CMS Approves Ohio Plan for More Private Rooms for Nursing Home Patients

July 2, 2024 Mike Smith

Article presented by National Bank of Kingston…

(Columbus) – Ohio Governor Mike DeWine announced that the Centers for Medicare & Medicaid Services (CMS) has approved a proposal from the Ohio Department of Medicaid (ODM) that will provide incentives for nursing homes to provide more private rooms for residents.

This plan is part of the governor’s comprehensive strategy to maximize the quality of care and quality of life for nursing home residents across Ohio.

“Most nursing home residents tell us that a single room significantly improves their sense of dignity, independence and comfort, and we know that single rooms also produce better health outcomes for residents.” said Governor DeWine. “In Ohio, we have the ability to provide a single room to every nursing home resident who wants one. Our proposal to make this a reality has now been approved by CMS and is also supported by the nursing home industry. We are working together to make single rooms more accessible in a way that ultimately benefits everyone.”

Under the governor’s direction, ODM developed a new reimbursement structure for Medicaid nursing home rooms that rewards facilities for each additional private room they provide.

This measure will incentivize existing nursing homes to convert more multi-resident rooms to single-occupancy rooms, while encouraging new nursing homes to prioritize single-occupancy rooms as they are built—a fundamental shift in policy designed to improve both resident satisfaction and health outcomes. Increasing the supply of single-occupancy rooms will benefit all potential nursing home residents, whether they pay out-of-pocket or are covered by Medicare or Medicaid.

According to national studies conducted by Health Management Associates, 82% of nursing home residents prefer a single room, while only 4% prefer a room with multiple residents. Currently, in Ohio, the majority of nursing home residents share a room with one other person – and often, residents have no say in who that person is.

Increasing the number of single rooms is also intended to improve the health of residents. Numerous studies in hospital settings have shown that moving from shared to single rooms immediately, substantially and sustainably reduces the risk of contracting and spreading potential infections. This same principle is particularly important for residents of nursing homes, who may be at particular risk of serious consequences if they become ill.

In long-term care facilities, private rooms also improve sleep patterns and reduce agitation and aggressive behavior in people with dementia.

“Ensuring the safety and dignity of our most vulnerable Ohioans is our top priority,” ODM Director Maureen Corcoran said. “By reducing the number of shared rooms, we are improving people’s mental wellbeing and reducing the risk of infection. We are taking proactive steps to protect care home residents and provide them with the best possible quality of care.”

With CMS approval, eligible nursing homes will receive an additional $30 per day on top of their regular daily rate for private rooms that also have a private bathroom, and an additional $20 per day for private rooms with a shared bathroom.

Work to implement the new reimbursement structure will take place over the coming months.

Ohio’s plan to expand the availability of private rooms is the latest in a series of nursing home quality improvement measures that have been implemented under Gov. DeWine.

Last year, following the creation of the Ohio Nursing Home Quality and Accountability Task Force, the Governor and General Assembly passed a package of historic nursing home investments and policy reforms as part of the state’s operating budget.

This program was designed to improve the quality of care and quality of life for nursing home residents through enhanced oversight, improved resources, increased transparency, resident empowerment, and more.

Earlier this year, Governor DeWine and the Ohio Department of Aging announced the launch of the Ohio Nursing Home Quality Navigator, a new online tool that provides users with detailed information about the state’s nursing homes in one convenient digital location. Work also continues to increase the reach of long-term care resident advocates, strengthen the state’s facility inspector base, and expand technical assistance to nursing homes, among other strategies.