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This website publishes administrative rules on their effective dates, as designated by the adopting state agencies, colleges, and universities.

Ohio Administrative Code Search

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Rule 5160-43-05 | Specialized recovery services program provider conditions of participation.

...(A) Specialized recovery service program providers shall maintain professional relationships with the individuals they serve. Providers shall furnish services in a person-centered manner that is in accordance with the individual's approved person-centered service plan, is attentive to the individual's needs and maximizes the individual's independence. Providers shall refrain from any behavior that...

Rule 5160-43-05 | Specialized recovery services program provider conditions of participation.

...(A) Specialized recovery service program providers shall maintain professional relationships with the individuals they serve. Providers shall furnish services in a person-centered manner that is in accordance with the individual's approved person-centered service plan, is attentive to the individual's needs and maximizes the individual's independence. Providers shall refrain from any behavior that...

Rule 5160-43-07 | Specialized recovery services program compliance: provider monitoring, oversight, structural reviews and investigations.

...(A) The Ohio department of medicaid (ODM) is responsible for the ongoing monitoring and oversight of all providers of specialized recovery services (hereafter referred to as providers) and contractors to ensure compliance with program requirements. (B) Monitoring and oversight of specialized recovery services program providers and recovery management contractors: (1) ODM and/or its designee (hereaft...

Rule 5160-43-07 | Specialized recovery services program compliance: provider monitoring, oversight, and investigations.

...(A) The Ohio department of medicaid (ODM) is responsible for the ongoing monitoring and oversight of all providers of specialized recovery services (hereafter referred to as providers) and contractors to ensure compliance with program requirements. (B) Monitoring and oversight of specialized recovery services program providers and recovery management contractors: (1) ODM and/or its designee ...

Rule 5160-43-08 | Specialized recovery services program billing procedures and payment rates for recovery management.

...(A) Definitions of terms used for billing and calculating rates. (1) "Billing unit" as used in column 4 of paragraph (C) of this rule, means a single fixed item, amount of time or measurement. (2) "Unit rate" as used in column 3 of paragraph (C) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for each fifteen minutes of service delivered. (B) Payment rates for individualized plac...

Rule 5160-43-08 | Specialized recovery services program billing procedures and payment rates for recovery management.

...(A) Definitions of terms used for billing and calculating rates. (1) "Billing unit" as used in column 4 of paragraph (C) of this rule, means a single fixed item, amount of time or measurement. (2) "Unit rate" as used in column 3 of paragraph (C) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for each fifteen minutes of service delivered. (B) Payment rates for individualized plac...

Rule 5160-43-08 | Specialized recovery services program billing procedures and payment rates for recovery management.

...(A) Definitions of terms used for billing and calculating rates. (1) "Billing unit" as used in column 4 of paragraph (C) of this rule, means a single fixed item, amount of time or measurement. (2) "Unit rate" as used in column 3 of paragraph (C) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for each fifteen minutes of service delivered, not to exceed a ma...

Rule 5160-43-08 | Specialized recovery services program billing procedures and payment rates for recovery management.

...(A) Definitions of terms used for billing and calculating rates. (1) "Billing unit" as used in column 4 of paragraph (C) of this rule, means a single fixed item, amount of time or measurement. (2) "Unit rate" as used in column 3 of paragraph (C) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for each fifteen minutes of service delivered. (B) Payment rates for individualized plac...

Rule 5160-43-09 | Specialized recovery services program criminal records checks for providers.

...(A) This rule sets forth the process and requirements for the criminal records checks of providers of home and community-based services (HCBS) to individuals enrolled in the specialized recovery services program. HCBS include peer recovery support and individualized placement and support-supported employment (IPS-SE). This rule only applies to all persons under final consideration for employment w...

Rule 5160-43-09 | Specialized recovery services program criminal records checks for providers.

...(A) This rule sets forth the process and requirements for the criminal records checks of providers of home and community-based services (HCBS) to individuals enrolled in the specialized recovery services program. HCBS include recovery management, peer recovery support and individualized placement and support-supported employment (IPS-SE). This rule only applies to all persons under final considera...

Rule 5160-43-09 | Specialized recovery services program criminal records checks for providers.

...(A) This rule sets forth the process and requirements for the criminal records checks of providers of home and community-based services (HCBS) to individuals enrolled in the specialized recovery services program. HCBS include recovery management and individualized placement and support-supported employment (IPS-SE). This rule only applies to all persons under final consideration for employment wit...

Rule 5160-44-01 | Nursing facility-based level of care home and community-based services programs: home and community-based settings.

...(A) Notwithstanding any provisions to the contrary in paragraph (E) of this rule, individuals receiving home and community-based services (HCBS) through either an Ohio department of medicaid (ODM) or Ohio department of aging (ODA) -administered waiver program authorized under section 1915(c) of the Social Security Act (as in effect on January 1, 2020) or the Ohio medicaid state plan authorized und...

Rule 5160-44-01 | Nursing facility-based level of care home and community-based services programs: home and community-based settings.

...(A) Notwithstanding any provisions to the contrary in paragraph (E) of this rule, individuals receiving home and community-based services (HCBS) through either an Ohio department of medicaid (ODM) or Ohio department of aging (ODA) -administered waiver program authorized under section 1915(c) of the Social Security Act (as in effect on January 1, 2021) or the Ohio medicaid state plan authorized und...

Rule 5160-44-01 | Nursing facility-based level of care home and community-based services programs: home and community-based settings.

...(A) Individuals receiving home and community-based services (HCBS) through either an Ohio department of medicaid (ODM) or Ohio department of aging (ODA) -administered waiver program authorized under section 1915(c) of the Social Security Act (as in effect on January 1, 2023) or the Ohio medicaid state plan authorized under section 1915(i) of the Social Security Act (as in effect on January 1, 2023...

Rule 5160-44-02 | Nursing facility-based level of care home and community-based services programs: person-centered planning.

...(A) Person-centered planning process. Individuals receiving home and community-based services (HCBS) through either an Ohio department of medicaid (ODM) or Ohio department of aging (ODA) -administered waiver program authorized under section 1915(c) of the Social Security Act (as in effect on January 1, 2016) or the Ohio medicaid state plan authorized under section 1915(i) of the Social Securi...

Rule 5160-44-02 | Nursing facility-based level of care home and community-based services programs: person-centered planning.

...(A) Person-centered planning process. Individuals receiving home and community-based services (HCBS) through either an Ohio department of medicaid (ODM) or Ohio department of aging (ODA) -administered waiver program authorized under section 1915(c) of the Social Security Act (as in effect on January 1, 2021) or the Ohio medicaid state plan authorized under section 1915(i) of the Social Securi...

Rule 5160-44-02 | Nursing facility-based level of care home and community-based services programs: person-centered planning and documentation standards.

...(A) Person-centered planning process. Individuals receiving home and community-based services (HCBS) through either an Ohio department of medicaid (ODM) or Ohio department of aging (ODA) -administered waiver program authorized under section 1915(c) of the Social Security Act (as in effect on January 1, 2024) or the Ohio medicaid state plan authorized under section 1915(i) of the Social Securi...

Rule 5160-44-05 | Nursing facility-based level of care home and community-based services (HCBS) programs, medicaid managed care organizations, the OhioRISE program, and specialized recovery services (SRS) program: incident management.

...This rule sets the standards and procedures for managing incidents that may have a negative impact on individuals. The purpose is to establish the procedures for reporting and addressing critical incidents and reportable incidents, and to implement a continuous quality improvement process to prevent and reduce the risk of harm to individuals. This rule applies to the Ohio department of aging (ODA), the Ohio...

Rule 5160-44-05 | Nursing facility-based level of care home and community-based services programs, medicaid managed care organizations, the OhioRISE program, and specialized recovery services program: incident management.

...This rule sets the standards and procedures for managing incidents that may have a negative impact on individuals. The purpose is to establish the procedures for reporting and addressing critical incidents and reportable incidents and to prevent and reduce the risk of harm to individuals. This rule applies to multiple programs administered by the Ohio department of aging (ODA) and the Ohio department of med...

Rule 5160-44-14 | Nursing facility-based level of care home and community-based services programs: community integration services.

...(A) Community integration services are independent living assistance and community support coaching activities that are necessary to enable an individual to live independently and have access to, choice of, and an opportunity to participate in, a full range of community activities. (B) Independent living assistance helps individuals to manage their households and personal affairs, self-administer...

Rule 5160-44-14 | Nursing facility-based level of care home and community-based services programs: community integration.

...(A) "Community integration" means independent living assistance and community support coaching activities that are necessary to enable an individual to live independently and have access to, choice of, and an opportunity to participate in, a full range of community activities. (B) "Independent living assistance" means help for individuals to manage their households and personal affairs, self-...

Rule 5160-44-16 | Nursing facility-based level of care home and community-based services programs: personal emergency response systems.

...(A) Personal emergency response systems (PERS) is a service with a monitoring, reminder and/or reporting component available to support individuals' independence in the community. PERS include telecommunications equipment, a central monitoring station (station), and a medium for two-way, hands-free communication between the individual and the station. Personnel at the station respond to an individ...

Rule 5160-44-16 | Nursing facility-based level of care home and community-based services programs: personal emergency response systems.

...(A) "Personal emergency response systems" (PERS) is a service with a monitoring, reminder and/or reporting component available to support individuals' independence in the community. PERS include telecommunications equipment, a central monitoring station (station), and a medium for two-way, hands-free communication between the individual and the station. Personnel at the station respond to an i...

Rule 5160-44-17 | Nursing facility-based level of care home and community-based services programs: out-of-home respite services.

...(A) "Out-of-home respite services" are services delivered to an individual in an out-of-home setting to allow respite for caregivers normally providing care. The service shall include an overnight stay. (1) An out-of-home respite provider shall make available the following: (a) Waiver nursing services as set forth in rule 5160-44-22 of the Administrative Code; (b) Personal care services as set ...

Rule 5160-44-17 | Nursing facility-based level of care home and community-based services programs: out-of-home respite.

...(A) "Out-of-home respite" are services delivered to an individual in an out-of-home setting to allow a period of rest or relief for caregivers normally providing care. The service will include an overnight stay. (1) An out-of-home respite provider will make available the following: (a) Waiver nursing services as set forth in rule 5160-44-22 of the Administrative Code; (b) Personal care services...