Nursing homes are facing a new mandate for COVID-19 testing.
Officials at the Centers for Medicare and Medicaid Services (CMS) say if they're not doing it, they'll be fined $400 a day or over $8,000 for each instance of noncompliance.
The government says nursing homes need to do widespread testing of residents and staff if any resident shows symptoms or tests positive.
Nursing homes will also be required to test staff more often, depending on the virus activity in the area.
The Trump administration says it is giving facilities $2.5 billion to help with costs.
Nursing homes continue to raise concerns about the cost of this testing and additional expenses like personal protective equipment and additional staffing due to the pandemic.
The mandate also comes as their sources of revenue have changed along with the number of residents declining.
With the added costs and revenue change, LeadingAge, the association of nonprofit providers of aging services, is hearing from some of its members that they may be forced to close. At least one nursing home in Rhode Island has had to do it already. Others are looking at the possibility of having to consolidate or alter the services provided.
Nursing homes get paid through Medicaid, Medicare and private payments. According to a Kaiser Family Foundation analysis of Certification and Survey Provider Enhanced Reports data, nationwide 62 percent is paid through Medicaid, 26 percent is paid through private payments and 12 percent is paid through Medicare.
Post-acute care through Medicare is a big revenue source for nursing homes. That means you're coming out of the hospital and need to rehab for a few weeks in a nursing home.
"With elective surgeries being closed down, there is no steady flow of residents who need that level of care. That's been cut off entirely," said Katie Smith Sloan, President and CEO of LeadingAge.
Sloan says they need those elective surgeries to start up again everywhere to fill that gap in revenue lost as a result of the pandemic.
The most recent survey from insurance company Genworth Financial finds the national median cost for a private room at a nursing home is more than $100,000 a year.
Depending on your financial situation, you may start paying this and then have Medicaid start paying later.
Leading Age says they haven't heard from their members that they'll be increasing prices because of the financial challenges they're facing.
"Nursing homes charge what the market will bear, and I don't think the market can bear much more than that," Sloan said. "I mean $100,000 a year is a lot of money for an individual living in a nursing home. It's a lot of money because it costs a lot to operate a nursing home."
LeadingAge looked at nursing home closures right before the pandemic started. It found more than 500 closed since June 2015. Some of these closures were because of low occupancy. Others were because of not getting enough money from Medicaid.
This story has been updated to include more information regarding costs facing nursing homes and how nursing home payments work.