Ohio Revised Code Search

....511 or 5124.512 of the Revised Code shall do all of the following: (A) Comply with all applicable federal statutes and regulations; (B) Comply with section 5124.07 of the Revised Code and all other applicable state statutes and rules; (C) Comply with all the terms and conditions of the exiting operator's provider agreement, including all of the following: (1) Any plan of correction; (2) Compliance with hea...

...ge of operator, the exiting operator shall be considered to be the operator of the ICF/IID for purposes of the medicaid program, including medicaid payments, until the effective date of the entering operator's provider agreement if the provider agreement is entered into under section 5124.511 or 5124.512 of the Revised Code.

...r agreement unless the department of health certifies the ICF/IID under Title XIX. The effective date of the provider agreement shall not precede any of the following: (A) The date that the department of health certifies the ICF/IID; (B) The effective date of the change of operator; (C) The date the requirement of section 5124.51 of the Revised Code is satisfied.

...The director of developmental disabilities may adopt rules under section 5124.03 of the Revised Code governing adjustments to the medicaid reimbursement rate for an ICF/IID that undergoes a change of operator. No rate adjustment resulting from a change of operator shall be effective before the effective date of the entering operator's provider agreement. This is the case regardless of whether the provider agree...

...The department of developmental disabilities' determination that a change of operator has or has not occurred for purposes of licensure under section 5123.19 of the Revised Code shall not affect either of the following: (A) A determination by the department of developmental disabilities or department of medicaid of whether or when a change of operator occurs; (B) The department of medicaid's determination of ...

...mination, the department of developmental disabilities shall estimate the amount of any overpayments made under the medicaid program to the exiting operator, including overpayments the exiting operator disputes, and other actual and potential debts the exiting operator owes or may owe to the department and United States centers for medicare and medicaid services under the medicaid program, including a franchis...

...s section, the department of developmental disabilities may withhold from payment due an exiting operator under the medicaid program the total amount specified in the notice provided under division (C) of section 5124.52 of the Revised Code that the exiting operator owes or may owe to the department and United States centers for medicare and medicaid services under the medicaid program. (B) In the case of a c...

...of this section, an exiting operator shall file with the department of developmental disabilities a cost report not later than ninety days after the last day the exiting operator's provider agreement is in effect. The cost report shall cover the period that begins with the day after the last day covered by the operator's most recent previous cost report filed under section 5124.10 or 5124.101 of the Revised Co...

...port with the department of developmental disabilities fails to file the cost report in accordance with that section, all payments under the medicaid program for the period the cost report is required to cover are deemed overpayments until the date the department receives the properly completed cost report. The department may impose on the exiting operator a penalty of one hundred dollars for each calendar day...

...The department of developmental disabilities may not provide an exiting operator final payment under the medicaid program until the department receives all properly completed cost reports the exiting operator is required to file under sections 5124.10 and 5124.522 of the Revised Code.

...The department of developmental disabilities shall determine the actual amount of debt an exiting operator owes the department and the United States centers for medicare and medicaid services under the medicaid program by completing all final fiscal audits not already completed and performing all other appropriate actions the department determines to be necessary. The department shall issue an initial debt summ...

...The department of developmental disabilities shall release the actual amount withheld under division (A) of section 5124.521 of the Revised Code, less any amount the exiting operator owes the department and United States centers for medicare and medicaid services under the medicaid program, as follows: (A) Unless the department issues the initial debt summary report required by section 5124.525 of the Revised...

...The department of developmental disabilities, at its sole discretion, may release the amount withheld under division (A) of section 5124.521 of the Revised Code if the exiting operator submits to the department written notice of a postponement of a change of operator, facility closure, or voluntary termination and the transactions leading to the change of operator, facility closure, or voluntary termination are...

...he exiting operator under section 5124.526 or 5124.527 of the Revised Code; (2) To pay the department of medicaid or department of developmental disabilities, and United States centers for medicare and medicaid services, the amount an exiting operator owes the department of medicaid or department of developmental disabilities and United States centers under the medicaid program. (B) Amounts paid from the medic...

...The director of developmental disabilities shall adopt rules under section 5124.03 of the Revised Code to implement sections 5124.50 to 5124.53 of the Revised Code. The rules shall specify all of the following: (A) The method by which written notices to the department required by sections 5124.50 to 5124.53 of the Revised Code are to be provided; (B) The forms and documents that are to be provided to the dep...

...rator of an ICF/IID may convert some or all of the beds in the ICF/IID from providing ICF/IID services to providing home and community-based services if all of the following requirements are met: (1) The operator provides the directors of health and developmental disabilities at least ninety days' notice of the operator's intent to make the conversion. (2) The operator complies with the requirements of sections 512...

...o acquires, through a request for proposals issued by the director of developmental disabilities, an ICF/IID for which a residential facility license was previously surrendered or revoked may convert some or all of the ICF/IID's beds from providing ICF/IID services to providing home and community-based services if all of the following requirements are met: (1) The person provides the directors of health and developm...

...The director of developmental disabilities may request that the medicaid director seek the approval of the United States secretary of health and human services to increase the number of slots available for home and community-based services by a number not exceeding the number of beds that were part of the licensed capacity of a residential facility that had its license revoked or surrendered under section 5123....

... of the licensed capacity of a residential facility. (B) The bed has been sold, leased, or otherwise transferred to another person or government entity.

...d- certified capacity exceeding eight shall not admit an individual as a resident unless all of the following apply: (a) The provider of the ICF/IID provides written notice about the individual's potential admission, and all information about the individual in the provider's possession, to the county board of developmental disabilities serving the county in which the individual resides at the time the notice is prov...

...onent established pursuant to section 5126.042 of the Revised Code, shall enroll the resident in the component if all of the following apply: (1) The resident is eligible and chooses to enroll in the component. (2) The component has an available slot. (3) The director of developmental disabilities determines that the department has the funds necessary to pay the nonfederal share of the medicaid expenditures for th...

.../IID became a downsized ICF/IID or partially converted ICF/IID. (b) On January 1, 2015, the ICF/IID's medicaid-certified capacity was at least twenty per cent less than the greatest medicaid-certified capacity it had before it became a downsized ICF/IID or partially converted ICF/IID. (2) An ICF/IID's sleeping room in which more than two residents reside if both of the following apply: (a) All of the residen...

... to the contrary, an ICF/IID operator shall not reserve or convert any portion of the ICF/IID's beds from providing ICF/IID services to providing services to individuals receiving services through the Ohio resilience through integrated systems and excellence (OhioRISE) program for children and youth involved in multiple state systems or children and youth with other complex behavioral health needs, if reserving or co...

...f section 5124.08 of the Revised Code shall be fined not less than five hundred dollars nor more than one thousand dollars for the first offense and not less than one thousand dollars nor more than five thousand dollars for each subsequent offense. Fines paid under this section shall be deposited in the state treasury to the credit of the general revenue fund.

...n management, as described in section 5126.14 of the Revised Code. (3) "Adult day habilitation services" does not include activities that are components of the provision of residential services, family support services, or supported living services. (C) "Appointing authority" means the following: (1) In the case of a member of a county board of developmental disabilities appointed by, or to be appointed by, a b...