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New Ohio Medicaid Program Increases Stakes for Nursing Homes

For many years, U.S. states have struggled to improve the quality of care in nursing homes by way of punishment – fines, citations and other forms of sanctions when severe issues were detected. Now Ohio is adopting a novel approach to help fragile seniors by giving out financial incentives. Our Illinois nursing home neglect lawyers at Pintas & Mullins hope this approach will help curb instances of nursing home abuse and neglect.

Efforts by Ohio state government officials are directed at dealing with longstanding issues in nursing homes, such as a lot of patients developing infections or painful bed sores, excess staff turnover and very few nurses. Experts note that while many care homes deliver first-rate care, there are many others that fell short.

Under the new approach, close to 10 percent of the Medicaid reimbursements to nursing homes hinges on the number of nurses on staff, rates of medical complications and residents’ satisfaction. Though seven other states has similar programs, Ohio’s program is expected to be the largest.

In the meantime, Medicare has plans to introduce a similar program for nursing homes all over the U.S. over the coming years. Government officials recently assessed the outcomes of a three-year demonstration project in Wisconsin, New York and Arizona that came to a close in July.

Though Ohio’s approach appears attractive, early experiments with rewarding facilities for superior healthcare have seen little success. Several experts were of the opinion that poor success rates may be a sign of inadequacy regarding the design of the programs, rather than an issue with the basic concept.

The current scheme by which nursing homes are provided a flat daily rate regardless of how poorly or nicely the employees treat patients does not offer considerable incentives to provide quality care.

Colorado, Kansas, Oklahoma, Vermont, Utah, Nevada, Georgia and some other states tried to change this situation by presenting a small incentive (ranging from 60 cents to $6.16 a day) if the facilities accomplished certain standards. Industry representatives state that those bonuses are inadequate to develop sufficient enthusiasm to change the status quo situation.

Ohio’s new program tackles the financial issues with bigger incentive sums. The state has close to 1000 nursing homes and its Medicaid program expends $4.5 billion on long-standing care.

Standards utilized in Ohio to measure performance include measures that address the nursing home residents’ freedom to make their own choices — when they get up in the morning or bathe, when and how they took meals, and if they had the option to discuss their treatment objectives as well as their end-of-life preferences.

Other standards pertain to family and patient satisfaction, environmental concerns, staffing levels, bed sores, pain or other clinical measures and regulatory shortages.

State officials revealed that it was imperative to begin with a plan which the industry would agree to and which would not punish a large number of nursing homes. A representative of the aging department said that their idea was to increase the stakes over time.

The success or failure of the State’s program would depend on nursing homes such as one particular 102-bed facility which claimed it would adhere to 18 of 20 standards set by Ohio.

Nursing home abuse and neglect is rampant across the country. Recently, a report revealed that a nursing home caretaker intentionally injured an elderly person under her car, pinching him painfully several times in the face.

Although many nursing homes delivery quality care, some nursing homes fail to provide the support and maintenance that elderly residents need. To get justice for nursing home abuse against a loved one, contact a nursing home abuse attorney.