Ohio skilled nursing facilities have shed or plan to shed 2,800 jobs in the wake of recent Medicare and Medicaid cuts, new survey results show. It could be just the start of losses to be felt around the country.

The Ohio Health Care Association and Academy of Senior Health Sciences conducted the survey in September. They revealed the results during a joint conference call Wednesday with the Alliance for Quality Nursing Home Care.

The Ohio survey is believed to be the first of its kind but reflects what is happening in other states, said Alan G. Rosenbloom, the president of the Alliance: “Ohio is Ground Zero for what is likely coming to the rest of the country.”

He said the loss of jobs reinforces what Avalere Health found in November. It said then that facilities could lay off up to 25,000 long-term care employees nationwide, and that an additional 2,500 jobs won’t be created.

Pete Van Runkle, the executive director of the Ohio Health Care Association, said his members had a “real shock” when the Centers for Medicare & Medicaid Services announced the average 11.1% reduction in Medicare reimbursement.

“That is more like 12% to 13% in Ohio,” Van Runkle noted. “And what has us even more concerned is that Congress isn’t done yet for what they are doing with Medicare, and the federal budget in general.”