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Nursing home groups urge statutory fix to PDPM conversion to avoid steep reimbursement cuts
Summary
LeadingAge Ohio and other nursing facility advocates told the Senate Finance Committee that a technical omission tied to the shift from RUGs to PDPM could cut nursing facility reimbursements statewide unless the legislature enacts a conversion adjustment now.
LeadingAge Ohio told the Ohio Senate Finance Committee that a technical change tied to the federal move from RUGs to PDPM will produce a de facto cut to nursing facility reimbursements unless the legislature enacts a statutory conversion factor.
The change arises as Ohio updates the case-mix measurement used to set Medicaid nursing home payments. Susan Wallace, president of LeadingAge Ohio, said the average statewide case-mix score under RUGs is about 3, while the average under PDPM would be about 1.4 — a difference that, without a conversion multiplier, would reduce reimbursement levels for many providers.
Wallace urged senators to adopt an omnibus amendment (technical-fix amendment cited in testimony as 2858) that…
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