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Section 5165.62 | Enforcement of provisions.

...d States secretary of health and human services for the enforcement of those sections of the "Social Security Act"; and with the rules authorized by section 5165.61 of the Revised Code. The department and agencies shall enforce sections 5165.60 to 5165.89 of the Revised Code for purposes of the medicare program only to the extent prescribed by the regulations, guidelines, and procedures issued by the secretary...

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.

...d States secretary of health and human services under Title XVIII and Title XIX, sections 5165.65 to 5165.68 of the Revised Code, and rules adopted under section 3721.022 of the Revised Code.

Section 5165.65 | Exit interview with administrator.

...(A) A department of health survey team shall 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 mem...

Section 5165.66 | Citations for failure to comply with one or more certification requirements.

...ction 5165.72 of the Revised Code. (F) Immediately upon determining the severity and scope of a finding at a nursing facility, the department of health shall notify the department of medicaid and any contracting agency of the finding, the severity and scope of the finding, and whether the finding creates immediate jeopardy. Immediately upon determining that an emergency exists at a facility that does not resul...

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.

...th survey team discloses a finding that immediate jeopardy exists, the department 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 lev...

Section 5165.69 | Plan of correction.

...d States secretary of health and human services under Title XVIII and Title XIX; (b) Includes all the information required by division (A) of this section. (2) The department may consult with the department of medicaid, department of aging, and office of the state long-term care ombudsman program when determining whether a plan, or modification of an existing plan, to which division (A)(4) of this section app...

Section 5165.70 | On-site monitoring.

...The department of health may appoint employees of the department to conduct 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 emplo...

Section 5165.71 | Deficiencies not substantially corrected.

...d States secretary of health and human services under Title XIX for certification of nursing facilities that have a deficiency. (2) The department of health has approved a plan of correction submitted by the facility under section 5165.69 of the Revised Code for each deficiency. (3) The provider agrees to repay the department of medicaid, in accordance with section 5165.85 of the Revised Code, the federal sha...

Section 5165.72 | Uncorrected deficiencies constituting severity level four findings.

...(A) If the department of health cites a deficiency, or cluster of deficiencies, that was not substantially corrected before a survey and constitutes a severity level four finding, the department of medicaid or contracting agency shall, subject to sections 5165.79 to 5165.83 of the Revised Code, impose a remedy for the deficiency or cluster of deficiencies. The department or agency may act under either division ...

Section 5165.73 | Uncorrected deficiencies constituting severity level three and scope level three or four findings.

...If the department of health cites a deficiency, or cluster of deficiencies, that was not substantially corrected before a survey and constitutes a severity level three and scope level three or four finding, the department of medicaid or a contracting agency may, subject to sections 5165.82 and 5165.83 of the Revised Code, impose one or more of the following remedies: (A) Do either of the following: (1) Issue...

Section 5165.74 | Uncorrected deficiencies constituting severity level one or two or severity level three, scope level two finding.

...(A) If the department of health cites a deficiency, or cluster of deficiencies, that was not substantially corrected before a survey and constitutes a severity level three and scope level two finding, the department of medicaid or a contracting agency may, subject to sections 5165.82 and 5165.83 of the Revised Code, impose one or more of the following remedies: (1) Do either of the following: (a) Issue an ord...

Section 5165.75 | Imposing remedies and fines.

... Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A. 1; (m) Any adverse effect that the action or fine would have on the health and safety of facility residents; (n) If the noncompliance that resulted in the citation of a deficiency or cluster of deficiencies existed before a change in ownership of the facility, whether the new owner or owners have had sufficient time to correct the noncompliance. (B) Whenever...

Section 5165.76 | Fine collected if termination order does not take effect.

...At the time the department of medicaid or a contracting agency, under section 5165.71, 5165.72, or 5165.77 of the Revised Code, 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 effe...

Section 5165.77 | Emergency remedies.

...r 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 impose one or more of the following remedies: (a) Appoint, subject to the continu...

Section 5165.771 | Special focus facility program.

...ed 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 every six months to evaluate the safety and quality of care provided by a nursing facility as requi...

Section 5165.78 | Appointment of temporary resident safety assurance manager.

...nt with federal law for paying for the services of temporary resident safety assurance managers; (4) Accounting and reporting requirements for temporary resident safety assurance managers; (5) Other procedures and requirements the director determines are necessary to implement this section.

Section 5165.79 | Terminating provider agreements.

...(A) As used in this section, "terminating" 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 c...

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.

...antially corrected, or the condition of immediate jeopardy that prompted the appointment under division (A)(1)(d) of section 5165.77 of the Revised Code cannot be eliminated, prior to the expiration of the appointment, it may take one of the following actions: (1) Appoint, subject to the continuing consent of the provider, a temporary manager for the facility; (2) Apply to the common pleas court of the county ...

Section 5165.82 | Residents to whom denial of medicaid payments applies.

...le resident of the facility on the day immediately preceding the effective date of the order and continues to be a medicaid eligible resident on and after that date; (2) An individual who was a resident of the facility on the day immediately preceding the effective date of the order, continues to be a resident on and after that date, and becomes medicaid eligible on or after that date; (3) An individual who w...

Section 5165.83 | Fines.

...de to the facility for nursing facility services provided to medicaid eligible residents for a period not to exceed twelve months following the date on which payment of the fine becomes due under division (J) of this section. An amount equal to the amount by which each payment is reduced shall be deposited to the credit of the residents protection fund in accordance with section 5162.66 of the Revised Code.

Section 5165.84 | Order denying payment when deficiency is not corrected within time limits.

...(A) The department of medicaid or a contracting agency shall issue an order 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 su...

Section 5165.85 | Termination of participation for failure to correct deficiency within six months.

... States department of health and human services of the facility's compliance with the plan of correction. (F) If a provider's obligation to repay the department of medicaid under division (D) of this section results from disallowance of federal financial participation by the United States department of health and human services, the provider shall not be required to repay the department of medicaid until the f...