Some Hospitals Giving Back CARES Act Funds

— Not clear if they're returning unspent money or simply repaying loans; reporting discrepancies abound

Last Updated October 29, 2020
MedicalToday
Coronavirus Aid, Relief, and Economic Security Act over a photo of the U.S. Capitol building

Several hospitals and healthcare systems have "returned" CARES Act funding, according to reports and , though it's not clear whether those funds were repaid or given back without being spent.

An analysis by also revealed discrepancies in public statements and reported distributions by some of the nations' top healthcare systems.

HCA Healthcare, the for-profit hospital system based in Nashville, Tenn., that it would "return, or repay early," its entire $1.6 billion in CARES Act distributions along with $4.4 billion in Medicare accelerated payments. Leadership determined the company didn't need the money after netting a $1.1 billion profit for the second quarter, according to the press release.

But HCA's , produced by watchdog Good Jobs First, indicates the company actually received $1.57 billion from general distributions -- loans that are often tied to Medicare accelerated payments -- plus $487 million in targeted grants.

That $2.1 billion total, derived from including Department of Health and Human Services (HHS) data, is well short of the $6 billion HCA noted in its press release.

In addition, the has recorded only about $141.5 million accepted by HCA entities via general CARES Act distributions, as of Tuesday. An an HHS spokesperson said its dataset "only includes payment amounts formally accepted by providers."

Researchers at Good Jobs First told that what public companies report publicly regarding CARES Act funds sometimes does not match HHS data. That has been the case with Tenet Healthcare and HCA, researcher director Philip Mattera said.

"HCA was not very clear in that announcement [the news release] about what exactly they are giving back or returning," Mattera said.

An HCA spokesperson said he was unfamiliar with the COVID Stimulus Watch database and declined further comment for this story, repeatedly pointing to the news release to answer questions.

The American Hospital Association and the Federation of American Hospitals also declined to comment for this story.

The , established under the CARES Act, involves both general distribution loans (which often include Medicare advance payments) and targeted grants for medical centers deemed to be most needy. But some Medicare funds are included in both categories and general distribution figures keep changing because they are based in part on providers completing forms, Mattera said.

"All of this makes it tough to pin down exact numbers," Mattera said.

Similar discrepancies were seen with Kaiser Permanente. The health system said it declined most of the more than $500 million it was eligible to receive, according to a spokesperson and a . Both sources noted Kaiser Permanente "declined all of [the money] except for $11.8 million for Maui Health System, a nonprofit subsidiary of Kaiser Foundation Hospitals."

But Maui Health System actually received $17.2 million, according to the .

"Bottom line: we did not accept or keep any of [the $500 million-plus] except the money for Maui Health System," the Kaiser Permanente spokesperson wrote.

Unlike the general distribution database, the targeted relief database . Thus far, 12 entities have returned those targeted payments.

Some of those were returned due to initial reporting errors. For instance, three hospitals within Minnesota's M Health system -- Fairview Southdale Hospital, St. Joseph's Hospital, and Fairview University of Minnesota Medical Center -- have returned a combined $49.5 million, and Drew Memorial Health System of Arkansas returned $8.9 million.

;Both the M Health hospitals and Drew Memorial received funds via a clerical error. M Health requested assistance, but returned the funds it received when officials realized the system did not qualify for them, said an M Health spokesperson. Drew Memorial was mistakenly perceived by HHS as being eligible for the targeted payments .

Kaiser Permanente's Los Angeles Medical Center gave back its payment of $8.6 million.

Tanner Medical Centers in Georgia returned their combined $62.6 million first-round payment.

In Alabama, Springhill Medical Center returned its $10.1 million payment and Coosa Valley Medical Center gave back $8.7 million.

HSHS St. John's Hospital in Illinois returned $27.9 million, Holy Name Medical Center in New Jersey returned $213.4 million, and University of Oklahoma Medical Center gave back $35.8 million.

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    Ryan Basen reports for MedPage’s enterprise & investigative team. He often writes about issues concerning the practice and business of medicine, nurses, cannabis and psychedelic medicine, and sports medicine. Send story tips to r.basen@medpagetoday.com.