In an undated (June 2020) Message, the American Health Care Association’s President and CEO Mark Parkinson tells member nursing facilities “Our profession faces its greatest challenge in history” and “the very survival of our sector.”
The message begins by reporting that people who have COVID-19 may be contagious while asymptomatic. As a consequence, and citing researchers from Harvard (David Grabowski), Brown (Vincent Mor), and the University of Chicago (R. Tamara Konetzka), he writes that facilities are not at fault when residents and staff become infected with COVID-19:
It wasn’t a matter of bad operators getting COVID-19 and good operators not getting it. The facts indicate that your Five-Star rating, profit vs. not for profit status, or prior deficiency history are not predictors of whether COVID-19 gets in your buildings. The most important factor determining whether COVID-19 ends up in a building is the surrounding community of where the building is located. If you are located in New York, you likely ended up with COVID-19 in your building. If you are located in the rural Midwest, you are less likely to have COVID-19 in your building. It depends on the outbreak in the surrounding community, which impacts the number of carriers without symptoms.
The Center for Medicare Advocacy notes that other researchers find a correlation between COVID-19 and low nurse staffing levels and low quality ratings.
The statement blames policymakers for allocating tests and personal protective equipment to hospitals, not nursing facilities and says “Tens of thousands of lives were lost due to this mistake.” It continued:
Now, we are being blamed. Rather than recognizing that long term care providers were helpless to identify pre-symptomatic carriers who were spreading the virus, we have been blamed. The knee jerk government response to an outbreak has been inspections, deficiencies and fines. At a time when we need collaboration and a helping hand, we are instead getting hit with a punitive approach.
It then reports that facilities are fighting back and that AHCA is as well in Washington, D.C., detailing a series of “small wins,” all related to reimbursement and including Medicare Advanced Payments, a 2% increase in Medicare rates as a result of the lifting of the Medicare sequester, a 2.3% increase in reimbursement beginning October 1, 2020, and no changes in the Patient-Driven Payment Model reimbursement (the new Medicare reimbursement system for skilled nursing facilities).
The message describes “an historic media campaign to fight back.” Funded by a $10 per skilled nursing facility bed assessment in June 2020 and a similar assessment in June 2021, AHCA will have $15 million for media and social media campaigns “to shape the national conversation.”
Next steps for AHCA include getting financial relief for assisted living, getting federal liability immunity for COVID-19, and getting additional funding for nursing facilities from the $62 billion that remain in the Provider Relief Fund.
July 16, 2020 – T. Edelman
 AHCA, “A Message from the President & CEO Mark Parkinson; We Won’t Back Down.” https://files.constantcontact.com/64f0b60b701/f86b03a3-a859-4098-b6d0-3866c56672d5.pdf.
 Yue Li, et al, “COVID-19 infections and deaths among Connecticut nursing home residents: facility correlates,” Journal of American Geriatric Society (Jun. 18, 2020), https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.16689.