The long-time head of the state's powerful nursing home lobby has resigned after months of internal differences in the organization.
The resignation of Jon Howell, first reported by Georgia Health News, came only a few months after he told lawmakers that the industry didn't need all of the money Gov. Nathan Deal recommended as part of a rate hike for select nursing homes. Several of those nursing homes are owned by one of Deal's top contributors.
But one state official said the "civil war" within the organization began before this year's General Assembly session.
The nursing home association is a major player at the statehouse, and owners have a big stake in what happens at the Capitol. The state pays more than $1 billion a year to nursing homes to care for Georgians. Owners have long been politically active, donating big money to state leaders and lawmakers who fund reimbursements.
Earlier this year, Deal recommended that select nursing homes get a $27 million a year rate increase, a bump stalled by the Department of Community Health board last year.
The industry has long been a major campaign backer of Deal's, as it has been for past governors from both parties. Contributions flowed in after the DCH board stalled the rate increase in September, including more than $60,000 in one day to Deal's re-election campaign about two weeks after the proposal was pulled.
The increase --- originally designed to go to the owners of about 40 nursing homes bought after Jan. 1, 2012 --- was stalled after The Atlanta Journal-Constitution and members of the DCH board raised questions about it. Industry officials pitched it as a way to provide extra money to new owners who upgraded their facilities, but advocates for the elderly said there was no guarantee how the money would be spent.
The Pruitt family, among Deal's top donors, have at least eight nursing homes that could benefit, according to DCH records. All eight were listed as changing ownership in 2014, including five during the General Assembly session in which the wording calling for the increase was initially inserted into the budget. The reimbursement change could increase annual payments to those homes by about $4 million.
The family's company, United Health Services, contributed $21,000 to 21 lawmakers days before the session started this year.
The industry contributed about $1 million to Deal's campaigns and Real PAC, the political action committee created to support Deal. Real PAC received about 40 percent of its contributions from the industry. The nursing home lobby also hired Deal's son-in-law just after the governor was elected in 2010.
After DCH board stalled the initial $27 million rate hike attempt, Deal recommended it be included in the budget for fiscal 2016, which begins July 1.
One nursing home owner contacted the AJC to say he was "disturbed as a taxpayer" by the request to give select owners a rate increase, describing it as political payback.
Howell told a House Budget subcommittee in February that the rate increase for new owners could be reduced to about $15 million in state and federal funding. "Some of these changes in ownership will result in lower costs, " Howell said.
Howell asked the subcommittee for a more general rate increase for all nursing homes, arguing that Georgia's reimbursement rates were the lowest in the Southeast.
But in the end, the General Assembly didn't go along with the rate increase for all nursing homes. And they included the $27 million Deal recommended.