Provider organizations in Oklahoma are hailing the passage of a nursing home funding bill that comes with a 15% rate hike — and a few strings attached.

The $34 million reform bill includes $22 million in additional federal funding, plus an additional $12 million in state funding that will be tied partly to performance metrics starting in October.

Providers who show a 5% improvement or meet national averages for rates of pressure ulcers, urinary tract infections, antipsychotic medication use and weight loss could gain a $5 per-patient-day bonus each quarter. That’s an average rate; if not all providers hit the benchmarks, those who do will split the bonus evenly.

The bill also includes more funding for increased direct care staffing and would hike residents’ personal needs allowance from $50 monthly to $75 monthly. It also adds five ombudsmen to work directly with residents.

It is the culmination of months of behind-the-scenes work by provider organizations who hope to move the needle forward in a state that often struggles in nationwide rankings.

Mary Brinkley, executive director of LeadingAge Oklahoma, called it a “landmark” bill that brings transparency and accountability to the industry.

“We didn’t ask for money,” Brinkley told McKnight’s Friday.  “We provided a plan. We said, ‘This is what we can do, but it costs money.’ ”

The bill now awaits the signature of Gov. Kevin Stitt (R). It has broad backing from providers, consumer advocates such as AARP and Republicans and Democrats in the state legislature.

“Nationally, we rank toward the bottom in the quality of care for seniors in our nursing homes,” Sen. Frank Simpson (R-Springer) said Wednesday. “The objective of the bill is to, No. 1, improve quality of care in our centers and doing that through an incentive program that incentivizes nursing homes to provide quality care.”

The Oklahoma Health Care Authority will periodically reexamine which metrics to include. As new problems crop up, the state can respond and motivate providers to address them.

Brinkley said her organization has already started outreach to help lower-performing providers get into the quality-improvement game. A priority will be implementing staff supports as a means to decrease turnover and achieve better outcomes.

The bill pushes facilities to increase their staffing ratio by 20%, from 2.41 nurse hours per patient day to 2.86. Brinkley said the bill would encourage more providers to provide 24-hour nurse staffing by 2020 so they can incorporate more flexible, patient-centered care. She is also advocating that facilities use increased reimbursement rates to invest in higher wages and staff education.

“Providers are going to have to ramp up,” she said.

Nico Gomez, president and CEO of Care Providers Oklahoma, told McKnight’s his members are proud of the pay-for-performance program, which they expect to “elevate the care of our residents and improve our national rankings on these metrics.”

“This was a historic investment by the governor and legislator in nursing home care for our residents,” Gomez said. “Now we have the opportunity and great responsibility to pay off this investment by showcasing what we can do for our residents and employees when the funding is right.”