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Senate Finance hearing spotlights nursing facility reimbursement shift, advocates press for statutory fix
Summary
LeadingAge Ohio and nursing home advocates urged the Senate Finance Committee to add statutory language to prevent an unintended cut tied to the federal shift from RUGS to PDPM and to protect providers while some suggested a phased transition and stop‑loss protections.
Chair Serino and members of the Senate Finance Committee heard extended testimony from LeadingAge Ohio about a technical change tied to the federal move from the RUGS case‑mix system to the Patient‑Driven Payment Model (PDPM) that advocates say would, if unaddressed, create an effective cut to nursing facility reimbursement.
Why it matters: The change affects how resident case‑mix scores are translated into payment; LeadingAge Ohio testified this would move an average statewide nursing case‑mix score from about 3 under RUGS to roughly 1.4 under PDPM and that a conversion factor is required to avoid large swings in provider payments across the state.
Susan Wallace,…
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