Rule 5160-3-41 | Nursing facilities (NFs): placement into peer groups.
(A) NF peer groups shall be assigned according to sections 5165.16, 5165.17, and 5165.19 of the Revised Code based on the provider's geographical location and the number of licensed beds reported on the provider's annual cost report for the calendar year preceding the fiscal year for which the rate is established.
(1) For a provider new to the medicaid program, the Ohio department of medicaid (ODM) shall initially determine the number of beds in the facility from the number of licensed beds documented in the provider's licensure application as verified by the Ohio department of health (ODH). ODM shall subsequently determine the number of beds in the facility from the number of licensed beds reported on the provider's annual cost report.
(2) In the case of a change of operator, the entering operator shall be assigned to the peer group that had previously been assigned to the exiting operator on the day immediately preceding the date on which the change of operator occurred. ODM shall subsequently determine the number of beds in the facility from the number of licensed beds reported on the entering provider's annual cost report.
(B) No adjustment will be made to the provider's placement in a peer group due to a change in bed size until the first day of the fiscal year following the filing of an annual cost report that reflects the change.
Supplemental Information