As Introduced 1
123rd General Assembly 4
Regular Session H. B. No. 403 5
1999-2000 6
REPRESENTATIVES TIBERI-VAN VYVEN-NETZLEY-GOODMAN-MOTTLEY- 8
OGG-DePIERO-OLMAN-TAYLOR-JONES-BUEHRER-EVANS-KRUPINSKI- 9
FLANNERY-BRITTON 10
_________________________________________________________________ 11
A B I L L
To amend sections 3701.83 and 5111.20 and to enact 13
sections 3721.60, 3721.61, 3721.611, 3721.62, 14
3721.63, 3721.64, 3721.65, 3721.651, 3721.66, 15
3721.67, 3721.671, and 3721.68 to 3721.70 of the 16
Revised Code to require the publication of the 17
Ohio Nursing Facility Consumer Guide and to make
an appropriation. 18
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 20
Section 1. That sections 3701.83 and 5111.20 be amended 22
and sections 3721.60, 3721.61, 3721.611, 3721.62, 3721.63, 23
3721.64, 3721.65, 3721.651, 3721.66, 3721.67, 3721.671, 3721.68, 24
3721.69, and 3721.70 of the Revised Code be enacted to read as 25
follows:
Sec. 3701.83. (A) There is hereby created in the state 34
treasury the general operations fund. Moneys in the fund shall 35
be used for the purposes specified in sections 3701.04, 3701.344, 36
3701.88, 3702.20, 3710.15, 3711.021, 3721.02, 3721.671, 3722.04, 38
3732.04, 3733.04, 3733.25, 3733.43, 3748.04, 3748.05, 3748.07, 40
3748.12, 3748.13, 3749.04, 3749.07, 4747.04, 4751.04, and 4769.09 41
of the Revised Code.
(B) The alcohol testing program fund is hereby created in 44
the state treasury. The director of health shall use the fund to
administer and enforce the alcohol testing and permit program 45
authorized by section 3701.143 of the Revised Code. 46
2
The fund shall receive transfers from the liquor control 49
fund created under section 4301.12 of the Revised Code. All 50
investment earnings of the alcohol testing program fund shall be 51
credited to the fund.
Sec. 3721.60. AS USED IN THIS SECTION AND SECTIONS 3721.61 53
TO 3721.70 OF THE REVISED CODE: 54
(A) "CLINICAL QUALITY INDICATOR" MEANS A MEASURE OF AN 56
ASPECT OF THE PHYSICAL OR MENTAL CONDITIONS OF THE RESIDENTS OF A 57
NURSING FACILITY THAT IS DERIVED FROM DATA TAKEN FROM RESIDENT 59
ASSESSMENT INSTRUMENTS SUBMITTED BY NURSING FACILITIES FOR 60
PURPOSES OF THE MEDICARE AND MEDICAID PROGRAMS. 61
(B) "MEDICAID" HAS THE SAME MEANING AS IN SECTION 5111.01 63
OF THE REVISED CODE. 64
(C) "MEDICARE" MEANS THE PROGRAM OPERATED PURSUANT TO 67
TITLE XVIII OF THE "SOCIAL SECURITY ACT," 49 STAT. 620 (1935), 42 69
U.S.C.A. 301, AS AMENDED. 70
(D) "NURSING FACILITY" MEANS A FACILITY, OR A DISTINCT 72
PART OF A FACILITY, THAT IS CERTIFIED AS A NURSING FACILITY OR A 74
SKILLED NURSING FACILITY FOR PURPOSES OF THE MEDICARE OR MEDICAID 75
PROGRAM.
(E) "STANDARD SURVEY" AND "DEFICIENCY" HAVE THE SAME 77
MEANINGS AS IN SECTION 5111.35 OF THE REVISED CODE. 79
(F) "SURVEY DATA TAG" MEANS ANY OF THE DATA TAGS USED IN 81
THE MEDICARE AND MEDICAID PROGRAMS FOR IDENTIFICATION OF SPECIFIC 82
REGULATORY REQUIREMENTS. 83
Sec. 3721.61. THE DEPARTMENT OF HEALTH SHALL DEVELOP AND 85
PUBLISH A GUIDE TO NURSING FACILITIES IN THIS STATE FOR USE BY 86
INDIVIDUALS CONSIDERING NURSING FACILITY PLACEMENT AND THEIR 87
FAMILIES, FRIENDS, AND ADVISORS. THE GUIDE SHALL BE TITLED THE 88
OHIO NURSING FACILITY CONSUMER GUIDE. 89
THE CONSUMER GUIDE SHALL BE PUBLISHED BOTH IN COMPUTERIZED 91
FORM FOR DISTRIBUTION OVER THE INTERNET AND IN PRINTED FORM FOR 92
DISTRIBUTION AS A PAMPHLET, BOOKLET, OR BOOK. THE COMPUTERIZED 93
FORM OF THE GUIDE SHALL BE MADE AVAILABLE NOT LATER THAN EIGHT 95
3
MONTHS AFTER THE EFFECTIVE DATE OF THIS SECTION AND SHALL BE 96
UPDATED IN ACCORDANCE WITH SECTION 3721.651 OF THE REVISED CODE. 97
THE PRINTED FORM SHALL BE MADE AVAILABLE NOT LATER THAN NINE
MONTHS AFTER THE EFFECTIVE DATE OF THIS SECTION. THEREAFTER, 99
UPDATED VERSIONS SHALL BE PUBLISHED SEMIANNUALLY. 100
Sec. 3721.611. THE DEPARTMENT OF HEALTH MAY CONTRACT WITH 102
ANY PERSON OR GOVERNMENT ENTITY TO PERFORM ANY FUNCTION RELATED 103
TO THE PUBLICATION OF THE OHIO NURSING FACILITY CONSUMER GUIDE OR 105
THE COLLECTION AND PREPARATION OF DATA AND OTHER MATERIAL FOR THE 107
GUIDE, EXCEPT THAT THE DEPARTMENT SHALL CONTRACT TO HAVE THE 109
CUSTOMER SATISFACTION SURVEYS CONDUCTED UNDER SECTION 3721.67 OF
THE REVISED CODE. IN AWARDING THE CONTRACT TO HAVE THE SURVEYS 111
CONDUCTED, THE DEPARTMENT SHALL CONTRACT WITH A PERSON OR
GOVERNMENT ENTITY THAT HAS EXPERIENCE IN SURVEYING THE CUSTOMER 112
SATISFACTION OF NURSING FACILITY RESIDENTS AND THEIR FAMILIES. 113
THE DEPARTMENT'S CONTRACT SHALL PERMIT THE PERSON OR GOVERNMENT 114
ENTITY TO SUBCONTRACT WITH OTHER PERSONS OR GOVERNMENT ENTITIES 115
FOR PURPOSES OF CONDUCTING ALL OR PART OF THE SURVEYS.
Sec. 3721.62. IN DEVELOPING AND PUBLISHING THE OHIO 117
NURSING FACILITY CONSUMER GUIDE, THE DEPARTMENT OF HEALTH SHALL 118
ADHERE TO THE FOLLOWING PRINCIPLES: 119
(A) THE GUIDE SHOULD BE DESIGNED TO PROVIDE USERS WITH A 121
VARIETY OF MEASURES OF NURSING FACILITY QUALITY AND WITH OTHER 122
INFORMATION USEFUL IN COMPARING AND SELECTING NURSING FACILITIES. 124
(B) THE GUIDE SHOULD PRESENT THE INFORMATION SPECIFIED IN 126
DIVISION (A) OF THIS SECTION IN A MANNER THAT IS EASY TO USE AND 127
UNDERSTAND. 128
(C) THE GUIDE SHOULD ALLOW USERS TO DETERMINE WHICH 130
MEASURES ARE MOST IMPORTANT TO THEM BUT SHALL NOT ESTABLISH A 131
RANKING OR GRADING SYSTEM.
(D) THE INFORMATION IN THE GUIDE SHOULD BE KEPT AS CURRENT 133
AS PRACTICABLE. 134
Sec. 3721.63. WITH REGARD TO THE ACCESSIBILITY OF THE OHIO 136
NURSING FACILITY CONSUMER GUIDE, THE FOLLOWING SHALL APPLY: 137
4
(A) THE DEPARTMENT OF HEALTH SHALL MAKE THE GUIDE 139
AVAILABLE TO ANY PERSON OR GOVERNMENT ENTITY AND SHALL NOT 140
RESTRICT ACCESS BY REQUIRING PAYMENT OF A FEE, USE OF A PASSWORD, 141
OR FULFILLMENT OF ANY OTHER CONDITION.
(B) THE DEPARTMENT OF HEALTH, THE DEPARTMENT OF HUMAN 143
SERVICES, AND THE DEPARTMENT OF AGING SHALL DEVELOP AND IMPLEMENT 145
PROGRAMS AND OTHER STRATEGIES TO ENCOURAGE USE OF THE GUIDE BY 146
INDIVIDUALS CONSIDERING NURSING FACILITY PLACEMENT AND THEIR 147
FAMILIES, FRIENDS, AND ADVISORS. 148
Sec. 3721.64. THE OHIO NURSING FACILITY CONSUMER GUIDE 150
SHALL INCLUDE INFORMATION ON EACH NURSING FACILITY IN THIS STATE. 151
FOR EACH FACILITY, THE GUIDE SHALL INCLUDE, TO THE EXTENT IT IS 153
AVAILABLE TO THE DEPARTMENT OF HEALTH, ALL OF THE FOLLOWING 154
INFORMATION:
(A) CUSTOMER SATISFACTION DATA OBTAINED UNDER SECTION 156
3721.67 OF THE REVISED CODE; 157
(B) CLINICAL QUALITY INDICATOR DATA OBTAINED UNDER SECTION 159
3721.68 OF THE REVISED CODE; 160
(C) DATA DERIVED FROM STANDARD SURVEYS OF EACH FACILITY, 162
AS SPECIFIED IN DIVISION (C)(3) OF SECTION 3721.65 AND DIVISION 164
(B)(3) OF SECTION 3721.66 OF THE REVISED CODE; 165
(D) ANY OTHER INFORMATION SPECIFIED IN SECTIONS 3721.60 TO 167
3721.70 OF THE REVISED CODE OR THE RULES ADOPTED UNDER SECTION 169
3721.69 OF THE REVISED CODE.
Sec. 3721.65. THE OHIO NURSING FACILITY CONSUMER GUIDE, AS 171
PUBLISHED IN COMPUTERIZED FORM, SHALL BE STRUCTURED IN ACCORDANCE 172
WITH THIS SECTION AND ANY APPLICABLE RULES ADOPTED UNDER SECTION 174
3721.69 OF THE REVISED CODE. 175
(A) THE OPENING ELECTRONIC PAGE OF THE CONSUMER GUIDE 177
SHALL INCLUDE ALL OF THE FOLLOWING GENERAL INFORMATION: 178
(1) A DESCRIPTION OF THE GUIDE; 180
(2) DISCLAIMERS STATING THE LIMITATIONS OF THE DATA 182
INCLUDED IN THE GUIDE. THE DISCLAIMERS SHALL INCLUDE A STATEMENT 183
THAT STANDARD SURVEYS OF NURSING FACILITIES ARE CONDUCTED AT 184
5
PERIODIC INTERVALS AND A STATEMENT THAT CONDITIONS AT A FACILITY 185
CAN CHANGE SIGNIFICANTLY BETWEEN STANDARD SURVEYS. 186
(3) A RECOMMENDATION THAT INDIVIDUALS CONSIDERING NURSING 188
FACILITY PLACEMENT VISIT ANY FACILITIES THEY ARE CONSIDERING; 189
(4) ELECTRONIC LINKS TO OTHER INFORMATION ON THE INTERNET 191
ABOUT SELECTING NURSING FACILITIES, INCLUDING INFORMATION 192
MAINTAINED BY PERTINENT GOVERNMENT AGENCIES AND PRIVATE 193
ORGANIZATIONS AND TELEPHONE NUMBERS FOR THOSE AGENCIES AND 194
ORGANIZATIONS;
(5) ANY OTHER INFORMATION THE DEPARTMENT SPECIFIES IN 196
RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE. 197
(B) THE CONSUMER GUIDE SHALL BE STRUCTURED IN A MANNER 199
THAT ALLOWS THE USER TO SEARCH FOR INFORMATION IN THE GUIDE IN 200
MULTIPLE WAYS, INCLUDING SEARCHES BY FACILITY NAME, COUNTY, AND 202
MUNICIPALITY.
(C) THE FIRST INFORMATION TO APPEAR ON THE COMPUTER SCREEN 204
FOLLOWING A SEARCH SHALL BE A LIST OF ALL FACILITIES IDENTIFIED 205
BY THE SEARCH. FOR ALL OF THE FACILITIES LISTED, THE CONSUMER 206
GUIDE SHALL PRESENT THE USER WITH SUMMARIZED COMPARATIVE 207
INFORMATION, AS FOLLOWS: 208
(1) THE RESPONSES MADE BY FAMILIES TO TWO SEPARATE 210
MEASURES OF CUSTOMER SATISFACTION INCLUDED IN THE SURVEYS 211
CONDUCTED UNDER SECTION 3721.67 OF THE REVISED CODE. THE TWO 212
MEASURES SHALL BE SPECIFIED IN RULES ADOPTED UNDER SECTION 214
3721.69 OF THE REVISED CODE. FOR EACH MEASURE, THE GUIDE SHALL 215
COMPARE THE RESPONSES FOR THE FACILITY TO THE STATEWIDE AVERAGE. 216
THE RESPONSES SHALL BE EXPRESSED AS PERCENTAGES OF FAMILIES THAT 217
ARE SATISFIED OR VERY SATISFIED WITH THE FACILITY. 218
(2) THE SCORES ON TWO SEPARATE CLINICAL QUALITY INDICATORS 220
CALCULATED UNDER SECTION 3721.68 OF THE REVISED CODE. THE TWO 222
INDICATORS SHALL BE SPECIFIED IN RULES ADOPTED UNDER SECTION
3721.69 OF THE REVISED CODE. FOR EACH INDICATOR, THE GUIDE SHALL 223
COMPARE THE FACILITY'S SCORE TO THE STATEWIDE AVERAGE. THE 224
SCORES SHALL BE EXPRESSED AS PERCENTAGES. 225
6
(3) THE DATE OF THE FACILITY'S MOST RECENT STANDARD 227
SURVEY, THE PERCENTAGE OF THE TOTAL NUMBER OF SURVEY DATA TAGS 228
WITH RESPECT TO WHICH THE FACILITY WAS FOUND TO BE IN COMPLIANCE 229
DURING THE SURVEY, THE STATEWIDE AVERAGE PERCENTAGE OF THE TOTAL 231
NUMBER OF SURVEY DATA TAGS WITH RESPECT TO WHICH FACILITIES WERE 232
FOUND TO BE IN COMPLIANCE DURING THE MOST RECENT STANDARD 233
SURVEYS, AND THE DATE THE FACILITY ACHIEVED SUBSTANTIAL 234
COMPLIANCE WITH MEDICARE AND MEDICAID CERTIFICATION REQUIREMENTS; 235
(4) AN ELECTRONIC LINK ALLOWING THE USER TO GAIN ACCESS TO 237
THE FACILITY-SPECIFIC INFORMATION MAINTAINED UNDER DIVISION (D) 238
OF THIS SECTION. 239
(D) IN ADDITION TO THE SUMMARIZED INFORMATION PROVIDED BY 241
THE GUIDE PURSUANT TO DIVISION (C) OF THIS SECTION, THE GUIDE 242
SHALL PROVIDE SPECIFIC COMPARATIVE INFORMATION ON EACH NURSING 243
FACILITY. WHEN THE GUIDE'S USER OPENS AN ELECTRONIC LINK TO 244
FACILITY-SPECIFIC INFORMATION, THE FIRST INFORMATION TO APPEAR ON 245
THE COMPUTER SCREEN SHALL INCLUDE ALL OF THE FOLLOWING: 246
(1) THE NAME OF THE FACILITY AND ITS OWNER, THE FACILITY'S 248
TELEPHONE NUMBER, AND THE FACILITY'S ADDRESS, INCLUDING THE 249
COUNTY IN WHICH THE FACILITY IS LOCATED. THE GUIDE SHALL INCLUDE 250
A COMPUTER FUNCTION THAT PINPOINTS ON A MAP THE FACILITY'S 251
LOCATION.
(2) THE FACILITY'S STATUS WITH REGARD TO MEDICARE AND 253
MEDICAID CERTIFICATION AND PRIVATE ACCREDITATION; 254
(3) THE NUMBER OF BEDS IN THE FACILITY; 256
(4) THE DIRECT CARE STAFFING LEVEL FOR THE FACILITY, 258
COMPARED TO THE AVERAGE STAFFING LEVEL FOR FACILITIES IN THE 259
FACILITY'S PEER GROUP, AS SPECIFIED IN RULES ADOPTED UNDER 260
SECTION 3721.69 OF THE REVISED CODE. STAFFING LEVELS SHALL BE 261
EXPRESSED ON A PER RESIDENT, PER DAY BASIS AND SHALL BE 262
CALCULATED BY ADDING THE HOURS OF STAFFING PERFORMED BY NURSE 263
AIDES, LICENSED PRACTICAL NURSES, AND REGISTERED NURSES, AS 265
REPORTED ON THE MOST RECENT COST REPORTS FILED UNDER SECTION 266
5111.26 OF THE REVISED CODE, AND DIVIDING THE SUM BY THE NUMBER 267
7
OF INPATIENT DAYS REPORTED ON THE COST REPORTS. 268
(5) AN ELECTRONIC LINK ALLOWING THE USER OF THE GUIDE TO 270
GAIN ACCESS TO A LISTING OF SERVICES PROVIDED BY THE FACILITY. 271
THE LISTING SHALL BE PRESENTED IN THE FORMAT SPECIFIED IN RULES 272
ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE. 273
(6) AT THE FACILITY'S OPTION, A PICTURE OF THE FACILITY, A 275
BRIEF STATEMENT PROVIDED BY THE FACILITY, AND AN ELECTRONIC LINK 276
TO ANY INFORMATION THE FACILITY MAINTAINS ABOUT ITSELF ON THE 277
INTERNET;
(7) THE SUMMARIZED INFORMATION SPECIFIED IN DIVISION (C) 279
OF THIS SECTION FOR THE FACILITY, WITH ELECTRONIC LINKS ALLOWING 281
THE USER TO GAIN ACCESS TO ADDITIONAL INFORMATION PRESENTED AS 283
FOLLOWS:
(a) FOR EACH QUESTION ASKED ON THE QUESTIONNAIRES USED IN 285
THE RESIDENT AND FAMILY SURVEYS CONDUCTED UNDER SECTION 3721.67 286
OF THE REVISED CODE, THE GUIDE SHALL PRESENT THE CUSTOMER 287
SATISFACTION RESPONSES TO THE FOUR-LEVEL SCALE USED IN ASKING THE 289
QUESTION. THE RESPONSES FOR THE FACILITY SHALL BE COMPARED TO 290
THE STATEWIDE AVERAGE AND SHALL BE EXPRESSED IN PERCENTAGES. 291
(b) FOR EACH CLINICAL QUALITY INDICATOR CALCULATED UNDER 293
SECTION 3721.68 OF THE REVISED CODE, THE GUIDE SHALL PRESENT THE 294
FACILITY'S SCORE COMPARED TO THE STATEWIDE AVERAGE SCORE. THE 295
SCORES SHALL BE EXPRESSED AS PERCENTAGES. 296
(c) THE GUIDE SHALL PRESENT A LIST OF ALL SURVEY DATA TAGS 298
FOR WHICH DEFICIENCIES WERE ISSUED DURING THE FACILITY'S MOST 299
RECENT STANDARD SURVEY, A BRIEF DESCRIPTION PERTAINING TO EACH 300
DATA TAG, DIRECTIONS OR ELECTRONIC LINKS FOR OBTAINING MORE 301
INFORMATION ABOUT THE FACILITY'S SURVEY HISTORY AND, AT THE 303
FACILITY'S OPTION, A BRIEF STATEMENT FROM THE FACILITY RESPONDING 304
TO THE DATA TAGS FOR WHICH DEFICIENCIES WERE ISSUED.
Sec. 3721.651. THE DEPARTMENT OF HEALTH SHALL UPDATE 307
INFORMATION IN THE COMPUTERIZED VERSION OF THE OHIO NURSING 308
FACILITY CONSUMER GUIDE AS FOLLOWS:
(A) THE CUSTOMER SATISFACTION DATA OBTAINED UNDER SECTION 310
8
3721.67 OF THE REVISED CODE SHALL BE UPDATED SEMIANNUALLY 313
FOLLOWING THE SURVEYS CONDUCTED UNDER THAT SECTION.
(B) THE CLINICAL QUALITY INDICATOR DATA OBTAINED UNDER 315
SECTION 3721.68 OF THE REVISED CODE SHALL BE UPDATED IN JANUARY, 317
APRIL, JULY, AND OCTOBER OF EACH YEAR, USING THE MOST RECENT 319
RESIDENT ASSESSMENT DATA AVAILABLE TO THE DEPARTMENT.
(C) THE DATA DERIVED FROM STANDARD SURVEYS OF EACH 321
FACILITY, AS SPECIFIED IN DIVISION (C)(3) OF SECTION 3721.65 AND 323
DIVISION (B)(3) OF SECTION 3721.66 OF THE REVISED CODE, SHALL BE 324
UPDATED WEEKLY, USING THE MOST RECENT STANDARD SURVEY DATA 325
AVAILABLE TO THE DEPARTMENT. THE DEPARTMENT SHALL IMMEDIATELY 327
MODIFY THE DATA INCLUDED IN THE CONSUMER GUIDE TO REFLECT EITHER 329
OF THE FOLLOWING:
(1) ANY CHANGE IN THE SURVEY DATA RESULTING FROM INFORMAL 331
DISPUTE RESOLUTION, APPEAL, OR ANY OTHER PROCESS; 332
(2) THE DATE OF CORRECTION OF ANY DEFICIENCY. 334
(D) ANY OTHER INFORMATION SPECIFIED IN SECTIONS 3721.60 TO 336
3721.70 OF THE REVISED CODE OR THE RULES ADOPTED UNDER SECTION 338
3721.69 OF THE REVISED CODE SHALL BE UPDATED AT THE TIME 339
SPECIFIED IN THOSE SECTIONS OR THE RULES.
Sec. 3721.66. THE OHIO NURSING FACILITY CONSUMER GUIDE, AS 341
PUBLISHED IN PRINTED FORM, SHALL BE STRUCTURED IN ACCORDANCE WITH 342
THIS SECTION AND ANY APPLICABLE RULES ADOPTED UNDER SECTION 344
3721.69 OF THE REVISED CODE.
(A) THE CONSUMER GUIDE SHALL INCLUDE THE FOLLOWING GENERAL 346
INFORMATION: 347
(1) A DESCRIPTION OF THE GUIDE, INCLUDING A REFERENCE TO 349
THE COMPUTERIZED VERSION OF THE GUIDE MAINTAINED ON THE INTERNET; 350
(2) DISCLAIMERS STATING THE LIMITATIONS OF THE DATA 352
INCLUDED IN THE GUIDE. THE DISCLAIMERS SHALL INCLUDE A STATEMENT 353
THAT STANDARD SURVEYS OF NURSING FACILITIES ARE CONDUCTED AT 354
PERIODIC INTERVALS AND A STATEMENT THAT CONDITIONS AT A FACILITY 355
CAN CHANGE SIGNIFICANTLY BETWEEN STANDARD SURVEYS. 356
(3) A RECOMMENDATION THAT INDIVIDUALS CONSIDERING NURSING 358
9
FACILITY PLACEMENT VISIT ANY FACILITY THEY ARE CONSIDERING; 359
(4) INFORMATION ABOUT SELECTING NURSING FACILITIES, 361
INCLUDING REFERENCES TO INFORMATION MAINTAINED BY PERTINENT 362
GOVERNMENT AGENCIES AND PRIVATE ORGANIZATIONS AND TELEPHONE 363
NUMBERS FOR THOSE AGENCIES AND ORGANIZATIONS; 364
(5) ANY OTHER INFORMATION THE DEPARTMENT SPECIFIES IN 366
RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE. 367
(B) THE CONSUMER GUIDE SHALL PRESENT A LIST OF ALL NURSING 369
FACILITIES IN THIS STATE, BY COUNTY. IN THE COUNTY LISTING, THE 370
GUIDE SHALL INCLUDE FOR EACH NURSING FACILITY ALL OF THE 372
FOLLOWING SUMMARIZED COMPARATIVE INFORMATION:
(1) THE RESPONSES MADE BY FAMILIES TO TWO SEPARATE 374
MEASURES OF CUSTOMER SATISFACTION INCLUDED IN THE SURVEYS 375
CONDUCTED UNDER SECTION 3721.67 OF THE REVISED CODE. THE TWO 376
MEASURES SHALL BE SPECIFIED IN RULES ADOPTED UNDER SECTION 378
3721.69 OF THE REVISED CODE. FOR EACH MEASURE, THE GUIDE SHALL 379
COMPARE THE RESPONSES FOR THE FACILITY TO THE STATEWIDE AVERAGE. 381
THE RESPONSES SHALL BE EXPRESSED AS PERCENTAGES OF FAMILIES THAT 382
ARE SATISFIED OR VERY SATISFIED WITH THE FACILITY. 383
(2) THE SCORES ON TWO SEPARATE CLINICAL QUALITY INDICATORS 385
CALCULATED UNDER SECTION 3721.68 OF THE REVISED CODE. THE TWO 387
INDICATORS SHALL BE SPECIFIED IN RULES ADOPTED UNDER SECTION 388
3721.69 OF THE REVISED CODE. FOR EACH INDICATOR, THE GUIDE SHALL 389
COMPARE THE FACILITY'S SCORE TO THE STATEWIDE AVERAGE. THE 390
SCORES SHALL BE EXPRESSED AS PERCENTAGES. 391
(3) THE DATE OF THE FACILITY'S MOST RECENT STANDARD 393
SURVEY, THE PERCENTAGE OF THE TOTAL NUMBER OF SURVEY DATA TAGS 394
WITH RESPECT TO WHICH THE FACILITY WAS FOUND TO BE IN COMPLIANCE 395
DURING THE SURVEY, THE STATEWIDE AVERAGE PERCENTAGE OF THE TOTAL 397
NUMBER OF SURVEY DATA TAGS ISSUED DURING THE MOST RECENT STANDARD 398
SURVEYS WITH RESPECT TO WHICH FACILITIES WERE FOUND TO BE IN 399
COMPLIANCE, AND THE DATE THE FACILITY ACHIEVED SUBSTANTIAL 401
COMPLIANCE WITH MEDICARE AND MEDICAID CERTIFICATION REQUIREMENTS. 402
(C) FOLLOWING THE SUMMARIZED INFORMATION PROVIDED BY THE 404
10
GUIDE PURSUANT TO DIVISION (B) OF THIS SECTION, THE GUIDE SHALL 405
PROVIDE SPECIFIC COMPARATIVE INFORMATION ON EACH NURSING 406
FACILITY. THE INFORMATION SHALL INCLUDE ALL OF THE FOLLOWING: 407
(1) THE NAME OF THE FACILITY AND ITS OWNER, THE FACILITY'S 409
TELEPHONE NUMBER, AND THE FACILITY'S ADDRESS, INCLUDING THE 410
COUNTY IN WHICH THE FACILITY IS LOCATED; 411
(2) THE FACILITY'S STATUS WITH REGARD TO MEDICARE AND 413
MEDICAID CERTIFICATION AND PRIVATE ACCREDITATION; 414
(3) THE NUMBER OF BEDS IN THE FACILITY; 416
(4) THE DIRECT CARE STAFFING LEVEL FOR THE FACILITY, 418
COMPARED TO THE AVERAGE STAFFING LEVEL FOR FACILITIES IN THE 419
FACILITY'S PEER GROUP, AS SPECIFIED IN RULES ADOPTED UNDER 420
SECTION 3721.69 OF THE REVISED CODE. STAFFING LEVELS SHALL BE 421
EXPRESSED ON A PER RESIDENT, PER DAY BASIS AND SHALL BE 422
CALCULATED BY ADDING THE HOURS OF STAFFING PERFORMED BY NURSE 423
AIDES, LICENSED PRACTICAL NURSES, AND REGISTERED NURSES, AS 425
REPORTED ON THE MOST RECENT COST REPORTS FILED UNDER SECTION 426
5111.26 OF THE REVISED CODE, AND DIVIDING THE SUM BY THE NUMBER 427
OF INPATIENT DAYS REPORTED ON THE COST REPORTS. 429
(5) A LIST OF SERVICES PROVIDED BY THE FACILITY. THE LIST 431
SHALL BE PRESENTED IN THE FORMAT SPECIFIED IN RULES ADOPTED UNDER 432
SECTION 3721.69 OF THE REVISED CODE. 433
(6) AT THE FACILITY'S OPTION, A PICTURE OF THE FACILITY, A 435
BRIEF STATEMENT PROVIDED BY THE FACILITY, AND A REFERENCE TO ANY 436
COMPUTERIZED INFORMATION THE FACILITY MAINTAINS ABOUT ITSELF ON 437
THE INTERNET; 438
(7) THE SUMMARIZED INFORMATION SPECIFIED IN DIVISION (B) 440
OF THIS SECTION FOR THE FACILITY. 442
Sec. 3721.67. (A) THROUGH THE CONTRACT REQUIRED UNDER 444
SECTION 3721.611 OF THE REVISED CODE, THE DEPARTMENT OF HEALTH 445
SHALL PROVIDE FOR THE CONDUCT OF CUSTOMER SATISFACTION SURVEYS 446
FOR USE IN PUBLISHING THE OHIO NURSING FACILITY CONSUMER GUIDE. 447
THE DEPARTMENT SHALL ENSURE THAT THE CUSTOMER SATISFACTION 448
SURVEYS ARE CONDUCTED AS FOLLOWS: 449
11
(1) THE SURVEYS SHALL BE CONDUCTED SEMIANNUALLY. 451
(2) THE SURVEYS SHALL CONSIST OF STANDARDIZED 453
QUESTIONNAIRES, ONE FOR NURSING FACILITY RESIDENTS AND ONE FOR 454
FAMILIES OF NURSING FACILITY RESIDENTS. EACH QUESTIONNAIRE SHALL 455
BE STRUCTURED IN A MANNER THAT USES A SCALE ALLOWING FOR FOUR 456
POSSIBLE ANSWERS TO EACH QUESTION CONCERNING CUSTOMER 457
SATISFACTION. EACH QUESTIONNAIRE SHALL ASK THE RESIDENT'S AGE 458
AND GENDER. THE RESIDENT QUESTIONNAIRE SHALL ASK WHO, IF ANYONE, 459
ASSISTED THE RESIDENT IN COMPLETING THE QUESTIONNAIRE. THE 460
FAMILY QUESTIONNAIRE SHALL ASK THE RELATIONSHIP OF THE PERSON 461
COMPLETING THE QUESTIONNAIRE TO THE RESIDENT. 462
(3) THE RESIDENT SURVEY SHALL BE CONDUCTED IN PERSON, 464
USING A STANDARDIZED SURVEY PROTOCOL. THE SURVEY SHALL BE 465
CONDUCTED IN A MANNER DESIGNED TO PRESERVE THE RESIDENT'S 466
CONFIDENTIALITY AS MUCH AS POSSIBLE. 467
(4) THE FAMILY SURVEY SHALL BE CONDUCTED USING ANONYMOUS 469
QUESTIONNAIRES DISTRIBUTED TO FAMILIES AND RETURNED TO A PERSON 470
OTHER THAN THE NURSING FACILITY. 471
(B) IN ADDITION TO BEING USED FOR THE CONSUMER GUIDE, THE 473
RESULTS OF THE SURVEYS CONDUCTED UNDER THIS SECTION SHALL BE 474
PROVIDED TO THE NURSING FACILITIES TO WHICH THEY PERTAIN. EACH 476
NURSING FACILITY IN THIS STATE SHALL PARTICIPATE AS NECESSARY FOR 477
SUCCESSFUL COMPLETION OF THE SURVEYS. 478
Sec. 3721.671. THE DEPARTMENT OF HEALTH MAY CHARGE A FEE, 480
NOT TO EXCEED TWO HUNDRED DOLLARS, FOR EACH OF THE SEMIANNUAL 481
CUSTOMER SATISFACTION SURVEYS CONDUCTED UNDER SECTION 3721.67 OF 482
THE REVISED CODE. THE FEE SHALL BE PAID BY THE NURSING FACILITY 484
AND IS SUBJECT TO REIMBURSEMENT THROUGH THE MEDICAID PROGRAM 485
PURSUANT TO SECTIONS 5111.20 TO 5111.32 OF THE REVISED CODE. 486
ALL FEES COLLECTED UNDER THIS SECTION SHALL BE DEPOSITED 489
INTO THE STATE TREASURY TO THE CREDIT OF THE GENERAL OPERATIONS
FUND CREATED UNDER SECTION 3701.83 OF THE REVISED CODE AND USED 490
FOR COSTS ASSOCIATED WITH THE PUBLISHING OF THE OHIO NURSING 492
FACILITY CONSUMER GUIDE, INCLUDING THE COST OF CONTRACTING WITH 493
12
PERSONS AND GOVERNMENT ENTITIES UNDER SECTION 3721.611 OF THE 494
REVISED CODE. AS THE DEPARTMENT'S CONTRACTOR, THE DEPARTMENT MAY 495
AUTHORIZE A PERSON OR GOVERNMENT ENTITY TO COLLECT THE FEES ON 496
BEHALF OF THE DEPARTMENT.
Sec. 3721.68. THE DEPARTMENT OF HEALTH SHALL CALCULATE 498
CLINICAL QUALITY INDICATORS FOR EACH NURSING FACILITY FOR USE IN 499
PUBLISHING THE OHIO NURSING FACILITY CONSUMER GUIDE. THE 500
INDICATORS SHALL BE CALCULATED BY USING THE MEASURES AND THE 501
CALCULATION METHODOLOGY THAT HAVE BEEN APPROVED OR RECOMMENDED 502
FOR USE IN THE MEDICARE OR MEDICAID PROGRAMS, EXCEPT THAT THE 503
DEPARTMENT MAY ADOPT RULES UNDER SECTION 3721.69 OF THE REVISED 504
CODE SPECIFYING DIFFERENT MEASURES OR A DIFFERENT CALCULATION 506
METHODOLOGY. THE CALCULATIONS SHALL BE MADE, AT A MINIMUM, AT 507
THE TIMES SPECIFIED IN RULES ADOPTED UNDER SECTION 3721.69 OF THE 508
REVISED CODE.
Sec. 3721.69. (A) EXCEPT AS PROVIDED IN DIVISION (B) OF 510
THIS SECTION, THE DEPARTMENT OF HEALTH SHALL ADOPT RULES TO 512
IMPLEMENT AND ADMINISTER SECTIONS 3721.60 TO 3721.68 OF THE 514
REVISED CODE. THE RULES SHALL SPECIFY ALL OF THE FOLLOWING: 516
(1) THE CONTENT OF THE COMPUTERIZED FORM OF THE OHIO 518
NURSING FACILITY CONSUMER GUIDE MAINTAINED ON THE INTERNET, 519
INCLUDING ANY INFORMATION IN ADDITION TO THE INFORMATION 521
SPECIFIED IN SECTION 3721.65 OF THE REVISED CODE; 522
(2) THE CONTENT OF THE PRINTED FORM OF THE CONSUMER GUIDE, 524
INCLUDING ANY INFORMATION IN ADDITION TO THE INFORMATION 525
SPECIFIED IN SECTION 3721.66 OF THE REVISED CODE; 526
(3) THE TWO CUSTOMER SATISFACTION MEASURES TO BE PUBLISHED 528
IN THE CONSUMER GUIDE PURSUANT TO DIVISION (C)(1) OF SECTION 529
3721.65 AND DIVISION (B)(1) OF SECTION 3721.66 OF THE REVISED 532
CODE;
(4) THE TWO CLINICAL QUALITY INDICATORS TO BE PUBLISHED IN 534
THE CONSUMER GUIDE PURSUANT TO DIVISION (C)(2) OF SECTION 3721.65 535
AND DIVISION (B)(2) OF SECTION 3721.66 OF THE REVISED CODE; 538
(5) FOR PURPOSES OF EXPRESSING AVERAGE STAFFING LEVELS 540
13
UNDER DIVISION (D)(4) OF SECTION 3721.65 AND DIVISION (C)(4) OF 541
SECTION 3721.66 OF THE REVISED CODE, CRITERIA TO BE USED IN 542
CLASSIFYING NURSING FACILITIES INTO PEER GROUPS, WHICH MAY BE 543
BASED ON CASE-MIX SCORES CALCULATED FOR NURSING FACILITIES UNDER 544
SECTION 5111.231 OF THE REVISED CODE, THE SIZE OF NURSING
FACILITIES, THE LOCATION OF FACILITIES, OR OTHER PERTINENT 545
FACTORS;
(6) THE FORMAT FOR LISTING OF NURSING FACILITY SERVICES IN 547
THE CONSUMER GUIDE AND THE MANNER IN WHICH THAT INFORMATION IS TO 548
BE COLLECTED FROM NURSING FACILITIES; 549
(7) IF CLINICAL QUALITY INDICATORS ARE TO BE CALCULATED 551
USING MEASURES AND METHODOLOGIES THAT ARE DIFFERENT FROM THOSE 552
THAT HAVE BEEN APPROVED OR RECOMMENDED FOR USE IN THE MEDICARE OR 553
MEDICAID PROGRAMS, THE ALTERNATIVE MEASURES AND METHODOLOGIES TO 555
BE USED IN MAKING THE CALCULATIONS;
(8) FEES THAT MAY BE COLLECTED UNDER SECTION 3721.671 OF 557
THE REVISED CODE FOR THE CONDUCT OF CUSTOMER SATISFACTION 559
SURVEYS;
(9) A METHOD OF INCLUDING ADDITIONAL LONG-TERM CARE 561
FACILITIES IN THE CONSUMER GUIDE PURSUANT TO CONSIDERATIONS MADE 562
UNDER DIVISION (B)(4) OF SECTION 3721.70 OF THE REVISED CODE; 563
(10) ANY OTHER REQUIREMENTS NECESSARY TO IMPLEMENT AND 565
ADMINISTER SECTIONS 3721.60 TO 3721.68 OF THE REVISED CODE. 566
(B) THE DEPARTMENT SHALL NOT ADOPT RULES UNDER THIS 568
SECTION UNLESS THE RULES FIRST HAVE BEEN RECOMMENDED BY THE 569
NURSING FACILITY CONSUMER GUIDE ADVISORY COUNCIL CREATED UNDER 571
SECTION 3721.70 OF THE REVISED CODE. IF THE COUNCIL DOES NOT 573
MAKE A RECOMMENDATION FOR RULES ADDRESSING ANY MATTER LISTED IN 574
DIVISION (A) OF THIS SECTION, THE DEPARTMENT IS NOT REQUIRED TO 575
ADOPT RULES ON THAT MATTER. 576
(C) ALL RULES ADOPTED UNDER THIS SECTION SHALL BE ADOPTED 578
IN ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE. INITIAL 580
RULES SHALL BE ADOPTED NOT LATER THAN SIX MONTHS AFTER THE 581
EFFECTIVE DATE OF THIS SECTION. 582
14
Sec. 3721.70. (A) THERE IS HEREBY CREATED THE NURSING 584
FACILITY CONSUMER GUIDE ADVISORY COUNCIL. THE COUNCIL SHALL BE 585
CONVENED BY THE DIRECTOR OF HEALTH AND SHALL CONSIST OF THE 587
FOLLOWING MEMBERS:
(1) A REPRESENTATIVE OF THE DEPARTMENT OF HEALTH, 589
APPOINTED BY THE DIRECTOR OF HEALTH; 590
(2) A REPRESENTATIVE OF THE DEPARTMENT OF AGING, APPOINTED 592
BY THE DIRECTOR OF AGING; 593
(3) A REPRESENTATIVE OF THE OHIO HEALTH CARE ASSOCIATION, 595
APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ASSOCIATION; 596
(4) A REPRESENTATIVE OF THE ASSOCIATION OF OHIO 598
PHILANTHROPIC HOMES, HOUSING, AND SERVICES FOR THE AGING, 599
APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ASSOCIATION; 601
(5) A REPRESENTATIVE OF THE OHIO ACADEMY OF NURSING HOMES, 603
APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ACADEMY; 604
(6) A REPRESENTATIVE OF THE OHIO ASSOCIATION OF REGIONAL 606
LONG-TERM CARE OMBUDSMEN, APPOINTED BY THE CHIEF ADMINISTRATOR OF 607
THE ASSOCIATION; 608
(7) A REPRESENTATIVE OF THE OHIO CHAPTER OF THE AMERICAN 610
ASSOCIATION OF RETIRED PERSONS, APPOINTED BY THE CHIEF 611
ADMINISTRATOR OF THE CHAPTER; 612
(8) A REPRESENTATIVE OF A RESEARCH ORGANIZATION, APPOINTED 614
BY THE CHIEF ADMINISTRATOR OF THE ORGANIZATION. THE RESEARCH 615
ORGANIZATION REPRESENTED SHALL BE SELECTED BY THE DIRECTOR OF 616
HEALTH FROM AMONG RESEARCH ORGANIZATIONS IN THIS STATE THAT HAVE 617
EXPERIENCE IN LONG-TERM CARE POLICY MATTERS. 618
EACH COUNCIL MEMBER SHALL SERVE AT THE DISCRETION OF THE 620
PERSON WHO APPOINTED THE MEMBER. EACH MEMBER SHALL SERVE WITHOUT 621
COMPENSATION OR REIMBURSEMENT FOR EXPENSES, EXCEPT TO THE EXTENT 622
THAT SERVING AS A MEMBER OF THE COUNCIL IS PART OF THE MEMBER'S 623
REGULAR DUTIES OF EMPLOYMENT. 624
THE MEMBER SERVING AS THE REPRESENTATIVE OF THE DEPARTMENT 626
OF HEALTH SHALL SERVE AS THE COUNCIL'S CHAIRPERSON. THE 627
DEPARTMENT SHALL SUPPLY MEETING SPACE AND STAFF SUPPORT FOR THE 628
15
COUNCIL.
(B) THE COUNCIL'S DUTIES INCLUDE ALL OF THE FOLLOWING: 630
(1) TO RECOMMEND RULES TO BE ADOPTED BY THE DEPARTMENT OF 632
HEALTH UNDER SECTION 3721.69 OF THE REVISED CODE; 633
(2) TO RECOMMEND ADMINISTRATIVE PRACTICES TO THE 635
DEPARTMENT FOR IMPROVING THE OPERATION AND THE CONTENT OF THE 636
OHIO NURSING FACILITY CONSUMER GUIDE; 637
(3) TO RECOMMEND LEGISLATIVE CHANGES NEEDED TO IMPROVE THE 639
CONSUMER GUIDE; 640
(4) TO CONSIDER WHETHER IT IS FEASIBLE TO INCLUDE IN THE 642
CONSUMER GUIDE OTHER LONG-TERM CARE FACILITIES, SUCH AS 643
RESIDENTIAL CARE FACILITIES, INTERMEDIATE CARE FACILITIES FOR THE 644
MENTALLY RETARDED, AND NURSING HOMES LICENSED UNDER SECTION 645
3721.02 OF THE REVISED CODE THAT ARE NOT NURSING FACILITIES OR 646
SKILLED NURSING FACILITIES.
(C) THE NURSING FACILITY CONSUMER GUIDE ADVISORY COUNCIL 648
IS NOT SUBJECT TO SECTION 101.84 OF THE REVISED CODE. 649
Sec. 5111.20. As used in sections 5111.20 to 5111.32 of 658
the Revised Code: 659
(A) "Allowable costs" are those costs determined by the 661
department of human services to be reasonable and do not include 662
fines paid under sections 5111.35 to 5111.61 and section 5111.99 663
of the Revised Code. 664
(B) "Capital costs" means costs of ownership and 666
nonextensive renovation. 667
(1) "Cost of ownership" means the actual expense incurred 669
for all of the following: 670
(a) Depreciation and interest on any capital assets that 672
cost five hundred dollars or more per item, including the 673
following: 674
(i) Buildings; 676
(ii) Building improvements that are not approved as 678
nonextensive renovations under section 5111.25 or 5111.251 of the 679
Revised Code; 680
16
(iii) Equipment; 682
(iv) Extensive renovations; 684
(v) Transportation equipment. 686
(b) Amortization and interest on land improvements and 688
leasehold improvements; 689
(c) Amortization of financing costs; 691
(d) Except as provided in division (I) of this section, 693
lease and rent of land, building, and equipment. 694
The costs of capital assets of less than five hundred 696
dollars per item may be considered costs of ownership in 697
accordance with a provider's practice.
(2) "Costs of nonextensive renovation" means the actual 699
expense incurred for depreciation or amortization and interest on 700
renovations that are not extensive renovations. 701
(C) "Capital lease" and "operating lease" shall be 703
construed in accordance with generally accepted accounting 704
principles.
(D) "Case-mix score" means the measure determined under 706
section 5111.231 of the Revised Code of the relative direct-care 707
resources needed to provide care and habilitation to a resident 708
of a nursing facility or intermediate care facility for the 709
mentally retarded. 710
(E) "Date of licensure," for a facility originally 712
licensed as a nursing home under Chapter 3721. of the Revised 713
Code, means the date specific beds were originally licensed as 714
nursing home beds under that chapter, regardless of whether they 715
were subsequently licensed as residential facility beds under 716
section 5123.19 of the Revised Code. For a facility originally 717
licensed as a residential facility under section 5123.19 of the 718
Revised Code, "date of licensure" means the date specific beds 719
were originally licensed as residential facility beds under that 720
section.
(1) If nursing home beds licensed under Chapter 3721. of 722
the Revised Code or residential facility beds licensed under 723
17
section 5123.19 of the Revised Code were not required by law to 724
be licensed when they were originally used to provide nursing 725
home or residential facility services, "date of licensure" means 726
the date the beds first were used to provide nursing home or
residential facility services, regardless of the date the present 727
provider obtained licensure. 728
(2) If a facility adds nursing home beds or residential 730
facility beds or extensively renovates all or part of the 731
facility after its original date of licensure, it will have a 732
different date of licensure for the additional beds or 733
extensively renovated portion of the facility, unless the beds 734
are added in a space that was constructed at the same time as the 735
previously licensed beds but was not licensed under Chapter 3721. 736
or section 5123.19 of the Revised Code at that time. 737
(F) "Desk-reviewed" means that costs as reported on a cost 739
report submitted under section 5111.26 of the Revised Code have 740
been subjected to a desk review under division (A) of section 741
5111.27 of the Revised Code and preliminarily determined to be 742
allowable costs. 743
(G) "Direct care costs" means all of the following: 745
(1)(a) Costs for registered nurses, licensed practical 747
nurses, and nurse aides employed by the facility; 748
(b) Costs for direct care staff, administrative nursing 750
staff, medical directors, social services staff, activities 751
staff, psychologists and psychology assistants, social workers 752
and counselors, habilitation staff, qualified mental retardation 753
professionals, program directors, respiratory therapists, 754
habilitation supervisors, and except as provided in division 755
(G)(2) of this section, other persons holding degrees qualifying 756
them to provide therapy; 757
(c) Costs of purchased nursing services; 759
(d) Costs of quality assurance; 761
(e) Costs of training and staff development, employee 763
benefits, payroll taxes, and workers' compensation premiums or 764
18
costs for self-insurance claims and related costs as specified in 765
rules adopted by the department of human services in accordance 766
with Chapter 119. of the Revised Code, for personnel listed in 768
divisions (G)(1)(a), (b), and (d) of this section; 769
(f) Costs of consulting and management fees related to 771
direct care;
(g) Allocated direct care home office costs. 773
(2) In addition to the costs specified in division (G)(1) 775
of this section, for intermediate care facilities for the 776
mentally retarded only, direct care costs include both of the 777
following: 778
(a) Costs for physical therapists and physical therapy 780
assistants, occupational therapists and occupational therapy 781
assistants, speech therapists, and audiologists; 782
(b) Costs of training and staff development, employee 784
benefits, payroll taxes, and workers' compensation premiums or 785
costs for self-insurance claims and related costs as specified in 786
rules adopted by the department of human services in accordance 787
with Chapter 119. of the Revised Code, for personnel listed in 788
division (G)(2)(a) of this section. 789
(3) Costs of other direct-care resources that are 791
specified as direct care costs in rules adopted by the department 792
of human services in accordance with Chapter 119. of the Revised 793
Code. 794
(H) "Fiscal year" means the fiscal year of this state, as 796
specified in section 9.34 of the Revised Code. 797
(I) "Indirect care costs" means all reasonable costs other 799
than direct care costs, other protected costs, or capital costs. 800
"Indirect care costs" includes but is not limited to costs of 801
habilitation supplies, pharmacy consultants, medical and 802
habilitation records, program supplies, incontinence supplies, 803
food, enterals, dietary supplies and personnel, laundry, 804
housekeeping, security, administration, liability insurance, 805
bookkeeping, purchasing department, human resources, 806
19
communications, travel, dues, license fees, subscriptions, home 807
office costs not otherwise allocated, legal services, accounting 808
services, minor equipment, maintenance and repairs, help-wanted 810
advertising, informational advertising, start-up costs, 811
organizational expenses, other interest, property insurance, 812
employee training and staff development, employee benefits, 813
payroll taxes, and workers' compensation premiums or costs for 814
self-insurance claims and related costs as specified in rules 815
adopted by the department of human services in accordance with 816
Chapter 119. of the Revised Code, for personnel listed in this 817
division. Notwithstanding division (B)(1) of this section, 818
"indirect care costs" also means the cost of equipment, including 819
vehicles, acquired by operating lease executed before December 1, 820
1992, if the costs are reported as administrative and general 821
costs on the facility's cost report for the cost reporting period 822
ending December 31, 1992.
(J) "Inpatient days" means all days during which a 824
resident, regardless of payment source, occupies a bed in a 825
nursing facility or intermediate care facility for the mentally 826
retarded that is included in the facility's certified capacity 827
under Title XIX of the "Social Security Act," 49 Stat. 610 828
(1935), 42 U.S.C.A. 301, as amended. Therapeutic or hospital 829
leave days for which payment is made under section 5111.33 of the 830
Revised Code are considered inpatient days proportionate to the 831
percentage of the facility's per resident per day rate paid for 832
those days. 833
(K) "Intermediate care facility for the mentally retarded" 835
means an intermediate care facility for the mentally retarded 836
certified as in compliance with applicable standards for the 837
medical assistance program by the director of health in 838
accordance with Title XIX of the "Social Security Act." 839
(L) "Maintenance and repair expenses" means, except as 841
provided in division (X)(2) of this section, expenditures that 842
are necessary and proper to maintain an asset in a normally 843
20
efficient working condition and that do not extend the useful 844
life of the asset two years or more. "Maintenance and repair 845
expenses" includes but is not limited to the cost of ordinary 846
repairs such as painting and wallpapering. 847
(M) "Nursing facility" means a facility, or a distinct 849
part of a facility, that is certified as a nursing facility by 850
the director of health in accordance with Title XIX of the 851
"Social Security Act," and is not an intermediate care facility 852
for the mentally retarded. "Nursing facility" includes a 853
facility, or a distinct part of a facility, that is certified as 854
a nursing facility by the director of health in accordance with 855
Title XIX of the "Social Security Act," and is certified as a 856
skilled nursing facility by the director in accordance with Title 857
XVIII of the "Social Security Act." 858
(N) "Other protected costs" means costs for medical 860
supplies; real estate, franchise, and property taxes; natural 861
gas, fuel oil, water, electricity, sewage, and refuse and 862
hazardous medical waste collection; allocated other protected 863
home office costs; FEES PAID UNDER SECTION 3721.671 OF THE 864
REVISED CODE; and any additional costs defined as other protected 866
costs in rules adopted by the department of human services in 867
accordance with Chapter 119. of the Revised Code. 868
(O) "Owner" means any person or government entity that has 870
at least five per cent ownership or interest, either directly, 871
indirectly, or in any combination, in a nursing facility or 872
intermediate care facility for the mentally retarded. 873
(P) "Patient" includes "resident." 875
(Q) Except as provided in divisions (Q)(1) and (2) of this 877
section, "per diem" means a nursing facility's or intermediate 878
care facility for the mentally retarded's actual, allowable costs 879
in a given cost center in a cost reporting period, divided by the 880
facility's inpatient days for that cost reporting period. 881
(1) When calculating indirect care costs for the purpose 883
of establishing rates under section 5111.24 or 5111.241 of the 884
21
Revised Code, "per diem" means a facility's actual, allowable 885
indirect care costs in a cost reporting period divided by the 886
greater of the facility's inpatient days for that period or the 887
number of inpatient days the facility would have had during that 888
period if its occupancy rate had been eighty-five per cent. 889
(2) When calculating capital costs for the purpose of 891
establishing rates under section 5111.25 or 5111.251 of the 892
Revised Code, "per diem" means a facility's actual, allowable 893
capital costs in a cost reporting period divided by the greater 894
of the facility's inpatient days for that period or the number of 895
inpatient days the facility would have had during that period if 896
its occupancy rate had been ninety-five per cent. 897
(R) "Provider" means a person or government entity that 899
operates a nursing facility or intermediate care facility for the 900
mentally retarded under a provider agreement. 901
(S) "Provider agreement" means a contract between the 903
department of human services and a nursing facility or 904
intermediate care facility for the mentally retarded for the 905
provision of nursing facility services or intermediate care 906
facility services for the mentally retarded under the medical 907
assistance program. 908
(T) "Purchased nursing services" means services that are 910
provided in a nursing facility by registered nurses, licensed 911
practical nurses, or nurse aides who are not employees of the 912
facility. 913
(U) "Reasonable" means that a cost is an actual cost that 915
is appropriate and helpful to develop and maintain the operation 916
of patient care facilities and activities, including normal 917
standby costs, and that does not exceed what a prudent buyer pays 918
for a given item or services. Reasonable costs may vary from 919
provider to provider and from time to time for the same provider. 920
(V) "Related party" means an individual or organization 922
that, to a significant extent, has common ownership with, is 923
associated or affiliated with, has control of, or is controlled 924
22
by, the provider. 925
(1) An individual who is a relative of an owner is a 927
related party. 928
(2) Common ownership exists when an individual or 930
individuals possess significant ownership or equity in both the 931
provider and the other organization. Significant ownership or 932
equity exists when an individual or individuals possess five per 933
cent ownership or equity in both the provider and a supplier. 934
Significant ownership or equity is presumed to exist when an 935
individual or individuals possess ten per cent ownership or 936
equity in both the provider and another organization from which 937
the provider purchases or leases real property. 938
(3) Control exists when an individual or organization has 940
the power, directly or indirectly, to significantly influence or 941
direct the actions or policies of an organization. 942
(4) An individual or organization that supplies goods or 944
services to a provider shall not be considered a related party if 945
all of the following conditions are met: 946
(a) The supplier is a separate bona fide organization. 948
(b) A substantial part of the supplier's business activity 950
of the type carried on with the provider is transacted with 951
others than the provider and there is an open, competitive market 952
for the types of goods or services the supplier furnishes. 953
(c) The types of goods or services are commonly obtained 955
by other nursing facilities or intermediate care facilities for 956
the mentally retarded from outside organizations and are not a 957
basic element of patient care ordinarily furnished directly to 958
patients by the facilities. 959
(d) The charge to the provider is in line with the charge 961
for the goods or services in the open market and no more than the 962
charge made under comparable circumstances to others by the 963
supplier. 964
(W) "Relative of owner" means an individual who is related 966
to an owner of a nursing facility or intermediate care facility 967
23
for the mentally retarded by one of the following relationships: 968
(1) Spouse; 970
(2) Natural parent, child, or sibling; 972
(3) Adopted parent, child, or sibling; 974
(4) Step-parent, step-child, step-brother, or step-sister; 976
(5) Father-in-law, mother-in-law, son-in-law, 978
daughter-in-law, brother-in-law, or sister-in-law; 979
(6) Grandparent or grandchild; 981
(7) Foster parent, foster child, foster brother, or foster 983
sister. 984
(X) "Renovation" and "extensive renovation" mean: 986
(1) Any betterment, improvement, or restoration of a 988
nursing facility or intermediate care facility for the mentally 989
retarded started before July 1, 1993, that meets the definition 990
of a renovation or extensive renovation established in rules 991
adopted by the department of human services in effect on December 992
22, 1992.
(2) In the case of betterments, improvements, and 994
restorations of nursing facilities and intermediate care 995
facilities for the mentally retarded started on or after July 1, 996
1993: 997
(a) "Renovation" means the betterment, improvement, or 999
restoration of a nursing facility or intermediate care facility 1,000
for the mentally retarded beyond its current functional capacity 1,001
through a structural change that costs at least five hundred 1,002
dollars per bed. A renovation may include betterment, 1,003
improvement, restoration, or replacement of assets that are 1,004
affixed to the building and have a useful life of at least five 1,005
years. A renovation may include costs that otherwise would be 1,006
considered maintenance and repair expenses if they are an 1,007
integral part of the structural change that makes up the 1,008
renovation project. "Renovation" does not mean construction of 1,009
additional space for beds that will be added to a facility's 1,010
licensed or certified capacity. 1,011
24
(b) "Extensive renovation" means a renovation that costs 1,013
more than sixty-five per cent and no more than eighty-five per 1,014
cent of the cost of constructing a new bed and that extends the 1,015
useful life of the assets for at least ten years. 1,016
For the purposes of division (X)(2) of this section, the 1,018
cost of constructing a new bed shall be considered to be forty 1,019
thousand dollars, adjusted for the estimated rate of inflation 1,020
from January 1, 1993, to the end of the calendar year during 1,021
which the renovation is completed, using the consumer price index 1,022
for shelter costs for all urban consumers for the north central 1,023
region, as published by the United States bureau of labor 1,024
statistics. 1,025
The department of human services may treat a renovation 1,027
that costs more than eighty-five per cent of the cost of 1,028
constructing new beds as an extensive renovation if the 1,029
department determines that the renovation is more prudent than 1,030
construction of new beds. 1,031
Section 2. That existing sections 3701.83 and 5111.20 of 1,033
the Revised Code are hereby repealed. 1,034
Section 3. All items in this section are hereby 1,036
appropriated as designated out of any moneys in the state 1,037
treasury to the credit of the general operations fund created by 1,038
section 3701.83 of the Revised Code. For all appropriations made 1,039
in this act, those in the first column are for fiscal year 2000
and those in the second column are for fiscal year 2001. The 1,040
appropriations made in this act are in addition to any other 1,041
appropriation made for the 1999-2001 biennium. 1,042
DOH DEPARTMENT OF HEALTH 1,044
State Special Revenue Fund Group 1,046
470 440-618 General Operations $ 700,000 $ 700,000 1,051
TOTAL SSR State Special Revenue 1,052
Fund Group $ 700,000 $ 700,000 1,055
TOTAL ALL BUDGET FUND GROUPS $ 700,000 $ 700,000 1,058
The foregoing appropriation item 440-618, General 1,061
25
Operations, shall be used by the Department of Health to 1,062
administer sections 3721.60 to 3721.69 of the Revised Code. 1,063
Of the foregoing appropriation item 440-618, General 1,065
Operations, not more than $200,000 in each fiscal year shall be 1,067
used to contract under section 3721.611 of the Revised Code with 1,068
a person or government entity to conduct the customer 1,069
satisfaction surveys required under section 3721.67 of the 1,070
Revised Code.
Within the limits set forth in this act, the Director of 1,072
Budget and Management shall establish accounts indicating the 1,073
source and amount of funds for each appropriation made in this 1,074
act and shall determine the form and manner in which 1,075
appropriation accounts shall be maintained. Expenditures from
appropriations contained in this act shall be accounted for as 1,076
though made in Am. Sub. H.B. 283 of the 123rd General Assembly. 1,077
The appropriations made in this act are subject to all 1,079
provisions of Am. Sub. H.B. 283 of the 123rd General Assembly 1,081
that are generally applicable to such approprations. 1,082
Section 4. The codified and uncodified sections of law 1,084
contained in this act are not subject to the referendum. 1,085
Therefore, under Ohio Constitution, Article II, Section 1d, and 1,086
section 1.471 of the Revised Code, the codified and uncodified 1,087
sections of law contained in this act go into immediate effect
when this act becomes law. 1,088