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Nursing-home groups urge statutory fix to avoid PDPM-driven cuts in Medicaid reimbursement
Summary
LeadingAge Ohio told the Senate Finance Committee a technical omission in HB 96 could produce large, unintended cuts to nursing facility reimbursements as the state moves from RUGS to PDPM case-mix scoring unless the legislature adopts a conversion factor amendment.
Susan Wallace, testifying for LeadingAge Ohio, told the Senate Finance Committee the department’s transition from the RUGS case-mix system to PDPM could produce an “immediate, effective cut” to nursing facility reimbursements unless the legislature adopts a statutory conversion factor. Wallace said the change is not a change in services but a change in measurement: under RUGS the average statewide case mix score was roughly 3.0, whereas PDPM-based nursing scores average about 1.4. Without a conversion multiplier the move would…
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