Ohio Revised Code Search

...opmental disabilities for a residential facility license under section 5123.19 of the Revised Code for the ICF/IID; (2) Not later than July 1, 2013, obtain the residential facility license for the ICF/IID. (B) The nursing home license of an ICF/IID shall cease to be valid at the earliest of the following: (1) The date that the ICF/IID's nursing home license is revoked or voided under section 3721.07 of the Rev...

...less the medicaid provider is a nursing facility or ICF/IID, the provider's provider agreement is not revalidated pursuant to division (B)(1) of section 5164.32 of the Revised Code. (9) The medicaid provider's provider agreement is suspended, terminated, or not revalidated because of either of the following: (a) Any reason authorized or required by one or more of the following: 42 C.F.R. 455.106, 455.23, 455.41...

...21.01 of the Revised Code, residential facility as defined in section 5123.19 of the Revised Code, or hospital long-term care unit as defined in section 5168.40 of the Revised Code. For purposes of division (A)(7) of this section, a decedent's last continuous stay includes up to thirty consecutive days during which the decedent was temporarily absent from the nursing home, residential facility, or hospital lon...

...n 3702.30 of the Revised Code; (3) A nursing home or residential care facility licensed under Chapter 3721. of the Revised Code; (4) A hospital or inpatient unit licensed under section 5119.33 of the Revised Code; (5) A residential facility as defined in section 5119.34 of the Revised Code; (6) A residential facility as defined in section 5123.19 of the Revised Code; (7) A community addiction services ...

...e hospital is a member, or of a skilled nursing facility as provided in the "Health Insurance for the Aged Act," 79 Stat. 313 (1965), 42 U.S.C. 1395x(k).

... 109.85 of the Revised Code. Nursing facility and ICF/IID providers whose provider agreements are terminated pursuant to this section may continue to receive medicaid payments for up to thirty days after the effective date of the termination if the provider makes reasonable efforts to transfer medicaid recipients to another facility or to alternate care and if federal financial participation is provided for the pa...

...and facilities, furnished to a nursing facility provider by a related party are includable in the allowable costs of the provider at the reasonable cost to the related party.

...se the following penalties on a nursing facility provider: (A) If the provider does not furnish invoices or other documentation that the department requests during an audit within sixty days after the request, a fine of no more than the greater of the following: (1) One thousand dollars per audit; (2) Twenty-five per cent of the cumulative amount by which the costs for which documentation was not furnished increas...

...hall conclude each survey of a nursing facility not later than one business day after the survey team ceases to need to be on site at the facility for the survey. Not later than the day that the survey team concludes the survey, the survey team shall conduct an exit interview with the administrator or other person in charge of the facility and any other facility staff members designated by the administrator or...

...of health shall deliver to the nursing facility a detailed statement, titled a statement of deficiencies, setting forth all findings and deficiencies cited on the basis of the survey, including any finding cited pursuant to division (E) of section 5165.66 of the Revised Code. The statement shall indicate the severity and scope level of each finding and fully describe the incidents or other facts that form the b...

...onduct on-site monitoring of a nursing facility whenever a finding is cited, including any finding cited pursuant to division (E) of section 5165.66 of the Revised Code, or an emergency is found to exist. Appointment of monitors under this section is not subject to appeal under section 5165.87 or any other section of the Revised Code. No employee of a facility for which monitors are appointed, no person employe...

...all provide a written statement to the nursing facility that specifies all of the following: (1) The effective date of each remedy; (2) The deficiency or cluster of deficiencies for which each remedy is imposed; (3) The severity and scope of the deficiency or cluster of deficiencies; (4) The rationale, including all applicable factors specified in division (A) of this section, for imposing the remedies.

...means a hospital, urgent care facility, nursing home, physician, podiatrist, dentist, pharmacist, chiropractor, certified registered nurse anesthetist, dietitian, or other health care provider licensed by this state, or group of such health care providers. (I) "Qualified alliance program" means an alliance program under which health care benefits are provided to one thousand or more participants. (J) "Small employ...

....01 of the Revised Code. (F) "Nursing facility" has the same meaning as in section 5165.01 of the Revised Code. (G) "Advanced practice registered nurse" has the same meaning as in section 4723.01 of the Revised Code. (H) "Physician assistant" means an individual who holds a valid license to practice as a physician assistant issued under Chapter 4730. of the Revised Code.

...strued to prevent a hospital or nursing facility from advertising, describing, or offering to provide respiratory care, or billing for respiratory care rendered by a person licensed under this chapter or persons who may provide limited aspects of respiratory care or respiratory care tasks pursuant to division (B) of section 4761.10 of the Revised Code. (C) Notwithstanding division (A) of section 4761.10 of the Revis...

...ent. (2) "Institution" means a nursing facility, ICF/IID, or a medical institution. (3) "Permanently institutionalized individual" means an individual to whom all of the following apply: (a) Is an inpatient in an institution; (b) Is required, as a condition of the medicaid program paying for the individual's services in the institution, to spend for costs of medical or nursing care all of the individual's in...

...no individual shall qualify for nursing facility services or other medicaid-funded long-term care services if the individual's equity interest in the individual's home exceeds five hundred thousand dollars. The medicaid director shall increase this amount effective January 1, 2011, and the first day of each year thereafter, by the percentage increase in the consumer price index for all urban consumers (all item...

...medicaid program covers. (R) "Nursing facility" has the same meaning as in section 5165.01 of the Revised Code. (S) "Optional services" means the health care services and items that may be covered by the medicaid state plan or a federal medicaid waiver and for which the medicaid program receives federal financial participation. (T) "Prescribed drug" has the same meaning as in 42 C.F.R. 440.120. (U) "Provider ...

...vices provided in a hospital or nursing facility. Any licensed occupational therapist may enter into a provider agreement with the department of medicaid to provide occupational therapy services under the medicaid program.

...cation, including a hospital or nursing facility. (b) The medicaid program shall not impose a prior authorization requirement on covered services. (c) The medicaid program shall not make coverage contingent upon the medicaid recipient first receiving a referral, prescription, or treatment from a prescriber. (C) If a service described in this section could be provided by either a chiropractor licensed under Chap...

...greement other than a hospital, nursing facility, or ICF/IID. (5) "Owner" means any person having at least five per cent ownership in a noninstitutional medicaid provider. (B)(1) Except as provided in division (C) of this section and in rules authorized by this section, the department of medicaid shall suspend the provider agreement held by a medicaid provider on determining either of the following: (a) Ther...

...o any of the following: (1) A nursing facility; (2) An ICF/IID; (3) A medicaid managed care organization; (4) Any other medicaid provider or type of medicaid provider designated in rules adopted under section 5162.02 of the Revised Code. (D) The department shall not process a medicaid claim submitted on or after January 1, 2013, unless the claim is submitted through an electronic claims submission process i...

...service provided by a hospital, nursing facility, or ICF/IID shall exceed the limits established under Subpart C of 42 C.F.R. Part 447.

...r admission to or resides in a nursing facility may appeal if adversely affected by a determination made by the department of mental health and addiction services under section 5119.40 of the Revised Code or by the department of developmental disabilities under section 5123.021 of the Revised Code. If the individual is an applicant for or recipient of medicaid, the individual may appeal pursuant to section 516...

...edicaid shall not revalidate a nursing facility provider agreement if the provider fails to maintain eligibility for the provider agreement as provided in section 5165.06 of the Revised Code.