Is it any surprise that a state that over-relies on nursing homes for long-term care has a shocking amount of fraud in its nursing home system? The Cleveland Plain Dealer reports:

"Some Cuyahoga County nursing homes have become warehouses for the homeless and mentally ill, using millions of taxpayer dollars to house patients who often don’t qualify for the care. Medicaid pays nursing homes to take in hundreds of Cuyahoga patients discharged every year from hospital psychiatric wards. The mentally ill are eligible for admission to nursing homes only if they need 24-hour supervision or hands-on assistance. But 60 percent of the psychiatric patients admitted into Cuyahoga nursing homes, most on Medicaid’s dime, don’t need the care, the state found."

Ohio has a powerful nursing home lobby. It spends 71% of its Medicaid long-term care funds on nursing homes (compared to the national average of 55.3%). At a time when other states are moving away from nursing home care, in Ohio legislators added an additional $80 million of state money (which means about $200 million after the federal match is added) to benefit them. 

Even though nursing home care is much more expensive than home or community-based care, Ohio continues to rely heavily on nursing homes for its long-term care needs. It shouldn't be surprising, then, that there appears to be rampant fraud in the system. It's time for the state to take a good look not only at the fraud in the system, but at the system itself. There is no justification for using expensive nursing home care for so much of the state's long-term care needs.