Advocacy Effort Delivers “Home Run” for Nursing Homes and Residents

In late 2018, several Care Providers Oklahoma members took stock of Oklahoma’s Medicaid landscape and had a realization: the status quo could not sustain a healthy skilled nursing home profession, even in the short term. With some of the lowest Medicaid reimbursement rates in the nation, the average Oklahoma facility was losing over $300,000 annually in unreimbursed Medicaid expenses and over one-third of all facilities were in danger of closing.

“Our owners decided something had to give,” said Care Providers Oklahoma CEO Nico Gomez. “Our directive was to swing for a home run because a base hit was not going to get us back into the game.”

The “homerun hitter,” it was decided, would need to be a new organization that represented a broader coalition than just nursing home administrators and staff. That new organization was formed and named the Oklahoma Health Action Network, or OHAN. The role of OHAN, beginning in late 2018 and continuing throughout the 2019 session, was to find and engage tens of thousands of Oklahoma voters and encourage them to contact their legislators in favor of significant funding increases tied to quality improvement measures at nursing homes.

OHAN found those voters online – through highly targeted Google and Facebook ads – with tremendous success. By the end of the 2019 legislative session, over 30,000 Oklahomans had sent over 60,000 emails to their state representatives and senators on behalf of Oklahoma nursing homes. At the same time, OHAN also worked to tell the stories of the men and women who stood to benefit most from these changes: nursing home residents.

“These were the real-life stories of men and women who had survived the Dust Bowl, raised kids, served our country, and still had a lot of life to live,” said Gomez. “We were asking voters and legislators the question, ‘are they worth it?’ Are these men and women in the Greatest Generation worth the resources required to give them a good quality of life? The answer we got was a resounding ‘yes.”

While OHAN pursued an aggressive digital advocacy campaign, the Care Providers Oklahoma Board and staff (as well as its longtime lobbying firm, FKG Consulting) worked to build bridges with other eldercare organizations. Their efforts led to an unprecedented coalition of advocates that included Care Providers Oklahoma, the AARP, LeadingAge and several other key organizations that brought seniors, eldercare professionals and advocates to the Capitol on a weekly basis to meet with legislators.

Ultimately, their advocacy efforts coalesced around SB 280: The Nursing Home Quality Assurance Initiative. The bill included a series of new quality improvement metrics, training requirements, and a large funding increase: a $23 per day per Medicaid resident boost that translated to over $100 million in annual increased state and federal funding.

Lawmakers, faced with a unified group of eldercare advocates and being contacted daily by dozens of constituents through OHAN’s web portal, voted for the bill almost unanimously. Governor Kevin Stitt signed the bill in May and it will now go into effect on October 1, 2019. It was the homerun swing the skilled nursing community had been waiting for.

“This is a gamechanger for the profession, for our facilities, and most importantly for our residents,” said Gomez. “It’s the largest increase in funding we’ve received in a generation, and it brings a lot of stability to a field of work and care that has faced underfunding for years. Our lawmakers deserve a lot of praise for delivering this win, as do our advocates and our members.”

Pictured above: Madge Herndon, of Plantation Village in Altus, and John Kuhlman, at Grace Living Centers, are two of the seniors interviewed and profiled by Oklahoma Health Action Network. Madge, born in 1914, grew up walking five miles a day to school during the Dust Bowl. John became a pastor after serving in the military. Read their stories at