Ohio Revised Code Search

... (7) "Long-term care facility" means a nursing home, residential care facility, or home for the aging, as those terms are defined in section 3721.01 of the Revised Code; a residential facility licensed under section 5119.34 of the Revised Code that provides accommodations, supervision, and personal care services for three to sixteen unrelated adults; a nursing facility, as defined in section 5165.01 of the Revised C...

...may make medicaid payments to a nursing facility provider under this chapter to reserve a bed for a recipient during a temporary absence under conditions prescribed by the department, to include hospitalization for an acute condition, visits with relatives and friends, and participation in therapeutic programs outside the facility, when the resident's plan of care provides for such absence and federal financial parti...

...r medicaid day payment rate for nursing facility services provided on or after that date in private rooms approved by the department of medicaid under division (C) of this section shall be the sum of both of the following: (1) The total per medicaid day payment rate determined for the nursing facility under section 5165.15 of the Revised Code; (2) The private room incentive payment. The private room incentive p...

... means either of the following: (1) A nursing home as defined in section 3721.01 of the Revised Code; (2) A facility or part of a facility that is certified as a skilled nursing facility or a nursing facility under Title XVIII or XIX of the "Social Security Act." (B) "Residential care facility" has the same meaning as in section 3721.01 of the Revised Code. (C) "Abuse" means any of the following: (1) Physic...

...ds to apply for admission to a nursing facility or resides in a nursing facility to undergo an assessment to determine whether the applicant or recipient needs the level of care provided by a nursing facility. The assessment may be performed concurrently with a long-term care consultation provided under section 173.42 of the Revised Code. To the maximum extent possible, the assessment shall be based on informa...

...dividual" means a resident of a nursing facility, an inpatient in a medical institution for whom a payment is made based on a level of care provided in a nursing facility, or an individual described in the "Social Security Act," section 1902(a)(10)(A)(ii)(VI), 42 U.S.C. 1396a(a)(10)(A)(ii)(VI). (4) "Look-back date" means the date that is a number of months specified in rules adopted under section 5163.02 of the Revi...

...sion (C) of this section, each nursing facility provider shall file with the department of medicaid an annual cost report for each of the provider's nursing facilities that participate in the medicaid program. The cost report for a year shall cover the calendar year or the portion of the calendar year during which the nursing facility participated in the medicaid program. Except as provided in division (D) of ...

... assessment data submitted by a nursing facility provider under section 5165.191 of the Revised Code. The department may conduct an exception review based on the findings of a medicaid certification survey conducted by the department of health, a risk analysis, or prior performance of the provider. Exception reviews shall be conducted by appropriate health professionals under contract with or employed by the depar...

... of a change of operator if the nursing facility participates in the medicaid program and the entering operator seeks to continue the nursing facility's participation. The written notice shall be provided to the department in accordance with the method specified in rules authorized by section 5165.53 of the Revised Code. The written notice shall be provided to the department not later than forty-five days before the ...

...denying medicaid payments to a nursing facility for all medicaid eligible residents admitted after its effective date, or an order issued under section 5165.72, 5165.73, or 5165.74 of the Revised Code denying medicaid payments to a nursing facility for medicaid eligible residents admitted after the effective date of the order who have specified diagnoses or special care needs, shall also apply to individuals a...

...e identity of any resident of a nursing facility; (b) The identity of any individual who submits a complaint about a nursing facility; (c) The identity of any individual who provides the department or agency with information about a nursing facility and has requested confidentiality; (d) Any information that reasonably would tend to disclose the identity of any individual described in division (A)(1)(a) to (c...

...f the Revised Code as a skilled nursing facility bed or long-term care bed in a manner that reduces the total number of hospital beds registered under that section as skilled nursing facility beds or long-term care beds and makes it impossible for the bed to ever be registered as a skilled nursing facility bed or long-term care bed. (B) "Change of operator" has the same meaning as in section 5165.01 of the Revised...

...ised Code shall not be paid for nursing facility services that a nursing facility not designated as an outlier nursing facility or unit provides to a resident who meets the criteria for admission to a designated outlier nursing facility or unit, as specified in rules authorized by section 5165.153 of the Revised Code. Instead, the provider of a nursing facility providing nursing facility services to such a resident s...

...section: (1) "Covered skilled nursing facility services" has the same meaning as in the "Social Security Act," section 1888(e)(2)(A), 42 U.S.C. 1395yy(e)(2)(A). (2) "Current medicare fee-for-service rate" means the fee-for-service rate in effect for a covered skilled nursing facility service under medicare at the time the service is provided. (3) "Skilled nursing facility" has the same meaning as in the "So...

...1 of the Revised Code that is a skilled nursing facility or nursing facility, both as defined in section 5165.01 of the Revised Code; (3) A county home or district home operated pursuant to Chapter 5155. of the Revised Code. (B) "Resident" means a resident or a patient of a home. (C) "Administrator" means all of the following: (1) With respect to a home as defined in section 3721.01 of the Revised Code, a nursing...

...(A) A temporary manager of a nursing facility appointed by the department of medicaid or a contracting agency under sections 5165.60 to 5165.89 of the Revised Code shall meet all of the following qualifications: (1) Be licensed as a nursing home administrator under Chapter 4751. of the Revised Code; (2) Have demonstrated competence as a nursing home administrator; (3) Have had no disciplinary action taken ag...

...ing agency imposes a fine on a nursing facility under section 5165.72, 5165.73, or 5165.74 of the Revised Code, it may impose one or more of the following: (1) One hundred sixty per cent of the amount calculated under division (C) of this section for any deficiency or cluster of deficiencies that constitutes a severity level four and scope level four finding; (2) One hundred forty per cent of the amount calcu...

...he Revised Code. (2) "Residential care facility" means a residential care facility, as defined in section 3721.01 of the Revised Code, that is issued a license pursuant to section 3721.02 of the Revised Code. (3) "Residential facility" means a residential facility licensed under section 5119.34 of the Revised Code that provides accommodations, supervision, and personal care services for three to sixteen unrel...

...fiscal year's rate paid for any nursing facility pursuant to this section at the request of the provider. The department shall use rates calculated for the current state fiscal year to make the payments due by the fifteenth day of November. If the rate paid to a provider for a nursing facility pursuant to this section is lower than the rate calculated for the nursing facility for the current state fiscal year, the d...

...No person, other than a nursing facility provider, shall submit a claim for medicaid payment for a service provided to a nursing facility resident if the service is included in a medicaid payment made to the nursing facility provider under this chapter or in the allowable expenses reported on a provider's cost report for a nursing facility. No nursing facility provider shall submit a separate claim for medicaid...

...y not deny a nursing home license to a facility seeking a license under this chapter as a nursing home on the grounds that the facility does not satisfy a requirement established in rules adopted under section 3721.04 of the Revised Code regarding the toilet rooms and dining and recreational areas of nursing homes if all of the following requirements are met: (A) The facility seeks a license under this chapte...

...ivision (D) of this section, no nursing facility shall admit as a resident any individual with a mental illness unless the facility has received evidence that the department of mental health and addiction services has determined both of the following under section 5119.40 of the Revised Code: (a) That the individual requires the level of services provided by a nursing facility because of the individual's physical a...

...ternative to hospital services, nursing facility services, or ICF/IID services. "Hospital" has the same meaning as in section 3727.01 of the Revised Code. "Hospital long-term care unit" has the same meaning as in section 5168.40 of the Revised Code. "ICDS participant" has the same meaning as in section 5164.01 of the Revised Code. "ICF/IID" and "ICF/IID services" have the same meanings as in section 5124....

...(A) As used in this section: "Nursing facility" has the same meaning as in section 5165.01 of the Revised Code. "PACE provider" has the same meaning as in the "Social Security Act," section 1934(a)(3), 42 U.S.C. 1396u-4(a)(3). (B) The department of aging shall establish a home first component of the PACE program under which eligible individuals may be enrolled in the PACE program in accordance with this section...

...dividual has been admitted to a nursing facility. (b) A physician, certified nurse-midwife if authorized as described in section 4723.438 of the Revised Code, clinical nurse specialist, or certified nurse practitioner has determined and documented in writing that the individual has a medical condition that, unless the individual is enrolled in home and community-based services such as the assisted living program, ...