As Reported by House Finance and Appropriations Committee 1
123rd General Assembly 4
Regular Session Sub. 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-ROBERTS-R. MILLER-D. MILLER-BOYD- 10
JONES-CORBIN-EVANS-STAPLETON-BARRETT 11
_________________________________________________________________ 12
A B I L L
To amend sections 5111.20 and 5111.62 and to enact 14
sections 173.45 to 173.59 and 3721.026 of the 15
Revised Code to require the publication of the 16
Ohio Long-Term Care Consumer Guide, to create a
nursing facility technical assistance program, 17
and to make an appropriation. 18
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 20
Section 1. That sections 5111.20 and 5111.62 be amended 22
and sections 173.45, 173.46, 173.47, 173.48, 173.49, 173.50, 23
173.51, 173.52, 173.53, 173.54, 173.55, 173.56, 173.57, 173.58, 24
173.59, and 3721.026 of the Revised Code be enacted to read as 25
follows:
Sec. 173.45. AS USED IN SECTIONS 173.45 TO 173.59 OF THE 28
REVISED CODE:
(A) "CLINICAL QUALITY INDICATOR" MEANS A MEASURE OF AN 30
ASPECT OF THE PHYSICAL OR MENTAL CONDITIONS OF THE RESIDENTS OF A 31
NURSING FACILITY THAT IS DERIVED FROM DATA TAKEN FROM RESIDENT 33
ASSESSMENT INSTRUMENTS SUBMITTED BY NURSING FACILITIES FOR 34
PURPOSES OF THE MEDICARE AND MEDICAID PROGRAMS. 35
(B) "MEDICAID" HAS THE SAME MEANING AS IN SECTION 5111.01 37
OF THE REVISED CODE. 38
(C) "MEDICARE" MEANS THE PROGRAM OPERATED PURSUANT TO 41
TITLE XVIII OF THE "SOCIAL SECURITY ACT," 49 STAT. 620 (1935), 42 43
2
U.S.C.A. 301, AS AMENDED. 44
(D) "NURSING FACILITY" MEANS EITHER OF THE FOLLOWING: 46
(1) A FACILITY, OR A DISTINCT PART OF A FACILITY, THAT IS 49
CERTIFIED AS A NURSING FACILITY OR A SKILLED NURSING FACILITY FOR 50
PURPOSES OF THE MEDICARE OR MEDICAID PROGRAM; 51
(2) A NURSING HOME LICENSED UNDER SECTION 3721.02 OF THE 54
REVISED CODE THAT IS NOT CERTIFIED AS A NURSING FACILITY OR 55
SKILLED NURSING FACILITY.
(E) "DEFICIENCY," "IMMEDIATE JEOPARDY," "STANDARD SURVEY," 57
AND "SUBSTANDARD CARE" HAVE THE SAME MEANINGS AS IN SECTION 59
5111.35 OF THE REVISED CODE. 60
(F) "SURVEY DATA TAG" MEANS ANY OF THE DATA TAGS USED IN 62
THE MEDICARE AND MEDICAID PROGRAMS FOR IDENTIFICATION OF SPECIFIC 63
REGULATORY REQUIREMENTS. 64
Sec. 173.46. THE DEPARTMENT OF AGING SHALL DEVELOP AND 66
PUBLISH A GUIDE TO NURSING FACILITIES IN THIS STATE FOR USE BY 67
INDIVIDUALS CONSIDERING NURSING FACILITY PLACEMENT AND THEIR 68
FAMILIES, FRIENDS, AND ADVISORS. THE GUIDE SHALL BE TITLED THE 69
OHIO LONG-TERM CARE CONSUMER GUIDE. 70
THE CONSUMER GUIDE SHALL BE PUBLISHED IN COMPUTERIZED FORM 72
FOR DISTRIBUTION OVER THE INTERNET. THE GUIDE SHALL BE MADE 74
AVAILABLE NOT LATER THAN FOURTEEN MONTHS AFTER THE EFFECTIVE DATE 75
OF THIS SECTION AND SHALL BE UPDATED IN ACCORDANCE WITH SECTION 76
173.52 OF THE REVISED CODE. 77
EVERY TWO YEARS, THE DEPARTMENT SHALL PUBLISH AN EXECUTIVE 79
SUMMARY OF THE CONSUMER GUIDE, AND SHALL MAKE THE EXECUTIVE 80
SUMMARY AVAILABLE IN BOTH COMPUTERIZED AND PRINTED FORMS. 81
Sec. 173.47. THE DEPARTMENT OF AGING MAY CONTRACT WITH ANY 83
PERSON OR GOVERNMENT ENTITY TO PERFORM ANY FUNCTION RELATED TO 84
THE PUBLICATION OF THE OHIO LONG-TERM CARE CONSUMER GUIDE OR THE 86
COLLECTION AND PREPARATION OF DATA AND OTHER MATERIAL FOR THE 88
GUIDE, EXCEPT THAT THE DEPARTMENT SHALL CONTRACT TO HAVE THE 90
CUSTOMER SATISFACTION SURVEYS CONDUCTED UNDER SECTION 173.54 OF
THE REVISED CODE. IN AWARDING THE CONTRACT TO HAVE THE SURVEYS 92
3
CONDUCTED, THE DEPARTMENT SHALL CONTRACT WITH A PERSON OR
GOVERNMENT ENTITY THAT HAS EXPERIENCE IN SURVEYING THE CUSTOMER 93
SATISFACTION OF NURSING FACILITY RESIDENTS AND THEIR FAMILIES. 94
THE DEPARTMENT'S CONTRACT SHALL PERMIT THE PERSON OR GOVERNMENT 95
ENTITY TO SUBCONTRACT WITH OTHER PERSONS OR GOVERNMENT ENTITIES 96
FOR PURPOSES OF CONDUCTING ALL OR PART OF THE SURVEYS.
Sec. 173.48. IN DEVELOPING AND PUBLISHING THE OHIO 98
LONG-TERM CARE CONSUMER GUIDE, THE DEPARTMENT OF AGING SHALL 99
ADHERE TO THE FOLLOWING PRINCIPLES: 100
(A) THE GUIDE SHOULD BE DESIGNED TO PROVIDE USERS WITH A 102
VARIETY OF MEASURES OF NURSING FACILITY QUALITY AND WITH OTHER 103
INFORMATION USEFUL IN COMPARING AND SELECTING NURSING FACILITIES. 105
(B) THE GUIDE SHOULD PRESENT THE INFORMATION SPECIFIED IN 107
DIVISION (A) OF THIS SECTION IN A MANNER THAT IS EASY TO USE AND 108
UNDERSTAND. 109
(C) THE GUIDE SHOULD ALLOW USERS TO DETERMINE WHICH 111
MEASURES ARE MOST IMPORTANT TO THEM BUT SHALL NOT ESTABLISH A 112
RANKING OR GRADING SYSTEM.
(D) THE INFORMATION IN THE GUIDE SHOULD BE KEPT AS CURRENT 114
AS PRACTICABLE. 115
(E) THE GUIDE SHOULD BE DESIGNED TO PROMOTE EXCELLENCE IN 117
NURSING FACILITY QUALITY. 118
(F) THE GUIDE SHOULD PROMOTE AWARENESS OF THE RANGE OF 120
LONG-TERM CARE SERVICES AVAILABLE TO OHIOANS. 121
Sec. 173.49. WITH REGARD TO THE ACCESSIBILITY OF THE OHIO 123
LONG-TERM CARE CONSUMER GUIDE AND THE EXECUTIVE SUMMARY OF THE 124
GUIDE, THE FOLLOWING SHALL APPLY: 125
(A) THE DEPARTMENT OF AGING SHALL MAKE THE GUIDE AND 127
SUMMARY AVAILABLE TO ANY PERSON OR GOVERNMENT ENTITY AND SHALL 129
NOT RESTRICT ACCESS BY REQUIRING PAYMENT OF A FEE, USE OF A 130
PASSWORD, OR FULFILLMENT OF ANY OTHER CONDITION.
(B) THE DEPARTMENT OF AGING SHALL DEVELOP AND IMPLEMENT 133
PROGRAMS AND OTHER STRATEGIES TO ENCOURAGE USE OF THE GUIDE BY 134
INDIVIDUALS CONSIDERING NURSING FACILITY PLACEMENT AND THEIR 135
4
FAMILIES, FRIENDS, AND ADVISORS. 136
Sec. 173.50. THE OHIO LONG-TERM CARE CONSUMER GUIDE SHALL 138
INCLUDE INFORMATION ON EACH NURSING FACILITY IN THIS STATE. FOR 139
EACH FACILITY, THE GUIDE SHALL INCLUDE, TO THE EXTENT IT IS 141
AVAILABLE TO THE DEPARTMENT OF AGING, ALL OF THE FOLLOWING 142
INFORMATION:
(A) CUSTOMER SATISFACTION DATA OBTAINED UNDER SECTION 144
173.54 OF THE REVISED CODE; 145
(B) CLINICAL QUALITY INDICATOR DATA OBTAINED UNDER SECTION 147
173.56 OF THE REVISED CODE; 148
(C) DATA DERIVED FROM STANDARD SURVEYS AS SPECIFIED IN 151
DIVISION (C)(3) OF SECTION 173.51 OF THE REVISED CODE; 152
(D) ANY OTHER INFORMATION SPECIFIED IN SECTIONS 173.45 TO 154
173.59 OF THE REVISED CODE OR THE RULES ADOPTED UNDER SECTION 156
173.57 OF THE REVISED CODE.
Sec. 173.51. THE OHIO LONG-TERM CARE CONSUMER GUIDE SHALL 159
BE STRUCTURED IN ACCORDANCE WITH THIS SECTION AND ANY APPLICABLE 161
RULES ADOPTED UNDER SECTION 173.57 OF THE REVISED CODE. 162
(A) THE OPENING ELECTRONIC PAGE OF THE CONSUMER GUIDE 164
SHALL INCLUDE ALL OF THE FOLLOWING GENERAL INFORMATION: 165
(1) A DESCRIPTION OF THE GUIDE; 167
(2) DISCLAIMERS STATING THE LIMITATIONS OF THE DATA 169
INCLUDED IN THE GUIDE. THE DISCLAIMERS SHALL INCLUDE A STATEMENT 170
THAT STANDARD SURVEYS OF NURSING FACILITIES ARE CONDUCTED AT 171
PERIODIC INTERVALS AND A STATEMENT THAT CONDITIONS AT A FACILITY 172
CAN CHANGE SIGNIFICANTLY BETWEEN STANDARD SURVEYS. 173
(3) A RECOMMENDATION THAT INDIVIDUALS CONSIDERING NURSING 175
FACILITY PLACEMENT VISIT ANY FACILITIES THEY ARE CONSIDERING; 176
(4) ELECTRONIC LINKS TO OTHER INFORMATION ON THE INTERNET 178
ABOUT SELECTING NURSING FACILITIES AND ABOUT OTHER LONG-TERM CARE 179
OPTIONS, INCLUDING INFORMATION MAINTAINED BY PERTINENT GOVERNMENT 181
AGENCIES AND PRIVATE ORGANIZATIONS AND TELEPHONE NUMBERS FOR 182
THOSE AGENCIES AND ORGANIZATIONS;
(5) ANY OTHER INFORMATION THE DEPARTMENT OF AGING 184
5
SPECIFIES IN RULES ADOPTED UNDER SECTION 173.57 OF THE REVISED 186
CODE.
(B) THE CONSUMER GUIDE SHALL BE STRUCTURED IN A MANNER 188
THAT ALLOWS THE USER TO SEARCH FOR INFORMATION IN THE GUIDE IN 189
MULTIPLE WAYS, INCLUDING SEARCHES BY FACILITY NAME, COUNTY, 191
MUNICIPALITY, POSTAL ZIP CODE, SOURCE OF NURSING FACILITY 192
PAYMENT, AND SPECIAL CARE SERVICE. 193
(C) THE FIRST INFORMATION TO APPEAR ON THE COMPUTER SCREEN 195
FOLLOWING A SEARCH SHALL BE A LIST OF ALL FACILITIES IDENTIFIED 196
BY THE SEARCH. FOR ALL OF THE FACILITIES LISTED, THE CONSUMER 197
GUIDE SHALL PRESENT THE USER WITH SUMMARIZED COMPARATIVE MEASURES 199
AND ELECTRONIC LINKS TO DEFINITIONS AND DESCRIPTIONS OF THE 200
MEASURES. THE GUIDE SHALL INCLUDE A FEATURE THAT ALLOWS THE USER
TO CHOOSE THE PARTICULAR COMPARATIVE MEASURES THAT WILL BE 201
DISPLAYED ON THE SCREEN. THE GUIDE ALSO MAY INCLUDE A CONSUMER 202
NEEDS ASSESSMENT FUNCTION TO ASSIST THE USER IN CHOOSING 203
MEASURES. THE COMPARATIVE MEASURES SHALL BE DERIVED FROM THE 204
FOLLOWING SOURCES:
(1) THE AGGREGATE RESPONSES MADE BY A FACILITY'S RESIDENTS 206
OR THEIR FAMILIES TO MEASURES OF CUSTOMER SATISFACTION INCLUDED 209
IN THE SURVEYS CONDUCTED UNDER SECTION 173.54 OF THE REVISED 210
CODE. THE MEASURES SHALL BE SPECIFIED IN RULES ADOPTED UNDER 212
SECTION 173.57 OF THE REVISED CODE. FOR EACH MEASURE, THE GUIDE 213
SHALL COMPARE THE RESPONSES FOR THE FACILITY TO THE STATEWIDE 214
AVERAGE OR TO A PEER-GROUP AVERAGE SPECIFIED IN RULE UNDER 215
SECTION 173.57 OF THE REVISED CODE. 216
(2) THE SCORES ON CLINICAL QUALITY INDICATORS CALCULATED 219
UNDER SECTION 173.56 OF THE REVISED CODE. THE INDICATORS SHALL 220
BE SPECIFIED IN RULES ADOPTED UNDER SECTION 173.57 OF THE REVISED 221
CODE. FOR EACH INDICATOR, THE GUIDE SHALL COMPARE THE FACILITY'S 222
SCORE TO THE STATEWIDE AVERAGE OR TO A PEER-GROUP AVERAGE 223
SPECIFIED IN RULE UNDER SECTION 173.57 OF THE REVISED CODE. THE 224
SCORES SHALL BE EXPRESSED AS PERCENTAGES. 225
(3) ALL OF THE FOLLOWING: 227
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(a) THE DATE OF THE FACILITY'S MOST RECENT STANDARD 229
SURVEY; 230
(b) THE PERCENTAGE OF SPECIFIED SURVEY DATA TAGS FOR WHICH 232
THE FACILITY WAS FOUND TO BE IN COMPLIANCE DURING THE FACILITY'S 233
MOST RECENT STANDARD SURVEY. THE DEPARTMENT OF AGING SHALL 235
SPECIFY IN RULE THE SURVEY DATA TAGS USED FOR THIS PURPOSE AND 236
MAY EXCLUDE TAGS THAT ARE NEVER OR VERY RARELY CITED DURING 237
SURVEYS.
(c) THE STATEWIDE AVERAGE PERCENTAGE OF THE SPECIFIED 239
SURVEY DATA TAGS FOR WHICH FACILITIES WERE FOUND TO BE IN 241
COMPLIANCE DURING THE MOST RECENT STANDARD SURVEYS. 242
ALTERNATIVELY, THE DEPARTMENT OF AGING MAY PRESCRIBE BY RULE THAT 243
A PEER-GROUP AVERAGE BE USED. 244
(d) THE NUMBER OF SPECIFIED SURVEY DATA TAGS CITED BY THE 246
DEPARTMENT OF HEALTH IN THE FACILITY'S MOST RECENT STANDARD 247
SURVEY; 248
(e) THE STATEWIDE AVERAGE NUMBER OF SPECIFIED SURVEY DATA 250
TAGS CITED BY THE DEPARTMENT OF HEALTH DURING THE MOST RECENT 251
STANDARD SURVEYS. ALTERNATIVELY, THE DEPARTMENT OF AGING MAY 253
PRESCRIBE BY RULE THAT A PEER-GROUP AVERAGE BE USED.
(f) THE DATE THE FACILITY ACHIEVED SUBSTANTIAL COMPLIANCE 255
WITH MEDICARE AND MEDICAID CERTIFICATION REQUIREMENTS; 256
(g) WHETHER THE DEPARTMENT OF HEALTH DETERMINED THAT THE 258
FACILITY PROVIDED SUBSTANDARD CARE TO RESIDENTS DURING TWO OF ITS 260
LAST THREE STANDARD SURVEYS; 261
(h) WHETHER THE DEPARTMENT OF HEALTH FOUND THAT THE CARE 263
PROVIDED BY THE FACILITY PLACED RESIDENTS IN IMMEDIATE JEOPARDY 265
DURING TWO OF ITS LAST THREE STANDARD SURVEYS. 266
(4) AN ELECTRONIC LINK FOR EACH FACILITY ON THE LIST 268
ALLOWING THE USER TO GAIN ACCESS TO INFORMATION ON THE FACILITY 270
MAINTAINED UNDER DIVISION (D) OF THIS SECTION. 272
(D) IN ADDITION TO THE SUMMARIZED INFORMATION PROVIDED BY 274
THE GUIDE PURSUANT TO DIVISION (C) OF THIS SECTION, THE GUIDE 275
SHALL PROVIDE SPECIFIC COMPARATIVE INFORMATION ON EACH NURSING 276
7
FACILITY. WHEN THE GUIDE'S USER OPENS AN ELECTRONIC LINK TO THE 278
SPECIFIC INFORMATION, THE FIRST INFORMATION TO APPEAR ON THE 279
COMPUTER SCREEN SHALL INCLUDE ALL OF THE FOLLOWING:
(1) THE NAME OF THE FACILITY AND ITS OWNER, THE FACILITY'S 281
TELEPHONE NUMBER AND ADDRESS, INCLUDING THE COUNTY IN WHICH THE 283
FACILITY IS LOCATED. THE GUIDE SHALL INCLUDE A FUNCTION THAT 284
PINPOINTS ON A MAP THE FACILITY'S LOCATION.
(2) THE FACILITY'S STATUS WITH REGARD TO MEDICARE AND 286
MEDICAID CERTIFICATION AND PRIVATE ACCREDITATION; 287
(3) THE NUMBER OF BEDS IN THE FACILITY; 289
(4) INFORMATION ABOUT THE FACILITY'S STAFFING AS 291
PRESCRIBED IN RULE BY THE DEPARTMENT OF AGING; 292
(5) AN ELECTRONIC LINK ALLOWING THE USER OF THE GUIDE TO 294
GAIN ACCESS TO A LISTING OF SERVICES PROVIDED BY THE FACILITY. 295
THE LISTING SHALL BE PRESENTED IN THE FORMAT SPECIFIED IN RULES 296
ADOPTED UNDER SECTION 173.57 OF THE REVISED CODE. 297
(6) AT THE FACILITY'S OPTION, A PICTURE OF THE FACILITY, A 299
BRIEF STATEMENT PROVIDED BY THE FACILITY, AND AN ELECTRONIC LINK 300
TO ANY INFORMATION THE FACILITY MAINTAINS ABOUT ITSELF ON THE 301
INTERNET;
(7) THE SUMMARIZED INFORMATION SPECIFIED IN DIVISION (C) 303
OF THIS SECTION FOR THE FACILITY, WITH ELECTRONIC LINKS ALLOWING 305
THE USER TO GAIN ACCESS TO ADDITIONAL INFORMATION PRESENTED AS 307
FOLLOWS:
(a) FOR EACH STATISTICALLY VALID AND RELIABLE QUESTION 309
ASKED ON THE QUESTIONNAIRES USED IN THE RESIDENT AND FAMILY 311
SURVEYS CONDUCTED UNDER SECTION 173.54 OF THE REVISED CODE, THE 312
GUIDE SHALL PRESENT THE CUSTOMER SATISFACTION RESPONSES. THE 314
RESPONSES FOR THE FACILITY SHALL BE COMPARED TO THE STATEWIDE 315
AVERAGE OR TO A PEER-GROUP AVERAGE SPECIFIED IN RULE UNDER 316
SECTION 173.57 OF THE REVISED CODE AND SHALL BE EXPRESSED IN 318
PERCENTAGES.
(b) FOR EACH CLINICAL QUALITY INDICATOR CALCULATED UNDER 321
SECTION 173.56 OF THE REVISED CODE, THE GUIDE SHALL PRESENT THE 322
8
FACILITY'S SCORE COMPARED TO THE STATEWIDE AVERAGE SCORE. THE 323
SCORES SHALL BE EXPRESSED AS PERCENTAGES. 324
(c) THE GUIDE SHALL PRESENT A LIST OF ALL SURVEY DATA TAGS 327
THAT WERE CITED DURING THE FACILITY'S MOST RECENT STANDARD 328
SURVEY, A BRIEF DESCRIPTION PERTAINING TO EACH DATA TAG, 329
DIRECTIONS OR ELECTRONIC LINKS FOR OBTAINING MORE INFORMATION 330
ABOUT THE FACILITY'S SURVEY HISTORY, AND LINKS TO THE TEXT OF 333
EACH CITATION AND TO THE FACILITY'S PLAN OF CORRECTION FILED WITH 334
THE STATE FOR EACH CITATION.
(8) ANY OTHER INFORMATION THE DEPARTMENT OF AGING 336
PRESCRIBES BY RULE.
Sec. 173.52. (A) THE DEPARTMENT OF AGING SHALL UPDATE 340
INFORMATION IN THE OHIO LONG-TERM CARE CONSUMER GUIDE AS FOLLOWS: 341
(1) THE CUSTOMER SATISFACTION DATA OBTAINED UNDER SECTION 343
173.54 OF THE REVISED CODE SHALL BE UPDATED ANNUALLY FOLLOWING 346
THE SURVEYS CONDUCTED UNDER THAT SECTION.
(2) THE CLINICAL QUALITY INDICATOR DATA OBTAINED UNDER 348
SECTION 173.56 OF THE REVISED CODE SHALL BE UPDATED IN JANUARY, 350
APRIL, JULY, AND OCTOBER OF EACH YEAR, USING THE MOST RECENT 352
RESIDENT ASSESSMENT DATA AVAILABLE TO THE DEPARTMENT.
(3) THE DATA DERIVED FROM STANDARD SURVEYS OF EACH NURSING 354
FACILITY, AS SPECIFIED IN DIVISION (C)(3) OF SECTION 173.51 OF 356
THE REVISED CODE, SHALL BE UPDATED WEEKLY, USING THE MOST RECENT 357
STANDARD SURVEY DATA AVAILABLE TO THE DEPARTMENT. THE DEPARTMENT 359
SHALL IMMEDIATELY MODIFY THE DATA INCLUDED IN THE CONSUMER GUIDE 360
TO REFLECT EITHER OF THE FOLLOWING: 361
(a) ANY CHANGE IN THE SURVEY DATA RESULTING FROM INFORMAL 363
DISPUTE RESOLUTION, APPEAL, OR ANY OTHER PROCESS; 364
(b) THE DATE OF CORRECTION OF ANY CITATION. 366
(4) ANY OTHER INFORMATION SPECIFIED IN SECTIONS 173.45 TO 368
173.59 OF THE REVISED CODE OR THE RULES ADOPTED UNDER SECTION 370
173.57 OF THE REVISED CODE SHALL BE UPDATED AT THE TIME SPECIFIED 371
IN THOSE SECTIONS OR THE RULES.
(B) THE DEPARTMENT OF AGING SHALL SPECIFY BY RULE 373
9
INFORMATION IN THE GUIDE THAT NURSING FACILITIES CAN 374
ELECTRONICALLY UPDATE WITHOUT THE NEED FOR ANY ACTION BY THE 376
DEPARTMENT. THE GUIDE SHALL INCLUDE A MECHANISM FOR SUCH 377
UPDATES. THIS DIVISION DOES NOT APPLY TO INFORMATION DESCRIBED 378
IN DIVISIONS (A)(1), (2), AND (3) OF THIS SECTION. 379
(C) THE DEPARTMENT OF HEALTH SHALL COOPERATE WITH THE 381
DEPARTMENT OF AGING TO ENSURE THAT STANDARD SURVEY INFORMATION IS 382
UPDATED IN ACCORDANCE WITH THIS SECTION. 383
Sec. 173.53. IN ADDITION TO THE COMPUTERIZED OHIO 385
LONG-TERM CARE CONSUMER GUIDE, THE DEPARTMENT OF AGING SHALL 387
PREPARE AND MAKE AVAILABLE TO THE PUBLIC PRINTED INFORMATION TO 388
ASSIST CONSUMERS IN MAKING LONG-TERM CARE AND NURSING FACILITY 389
PLACEMENT DECISIONS, PARTICULARLY CONSUMERS WHO DO NOT HAVE 390
ACCESS TO THE INTERNET. THE PRINTED INFORMATION SHALL SPECIFY 391
ORGANIZATIONS THAT WILL PROVIDE CONSUMERS FREE ON-SITE ACCESS TO 392
THE CONSUMER GUIDE AND WILL MAIL TO CONSUMERS FREE PAPER COPIES 393
OF ELECTRONIC PAGES OF THE GUIDE.
Sec. 173.54. (A) THROUGH THE CONTRACT REQUIRED UNDER 395
SECTION 173.47 OF THE REVISED CODE, THE DEPARTMENT OF AGING SHALL 396
PROVIDE FOR CUSTOMER SATISFACTION SURVEYS FOR USE IN PUBLISHING 397
THE OHIO LONG-TERM CARE CONSUMER GUIDE. THE DEPARTMENT SHALL 398
ENSURE THAT THE CUSTOMER SATISFACTION SURVEYS ARE CONDUCTED AS 399
FOLLOWS: 400
(1) THE SURVEYS SHALL BE CONDUCTED ANNUALLY. 402
(2) THE SURVEYS SHALL CONSIST OF STANDARDIZED, 404
STATISTICALLY VALID AND RELIABLE QUESTIONNAIRES FOR NURSING 406
FACILITY RESIDENTS AND FOR FAMILIES OF NURSING FACILITY 407
RESIDENTS. EACH QUESTIONNAIRE SHALL BE STRUCTURED IN A MANNER 408
THAT PRODUCES STATISTICALLY TESTED VALID AND RELIABLE RESPONSES, 409
AS SPECIFIED IN RULES ADOPTED BY THE DEPARTMENT. EACH 410
QUESTIONNAIRE SHALL ASK THE RESIDENT'S AGE AND GENDER. THE 411
RESIDENT QUESTIONNAIRE SHALL ASK WHO, IF ANYONE, ASSISTED THE 412
RESIDENT IN COMPLETING THE QUESTIONNAIRE. THE FAMILY 413
QUESTIONNAIRE SHALL ASK THE RELATIONSHIP OF THE PERSON COMPLETING 414
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THE QUESTIONNAIRE TO THE RESIDENT. 415
(3) THE RESIDENT SURVEY SHALL BE CONDUCTED IN PERSON, 417
USING A STANDARDIZED SURVEY PROTOCOL DEVELOPED BY THE DEPARTMENT 418
IN CONSULTATION WITH THE LONG-TERM CARE CONSUMER GUIDE ADVISORY 419
COUNCIL. THE SURVEY SHALL BE CONDUCTED IN A MANNER DESIGNED TO 421
PRESERVE THE RESIDENT'S CONFIDENTIALITY AS MUCH AS POSSIBLE. 422
(4) THE FAMILY SURVEY SHALL BE CONDUCTED USING ANONYMOUS 424
QUESTIONNAIRES DISTRIBUTED TO FAMILIES AND RETURNED TO A PERSON 425
OTHER THAN THE NURSING FACILITY, IN ACCORDANCE WITH A 426
STANDARDIZED SURVEY PROTOCOL DEVELOPED BY THE DEPARTMENT IN 428
CONSULTATION WITH THE LONG-TERM CARE CONSUMER GUIDE ADVISORY 429
COUNCIL.
(B) IN ADDITION TO BEING USED FOR THE CONSUMER GUIDE, THE 431
RESULTS OF THE SURVEYS CONDUCTED UNDER THIS SECTION SHALL BE 432
PROVIDED TO THE NURSING FACILITIES TO WHICH THEY PERTAIN. EACH 434
NURSING FACILITY IN THIS STATE SHALL PARTICIPATE AS NECESSARY FOR 435
SUCCESSFUL COMPLETION OF THE SURVEYS. 436
Sec. 173.55. THE DEPARTMENT OF AGING MAY CHARGE A FEE, NOT 438
TO EXCEED FOUR HUNDRED DOLLARS, FOR EACH OF THE ANNUAL CUSTOMER 439
SATISFACTION SURVEYS CONDUCTED UNDER SECTION 173.54 OF THE 441
REVISED CODE. THE FEE SHALL BE PAID BY THE NURSING FACILITY AND 442
IS SUBJECT TO REIMBURSEMENT THROUGH THE MEDICAID PROGRAM PURSUANT 443
TO SECTIONS 5111.20 TO 5111.32 OF THE REVISED CODE. 444
ALL FEES COLLECTED UNDER THIS SECTION SHALL BE DEPOSITED TO 447
THE CREDIT OF THE LONG-TERM CARE CONSUMER GUIDE FUND, WHICH IS
HEREBY CREATED IN THE STATE TREASURY. THE FUND SHALL BE USED FOR 450
COSTS ASSOCIATED WITH PUBLISHING THE OHIO LONG-TERM CARE CONSUMER 451
GUIDE, INCLUDING THE COST OF CONTRACTING WITH PERSONS AND 452
GOVERNMENT ENTITIES UNDER SECTION 173.47 OF THE REVISED CODE. 453
THE DEPARTMENT MAY CONTRACT WITH A PERSON OR GOVERNMENT ENTITY TO 455
COLLECT THE FEES ON BEHALF OF THE DEPARTMENT. 456
Sec. 173.56. FOR PURPOSES OF THE LONG-TERM CARE CONSUMER 458
GUIDE, THE DEPARTMENT OF AGING SHALL USE CLINICAL QUALITY 460
INDICATORS THAT THE DEPARTMENT OF HEALTH CALCULATES FOR EACH 461
11
NURSING FACILITY USING METHODS ESTABLISHED BY THE UNITED STATES 462
HEALTH CARE FINANCING ADMINISTRATION FOR THE PURPOSES OF THE 464
MEDICARE AND MEDICAID PROGRAMS.
Sec. 173.57. (A) THE DEPARTMENT OF AGING SHALL ADOPT 466
RULES TO IMPLEMENT AND ADMINISTER SECTIONS 173.45 TO 173.59 OF 469
THE REVISED CODE. THE RULES SHALL SPECIFY ALL OF THE FOLLOWING: 471
(1) THE CONTENT OF THE OHIO LONG-TERM CARE CONSUMER GUIDE, 474
INCLUDING ANY INFORMATION IN ADDITION TO THE INFORMATION 476
SPECIFIED IN SECTION 173.51 OF THE REVISED CODE; 477
(2) THE CONTENT OF THE COMPUTERIZED AND PRINTED FORMS OF 480
THE EXECUTIVE SUMMARY OF THE CONSUMER GUIDE;
(3) THE CUSTOMER SATISFACTION MEASURES TO BE PUBLISHED IN 482
THE CONSUMER GUIDE PURSUANT TO DIVISION (C)(1) OF SECTION 173.51 483
OF THE REVISED CODE; 485
(4) THE CLINICAL QUALITY INDICATORS TO BE PUBLISHED IN THE 487
CONSUMER GUIDE PURSUANT TO DIVISION (C)(2) OF SECTION 173.51 OF 489
THE REVISED CODE; 490
(5) FOR PURPOSES OF STAFFING COMPARISONS UNDER DIVISION 493
(D)(4) OF SECTION 173.51 OF THE REVISED CODE, CRITERIA TO BE USED
IN CLASSIFYING NURSING FACILITIES INTO PEER GROUPS, WHICH MAY BE 495
BASED ON CASE-MIX SCORES CALCULATED UNDER SECTION 5111.231 OF THE 496
REVISED CODE, THE SIZE OF NURSING FACILITIES, THE LOCATION OF 497
FACILITIES, OR OTHER PERTINENT FACTORS;
(6) THE FORMAT FOR LISTING NURSING FACILITY SERVICES IN 499
THE CONSUMER GUIDE AND THE MANNER IN WHICH THAT INFORMATION IS TO 500
BE COLLECTED FROM NURSING FACILITIES; 501
(7) FEES THAT MAY BE COLLECTED UNDER SECTION 173.55 OF THE 503
REVISED CODE FOR CONDUCTING CUSTOMER SATISFACTION SURVEYS. IF 505
THE STATE RECEIVES FEDERAL FUNDING THAT CAN BE USED TO OFFSET 506
GUIDE OPERATING COSTS, THE DEPARTMENT SHALL REDUCE THE AMOUNT OF 507
THE FEE PROPORTIONALLY.
(8) A METHOD OF INCLUDING ADDITIONAL LONG-TERM CARE 509
FACILITIES AND SERVICE PROVIDERS IN THE CONSUMER GUIDE PURSUANT 511
TO CONSIDERATIONS MADE UNDER DIVISION (B)(4) OF SECTION 173.58 OF 512
12
THE REVISED CODE;
(9) ANY OTHER REQUIREMENTS NECESSARY TO IMPLEMENT AND 514
ADMINISTER SECTIONS 173.45 TO 173.59 OF THE REVISED CODE. 515
(B) THE DEPARTMENT SHALL DEVELOP RULES UNDER THIS SECTION 517
IN CONSULTATION WITH THE LONG-TERM CARE CONSUMER GUIDE ADVISORY 519
COUNCIL CREATED UNDER SECTION 173.58 OF THE REVISED CODE. BEFORE 521
FILING A RULE UNDER SECTION 119.03 OF THE REVISED CODE, THE 522
DEPARTMENT SHALL PRESENT IT TO THE ADVISORY COUNCIL AND PROVIDE 523
THE COUNCIL A REASONABLE TIME TO COMMENT ON IT. 524
(C) ALL RULES ADOPTED UNDER THIS SECTION SHALL BE ADOPTED 526
IN ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE. INITIAL 528
RULES SHALL BE ADOPTED NOT LATER THAN SIX MONTHS AFTER THE 529
EFFECTIVE DATE OF THIS SECTION. 530
Sec. 173.58. (A) THERE IS HEREBY CREATED THE LONG-TERM 532
CARE CONSUMER GUIDE ADVISORY COUNCIL. THE COUNCIL SHALL BE 533
CONVENED BY THE DIRECTOR OF AGING AND SHALL CONSIST OF THE 535
FOLLOWING MEMBERS:
(1) A REPRESENTATIVE OF THE DEPARTMENT OF AGING, APPOINTED 537
BY THE DIRECTOR OF AGING; 538
(2) A REPRESENTATIVE OF THE DEPARTMENT OF HEALTH, 540
APPOINTED BY THE DIRECTOR OF HEALTH; 541
(3) A REPRESENTATIVE OF THE DEPARTMENT OF JOB AND FAMILY 543
SERVICES, APPOINTED BY THE DIRECTOR OF JOB AND FAMILY SERVICES; 544
(4) THE STATE LONG-TERM CARE OMBUDSPERSON; 546
(5) A FAMILY MEMBER OF A NURSING FACILITY RESIDENT, 548
APPOINTED BY THE GOVERNOR; 549
(6) A REPRESENTATIVE OF THE OHIO ASSOCIATION OF AREA 551
AGENCIES ON AGING, APPOINTED BY THE PRESIDENT OF THE ASSOCIATION; 552
(7) TWO REPRESENTATIVES OF THE OHIO HEALTH CARE 554
ASSOCIATION, APPOINTED BY THE CHIEF ADMINISTRATOR OF THE 555
ASSOCIATION;
(8) TWO REPRESENTATIVES OF THE ASSOCIATION OF OHIO 557
PHILANTHROPIC HOMES, HOUSING, AND SERVICES FOR THE AGING, 558
APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ASSOCIATION; 560
13
(9) TWO REPRESENTATIVES OF THE OHIO ACADEMY OF NURSING 562
HOMES, APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ACADEMY; 563
(10) A REPRESENTATIVE OF THE OHIO ASSOCIATION OF REGIONAL 565
LONG-TERM CARE OMBUDSMEN, APPOINTED BY THE CHIEF ADMINISTRATOR OF 566
THE ASSOCIATION; 567
(11) A REPRESENTATIVE OF THE OHIO CHAPTER OF THE AMERICAN 570
ASSOCIATION OF RETIRED PERSONS, APPOINTED BY THE CHIEF 571
ADMINISTRATOR OF THE CHAPTER; 572
(12) A REPRESENTATIVE OF A CONSUMER GROUP OR OTHER 575
NOT-FOR-PROFIT ENTITY THAT IS ORGANIZED FOR THE PURPOSE OF 576
PROMOTING IMPROVED CARE FOR NURSING HOME RESIDENTS, APPOINTED BY 577
THE GOVERNOR;
(13) A REPRESENTATIVE OF A RESEARCH ORGANIZATION, 579
APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ORGANIZATION. THE 580
RESEARCH ORGANIZATION REPRESENTED SHALL BE SELECTED BY THE 581
DIRECTOR OF AGING FROM AMONG RESEARCH ORGANIZATIONS IN THIS STATE 582
THAT HAVE EXPERIENCE IN LONG-TERM CARE POLICY MATTERS. 583
EACH COUNCIL MEMBER SHALL SERVE AT THE DISCRETION OF THE 585
AUTHORITY THAT APPOINTED THE MEMBER. EACH MEMBER SHALL SERVE 586
WITHOUT COMPENSATION OR REIMBURSEMENT FOR EXPENSES, EXCEPT TO THE 587
EXTENT THAT SERVING AS A MEMBER OF THE COUNCIL IS PART OF THE 588
MEMBER'S REGULAR DUTIES OF EMPLOYMENT. 589
THE MEMBER SERVING AS THE REPRESENTATIVE OF THE DEPARTMENT 591
OF AGING SHALL SERVE AS THE COUNCIL'S CHAIRPERSON. THE 592
DEPARTMENT SHALL SUPPLY MEETING SPACE AND STAFF SUPPORT FOR THE 593
COUNCIL.
(B) THE COUNCIL'S DUTIES INCLUDE ALL OF THE FOLLOWING: 595
(1) TO RECOMMEND AND HELP DEVELOP RULES TO BE ADOPTED BY 597
THE DEPARTMENT OF AGING UNDER SECTION 173.57 OF THE REVISED CODE; 599
(2) TO RECOMMEND ADMINISTRATIVE PRACTICES TO THE 601
DEPARTMENT FOR IMPROVING THE OPERATION AND CONTENT OF THE OHIO 602
LONG-TERM CARE CONSUMER GUIDE; 603
(3) TO RECOMMEND LEGISLATIVE CHANGES NEEDED TO IMPROVE THE 605
CONSUMER GUIDE; 606
14
(4) TO CONSIDER WHETHER IT IS FEASIBLE TO INCLUDE IN THE 608
CONSUMER GUIDE OTHER LONG-TERM CARE FACILITIES, SUCH AS 609
RESIDENTIAL CARE FACILITIES AND INTERMEDIATE CARE FACILITIES FOR 610
THE MENTALLY RETARDED, AND LONG-TERM CARE SERVICE PROVIDERS, SUCH 611
AS HOME HEALTH AGENCIES AND ADULT DAY SERVICE PROVIDERS; 612
(5) TO CONSIDER WHETHER IT IS FEASIBLE TO INCLUDE IN THE 614
CONSUMER GUIDE MEASUREMENTS OF QUALITY OF LIFE STANDARDS. 615
(C) THE LONG-TERM CARE CONSUMER GUIDE ADVISORY COUNCIL IS 617
NOT SUBJECT TO SECTION 101.84 OF THE REVISED CODE. 618
Sec. 173.59. (A) THE DEPARTMENT OF AGING SHALL INCLUDE NO 620
ADVERTISING IN THE OHIO LONG-TERM CARE CONSUMER GUIDE THAT SHALL 621
CAUSE A CONFLICT OF INTEREST. 622
(B) THIS SECTION DOES NOT AFFECT INFORMATION INCLUDED IN 624
THE OHIO LONG-TERM CARE CONSUMER GUIDE UNDER DIVISION (D)(6) OF 626
SECTION 173.51 OF THE REVISED CODE. 627
Sec. 3721.026. (A) AS USED IN THIS SECTION, 629
"CERTIFICATION REQUIREMENTS," "COMPLIANCE," "NURSING FACILITY," 630
AND "SURVEY" HAVE THE SAME MEANINGS AS IN SECTION 5111.35 OF THE 631
REVISED CODE.
(B) THE DIRECTOR OF HEALTH SHALL ESTABLISH A UNIT WITHIN 633
THE DEPARTMENT OF HEALTH TO PROVIDE ADVICE AND TECHNICAL 634
ASSISTANCE TO NURSING FACILITIES FOR THE PURPOSE OF IMPROVING 635
COMPLIANCE WITH CERTIFICATION REQUIREMENTS. THE DIRECTOR SHALL 636
ASSIGN TO THE UNIT EMPLOYEES WHO HAVE TRAINING OR EXPERIENCE IN 637
CONDUCTING OR SUPERVISING SURVEYS, BUT EMPLOYEES ASSIGNED TO THE 638
UNIT SHALL NOT CONDUCT SURVEYS. THE DIRECTOR SHALL ADOPT RULES 639
IN ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE TO IMPLEMENT 640
THIS SECTION. 641
(C) ON OR BEFORE THE LAST DAY OF DECEMBER EACH YEAR, THE 643
DIRECTOR SHALL SUBMIT A REPORT TO THE GOVERNOR AND THE GENERAL 646
ASSEMBLY DESCRIBING THE UNIT'S ACTIVITIES THAT YEAR AND ITS
EFFECTIVENESS IN IMPROVING COMPLIANCE WITH CERTIFICATION 647
REQUIREMENTS. 648
Sec. 5111.20. As used in sections 5111.20 to 5111.32 of 657
15
the Revised Code: 658
(A) "Allowable costs" are those costs determined by the 660
department of job and family services to be reasonable and do not 661
include fines paid under sections 5111.35 to 5111.61 and section 663
5111.99 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
(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
16
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
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
17
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
costs for self-insurance claims and related costs as specified in 765
rules adopted by the director of job and family services in 767
accordance with Chapter 119. of the Revised Code, for personnel 769
listed in divisions (G)(1)(a), (b), and (d) of this section; 770
(f) Costs of consulting and management fees related to 772
direct care;
(g) Allocated direct care home office costs. 774
(2) In addition to the costs specified in division (G)(1) 776
of this section, for intermediate care facilities for the 777
mentally retarded only, direct care costs include both of the 778
following: 779
(a) Costs for physical therapists and physical therapy 781
assistants, occupational therapists and occupational therapy 782
assistants, speech therapists, and audiologists; 783
(b) Costs of training and staff development, employee 785
benefits, payroll taxes, and workers' compensation premiums or 786
costs for self-insurance claims and related costs as specified in 787
rules adopted by the director of job and family services in 789
18
accordance with Chapter 119. of the Revised Code, for personnel 790
listed in division (G)(2)(a) of this section. 791
(3) Costs of other direct-care resources that are 793
specified as direct care costs in rules adopted by the director 795
of job and family services in accordance with Chapter 119. of the 796
Revised Code. 797
(H) "Fiscal year" means the fiscal year of this state, as 799
specified in section 9.34 of the Revised Code. 800
(I) "Indirect care costs" means all reasonable costs other 802
than direct care costs, other protected costs, or capital costs. 803
"Indirect care costs" includes but is not limited to costs of 804
habilitation supplies, pharmacy consultants, medical and 805
habilitation records, program supplies, incontinence supplies, 806
food, enterals, dietary supplies and personnel, laundry, 807
housekeeping, security, administration, liability insurance, 808
bookkeeping, purchasing department, human resources, 809
communications, travel, dues, license fees, subscriptions, home 810
office costs not otherwise allocated, legal services, accounting 811
services, minor equipment, maintenance and repairs, help-wanted 813
advertising, informational advertising, start-up costs, 814
organizational expenses, other interest, property insurance, 815
employee training and staff development, employee benefits, 816
payroll taxes, and workers' compensation premiums or costs for 817
self-insurance claims and related costs as specified in rules 818
adopted by the director of job and family services in accordance 819
with Chapter 119. of the Revised Code, for personnel listed in 821
this division. Notwithstanding division (B)(1) of this section, 822
"indirect care costs" also means the cost of equipment, including 823
vehicles, acquired by operating lease executed before December 1, 824
1992, if the costs are reported as administrative and general 825
costs on the facility's cost report for the cost reporting period 826
ending December 31, 1992.
(J) "Inpatient days" means all days during which a 828
resident, regardless of payment source, occupies a bed in a 829
19
nursing facility or intermediate care facility for the mentally 830
retarded that is included in the facility's certified capacity 831
under Title XIX of the "Social Security Act," 49 Stat. 610 832
(1935), 42 U.S.C.A. 301, as amended. Therapeutic or hospital 833
leave days for which payment is made under section 5111.33 of the 834
Revised Code are considered inpatient days proportionate to the 835
percentage of the facility's per resident per day rate paid for 836
those days. 837
(K) "Intermediate care facility for the mentally retarded" 839
means an intermediate care facility for the mentally retarded 840
certified as in compliance with applicable standards for the 841
medical assistance program by the director of health in 842
accordance with Title XIX of the "Social Security Act." 843
(L) "Maintenance and repair expenses" means, except as 845
provided in division (X)(2) of this section, expenditures that 846
are necessary and proper to maintain an asset in a normally 847
efficient working condition and that do not extend the useful 848
life of the asset two years or more. "Maintenance and repair 849
expenses" includes but is not limited to the cost of ordinary 850
repairs such as painting and wallpapering. 851
(M) "Nursing facility" means a facility, or a distinct 853
part of a facility, that is certified as a nursing facility by 854
the director of health in accordance with Title XIX of the 855
"Social Security Act," and is not an intermediate care facility 856
for the mentally retarded. "Nursing facility" includes a 857
facility, or a distinct part of a facility, that is certified as 858
a nursing facility by the director of health in accordance with 859
Title XIX of the "Social Security Act," and is certified as a 860
skilled nursing facility by the director in accordance with Title 861
XVIII of the "Social Security Act." 862
(N) "Other protected costs" means costs for medical 864
supplies; real estate, franchise, and property taxes; natural 865
gas, fuel oil, water, electricity, sewage, and refuse and 866
hazardous medical waste collection; allocated other protected 867
20
home office costs; FEES PAID UNDER SECTION 173.55 OF THE REVISED 868
CODE; and any additional costs defined as other protected costs 870
in rules adopted by the director of job and family services in 872
accordance with Chapter 119. of the Revised Code. 873
(O) "Owner" means any person or government entity that has 875
at least five per cent ownership or interest, either directly, 876
indirectly, or in any combination, in a nursing facility or 877
intermediate care facility for the mentally retarded. 878
(P) "Patient" includes "resident." 880
(Q) Except as provided in divisions (Q)(1) and (2) of this 882
section, "per diem" means a nursing facility's or intermediate 883
care facility for the mentally retarded's actual, allowable costs 884
in a given cost center in a cost reporting period, divided by the 885
facility's inpatient days for that cost reporting period. 886
(1) When calculating indirect care costs for the purpose 888
of establishing rates under section 5111.24 or 5111.241 of the 889
Revised Code, "per diem" means a facility's actual, allowable 890
indirect care costs in a cost reporting period divided by the 891
greater of the facility's inpatient days for that period or the 892
number of inpatient days the facility would have had during that 893
period if its occupancy rate had been eighty-five per cent. 894
(2) When calculating capital costs for the purpose of 896
establishing rates under section 5111.25 or 5111.251 of the 897
Revised Code, "per diem" means a facility's actual, allowable 898
capital costs in a cost reporting period divided by the greater 899
of the facility's inpatient days for that period or the number of 900
inpatient days the facility would have had during that period if 901
its occupancy rate had been ninety-five per cent. 902
(R) "Provider" means a person or government entity that 904
operates a nursing facility or intermediate care facility for the 905
mentally retarded under a provider agreement. 906
(S) "Provider agreement" means a contract between the 908
department of job and family services and a nursing facility or 909
intermediate care facility for the mentally retarded for the 910
21
provision of nursing facility services or intermediate care 911
facility services for the mentally retarded under the medical 912
assistance program. 913
(T) "Purchased nursing services" means services that are 915
provided in a nursing facility by registered nurses, licensed 916
practical nurses, or nurse aides who are not employees of the 917
facility. 918
(U) "Reasonable" means that a cost is an actual cost that 920
is appropriate and helpful to develop and maintain the operation 921
of patient care facilities and activities, including normal 922
standby costs, and that does not exceed what a prudent buyer pays 923
for a given item or services. Reasonable costs may vary from 924
provider to provider and from time to time for the same provider. 925
(V) "Related party" means an individual or organization 927
that, to a significant extent, has common ownership with, is 928
associated or affiliated with, has control of, or is controlled 929
by, the provider. 930
(1) An individual who is a relative of an owner is a 932
related party. 933
(2) Common ownership exists when an individual or 935
individuals possess significant ownership or equity in both the 936
provider and the other organization. Significant ownership or 937
equity exists when an individual or individuals possess five per 938
cent ownership or equity in both the provider and a supplier. 939
Significant ownership or equity is presumed to exist when an 940
individual or individuals possess ten per cent ownership or 941
equity in both the provider and another organization from which 942
the provider purchases or leases real property. 943
(3) Control exists when an individual or organization has 945
the power, directly or indirectly, to significantly influence or 946
direct the actions or policies of an organization. 947
(4) An individual or organization that supplies goods or 949
services to a provider shall not be considered a related party if 950
all of the following conditions are met: 951
22
(a) The supplier is a separate bona fide organization. 953
(b) A substantial part of the supplier's business activity 955
of the type carried on with the provider is transacted with 956
others than the provider and there is an open, competitive market 957
for the types of goods or services the supplier furnishes. 958
(c) The types of goods or services are commonly obtained 960
by other nursing facilities or intermediate care facilities for 961
the mentally retarded from outside organizations and are not a 962
basic element of patient care ordinarily furnished directly to 963
patients by the facilities. 964
(d) The charge to the provider is in line with the charge 966
for the goods or services in the open market and no more than the 967
charge made under comparable circumstances to others by the 968
supplier. 969
(W) "Relative of owner" means an individual who is related 971
to an owner of a nursing facility or intermediate care facility 972
for the mentally retarded by one of the following relationships: 973
(1) Spouse; 975
(2) Natural parent, child, or sibling; 977
(3) Adopted parent, child, or sibling; 979
(4) Step-parent, step-child, step-brother, or step-sister; 981
(5) Father-in-law, mother-in-law, son-in-law, 983
daughter-in-law, brother-in-law, or sister-in-law; 984
(6) Grandparent or grandchild; 986
(7) Foster parent, foster child, foster brother, or foster 988
sister. 989
(X) "Renovation" and "extensive renovation" mean: 991
(1) Any betterment, improvement, or restoration of a 993
nursing facility or intermediate care facility for the mentally 994
retarded started before July 1, 1993, that meets the definition 995
of a renovation or extensive renovation established in rules 996
adopted by the director of job and family services in effect on 998
December 22, 1992.
(2) In the case of betterments, improvements, and 1,000
23
restorations of nursing facilities and intermediate care 1,001
facilities for the mentally retarded started on or after July 1, 1,002
1993: 1,003
(a) "Renovation" means the betterment, improvement, or 1,005
restoration of a nursing facility or intermediate care facility 1,006
for the mentally retarded beyond its current functional capacity 1,007
through a structural change that costs at least five hundred 1,008
dollars per bed. A renovation may include betterment, 1,009
improvement, restoration, or replacement of assets that are 1,010
affixed to the building and have a useful life of at least five 1,011
years. A renovation may include costs that otherwise would be 1,012
considered maintenance and repair expenses if they are an 1,013
integral part of the structural change that makes up the 1,014
renovation project. "Renovation" does not mean construction of 1,015
additional space for beds that will be added to a facility's 1,016
licensed or certified capacity. 1,017
(b) "Extensive renovation" means a renovation that costs 1,019
more than sixty-five per cent and no more than eighty-five per 1,020
cent of the cost of constructing a new bed and that extends the 1,021
useful life of the assets for at least ten years. 1,022
For the purposes of division (X)(2) of this section, the 1,024
cost of constructing a new bed shall be considered to be forty 1,025
thousand dollars, adjusted for the estimated rate of inflation 1,026
from January 1, 1993, to the end of the calendar year during 1,027
which the renovation is completed, using the consumer price index 1,028
for shelter costs for all urban consumers for the north central 1,029
region, as published by the United States bureau of labor 1,030
statistics. 1,031
The department of job and family services may treat a 1,033
renovation that costs more than eighty-five per cent of the cost 1,034
of constructing new beds as an extensive renovation if the 1,035
department determines that the renovation is more prudent than 1,036
construction of new beds. 1,037
Sec. 5111.62. The proceeds of all fines, including 1,046
24
interest, collected under sections 5111.35 to 5111.62 of the 1,047
Revised Code shall be deposited in the state treasury to the 1,048
credit of the residents protection fund, which is hereby created. 1,049
Moneys in the fund shall be used solely for the protection of the 1,050
health or property of residents of nursing facilities in which 1,051
the department of health finds deficiencies, including payment 1,052
for the costs of relocation of residents to other facilities, 1,053
maintenance of operation of a facility pending correction of 1,054
deficiencies or closure, and reimbursement of residents for the 1,055
loss of money managed by the facility under section 3721.15 of 1,056
the Revised Code. MONEY IN THE FUND ALSO SHALL BE USED FOR THE 1,058
PURPOSES OF SECTION 3721.026 OF THE REVISED CODE. The fund shall 1,060
be maintained and administered by the department of job and 1,061
family services under rules developed in consultation with the 1,062
departments of health and aging and adopted by the director of 1,063
job and family services under Chapter 119. of the Revised Code. 1,065
Section 2. That existing sections 5111.20 and 5111.62 of 1,067
the Revised Code are hereby repealed. 1,068
Section 3. Notwithstanding the fourteen-month publishing 1,070
deadline established in section 173.46 of the Revised Code, the 1,071
Department of Aging shall not publish the Ohio Long-term Care 1,072
Consumer Guide unless it includes in the guide the results of 1,073
customer satisfaction surveys conducted under section 173.54 of 1,074
the Revised Code. For the purposes of this condition, the 1,075
department may publish the guide if it includes in the guide the 1,076
results of surveys of families of nursing facility residents 1,077
covering at least twenty-five per cent of the nursing facilities 1,078
in this state and it has established a process for conducting 1,079
both family and resident satisfaction surveys under section 1,080
173.54 of the Revised Code.
Section 4. All items in this section are hereby 1,082
appropriated as designated out of any moneys in the state 1,083
treasury to the credit of the State Special Revenue Fund Group. 1,084
For all appropriations made in this act, those in the first 1,085
25
column are for fiscal year 2000 and those in the second column 1,086
are for fiscal year 2001. The appropriations made in this act 1,087
are in addition to any other appropriations made for the 1,088
1999-2001 biennium.
AGE DEPARTMENT OF AGING 1,089
State Special Revenue Fund Group 1,090
5K9 490-613 Long-Term Care 1,093
Consumer Guide $ 0 $ 807,000 1,095
TOTAL SSR State Special Revenue 1,096
Fund Group $ 0 $ 807,000 1,099
TOTAL ALL BUDGET FUND GROUPS $ 0 $ 807,000 1,101
Long-Term Care Consumer Guide 1,104
Not later than July 15, 2000, the Director of Budget and 1,106
Management shall transfer $407,000 cash from Fund 4E3, Resident 1,107
Protection Fund, to Fund 5K9, Long-Term Care Consumer Guide Fund. 1,108
The foregoing appropriation item 490-613, Long-Term Care 1,110
Consumer Guide, shall be used by the Department of Aging for 1,111
costs associated with publishing the Ohio Long-Term Care Consumer 1,112
Guide.
DOH DEPARTMENT OF HEALTH 1,114
State Special Revenue Fund Group 1,116
5L1 440-623 Nursing Facility 1,118
Technical Assistance
Program $ 0 $ 1,400,000 1,120
TOTAL SSR State Special Revenue 1,121
Fund Group $ 0 $ 1,400,000 1,124
TOTAL ALL BUDGET FUND GROUPS $ 0 $ 1,400,000 1,127
Nursing Facility Technical Assistance Program 1,130
Not later than July 15, 2000, the Director of Budget and 1,132
Management shall transfer $1,400,000 cash from Fund 4E3, Resident 1,133
Protection Fund, to Fund 5L1, Nursing Facility Technical 1,134
Assistance Fund, to be used in accordance with section 3721.026 1,135
of the Revised Code. 1,136
Within the limits set forth in this act, the Director of 1,138
26
Budget and Management shall establish accounts indicating source 1,139
and amount of funds for each appropriation made in this act, and 1,140
shall determine the form and manner in which appropriation 1,141
accounts shall be maintained. Expenditures from appropriations 1,142
contained in this act shall be accounted for as though made in 1,143
Am. Sub. H.B. 283 of the 123rd General Assembly. 1,144
The appropriations made in this act are subject to all 1,146
provisions of Am. Sub. H.B. 283 of the 123rd General Assembly. 1,147
Section 5. The codified and uncodified sections of law 1,149
contained in this act are not subject to the referendum, and take 1,150
effect on the later of July 1, 2000, or the day this act becomes 1,151
law.