House Bill 96, the FY26-27 state operating budget, cleared both the House and Senate on June 25, 2025, after a packed week of final negotiations between the two chambers on the measure. The policy-laden spending package now heads to Governor Mike DeWine, who may consider exercising his veto powers on certain legislative-added provisions, before ultimately signing the bill by June 30.
The budget maintains contingency language that will terminate Medicaid expansion coverage should the federal matching rate drop, and also institutes overall spending reductions in the Medicaid program that were added in the Senate version (1 percent in FY26 and 1.5 percent in FY27).
Critically, the budget includes the LeadingAge Ohio-requested Patient Driven Payment Model (PDPM) transition language fix that was added by the Senate. Because PDPM scores are so much lower than RUGS scores (1.4 statewide average compared to 3.0 state average), a multiplier is needed to be applied to ensure budget neutrality. This multiplier would be included in the rates from January 1, 2026, until the next rebasing takes effect. Additionally, the bill maintains the executive-proposed implementation of the PDPM, using only the nursing score and phasing it in over three years, but adds clarifying language regarding which case mix scores should be used to calculate the rate settings across the biennium.
Additionally, problematic House-added language pertaining to a cap on the private room incentive was taken out of the final bill, maintaining current law and an annual cap of $160 million, and the House-added language raising the Personal Needs Allowance from $50 to $75 was included in the final bill.
The bill also includes House-backed language intending to allow PACE organizations to provide services to individuals prior to the Medicaid application being approved. However, the Conference Committee used the uncorrected House language referencing “presumptive eligibility” despite advocacy to amend the language before passage. For this reason, it is possible that this language will be vetoed.
Additional items included in the Medicaid portion of the budget include:
- Add-on payment of $110 per treatment for individuals receiving dialysis in nursing facilities.
- Includes a House-added provision that would allow individuals to choose their Medicaid managed care plan, and would randomly assign individuals to a managed care plan without preference if they do not make an election.
- Removes a House-added provision that would have required the Director to allow enrollment in non-MyCare special needs plans for duals (D-SNPs).
- Maintains the executive proposal for data collection on direct care HCBS worker wages, but requires the report to also be shared with leadership of the General Assembly.
- Requires the Department of Insurance to examine individuals under age 65 with end-stage renal disease and identify Medicare coverage gaps for these individuals.
- Requires Medicaid to provide notice to the legislature before seeking state plan amendments or Medicaid waiver amendments if these amendments would add either costs or grow Medicaid enrollments.
- Creates numerous reporting requirements for Medicaid, including:
- Requires Medicaid to produce annual reports on fraud, waste, and abuse in its program;
- Requires immediate notice to the legislature if CMS takes actions related to the quarterly Medicaid expenditure report;
- Requires an annual report on budgeted, actual, and forecasted number of FTEs and related expenditures;
- Requires a quarterly report to the General Assembly on the presumptive eligibility error rate;
- Requires the creation of a managed care financial dashboard, including actuarial metrics and per-member, per-month costs;
- Includes $5 million per fiscal year for performance incentives to county JFS offices, related to renewal timeliness and accuracy.
- Includes House-backed language that would require Medicaid and the Department of Developmental Disabilities to provide education on electronic visit verification (EVV), notify providers if a claim isn’t supported by EVV data, prohibits claims denial solely based on EVV data, and prohibits the state from instituting more-restrictive requirements than are federally required.
- Prohibits Medicaid funds from being used for diversity, equity & inclusion initiatives.
- Permits transfers from the Health & Human Services Fund to Medicaid to support payments for health services to providers, with the approval of the Controlling Board.
- Requires the Auditor of State to evaluate whether individuals in the aged, blind and disabled (ABD) group are eligible for Medicaid, examining whether those individuals have countable assets that exceed the limits specified under federal law.
- Abolishes the Joint Medicaid Oversight Committee (JMOC), instead directing the Legislative Service Commission (PSC) to assist standing committees of the House and Senate that deal with Medicaid on program oversight.
Most of the Executive-proposed provisions of the Department of Aging’s budget were maintained, including:
- Maintains executive-proposed increases to initial license fees, renewal fees and resident license fees administered under the Bureau of Executives of Long-term Services and Supports (BELTSS).
- Maintains ombudsman oversight of the MyCare Ohio successor program.
- Maintains house-approved levels of funding for the Senior Community Services line item, including an earmark for the iConnect program.
Please join the LeadingAge Ohio policy team for a special Advocacy in Action call on Monday, July 7, where the team will provide a complete review of the budget, including any vetoes by Governor DeWine. For questions, please contact Eli Faes at efaes@leadingageohio.org. Top You Asked: Does the CMS ePOC system update affect Ohio nursing homes?
We Answered: No. Ohio nursing homes will not be affected by the CMS transition to the new iQIES ePOC (Electronic Plan of Correction) system launching July 14, 2025.
This recent CMS announcement has caused some confusion, especially for multi-state providers that received communications regarding the ePOC system launch. However, in Ohio, the Ohio Department of Health (ODH) does not currently use the CMS ePOC platform. Because ODH manages plan of correction (POC) submissions through a separate system, Ohio providers do not need to take any additional steps related to the ePOC rollout at this time.
If your organization operates in multiple states, it is important to check with each state's survey agency to understand whether the iQIES ePOC system applies to your other locations.
While the July 14 launch does not apply to Ohio, it is possible that this functionality could expand to additional states in the future. LeadingAge Ohio will continue to monitor for any updates that may eventually impact providers in our state. Top The next Survey Success Collaborative launches July 24, offering a 6-month series on long-term care survey preparedness and sustainable compliance practices. This series guides teams through survey expectations, EMR optimization, risk evaluation, and plan of correction development. Participants will leave with step-by-step tools, actionable insights, and a clearer path toward consistent regulatory success.
Join this collaborative for peer-informed and expert solutions to help long-term care providers thrive in a challenging regulatory environment.
Register here. Join us for LeadingAge Ohio 2025 Annual Conference & Trade Show, taking place August 26–28, 2025, in Columbus, Ohio. Join hundreds of professionals from across the aging services continuum for three days of education, inspiration, and connection.
Whether you're a seasoned executive, new to the field, or somewhere in between, this conference has something for you:
- Dozens of interdisciplinary breakout sessions offering CEs and top insights
- A robust trade show featuring products and services to support your operations
- Meaningful opportunities to network with peers and learn from thought leaders
- A chance to celebrate our shared values and the people who make this work possible
Make plans now to be part of this inspiring event that brings our community together each year to grow, reflect, and lead.
Visit www.laoconference.org to explore the full schedule, register your team, and secure your accommodations. LeadingAge Ohio has partnered with Cinematic Health to offer members discounted access to ReadyCNA — an immersive, story-driven online curriculum that fulfills the classroom portion of Ohio’s CNA training.
Designed to go beyond compliance, ReadyCNA helps prepare future CNAs for the emotional, interpersonal, and physical realities of care work. By building real-world readiness from day one, this program supports not only student success, but long-term staff retention for providers across the state.
Learn more about this program here. The Nominating Committee of the LeadingAge Ohio Board of Directors is now accepting nominations for board service beginning in November 2025. In addition to identifying the annual board slate, the committee also seeks rising leaders across the membership to serve on LeadingAge Ohio committees.
Board members help guide the strategic direction of the association, meeting quarterly in Columbus—with occasional virtual meetings to address timely issues. Board candidates must be senior leaders at a LeadingAge Ohio member organization and reflect the diversity of the association’s membership in experience, geography, services, and background. This year, the committee is especially seeking individuals with expertise in philanthropy, managed/value-based care, and workforce development.
Committee service is open to professionals at any stage of their career and offers a valuable opportunity to contribute to statewide efforts, grow professionally, and build connections across the field. While we welcome new members to all LeadingAge Ohio committees, the association’s current needs include the Professional Development Committee, Affordable Housing Subcommittee, Home, Hospice & Palliative Care Committee (with an emphasis on Home Care), and the NF/AL Reimbursement Subcommittee.
To nominate yourself or a colleague, click here to complete the nomination form and email it to Molly Homan at mhoman@leadingageohio.org. Those interested in board service are also encouraged to contact Nominating Committee Chair Allison Salopeck at Allison.Salopeck@jenningsohio.org. Nominations are accepted through June 30, 2025. There's always something happening at LeadingAge Ohio, and we don’t want you to miss a moment. From educational opportunities to networking events, our calendar is packed with ways for members to stay informed, engaged, and connected.
Explore what's ahead and make plans to join us—whether you're looking to expand your knowledge, connect with peers, or get involved in shaping the future of aging services in Ohio.
View all upcoming events here and mark your calendar today!
Top As federal legislative and regulatory discussions accelerate, LeadingAge’s national policy team continues to elevate the voice of nonprofit aging services providers and advocate for policies that support mission-driven care. Below is a roundup of recent federal-level advocacy actions taken by LeadingAge:
- Urging HHS to Reinstate HICPAC:
LeadingAge submitted a letter to the U.S. Department of Health and Human Services (HHS) calling for the reinstatement of the Healthcare Infection Control Practices Advisory Committee (HICPAC), which plays a critical role in developing infection control guidance for the Centers for Disease Control and Prevention (CDC).
Read the letter here.
- Budget Reconciliation Concerns Sent to Senate Leadership:
LeadingAge urged Senate leadership to delay a floor vote on the budget reconciliation bill, citing serious concerns about its potential consequences for long-term care and other health care providers.
Read the letter here.
- LeadingAge Comments Cited in Senator Sanders’ Report:
A new report from Senator Bernie Sanders highlights the negative impacts of health care provider funding cuts proposed in the One Big Beautiful Bill Act. LeadingAge’s insights into the implications for long-term care were prominently featured.
Read the report here.
Across the country, residents in LeadingAge member communities have expressed a strong desire to speak out in support of their foreign-born caregivers and staff—individuals who provide vital services in caregiving, hospitality, and daily operations. Many of these workers, while legally employed, now face uncertainty due to shifting federal policies that limit temporary protections for immigrant workers.
In response, LeadingAge has developed a new Immigration Advocacy Toolkit for Residents, designed to help residents take action and urge Congress to protect these essential members of their community. The toolkit provides clear, accessible resources for residents to share their voices and advocate for policies that reflect the values of compassion and support.
Members are invited to download the toolkit and engage residents in this critical advocacy effort. Top The Ohio Department of Medicaid (ODM) released a request for proposals for organizations to serve as a care management agency for the Ohio Home Care Waiver (OHCW) and Specialized Recovery Services (SRS) programs.
Through the selection process, CareStar has been awarded the contract and will serve as the care management agency for both programs, effective July 1, 2025.
In the days ahead, CareStar will communicate with individuals and providers who may experience a change with their care management agency.
If you have questions about your OHCW or SRS services or care, please contact the Ohio Medicaid Consumer Hotline at 800-324-8680.
For more information about the OHCW and SRS programs, please visit the following ODM webpages.
The Ohio Department of Health’s Provider Resources and Education Program (PREP) has developed tools to aid long-term care facilities in meeting federal regulations and the State of Ohio law and rule requirements when providing respiratory care.
PREP’s Respiratory Survey Readiness Tools address:
- Aerosolized care;
- BiPAP/CPAP (bi-level positive airway pressure/continuous positive airway pressure);
- Breathing exercises;
- Oxygen administration; and
- Ventilator/tracheostomy care.
The tools provide guidance in helping facilities review the facility assessment, policy, and resident record, as well as complete observations and interviews with residents and staff. Using these tools, facilities can perform self-assessments to ensure federal regulations and state laws and rules are followed, leading to improved quality in respiratory care.
You can find the training in the PREP section of the ODH website. Search under Health Education Resources and Forms at this link.
Top A recent analysis conducted by NORC at the University of Chicago sheds new light on hospital discharge patterns for Medicare Advantage (MA) enrollees compared to those enrolled in traditional fee-for-service (FFS) Medicare. The study, which reviewed encounter claims data from 2018 to 2022, found that MA enrollees experienced longer hospital stays—ranging from 2 to 9 additional days—prior to transitioning to post-acute care (PAC).
The findings are especially notable for MA beneficiaries discharged to skilled nursing facilities (SNFs), where hospital length of stay increased by 29%, and to home health services, where length of stay was 20% longer, compared to their FFS counterparts.
While the study did not examine the role of prior authorization requirements or availability of PAC services, the data raise important questions about how MA plan policies may influence discharge timing and transitions of care.
Additional findings include:
- MA hospital discharges to PAC increased by 5.6% between 2018 and 2022
- Traditional Medicare discharges to PAC declined by 1.5% over the same period
- MA enrollees are 12.4% more likely to be discharged to home health than traditional Medicare beneficiaries
These trends highlight the need for ongoing monitoring of MA utilization patterns and their impact on care delivery for older adults.
The full bulletin is available on the LeadingAge website. Top This week, the Ohio Department of Medicaid this letter to all nursing homes and intermediate care facilities that have claims overpayments regarding a new Claims Overpayment/Recoupment Dashboard, which went live this week. The letter included a dashboard link, information about what is included, the timeline, and the process for providers to follow if they do not agree with a claim identified as an overpayment. Providers who would like all of their identified overpayments to be recouped at one time instead of incrementally will be able to report that preference to ODM as directed in the letter.
If you did not receive the letter but believe you should have, please double-check the two e-mail addresses on file in OMES:PNM, which were used to construct Medicaid’s mailinst list.
Questions regarding overpayments may be directed to Susan Wallace at swallace@leadingageohio.org. Recent harm-level citations have been issued when lift devices were not used according to the manufacturer's instructions or the facility’s internal policies. In these cases, issues were consistently related to gaps in nursing assistant competency and staffing practices. For example, staff did not fully understand the lift policy for all device types, used manual transfers when the lift was not functioning, believed they were strong or capable enough to complete the transfer on their own or partially alone while waiting for help, applied the sling incorrectly or selected the wrong type of sling, or chose not to retrieve the lift or locate a second staff member due to time pressures.
Providers should remember that manufacturer guidelines can vary significantly depending on the type of lift. For example, a mechanical sit-to-stand lift may specify not only the number of staff required but also that a resident-specific clinical assessment must be completed by a qualified individual to determine whether the lift is appropriate for that resident. Under F-tag 689, §483.25 Accidents, CMS states that the facility must implement interventions, including adequate supervision and assistive devices, consistent with a resident’s needs, goals, care plan and current professional standards of practice in order to eliminate the risk, if possible, and, if not, reduce the risk of an accident.
Some providers choose to adopt a facility-wide policy requiring two staff members for all lift transfers, regardless of the type of lift used. This approach is part of a broader system-based effort to prevent injuries and improve resident safety. The CMS State Operations Manual Appendix PP further notes that a facility’s interdisciplinary and systematic approach may include:
- Identification of hazards, including inadequate supervision, and a resident’s risks of potentially avoidable accidents in the resident environment;
- Evaluation and analysis of hazards and risks;
- Implementation of individualized, resident-centered interventions, including adequate supervision and assistive devices, to reduce individual risks related to hazards in the environment; and
- Monitoring for effectiveness and modification of interventions when necessary.
A key element of a systematic approach is the consistent application of a process to address identified hazards and/or risks. Risks may pertain to individual residents, groups of residents, or the entire facility. Hazards may include, but are not limited to, aspects of the physical plant, equipment, and devices that are defective or are not used properly (per manufacturer’s specifications), are disabled/removed, or are not individually adapted or fitted to the resident’s needs. An effective system not only proactively identifies environmental hazards and the resident’s risk for an avoidable accident, but also evaluates the resident’s need for supervision.
LeadingAge Ohio encourages facilities to monitor compliance using the surveyor guidance found in the State Operations Manual Appendix PP. Additionally, the survey pathways can be found in the Survey Resources zip file on the CMS Nursing Home webpage and under the downloads section on this CMS webpage. LeadingAge Ohio has provided survey tips to help navigate the changes in the revised QSO-25-14- NH memo. The previously provided survey tips can be accessed on the LeadingAge Ohio webpage under the Communications tab, then The Source tab. CMS has updated the survey resources on the CMS Nursing Home webpage in accordance with the revised QSO-25-14- NH memo. LeadingAge has developed webinars and resources on the requirements of participation which are located on the LeadingAge learning hub. LeadingAge continues to add QuickCasts on the regulatory groups. Updated resources have also been added on the Nursing Home RoP Tools and Resources webpage.
For more information about the requirements of participation and citations occurring in Ohio, please join us on the monthly STAT: Survey Tips and Tactics call. Register now for the July 9 call at 11:00AM. LeadingAge Ohio is sharing tips to assist members during the survey process. Send questions you would like addressed in future Tips of the Week to Stephanie DeWees at sdewees@leadingageohio.org. Top United Church Homes (UCH) is extending its NaviGuide service-coordination program by partnering with RiverWoods in Exeter, NH and ElderHelp of San Diego. Since launching in March 2022, NaviGuide has helped over 1,000 older adults and their families access healthcare and aging services with better outcomes.
The program is now live at RiverWoods and is scheduled to launch in San Diego on August 1. “These collaborations help us bring trusted, community-based support right where older adults live,” said UCH Chief Growth Officer Terry Spitznagel.
For the full press release, visit the United Church Homes newsroom.
Learn more about NaviGuide at uchnaviguide.org. Top LeadingAge Ohio holds valuable education webinars and in-person events throughout the year. Opportunities are added weekly. See the complete Schedule of Events. Top
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