Ohio Revised Code Search
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Section 5165.526 | Release of amount withheld less amounts owed.
...The department of medicaid shall release the actual amount withheld under division (A) of section 5165.521 of the Revised Code, less any amount the exiting operator owes the department under the medicaid program, as follows: (A) Unless the department issues the initial debt summary report required by section 5165.525 of the Revised Code not later than sixty days after the date the exiting operator files the proper... |
Section 5165.527 | Release of amount withheld on postponement of change of operator.
...The department of medicaid, at its sole discretion, may release the amount withheld under division (A) of section 5165.521 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 withdrawal of participation and the transactions leading to the change of operator, facility closure, or voluntary withdrawal of pa... |
Section 5165.528 | Disposition of amounts withheld from payment due an exiting operator.
...(A) All amounts withheld under section 5165.521 of the Revised Code from payment due an exiting operator under the medicaid program shall be deposited into the medicaid payment withholding fund created by the controlling board pursuant to section 131.35 of the Revised Code. Money in the fund shall be used as follows: (1) To pay an exiting operator when a withholding is released to the exiting operator under sectio... |
Section 5165.53 | Adoption of rules regarding change in operators.
...The medicaid director shall adopt rules under section 5165.02 of the Revised Code to implement sections 5165.50 to 5165.53 of the Revised Code, including rules applicable to an exiting operator that provides written notification under section 5165.50 of the Revised Code of a voluntary withdrawal of participation. Rules adopted under this section shall comply with the "Social Security Act," section 1919(c)(2)(F)... |
Section 5165.60 | Definitions for sections 5165.60 to 5165.89.
...sed Code. (D)(1) "Deficiency" means a finding cited by the department of health during a survey, on the basis of one or more actions, practices, situations, or incidents occurring at a nursing facility, that constitutes a severity level three finding, severity level four finding, scope level three finding, or scope level four finding. Whenever the finding is a repeat finding, "deficiency" also includes any fin... |
Section 5165.61 | Adoption of rules.
...The medicaid director may adopt rules under section 5165.02 of the Revised Code that are consistent with regulations, guidelines, and procedures issued by the United States secretary of health and human services under the "Social Security Act," sections 1819 and 1919, 42 U.S.C. 1395i-3 and 1396r, and necessary for administration and enforcement of sections 5165.60 to 5165.89 of the Revised Code. If the secretar... |
Section 5165.62 | Enforcement of provisions.
...The department of medicaid is hereby authorized to enforce sections 5165.60 to 5165.89 of the Revised Code. The department may enforce the sections directly or through contracting agencies. The department and agencies shall enforce the sections in accordance with the requirements of the "Social Security Act," sections 1819 and 1919, 42 U.S.C. 1395i-3 and 1396r, that apply to nursing facilities; with regulations... |
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.
...(A) The department of health shall conduct a survey, titled a standard survey, of every nursing facility in this state on a statewide average of not more than once every twelve months. Each nursing facility shall undergo a standard survey at least once every fifteen months as a condition of meeting certification requirements. The department may extend a standard survey; such a survey is titled an extended surve... |
Section 5165.65 | Exit interview with administrator.
...rvey team's recommendations regarding findings of noncompliance with certification requirements; (3) An audio or audiovisual recording of the interview. If the survey team selects this option, at least two copies of the recording shall be made and the survey team shall select one copy to be kept by the survey team for use by the department of health. (B) All expenses of copying under division (A)(1) of this s... |
Section 5165.66 | Citations for failure to comply with one or more certification requirements.
...ection 3721.17 of the Revised Code, a finding shall be cited only on the basis of a survey and a determination that one or more actions, practices, situations, or incidents at a nursing facility caused or resulted from the facility's failure to comply with one or more certification requirements. The department of health shall determine whether the actions, practices, situations, or incidents can be justified b... |
Section 5165.67 | Survey results.
... 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, that statement of deficiencies, and the findings and deficiencies cited in that statement shall not be used in eithe... |
Section 5165.68 | Statement of deficiencies.
...ent of health 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 a... |
Section 5165.69 | Plan of correction.
...approval a plan of correction for each finding cited in the statement. The plan shall include all of the following: (1) Detailed descriptions of the actions the facility will take to correct each finding, including actions the facility will take to protect residents situated similarly to the residents affected by the causes of the findings; (2) The date by which each finding will be corrected; (3) A detailed ... |
Section 5165.70 | On-site monitoring.
...ring 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 employee of a facility for which monitors are appointed, no person employed by the facility wi... |
Section 5165.71 | Deficiencies not substantially corrected.
... not constitute a severity level four finding or create immediate jeopardy, the department of medicaid or a contracting agency shall permit the nursing facility to continue participating in the medicaid program for up to six months after the exit interview, if all of the following apply: (1) The facility meets the requirements, established in regulations issued by the United States secretary of health and hum... |
Section 5165.72 | Uncorrected deficiencies constituting severity level four findings.
...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 (A)(1) or (2) of this section: (1) The department or agency may impose one or more of the following remedies: (a) Issue an order t... |
Section 5165.73 | Uncorrected deficiencies constituting severity level three and scope level three or four findings.
...l 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 an order denying medicaid payments to the facility for all medicaid eligible residents admitted after the effective date of the order; (2) Impose a fine. (B)... |
Section 5165.74 | Uncorrected deficiencies constituting severity level one or two or severity level three, scope level two finding.
...erity 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 order denying medicaid payments to the facility for all medicaid eligible residents admitted after the effective date of the order; (b) Impose a fine. (2) ... |
Section 5165.75 | Imposing remedies and fines.
...(A) In determining which remedies to impose under section 5165.72, 5165.73, or 5165.74 of the Revised Code, including whether a fine should be imposed, the department of medicaid or a contracting agency shall do both of the following: (1) Impose the remedies that are most likely to achieve correction of deficiencies, encourage sustained compliance with certification requirements, and protect the health, safety... |
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.
...(A) If the department of health finds during a survey that an emergency exists at a nursing facility, as the result of a deficiency or 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... |
Section 5165.771 | Special focus facility program.
...of medicaid any standard health survey findings that form the basis, in whole or in part, for an order issued pursuant to division (B) of this section terminating a nursing facility's participation in the medicaid program. Any challenges to standard health survey findings shall be made to the department of health. (2) A nursing facility shall not appeal to the department of medicaid a determination by the United S... |
Section 5165.78 | Appointment of temporary resident safety assurance manager.
...(A) If the department of medicaid determines that a nursing facility is experiencing or is likely to experience a serious financial loss or failure that jeopardizes or is likely to jeopardize the health, safety, and welfare of its residents, the department, subject to the provider's consent, may appoint a temporary resident safety assurance manager in the nursing facility to take actions the department determin... |
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... |