Cincinnati Could Bill Nursing Homes for Lift-Assists, Citing $1M Strain on Fire Department

Cincinnati, OH — Cincinnati officials are weighing a plan to bill nursing homes and other senior living facilities for non-emergency “lift-assist” calls, saying the growing number of requests is diverting firefighters from urgent incidents and costing taxpayers at least $1 million a year.

City data show the Cincinnati Fire Department (CFD) now handles roughly 1,600 lift-assists annually, with more than 70% originating from long-term care settings. These calls typically involve helping a resident up after a fall when no medical transport is required. Each response ties up crews for about 45 minutes on average.

What the proposal would do

Under a draft framework discussed by City Council’s health committee this week, facilities could be charged a fee per lift-assist — likely in the $250 to $500 range — with true emergencies exempt. Officials say the goal is to encourage better staffing and fall-prevention practices, not to punish residents.

“These calls are not emergencies — they’re everyday needs that facilities should handle with proper staffing,” City Manager Debra G. Mullins said at a council meeting. “Taxpayers shouldn’t foot the bill for private business shortcomings. We’re looking at a fair fee structure to encourage better practices without punishing vulnerable residents.”

Council members signaled interest in piloting the approach in neighborhoods with high call volumes as early as the second quarter of 2026. The plan could come up for a vote early next year following public hearings in December.

Why the city is acting now

Lift-assists have surged since the pandemic, city officials say, citing staffing shortages in elder care settings and an aging population across Hamilton County. CFD leaders warn the volume is stretching resources and occasionally delaying responses to life-threatening incidents.

“Our firefighters are heroes, but they’re not orderlies,” said CFD Chief of Operations Tom Muething. “Last year, we had a heart attack call delayed by 12 minutes because an engine was tied up on a lift-assist. This policy could save lives by reallocating resources.”

According to department figures, lift-assists accounted for roughly 12% of all CFD responses in fiscal 2024, up from about 8% in 2019. The department’s operating budget has surpassed $100 million, including significant overtime costs tied to rising call volume.

Pushback from providers

Nursing home leaders argue new fees would compound financial pressures in a sector still recovering from pandemic-era losses and ongoing workforce shortages. They warn facilities may have to cut services or could face closures if costs rise further.

“Nursing homes are already operating on razor-thin margins — average reimbursement from Medicare is $220 per day per resident, barely covering basics,” said Ohio Health Care Association CEO Vanessa M. Reiser. “Fees like this could force closures or staff cuts, ultimately harming the elders we all care about.”

Families are also watching closely. One Cincinnati resident wrote on social media that the idea is “terrifying,” worrying facilities might delay calling for help for fear of a bill after her mother fell three times in a month.

What other cities have learned

Several departments nationwide have adopted similar billing in recent years. In Decatur, Illinois, a $500 fee introduced in 2025 reduced lift-assist calls by about 60% within three months, according to local fire officials. “Facilities invested in lifts and training — it’s a win for everyone,” Decatur Fire Chief Steve Walker said in a previously published report.

In Cincinnati, the city estimates the policy could bring in $400,000 to $800,000 annually, depending on the final fee and compliance, offsetting a projected shortfall in CFD’s 2026 budget. Officials noted Medicaid and Medicare are unlikely to reimburse the charges, raising questions about how facilities would absorb the costs. The city is still working through enforcement and appeals processes, including how to handle repeat calls and low-income operators.

What’s next

The council’s health committee plans to solicit feedback from providers, unions, and resident advocates before drafting final legislation. If approved, the plan would exempt calls involving injuries or medical transport and focus on non-emergency, repeat incidents from facilities that city officials say could be prevented with better protocols.

For now, the debate centers on balancing public safety with elder care realities. The move marks a shift in how cities define the role of fire departments — and who pays — at a time when emergency services are busier than ever.