A draft of Ohio Governor DeWine’s State Fiscal Year 2022-2023 Executive Budget Proposal includes provisions to address quality of care in the state’s nursing homes. The provisions include voluntary downsizing, ability for the Ohio Department of Health (ODH) to take action when resident health and safety is in jeopardy, training opportunities to address areas prominent during surveys and a quality incentive payment. 

In summary, the draft executive budget includes the following:

• ODH will operate a long-term care bed buyback program, in consultation with the Department of Aging and the Department of Medicaid, during state fiscal years 2022 and 2023, under which nursing facility operators may voluntarily and permanently surrender for compensation from the Department one or more licensed long-term care beds due to a decrease in bed utilization.  To participate, the nursing home must be located in an over-bedded county and, after the bed surrender, have sufficient beds to meet the county’s bed need. ODH will develop criteria to evaluate competing applications and priority will be given to those current with franchise permit fees. While an application is pending, no nursing facility operator shall submit to the Department, either as an applicant or source facility, a certificate of need involving any of the long-term care beds licensed at the nursing facility or a change of operator application.
• When the director of health determines that immediate action is necessary to protect the health and safety of residents, the director may issue orders (including specifying actions) that a home must take immediately to address resident health and safety. Such orders may include appointing a temporary administrator and transferring residents.
• Initiatives to incentivize quality improvement in long-term care facilities or to connect long-term care facilities with technical assistance programming that includes training on infection control, elder abuse, or other topics identified by ODH and informed by trends in surveys.
• Implementation of a per Medicaid day quality incentive payment. Quality improvement standards will be used to determine a quality incentive payment to be made to qualifying nursing facilities. To be eligible, a nursing facility must have a home office located in Ohio and have key program staff who are residents of Ohio and are based and working in Ohio.

The executive budget is expected to be formally introduced with a House bill later this month and the language included may change from the draft reviewed for this analysis. This is the beginning of the budget process and these provisions may or may not be implemented in the final budget approved.

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