State Spotlight - Ohio: From Broke to Getting By

Ohio just pulled off one of the biggest Medicaid rate increases in the nation - 17% in FY 2024, putting them in the top tier nationally. Compare that to most states getting 3-8%, and you start to understand why Ohio operators went from crying to (quietly) celebrating.

What Led to the Big Increase: Governor Mike DeWine and the Ohio Legislature passed House Bill 33 (the 2024-2025 budget bill) with $3.4 billion in total provider rate increases. The nursing home bump was part of DeWine's commitment to "making sure every Ohioan receives quality care."

But here's the backstory: Ohio had the 6th highest average Medicaid reimbursement rate in the United States in 2003, but then they "reformed" their system in 2006 to make it more "efficient." Translation: they cut rates to stop "rewarding" facilities that were supposedly overstaffed. Fast forward to 2024, and Ohio realized maybe paying decent rates actually helps with care quality. Novel concept.

Where Ohio Stands Now: The 17% increase puts Ohio among the top performers nationally. Other big increases in 2024: Iowa (25.49%), Nevada (24.5%), Rhode Island (14.5%), and Texas (8-14%). Most states are still in the 3-8% range, making Ohio's jump look even more impressive.

The Provider Tax Advantage: Here's Ohio's secret weapon: they're one of only 7 states with provider tax waivers. While other states are hitting nursing homes with provider taxes that can reach 6% of net revenues, Ohio facilities get to keep more of their reimbursement. It's like playing poker with house money.

The Reality Check: Even with the 17% increase, remember that nationally, Medicaid typically pays about 70% of what private payers pay. And nationally, Medicaid payment rates for the average nursing home covered about 82 cents per every dollar of reported cost.

Bottom Line: Ohio went from being "efficient" (aka cheap) to being competitive. The 17% increase shows what happens when states decide that maybe, just maybe, paying facilities enough to actually operate is good policy. Now the question is whether other states will follow Ohio's lead or keep pretending that nursing homes can operate on government goodwill and Excel spreadsheet magic.

Jewish Operators in Ohio

Ohio is home to the Kingpin of Jewish snfs Ronnie Wilhelm who runs Communicare reputed to be at 130 homes by now.

Nossan Hochstater runs Allegiant and either leases from NobleCare or is in some kind of partnership with them.

Meir Gutman and Baruch Fink have 12 homes.

Chaim Hertanu from CareCore - 12 homes.

Mendel Brecher - 11 homes.

Mark Stein a good Jew also out of 5 towns has 4 homes. (5 towns is starting to give Lakewood a run for its money).

Mattisyahu Nussbaum - Luxorcare - 10 homes.

Nachy Steinmetz recently snatched up - in partnership with Aaron Sonnnesion 6 buildings that were operated by Embassy and now renamed to Heritage. Mazal Tov to Nachy Steinmetz on making the jump from ALFs to SNFs!

Yehuda Wenger is operating NextLevel Care (5 homes).

Then we have the Sherman Bros alex and sam running AOM (reputed to be in the 20s count of facilities).

Next we have a smart Jew out of 5 towns Sendy Kiss who is managing homes in receivership.

Matis Fried is Garden Springs healthcare at 5 homes.

Then we have Ayden Healthcare owned my Meir Kaplan out of 5 towns running 4 homes with Zalman Sommers managing them.