Ohio Legislation makes Medicaid payments contigent on Quality of Care

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In recent years, there has been a surge of news exposing the neglect and often abuse of the elderly in nursing homes.  This has made states’ take a greater interest in the quality of care in nursing homes and how they regulate it.  Ohio has come up with a bill that will aim to improve the overall quality of care their residents pay for.  Their house bill 153 seeks to use medicaid payments to motivate nursing homes to improve their practices.

Measuring Quality of Care

A subcommittee made up of elderly advocates, nursing home representatives, state officials and legislators.  They created a list of measures that were defined, and developed into a calculated point system that could determine the quality level of a nursing home. For example to receive one point the nursing home must enroll in “Advancing Excellence in Nursing Home Campaign” and select at least three goals.  Another point was given to homes that assured that at least 50% of Medicaid certified beds were in private rooms. There are 20 measures that will earn the nursing home one point, they are divided into categories: framework, choice, clinical, environment, and staffing.

Calculating Payments

A facility is required to get 5 points to receive the full quality payment, which is $16.44 per Medicaid bed day in 2013. Facilities with less than 5 points receive one-fifth of the full quality payment per point. The budget assumes that every nursing facility will receive the full quality incentive payment. If some facilities do not achieve 5 points and there is a residual amount left at the end of the fiscal year, then that amount will be distributed to facilities that earned more than 5 points based on each facility’s Medicaid bed days and total points received.

To see a full list of these measures and how they are calculated in this 5 point system go here.


These measures aim to:

  • Encourage person centered care
  • Limit staff turnover
  • Improve family Satisfaction
  • Reduce Bed sores and Urinary track infections

If Bill 153 is successful in passing it may act as an example to other state governments on how to attain quality care in their nursing homes.

What has your state been doing to try to improve the quality of care available to seniors?

Remember to always watch out for these warning signs of elder abuse and notify your local authorities if you suspect your aging loved one or community member is being abused.

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