Rolf Martin Lang LLP Helps Secure Landmark Victory in Ohio Supreme Court for Nursing Home Providers

Rolf Martin Lang LLP (ROLF) is proud to announce a significant legal victory in the Ohio Supreme Court on behalf of Ohio’s leading nursing home associations—the Ohio Health Care Association (OHCA), LeadingAge Ohio,and The Academy of Senior Health Sciences. In a unanimous decision issued September 2, 2025, the Court granted a writ of mandamus ordering the Ohio Department of Medicaid (ODM) to recalculate the state’s Medicaid Quality Incentive (QI) payment pool in full compliance with statutory requirements.

At the heart of the case was how ODM calculated the size of the QI pool following the most recent rebasing. Rather than using 60% of the increase in each facility’s “rate for direct care costs,” as required by R.C. 5165.26(E), ODM instead relied on the narrower “price” figure—excluding the case-mix factors that directly reflect resident acuity. This approach significantly shortchanged the QI pool and reduced incentive payments to providers delivering high-quality care.

“The Supreme Court’s decision sends a clear message: when the General Assembly enacts a formula in statute, agencies must apply it exactly as written,” said Aric Martin, Managing Partner at ROLF and lead counsel for ROLF on the case. “We are honored to have helped achieve a result that strengthens both legal accountability and quality-based reimbursement for providers across Ohio.”

Joseph Petros, a partner at ROLF who co-counseled on the case, added: “This case was about ensuring that funding tied to quality is calculated fairly and lawfully. The Court agreed. That means more resources going where they belong—toward delivering better outcomes for residents.”

ROLF co-counseled the matter alongside Barnes & Thornburg LLP, and extends sincere thanks to David Paragas, Kian Hudson, and their team for their invaluable contributions and partnership throughout the litigation.

The Court ordered ODM to recalculate the QI pool using the method required by law and rejected ODM’s argument that the case was moot—affirming that the statute remains fully in effect.

This decision restores millions of dollars in quality-linked Medicaid funding and reinforces the rule of law in provider reimbursement.

DOCKET:
For a copy of the complete Supreme Court docket, please click HERE.

SELECTED NEWS COVERAGE:
Court News of Ohio: State Must Recalculate Medicaid Payments to Nursing Homes
Columbus Dispatch: Ohio Supreme Court Delivers Win to Nursing Homes over Medicaid Payments (subscription required)
WKBN: SUPCO rules in favor for nursing home funding