As the situation changes and information becomes available surrounding COVID-10 and it's affect on the industry, please place your questions in the below categories. 

You are not required to respond to all questions, and all responses will have identifying information removed. Responses are confidential.

Question Title

* 1. How many total clients do you serve?

Please list:
- Unique Discrete clients
- MA, MNCare, Medicare, Commercial, Self-Pay clients

Question Title

* 2. What is your licensed residential capacity, number of empty beds, or waiting list?

Question Title

* 3. How many facilities do you operate?

Please list:
- medium or intensive services
- number of outpatient sites
- number of residential site

Question Title

* 4. How many days can you sustain operations without state or federal financial support?

Question Title

* 5. If there are no changes, what is the total revenue you anticipate losing in March 2020?

Please list:
- Whole Dollar Number
- Percentage of Operating Budget

Question Title

* 6. If there are no changes, what is the total revenue you anticipate losing in April 2020?

Please List
- Whole Dollar Number
- Percentage of Operating Budget

Question Title

* 7. If there are no changes, what is the total revenue you anticipate losing in May 2020?

Please List
- Whole Dollar Number
- Percentage of Operating Budget

Question Title

* 8. If there are no changes, when will you have to make decisions about laying off or furloughing employees?

Question Title

* 9. How many staff are you currently faced with laying off or furloughing? 

Please List:
- Staff Reductions (Whole Number)
- Staff Reductions (Percentage)

Question Title

* 10. Currently, how many of your total clients do you anticipate will lose service access? 

Please list:
- Total Clients Impact (Whole Number)
- Total Clients Losing Services (Percentage)

Question Title

* 11. Currently, how many of your total clients have lost service access? 

Please list:
- Total Clients Impact (Whole Number)
- Total Clients Losing Services (Percentage)

Question Title

* 12. How much do you anticipate applying for in federal assistance? (excluding payroll tax credits)

Question Title

* 13. Do you have any expenses or revenue shortfalls that are unable to be covered by existing programs that provide loans and grants for the COVID-19 incident?

(examples: PPE, telehealth, fixed costs that cannot be covered without a fully operational site, hazard pay for staff, overtime, laptops, etc.)

Question Title

* 14. Any further comments on financial impacts of COVID-19 on your organization?

Question Title

* 15. Top reasons for loss in service revenue:

(Please check all that apply)

Question Title

* 16. If MARRCH could do one thing to make your life easier, what would it be?

0 of 16 answered
 

T