Ohio Administrative Code Search

...djudicatory hearing pursuant to Chapter 119. of the Revised Code, payment will continue for medicaid-covered services provided to eligible residents during the appeal of and the proposed termination of an ICFIID's provider agreement. Payment will not be made under this provision for services rendered on or after the effective date of the issuance of a final order of adjudication pursuant to Chapte...

... the following definitions apply: (1) "Admission" occurs when an individual who was not being counted in the census of any Ohio medicaid-certified ICFIID becomes a resident of an ICFIID. An admission may be a new admission or a return admission after a discharge. (2) "Advanced practice registered nurse" has the same meaning as in section 4723.01 of the Revised Code. (3) "Bed-hold day" means...

...ollowing definitions shall apply: (1) "Patient liability" means an individual's financial obligation toward the medicaid cost of care. (2) "Personal needs allowance" means a required deduction in the computation of patient liability for needs of a resident of an ICFIID. (3) "Personal needs allowance account" means an account or petty cash fund that holds the money of a resident of an IC...

... the following definitions apply: (1) "Patient liability" means an individual's financial obligation toward the medicaid cost of care. (2) "Personal needs allowance" means a required deduction in the computation of patient liability for needs of a resident of an ICFIID. (3) "Personal needs allowance account" means an account or petty cash fund that holds the personal needs allowance fun...

... the following definitions apply: (1) "Patient liability" means an individual's financial obligation toward the medicaid cost of care. (2) "Personal needs allowance" means a required deduction in the computation of patient liability for needs of a resident of an ICFIID. (3) "Personal needs allowance account" means an account or petty cash fund that holds the personal needs allowance fun...

...d in this rule is governed by rule 5123-7-12 of the Administrative Code. (B) Dental services All covered dental services provided by licensed dentists are reimbursed directly to the provider of the dental services in accordance with Chapter 5160-5 of the Administrative Code. Personal hygiene services provided by staff or contracted personnel of the ICFIID are reimbursed through the ICFIID cost r...

...ords. (B) Submission of cost reports (1) An ICFIID shall utilize the medicaid information technology system maintained by the Ohio department of medicaid to submit a cost report to the department in accordance with sections 5124.10, 5124.101, and 5124.522 of the Revised Code. (2) For good cause, an ICFIID may request and the department may grant an extension of fourteen calendar days for submit...

...ords. (B) Submission of cost reports (1) An ICFIID shall utilize the medicaid information technology system maintained by the Ohio department of medicaid to submit a cost report to the department in accordance with sections 5124.10, 5124.101, and 5124.522 of the Revised Code. (2) For good cause, an ICFIID may request and the department may grant an extension of fourteen calendar days for submit...

...ords. (B) Submission of cost reports (1) An ICFIID will utilize the medicaid information technology system maintained by the Ohio department of medicaid to submit a cost report to the department in accordance with sections 5124.10, 5124.101, and 5124.522 of the Revised Code. (2) For good cause, an ICFIID may request and the department may grant an extension of fourteen calendar days for submitt...

...ollowing definitions shall apply: (1) "Change of operator" has the same meaning as in section 5124.01 of the Revised Code. (2) "Exiting operator" has the same meaning as in section 5124.01 of the Revised Code. (3) "Facility closure" has the same meaning as in section 5124.01 of the Revised Code. (4) "Involuntary termination" has the same meaning as in section 5124.01 of the Revised Cod...

... included in the ICFIID per diem rate (1) An ICFIID shall: (a) Submit claims for payment to the Ohio department of medicaid in accordance with rule 5160-1-19 of the Administrative Code. (b) Submit claims for payment either directly or through a "trading partner" as that term is defined in rule 5160-1-20 of the Administrative Code. (c) Be a medicaid provider in an active enrollment status for all dates within the ...

...D shall use the following guidelines: (1) Any item that costs five hundred or more dollars and has a useful life of two or more years shall be capitalized and depreciated over the asset's useful life. (2) An ICFIID that has a capitalization policy in effect on the effective date of this rule to capitalize items that cost less than five hundred dollars shall continue to follow its policy and shal...

...ID will use the following guidelines: (1) Any item that costs five hundred or more dollars and has a useful life of two or more years will be capitalized and depreciated over the asset's useful life. (2) An ICFIID that has a capitalization policy in effect on the effective date of this rule to capitalize items that cost less than five hundred dollars will continue to follow its policy and will o...

... which are calculated as follows: (1) The compensation cost limits for owners and relatives of owners are calculated from: (a) Cost reports with a December thirty-first end date; and (b) Desk-reviewed and preliminarily determined to be allowable costs. (2) For each wage and hour chart of account number from attachment 6 of the cost report, calculate the compensation cost limits as follows:...

... which are calculated as follows: (1) The compensation cost limits for owners and relatives of owners are calculated from: (a) Cost reports with a December thirty-first end date; and (b) Desk-reviewed and preliminarily determined to be allowable costs. (2) For each wage and hour chart of account number from attachment 6 of the cost report, calculate the compensation cost limits as follows:...

...istrators, are calculated as follows: (1) The compensation cost limits for administrators are calculated from: (a) Cost reports with a December thirty-first end date; and (b) Desk-reviewed and preliminarily determined to be allowable costs. (2) For each administrator, calculate the hourly rate from schedule C-1 of the cost report as follows: (a) Calculate the number of days employed by subtra...

...istrators, are calculated as follows: (1) The compensation cost limits for administrators are calculated from: (a) Cost reports with a December thirty-first end date; and (b) Desk-reviewed and preliminarily determined to be allowable costs. (2) For each administrator, calculate the hourly rate from schedule C-1 of the cost report as follows: (a) Calculate the number of days employed by subtra...

...rate calculation prescribed in section 5124.171 of the Revised Code. (B) Definitions For the purposes of this rule, the following definitions shall apply: (1) "Costs of ownership" means the actual expense incurred for: (a) Depreciation and interest on any items capitalized including: (i) Buildings; (ii) Building improvements; (iii) Equipment; (iv) Extensive renovation; (v) Transpo...

...rate calculation prescribed in section 5124.17 of the Revised Code. (B) Definitions For the purposes of this rule, the following definitions apply: (1) "Costs of ownership" means the actual expense incurred for: (a) Depreciation and interest on any items capitalized including: (i) Buildings; (ii) Building improvements; (iii) Equipment; (iv) Extensive renovation; (v) Transportation...

...ollowing definitions shall apply: (1) "Extensive renovation" has the same meaning as in rule 5123-7-24 of the Administrative Code. (2) "Nonextensive renovation" means a project, approved by the department prior to the effective date of this rule in accordance with rule 5123:2-7-25 of the Administrative Code as it existed on the day immediately prior to the effective date of this rule, fo...

... the following definitions apply: (1) "Extensive renovation" has the same meaning as in rule 5123-7-24 of the Administrative Code. (2) "Nonextensive renovation" means a project, approved by the department prior to July 8, 2018 in accordance with rule 5123:2-7-25 of the Administrative Code as it existed on July 7, 2018, for the betterment, improvement, or restoration of an ICFIID beyond i...

...on established pursuant to section 5124.26 of the Revised Code for providing short-term intensive behavioral support to youth with complex behavioral support needs in a discrete unit or building of six or fewer beds. (B) Definitions For the purposes of this rule, the following definitions apply: (1) "Accredited college or university" means a college or university accredited by a national or...

... the following definitions apply: (1) "Adult" means a person twenty-two years of age or older. (2) "Business day" means a day of the week, excluding Saturday, Sunday, or a legal holiday as defined in section 1.14 of the Revised Code. (3) "Designated outlier coordinator" means a department staff member who coordinates the general operations of the ICFIID outlier services program. The designa...

...abilities profile pursuant to sections 5124.19 to 5124.193 of the Revised Code. (B) Definitions For the purposes of this rule, the following definitions shall apply: (1) "Annual facility average case mix score" means the ICFIID's average case mix score of all qualifying quarters in a calendar year. (2) "Case mix score" means the measure of the relative direct care resources needed to provide c...

...abilities profile pursuant to sections 5124.19 to 5124.193 of the Revised Code. (B) Definitions For the purposes of this rule, the following definitions apply: (1) "Annual facility average case mix score" means the ICFIID's average case mix score of all qualifying quarters in a calendar year. (2) "Case mix score" means the measure of the relative direct care resources needed to provide care an...