Ohio Revised Code Search

...denying medicaid payments to a nursing facility for all medicaid eligible residents admitted to the facility on or after the effective date of the order, if the facility has failed to substantially correct within ninety days after the exit interview a deficiency or cluster of deficiencies in accordance with the plan of correction it submitted under section 5165.69 of the Revised Code, as determined by the depa...

...(A) If a nursing facility notifies the department of medicaid or a contracting agency, at any time during the six-month period following the exit interview of a survey that was the basis for citing a deficiency or deficiencies, that the deficiency or deficiencies have been substantially corrected in accordance with the plan of correction submitted and approved under section 5165.69 of the Revised Code, the depa...

...A nursing home or residential care facility may use one or more medication aides to administer prescription medications to its residents, subject to both of the following conditions: (A) Each individual used as a medication aide must hold a current, valid medication aide certificate issued by the board of nursing under this chapter. (B) The nursing home or residential care facility shall ensure that the requireme...

...1 of the Revised Code; (16) "Nursing facility" and "nursing facility services" have the same meanings as in section 5165.01 of the Revised Code. (17) "Ordering or referring only provider" means a medicaid provider who orders, prescribes, refers, or certifies a service or item reported on a claim for medicaid payment but does not bill for medicaid services. (18) "Political subdivision" means a municipal corpo...

...his section does not prohibit a nursing facility provider from excluding one or more parts of the nursing facility from the provider agreement pursuant to division (B)(1) of section 5165.08 of the Revised Code.

... the facility and the types of skilled nursing care that the facility may provide. A residential care facility that, pursuant to section 3721.012 of the Revised Code, has a policy of entering into risk agreements with residents or their sponsors shall provide each prospective resident or the individual's sponsor a written explanation of the policy and the provisions that may be contained in a risk agreement. A...

...nce is a nursing home, residential care facility, rehabilitation facility, or similar institutional facility or heath care facility. (b) If the patient is an adult and a hospice patient or client of a home health agency, the patient, the licensed health professional authorized to prescribe drugs who prescribed the drug to the patient, or an employee or agent of the prescriber has notified the pharmacist that the pa...

... A long-term care facility, including a nursing home; (e) A surgical facility; (f) An inpatient rehabilitation facility; (g) A memory care center; (h) A health care practitioner's office; (i) Any other licensed inpatient facility. (B) To qualify for a license as a basic life-support, intermediate life-support, advanced life-support, or mobile intensive care unit organization, an emergency medical service organi...

...atient in an accessible skilled nursing facility acceptable to the patient within the thirty-day period, but was unable to do so. (D) No hospital bed recategorized after August 5, 1989, as a skilled nursing bed shall be covered by a provider agreement under the medicaid program. (E) Nothing in this section requires a hospital to place a patient in any nursing home if the patient does not wish to be placed in the ...

...racting agency shall permit the nursing facility to continue participating in the medicaid program for up to six months after the exit interview, if all of the following apply: (1) The facility meets the requirements, established in regulations issued by the United States secretary of health and human services under Title XIX for certification of nursing facilities that have a deficiency. (2) The department o...

...The results of a survey of a nursing facility that is conducted under section 5165.64 of the Revised Code, including any statement of deficiencies and all findings and deficiencies cited in the statement on the basis of the survey, shall be used solely to determine the nursing facility's compliance with certification requirements or with this chapter or another chapter of the Revised Code. Those results of a survey, ...

...166.01 of the Revised Code. "Nursing facility" has the same meaning as in section 5165.01 of the Revised Code. "PASSPORT program" means the preadmission screening system providing options and resources today program (PASSPORT) that consists of a medicaid-funded component created under section 173.52 of the Revised Code and a state-funded component created under section 173.522 of the Revised Code and provides h...

...(A) Whenever a nursing facility receives a statement of deficiencies under section 5165.68 of the Revised Code, the facility shall submit to the department of health for its approval a plan of correction for each finding cited in the statement. The plan shall include all of the following: (1) Detailed descriptions of the actions the facility will take to correct each finding, including actions the facility wil...

... includes not renewing. (B) A nursing facility's participation in the medicaid program shall be terminated under sections 5165.60 to 5165.89 of the Revised Code as follows: (1) If the department of medicaid is terminating the facility's participation, it shall issue an order terminating the facility's provider agreement. (2) If the department of health, acting as a contracting agency, is terminating the faci...

...otice, statement, or order to a nursing facility under sections 5165.60 to 5165.66 and 5165.69 to 5165.89 of the Revised Code by certified mail, hand delivery, or other means reasonably calculated to provide prompt actual notice. If the notice, statement, or order is mailed, it shall be addressed to the administrator of the facility as indicated in the department's or agency's records. If it is hand delivered, it sha...

... the Revised Code terminating a nursing facility's participation in the medicaid program; (2) Appointment of a temporary manager of a facility under division (A)(1)(b) or (2)(b) of section 5165.72, or division (A)(1)(d) of section 5165.77 of the Revised Code; (3) An order issued under section 5165.72, 5165.73, 5165.74, 5165.77, or 5165.84 of the Revised Code denying medicaid payments to a facility for all medic...

...As used in this section: (1) "Nursing facility" has the same meaning as in section 5165.01 of the Revised Code. (2) "PASRR" means the preadmission screening and annual resident review of individuals with mental illnesses and intellectual disabilities required by the "Social Security Act," 42 U.S.C. 1396r(e)(7). (B) A county home or district home that is a nursing facility may provide sub-acute detoxification...

...ised Code shall not be paid for nursing facility services provided to low case-mix residents. Instead, the total rate for such nursing facility services shall be one hundred fifteen dollars per medicaid day.

...aid payment shall be made to a nursing facility provider for the day a medicaid recipient is discharged from the nursing facility.

...ment the department makes to a nursing facility provider who continues to participate in medicaid: (1) Any amount the provider is required to refund, and any interest charged, under section 5165.41 of the Revised Code; (2) The amount of any penalty imposed on the provider under section 5165.42 of the Revised Code. (B) The department and a nursing facility provider may enter into an agreement under which a de...

...assessment data conducted for a nursing facility under section 5165.193 of the Revised Code after the effective date of the nursing facility's medicaid payment rate for direct care costs that is based on the resident assessment data; (C) Any medicaid payment deemed an overpayment under section 5165.523 of the Revised Code; (D) Any penalty the department imposes under section 5165.42 of the Revised Code or sect...

...eview of a claim submitted by a nursing facility provider and paid by the medicaid program to determine whether the provider was overpaid. The department shall provide the provider a written summary of the review's results. The review's results are not subject to an adjudication under Chapter 119. of the Revised Code; however, the provider may request that the medicaid director reconsider the review's results. ...

...artment of health certifies the nursing facility for participation in medicaid. The effective date of the provider agreement shall not precede any of the following: (A) The date that the department of health certifies the nursing facility; (B) The effective date of the change of operator; (C) The date the requirement of section 5165.51 of the Revised Code is satisfied.

...led a standard survey, of every nursing facility in this state on a statewide average of not more than once every twelve months. Each nursing facility shall undergo a standard survey at least once every fifteen months as a condition of meeting certification requirements. The department may extend a standard survey; such a survey is titled an extended survey. (B) The department may conduct surveys in addition t...

...itutionalization in a hospital, skilled nursing facility, or intermediate care facility for individuals with intellectual disabilities. (G) "Private, nonprofit therapeutic wilderness camp" means a structured, alternative residential setting for children who are experiencing emotional, behavioral, moral, social, or learning difficulties at home or school in which all of the following are the case: (1) The childr...