Ohio Revised Code Search
Section |
---|
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.
...ity into compliance with certification requirements, and otherwise ensure the health and safety of the residents. (2) A temporary manager appointed under section 5165.77 of the Revised Code is hereby vested, subject to division (C) of this section, with the authority necessary to eliminate the emergency, bring the facility into compliance with certification requirements, and otherwise ensure the health and saf... |
Section 5165.82 | Residents to whom denial of medicaid payments applies.
...id or contracting agency shall provide public notice implementing an order under section 5165.72, 5165.73, 5165.74, 5165.77, or 5165.84 of the Revised Code denying medicaid payments to a nursing facility for all medicaid eligible residents by publishing in a newspaper of general circulation in the county in which the facility is located an announcement stating: "By order of the (Ohio Department of Medicaid or n... |
Section 5165.83 | Fines.
...(A) As used in this section, "certified beds" means beds certified under Title XVIII or Title XIX. (B) If the department of medicaid or a contracting 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... |
Section 5165.84 | Order denying payment when deficiency is not corrected within time limits.
...ity receives the order or the date the public notice required under division (F) of section 5165.82 of the Revised Code is published. The order is subject to appeal under Chapter 119. of the Revised Code; however the order may take effect prior to or during the pendency of any hearing under that chapter. In that case, the department or agency shall provide the facility an opportunity for a hearing in accordanc... |
Section 5165.85 | Termination of participation for failure to correct deficiency within six months.
...(A) If a nursing facility notifies the department of medicaid or a contracting agency, at any time during the six-month period following the exit interview of a survey that was the basis for citing a deficiency or deficiencies, that the deficiency or deficiencies have been substantially corrected in accordance with the plan of correction submitted and approved under section 5165.69 of the Revised Code, the depa... |
Section 5165.86 | Delivery of notices.
...The department of medicaid, the department of health, and any contracting agency shall deliver a written notice, statement, or order to a nursing facility under sections 5165.60 to 5165.66 and 5165.69 to 5165.89 of the Revised Code by certified mail, hand delivery, or other means reasonably calculated to provide prompt actual notice. If the notice, statement, or order is mailed, it shall be addressed to the administr... |
Section 5165.87 | Appeals.
...(A) Except as provided in division (B) of this section, the following remedies are subject to appeal under Chapter 119. of the Revised Code: (1) An order issued under section 5165.71, 5165.72, 5165.77, or 5165.85 of the Revised Code terminating a nursing facility's participation in the medicaid program; (2) Appointment of a temporary manager of a facility under division (A)(1)(b) or (2)(b) of section 5165.72, o... |
Section 5165.88 | Confidentiality.
...o identify such an individual is not a public record for the purposes of section 149.43 of the Revised Code, and is not subject to inspection and copying under section 1347.08 of the Revised Code. (C) If the department or a contracting agency, or an agency or individual to whom the department or contracting agency was required by court order or for administration or enforcement of a statute relating to nursing... |
Section 5165.89 | Hearing on transfer or discharge of resident who medicaid or medicare beneficiary.
...The department of health shall be the designee of the department of medicaid for the purpose of conducting a hearing pursuant to section 3721.162 of the Revised Code concerning a nursing facility's decision to transfer or discharge a resident if the resident is a medicaid recipient or medicare beneficiary. |
Section 5165.99 | Penalty.
...(A) Whoever violates section 5165.102 or division (E) of section 5165.08 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. (... |
Section 5166.01 | Definitions.
...hich the medicaid program's eligibility requirements for aged, blind, and disabled individuals are more restrictive than the eligibility requirements for the supplemental security income program. "Administrative agency" means, with respect to a home and community-based services medicaid waiver component, the department of medicaid or, if a state agency or political subdivision contracts with the department under s... |
Section 5166.02 | Rules governing medicaid waiver components.
...ll of the following: (1) Eligibility requirements for the medicaid waiver components; (2) The type, amount, duration, and scope of medicaid services the medicaid waiver components cover; (3) The conditions under which the medicaid waiver components cover medicaid services; (4) The amounts the medicaid waiver components pay for medicaid services or the methods by which the amounts are determined; (5) Th... |
Section 5166.03 | Notice of intent to request medicaid waiver.
...The medicaid director may not submit a request to the United States secretary of health and human services for a medicaid waiver under the "Social Security Act," section 1115, 42 U.S.C. 1315, unless the director provides the speaker of the house of representatives and president of the senate written notice of the director's intent to submit the request at least ten days before the date the director submits the ... |
Section 5166.04 | Home and community-based services medicaid waiver components.
...The following requirements apply to each home and community-based services medicaid waiver component: (A) Only an individual who qualifies for a component shall receive that component's medicaid services. (B) A level of care determination shall be made as part of the process of determining whether an individual qualifies for a component and shall be made each year after the initial determination if, during su... |
Section 5166.041 | Provision of nursing services in a group visit under a home and community-based services medicaid waiver component.
...A medicaid provider of nursing services may provide nursing services in a group visit under a home and community-based services medicaid waiver component if the component covers the nursing services, the number of medicaid recipients who receive the nursing services during the group visit does not exceed four, and all of the following apply to all of those medicaid recipients: (A) They are enrolled in the component;... |
Section 5166.05 | Review of plans of care and individual service plans.
...The department of medicaid may review and approve, modify, or deny written plans of care and individual service plans that section 5166.04 of the Revised Code requires be created for individuals determined eligible for a home and community-based services medicaid waiver component. If a state agency or political subdivision contracts with the department under section 5162.35 of the Revised Code to administer a h... |
Section 5166.06 | Agency records of costs of medicaid waiver components.
...Each administrative agency shall maintain, for a period of time the department of medicaid shall specify, financial records documenting the costs of medicaid services provided under the home and community-based services medicaid waiver components that the agency administers, including records of independent audits. The administrative agency shall make the financial records available on request to the United Sta... |
Section 5166.07 | Agency accountable for medicaid waiver components funds.
...Each administrative agency is financially accountable for funds expended for medicaid services covered by the home and community-based services medicaid waiver components that the agency administers. |
Section 5166.08 | Agency contracting for medicaid waiver components; assurance of compliance.
...ubdivision will not violate any of the requirements of sections 5166.01 to 5166.07 of the Revised Code. |
Section 5166.09 | Reservation of participant capacity for individuals related to active duty military who were receiving services in another state.
...Every home and community-based services medicaid waiver component shall reserve a portion of the participant capacity of the waiver for eligible individuals whose spouse or parent or legal guardian is an active duty military service member and, at the time of the service member's transfer to Ohio, the eligible individual was receiving home and community-based services in another state. |
Section 5166.10 | Transfer of enrollee in one medicaid waiver component to another.
...To the extent necessary for the efficient and economical administration of medicaid waiver components, the department of medicaid may transfer an individual enrolled in a medicaid waiver component administered by the department to another medicaid waiver component the department administers if the individual is eligible for the medicaid waiver component and the transfer does not jeopardize the individual's heal... |
Section 5166.11 | Creation of medicaid waiver components for home and community-based services programs.
...caid waiver components; (4) Any other requirements the department selects for the medicaid waiver components. (C) (D) After the first of any of the medicaid waiver components that the department administers under this section begins to enroll eligible individuals, the department may cease to enroll additional individuals in a medicaid waiver component of the Ohio home care program. |
Section 5166.121 | Home first component for the Ohio home care waiver program.
...(A) Unless the Ohio home care waiver program is terminated pursuant to section 5165.12 of the Revised Code, the department of medicaid shall establish a home first component for the Ohio home care waiver program. An individual is eligible for the Ohio home care waiver program's home first component if the individual has been determined to be eligible for the Ohio home care waiver program and at least one of the... |
Section 5166.16 | Integrated care delivery system medicaid waiver.
...(A) As used in this section and section 5166.161 of the Revised Code, "ODA or MCD medicaid waiver component" means all of the following: (1) The medicaid-funded component of the PASSPORT program; (2) The medicaid-funded component of the assisted living program; (3) The Ohio home care waiver program. (B) The medicaid director may create a home and community-based services medicaid waiver component as part ... |