Trumbull, Mahoning nursing homes form coalition, sue over Medicaid plan

By Elise Franco

YOUNGSTOWN — Nursing homes in Trumbull and Mahoning counties are banding together to reverse a Medicaid proposal that could cost the facilities millions of dollars.

A lawsuit was filed Monday in Mahoning County Common Pleas Court by the Senior Rights Advocacy Group of Northeast Ohio against the Ohio Department of Job and Family Services. The group includes Windsor House, EDM Management, Shepherd of the Valley Lutheran Retirement Services, Youngstown Area Jewish federation, Prasant Group, Beeghly Oaks and Pembrooke Place.

Bonnie Deutsch Burdman, group spokeswoman, said at a Monday news conference that the suit is necessary because under the state’s “peer group system,” the system in which nursing home facilities are ranked in Ohio, Trumbull and Mahoning counties were arbitrarily categorized as “rural.” The proposed change would go into effect July 1.

Under the group system, counties can be classified as rural, urban and Cincinnati peer groups. Rural receives the least amount of funding, followed by urban and Cincinnati.

“Neither of these counties has ever before been classified as rural by any government entity,” Burdman said.

She said if Gov. Ted Strickland’s new budget passes and these groups are put into place, nursing facilities in Trumbull and Mahoning counties will receive up to $40 per patient, per day less than those in the Cincinnati group.

They “could collectively lose more than $20 million per year, potentially forcing many to close their doors,” Burdman said. “Seniors will be out of options, and up to 6,000 good-paying jobs with good benefits might be gone.”

For the past three years, Burdman said, the advocacy group has been working with the state Legislature to seek a cost-effective and sensible redistribution of Ohio’s Medicaid funding.

“To date, these efforts to change the law have been unsuccessful,” she said. “This is why we ultimately decided today to go to court.”

“Best-case scenario, the Mahoning Valley is properly put into the urban group,” she said. “It’s where we belong. The current grouping has no rational basis.”

Gary Wess, Heritage Manor executive director, said this new group would significantly affect his facility.

“We are always in danger when you’re talking about Medi- caid dollars,” he said.

Wess said because Heritage Manor, which has 58 private rooms and seven semiprivate rooms, is a not-for-profit facility, it depends greatly on Medicaid money to operate.

“If the money doesn’t come in this way, we have to find a way to scrape it up ourselves,” he said.

Tony Paglia, vice president of government affairs for the Youngstown/Warren Regional Chamber, said the chamber’s board of directors voted unanimously to back the lawsuit.

“They have a compelling case in that they haven’t been treated equitably,” he said. “We’re concerned that an unfair system is going to jeopardize these homes.”

According to the lawsuit, the Ohio Medicaid reimbursement formula was cost-based. A 2003 analytical study by the Department of Job and Family Services was then done to determine a need to change the formula.

The lawsuit states Youngstown is listed by the U.S. Census Bureau as the seventh-largest metropolitan area in Ohio, yet it is was still grouped in the rural category.

It goes on to state, “Ohio Department of Job and Family Services did not provide any explanation regarding the criteria used to assign counties into their respective groups.”

Paglia said the study seems as if it might be flawed.

“The state needs to take another look,” he said. “It’s resulted in the Mahoning Valley being at the bottom again, and I think we’re all tired of being at the bottom.”

efranco@vindy.com