Ohio lawmakers advanced a budget corrections measure this week that cements a forward-looking change to the nursing facility quality incentive payment formula, confirming that the interpretation used by the Ohio Department of Medicaid will govern future payments despite the Ohio Supreme Court’s ruling in State ex rel. LeadingAge Ohio v. Ohio Department of Medicaid. The change was enacted through an omnibus amendment to House Bill 184, which passed both chambers Wednesday evening.
The amendment replaces the current reference to a “rate” with “cost per case mix unit,” a statutory adjustment that allows the Department to continue using its interpretation rather than the Court-affirmed method. As enacted, the revised language applies only to payments made once the bill takes effect—90 days after the Governor’s signature. The Supreme Court’s interpretation remains in force for state fiscal year 2024, state fiscal year 2025, and for the period between July 1, 2025, and the statute’s implementation.
During Senate Finance Committee deliberations, Chair Jerry Cirino reiterated that the change is entirely prospective, emphasizing that it does not resolve the substantial underpayments recognized by the Court. Chair Cirino stated that “nothing retroactive” is included in the bill, echoing his earlier remarks that the amendment clarifies what lawmakers intended during the last General Assembly regarding the quality pool calculation.
The Senate’s floor discussion reflected unease among several lawmakers about both the speed of the process and the potential impact on providers. Senator Al Cutrona cast the single opposing vote, questioning the lack of deliberation. Senator George Lang supported the measure but reported that some nursing facilities fear significant financial consequences and noted the difficulty of assessing those concerns with limited review time.
In the House, members concurred with the Senate changes by a wide margin. Representative Brian Stewart, the bill’s primary sponsor, stated that nursing facilities will receive the payments identified by the Court but contended that focusing solely on the ruling overlooks broader Medicaid budget considerations. Representative Munira Abdullahi raised procedural concerns, criticizing the late addition of multiple provisions to the bill.
With legislative activity concluded for the year, LeadingAge Ohio will meet with the Ohio Department of Medicaid to review the implications of the prospective change and to ensure members have clear guidance on next steps. Additional updates will be provided as more information becomes available. Top You Asked: How can a facility access the Ohio Department of Health Geriatric Simulator Suit Loan Program?
ODH Answered: Facilities can access this training resource by completing the online Walking in Their Shoes: Geriatric Simulator Suit Program Registration. The aging simulation suits, and equipment allow healthcare professionals to experience what it may feel like to be an older adult living with age-related disabilities or illness. Through guided simulation activities, often involving common activities of daily living (ADLs), participants gain insight into the physical and cognitive challenges many older adults face.
The Geriatric Simulator Suit is designed to help staff better understand:
- Physical aspects of aging, such as visual impairment, hearing loss, decreased mobility, and changes in bone and joint function.
- Cognitive changes, including how impairments may impact communication, decision-making, and daily functioning.
- Ways to enhance empathy, respect, and person-centered care for residents experiencing these changes.
By “walking in their shoes,” staff can deepen their understanding of the resident experience and identify strategies to help older adults live longer, healthier, and more fulfilling lives. Top Just a reminder that LeadingAge Ohio’s headquarters relocated Wednesday, November 19 to our new Worthington office:
445 Hutchinson Avenue, Suite 700, Columbus, OH 43235
Phone numbers and emails remain the same. Please update your remittance and mailing records. An exclusive network for LeadingAge Ohio members, the Ohio Aging Services Network levels up negotiating power and helps members navigate managed care through its contracting services. LeadingAge Ohio members that join the network receive highly competitive reimbursements and, through peer-to-peer learning, improved quality metrics. Learn more about how OASN can support your contracts and care here. Last week, Randi Hamill, Director of Workforce Development and Initiatives, joined LeadingAge Virginia’s Betsy Archer to share insights from LeadingAge Virginia’s newly released study, The Tipping Point: Exploring the Risks of Benefit Cliffs Among Direct Care Workers, in collaboration with PHI.
Betsy and Randi explored how benefit cliffs—sudden losses in public benefits triggered by small wage increases—create real financial risks for direct care workers and challenges for providers working to strengthen their workforce.
Access the webinar recording here to learn more about the implications of benefit cliffs and how to support your affected workforce.
Questions? Reach out to Randi Hamill at rhamill@leadingageohio.org. Top A new on-demand QuickCast is now available on the LeadingAge Learning Hub. Making Sense of the New Medicare Cost Report, presented by LeadingAge partner Berry, Dunn, McNeil & Parker LLC, offers a 13-minute overview of updates to the CMS 2540-24 form and the revised reporting requirements. The session is available at no cost to LeadingAge members through the LeadingAge Learning Hub. Top The Ohio Department of Aging has released a memo detailing the next phase of the S-AGE platform transition, with updates to user access, role assignments, and account management. The full memo is available on the provider communications page. S-AGE serves as the primary system for assisted living waiver providers, PASSPORT agencies, and other home- and community-based services organizations to complete provider certification, manage service authorizations, and submit claims. As the Department moves toward full implementation, accurate user lists will be critical for uninterrupted access.
Because S-AGE supports certification, billing, and reporting functions, LeadingAge Ohio encourages providers to review current users and contact information to ensure they reflect active staff and appropriate roles. Outdated or duplicated accounts have already caused delays for some organizations during the transition. Verifying this information now will help prevent disruptions as the system enters its final stages. LeadingAge Ohio will share additional updates as further guidance becomes available. A new rule outlining how the Ohio Department of Aging publishes and gathers public comment on the state plan on aging is now in effect. Ohio Administrative Code 173-3-11 formalizes the Department’s process for posting the plan, notifying stakeholders of input opportunities, and complying with federal requirements under the Older Americans Act.
As Ohio’s federally designated State Unit on Aging, the Department must submit a state plan to the Administration for Community Living to access Older Americans Act funding. These dollars support essential services delivered through the Department and the state’s 12 area agencies on aging, including home-delivered and congregate meals, transportation, home modifications, adult day services, respite, and caregiver supports. Because the plan guides priorities for these programs, the new rule provides a clearer framework for public engagement as the next planning cycle approaches.
The rule emerged from a federal requirement that each state adopt a policy governing development of its plan. The Department held a stakeholder meeting in May and followed with a pre-public comment period in July before releasing the proposed rule later that month. The rule was finalized in the Administrative Code this fall.
With the current state plan covering 2023–2026, the next planning cycle will begin in the coming year. Providers may want to review the rule and monitor the Department’s website for notice of hearings or comment periods, as the rule specifies that these must be posted online and shared through email subscription services. Engagement early in the process will help ensure provider perspectives are considered as Ohio develops its next plan.
LeadingAge Ohio will share updates as the Department begins work on the forthcoming planning cycle. The Ohio Department of Health has resumed normal survey and certification operations following the end of the federal shutdown. In a notice to nursing facilities, ODH reported that it is prioritizing reviews of plans of correction, revisits, and surveys that were interrupted when the shutdown began. Complaint investigations involving potential immediate jeopardy continued throughout the lapse.
ODH is working with the Centers for Medicare & Medicaid Services to determine how federal certification and enforcement work impacted during the shutdown should proceed. The department will issue updates as federal guidance becomes available. The Ohio House of Representatives has advanced House Bill 476, a proposal that would allow nonprofit and tax-exempt organizations, including senior living and aging services providers, to sell raffle tickets online. The legislation responds to recent enforcement actions by the Ohio Attorney General’s Office, which halted online raffles conducted by local nonprofits. While these actions primarily affected community groups such as volunteer fire departments and animal shelters, the statutory restrictions apply broadly to all nonprofit organizations. For LeadingAge Ohio members that rely on donor events, resident councils, or auxiliary groups to support programs, online raffles have become a practical fundraising tool. Representative David Thomas noted that many organizations had adopted digital platforms in good faith, only to encounter outdated statutes that did not reflect current practice.
By affirming that eligible nonprofits may conduct online raffles under clear requirements, House Bill 476 would provide a path forward for mission-driven aging services organizations that use small-scale fundraising to support resident activities, benevolent care, or community outreach. Representative Meredith Craig emphasized that the enforcement actions were not prompted by misconduct but by limitations in existing law, and she called the bill a necessary correction. The measure now moves to the Ohio Senate for consideration. LeadingAge Ohio will continue to monitor its progress and share updates as the Senate begins work on the bill. Top The federal government has reopened following passage of a short-term spending package that ends the record shutdown and restores full agency operations. LeadingAge outlines the immediate implications for aging services in its shutdown update, including the return of program oversight functions and continuation of federal payment and regulatory activity. At the same time, the Department of Housing and Urban Development announced a significant shift in Continuum of Care funding that moves resources away from Permanent Supportive Housing units, a change expected to affect older adults who rely on stable, service-enriched housing.
Additional federal developments include an anticipated extension of telemedicine flexibilities for prescribing controlled medications, signaled by a Drug Enforcement Administration final rule now under review at the Office of Management and Budget. More details are available in the DEA update. LeadingAge and the Post-Acute Care Coalition also submitted recommendations to the Centers for Medicare and Medicaid Services aimed at improving access and reducing administrative burden in Medicare Advantage prior authorization processes. The full recommendations are outlined in the joint PAC–LeadingAge submission. The Centers for Medicare and Medicaid Services issued a “Dear Colleague” letter to clarify state implementation of Medicaid provider tax changes included in HR 1. LeadingAge summarized the guidance in its explanatory release, which outlines the law’s prohibition on new provider taxes not already in place before July 4, the phase-down of the hold harmless cap to 3.5 percent for expansion states and the tighter definition of “generally redistributive,” limiting the use of non-uniform or non-broad-based taxes.
The letter offers preliminary direction on sections 71115 and 71117, affecting hold harmless requirements and waiver flexibility tied to the uniform tax standard.
Potential implications for Ohio:
- The prohibition on new provider taxes, combined with a narrower definition of what qualifies as “generally redistributive,” may constrain tools policymakers have traditionally used to bolster Medicaid rates.
- The phase-down of the hold-harmless standard could lead to adjustments to the structure of Medicaid payments.
LeadingAge Ohio will continue to watch how the Ohio Department of Medicaid interprets the federal guidance and will keep members informed as the state outlines next steps. The U.S. Department of Education has released a new funding opportunity through the Fund for the Improvement of Postsecondary Education – Special Projects (FIPSE-SP), focused on building or expanding short-term workforce credential programs. This grant aims to support colleges, nonprofit organizations, and partner entities in developing programs that prepare learners for in-demand roles. For aging services, the most relevant areas include creating new short-term programs aligned with employer needs and expanding existing offerings to increase capacity and strengthen the pipeline for essential positions.
Many LeadingAge Ohio members already collaborate closely with secondary and postsecondary institutions, making this opportunity particularly timely. Potential projects may support training for direct care workers, certified nursing assistants, home health aides, or other roles essential to long-term services and supports. Grants range from approximately $1 million to $4 million over up to four years, offering substantial backing for program development and employer engagement. Providers considering this opportunity should note the December 3, 2025 application deadline. Additional information about the U.S. Department of Education’s grant processes is available here, and details specific to this funding opportunity can be found here. Members interested in exploring possibilities may contact Randi Hamill at rhamill@leadingageohio.org. Top Valley Hospice welcomed community members to a “There’s No Place Like Valley Hospice” celebration in Wintersville as the organization marked its 40th anniversary. St. Florian Hall was transformed for the occasion, with dinner, entertainment and recognition of trustees Jim Padden and Tom Timmons, along with Trinity Health System, for their long-standing partnership. Coverage of the event is available in the report on the 40th anniversary celebration.
The anniversary highlighted the organization’s decades of support for individuals and families across the region. Speakers reflected on the continuity of care Valley Hospice has provided since its founding and the relationships built with community partners who have supported its mission for four decades. Congratulations to the entire Valley Hospice team on this milestone. Otterbein SeniorLife has announced plans to acquire Lake Vista of Cortland from Ohio Living, marking an important transition for both organizations. The announcement, shared by Otterbein SeniorLife, outlines the intention to bring the community into the Otterbein network while maintaining continuity for residents and staff. The full statement is available through Otterbein SeniorLife’s public post.
LeadingAge Ohio congratulates Otterbein SeniorLife on this milestone and extends appreciation to both organizations for their continued commitment to mission-driven care in northeast Ohio. LeadingAge Ohio will share additional updates as the transition progresses and more information becomes available. Top Enrollment is now open for the Winter 2026 session of the Core of Knowledge, a program designed for Administrators-in-Residence that fulfills the academic requirement set by the Board of Executives of Long-Term Services and Supports (BELTSS) for qualifying to sit for the state licensure board examination to become a Licensed Nursing Home Administrator (LNHA).
The three-week course will be held January 12–30, 2026, Monday through Thursday, at the OCLC Conference Center. This is one of only two opportunities to complete the required coursework in 2026.
The deadline to register is December 5, 2025. Learn more and register for the 2026 Winter Core of Knowledge. For additional information, contact Corey Markham at cmarkham@leadingageohio.org. LeadingAge Ohio holds valuable education webinars and in-person events throughout the year. Opportunities are added weekly. See the complete Schedule of Events. Top
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