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Section 5165.01 | Definitions.

...ate under this chapter, "as of the last day of the calendar year" refers to the occupancy and utilization rates during the calendar year identified in the cost report filed under section 5165.10 of the Revised Code. (F)(1) "Capital costs" means the actual expense incurred by a nursing facility for all of the following: (a) Depreciation and interest on any capital assets that cost five hundred dollars or more pe...

Section 5165.011 | Nursing facility references.

...(A) Except as provided in division (B) of this section, whenever "skilled nursing facility," "intermediate care facility," or "dual skilled nursing and intermediate care facility" is referred to or designated in any statute, rule, contract, provider agreement, or other document pertaining to the medicaid program, the reference or designation is deemed to refer to a nursing facility. (B) A reference to or desi...

Section 5165.02 | Rules.

...The medicaid director shall adopt rules as necessary to implement this chapter. The rules shall be adopted in accordance with Chapter 119. of the Revised Code.

Section 5165.03 | Admission of mentally ill person to nursing facility.

...(A) As used in this section: (1) "Dementia" includes Alzheimer's disease or a related disorder. (2) "Serious mental illness" means "serious mental illness," as defined by the United States department of health and human services in regulations adopted under section 1919(e)(7)(G)(i) of the "Social Security Act," 42 U.S.C. 1396r(e)(7)(G)(i). (3) "Individual with a mental illness" means an individual who has a se...

Section 5165.031 | Hearing.

...An individual who applies for admission to or resides in a nursing facility may appeal if adversely affected by a determination made by the department of mental health and addiction services under section 5119.40 of the Revised Code or by the department of developmental disabilities under section 5123.021 of the Revised Code. If the individual is an applicant for or recipient of medicaid, the individual may app...

Section 5165.04 | Assessment to determine level of care.

... one of the following: (a) One working day after the person or the person's representative submits the application or notifies the department of the person's intention to apply and submits all information required for providing the level of care determination, as specified in rules authorized by division (F)(2) of this section; (b) A later date requested by the person or the person's representative. (2) In th...

Section 5165.06 | Nursing facility eligibility.

...Subject to section 5165.072 of the Revised Code, an operator is eligible to enter into and retain a provider agreement for a nursing facility if all of the following apply: (A) The nursing facility is certified by the director of health for participation in medicaid; (B) The nursing facility is licensed by the director of health as a nursing home if so required by law and the operator is the licensed operator of...

Section 5165.07 | Provider agreement requirements.

...(A) Except as provided in section 5165.072 of the Revised Code, the department of medicaid shall enter into a provider agreement with a nursing facility operator who applies, and is eligible, for the provider agreement. (B) A provider agreement shall require the department to make medicaid payments to the provider in accordance with this chapter for nursing facility services the nursing facility provides to it...

Section 5165.071 | Facility operator may contract with more than one provider.

...A nursing facility operator may enter into provider agreements for more than one nursing facility.

Section 5165.072 | Revalidation.

...The department of medicaid shall not revalidate a nursing facility provider agreement if the provider fails to maintain eligibility for the provider agreement as provided in section 5165.06 of the Revised Code.

Section 5165.073 | Termination for non-compliance with installation of fire extinguishing and fire alarm systems.

...The department of medicaid shall terminate the provider agreement with a nursing facility provider that does not comply with the requirements of section 3721.071 of the Revised Code for the installation of fire extinguishing and fire alarm systems.

Section 5165.08 | Nursing facilities' provider agreement terms.

... the exclusion not less than forty-five days before the first day of the calendar quarter in which the exclusion is to occur. (2) Prohibit the provider from doing either of the following: (a) Discriminating against a resident on the basis of race, color, sex, creed, or national origin; (b) Subject to division (D) of this section, failing or refusing to do either of the following: (i) Except as otherwise prohibite...

Section 5165.081 | Action against facility for breach of provider agreement or other duties.

...A nursing facility resident has a cause of action against a nursing facility provider for breach of the provider agreement obligations or other duties imposed by section 5165.08 of the Revised Code. The action may be commenced by the resident, or on the resident's behalf by the resident's sponsor or a residents' rights advocate, by the filing of a civil action in the court of common pleas of the county in which...

Section 5165.082 | Qualification of beds.

...(A) Except as provided in division (B) of this section, the operator of a nursing facility that elects to have the nursing facility participate in the medicaid program shall qualify all of the nursing facility's medicaid-certified beds in the medicare program. The medicaid director may adopt rules under section 5165.02 of the Revised Code to establish the time frame in which a nursing facility must comply with ...

Section 5165.10 | Annual cost report.

...st report is due not later than ninety days after the end of the calendar year, or portion of the calendar year, that the cost report covers. (B) If a nursing facility undergoes a change of provider that the department determines, in accordance with rules adopted under section 5165.02 of the Revised Code, is not an arm's length transaction, the new provider shall file the nursing facility's cost report in ac...

Section 5165.101 | Cost of franchise permit fee not reimbursable expense.

...A nursing facility provider filing the nursing facility's cost report with the department of medicaid under section 5165.10 or 5165.522 of the Revised Code shall report as a nonreimbursable expense the cost of the nursing facility's franchise permit fee.

Section 5165.102 | Fines excluded from cost report.

...No nursing facility provider shall report fines paid under sections 5165.60 to 5165.89 or section 5165.99 of the Revised Code in a cost report filed under section 5165.10 or 5165.522 of the Revised Code.