NCAL Executive Director Scott Tittle commented on the announcement, thanking HHS for their efforts to prioritize our nation’s assisted living communities.

“This financial aid is welcome news for the tens of thousands of assisted living providers and the hundreds of thousands of seniors they serve.”

Scott Tittle – Executive Director, National Center for Assisted Living

HHS announced a $2 billion incentive payment plan for nursing homes as part of the $5 billion Provider Relief Fund distribution announced in early August. Nursing homes will have their performance measured on their ability to keep new COVID infection rates and mortality low among residents.

AHCA/NCAL President & CEO Mark Parkinson published an op-ed on LinkedIn discussing the steps public health officials should take so long term care facilities can safely resume visitations.

AHCA/NCAL President and CEO Mark Parkinson had a letter to the editor published in The New York Times highlighting the lack of assistance long term care providers received at the beginning of the pandemic, as well as long standing staffing shortages and low Medicaid reimbursement rates. He called on Congress to help us address this historic challenge.

“Though nursing homes care for one of the most vulnerable populations, the focus remained on hospitals. Lack of access to personal protective equipment and testing was a serious challenge.”

Mark Parkinson, AHCA/NCAL President and CEO

The Centers for Medicare and Medicaid Services issued revised guidance providing detailed recommendations on ways nursing homes can safely facilitate visitation during the COVID-19 pandemic.

AHCA/NCAL President and CEO penned an op-ed in Provider Magazine calling attention to the lack of support long term care providers received early in the pandemic and called for additional support from Congress in COVID-19 relief funding and future Medicaid reimbursement reforms.

“Caregivers in nursing homes and assisted living communities have done everything in their power to protect our most vulnerable from COVID-19. Despite unprecedented challenges and delayed support early on, they have bravely answered the call of duty and have saved thousands of lives.”

Mark Parkinson, AHCA/NCAL President and CEO

The Trump administration announced a plan to distribute 150 million rapid COVID-19 tests, including 18 million for nursing homes and 15 million for assisted living communities.

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) sent a letter to the National Governors Association (NGA) and state governors urging them to prioritize COVID-19 vaccine distribution to all long term care communities.

“Given that long term care facilities care for our most vulnerable when it comes to this virus and employ hundreds of thousands of essential health care workers, we urge that your plans to the CDC make residents and staff of these settings the highest priority for the vaccine.”

Mark Parkinson and Scott Tittle

The Department of Health and Human Services announced a partnership with CVS and Walgreens to deliver and administer COVID-19 vaccines to long term care facilities when they are available.

The American Health Care Association/National Center for Assisted Living released a report showing U.S. long term care communities could see a third spike of increasing new COVID-19 cases due to community spread among the general population.

In response to a recent decision by State Administrative Law Judge Matt Perkins regarding Life Care Center of Kirkland in Washington State, AHCA/NCAL President & CEO Mark Parkinson penned an op-ed in Morning Consult calling for more coordination between providers, public health officials and lawmakers to protect vulnerable long term care residents.

AHCA/NCAL released a report showing increased COVID-19 cases in nursing homes as a result of community spread among the general population. During the week of October 18, 43% of new COVID cases in nursing homes were from Midwest states with major spikes in community spread in the upper parts of the region.

AHCA/NCAL released a statement applauding H.R. 8540, the Keeping Seniors Safe from COVID-19 Through Home Design Act. The bill would commission a study by the federal government that would develop best practices in senior housing design to mitigate the spread of COVID-19 and other contagious diseases.

“As we look to the future, we must take the lessons we’ve learned from the COVID-19 pandemic to adopt meaningful reforms that will ensure long term care providers are equipped to handle future public health crises.”

Mark Parkinson – President and CEO, AHCA/NCAL

AHCA/NCAL released a statement following the 2020 election congratulating President-elect Joe Biden and all those elected to Congress. President and CEO Mark Parkinson also expressed the need for immediate action from Congress to get long term care providers the resources they need.

AHCA/NCAL released updated data showing a spike in new COVID-19 cases in nursing homes, due to community spread among the general public.

AHCA/NCAL urged Americans to exercise caution around holiday gatherings to limit community spread of COVID-19 and stop the virus from entering long term care communities.

“We understand everyone wants to see their family and friends during the holidays, but we really need to consider our parents and grandparents who are living in our nation’s long term care facilities.”

Dr. David Gifford – Chief Medical Officer, AHCA/NCAL

AHCA/NCAL released a report showing that weekly new COVID-19 cases in nursing homes had reached a record high due to community spread among the general population.

Mark Parkinson, AHCA/NCAL President & CEO, appeared on CNN with Kate Bolduan to discuss the need for caution from the general public celebrating the holidays and prioritization for long term care residents to receive the COVID-19 vaccine.

AHCA/NCAL President and CEO Mark Parkinson appeared on Good Morning America to discuss the impacts of COVID-19 on long term care communities as cases reached record highs.

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted to recommend health care workers and long term care residents receive the first doses of a COVID-19 vaccine when it is available. AHCA/NCAL applauded this decision, and called on governors to implement this guidance to protect long term care residents and staff.

AHCA/NCAL President and CEO Mark Parkinson joined The News with Shepard Smith on CNBC to discuss the need for long term care residents and staff to be prioritized for the COVID-19 vaccine.

President-Elect Joe Biden nominated California Attorney General Xavier Becerra for Secretary of the U.S. Department of Health and Human Services (HHS). AHCA/NCAL congratulated Becerra and expressed optimism that they could work together to improve long term care using lessons learned from the COVID-19 pandemic.

An advisory panel formally recommended that the Food and Drug Administration authorize Pfizer’s COVID-19 vaccine. AHCA/NCAL has previously expressed the need for long term care staff and residents to be prioritized to receive the vaccine once available.

The U.S. Food and Drug Administration approved an emergency use authorization for Pfizer and BioNTech’s coronavirus vaccine. AHCA/NCAL welcomed this authorization and called on governors to prioritize long term care residents and staff in distribution plans.

AHCA/NCAL released the results from a survey of nursing homes, which found two-thirds won’t make it another year given increased costs due to COVID.

AHCA/NCAL released an updated report showing record-breaking numbers of new COVID-19 cases among nursing home residents.

AHCA/NCAL released a statement criticizing the latest COVID-19 relief package, calling for more financial support for long term care providers who are facing increased costs and imminent closures.

In a letter to Alex Azar, Secretary of Health and Human Services, AHCA/NCAL urged the federal government to extend the COVID-19 public health emergency beyond its January 23, 2021 expiration date so health care providers can continue to offer the most efficient and effective care possible during the continuing COVID-19 pandemic.

AHCA/NCAL called on Congress for immediate support to help long term care providers continue to fight COVID-19.

AHCA/NCAL called for workforce support as long term care staff are stretched thin and exhausted from the pandemic.

“COVID-19 is taking a considerable toll, physically and emotionally, on our health care heroes in long term care … Burnout is a real concern for all health care workers during this pandemic.”

Dr. David Gifford – Chief Medical Officer, American Health Care Association/National Center for Assisted Living

The Center for Health Policy Evaluation in Long Term Care (CHPE) released an analysis indicating that COVID-19 vaccines may be reducing spread of the virus in nursing homes. AHCA/NCAL called for additional research to help expedite the reopening on long term care facilities to visitors and group activities.

AHCA/NCAL conducted an analysis that estimated that the long term care industry is expected to lose $94 billion over a two-year period (2020-2021). The same analysis estimated that without immediate assistance, more than 1,600 nursing homes could close in 2021.

AHCA and LeadingAge, with support from the CDC, announced the nationwide goal of getting 75% of the approximately 1.5 million nursing home staff vaccinated by June 30, 2021.

AHCA/NCAL president & CEO Mark Parkinson joined Kate Bolduan to talk about a new report showing that to due long term care being made a priority for the vaccines, nursing homes in the U.S. have experienced an 82% drop in new COVID-19 cases since their peak in December, the lowest number of new cases since the federal government started tracking in May 2020.

AHCA/NCAL expanded the #GetVaccinated campaign with a new website and ad campaign, encouraging long term care staff and others to get vaccinated against COVID-19.

AHCA/NCAL sent letters to White House Senior Advisor Andy Slavitt, White House Senior Policy Advisor for COVID-19 Equity Dr. Cameron Webb and the National Governors Association, requesting that long term care facilities remain a priority for the COVID-19 vaccines as the next phase of distribution begins.

The American Health Care Association and LeadingAge released the Care For Our Seniors Act, a reform agenda to address long-standing challenges affecting the quality of care provided in America’s nursing homes.

A new survey by OnShift reveals that between December 2020 and March 2021, willingness of long term care staff to get the COVID-19 vaccine increased by 94 percent, and plans to decline decreased by 41 percent.

AHCA/NCAL urged members of the public to get vaccinated and slow the spread in the face of rising community cases of COVID-19.

In observance of Careers in Aging Week, AHCA/NCAL called on lawmakers to help address workforce challenges in long term care with meaningful policy solutions.

As Congress debates a major infrastructure package, AHCA/NCAL again called on lawmakers to support the Care For Our Seniors Act to transform and modernize nursing home structures. Shifting to private rooms in nursing homes would offer residents more privacy and dignity, as well as support infection prevention and control.

In response to COVID-19 vaccinations, CMS and CDC reduced restrictions on testing, visitations, and activities for fully vaccinated residents in long term care facilities.

The nursing home industry called on policymakers to aid facilities in preparing for future infectious disease outbreaks, with federal and state stockpiles supporting at least a 30-day supply of masks, gowns, gloves and other PPE at every nursing home in the country.

The Center for Medicare and Medicaid Services (CMS) announced its interim final rule which requires long term care facilities to publicly report its vaccination rates. AHCA/NCAL, which has supported publicly reporting vaccination rates, said they appreciated CMS taking this step as it helps facilitate in-person visits, track vaccine effectiveness and helps ensure the industry meets its goal to vaccinate 75 percent of staff by the end of June. 

The Center for Health Policy and Evaluation in Long-Term Care, the research division of AHCA/NCAL, published a study in the Journal of the American Geriatrics Society which found that Pfizer-BioNTech COVID-19 vaccines are effective in reducing new cases and deaths among residents and staff in long term care. The study’s findings confirm continued calls to prioritize long term care residents and staff for the vaccines.

Following a U.S. Senate Health, Education, Labor & Pensions Committee hearing on the dire shortage of workers in health care, AHCA/NCAL President and CEO Mark Parkinson thanked Senator Susan Collins (R-ME) for bringing attention to the issue within nursing homes and urged lawmakers to work together with industry leaders on policies that will address the crisis.

The U.S. Department of Health and Human Services (HHS) revised reporting requirements for recipients, such as nursing homes and assisted living communities, of Provider Relief Fund payments. AHCA/NCAL applauded the news, as the association and more than 100 members of Congress had asked for flexibilities since long term care providers are still grappling with ongoing costs to address the COVID-19 pandemic.

The Occupational Safety and Health Administration (OSHA) released Emergency Temporary Standards (ETS) to address exposure to COVID-19 to workers in health care settings. Providers had to be in compliance with most of the ETS by July 6, 2021. AHCA/NCAL requested flexibility and recognition of good faith efforts given the complexity of the standards with little time to implement.

AHCA/NCAL released a survey that shows 94% of nursing homes and 81% of assisted living communities have experienced a shortage of workers recently. Providers across the U.S. struggled with workforce shortages before the COVID-19 pandemic, but now three-quarters of nursing homes and more than half of assisted living communities say their facility’s workforce situation has gotten worse compared to 2020.  

AHCA/NCAL Chief Medical Officer Dr. David Gifford said that while the nursing home industry has made significant progress in increasing COVID-19 vaccinations among staff, more work needs to be done. 

AHCA/NCAL called on HHS to release the remainder of the Provider Relief Fund after recent survey results highlighted the severity of the economic crisis within the long term care industry due to the COVID-19 pandemic. 

Our sluggish economic recovery puts thousands of facilities in danger of closing, threatening access to long term care for vulnerable seniors and individuals with disabilities.

Mark Parkinson

AHCA/NCAL urged lawmakers allocate funding to help nursing homes and assisted living communities make capital improvements, so residents can receive the highest quality of care and additional protection. Any infrastructure package should include helping facilities upgrade their indoor air quality, technology, emergency preparedness back-up systems, and sanitization and monitoring practices.

AHCA/NCAL issued a statement urging lawmakers to avoid using unused Provider Relief Funds to cover the costs of a potential infrastructure package. With the Delta variant spreading throughout the U.S., long term care providers need ongoing support as they continue to fight the virus. 

With COVID cases rising across the country due to the highly contagious Delta variant, AHCA/NCAL issued a policy statement strongly urging all long term care personnel to get vaccinated and expressed support for providers who adopt mandatory staff COVID-19 vaccine policies in their facilities. 

AHCA/NCAL CEO issued a statement praising a group of lawmakers for their work around the reauthorization and modernization of the Elder Justice Act. The bill includes proposals from the Care for Our Seniors Act that will help long term care facilities invest in their workforce.

We are glad to see policymakers provide a desperately needed focus on workforce investment, including assistance for caregivers with everyday life, like loans, tuition, childcare and transportation.

Mark Parkinson, AHCA/NCAL CEO and President

AHCA/NCAL sent a letter to U.S. Department of Health and Human Services Secretary Xavier Becerra urging the agency to allocate $13 billion from the Provider Relief Fund to long term care providers. 

Ensuring that this funding is delivered to long term care providers immediately is critical to our primary role of caring for and protecting our nation’s seniors and most vulnerable.”

Mark Parkinson

AHCA/NCAL expressed appreciation to the Biden Administration for their plan to deliver COVID-19 booster shots directly to long term care residents and staff and pledged to work with public health officials to advise and streamline the process.

AHCA/NCAL sent a letter to HHS Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure, offering several solutions to ensure success of the administration’s vaccine mandate policy for nursing homes, including applying the policy to all health care settings and dedicating resources to providers to support their vaccination efforts.

AHCA/NCAL President and CEO Mark Parkinson appeared on ABC’s GMA3 to discuss President Biden’s federal vaccine mandate for nursing home workers. He said nursing homes could lose “tens of thousands, maybe hundreds of thousands” of employees and encouraged the administration to mandate vaccinations for all health care workers.

America’s nursing homes faced challenges long before the COVID-19 pandemic. In Why It’s Time To Transform America’s Nursing Homes, AHCA leaders and long term care providers urge lawmakers to apply the lessons of the pandemic to improve quality of care in our nursing homes.

More than 40 U.S. senators, led by Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH) signed a letter to HHS Secretary Xavier Becerra urging the department to distribute the remaining resources of the Provider Relief Fund to health care providers, including nursing homes and assisted living communities.

In a letter to HHS, Senate Republican Leader Mitch McConnell (R-KY) and Senators Roy Blunt (R-MO), Richard Burr (R-NC), Richard Shelby (R-AL) and Mike Crapo (R-ID) note that it has been 11 months since the last PRF distribution. As the nation experiences the “fourth wave” of the pandemic, the senators urged the department to immediately allocate funds to health care providers. 

AHCA/NCAL expressed the need for longer-term investments from the federal government. They called on Congress to allocate resources in the bipartisan infrastructure package that are necessary to help improve quality of care.

AHCA/NCAL released a survey highlighting the urgent need for Congress to address the labor shortage within the long term care industry. The survey shows that 99% of nursing homes and 96% of assisted living communities in the U.S. are facing a workforce crisis. 

AHCA/NCAL expressed appreciation to the CDC and FDA for recognizing the high-risk exposure of COVID-19 within the long term care industry and approving the Pfizer booster shot for residents and staff. 

AHCA/NCAL applauded Congressman Fred Keller (R-PA) for introducing the Strengthening Knowledge, Improving Learning, and Livelihoods (SKILLS) Act, which would create a pipeline of essential workers for the long term care sector. 

We appreciate Congressman Keller making the long term care workforce a priority, and we look forward to working with him to help pass this bill.

Mark Parkinson AHCA/NCAL CEO and President

Direct care staffing agencies are charging exorbitant prices to long term care facilities that need caregivers in the midst of an ongoing workforce crisis. AHCA/NCAL sent a letter to the Federal Trade Commission, requesting assistance in combating price-gouging practices. 

Following approval from the FDA, the CDC recommended Moderna and Johnson & Johnson vaccine booster shots for certain groups, including long term care residents and workers. Individuals can also mix and match vaccine brands for their booster dose. AHCA/NCAL applauded the news.

The rollout of the Pfizer booster shot has gone incredibly well in long term care, and we are confident that adding Moderna and Johnson and Johnson into the mix will catapult our efforts.”

Dr. David Gifford, AHCA/NCAL Chief Medical Officer

Ahead of a U.S. House Energy & Commerce Health Subcommittee hearing on supporting caregivers and health care providers, AHCA/NCAL issued support for HR.331, the Nurses Certification and Recognition of Experience (Nurses CARE) Act and H.R. 5602, the Bolstering Infectious Outbreaks (BIO) Preparedness Workforce Act of 2021, which would help alleviate staffing challenges and recruit more workers to the industry. 

The Occupational Safety and Health Administration (OSHA) and the Centers for Medicare and Medicaid Services (CMS) each issued emergency regulations requiring all workers in large private businesses and Medicare and Medicaid-certified health care settings to be vaccinated against COVID-19. AHCA/NCAL warned that the CMS policy, which does not include any resources for providers, could exacerbate the workforce crisis within long term care. 

Even a small percentage of staff members leaving their jobs due to this mandate would have a disastrous impact on vulnerable seniors who need around-the-clock care.

Mark Parkinson, AHCA/NCAL President and CEO

A new provision in the Build Back Better Act (H.R. 5376) would require nursing homes to have a registered nurse (RN) on-staff at all times. AHCA/NCAL supports having a 24-hour RN on staff, but without funding and coordinated efforts to attract more caregivers to the profession, the provision will further limit access to care. 

Lawmakers should remove this provision from the reconciliation package and give this matter the thorough consideration it deserves

Clif Porter, AHCA/NCAL Senior Vice President for Government Relations

Industry leaders held a press conference regarding two provisions in the Build Back Better Act (H.R. 5376) that will have a devastating impact on nursing homes and could force thousands more facilities to further limit admissions or possibly close their doors. The unfunded staffing mandates would cost billions of dollars a year and require hiring more than 150,000 new caregivers. 

AHCA/NCAL produced and released a short film documentary titled, “Closed Doors, Open Hearts: Nursing Homes and COVID-19” to highlight the many challenges for long term care residents and families, as well as the heroes that fought to keep residents safe during the COVID-19 pandemic. 

AHCA/NCAL expressed appreciation after the U.S.District Court in the Western District of Louisiana issued a nationwide injunction on the CMS vaccine mandate for health care workers, citing concern that the mandate will worsen the historic labor crisis within the industry.

We continue to urge CMS to allow a regular testing option for unvaccinated staff and, therefore, support any legal remedy or CMS action that would bring about this solution.”

Mark Parkinson, AHCA/NCAL CEO and President

Lawmakers passed the Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610), helping to protect beneficiary access to essential healthcare services by temporarily reducing or delaying Medicare payment cuts scheduled for 2022. AHCA/NCAL thanked members of Congress:

This interim relief is appreciated, and we are eager to work with Members of both houses to enact permanent solutions in the new year.

Clif Porter, AHCA/NCAL Senior Vice President of Governmental Relations

AHCA/NCAL President and CEO Mark Parkinson joined Kate Bolduan on CNN, sharing that 55 percent of long term care residents have received their COVID booster so far – more than double the percentage of the general population. As providers continue to make booster uptake their top priority, Parkinson said, “It is absolutely critical to get the booster vaccine. Whether you’re in a nursing home or an assisted living community, or just a resident in the general population.” 

With the Omicron variant projected to last for weeks to come and long term care facilities continuing to face a historic labor crisis, AHCA/NCAL sent a letter to  U.S. Human and Health Services Secretary Xavier Becerra to request the extension of the Public Health Emergency, which is set  to end on January 16th. 

A new report shows that COVID-19 cases have significantly increased in nursing homes due to community spread among the general population according to the data released by the CDC. AHCA/NCAL is calling on public health officials to direct support toward long term care and on members of the public to get vaccinated and boosted. 

AHCA/NCAL expressed concern that the repercussions of the federal vaccine mandate for health care workers would further devastate an already decimated workforce and asked that CMS and state surveyors consider regular testing options for unvaccinated staff to prevent worsening staff shortages. 

When we are in the midst of another COVID surge, caregivers in vaccine hesitant communities may walk off the job because of this policy, further threatening access to care for thousands of our nation’s seniors.

Mark Parkinson, AHCA/NCAL CEO and President

Nurse and direct care staffing agencies are exploiting the critical workforce shortage within the health care system, charging exorbitantly high prices that hospitals and nursing homes have no choice but to pay. AHCA/NCAL and the American Hospital Association (AHA)  sent a joint letter to White House COVID-19 Response Team Coordinator Jeffrey Zients to request immediate assistance from the federal government. 

The[RR1]  workforce challenges in the U.S. long term care industry, which have been exacerbated by the pandemic, remains at a crisis level. A report from AHCA/NCAL showed that overall long term care workforce levels are the lowest they have been in 15 years.

In a hearing before the U.S. Senate Subcommittee on Employment and Workplace Safety, lawmakers expressed their commitment to addressing the health care labor crisis that has grown increasingly more severe as the pandemic continues.

AHCA/NCAL President & CEO Mark Parkinson sent a letter to Congressional leadership urging them to take additional steps to help long term care facilities respond to Omicron, address staffing shortages, and keep their doors open for their residents.

Ahead of the State of the Union, the White House released a set of proposals to reform nursing homes. The industry responded:

“Additional oversight without corresponding assistance will not improve resident care. To make real improvements, we need policymakers to prioritize investing in this chronically underfunded health care sector and support providers’ improvement on the metrics that matter for residents.

Mark Parkinson, AHCA/NCAL CEO and President

AHCA/NCAL released a new report by CLA (CliftonLarsenAllen LLP) demonstrating the financial impact of the COVID-19 pandemic on the nation’s nursing homes. Skyrocketing labor costs coupled with declining revenue has resulted in negative operating margins. The economic crisis threatens more facility closures and therefore, reduced access to care for seniors across the country.

After President Biden’s remarks during the State of The Union, AHCA/NCAL sent a letter to U.S. Department of Health and Human Services (HHS) requesting a meeting with the White House, HHS, and CMS to clarify some of the inaccuracies informing the president’s nursing home reform agenda.

A new report released by AHCA/NCAL highlights federal data that shows the quality of care in nursing homes had been on an upward trend in the 10 years prior to the COVID-19 pandemic.

In a new report summarizing Bureau of Labor Statistics data, AHCA/NCAL found that nursing homes lost another 2,500 jobs in March, deepening a historic labor crisis that is worse than any other health care sector. The entire long term care industry has lost more than 400,000 employees since the start of pandemic.

The Centers for Medicaid & Medicare Services announced it would be ending a number of pandemic-related emergency waivers for long term care facilities, but not hospitals. AHCA/NCAL raised concerns about the phase out of the waivers while the industry is facing a historic workforce crisis.  

This pandemic is far from over, and the long term care workforce crisis has never been more dire. Now is not the time to let crucial supports and flexibilities necessary to combat the virus end.

Holly Harmon, RN, Senior Vice President of Quality, Regulatory & Clinical Services for AHCA/NCAL

The Centers for Medicare and Medicaid Services released a proposed rule for the Skilled Nursing Facility Prospective Payment System for FY 2023 and proposed cutting Medicare payments by $320 million. Industry leaders warned cuts could deepen the sector’s economic crisis.

Many nursing homes already face imminent closure, and this Medicare cut could force more seniors across the country to relocate and find alternative care farther away from family and loved ones.”

Mark Parkinson, President and CEO of AHCA

A new report from AHCA/NCAL highlights nursing homes closures across the country since 2015. The data shows that over 300 facilities have closed during the COVID-19 pandemic began in 2020 and more than 400 more are projected to close in 2022, based on current financials. 

AHCA/NCAL joined 15 other national health care organizations in sending a letter to U.S. Health and Human Services Secretary Xavier Becerra to request an extension of the Public Health Emergency declaration. The organizations argued that the PHE offers key resources and flexibilities that are critical to helping providers adapt to the changing dynamics of the ongoing pandemic. 

A new report from the Assistant Secretary for Planning and Evaluation (ASPE) found that long term care facilities were more heavily impacted by workforce shortages than other health care sectors. The report found that between December 2020 and December 2021, hospitals lost 32,900 employees while nursing and residential care facilities lost upwards of 145,000 workers.

AHCA released a report conducted by accounting and consulting firm CLA, which found that the nursing home economic crisis has a disproportionate impact on minorities and more clinically complex residents. The study found that nursing homes considered at financial risk tend to reside in counties that serve a higher proportion of racial and ethnic minorities, as well as residents with a higher average clinical risk score. 

A new survey released by AHCA highlights the severe staffing and economic crises that nursing home providers across the U.S. continue to face. Sixty percent of nursing homes providers say their workforce situation has worsened since January, and 73 percent are concerned that staffing challenges may force them to close.

NCAL released the results of its “State of the Assisted Living Industry” survey, revealing that assisted living providers are still facing a serious staffing and economic crisis. Eighty-seven percent of respondents said they are experiencing difficulty hiring new staff and more than half of providers said their overall workforce situation has worsened since January 2022.

The Centers for Medicare and Medicaid Services (CMS) rescinded guidance that state inspectors working under contract with the agency to inspect nursing homes must be fully vaccinated against COVID-19. The Advancing Excellence in Long-Term Care Collaborative issued a statement criticizing the move, citing staff vaccination requirements, increasing COVID-19 cases, the continuous emergence of new variants, and the CDC’s recommendation for additional booster shots for older adults.

Bipartisan groups of both the U.S. Senate and House of Representatives sent letters to Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure, urging the Biden administration to reconsider a proposed $330 million cut in Medicare funding for nursing homes. In a statement, AHCA/NCAL underscored the negative impact funding cuts would have on seniors, especially as the long term care industry continues to grapple with a historic workforce and economic crisis.

Cutting millions in nursing home funding will put access to care for our most vulnerable citizens at risk.

Mark Parkinson, AHCA/NCAL CEO and President

With the Biden Administration proposing a minimum staffing requirement for nursing homes, a new report by CliftonLarsonAllen found that the mandate would require hiring more than 187,000 nurses and nurses’ aides at a cost of $10 billion annually for their wages and benefits. CLA estimates that more than 215,000 nursing home residents could be displaced as many facilities would have to reduce their census in order to meet the staffing ratio requirement. 

AHCA/NCAL sent a letter to HHS Secretary Xavier Becerra requesting the extension of the Public Health Emergency in the midst of new COVID-19 variants emerging and flu season approaching. In addition, AHCA/NCAL requested for HHS to update its COVID-19 guidance for health care settings.

A new AHCA/NCAL report projects that without government assistance, the nursing home workforce will not recover to pre-pandemic levels until at least 2026. The projection is based on the nursing home sector’s modest, average job gains from the last four months.

A bipartisan group of 14 lawmakers sent a letter to CMS requesting the agency’s support of H.R. 7744, the Building America’s Healthcare Workforce Act. The AHCA/NCAL-backed bill would extend 1135 waiver flexibilities for temporary nursing aides (TNAs) serving in nursing homes for 24 months after the public health emergency (PHE) ends.

The House Select Subcommittee on the Coronavirus Crisis held a hearing on the impact of COVID-19 on nursing homes and released a corresponding a report. AHCA/NCAL President and CEO Mark Parkinson reacted to the hearing and report, highlighting that lawmakers focused on the early stages of the pandemic, and that progress was seen after long term care received the aid needed.

Noting the progress made in being able to fight COVID-19, the Centers for Disease Control and Prevention (CDC) updated protocols for health care settings, including nursing homes and assisted living communities. AHCA/NCAL welcomed the news, stating it will help improve residents’ quality of life.

AHCA/NCAL released a statement urging CMS to reissue a blanket waiver that allowed nursing homes to employ temporary nurse aides (TNAs) during the pandemic. The deadline for current TNAs  to become certified nursing assistants (CNAs) is this Friday, October 7th. If CMS does not reissue the nationwide waiver, thousands of TNAs will lose their jobs.

AHCA/NCAL expressed disappointment after the Centers for Medicare & Medicaid Services (CMS) allowed the nationwide temporary nurse aide (TNA) waiver to expire. The waiver allowed nursing homes to employ TNAs during the COVID-19 pandemic. Thousands of TNAs stand to lose their jobs as a result, all while nursing homes continue to battle historic staffing shortages. 

Health and Human Services (HHS) Secretary Xavier Becerra extended the COVID-19 public health emergency (PHE) effective through January 11, 2023. With new COVID-19 variants emerging and the start of flu season, extending the PHE will ensure that long term care facilities have the necessary resources to continue providing quality care to our nation’s seniors. 

AHCA/NCAL sent a letter to U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra requesting an extension of the Public Health Emergency (PHE). Extending the PHE declaration beyond its current January 11, 2023 expiration will ensure long term care and other health care providers have the necessary resources to continue providing quality care for America’s most vulnerable population.

AHCA/NCAL and LeadingAge applauded the White House for announcing a six-week campaign to increase COVID booster shots, especially among older adults. The two organizations released a plan to specifically target residents in long term care communities by working with public health agencies and other health care providers.

Analyzing CDC and CMS data, the Government Accountability Office found that transmission of COVID-19 in the community surrounding a nursing home, known as community spread, had the strongest association with the duration of an outbreak.

AHCA/NCAL recently released an updated report from CLA regarding a potential federal staffing minimum for America’s nursing homes. CLA estimates more than 191,000 nurses and nurse’s aides are needed at the annual cost of $11.3 billion in order for nursing homes to meet the potential staffing mandate.

In a letter to the U.S. Occupational Safety and Health Administration (OSHA), AHCA/NCAL requested that workplace safety standards remain consistent with updated CDC COVID-19 standards, expressing that the protocols previously established are no longer prudent due to new, less severe COVID-19 variants.

An AHCA/NCAL survey reveals nursing home providers continue to face a labor and economic crisis nearly three years into the COVID-19 pandemic. More than half of nursing homes are having to turn away new residents because of staffing shortages.

AHCA/NCAL launched Careers in Caring, a national campaign to address staffing shortages and strengthen the long term care workforce. The campaign’s dedicated website, CareersInCare.org, is a one-stop shop of resources and tools to assist long term care providers and professionals in their hiring efforts.

An analysis of year-end data from the Bureau of Labor Statistics shows that nursing homes have lost 210,000 jobs over the course of the pandemic–the worst job loss of any health care sector. At the current pace of job growth, the nursing home workforce would not return to pre-pandemic levels until 2027.

The Biden Administration informed Congress that the COVID-19 Public Health Emergency will end May 11, 2023. For long term care, this means the end of many flexibilities and resources that helped providers in fighting the virus and providing efficient and effective care during the pandemic.

AHCA/NCAL released  its State of the Nursing Home Sector report, a data-backed overview of the industry’s historic labor shortage and financial crisis and their impact on access to care. The report underscores the urgent need for lawmakers to pass meaningful reforms to help strengthen nursing homes.  

Members of the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing to discuss the impact that nationwide staffing shortages are having on our healthcare system. In a statement released ahead of the hearing, AHCA/NCAL underscored the acute crisis within the long term care sector and called on Members of Congress to make meaningful investments that will better support and strengthen its workforce.

In an op-ed in RealClearHealth, Mark Parkinson, president and CEO of AHCA/NCAL discusses the current state of nursing homes and the negative impact an unfunded federal staffing mandate would have on seniors’ access to care. Instead of a one-size-fits-all approach, Parkinson calls on policymakers to work together to pass comprehensive solutions that will help rebuild and strengthen the nursing home workforce.

The Biden Administration has invested trillions in private industries and government sectors to help create jobs. Instead of unfunded staffing mandates, AHCA called on leaders in Washington to take the same approach and invest in long term care to help grow its workforce.

The National Center for Assisted Living (NCAL) released a white paper,“The Importance of Expanding Affordable Living Options and Proposed Solutions,” outlining challenges with affordable assisted living and NCAL’s proposed solutions. In addition to the white paper, NCAL is developing resources to help members explore the idea of moving into the affordable assisted living space.

In a  joint letter, the American Hospital Association (AHA) and the American Health Care Association (AHCA) urged Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure against unfunded federal staffing mandates ahead of the administration’s anticipated regulation. The groups warned that an unfunded mandate would put seniors’ access to care at further risk and exacerbate capacity issues for hospitals.

The U.S. State Department indicated a green card freeze impacting international nurses at a time when the long term sector desperately needs more nurses. AHCA/NCAL called on Congress to expand and expedite opportunities for international caregivers, as immigrants make up a vital part of the long term care workforce and are helping to address the sector’s historic labor crisis.

The U.S. Department of Health and Human Services let the COVID-19 public health emergency come to an end. Coming out of the pandemic, AHCA/NCAL outlined three policy priorities to help the long term care sector move forward, including eliminating Medicare’s three-day stay requirement, creating a realistic career pathway from temporary nurse aides, and advocating for programs that invest in the long term care workforce.