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Ohio legislature proposed a $300 million plan for nursing homes

An Ohio lawmaker last year proposed allocating $ 300 million in federal COVID-19 relief funds, distributed among Ohio nursing homes without any commitment.

Ten days later, Ms. Sara Carruthers, R-Hamilton, received a $ 13,200 campaign contribution from the general manager of a chain of 59 nursing homes, $ 13,200 from her business partner and $ 13,200 from her wife. CEO.

Two weeks later, a lobbyist from a nursing home association who supported the bill gave him $ 13,200 more. The four contributions together account for almost half of all Carruthers’ 2021 fundraising.

The legislation, the House Bill 461, was not technically passed. However, the idea was incorporated into a separate appropriation bill that distributed $ 4.1 billion in federal pandemic relief funds to schools, daycare and others. This bill gave an additional $ 300 million to nursing homes, above the approximately $ 6.44 billion they receive in state and federal Medicaid funds, as long as the low-skilled industry spends it on its strength. and not in executives, administrators or staffing agencies.

However, on Wednesday, an amended form of HB 461 reappeared before the House Economic Development and Labor Committee as a completely rewritten document.

Instead of giving the facility a $ 300 million global payment, the new version of the bill requires the state Medicaid Department to pay the facility an additional refund for each resident staying in a facility. private room (instead of shared).

State analysts have not yet offered a formal estimate of the cost of the idea. However, Robert Applebaum, director of the Ohio Long-Term Care Research Project at the University of Miami, offered a high-end estimate of about $ 343 million in costs in the first year alone.

Carruthers did not respond to phone calls or an email to his legislative office.

Does the bill make sense?

Applebaum said there are many good facilities that make a sincere effort to provide adequate care that simply do not earn enough money with the state formula to reimburse the facilities for the care provided to Medicaid patients. This formula is established by state law.

However, some Ohio homes offer dangerously poor care. An investigation by the Ohio Capital Journal identified dozens of facilities that, according to federal regulators, put the health and safety of residents in “immediate danger” during the pandemic. At least 84 residents have died in connection with alleged breaches of infection control at 13 Ohio facilities during the pandemic. In addition, despite a federal requirement, only 77% of nursing home workers are vaccinated against COVID-19, the third lowest rate per state, according to federal data analyzed by ProPublica investigative journalism.

“It’s not that nursing homes don’t have one [federal COVID relief funds], but why not take advantage of it as an opportunity to improve the quality of the facilities? ” said Applebaum.

He said states can adopt strategies to improve care, such as providing more funds to go to often underpaid workers; or create a pot of money specifically for facilities that meet certain quality goals.

While it is reasonable to run the facility to place residents in private rooms, Applebaum wondered what the added costs are for the vacant facility or why lawmakers are setting such a low bar.

To reach its estimate of $ 343 million: there are about 940 nursing homes in the state, each with an average census of about 69 residents. Care for about 60% of these residents is funded by Medicaid. The bill, as written, offers an additional $ 25 per patient per day in a private room. Therefore, assuming all Medicaid patients end up in private rooms, the bill will cost $ 343 million a year. However, this crude formula probably means that more residents end up in private rooms than expected.

In recent years, the bill allows the Medicaid Department to determine additional reimbursements for housing patients in a private room.


Carruthers filed HB 461 on October 25, 2021. On November 4 of that year, Brian and Gretchen Colleran each contributed $ 13,200 to their campaign. Brian Colleran is the CEO of Foundation Health Solutions, which operates 59 nursing homes in Ohio. His business partner, Daniel Parker, contributed the same amount on the same day.

In 2017, Colleran and Parker paid $ 20 million to resolve Medicaid fraud allegations filed through the U.S. Department of Justice. He was accused of billing Medicaid for unnecessary treatment at 18 of his nursing facilities and billing Medicare for hospice services for ineligible patients. The agreement is not a guilty plea, and they were not convicted of any crime.

The two did not respond to a voice message and the written consultation left the company.

On November 19, 2021, Roger King, a lobbyist whose only client is the Academy of Senior Health Sciences, gave him $ 13,200 more. King’s phone number listed in the lobby forms addressed a call to the Executive Director of the Academy, who did not respond to the voice message.

Carruthers’ bill received its first hearing on Wednesday in its new form on a committee focused primarily on labor and economic issues, unlike committees that typically handle Medicaid and long-term care issues such as the Health Committee. , the Subcommittee on Health Finance and Human Services. , or the Commission on Families, Aging and Human Services.

The committee is chaired by Rep. Jay Edwards, R-Nelsonville, who himself has received more than $ 80,000 in campaign contributions since 2020 from Parker, Brian Colleran and Gretchen Colleran, according to campaign funding reports.

In an interview, Edwards said he knew Colleran and Parker and had “talked to them about their operations,” but that he had nothing to do with them. He acknowledged that the Carruthers bill “probably” has little to do with the workforce or the problems of economic development. However, he said it could be said that private rooms could increase staffing needs, making the bill a labor force problem.

During Wednesday’s hearing, Cincinnati Democrat MP Catherine Ingram asked why it looks like the bill was rewritten instead of presented as a new, unique bill. In an interview, he said it was part of a strategy to keep the legislation in a friendly committee where a chair would follow it up quickly, which he believes is the current strategy.

He said he supports funding for care for the elderly, but that money should keep up with growing consumer demand to provide more home care and keep Ohio residents out of nursing homes.

Ohio House Speaker Bob Cupp R-Lima did not answer questions about contributions to Carruthers or why a nursing home bill is being reviewed by an economic committee and labor.

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