Enhanced FMAP Update and Advocacy

Enhanced FMAP Update and Advocacy

The Governor’s office and the Office of Financial Management have implemented a new, reduced COVID add-on for nursing homes and assisted living facilities.  They have also extended the retainer payments made available to assisted living facilities and adult day providers.  

The Governor has chosen to sweep the enhanced FMAP dollars in full and uses those funds to begin plugging the state’s budget hole. The money to provide the reduced COVID add-ons and retainer payments is coming from the CARES Act.

The new amount for nursing homes is dropping from $29 to $13 retroactively from to July 1 through July 31.  The amount drops to $5 from August 1 through September 30.  The total amount of money that has been allocated for nursing homes is $6,334,000.  The previous amount allocated was $42 million and covered March 1 through June 30.

The new amount for assisted living facilities is dropping from $9.31 to $4.79.  This will also be retroactively applied back to July 1 and will continue through September 30.  The total amount of money that has been allocated for assisted living is $3,061,520.  The previous amount allocated was $7.6 million and covered March 1 through June 30.

The retainer payments are set to continue at 70% of the normal daily rate for both assisted living and adult day programs.

The Governor’s office justifies the sweep of the enhanced FMAP and a 75% cut in COVID funding for nursing homes by pointing to the new funding nursing homes received starting July 1st. As you know, the skilled nursing facility rates were adjusted on July 1st by updating the cost data from 2016 to 2018 to set rates. Inslee’s office suggests that this funding, through rate rebasing, can then be largely substituted for the COVID dollars facilities have been receiving. This is flawed reasoning.

Skilled nursing payments still lag costs by two plus years even after rebasing and the July rate increases are intended to begin to close the $100 million gap between rates and cost of care.  COVID costs bring new spending requirements to purchase needed supplies and staffing to fight this virus. Obviously COVID costs are not included in the 2018 operating costs for skilled nursing and are, therefore, not reflected in the July 1st rates.  

While facilities experienced an increase in rates on July 1st they continue to need the full COVID funding in addition to that rate adjustment.  Without adequate funding, facilities will not be able to purchase supplies and maintain adequate staffing.  Visitation will be slowed, if it occurs at all.  Rates of infection will likely climb in skilled nursing and other long term care settings. Hospitals will likely be impacted as we will lack the resources to treat in place.  

We encourage you to take a moment to tell your legislators and the Governor to say NO to cutting vitally important COVID funding needed to protect the lives of seniors and their health care workers.  You can call the Legislative Hotline at 1-800-562-6000, the Governor’s office at (360) 902-4111 or contact your legislator directly following the instructions here.  You can also contact the Governor hereand send the following message – 

“Enhanced FMAP COVID funding for the state’s Medicaid programs has saved lives! These funds have helped buy PPE, ensured adequate staffing and back up staffing, subsidized the cost of fit testing for masks, and paid for enhanced environmental services to keep residents safe. Say NO to efforts to cut COVID funding.”

At this time, contacting the Governor’s office will be the most effective.

Thank you for joining us in advocating for this much needed funding.




David Carter
| Director, Health Care Finance & Policy

C 360.888.5702