(Revised January 18, 2022)
1. Question: What facilities are eligible for Hospital Staffing Assistance Funds awarded under this program?
Eligibility was determined from Healthcare Resource Tracking System (HRTS) data from July 6, 2021 – December 21, 2021 for acute care hospitals. Eligible hospitals were those that met one of the following criteria for at least a week during each 14-day period:
- Adult staffed floor bed utilization averaged 75% or more AND COVID-19 positive patients occupied 10% or more of staffed floor beds;
- Adult staffed floor bed utilization averaged 85% or more AND COVID-19 positive patients occupied 6% or more of staffed floor beds;
- Adult ICU staffed bed utilization averaged 70% or greater AND COVID-19 positive patients occupied 30% or greater of total adult staffed ICU beds.
|Date of TDH data for eligibility determination||One of these week periods must meet eligibility criteria||If ONE of the weeks is eligible, hospital can invoice for reimbursable expenses in this period|
|July 20, 2021||July 6 – 12
OR July 13 – 19
|July 6-August 3, 2021|
|August 3, 2021||July 20 – July 26
OR July 27 – Aug 2
|July 20 – August 17, 2021|
|August 17, 2021||Aug 3 – Aug 9
OR Aug 10 – Aug 16
|August 3 – 31, 2021|
|August 31, 2021||Aug 17 – Aug 23
OR Aug 24 - 30
|August 17 – September 14, 2021|
|September 14, 2021||Aug 31 – Sep 6
OR Sep 7 – Sep 13
|August 31 – September 28, 2021|
|September 28, 2021||Sep 14 – Sep 20
OR Sep 21 - 27
|September 14 – October 12, 2021|
|October 12, 2021||Sep 28 – Oct 4
OR Oct 5 – Oct 11
|September 28 – October 26, 2021|
|October 26, 2021||Oct 12 – 18
OR Oct 19 - 25
|October 12 – November 9, 2021|
|November 9, 2021||Oct 26 – Nov 1
OR Nov 2 - 8
|October 26 – November 23, 2021|
|November 23, 2021||Nov 9 – 15
OR Nov 16 – 22
|November 9 – December 7, 2021|
|December 7, 2021||Nov 23 – 29
OR Nov 30 – Dec 6
|November 23 – December 21, 2021|
|December 21, 2021||Dec 7 – Dec 13
OR Dec 14 – Dec 20
|December 7 – 31, 2021|
2. Question: How will a hospital know if it is eligible for funding under this program?
If the hospital met the eligibility criteria, TDH will notify them and include the weeks from July 6, 2021 – December 21, 2021 that they met the eligibility requirements for.
3. Question: Are recipients required to apply for funds?
No, applications are not required under this program. Eligibility was determined automatically based on seven-day averages of hospital staffed bed utilizations during July 6, 2021 through December 21, 2021. These utilization rates were calculated by the Tennessee Department of Health based on data reported by hospitals in the Healthcare Resource Tracking System. The eligible hospital will have until January 31, 2022 to submit their onetime invoice and all requested supporting documentation through the CAMS system for eligible expenses.
4. Question: How much funding will each hospital receive?
A maximum of $259,200 of funding per month is available for staffing expenditures during the periods in which they qualified based on eligibility criteria described above. The eligible hospital will have until January 31, 2021 to submit their onetime invoice and all requested supporting documentation through the CAMS system for eligible expenses.
5. Question: Will there be any advances of funds or will all funds be disbursed on a reimbursement basis?
There will be no advance of funds. All funds will be issued on a reimbursement basis once supporting documentation is provided. The eligible hospital will have until January 31, 2022 to submit their onetime invoice and all requested supporting documentation through the CAMS system for eligible expenses.
6. Question: What substantiating documentation for program expenses will be required?
Supporting documentation for all expenses will be required. Such support may include, but is not limited to, receipts, invoices, and proof of payment. Recipients should also include a detailed narrative with their reimbursement request outlining the specific expense(s) and why they were necessary due to COVID-19.
7. Question: What will a hospital need to complete the eligibility attestation form for this program?
Hospitals need to attest to the following questions and statements with a yes/no answer once they have been registered in the CAMS system:
- I certify that this funding is not supplanting other federal funds, including FEMA assistance, nor requesting duplicate reimbursement for services covered by other programs.
- I am receiving federal Department of Health and Human Services (HHS) Funding.
- (If yes to previous question) I certify that I expended all of my HHS funding earmarked for staffing before applying for TDH funding.
- I certify that I am not actively recruiting staff from other TN hospitals.
Earmarked funding can include previously provided funds that have been budgeted for staffing or are required under the grant to be expended towards staffing costs. Hospitals are attesting to not having duplicate funding sources for the same expense.
8. Question: How will hospitals receive reimbursement for eligible staffing costs?
Once a hospital is notified of eligibility, it will need to promptly provide TDH staff (firstname.lastname@example.org) with updated contact information if necessary. The contact information for the email recipients will be the default information given to HORNE, our third-party grant manager. HORNE personnel will then assist in collecting an online attestation form and will coordinate onboarding into their invoicing system. All payments will be made in accordance with the settings associated with the recipient’s Supplier ID that is identified in Tennessee’s Edison Accounting System.
9. Question: Is there additional information that will be needed prior to cost reimbursement?
Hospitals will need to provide supporting documentation for eligible costs incurred. Hospitals will need to upload a brief description of how staffed bed capacity was increased, including the number of additional beds they were able to provide.
10. Question: What is the deadline to receive the funds?
This funding is reimbursement for eligible costs during the time of July 6, 2021 through December 31, 2021. A hospital will only be eligible for a maximum of $259,200 for any 4-week period. The last day to incur eligible costs is December 31, 2021. The eligible hospital will have until January 31, 2022 to submit their onetime invoice and all requested supporting documentation through the CAMS system for eligible expenses.
11. Question: Is there a cap on the amount of reimbursement requests?
Yes, each hospital is eligible to receive a maximum amount of $259,200.00 per any four-week period for times they were eligible from July 6, 2021 through December 21, 2021.
12. Question: What documentation is required for reimbursement of payroll expenses?
The Request for Reimbursement (RFF) documentation should include a detailed narrative explaining the use of the funds including the activities/duties performed and how those were in response to the COVID-19 public health emergency. Additionally, the normal capacity as compared to the increased capacity/need as a result of the expansion would be considered appropriate supporting documentation with the accompanying proof of payment for the funds requested for reimbursement.
13. Question: What will the allocation amount be if a Hospital is eligible for multiple periods?
During times that the hospital was eligible from July 6 – December 21, 2021, there is a maximum allotment of $259,200 for any eligible expenses for any 4 week period and $129,600 for eligible expenses for any 2 week period.
14. Question: What if I had a contract with the State utilizing CRF funds from August 1, 2021 through September 30, 2021?
If you requested reimbursement for eligible periods under this contract, you cannot request additional funds for previously eligible periods. You may only request reimbursement for new periods that you are eligible for under this broader criterion. The email you receive from the State will outline which periods you were eligible for previously and which ones are new as well as the remaining money you may request.
15. Question: What if our hospital received an eligibility email in October for the periods between Sept 28-Oct 26 and/or Oct 12-Nov 9? We submitted that invoice via RedCAP but it was past the date of our August/September contract.
If you received an eligibility email in October stating that you were eligible for September 28th to October 26th and/or October 12th to November 9th, those funds have now been incorporated into your eligibility and funding for this round. Any invoices for October/November submitted to RedCAP will not be processed. This eligibility and funding amount has already been factored into the total amount you can invoice for in this one-time invoice submitted to Horne, as stated in the December eligibility email.
1. Question: What expenses are eligible under the Hospital Assistance Program?
Only staffing costs are considered eligible expenses under this program. TDH will reimburse staffing costs associated with the hospital expansions. Eligible costs include:
- Hazard pay for staff (i.e., additional pay for performing hazardous duty or work involving physical hardship related to COVID-19);
- Overtime pay for critical staff;
- Payments to a supplemental staffing agency;
- Housing and travel costs for staff to the extent such is not already covered by the staffing contract; and
- Pay differentials for staff willing to work shifts beyond their normal schedule.
Hospitals cannot use the funding in this contract to supplant other federal funding and must attest that any expense reimbursed under this contract is not reimbursed under any other program. This requirement is not meant to preclude the hospital from billing any form of insurance for care provided to any patient. If applicable, the hospital must first exhaust all funds from the federal Department of Health and Human Services earmarked for staffing before invoicing the State for further funding under this contract. The hospital must also attest that it will not use the funding in this contract to directly recruit staff from other Tennessee hospitals. Eligible hospitals must follow all applicable State and federal laws for hiring medical staff, and hospitals must meet all State and federal standards for providing healthcare.
2. Question: Can any of the funds be used for administrative expenses under this program?
Hospitals may apply an indirect cost rate of 10% of the eligible expenses, to eligible direct staffing payroll expenses. For example, if a Hospital incurred $100,000 in eligible staffing expense. If hospital elects, they can apply an indirect cost rate of up to 10% for a maximum reimbursable amount of $110,000 in total.
3. Question: Are bonuses and incentives for staff an eligible cost under this program?
No. These costs are not eligible due to federal funding restrictions.
4. Question: Can recipients use the funds to reimburse eligible expenses incurred prior to this program?
Grant funds may be used to cover eligible costs incurred from July 6, 2021 – December 31, 2021.
5. Question: Are staffing expenses related to care of all patients eligible or only those dedicated to COVID positive patients?
If the hospital has incurred additional costs for expanded staffing as a result of COVID, this expense would be eligible. If the staff would have been working regardless of COVID, this would not be an eligible expense. Likewise, if the staffing costs is covered by insurance reimbursement, this would not be an eligible expense.
6. Question: Are regular salaries considered eligible expenses if they are staffing expanded beds and expanded beds are used for COVID patients?
Only overtime pay, hazard pay, and contract staffing as a result of COVID expansion and related treatment of COVID patients is eligible under this program. Documentation will be required to be submitted demonstrating the hazard pay was directly tied to COVID-19 duties performed by the staff. Regular pay for staff assistance for non-COVID patients is not eligible as this would be covered by traditional payment mechanisms such as insurance reimbursement.
7. Question: Is over-flow payroll an eligible expense?
The goal of this program is to provide reimbursement for hospital staff required to provide patient care for additional hospital staffing capacity. We understand that COVID patient beds may require a hospital to expand capacity through the use overflow beds. Only overtime pay, hazard pay, and contract staffing as a result of COVID expansion and related treatment of COVID patients is eligible under this program. Regular pay for staff assistance non-COVID patients is not eligible.
8. Question: Are clinical contract employee expenses eligible if they were not budgeted for prior to the COVID-19 Pandemic?
Only overtime pay, hazard pay, and contract staffing as a result of COVID expansion and related treatment of COVID patients is eligible under this program. Contract staffing to meet your staffing requirements for normal operations is not eligible, but contracted labor that is higher than budgeted due to COVID care (actual minus budgeted) would be eligible.
9. Question: Would an increase in base pay for PRN RNs and LPNs be an eligible expense?
Yes. If the hospital can demonstrate increased reliance and use of PRN staff as a result of COVID and that cost was anticipated in the planned response, that cost (actual minus budgeted or baseline pay) would be eligible. Hazard pay under a board approved hazard pay policy in response to COVID to get increased participation of staff is an eligible expense.
10. Question: Is RN staffing for drive through COVID testing eligible?
No, drive through COVID testing is not related to expanded hospital capacity and is therefore ineligible.