Ohio Providing $350-Plus Million to Address LTC Direct-Care Workforce Shortages

Date January 17, 2022
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The Ohio Senate and House have passed legislation to provide in excess of $350 million for the State’s long-term care (LTC) facilities and services. The bill, sponsored by State Reps. Al Cutrona (R) and D.J. Swearingen (R), restricts payments to pay, bonuses, and incentives to recruit and retain the direct-care workforce. The monies cannot be used to pay other operating costs and expenses.

In addition to $300 million for nursing homes, the bill sets aside $23 million for hospice services and $33 million for assisted living facilities, which have also experienced staff challenges during the COVID-19 pandemic. The money is derived from federal funds allocated to Ohio, and according to the legislation, must be distributed by the end of 2022. But the State has not yet announced when funds will be distributed, and apparently is awaiting federal approval.

The Ohio Department of Medicaid (ODM) will be responsible for distributing the money. ODM plans to allocate the money based on each skilled nursing facility’s (SNF) certified bed count as of December 31, 2021. Current expectations are that $3,500 will be allocated for each “skilled” bed. ODM has confirmed that $500 will be allocated for each Assisted Living bed, matching the request of the Ohio Health Care Association.

According to the U.S. Bureau of Labor Statistics, about 420,000 skilled employees have left the profession over the past two years. Ohio operators have been offering incentives for sign-on bonuses and educational costs, but the efforts have failed to make a dent in employment shortfalls. It appears the State is hoping that money will convince the workers to stay, maybe even come back. But studies show that especially younger workers are more concerned about COVID-related health issues and free time than bonuses.

Can Ohio LTC facilities use the money for costs like maintenance, dietary and janitorial staff? Not according to the letter of the law, which limits payments to those directly caring for patients. Facilities could benefit by using the funds to address a variety of expenses. With elective surgeries reduced and a general unease of the public, the number of private therapy patients, who generate higher revenues, has fallen, as has the number of Medicare patients as the concentration of Medicaid patients grows, driving down per patient revenues and creating losses for providers. The State would be wise to allow long-term care facilities to use the funds to pay a wider range of expenses so they can remain open and providing care.

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