We are seeking to gauge the additional costs nursing homes are facing due to the COVID-19 emergency and to collect current indicators of the severity of the existing financial stress member organizations are enduring.  This information will allow us to educate policymakers and more effectively advocate for needed financial relief.   The information you provide will be kept strictly confidential and will be used only in the aggregate.

IF YOUR ORGANIZATION OPERATES MULTIPLE NURSING HOMES PLEASE COMPLETE A SEPARATE SURVEY FOR EACH. 

Please complete and submit the survey at your earliest convenience, but no later than Friday, August 21st.  If you have questions on the survey please contact Carl Pucci at cpucci@nyshfa.org.

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* 1. Respondent Contact Information

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* 2. Staffing Costs. Please enter the estimated ADDITIONAL TOTAL staffing costs related to COVID-19 that your facility incurred during the period May 1 through June 30, 2020 (i.e., costs that you would not have incurred had it not been for COVID-19).

Please include costs related to:
 - maintaining current or higher staffing levels (including overtime)
 - staffing pattern disruptions/new staffing patterns due to any COVID-19 unit re-configurations
 - back-filling for unavailable staff                  - please do NOT include staff testing costs here- enter them in Q3
 - paid leave for quarantined staff                  - hazard pay or enhanced wages
 - increased housekeeping/cleaning staff      - increased contract staff 
 - replacements for staff in training                - staff hours for pandemic planning
 - consultants and trainers                             - child care and other staff benefit cost increases

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* 3. Staff Testing Costs. Please enter the estimated costs your nursing home incurred during the period May 1 through June 30, 2020 related to mandatory testing of staff for COVID-19.

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* 4. Supplies and Metarials. Please enter the estimated ADDITIONAL equipment and material costs related to COVID-19 that your facility incurred during the period May 1 through June 30, 2020 (i.e., costs that you would not have incurred had it not been for COVID-19).

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* 5. Lost Revenue: ADHC & Outpatient Therapies. If your organization was impacted by the ordered closure of your Adult Day Health Care program and/or the discontinuation or reduced volume of outpatient therapies, please enter the estimated lost revenue for the period May 1 through June 30, 2020.

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* 6. Lost Revenue: May & June. If your nursing home patient revenue in May and/or June was lower than expected or projected, please enter the estimated lost revenue during the period May 1 through June 30, 2020.

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* 7. Lost Revenue: 6 Months. If your nursing home patient revenue in 2020 has been lower than budgeted or projected, please enter the estimated shortfall for the period Jan. 1 through June 30, 2020.

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* 8. Revenue: 6 Months. What was your budgeted nursing home home patient revenue for the period Jan. 1 through June 30, 2020.

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* 9. Increased Expenses: 6 Months. If actual expenses for the first half of the year (Jan. 1 - June 30, 2020) exceed projected or budgeted expenses, please enter the overage amount.

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* 10. Expenses: 6 Months. What were your projected or budgeted nursing home expenses for the period Jan. 1 through June 30, 2020.

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* 11. Financial Relief. Approximately what percentage of COVID related expenses and revenue losses do you anticipate will be covered by the total COVID relief funding you have received and expect to receive? (CARES Act Provider Relief funding, forgivable portion of PPP loans, FEMA Public Assistance)

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* 12. Additional Info/Comments. Please provide any additional information or clarifying comments.

0 of 12 answered
 

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