Ohio Revised Code Search

... 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 determined under division (E) of this section. (b) The sum determined for the fiscal year under division (G) of this section. (2) The ICF/IID's per...

...of the Revised Code for the following calendar quarter: (i) For the rate determined for fiscal year 2019, the calendar quarter ending December 31, 2017; (ii) For the rate determined for each subsequent fiscal year, the calendar quarter ending on the last day of March of the calendar year in which the fiscal year begins. (b) The lesser of the following: (i) The ICF/IID's cost per case-mix unit for the applicab...

... (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 of the follow...

...e assessment data for ICF/IID residents under section 5124.191 of the Revised Code; (2) For each of the ICF/IID resident's domain assessment scores and using values specified in rules authorized by this section, assign the following points: (a) If the resident's assessment score for the domain is more than one standard deviation above the mean assessment score for the domain for all ICF/IID residents as of Decemb...

...and revised for the ICF/IID's residents under section 5124.191 of the Revised Code; (b) The case-mix scores of the ICF/IID's residents as determined under section 5124.192 of the Revised Code. (2) After the end of each calendar year, determine an annual average case-mix score for each ICF/IID using the ICF/IID's quarterly case-mix scores for that calendar year. (B)(1) Subject to divisions (B)(2) and (3) of this...

...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...

...esser 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 inflation rate estimated under division (E) of ...

...d medical supplies, as published by the United States bureau of labor statistics; (B) If the United States bureau of labor statistics ceases to publish the index specified in division (A) of this section, the index that is subsequently published by the bureau and covers nonprescription drugs and medical supplies.

...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...

...determines that the protocol is acceptable; (2) The provider and ICF/IID meet all other eligibility requirements 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 p...

...determines that the protocol is acceptable; (2) The provider meets all other eligibility requirements 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 describe...

...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.

...er this chapter to account for reasonable additional costs that must be incurred by ICFs/IID to comply with requirements 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.

... rate to any resident who is not eligible for medicaid.

...pient is discharged from the ICF/IID, unless the recipient is discharged from the ICF/IID because all of the beds in the ICF/IID are converted from providing ICF/IID services to providing home and community-based services pursuant to section 5124.60 or 5124.61 of the Revised Code.

...ts under this section as specified in rules authorized by this section; (2) The resident's plan of care provides for the absence; (3) Federal financial participation is available for the payments. (C) The maximum period during which medicaid payments may be made to reserve a bed shall not exceed the maximum period specified in federal regulations and shall not be more than thirty days during any calendar year for ...

...d to a medicaid recipient who is eligible for the services and resided in the ICF/IID before the effective date of the involuntary termination.

... fiscal year. If the department is unable to calculate the rates so that they can be paid by that date, the department shall pay each provider the rate calculated for the provider's ICFs/IID under those sections at the end of the previous fiscal year. If the department also is unable to calculate the rates to make the payments due by the fifteenth day of September and the fifteenth day of October, the departmen...

...xisting ICF/IID or replaced at the same site, the department, through the rate reconsideration process, may proportionately increase the ICF/IID's per medicaid day capital component rate determined under that section to account for the costs of the beds that are added or replaced. (2) If the department grants an increase under division (D)(1) of this section, the increase shall go into effect one month after the fi...

... cost report than the provider was entitled to receive, the department of developmental disabilities shall adjust the provider's rate for the ICF/IID prospectively to reflect the corrected information. The department shall pay the adjusted rate beginning two months after the first day of the month after the provider files the amended cost report.

...ly amends a cost report for the ICF/IID under section 5124.107 of the Revised Code; (2) The department makes a finding based on an audit under section 5124.109 of the Revised Code. (B) The department shall apply the redetermined rate to the periods when the provider received the incorrect rate to determine the amount of the overpayment. The provider shall refund the amount of the overpayment. The department may c...

...enty-five per cent of the cumulative amount by which the costs for which documentation was not furnished increased the total medicaid payments to the provider during the fiscal year for which the costs were used to determine a rate. (B) If an exiting operator or owner fails to provide notice of a facility closure or voluntary termination as required by section 5124.50 of the Revised Code, or an exiting operator...

...ge bank prime rate using statistical release H.15, "selected interest rates," a weekly publication of the federal reserve board, or any successor publication. If statistical release H.15, or its successor, ceases to contain the bank prime rate information or ceases to be published, the department shall request a written statement of the average bank prime rate from the federal reserve bank of Cleveland or the ...

... participate in medicaid: (1) Any amount the provider is required to refund, and any interest charged, under section 5124.41 of the Revised Code; (2) The amount of any penalty imposed on the provider under section 5124.42 of the Revised Code. (B) The department and an ICF/IID provider may enter into an agreement under which a deduction required by division (A) of this section is taken in installments from pa...