Ohio Administrative Code Search

... An ODM-administered waiver service provider shall maintain a professional relationship with the individuals to whom they provide services. Providers shall furnish services in a manner that is in accordance with the individual's approved person-centered services plan, is attentive to the individual's needs, and maximizes the individual's independence. A provider shall refrain from any behavior tha...

... An ODM-administered waiver service provider shall maintain a professional relationship with the individuals to whom they provide services. Providers shall furnish services in a manner that is in accordance with the individual's approved person-centered services plan, is attentive to the individual's needs, and maximizes the individual's independence. A provider shall refrain from any behavior tha...

... An ODM-administered waiver service provider will maintain a professional relationship with the individuals to whom they provide services. Providers will furnish services in a manner that is in accordance with the individual's approved person-centered services plan, is attentive to the individual's needs, and maximizes the individual's independence. A provider will refrain from any behavior that ...

...he following: (a) A home health agency provider of Ohio home care waiver services, as described in Chapter 5160-46 of the Administrative Code; (b) An Ohio department of aging (ODA) agency provider certified under section 173.391 of the Revised Code; and (c) A department of developmental disabilities (DODD) agency provider certified under section 5123.045 of the Revised Code. (2) "Appendix K" ...

...o receive SFC. (B) The waiver service provider will: (1) Be an agency provider as defined in rule 5160-45-01 of the Administrative Code meeting the following criteria: (a) For the Ohio home care waiver program, providers will be a medicare-certified home health agency or otherwise-accredited agency and operate in accordance with Chapter 5160-45 of the Administrative Code. (b) For the PA...

...f the Administrative Code. (D) "Agency provider" is an entity that is eligible to furnish services in the medicaid program upon execution of a medicaid provider agreement in accordance with rule 5160-1-17.2 of the Administrative Code. (E) "Applicant" is a person who is requesting a determination of eligibility for enrollment in an ODM-administered waiver. (F) "Authorized representative" is a pe...

...f the Administrative Code. (D) "Agency provider" is an entity that is eligible to furnish services in the medicaid program upon execution of a medicaid provider agreement in accordance with rule 5160-1-17.2 of the Administrative Code. (E) "Applicant" is a person who is requesting a determination of eligibility for enrollment in an ODM-administered waiver. (F) "Authorized representative" is a pe...

... direction of approved waiver service providers. (A) Individual rights. An individual enrolled in an ODM-administered waiver has the right to: (1) Be treated with dignity and respect. (2) Be protected from abuse, neglect, exploitation and other threats to personal health, safety and well-being. (3) Appoint an authorized representative to act on their behalf in accordance with 5160-1-33 of t...

... direction of approved waiver service providers. (A) Individual rights. An individual enrolled in an ODM-administered waiver has the right to: (1) Be treated with dignity and respect. (2) Be protected from abuse, neglect, exploitation and other threats to personal health, safety and well-being. (3) Appoint an authorized representative to act on their behalf in accordance with 5160-1-33 of t...

... direction of approved waiver service providers. (A) Individual rights. An individual enrolled in an ODM-administered waiver has the right to: (1) Be treated with dignity and respect. (2) Be protected from abuse, neglect, exploitation and other threats to personal health, safety and well-being. (3) Appoint an authorized representative to act on their behalf in accordance with 5160-1-33 of t...

... as a non-agency personal care aide provider. (b) Home care attendant services: (i) Completion of training identified in paragraph (A)(9) of rule 5160-44-27 of the Administrative Code; or (ii) Enrollment with ODM as a home care attendant provider and having completed training for the individual served. (c) Waiver nursing services: (i) Maintain an active, unrestricted Ohio nursin...

...management services (FMS) entity is the provider of self-directed goods and services. The FMS completes the purchase and reimbursement of self-directed goods and services approved in the person-centered services plan. (D) Coverage. (1) Self-directed goods and services are covered through self-direction budget authority, as described in rule 5160-45-03.2 of the Administrative Code. (2) Self-directed...

...medicaid (ODM) -administered waiver provider applicants must successfully complete the provider enrollment process set forth in this rule and receive approval from ODM before furnishing services to an individual enrolled on an ODM-administered waiver. Services furnished before ODM approves and enrolls the provider applicant are not reimbursable. (B) The provider applicant must complete and su...

... of medicaid (ODM) -administered waiver provider applicants must successfully complete the provider enrollment process set forth in this rule and receive approval from ODM before furnishing services to an individual enrolled on an ODM-administered waiver. Services furnished before ODM approves and enrolls the provider applicant and before the provider is added to the approved person-centered services plan are not rei...

...nitor every ODM-administered waiver provider. Monitoring activities shall include, but not be limited to: (1) A structural review of compliance with all ODM-administered waiver provider requirements in accordance with paragraph (B) of this rule. (2) Investigation of provider occurrences in accordance with paragraph (C) of this rule. (B) Structural reviews. (1) Medicare-certified and ot...

...nitor every ODM-administered waiver provider. Monitoring activities shall include, but not be limited to: (1) A structural review of compliance with all ODM-administered waiver provider requirements in accordance with paragraph (B) of this rule. (2) Investigation of provider occurrences in accordance with paragraph (C) of this rule. (B) Structural reviews. (1) Medicare-certified and ot...

...so a community-based long term care provider who are subject to database reviews and criminal records checks in accordance with section 173.38 of the Revised Code and rules adopted thereunder. (B) For the purposes of this rule, (1) "Applicant" means a person who is under final consideration for employment with a waiver agency in a full-time, part-time or temporary position that involves prov...

... criminal records checks of independent providers of home and community-based services (HCBS) in Ohio department of medicaid (ODM) -administered waiver programs. (B) For the purposes of this rule, (1) "Anniversary date" means the later of the effective date of the provider agreement relating to the independent provider or sixty days after the effective date of section 5164.341 of the Revised...

...all ODM-administered waiver service providers and all ODM-administered waiver contractors in order to assure providers' and contractors' compliance with ODM-administered waiver program requirements. (B) Monitoring and oversight of ODM-administered waiver service providers. (1) ODM and its designee shall conduct ongoing monitoring and oversight of ODM-administered waiver service providers to ...

... this rule, an applicant or independent provider who has been convicted of or pleaded guilty to an offense listed in paragraph (B)(5) of rule 5160-45-08 of the Administrative Code may be selected by an individual enrolled on an ODM-administered waiver program to provide them with HCBS pursuant to the timeframes set forth in this rule. (C) Tier I. Permanent exclusion. (1) No waiver agency sha...

... this rule, an applicant or independent provider who has been convicted of or pleaded guilty to an offense listed in paragraph (B)(5) of rule 5160-45-08 of the Administrative Code may be selected by an individual enrolled on an ODM-administered waiver program to provide them with HCBS pursuant to the timeframes set forth in this rule. (C) Tier I. Permanent exclusion. (1) No waiver agency sha...

...e waiver. This rule also sets forth the provider requirements and specifications for the delivery of those Ohio home care waiver services. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administrative Code. (A) Personal care aide services. (1) "Personal care aide ...

...e waiver. This rule also sets forth the provider requirements and specifications for the delivery of those Ohio home care waiver services. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administrative Code. (A) Personal care aide services. (1) "Personal care aide ...

...e waiver. This rule also sets forth the provider requirements and specifications for the delivery of those Ohio home care waiver services. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administrative Code. (A) Personal care aide services. (1) "Personal care aide...

...per job bid rate negotiated between the provider and the individual's case manager. (3) "Billing unit," as used in table B, column 3 of paragraph (B) of this rule, means a single fixed item, amount of time or measurement (e.g., a meal, a day, or mile, etc.). (4) "Caretaker relative" has the same meaning as in rule 5160:1-1-01 of the Administrative Code. (5) "Group rate," as used in paragraph (D)(1) of this rule, m...