Ohio faces two incontestable facts when it comes to nursing-home care -- facts that lobbyists for nursing homes (and their Capitol Hill allies) want Congress to ignore.
First, two of every five Ohio nursing homes provide care deemed substandard under federal regulations. That's as of 2015, the latest year for which data are available.
Second, the graying of Ohio is raising demand for nursing homes at the very time their quality is falling short: About 16 percent of all Ohio residents are age 65 or older now; the proportion was just 14 percent in 2010.
So what is Congress' response to these deficiencies?
As The Plain Dealer's John Caniglia and Jo Ellen Corrigan recently reported, 146 members of Congress (122 House members, with Ohio Republican Rep. Jim Renacci in the lead, and 24 senators, none from Ohio) want federal officials to reconsider - as in, "loosen" - their recently revised (toughened) standards for nursing home care.
Surely it's more than a coincidence that the campaigns of 128 of the 146 protesting lawmakers received more than $2.5 million in donations from the nursing home industry -- led by Renacci, who got the top amount, $166,400 since he took office in 2011, according to Caniglia and Corrigan, citing FollowTheMoney.org data.
Nor do the lawmakers' complaints about the standards pass the sniff test.
A lengthy investigation of Ohio nursing homes by Caniglia and Corrigan -- that uncovered numerous deficiencies in nursing home care, residents' rights, training, staffing and oversight -- has clearly shown the need for tougher federal regulation of nursing homes, not loosened standards.
Last year, the Centers for Medicare and Medicaid Services toughened the rules on acceptable care for the more than 15,000 nursing homes nationally that take Medicare and Medicaid patients. Some of the rules took effect immediately; others are being phased in.
Those who advocate for patients support the 2016 revisions and cite The Plain Dealer series in support of their need, according to Caniglia and Corrigan.
But Renacci, a Republican from Wadsworth who's now running for governor and who once owned more than 20 Ohio nursing homes, complained to the reporters that the new rules are "too sweeping" and micromanage care.
"You have Washington bureaucrats telling nursing home owners how to find a set of lost dentures," he told Caniglia and Corrigan.
The protesting lawmakers estimate the initial cost of the regulations would be $62,900 per facility, warning the changes could imperil nursing homes with tight financial margins in rural and other traditionally underserved areas.
Yet when measured against the value of the many lives entrusted to nursing homes -- and the chronic, sometimes dangerous deficiencies uncovered by Caniglia and Corrigan -- that projected cost for improved regulations, if accurate, sounds reasonable.
Nor are the new standards radical. Among other provisions, the rules would:
*Require nursing homes to determine a care plan within 48 hours of a patient's arrival, rather than the previously permitted three weeks.
*Require nursing homes to have a grievance officer and an infection control specialist, the latter of whom could be a nurse already on staff with additional training.
*Require nursing homes to provide better training for nurses' aides who care for patients with dementia.
Caniglia and Corrigan's reporting has demonstrated that more and better regulations are needed, not fewer. Renacci is wrong - the new rules aren't sweeping; they represent common sense. The nursing-home lobby's clout must not outweigh the needs of older Americans.
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