Congress appropriated $178 billion to HHS to provide funds to eligible providers for health care-related expenses or lost revenues attributable to COVID-19 under the Provider Relief Fund (PRF) program. HHS was responsible for initial PRF program oversight and policy decisions, and the Health Resources and Services Administration (HRSA} administered the PRF program.
Providers receiving PRF payments were to ensure that the payments were: (1) used to prevent, prepare for, or respond to COVID-19; (2) used for health care-related expenses or lost revenues attributable to COVID-19; (3) not used to cover expenses or losses reimbursed by other funding sources; and (4) not used to pay salaries in excess of a certain threshold or to pay for certain prohibited activities.
The HHS Office of Inspector General (OIG) identified 3,690 ALFs that received and kept one or more PRF payments totaling approximately $640.7 million during CYs 2020 and 2021. The OIG selected for audit a non-statistical sample of 30 ALFs that received PRF payments from General Distributions totaling $156.1 million during CYs 2020 and 2021. The OIG selected ALFs based on a risk analysis that included geographic location (i.e., COVID-19 high-impact areas, urban and rural areas), total PRF payment amounts, and organizational structure (ALF groups and stand-alone ALFs). The OIG reviewed the selected ALFs’ use of PRF payments received from General Distributions.
The OIG stated its findings in its December 2025 report entitled “Nine of Thirty Selected Assisted Living Facilities Did Not Comply With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments.” Of the 30 selected ALFs it reviewed, 7 ALFs claimed a total of $283,000 in unallowable PRF expenditures, and 2 ALFs inaccurately reported $11 million in lost revenues. These nine ALFs received a total of $25.6 million in PRF payments. The remaining ALFs used PRF funds for allowable expenditures and lost revenues.
“These deficiencies occurred because although ALFs attested to the PRF terms and conditions and HRSA provided continuously updated guidance to PRF recipients, the ALFs made clerical errors in their reporting of expenditures and did not always correctly interpret HRSA guidance, maintain documentation to support reported expenditures, or have procedures to verify the accuracy of lost revenue calculations.”
The OIG recommended to HRSA that it (1) require the two ALFs that the OIG determined as having inaccurately calculated and reported lost revenues totaling $11 million to identify and return to the Federal Government any
PRF payments used to offset inaccurately calculated lost revenues or replace them with allowable unreimbursed lost revenues or eligible expenses, if any. and (2) require the selected ALFs to return any unallowable expenditures and lost revenue amounts to the Federal Government or ensure that the ALFs properly account for these expenditures and lost revenues. HRSA concurred with the OIG’s recommendations.
If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publicly known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.
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