On today’s all-member call, LeadingAge Ohio provided an update on the Ohio Supreme Court’s ruling in our mandamus case concerning calculation of nursing facility quality-incentive payments.
On September 2, the Court granted a writ ordering the Ohio Department of Medicaid to recalculate the quality-incentive pool using the change in each facility’s rate for direct care costs—not merely the change in the statewide “price” factor—consistent with R.C. 5165.26(E)(1)(a). The unanimous decision was explained in a 16-page opinion from the Supreme Court of Ohio.
To equip our members for conversations they will inevitably have about this case, LeadingAge Ohio has prepared additional resources:
Key points for members to emphasize include:
- What the Court held: The Department must build the quality-incentive pool using 60 percent of the per-diem change in each facility’s rate for direct care costs (which reflects the price times the facility’s case-mix score), as required by R.C. 5165.26(E)(1)(a). The Court rejected use of only the change in the price factor.
For statutory context members can cite: the quality incentive payment framework, the calculation of payments, the capital cost rate, and the case-mix scores.
- Not moot: The Court denied the Department’s mootness argument and confirmed that the statutory formula remains in effect, so the calculation issue is a live controversy.
- Our posture: LeadingAge Ohio exhausted every other avenue before pursuing litigation, including multiple meetings with the Ohio Department of Medicaid, the Governor’s office, and legislators. Our association is not adversarial or litigious by nature; litigation was a last resort to secure adherence to law.
- How to frame it: This is about accuracy and fairness under the statute. The pool’s size must follow the formula the General Assembly enacted. Members can emphasize that this ruling supports predictable, lawful Medicaid funding while implementation details are addressed.
- Provider impact: Ohio’s nursing homes continue to serve with significant Medicaid operating losses; this case seeks proper application of the quality-incentive formula to support stability of care statewide. Members should avoid overstating organization-specific impacts until official recalculations are released.
Next steps include ongoing legal and policy work, engagement with key legislative leaders, and timely member updates via The Source and special alert emails. Further questions may be directed to Susan Wallace at swallace@leadingageohio.org. The Ohio Department of Medicaid has released a draft rule to increase the Personal Needs Allowance (PNA) from $50 to $75, an important change that LeadingAge Ohio strongly supported during the state operating budget process. The increase is slated to take effect October 1, 2025.
As currently written, the rule applies only to individuals residing in medical institutions who do not have a base eligibility category that uses the modified adjusted gross income methodology in accordance with Ohio Administrative Code Chapter 5160:1. This definition does not appear to include residents of assisted living facilities.
One of the Ohio Aging Advocacy Coalition’s budget priorities was to increase the nursing facility and assisted living personal needs allowance to at least $75 per month. Extending the increase to assisted living residents would provide additional resources for personal expenses and greater flexibility in meeting daily needs. The Coalition will be submitting a formal comment to the Ohio Department of Medicaid reflecting this position.
The comment period is open from September 10 through September 17, 2025. All clearance comments should be submitted to Rules@Medicaid.Ohio.gov.
All comments become part of the public record. Members should avoid including protected health information but are encouraged to provide input based on their expertise and experience. Engagement at this stage ensures that the perspectives of nonprofit providers are reflected in Ohio’s Medicaid policy. Top You Asked: Are Enhanced Barrier Precautions (EBP) recommended for healthcare settings other than nursing homes?
We Answered: No, EBP is not recommended for settings other than nursing homes. The Centers for Disease Control and Prevention (CDC) states that at this time, CDC has not recommended implementation of Enhanced Barrier Precautions (EBP) in other healthcare settings. All healthcare facilities should have practices in place to prevent transmission of multidrug-resistant organisms (MDROs). Acute care facilities routinely use Contact Precautions as one strategy to prevent MDRO transmission. Contact Precautions has created challenges for nursing homes trying to balance interventions to prevent MDRO transmission with residents' quality of life. EBP is a less restrictive approach to MDRO prevention that places fewer limitations on resident activities than Contact Precautions.
The studies that informed EBP, including defining which care activities most commonly result in transfer of MDROs to staff hands and clothing, were conducted in adult nursing home populations. Such activities and risks might be different among pediatric nursing home populations and additional consideration is needed when implementing EBP in these settings. Nursing homes with pediatric residents who implement EBP for their pediatric population as part of their MDRO prevention plan may need to redefine high-contact resident care activities based on the anticipated degree of contact and developmental abilities of pediatric residents (e.g., repositioning an infant compared to a young adult may require different levels of assistance). Top LeadingAge Ohio members are invited to join the Advocacy in Action call on Monday, September 15, at 10:00 a.m. for a federal update from Mollie Gurian, vice president of home-based and HCBS policy at LeadingAge. Gurian will review the FY26 appropriations process, efforts to extend telehealth flexibilities, the proposed Home Health Payment rule for CY 2026, and other federal developments.
The LeadingAge Ohio policy team will also be on the call to answer questions and provide an update on state advocacy efforts, giving members timely information on both national and Ohio priorities.
Register today to stay current on the latest advocacy issues. The organizational profile is an essential part of ensuring your entire team has access to LeadingAge Ohio’s education, advocacy, networking opportunities, and all member resources and benefits. By keeping your staff roster current, you make it possible for new and existing employees to stay connected to the information and support they need to serve older Ohioans.
Updating your organizational profile is quick and simple. Members can log in to the profile update page, scroll to the bottom, and click the “Add Employee” button to enter new staff or update existing contacts. We encourage you to bookmark this page for easy access in the future.
Taking a few minutes to maintain your profile ensures that the right people in your organization receive timely updates about education and training opportunities, policy and advocacy alerts, and new member resources. Keeping this information up to date strengthens your connection to LeadingAge Ohio and ensures your whole team benefits from the value of membership. The LeadingAge Ohio Political Action Committee (PAC) invites members, partners, and guests to spend Monday, September 29, 2025, at the Golf Club of Dublin for a day on the green that makes a difference.
More than just a round of golf, the annual PAC Outing combines spirited competition, camaraderie, and the chance to connect with colleagues and partners—all while enjoying a beautiful course setting. Every swing supports LeadingAge Ohio’s advocacy, ensuring older Ohioans and the professionals who serve them have a strong voice at the statehouse.
Registration opens at 9:00 a.m. with a 10:00 a.m. shotgun start. Both foursomes and individual golfers are welcome, and spots are available through Friday, September 26. Sponsorships are also open for those who want to further champion the PAC’s mission.
View full event details and register. For questions regarding sponsorship, please contact Corey Markham, Director of Education and Business Development, at cmarkham@leadingageohio.org.
Please note that contributions to Political Action Committees must be made by individuals, partnerships, or LLCs, not corporations, and are not tax-deductible. All contributions are voluntary and will not influence membership standing or benefits. There's always something happening at LeadingAge Ohio, and we don’t want you to miss a moment. From educational opportunities to networking events, our calendar is packed with ways for members to stay informed, engaged, and connected.
Explore what's ahead and make plans to join us—whether you're looking to expand your knowledge, connect with peers, or get involved in shaping the future of aging services in Ohio.
View all upcoming events here and mark your calendar today!
Top As the demand for aging services professionals continues to rise, September’s National Workforce Development Month shines a spotlight on building strong, sustainable teams. LeadingAge Ohio is proud to highlight the Next Level Leadership Series as a timely resource to grow the next generation of leaders.
Over six virtual sessions, participants will “build their leadership muscles” by exploring best practices, identifying personal strengths, and developing the confidence and resilience needed to advance their careers. With its small, interactive cohort format, the series offers a unique chance to learn alongside peers while gaining practical tools for everyday leadership. There’s still time to join this year’s group—register by October 27 for the Next Level Leadership Series.
Throughout September, LeadingAge is also sharing workforce strategies and success stories from across the country on the National Workforce Development Month campaign page. Closer to home, LeadingAge Ohio provides year-round resources, including Gateways to Care, a statewide hub connecting job seekers with careers in aging services, and the LeadingAge Ohio Careers portal, which highlights opportunities across the field. As part of National Workforce Development Month, LeadingAge has released a new QuickCast for members focused on strengthening and professionalizing the caregiving workforce. The program highlights strategies such as expanding the pipeline of caregivers, improving training and education, creating clear career pathways, raising compensation, and addressing long-term care financing challenges.
In the session, Molly Carpenter, director of workforce strategy and development at LeadingAge and the LeadingAge LTSS Center at UMass Boston, examines these strategies with practical prompts and recommended steps that providers can consider. The QuickCast also features panel discussions, videos, and downloadable resources to help members explore workforce solutions from multiple angles.
This free resource is available exclusively to LeadingAge members and offers timely guidance for Ohio providers working to stabilize and grow their workforce. Top The Ohio Department of Aging has concluded a series of six town halls held across the state in August and September to gather input on the 2027–2030 State Plan on Aging. These conversations, combined with feedback from earlier listening sessions, will guide the department in building a roadmap that helps older Ohioans live longer, healthier lives with dignity and autonomy.
While the in-person town halls have ended as of today, Ohioans still have the opportunity to contribute to the plan by completing the Statewide Needs Assessment Survey. The survey is designed to capture what matters most to older Ohioans, adults with disabilities, caregivers, and the professionals who serve them.
Ohio Department of Aging Director Ursel J. McElroy emphasized that the feedback process is central to the department’s work: “Listening to Ohioans and getting their feedback is an important part of guiding the Department of Aging. Together, we can accomplish our vision of making Ohio the best place to age in the nation.”
The State Plan on Aging, updated every four years, serves as Ohio’s comprehensive roadmap to improve the overall health and well-being of older adults. The most recent plan, covering 2023–2026, stood out nationally for its collaborative approach that called on partners across public and private sectors to join in advancing quality of life for all Ohioans.
Members and partners are encouraged to share the survey widely so that the voices of older adults and caregivers are well represented in directing the future of aging in Ohio. During the September 5, 2025, MyCare Advisory Workgroup meeting, the Ohio Department of Medicaid (ODM) shared information on benefits, changes and impacts for members and providers. Importantly, ODM also shared that Buckeye Health Plan will remain a plan choice for its existing geography, but will not be permitted to expand to other MyCare counties or statewide in 2026 due to not meeting the readiness review requirements. If an individual gets care through Buckeye Health plan today and wants to keep their plan, no action will be required. This leaves three Next Generation MyCare plans that will be available in historically MyCare counties beginning on January 1, 2026, and then statewide later in the year:
Provider networks will need to secure contracts with these three MyCare Ohio plans in order to continue serving consumers.
Questions about Next Generation MyCare can be directed to the MyCare Ohio webpage. Top Congress is considering legislation to protect home health care from significant Medicare payment cuts. The bipartisan Medicare Beneficiary Home Health Access Protection Act of 2025 (H.R. 5142), introduced September 4, would pause the proposed reductions and allow time to evaluate their impact. LeadingAge has issued an Action Alert urging members to contact their representatives to co-sponsor the legislation. For Ohio’s nonprofit home health providers, this advocacy could help preserve access to care for thousands of older adults.
Hospice providers may also be affected by federal policy discussions. LeadingAge, in coalition with national hospice associations, is calling on Congress to extend telehealth flexibilities for the face-to-face encounter required for recertification of hospice eligibility. Without action, this flexibility could expire, creating unnecessary barriers for patients and families in rural and underserved areas. Learn more about the advocacy effort on the LeadingAge website.
Finally, CMS has released details on the new Rural Health Transformation (RHT) Program, including the application process and timelines for states. The program is intended to support delivery system reform and expand access to care in rural communities. For Ohio’s rural nonprofit providers, the RHT initiative could offer new opportunities to strengthen services and sustain care delivery models in areas with limited resources. Top According to the State Operations Manual Appendix PP, F883, facilities must have an effective immunization program. This program must include collaboration with the medical director to develop resident care policies for immunization(s) that reflect current standards of practice and that include the vaccination schedule including mechanisms for recording and monitoring for administration of vaccines in accordance with national recommendations.
Facilities must also track residents’ vaccination histories to ensure new vaccine recommendations are offered to eligible residents. To support a resident’s right to make informed choices, facilities are responsible for providing residents or their representatives with education on the benefits and potential side effects of immunizations.
CMS requires facilities to follow the CDC and ACIP recommendations for vaccines. For up-to-date information on indications and timing of pneumococcal vaccines, CMS states facilities should refer to CDC’s ACIP Vaccine Recommendations and Guidelines website located at:
Facilities should also routinely monitor compliance using the surveyor guidance outlined in the State Operations Manual Appendix PP. LeadingAge Ohio is offering two important programs in October to support nursing facilities in preparing for upcoming changes and staying compliant.
On Thursday, October 9, MDS nurses and clinical leaders can attend Reimbursement Day at the Quest Conference Center in Westerville. This full-day workshop will prepare facilities for Ohio Medicaid’s adoption of the nursing-only component of PDPM beginning in 2026, while also addressing Medicare Part A reimbursement. The training will feature facility-specific financial projections, interactive coding case studies, and strategies that connect MDS coding to both reimbursement and quality outcomes.
The following week, on Wednesday, October 15, members are invited to a live webinar with ODH: Life Safety and Emergency Preparedness Hot Topics, Updates and Best Practices for Compliance. Experts from the Bureau of Survey and Certification will provide the latest updates on Life Safety Code deficiencies, best practices for compliance, and new requirements under Appendix Z. The session will conclude with a moderated question-and-answer discussion to address member concerns.
Together, these timely programs will equip providers with the knowledge and tools to strengthen compliance and position their organizations for success in the year ahead. The Centers for Medicare & Medicaid Services (CMS) has confirmed the launch of a $75 million initiative to help address the nursing home workforce shortage. Administrator Mehmet Oz announced that funds will be available to states for tuition reimbursement, stipends, and certified nurse aide (CNA) training programs.
While CMS is moving to repeal the federal staffing mandate announced in 2023, the incentive program will continue. Oz described it as a way to “tackle nursing home staff shortages,” especially in rural communities. States are encouraged to supplement federal dollars with civil monetary penalty funds, which would be matched to expand the program.
For Ohio, this could provide new opportunities to support recruitment and retention. The Ohio Department of Health has historically used civil monetary penalty funds for training initiatives and quality improvement projects; this federal match could significantly increase those investments.
Reaction across the sector has been mixed, with some welcoming the support and others questioning whether $75 million nationwide is enough. Still, LeadingAge and LeadingAge Ohio view the move as a step in the right direction. As Jodi Eyigor, senior director of nursing home quality and health regulation for LeadingAge, noted: “This news is a welcome refocusing on what’s paramount … ensuring quality care. That is, investments in supports and solutions to retain, strengthen and grow the aging services workforce.”
Read the full report from McKnight’s Long-Term Care News. The Centers for Medicare & Medicaid Services (CMS) has issued updated guidance that changes how Nursing Home Care Compare calculates health inspection ratings. In a September 10, 2025 memo (QSO-25-20-NH REVISED), CMS announced that it will remove the oldest of the three survey cycles used in the Health Inspection rating, ensuring that star ratings reflect more recent performance. This adjustment is expected to make the Five-Star Quality Rating System more responsive to current survey outcomes.
The memo also outlines upcoming changes to how CMS reports chain-level performance and quality measures. Beginning January 28, 2026, CMS will move to a claims- and MDS-based methodology for the long-stay antipsychotic measure, a shift that is projected to increase reported rates of antipsychotic use. Facilities should prepare for how these changes could influence their star ratings and consumer perception. CMS also confirmed that COVID-19 vaccination measures will remain available but will not appear on the primary Care Compare profile page.
For Ohio nursing homes, these updates mean that public-facing ratings may shift in the coming months, which could affect how residents, families, and referral partners view provider performance. LeadingAge Ohio will continue to monitor the implications of these changes and provide members with strategies to respond. The latest Five-Star Reports and SNF Trend Reports are now available for members to download from the LeadingAge Quality Metrics website. Reports are also being loaded into the LeadingAge Report Portal and will be accessible there once the upload is complete. These updates include July 2025 data, with MDS-based quality measures drawn from 2024Q2–2025Q1, claims-based measures from 2024Q1–2024Q4, and staffing numbers from 2025Q1.
The July refresh also incorporates a specification change to survey ratings. Rather than being based on the three most recent survey cycles, survey ratings now reflect only the two most recent cycles, while continuing to account for complaint and infection control deficiencies within the 13–36 month window. This change may impact survey scores differently depending on whether a new survey was included in the July dataset. Members can review statewide impacts in the analysis provided alongside the Trend Reports.
Additionally, you likely saw that the Supreme Court of Ohio ruled in favor of LeadingAge Ohio and Ohio nursing homes in its decision pertaining to the quality incentive payment (QIP). As of yet, Medicaid has not shared its plans for adjusting the quality-based portion of the payment, nor has it clarified intentions related to QIP payments going back to July 2023. LeadingAge Ohio is in active conversations with the Department and will update members as soon as more information is available. Top LeadingAge Ohio member Bethany Village in Kettering, Ohio will celebrate a remarkable milestone today, Thursday, September 11, as the community honors Leslie Laramy for 50 years of service.
The celebration, designated “Leslie Laramy Day,” will begin with an indoor parade at 10:30 a.m., followed by remarks of appreciation. Staff and residents will then gather for lunch and treats in the employee break room to recognize Leslie’s contributions.
Leslie has devoted her career to dietary services at Bethany Village, serving as a Dietetic Technician in both long-term nursing care and the Bethany Rehabilitation Center. She is officially the longest-tenured employee in the organization’s history, having been with Bethany for five of its nearly eight decades of operation. In her role, Leslie skillfully balances resident needs with nutritional standards, ensuring high-quality dietary care that supports health and well-being.
Despite reaching this extraordinary milestone, Leslie has not announced any retirement plans and continues to faithfully serve residents each day.
Learn more about Bethany Village on their website. Has your organization recently celebrated a major milestone? Opened a new building? Been featured in the news? Whether it’s a groundbreaking, an award, or a great story from your community, we want to help spread the word.
LeadingAge Ohio members are doing incredible work across the state, and we’re proud to highlight those efforts. Share your press releases, social media posts, or media coverage with us and we’ll feature them in the Member News section of The Source. We may also help amplify your story on LeadingAge Ohio’s social media channels.
To submit a news item, simply email Laurinda Johnson at ljohnson@leadingageohio.org. We can’t wait to celebrate your success! Top LeadingAge Ohio holds valuable education webinars and in-person events throughout the year. Opportunities are added weekly. See the complete Schedule of Events. Top
|
