Nursing homes and home healthcare agencies are already feeling the pinch of the state's new two-year budget.
Cuts in the rates of Medicaid reimbursements are forcing some facilities to make difficult decisions as they try to balance cost-cutting measures with patient care.
Gov. John Kasich's administration said it's a transformational state budget. Officials are attempting to shift the balance of power in long-term health care away from nursing homes and toward home and community-based care.
But the shift will be bumpy road for some.
Heritage Adult Day Health Centers provide nursing care, meals and activities for seniors who are still living at home but need around-the-clock care.
"This is sort of often the last stop before family members have to make the choice for placement. We're able to keep people out for, at least, on average about two years – out of a nursing home facility," said Executive Director Erica Drewry.
Drewry said Heritage fully agrees with the state's new emphasis on home and community services. The new state budget increases overall spending on such programs but at the same time, it cuts the Medicaid reimbursement rate by 3 percent. That means staff cuts right away and a question mark for the future.
"As we lose reimbursement, I think the question of viability is the issue and then I think families just won't have access to the services they need," Drewry said.
Nursing homes are feeling a similar pinch with Medicaid reimbursement cuts of 6 percent, dropping the daily per patient rate paid by the state from $177 to $167.
Nurse Aide Lyndsey Leffler said the cuts will mean that aides who don't lose their jobs will likely be asked to do more.
"The residents are really going to suffer because right now we can take care of 16 to 21 patients a piece which is a lot of residents and we have to take care of more. I just don't think the residents will receive the care they deserve," Leffler said.
But Bonnie Kantor-Burman, director of the Ohio Department of Aging, said the new policy focuses on giving the patient choices. She said there are financial incentives for nursing homes to improve quality and to provide care that's more individualized rather than institutionalized.
"We are expecting a different way of doing business because it's what our consumers have told us it's what they want and we're trying to help everyone understand and expect excellence," Burman said.
She said that while everyone is being asked to tighten their belts, the state's new policy gives nursing homes the tools they need to adapt for the future.
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