Federal financial aid is finally coming for nursing homes, but no relief is yet in sight for assisted living facilities and other long-term care providers stricken by COVID-19 in the coronavirus pandemic.

President Donald Trump directed $4.9 billion in aid to nursing homes across the country on Friday from the $175 billion in relief Congress approved for hospitals and other health care providers in the CARES Act and other emergency legislation.

“This funding secured by President Trump will help nursing homes keep the seniors they care for safe during the COVID-19 pandemic,” Secretary of Health and Human Services Alex Azar said in an announcement of the funding.

Nursing homes, assisted living facilities and other long-term care operations have been anything but safe during the pandemic, which has caused 667 deaths in long-term care in Virginia, or 59% of all deaths from the disease in the state through Friday morning.

The new federal aid will go exclusively to nursing homes, almost all of which are funded and regulated through the Medicare and Medicaid health insurance programs in Virginia. Assisted living facilities, including memory care units, are licensed and regulated by the Virginia Department of Social Services and do not receive Medicaid funding.

“We definitely have some work to do on the assisted living end,” said Keith Hare, president of the Virginia Health Care Association and Center for Assisted Living, which represent almost 300 nursing homes and 100 assisted living facilities, respectively. “We’re hopeful that will come next.”

State health commissioner Norman Oliver told legislators on Tuesday that assisted living and other providers accounted for more than one-third of COVID-19 cases and almost half the deaths in Virginia long-term care facilities.

Gov. Ralph Northam provided budget relief to nursing homes through a $20 per patient monthly Medicaid payment to help with staffing, but Hare said the challenge has been finding a suitable mechanism at the federal and state levels to direct money to assisted living facilities.

“I have not spoken to anyone at the state and federal level who disagreed that they definitely need this funding,” Hare said.

Help for long-term care providers has been a bipartisan goal of Virginia’s congressional delegation. Rep. Abigail Spanberger, D-7th, led an effort last month that included Reps. Morgan Griffith, R-9th; Jennifer Wexton, D-10th; and Denver Riggleman, R-5th, to seek $15 billion in aid for nursing homes and $10 billion for assisted living. Rep. Rob Wittman, R-1st, also has lobbied the administration for $10 billion in aid for long-term care facilities.

“For weeks, I’ve called on HHS to expedite the process of delivering congressionally approved resources to our most vulnerable neighbors and the dedicated men and women who work around the clock to care for them,” Spanberger said Friday.

“Today, I’m encouraged that HHS is finally recognizing the need to respond to the severity of this crisis in our nursing homes and assisted living facilities.”

“This funding is not nearly enough to account for the COVID-19 testing, personal protective equipment, and staffing that will be needed in the weeks and months to come,” she said. “Additionally, HHS’s funding methodology has excluded most assisted living facilities from receiving payments, which could leave behind thousands of central Virginia residents and their families in a moment of extreme uncertainty.”

The American Health Care Association and National Center for Assisted Living welcomed the funding for nursing homes on Friday, but reminded the administration that other long-term care providers also need help.

“Given the gravity of the situation we are facing with this deadly virus and its impact on our vulnerable residents, long-term care facilities require additional support and funding from state and federal governments to reduce its spread,” said Mark Parkinson, president and CEO of the organizations.

“Notably, assisted living communities have yet to receive any direct aid, despite also serving vulnerable seniors.”

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