A tier worth crying over

A tier worth crying over

Nursing homes in Mahoning and Trumbull counties have been trying for three years to convince the state Legislature and the Ohio Department of Job and Family Services of something that should not be that tough to grasp: this isn’t predominantly farm country.

Actually, during those years, the state has changed the terminology it uses to justify its plan to shortchange area nursing homes, but the effect is the same.

In 2005, when the state had a Republican House, Senate and governor, it wasn’t too much of a surprise when Mahoning Valley nursing homes came out on the short end of the stick. Three paragraphs in the 2,300-page budget bill passed by the Ohio General Assembly established three geographic “peer groups” for all the nursing homes in the state that accept Medicaid reimbursement. Essentially, those groups are rural, which get the lowest reimbursement; urban, which get the middle reimbursement, and the six-county Cincinnati area, which gets the highest. Mahoning and Trumbull counties were put in the rural category, a classification that would cost area nursing homes tens of millions of dollars in Medicaid reimbursements each year.

Blinded to the disparities

From a political standpoint, it wasn’t difficult to understand what was happening. The state was run by Republicans and Cincinnati, the party’s stronghold, was being given the biggest piece of the nursing home reimbursement pie. Queen City legislators were not the least bit bothered by the fact that some of the counties in the six-county Cincinnati area were far more rural than Mahoning and Trumbull counties.

Today, some things have changed. The House is controlled by Democrats. The governor is a Democrat. And the reimbursement schedule now refers to tiers 1,2 and 3 rather than rural, urban and Cincinnati area. But Mahoning and Trumbull counties are still lumped in with predominantly rural counties in the lowest tier.

Nursing homes here are expected to operate on reimbursements of about $140 a day, while most other urban counties get $155 and the Cincinnati operators get $175.

The difference means nursing homes here face an impossible challenge, compared to their more favored brethren, and the two-county area’s economy loses nearly $20 million a year. That money would pay for a lot of nurses and orderlies to tend to patients and a lot of money for maintenance and improvements at the facilities.

A group of nursing homes — Windsor House, EDM Management, Shepherd of the Valley Lutheran Retirement Services, Youngstown Area Jewish federation, Prasant Group, Beeghly Oaks and Pembrooke Place — has filed a lawsuit challenging the state’s action. But it shouldn’t have come to this. The state’s politicians should have recognized that what they were doing was wrong and rectified the disparity. There’s still time for the administration and the General Assembly to do that.