Most of the Ohio QIP is a straight line: every point is worth the same, $1.03 per Medicaid day for SFY2027. The floor is where the line breaks. Fall under it and every clinical and staffing point is zeroed at once.
How the floor is set
The floor is the 25th percentile of all Ohio buildings' metric points (clinical plus staffing, with occupancy left out). ODM strikes it once a year, at the July 1 setting, and keeps it for the January recalculation. For SFY2027, rates in force July 2026 through June 2027, it is 35.75 points. The year before it was 32.0.
Because it's a percentile, roughly a quarter of Ohio buildings are under it every period. It isn't a bar a good building clears once; it's a line that moves as everyone else improves.
Why one measure can decide it
Ohio scores each measure the way Five-Star does, divided by 20, with one twist: a measure in CMS's lowest band scores zero in Ohio instead of 20 or 15. So a building that slips from the second-lowest band to the lowest on a 100-point measure, like catheters or falls with major injury, loses a full 2 points.
A worked example. A building sits at 37.5 metric points. One more resident with a catheter pushes that measure into its lowest band. The building drops to 35.5, a quarter point under the floor, and every metric point goes. At $1.03 per point and 50 Medicaid residents, that is about $705,000 a year, or about $352,000 for the six-month rate period it lands in. The 3 occupancy points are still paid.
Why you won't see it coming in a spreadsheet
Ohio reads CMS's June publication for the July rate and the December publication for the January rate, each a four-quarter average. The quarter ending September 2026 first counts toward the July 2027 rate. A tracker built from Care Compare is looking at work that finished a year ago. To see the floor coming, you have to score the current quarter from your own charting, resident by resident.
See your building’s Ohio add-on and distance to the floor.
What to do about it
- Know your margin. Under two points, treat every resident on a 100-point measure as decisive.
- Watch the cliff measures. Falls with major injury drives most single-measure zeroes in Ohio.
- Don't miss a PBJ quarter. A missing quarter zeroes the staffing points, up to 5.
- Correct coding before the SNF QRP submission deadline, about four and a half months after the quarter.
More on how the whole program is scored: Ohio QIP, explained.
