PPP and Skilled Nursing By the Numbers: $165M in Small Loans, 35K Jobs Retained

Skilled nursing operators and associated providers received about $165 million in small loans under a federal program designed to keep businesses afloat during the pandemic, an analysis of public data by Skilled Nursing News has found.

In turn, those 3,300 loans — all under $150,000 apiece — helped operators in the space preserve a total of 35,210 jobs across the 50 states, Puerto Rico, and Guam, according to federal data analyzed by SNN.

For comparison, more than 15,000 agencies involved in the home health care space pulled down around $666 million in total relief through those $150,000-and-under loans, a separate analysis for our sister website Home Health Care News determined.


The federal Payroll Protection Program, part of the larger $2 trillion CARES Act coronavirus stimulus package passed in March, made hundreds of billions in potentially forgivable loans available to firms of all types through the Small Business Administration.

Under the terms of the program, businesses could receive up to $10 million in emergency financing from private lenders backed by the SBA. Any portion of that money put toward essential expenses — primarily payroll, but also costs such as mortgage interest, rent, and utilities — can be fully forgiven, with a 4% interest rate and 10-year repayment term on proceeds spent for any other purpose.

The forgiveness could also be jeopardized if employers lay off workers after receiving the funds, as the retention of workers during the initial COVID-19 economic downturn in March was a major rationale for the program.


“It’s a loan that’s designed to allow people to retain their workforce, and then assist with some of the operational expenses during the crisis time,” Adam Sherman, head of senior care lending at major SBA player Live Oak Bank, told SNN in March. “The big hook, the big carrot on this particular program is that the loan is 100% forgivable if the business spends the money on the right things.”

The SBA and the Department of the Treasury have indicated that companies receiving under $2 million in PPP loans will automatically be assumed to have acted in good faith with their applications, and will not be targeted for audits under a “safe harbor” strategy, citing the necessity of sending funds quickly as well as limited capacity for investigations.

“SBA has determined that this safe harbor is appropriate because borrowers with loans below this threshold are generally less likely to have had access to adequate sources of liquidity in the current economic environment than borrowers that obtained larger loans,” according to a Treasury FAQ on the program. “This safe harbor will also promote economic certainty as PPP borrowers with more limited resources endeavor to retain and rehire employees.”

That said, back in March, Sherman recommended that all borrowers maintain detailed records of how they spend their PPP dollars to ensure full compliance.

SNN used the North American Industry Classification System (NAICS) identification codes — 6231 and 632110 — for “nursing care (skilled nursing facilities)” to identify the businesses in the space that received PPP loans of under $150,000.

In addition to traditional nursing home operators, the classification also includes convalescent homes and hospitals, assisted living facilities that provide nursing care, rest homes with a nursing component, and inpatient care hospices, according to NAICS.

Loans by state

Unsurprisingly, the states with the greatest populations led the way in total financing sent to skilled nursing providers: Operators in California accessed a total of $25.7 million of small-dollar PPP loans, well ahead of second-place Texas with $12.4 million in SBA backing. Florida came in third with a little over $10 million, followed by Illinois ($7.5 million) and North Carolina ($6.9 million) to round out the top five; explore the interactive map below to see how your state fared.

Nationwide, the loans averaged a little under $50,000 apiece, saving an average of about 11 jobs per company.

The figures presented here represent just a fraction of the $525 billion in total loans issued under the program through the end of June; interested businesses also have until August 8 to apply for funds through an extended deadline.

PPP also served as only one avenue of relief for nursing homes, with the federal government releasing billions in CARES Act aid to all health care providers based on prior Medicare and Medicaid reimbursements — as well as a specific tranche of $4.9 billion dedicated exclusively to skilled nursing facilities, and another $5 billion for SNFs released this week.

This article was written by Alex Spanko based on data analysis and visualization by Aging Media Network senior web designer Kosti Marko.