Mandatory Vaccination Programs and What That Means for Your Hospice

Looking at the state of the world today, it’s safe to say that the COVID-19 pandemic brought with it long-term consequences, not just to the people’s health and well-being, but also to the way the world operates.

For instance, with more than 220 million people infected with the virus, some countries saw it fit to require the public to bring their vaccination cards with them at all times. Before a person enters an establishment, they will have to show proof of their vaccination, or at the very least, a recent test showing negative results.

While controversial, the vaccination cards do allow shop owners, hospitals, supermarkets, and other places people frequent to determine how to protect their patrons from contracting the virus, especially now with the highly transmissible Delta variant.


Enforcing Vaccine Mandates in the Workplace

So it wasn’t a surprise when this month the Biden administration tasked the Occupational Safety and Health Administration (OSHA) to come up with guidelines for employers with 100 or more workers to require that all employees be vaccinated against COVID-19 or undergo weekly testing.

The Department of Labor’s Occupational Safety and Health Administration (OSHA) will soon issue an emergency temporary standard to implement the requirement. Companies that fail to comply could face a fine of up to $14,000 per violation.

In addition, big companies will also be required to provide PTO for the time it takes employees to get vaccinated and/or recover if they feel ill after receiving the vaccine. While the emphasis seems to be shifting toward an employer-enforcement model in the ongoing battle against the pandemic, we have reason to believe that they may shift to phasing in penalties or initial penalty abatement if this type of legislation is passed too quickly.

While this mandate certainly removes the burden on our hospice clients grappling with the decision to mandate vaccines or not, depending on the specifics of the final rule, the requirement could create new administrative burdens, human resource challenges, and unanticipated costs. The alternative for our hospices could be inquiries about vaccine status, weekly testing, and still run the risk of patient exposure from an unvaccinated employee.

One looming question that remains unanswered is who will be responsible for paying for the required testing for unvaccinated workers: employers, employees, insurers, or the federal government? This is brand new and still in development, so we can’t say at this point, however, it does seem that the burden falls again to employers to police their payroll.

So, what do we need to do and how should our agencies respond?

If you’re an employer without a current vaccination mandate or testing protocol in place,  it’s probably best to hang tight for the moment. However, employers are already screening out new employees based on vaccination status. It isn’t long before vaccination status could be a determining factor for future employment even for existing employees, particularly for large agencies.

OSHA’s rule hasn’t been finalized yet, so it’s best not to rush out any new policy until we have a better grasp on specifics – including how to process disability and religious accommodation requests from employees who refuse vaccination and testing. Once the rule comes out, we’ll be sure to dive deeper into it and offer suggestions for developing a plan that works like applying for financial assistance from relief fund providers.


PRF Round Four

Last week, the Health Resources and Services Administration (HRSA) announced $25.5 billion in new funding available for health care providers affected by the COVID-19 pandemic. This funding includes an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers who can document revenue loss and expenses associated with the pandemic.

PRF Phase 4 payments will be based on providers’ lost revenues and expenditures between July 1, 2020, and March 31, 2021. Furthermore, PRF Phase 4 will reimburse smaller providers (loans <$500K) first for their lost revenues and COVID19 expenses before opening up funding to larger providers. PRF Phase 4 will also include bonus payments for providers who serve Medicaid, CHIP, and/or Medicare patients, who tend to be lower income and have greater and more complex medical needs.

To ensure timely distribution of funds and to minimize administrative burdens, HRSA will offer a single application for all providers and use existing Medicaid, CHIP and Medicare claims data in calculating payments. The application portal will open on September 29, 2021.

Let us know if you would like us to determine eligibility for these funds and/or work on documentation for PRF round 4. We would argue that likely ALL providers could show either ongoing COVID-19 expenses and ‘lost revenue’ based on the calculations we’ve prepared for the original PRF rounds. Unlike previous PPP and PRF funding work, however, we will support our agencies’ applications for this voluntary program under our ‘out of scope hourly billing’ terms.

Also per HHS on the current PRF deadline of September 30, 2021:

“Additionally, in light of the challenges providers across the country are facing due to recent natural disasters and the Delta variant, HHS is announcing today a final 60-day grace period to help providers come into compliance with their PRF Reporting requirements if they fail to meet the deadline on September 30, 2021, for the first PRF Reporting Time Period. While the deadlines to use funds and the Reporting Time Period will not change, HHS will not initiate collection activities or similar enforcement actions for non compliant providers during this grace period.”

If you have any questions or concerns, please reach out to the Blackmor, CPA team. We’re sure there are still many changes to come, but we’ll be here with our advice along the way.