Ohio Revised Code Search
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Section 5165.60 | Definitions for sections 5165.60 to 5165.89.
... rights" means the rights of a nursing facility resident under sections 3721.10 to 3721.17 of the Revised Code, the "Social Security Act," sections 1819(c) and 1919(c), 42 U.S.C. 1395i-3(c) and 1396r(c), and federal regulations issued under those sections of the "Social Security Act." As used in sections 5165.60 to 5165.89 of the Revised Code: (A) "Certification requirements" means the requirements for nursi... |
Section 5165.61 | Adoption of rules.
...The medicaid director may adopt rules under section 5165.02 of the Revised Code that are consistent with regulations, guidelines, and procedures issued by the United States secretary of health and human services under the "Social Security Act," sections 1819 and 1919, 42 U.S.C. 1395i-3 and 1396r, and necessary for administration and enforcement of sections 5165.60 to 5165.89 of the Revised Code. If the secretar... |
Section 5165.62 | Enforcement of provisions.
...The department of medicaid is hereby authorized to enforce sections 5165.60 to 5165.89 of the Revised Code. The department may enforce the sections directly or through contracting agencies. The department and agencies shall enforce the sections in accordance with the requirements of the "Social Security Act," sections 1819 and 1919, 42 U.S.C. 1395i-3 and 1396r, that apply to nursing facilities; with regulations... |
Section 5165.63 | Contracts with state agencies for enforcement.
...The department of medicaid may enter into contracts with other state agencies pursuant to section 5162.35 of the Revised Code that authorize the agencies to perform all or part of the duties assigned to the department of medicaid under sections 5165.60 to 5165.89 of the Revised Code. Each contract shall specify the duties the agency is authorized to perform and the sections of the Revised Code under which the a... |
Section 5165.64 | Annual standard surveys.
...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... |
Section 5165.65 | Exit interview with administrator.
...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... |
Section 5165.66 | Citations for failure to comply with one or more certification requirements.
... situations, or incidents at a nursing facility caused or resulted from the facility's failure to comply with one or more certification requirements. The department of health shall determine whether the actions, practices, situations, or incidents can be justified by either of the following: (1) The actions, practices, situations, or incidents resulted from a resident exercising the resident's rights guarante... |
Section 5165.67 | Survey results.
...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, ... |
Section 5165.68 | Statement of deficiencies.
...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... |
Section 5165.69 | Plan of correction.
...(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... |
Section 5165.70 | On-site monitoring.
...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... |
Section 5165.71 | Deficiencies not substantially corrected.
...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... |
Section 5165.72 | Uncorrected deficiencies constituting severity level four findings.
... Issue an order terminating the nursing facility's participation in the medicaid program. (b) Do either of the following: (i) Regardless of whether the provider consents, appoint a temporary manager of the facility. (ii) Apply to the common pleas court of the county in which the facility is located for such injunctive or other equitable relief as is necessary for the appointment of a special master with such ... |
Section 5165.73 | Uncorrected deficiencies constituting severity level three and scope level three or four findings.
... order denying medicaid payments to the facility for all medicaid eligible residents admitted after the effective date of the order; (2) Impose a fine. (B) Issue an order denying medicaid payments to the facility for medicaid eligible residents admitted after the effective date of the order who have certain diagnoses or special care needs specified by the department or agency; (C) Issue an order requiring the... |
Section 5165.74 | Uncorrected deficiencies constituting severity level one or two or severity level three, scope level two finding.
... order denying medicaid payments to the facility for all medicaid eligible residents admitted after the effective date of the order; (b) Impose a fine. (2) Issue an order denying medicaid payments to the facility for medicaid eligible residents admitted after the effective date of the order who have certain diagnoses or special care needs specified by the department or agency; (3) Issue an order requiring the... |
Section 5165.75 | Imposing remedies and fines.
...tect the health, safety, and rights of facility residents, but that are not directed at punishment of the facility; (2) Consider all of the following: (a) The presence or absence of immediate jeopardy; (b) The relationships of groups of deficiencies to each other; (c) The facility's history of compliance with certification requirements generally and in the specific area of the deficiency or deficiencies; (d... |
Section 5165.76 | Fine collected if termination order does not take effect.
..., issues an order terminating a nursing facility's participation in the medicaid program, the department or agency may also impose a fine, in accordance with sections 5165.72 to 5165.74 and 5165.83 of the Revised Code, to be collected in the event the termination order does not take effect. The department or agency shall not collect this fine if the termination order takes effect. |
Section 5165.77 | Emergency remedies.
...y that an emergency exists at a nursing facility, as the result of a deficiency or cluster of deficiencies that creates immediate jeopardy, the department of medicaid or a contracting agency shall impose one or more of the remedies described in division (A)(1) of this section and, in addition, may take one or both of the actions described in division (A)(2) of this section. (1) The department or agency shall i... |
Section 5165.771 | Special focus facility program.
... in this section: (1) "Special focus facility program" means the program conducted by the United States secretary of health and human services pursuant to the "Social Security Act," section 1919(f)(10), 42 U.S.C. 1396r(f)(10). (2) "Standard health surveys" mean the comprehensive on-site inspections conducted by the department of health on behalf of the United States centers for medicare and medicaid services ev... |
Section 5165.78 | Appointment of temporary resident safety assurance manager.
... of medicaid determines that a nursing facility is experiencing or is likely to experience a serious financial loss or failure that jeopardizes or is likely to jeopardize the health, safety, and welfare of its residents, the department, subject to the provider's consent, may appoint a temporary resident safety assurance manager in the nursing facility to take actions the department determines are appropriate t... |
Section 5165.79 | Terminating provider agreements.
... 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... |
Section 5165.80 | Transfer of residents to other appropriate care settings.
...(A) Whenever a nursing facility is closed under sections 5165.60 to 5165.89 of the Revised Code, the department of medicaid or contracting agency shall arrange for the safe and orderly transfer of all residents, including residents who are not medicaid eligible residents, to other appropriate care settings. Whenever a nursing facility's participation in the medicaid program is terminated under sections 5165.60 ... |
Section 5165.81 | Qualifications of temporary manager of nursing facility.
...(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... |
Section 5165.82 | Residents to whom denial of medicaid payments applies.
...ty on that or a subsequent date due to hospitalization or participation in therapeutic programs outside the facility, and chooses to return to the facility; (4) An individual who was a resident of the facility prior to the effective date of the order, is temporarily absent from the facility on that or a subsequent date due to hospitalization or participation in therapeutic programs outside the facility, become... |
Section 5165.83 | Fines.
...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... |