Ohio’s private room incentive payment (RC 5165.158) was designed to modernize our nursing homes—rewarding facilities that invest in true private rooms, improve infection control, and restore dignity to residents. But a glaring loophole is letting the worst-performing facilities keep collecting bonus payments they no longer deserve.
Here’s the problem:
- A facility can’t apply for private room add-on payments if it’s a 1-Star home, a Special Focus Facility (SFF), or on the SFF watch list.
- But once approved, a facility that later drops to 1-Star or SFF status still gets to keep the money.
That means taxpayer dollars are flowing to failing facilities—even those flagged by CMS as among the most dangerous in the country—while higher-quality providers are shut out. Because the program’s funding is capped, every dollar sent to a failing home is a dollar denied to operators who are actually delivering safe, quality care.
This wasn’t intentional policy; it’s a drafting error. But the consequences are real:
- Rewarding failure by continuing payments after a facility falls to the bottom.
- Blocking progress by preventing stronger facilities from accessing capped funds.
- Undermining trust in Ohio’s commitment to quality and modernization.
The fix is simple and urgent: payments must stop the moment a facility becomes a 1-Star, Special Focus Facility, or SFF watch facility. Anything less is indefensible.
Ohio already recognized the importance of private rooms by creating this add-on. Now lawmakers must make sure it works as intended.
It’s time to close the loophole.
See related pieces:
Why Shared Bathrooms Undermine Ohio's Private Room Policy
Reforming Ohio's Private Room Incentive Policy
Post-Script
According to data published by the Ohio Department of Medicaid (source), nearly 90 one-star nursing facilities are currently receiving private room incentive payments.
Even more concerning, the September 2025 CMS Special Focus Facility list (source) shows more than 10 SFF or watch-list facilities doing the same.
These are exactly the providers the law was meant to exclude — yet they’re still being paid.
The numbers make one thing clear: this loophole isn’t theoretical. It’s active, costly, and fixable.
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Over 100 Failing Nursing Homes in Ohio Still Collecting Private Room Incentive Payments
