Rule 5122-41-01 | Purpose, definitions and general standards.
(A) The purpose of this chapter is to describe the standards for a psychiatric residential treatment facility (PRTF).
(B) Definitions:
(1) "Ancillary services" means services that supplement and support the clinical services provided by the PRTF staff and are not considered direct care. An example of an ancillary service in the context of the PRTF setting would be time set aside for personal meditation or reflection.
(2) "Caregiver" means the person identified in the individual plan of care that will ultimately support the timely and effective transition of the youth into the community.
(3) "CMS" means the centers for medicare and medicaid services.
(4) "Department" means the Ohio department of mental health and addiction services.
(5) "Discharge" means a youth is leaving the PRTF without meeting treatment goals.
(6) "Home-like environment" or "home-like" means a living environment that provides for positive, nurturing interactions between caregivers and youth which may reduce the tensions of living in a group setting. Home-like environments provide softness and challenge, stability and flexibility, space for shared living and for private moments. Furnishings should be chosen for comfort as well as for durability. The home-like environment should include items such as artwork, artifacts, plants, pillows, and area rugs to add softness. The selection of wall colors, lighting fixtures, furniture, window treatments, floor coverings, and decorative accessories should also enhance the home-like environment. The home-like environment should not compromise the health and safety considerations of the youth residing in the PRTF.
(7) "Provider agreement" means a contract between the Ohio department of medicaid and an operator of a PRTF for the provision of PRTF services under the medicaid program, pursuant to rule 5160-1-17.2 of the Administrative Code. The signature of the operator or the operator's authorized agent binds the operator to the terms of the Agreement.
(8) "PRTF" means a psychiatric residential treatment facility as defined by 42 C.F.R. 483.354, as authorized under section 1905 (a)(16) and (h) of the Social Security Act.
(9) "Sensory room" means a designated therapeutic space that provides a safe and controlled environment designed to stimulate the senses and promote self-regulation. The room is equipped with various sensory equipment and materials, such as soft lighting, comfortable seating, tactile objects, and calming music, to help individuals manage sensory processing difficulties, reduce stress, and promote relaxation. A sensory room cannot be used for seclusion or restraint.
(10) "Serious injury" means any significant impairment of the physical condition of the youth as determined by qualified medical personnel. This includes, but is not limited to burns, lacerations, bone fractures, substantial hematoma, and injuries to internal organs, whether self-inflicted or inflicted by someone else.
(11) "Transition" means a youth has met their treatment goals and is transitioning to a community setting or a lower level of residential care including a group home.
(12) "Youth" means a person under the age of twenty-one.
(C) A PRTF will:
(1) Be licensed as a class one residential facility pursuant to Chapter 5122-30 of the Administrative Code, but is not required to meet the qualified residential treatment program (QRTP) standards pursuant to rule 5122-30-32 of the Administrative Code. The PRTF license will be congruent with the class one residential facility.
(2) Be selected by the Ohio department of medicaid or its designee to provide PRTF services to Ohio medicaid recipients and obtain and maintain an active provider agreement with the Ohio department of medicaid.
(3) Document PRTF services in accordance with Chapter 5122-27 of the Administrative Code.
(4) Maintain compliance with applicable state and federal laws and regulations.
(5) Hold and maintain other licenses or certificates as applicable, e.g. school, dietary, etc.
(6) Meet the federal emergency preparedness standards of 42 C.F.R. 441.184.
(7) Ensure youths receive equitable access to education.
(8) File an application with the department documenting compliance with the standards of this paragraph.
(D) PRTF psychiatric services for individuals under the age of twenty-one are to be:
(1) Provided under the direction of a physician;
(2) Provided by a psychiatric facility that is not a hospital and is accredited by the joint commission, the commission on accreditation of rehabilitation facilities, or the council on accreditation as a behavioral health residential treatment facility.
(3) Provided before the individual reaches the age of twenty-one, or, if the individual was receiving the services immediately before they reached the age of twenty-one, before the earlier of:
(a) The date the individual no longer needs the services; or,
(b) The date the individual reaches the age of twenty-two.
(4) Documented as necessary with a certification of need, as described in 42 C.F.R. 441.152.
(E) A PRTF will comply with the rules for restraint and seclusion, in accordance with rules 5122-26-16 and 5122-26-16.1 of the Administrative Code.
(F) Serious occurrence incident notification.
(1) A PRTF will meet the incident reporting standards of rule 5122-30-16 of the Administrative Code for residential facilities.
(2) In addition to the incident notification standards of rule 5122-30-16 of the Administrative Code, a PRTF will also report the following serious occurrences in writing to the department, the Ohio department of medicaid if the individual is medicaid eligible, and disability rights Ohio by the close of business the next business day following the incident:
(a) Youth death, which will also be reported to the CMS regional office.
(b) Suicide attempt.
(c) Serious injury.
(d) Substantiated abuse or neglect.
(3) The report will include the name of the youth; a description of the occurrence; and the name, street address, and telephone number of the facility.
(4) In the case of a minor, the facility will notify the youth's parents, custodian, or legal guardian as soon as possible, and in no case later than twenty-four hours after the incident.
(5) Staff will document in the youth's record that the serious occurrence was reported in accordance with this paragraph, including the name of the person with the Ohio department of medicaid and disability rights Ohio and the name of the parents, custodian, or legal guardian to whom the incident was reported. A copy of the report will be maintained in the youth's record, as well as in the incident and accident report logs kept by the facility.
(G) Each PRTF will collect and analyze PRTF performance improvement and outcomes data to identify areas of focus and performance improvement.
Last updated October 2, 2023 at 8:35 AM
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