Ohio Revised Code Search

...) Prescribe the form to be used for completing a cost report and a uniform chart of accounts for the purpose of reporting costs on the form; (B) Distribute a paper copy of the form, or computer software for electronic submission of the form, to each provider at least sixty days before the date the cost report is due; (C) Establish guidelines for completing the form.

...t at a reasonable rate established in rules adopted under section 5124.03 of the Revised Code for the period that the rate excluded the costs.

... to division (E) of that section, or files an incomplete or inadequate report for the ICF/IID under that section, the department of developmental disabilities shall do both of the following: (1) Give written notice to the provider that the provider agreement for the ICF/IID will be terminated in thirty days unless the provider submits a complete and adequate cost report for the ICF/IID within thirty days; (2...

...hree years after an ICF/IID provider files a cost report with the department of developmental disabilities under section 5124.10 or 5124.101 of the Revised Code, the provider may amend the cost report if the provider discovers a material error in the cost report or additional information to be included in the cost report. The department shall review the amended cost report for accuracy and notify the provider ...

...f whether the reported costs are allowable costs. The department shall notify each ICF/IID provider of whether any of the reported costs are preliminarily determined not to be allowable costs, the medicaid payment rate determined under this chapter as a result of the determination regarding allowable costs, and the reasons for the determination and resulting rate. The department shall allow the provider to veri...

...s may conduct an audit, as defined in rules adopted under section 5124.03 of the Revised Code, of any cost report filed under section 5124.10, 5124.101, or 5124.522 of the Revised Code. The decision whether to conduct an audit and the scope of the audit, which may be a desk or field audit, may be determined based on prior performance of the provider, a risk analysis, or other evidence that gives the department ...

...rt year; (c) For state fiscal year 2026, a professional workforce development payment equal to ten and four hundred five thousandths per cent of the ICF/IID's desk-reviewed, actual, allowable, per medicaid day direct care costs from the applicable cost report year. (B) The department shall adjust the total per medicaid day payment rate otherwise determined for an ICF/IID under this section as directed by the ge...

...ew ICF/IID's peer group for the applicable cost report year; (ii) Multiply the amount determined under division (B)(2)(a)(i) of this section by the median annual average case-mix score for the new ICF/IID's peer group for that period; (iii) Adjust the product determined under division (B)(2)(a)(ii) of this section by the rate of inflation estimated under division (D) of section 5124.19 of the Revised Code. (...

...nce with a methodology established in rules authorized by this section. (B) The department may designate an ICF/IID, or discrete unit of an ICF/IID, as an outlier ICF/IID or unit if the ICF/IID or unit serves residents who have either of the following: (1) Diagnoses or special care needs that require direct care resources that are not measured adequately by the resident assessment instrument specified in rules au...

... the extent, if any, provided for in rules authorized by this section, the total per medicaid day payment rate determined under section 5124.15 of the Revised Code shall not be paid for ICF/IID services that an ICF/IID not designated as an outlier ICF/IID or unit provides to a resident who meets the criteria for admission to a designated outlier ICF/IID or unit, as specified in rules authorized by section 5124...

...according to the reasonable cost principles of Title XVIII.

...ual the sum of the following: (1) The lesser of the following: (a) The sum of all of the following: (i) The ICF/IID's per diem fair rental value rate for the fiscal year as determined under division (B) of this section; (ii) The ICF/IID's per diem equipment rate for the fiscal year as determined under division (D) of this section; (iii) The ICF/IID's per diem secondary building rate for the fiscal year as d...

...which the fiscal year begins. (b) The lesser of the following: (i) The ICF/IID's cost per case-mix unit for the applicable cost report year as determined under division (B) of this section; (ii) The maximum cost per case-mix unit for the ICF/IID's peer group for the fiscal year for which the rate is determined as determined under division (C) of this section. (2) Adjust the product determined under division (...

... an ICF/IID. (B) In accordance with rules adopted under section 5124.03 of the Revised Code, the department of developmental disabilities shall assess each ICF/IID resident regardless of payment source and compile complete assessment data on the residents. The department shall perform the initial assessment of an ICF/IID resident. The department may perform a subsequent assessment of an ICF/IID resident under any o...

...sident's acuity group as specified in rules authorized by this section. (B) The department shall place each ICF/IID resident into one of the acuity groups. In determining which acuity group an ICF/IID resident is to be placed into, the department shall do all of the following: (1) In accordance with rules authorized by this section and using the most recent resident assessment data for the ICF/IID resident availa...

... a case-mix score that is five per cent less than the ICF/IID's case-mix score as of the day immediately preceding the day on which the reduction takes effect if the provider does not timely comply with division (D) of section 5124.191 of the Revised Code. (2) Subject to division (B)(3) of this section, before assigning a case-mix score to an ICF/IID under division (B)(1) of this section, the department shall perm...

...s to either of the following is valid unless the change is applied prospectively and the department complies with division (B) of this section: (1) The department's instructions or guidelines for the resident assessment instrument used to compile or revise assessment data of ICF/IID residents under section 5124.191 of the Revised Code; (2) The methodology prescribed in rules authorized by division (C)(1)(b) of se...

...nt rate. An ICF/IID's rate shall be the lesser of the individual rate determined under division (B) of this section and the maximum rate determined for the ICF/IID's peer group under division (C) of this section. (B) An ICF/IID's individual rate is the sum of the following: (1) The ICF/IID's desk-reviewed, actual, allowable, per diem indirect care costs for the applicable cost report year, adjusted for the inflat...

...ICF/IID's desk-reviewed, actual, allowable, per diem other protected costs from the applicable cost report year, adjusted for inflation using the following: (A) Subject to division (B) of this section, the consumer price index for all urban consumers for nonprescription drugs and medical supplies, as published by the United States bureau of labor statistics; (B) If the United States bureau of labor statistics cea...

...cators workgroup established by Section 261.230 this act . (C) An ICF/IID's per medicaid day quality incentive payment for a fiscal year shall be the product of the following: (1) The relative weight point value for the fiscal year as determined under division (D) of this section; (2) The number of points the ICF/IID was awarded under division (B) of this section for the fiscal year. (D) The relative weight p...

...ts for the rate add-on established in rules authorized by this section. (B) An ICF/IID that has been approved by the department of developmental disabilities to provider outlier ICF/IID services under this section shall provide the services in accordance with both of the following: (1) The best practices protocol the department of developmental disabilities determined is acceptable; (2) Requirements regarding the ...

...ts for the rate add-on established in rules adopted under section 5124.03 of the Revised Code. (B) An ICF/IID that has been approved by the department to provide outlier ICF/IID services under this section shall provide the services in accordance with both of the following: (1) The best practices protocol described in division (A)(1) of this section; (2) Requirements regarding the services established in rules ...

...equivalents and shall be specified in rules adopted under section 5124.03 of the Revised Code. Compensation cost limits for administrators shall be based on compensation costs for administrators who are not owners or relatives of owners, as reported on ICFs/IID's cost reports.

...provider by a related party are includable in the allowable costs of the provider at the reasonable cost to the related party.

...ements of federal or state statutes, rules, or policies enacted or amended after January 1, 1992, or with orders issued by state or local fire authorities.