Location, location, location.
The real estate agent's mantra appears to apply to other things, too, including whether your county is a metropolis or a backwater in the eyes of those who dole out state Medicaid money.
Erie County with 79,000 people and three, count 'em, three municipalities that are officially cities, is rural compared with Ottawa County's 40,000 people and one official city. That's what the Ohio Department of Jobs & Family Services says, anyway. And so the state aid paid out to nursing homes in Erie County is lower.
It's because Ottawa County's closer to the Toledo metropolitan area, explain the state bean counters, and nursing homes and care in urban areas costs more, and that sort of has its own internal logic.
But apart from the silliness of whether one county's a Medicaid metropolis and the other's a healthcare hick town is the quite serious matter of the money paid out to help take care of patients who rely on Medicaid.
An elderly person living in a nursing home has medical needs, regardless of how close he or she lives to the bright lights of the big city. And if you want internal logic, then Sandusky, Huron and Vermilion are urban areas, and farther from the major medical centers than the counties on either side of us (that's the theory, anyway, behind turning Firelands Regional Medical Center into a regional medical powerhouse) and so have to rely on local resources more than those who can count Toledo and Cleveland as the People Next Door.
A person needing Medicaid help needs that help, whether he or she lives in Sandusky or Clay Center.
So the whole business of who's urban and who's rural goes beyond silly and into serious. Clearly, this is a classification system that has to be reclassified.
It could be a matter of life and death.