As Reported by the Senate Finance and Financial 2
Institutions Committee 2
123rd General Assembly 5
Regular Session Sub. H. B. No. 403 6
1999-2000 7
REPRESENTATIVES TIBERI-VAN VYVEN-NETZLEY-GOODMAN-MOTTLEY- 9
OGG-DePIERO-OLMAN-TAYLOR-JONES-BUEHRER-EVANS-KRUPINSKI- 10
FLANNERY-BRITTON-ROBERTS-R. MILLER-D. MILLER-BOYD- 11
CORBIN-EVANS-STAPLETON-BARRETT-GARDNER-SCHURING-METTLER- 12
WINKLER-BUCHY-HARTNETT-SALERNO-ALLEN-O'BRIEN-PATTON-DISTEL- 14
J. BEATTY-VERICH-BARNES-CLANCY-CALVERT-HOLLISTER-REDFERN-
GOODING-VESPER-A. CORE-WIDENER-HOOPS-PETERSON-JOLIVETTE- 15
HARRIS-TERWILLEGER-AUSTRIA-STEVENS-SENATORS HOTTINGER- 16
WHITE-JOHNSON 17
_________________________________________________________________ 19
A B I L L
To amend sections 173.19, 3702.525, 3721.21, 21
5111.20, 5111.25, 5111.251, and 5111.62 and to 22
enact sections 173.45 to 173.59, 3721.026, and 23
3721.027 of the Revised Code to require the
publication of the Ohio Long-Term Care Consumer 25
Guide, to create a nursing facility technical 26
assistance program, to change the method of 28
calculating nursing facilities' and intermediate
care facilities for the mentally retarded's 29
Medicaid reimbursement rates for indirect care 30
and capital costs for fiscal year 2001, to 31
specify in the law governing nursing homes that 32
neglect does not include allowing a resident to
receive only treatment by spiritual means through 33
prayer in accordance with the tenets of a 34
recognized religious denomination, to require the 35
Department of Health to investigate valid 36
complaints that the State Long-Term Care 37
Ombudsperson Program has been unable to resolve, 38
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to make an exception to the certificate of need 40
implementation deadline, and to make an 41
appropriation. 42
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 44
Section 1. That sections 173.19, 3702.525, 3721.21, 46
5111.20, 5111.25, 5111.251, and 5111.62 be amended and sections 48
173.45, 173.46, 173.47, 173.48, 173.49, 173.50, 173.51, 173.52, 49
173.53, 173.54, 173.55, 173.56, 173.57, 173.58, 173.59, 3721.026,
and 3721.027 of the Revised Code be enacted to read as follows: 51
Sec. 173.19. (A) The office of the state long-term care 60
ombudsperson program, through the state long-term care 61
ombudsperson and the regional long-term care ombudsperson 63
programs, shall receive, investigate, and attempt to resolve 65
complaints made by residents, recipients, sponsors, providers of 66
long-term care, or any person acting on behalf of a resident or 67
recipient, relating to either of the following: 68
(1) The health, safety, welfare, or civil rights of a 70
resident or recipient or any violation of a resident's rights 71
described in sections 3721.10 to 3721.17 of the Revised Code; 72
(2) Any action or inaction or decision by a provider of 74
long-term care or representative of a provider, a governmental 75
entity, or a private social service agency that may adversely 76
affect the health, safety, welfare, or rights of a resident or 77
recipient. 78
(B) The department of aging shall adopt rules in 80
accordance with Chapter 119. of the Revised Code regarding the 81
handling of complaints received under this section, including 82
procedures for conducting investigations of complaints. The 83
rules shall include procedures to ensure that no representative 84
of the office investigates any complaint involving a provider of 85
long-term care with which the representative was once employed or 86
associated. 87
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The state ombudsperson and regional programs shall 89
establish procedures for handling complaints consistent with the 91
department's rules. Complaints shall be dealt with in accordance 92
with the procedures established under this division. 93
(C) The office of the state long-term care ombudsperson 96
program may decline to investigate any complaint if it determines 97
any of the following: 98
(1) That the complaint is frivolous, vexatious, or not 100
made in good faith; 101
(2) That the complaint was made so long after the 103
occurrence of the incident on which it is based that it is no 104
longer reasonable to conduct an investigation; 105
(3) That an adequate investigation cannot be conducted 107
because of insufficient funds, insufficient staff, lack of staff 108
expertise, or any other reasonable factor that would result in an 109
inadequate investigation despite a good faith effort; 110
(4) That an investigation by the office would create a 112
real or apparent conflict of interest. 113
(D) If a regional long-term care ombudsperson program 115
declines to investigate a complaint, it shall refer the complaint 116
to the state long-term care ombudsperson. 117
(E) Each complaint to be investigated by a regional 119
program shall be assigned to a representative of the office of 120
the state long-term care ombudsperson program. If the 121
representative determines that the complaint is valid, the 122
representative shall assist the parties in attempting to resolve 124
it. If the representative is unable to resolve it, the 126
representative may SHALL refer the complaint to the state 128
ombudsperson.
In order to carry out the duties of sections 173.14 to 130
173.26 of the Revised Code, a representative has the right to 132
private communication with residents and their sponsors and 133
access to long-term care facilities, including the right to tour 134
resident areas unescorted and the right to tour facilities 135
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unescorted as reasonably necessary to the investigation of a 136
complaint. Access to facilities shall be during reasonable hours 137
or, during investigation of a complaint, at other times 138
appropriate to the complaint. 139
When community-based long-term care services are provided 141
at a location other than the recipient's home, a representative 142
has the right to private communication with the recipient and the 144
recipient's sponsors and access to the community-based long-term 145
care site, including the right to tour the site unescorted. 146
Access to the site shall be during reasonable hours or, during 147
the investigation of a complaint, at other times appropriate to 148
the complaint. 149
(F) The state ombudsperson shall determine whether 151
complaints referred to the ombudsperson under division (D) or (E) 153
of this section warrant investigation. The ombudsperson's 155
determination in this matter is final. 156
Sec. 173.45. AS USED IN SECTIONS 173.45 TO 173.59 OF THE 159
REVISED CODE:
(A) "CLINICAL QUALITY INDICATOR" MEANS A MEASURE OF AN 161
ASPECT OF THE PHYSICAL OR MENTAL CONDITIONS OF THE RESIDENTS OF A 162
NURSING FACILITY THAT IS DERIVED FROM DATA TAKEN FROM RESIDENT 164
ASSESSMENT INSTRUMENTS SUBMITTED BY NURSING FACILITIES FOR 165
PURPOSES OF THE MEDICARE AND MEDICAID PROGRAMS. 166
(B) "MEDICAID" HAS THE SAME MEANING AS IN SECTION 5111.01 168
OF THE REVISED CODE. 169
(C) "MEDICARE" MEANS THE PROGRAM OPERATED PURSUANT TO 172
TITLE XVIII OF THE "SOCIAL SECURITY ACT," 49 STAT. 620 (1935), 42 174
U.S.C.A. 301, AS AMENDED. 175
(D) "NURSING FACILITY" MEANS EITHER OF THE FOLLOWING: 177
(1) A FACILITY, OR A DISTINCT PART OF A FACILITY, THAT IS 180
CERTIFIED AS A NURSING FACILITY OR A SKILLED NURSING FACILITY FOR 181
PURPOSES OF THE MEDICARE OR MEDICAID PROGRAM; 182
(2) A NURSING HOME LICENSED UNDER SECTION 3721.02 OF THE 185
REVISED CODE THAT IS NOT CERTIFIED AS A NURSING FACILITY OR 186
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SKILLED NURSING FACILITY.
(E) "DEFICIENCY," "IMMEDIATE JEOPARDY," "STANDARD SURVEY," 188
AND "SUBSTANDARD CARE" HAVE THE SAME MEANINGS AS IN SECTION 190
5111.35 OF THE REVISED CODE. 191
(F) "SURVEY DATA TAG" MEANS ANY OF THE DATA TAGS USED IN 193
THE MEDICARE AND MEDICAID PROGRAMS FOR IDENTIFICATION OF SPECIFIC 194
REGULATORY REQUIREMENTS. 195
Sec. 173.46. THE DEPARTMENT OF AGING SHALL DEVELOP AND 197
PUBLISH A GUIDE TO NURSING FACILITIES IN THIS STATE FOR USE BY 198
INDIVIDUALS CONSIDERING NURSING FACILITY PLACEMENT AND THEIR 199
FAMILIES, FRIENDS, AND ADVISORS. THE GUIDE SHALL BE TITLED THE 200
OHIO LONG-TERM CARE CONSUMER GUIDE. 201
THE CONSUMER GUIDE SHALL BE PUBLISHED IN COMPUTERIZED FORM 203
FOR DISTRIBUTION OVER THE INTERNET. THE GUIDE SHALL BE MADE 205
AVAILABLE NOT LATER THAN FOURTEEN MONTHS AFTER THE EFFECTIVE DATE 206
OF THIS SECTION AND SHALL BE UPDATED IN ACCORDANCE WITH SECTION 207
173.52 OF THE REVISED CODE. 208
EVERY TWO YEARS, THE DEPARTMENT SHALL PUBLISH AN EXECUTIVE 210
SUMMARY OF THE CONSUMER GUIDE, AND SHALL MAKE THE EXECUTIVE 211
SUMMARY AVAILABLE IN BOTH COMPUTERIZED AND PRINTED FORMS. 212
Sec. 173.47. THE DEPARTMENT OF AGING MAY CONTRACT WITH ANY 214
PERSON OR GOVERNMENT ENTITY TO PERFORM ANY FUNCTION RELATED TO 215
THE PUBLICATION OF THE OHIO LONG-TERM CARE CONSUMER GUIDE OR THE 217
COLLECTION AND PREPARATION OF DATA AND OTHER MATERIAL FOR THE 219
GUIDE, EXCEPT THAT THE DEPARTMENT SHALL CONTRACT TO HAVE THE 221
CUSTOMER SATISFACTION SURVEYS CONDUCTED UNDER SECTION 173.54 OF
THE REVISED CODE. IN AWARDING THE CONTRACT TO HAVE THE SURVEYS 223
CONDUCTED, THE DEPARTMENT SHALL CONTRACT WITH A PERSON OR
GOVERNMENT ENTITY THAT HAS EXPERIENCE IN SURVEYING THE CUSTOMER 224
SATISFACTION OF NURSING FACILITY RESIDENTS AND THEIR FAMILIES. 225
THE DEPARTMENT'S CONTRACT SHALL PERMIT THE PERSON OR GOVERNMENT 226
ENTITY TO SUBCONTRACT WITH OTHER PERSONS OR GOVERNMENT ENTITIES 227
FOR PURPOSES OF CONDUCTING ALL OR PART OF THE SURVEYS.
Sec. 173.48. IN DEVELOPING AND PUBLISHING THE OHIO 229
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LONG-TERM CARE CONSUMER GUIDE, THE DEPARTMENT OF AGING SHALL 230
ADHERE TO THE FOLLOWING PRINCIPLES: 231
(A) THE GUIDE SHOULD BE DESIGNED TO PROVIDE USERS WITH A 233
VARIETY OF MEASURES OF NURSING FACILITY QUALITY AND WITH OTHER 234
INFORMATION USEFUL IN COMPARING AND SELECTING NURSING FACILITIES. 236
(B) THE GUIDE SHOULD PRESENT THE INFORMATION SPECIFIED IN 238
DIVISION (A) OF THIS SECTION IN A MANNER THAT IS EASY TO USE AND 239
UNDERSTAND. 240
(C) THE GUIDE SHOULD ALLOW USERS TO DETERMINE WHICH OF THE 242
AVAILABLE MEASURES ARE MOST IMPORTANT TO THEM. 244
(D) THE INFORMATION IN THE GUIDE SHOULD BE KEPT AS CURRENT 246
AS PRACTICABLE. 247
(E) THE GUIDE SHOULD BE DESIGNED TO PROMOTE EXCELLENCE IN 249
NURSING FACILITY QUALITY. 250
(F) THE GUIDE SHOULD PROMOTE AWARENESS OF THE RANGE OF 252
LONG-TERM CARE SERVICES AVAILABLE TO OHIOANS. 253
Sec. 173.49. WITH REGARD TO THE ACCESSIBILITY OF THE OHIO 255
LONG-TERM CARE CONSUMER GUIDE AND THE EXECUTIVE SUMMARY OF THE 256
GUIDE, THE FOLLOWING SHALL APPLY: 257
(A) THE DEPARTMENT OF AGING SHALL MAKE THE GUIDE AND 259
SUMMARY AVAILABLE TO ANY PERSON OR GOVERNMENT ENTITY AND SHALL 261
NOT RESTRICT ACCESS BY REQUIRING PAYMENT OF A FEE, USE OF A 262
PASSWORD, OR FULFILLMENT OF ANY OTHER CONDITION.
(B) THE DEPARTMENT OF AGING SHALL DEVELOP AND IMPLEMENT 265
PROGRAMS AND OTHER STRATEGIES TO ENCOURAGE USE OF THE GUIDE BY 266
INDIVIDUALS CONSIDERING NURSING FACILITY PLACEMENT AND THEIR 267
FAMILIES, FRIENDS, AND ADVISORS. 268
Sec. 173.50. THE OHIO LONG-TERM CARE CONSUMER GUIDE SHALL 270
INCLUDE INFORMATION ON EACH NURSING FACILITY IN THIS STATE. FOR 271
EACH FACILITY, THE GUIDE SHALL INCLUDE, TO THE EXTENT IT IS 273
AVAILABLE TO THE DEPARTMENT OF AGING, ALL OF THE FOLLOWING 274
INFORMATION:
(A) CUSTOMER SATISFACTION DATA OBTAINED UNDER SECTION 276
173.54 OF THE REVISED CODE; 277
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(B) CLINICAL QUALITY INDICATOR DATA OBTAINED UNDER SECTION 279
173.56 OF THE REVISED CODE; 280
(C) DATA DERIVED FROM STANDARD SURVEYS AS SPECIFIED IN 283
DIVISION (C)(3) OF SECTION 173.51 OF THE REVISED CODE; 284
(D) ANY OTHER INFORMATION SPECIFIED IN SECTIONS 173.45 TO 286
173.59 OF THE REVISED CODE OR THE RULES ADOPTED UNDER SECTION 288
173.57 OF THE REVISED CODE.
Sec. 173.51. THE OHIO LONG-TERM CARE CONSUMER GUIDE SHALL 291
BE STRUCTURED IN ACCORDANCE WITH THIS SECTION AND ANY APPLICABLE 293
RULES ADOPTED UNDER SECTION 173.57 OF THE REVISED CODE. 294
(A) THE OPENING ELECTRONIC PAGE OF THE CONSUMER GUIDE 296
SHALL INCLUDE ALL OF THE FOLLOWING GENERAL INFORMATION: 297
(1) A DESCRIPTION OF THE GUIDE; 299
(2) DISCLAIMERS STATING THE LIMITATIONS OF THE DATA 301
INCLUDED IN THE GUIDE. THE DISCLAIMERS SHALL INCLUDE A STATEMENT 302
THAT STANDARD SURVEYS OF NURSING FACILITIES ARE CONDUCTED AT 303
PERIODIC INTERVALS AND A STATEMENT THAT CONDITIONS AT A FACILITY 304
CAN CHANGE SIGNIFICANTLY BETWEEN STANDARD SURVEYS. 305
(3) A RECOMMENDATION THAT INDIVIDUALS CONSIDERING NURSING 307
FACILITY PLACEMENT VISIT ANY FACILITIES THEY ARE CONSIDERING; 308
(4) ELECTRONIC LINKS TO OTHER INFORMATION ON THE INTERNET 310
ABOUT SELECTING NURSING FACILITIES AND ABOUT OTHER LONG-TERM CARE 311
OPTIONS, INCLUDING INFORMATION MAINTAINED BY PERTINENT GOVERNMENT 313
AGENCIES AND PRIVATE ORGANIZATIONS AND TELEPHONE NUMBERS FOR 314
THOSE AGENCIES AND ORGANIZATIONS;
(5) ANY OTHER INFORMATION THE DEPARTMENT OF AGING 316
SPECIFIES IN RULES ADOPTED UNDER SECTION 173.57 OF THE REVISED 318
CODE.
(B) THE CONSUMER GUIDE SHALL BE STRUCTURED IN A MANNER 320
THAT ALLOWS THE USER TO SEARCH FOR INFORMATION IN THE GUIDE IN 321
MULTIPLE WAYS, INCLUDING SEARCHES BY FACILITY NAME, COUNTY, 323
MUNICIPALITY, POSTAL ZIP CODE, SOURCE OF NURSING FACILITY 324
PAYMENT, AND SPECIAL CARE SERVICE. 325
(C) THE FIRST INFORMATION TO APPEAR ON THE COMPUTER SCREEN 327
8
FOLLOWING A SEARCH SHALL BE A LIST OF ALL FACILITIES IDENTIFIED 328
BY THE SEARCH. FOR ALL OF THE FACILITIES LISTED, THE CONSUMER 329
GUIDE SHALL PRESENT THE USER WITH SUMMARIZED COMPARATIVE MEASURES 331
AND ELECTRONIC LINKS TO DEFINITIONS AND DESCRIPTIONS OF THE 332
MEASURES. THE GUIDE SHALL INCLUDE A FEATURE THAT ALLOWS THE USER
TO CHOOSE THE PARTICULAR COMPARATIVE MEASURES THAT WILL BE 333
DISPLAYED ON THE SCREEN. THE GUIDE ALSO MAY INCLUDE A CONSUMER 334
NEEDS ASSESSMENT FUNCTION TO ASSIST THE USER IN CHOOSING 335
MEASURES. THE COMPARATIVE MEASURES SHALL BE DERIVED FROM THE 336
FOLLOWING SOURCES:
(1) THE AGGREGATE RESPONSES MADE BY A FACILITY'S RESIDENTS 338
OR THEIR FAMILIES TO MEASURES OF CUSTOMER SATISFACTION INCLUDED 341
IN THE SURVEYS CONDUCTED UNDER SECTION 173.54 OF THE REVISED 342
CODE. THE MEASURES SHALL BE SPECIFIED IN RULES ADOPTED UNDER 344
SECTION 173.57 OF THE REVISED CODE. FOR EACH MEASURE, THE GUIDE 345
SHALL COMPARE THE RESPONSES FOR THE FACILITY TO THE STATEWIDE 346
AVERAGE OR TO A PEER-GROUP AVERAGE SPECIFIED IN RULE UNDER 347
SECTION 173.57 OF THE REVISED CODE. 348
(2) THE SCORES ON CLINICAL QUALITY INDICATORS CALCULATED 351
UNDER SECTION 173.56 OF THE REVISED CODE. THE INDICATORS SHALL 352
BE SPECIFIED IN RULES ADOPTED UNDER SECTION 173.57 OF THE REVISED 353
CODE. FOR EACH INDICATOR, THE GUIDE SHALL COMPARE THE FACILITY'S 354
SCORE TO THE STATEWIDE AVERAGE OR TO A PEER-GROUP AVERAGE 355
SPECIFIED IN RULE UNDER SECTION 173.57 OF THE REVISED CODE. THE 356
SCORES SHALL BE EXPRESSED AS PERCENTAGES. 357
(3) ALL OF THE FOLLOWING: 359
(a) THE DATE OF THE FACILITY'S MOST RECENT STANDARD 361
SURVEY; 362
(b) THE PERCENTAGE OF SPECIFIED SURVEY DATA TAGS FOR WHICH 364
THE FACILITY WAS FOUND TO BE IN COMPLIANCE DURING THE FACILITY'S 365
MOST RECENT STANDARD SURVEY. THE DEPARTMENT OF AGING SHALL 367
SPECIFY IN RULE THE SURVEY DATA TAGS USED FOR THIS PURPOSE AND 368
MAY EXCLUDE TAGS THAT ARE NEVER OR VERY RARELY CITED DURING 369
SURVEYS.
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(c) THE STATEWIDE AVERAGE PERCENTAGE OF THE SPECIFIED 371
SURVEY DATA TAGS FOR WHICH FACILITIES WERE FOUND TO BE IN 373
COMPLIANCE DURING THE MOST RECENT STANDARD SURVEYS. 374
ALTERNATIVELY, THE DEPARTMENT OF AGING MAY PRESCRIBE BY RULE THAT 375
A PEER-GROUP AVERAGE BE USED. 376
(d) THE NUMBER OF SPECIFIED SURVEY DATA TAGS CITED BY THE 378
DEPARTMENT OF HEALTH IN THE FACILITY'S MOST RECENT STANDARD 379
SURVEY; 380
(e) THE STATEWIDE AVERAGE NUMBER OF SPECIFIED SURVEY DATA 382
TAGS CITED BY THE DEPARTMENT OF HEALTH DURING THE MOST RECENT 383
STANDARD SURVEYS. ALTERNATIVELY, THE DEPARTMENT OF AGING MAY 385
PRESCRIBE BY RULE THAT A PEER-GROUP AVERAGE BE USED.
(f) THE DATE THE FACILITY ACHIEVED SUBSTANTIAL COMPLIANCE 387
WITH MEDICARE AND MEDICAID CERTIFICATION REQUIREMENTS; 388
(g) WHETHER THE DEPARTMENT OF HEALTH DETERMINED THAT THE 390
FACILITY PROVIDED SUBSTANDARD CARE TO RESIDENTS DURING TWO OF ITS 392
LAST THREE STANDARD SURVEYS; 393
(h) WHETHER THE DEPARTMENT OF HEALTH FOUND THAT THE CARE 395
PROVIDED BY THE FACILITY PLACED RESIDENTS IN IMMEDIATE JEOPARDY 397
DURING TWO OF ITS LAST THREE STANDARD SURVEYS. 398
(4) AN ELECTRONIC LINK FOR EACH FACILITY ON THE LIST 400
ALLOWING THE USER TO GAIN ACCESS TO INFORMATION ON THE FACILITY 402
MAINTAINED UNDER DIVISION (D) OF THIS SECTION. 404
(D) IN ADDITION TO THE SUMMARIZED INFORMATION PROVIDED BY 406
THE GUIDE PURSUANT TO DIVISION (C) OF THIS SECTION, THE GUIDE 407
SHALL PROVIDE SPECIFIC COMPARATIVE INFORMATION ON EACH NURSING 408
FACILITY. WHEN THE GUIDE'S USER OPENS AN ELECTRONIC LINK TO THE 410
SPECIFIC INFORMATION, THE FIRST INFORMATION TO APPEAR ON THE 411
COMPUTER SCREEN SHALL INCLUDE ALL OF THE FOLLOWING:
(1) THE NAME OF THE FACILITY AND ITS OWNER, THE FACILITY'S 413
TELEPHONE NUMBER AND ADDRESS, INCLUDING THE COUNTY IN WHICH THE 415
FACILITY IS LOCATED. THE GUIDE SHALL INCLUDE A FUNCTION THAT 416
PINPOINTS ON A MAP THE FACILITY'S LOCATION.
(2) THE FACILITY'S STATUS WITH REGARD TO MEDICARE AND 418
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MEDICAID CERTIFICATION AND PRIVATE ACCREDITATION; 419
(3) THE NUMBER OF BEDS IN THE FACILITY; 421
(4) INFORMATION ABOUT THE FACILITY'S STAFFING AS 423
PRESCRIBED IN RULE BY THE DEPARTMENT OF AGING; 424
(5) AN ELECTRONIC LINK ALLOWING THE USER OF THE GUIDE TO 426
GAIN ACCESS TO A LISTING OF SERVICES PROVIDED BY THE FACILITY. 427
THE LISTING SHALL BE PRESENTED IN THE FORMAT SPECIFIED IN RULES 428
ADOPTED UNDER SECTION 173.57 OF THE REVISED CODE. 429
(6) AT THE FACILITY'S OPTION, A PICTURE OF THE FACILITY, A 431
BRIEF STATEMENT PROVIDED BY THE FACILITY, AND AN ELECTRONIC LINK 432
TO ANY INFORMATION THE FACILITY MAINTAINS ABOUT ITSELF ON THE 433
INTERNET;
(7) THE SUMMARIZED INFORMATION SPECIFIED IN DIVISION (C) 435
OF THIS SECTION FOR THE FACILITY, WITH ELECTRONIC LINKS ALLOWING 437
THE USER TO GAIN ACCESS TO ADDITIONAL INFORMATION PRESENTED AS 439
FOLLOWS:
(a) FOR EACH STATISTICALLY VALID AND RELIABLE QUESTION 441
ASKED ON THE QUESTIONNAIRES USED IN THE RESIDENT AND FAMILY 443
SURVEYS CONDUCTED UNDER SECTION 173.54 OF THE REVISED CODE, THE 444
GUIDE SHALL PRESENT THE CUSTOMER SATISFACTION RESPONSES. THE 446
RESPONSES FOR THE FACILITY SHALL BE COMPARED TO THE STATEWIDE 447
AVERAGE OR TO A PEER-GROUP AVERAGE SPECIFIED IN RULE UNDER 448
SECTION 173.57 OF THE REVISED CODE AND SHALL BE EXPRESSED IN 450
PERCENTAGES.
(b) FOR EACH CLINICAL QUALITY INDICATOR CALCULATED UNDER 453
SECTION 173.56 OF THE REVISED CODE, THE GUIDE SHALL PRESENT THE 454
FACILITY'S SCORE COMPARED TO THE STATEWIDE AVERAGE SCORE. THE 455
SCORES SHALL BE EXPRESSED AS PERCENTAGES. 456
(c) THE GUIDE SHALL PRESENT A LIST OF ALL SURVEY DATA TAGS 459
THAT WERE CITED DURING THE FACILITY'S MOST RECENT STANDARD 460
SURVEY, A BRIEF DESCRIPTION PERTAINING TO EACH DATA TAG, 461
DIRECTIONS OR ELECTRONIC LINKS FOR OBTAINING MORE INFORMATION 462
ABOUT THE FACILITY'S SURVEY HISTORY, AND LINKS TO THE TEXT OF 465
EACH CITATION AND TO THE FACILITY'S PLAN OF CORRECTION FILED WITH 466
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THE STATE FOR EACH CITATION.
(8) ANY OTHER INFORMATION THE DEPARTMENT OF AGING 468
PRESCRIBES BY RULE.
Sec. 173.52. (A) THE DEPARTMENT OF AGING SHALL UPDATE 472
INFORMATION IN THE OHIO LONG-TERM CARE CONSUMER GUIDE AS FOLLOWS: 473
(1) THE CUSTOMER SATISFACTION DATA OBTAINED UNDER SECTION 475
173.54 OF THE REVISED CODE SHALL BE UPDATED ANNUALLY FOLLOWING 478
THE SURVEYS CONDUCTED UNDER THAT SECTION.
(2) THE CLINICAL QUALITY INDICATOR DATA OBTAINED UNDER 480
SECTION 173.56 OF THE REVISED CODE SHALL BE UPDATED IN JANUARY, 482
APRIL, JULY, AND OCTOBER OF EACH YEAR, USING THE MOST RECENT 484
RESIDENT ASSESSMENT DATA AVAILABLE TO THE DEPARTMENT.
(3) THE DATA DERIVED FROM STANDARD SURVEYS OF EACH NURSING 486
FACILITY, AS SPECIFIED IN DIVISION (C)(3) OF SECTION 173.51 OF 488
THE REVISED CODE, SHALL BE UPDATED WEEKLY, USING THE MOST RECENT 489
STANDARD SURVEY DATA AVAILABLE TO THE DEPARTMENT. THE DEPARTMENT 491
SHALL MODIFY THE DATA INCLUDED IN THE CONSUMER GUIDE TO REFLECT 493
EITHER OF THE FOLLOWING:
(a) ANY CHANGE IN THE SURVEY DATA RESULTING FROM INFORMAL 495
DISPUTE RESOLUTION, APPEAL, OR ANY OTHER PROCESS; 496
(b) THE DATE OF CORRECTION OF ANY CITATION. 498
(4) ANY OTHER INFORMATION SPECIFIED IN SECTIONS 173.45 TO 500
173.59 OF THE REVISED CODE OR THE RULES ADOPTED UNDER SECTION 502
173.57 OF THE REVISED CODE SHALL BE UPDATED AT THE TIME SPECIFIED 503
IN THOSE SECTIONS OR THE RULES.
(B) THE DEPARTMENT OF AGING SHALL SPECIFY BY RULE 505
INFORMATION IN THE GUIDE THAT NURSING FACILITIES CAN 506
ELECTRONICALLY UPDATE WITHOUT THE NEED FOR ANY ACTION BY THE 508
DEPARTMENT. THE GUIDE SHALL INCLUDE A MECHANISM FOR SUCH 509
UPDATES. THIS DIVISION DOES NOT APPLY TO INFORMATION DESCRIBED 510
IN DIVISIONS (A)(1), (2), AND (3) OF THIS SECTION. 511
(C) THE DEPARTMENT OF HEALTH SHALL COOPERATE WITH THE 513
DEPARTMENT OF AGING TO ENSURE THAT STANDARD SURVEY INFORMATION 514
AND QUALITY INDICATOR DATA ARE UPDATED IN ACCORDANCE WITH THIS 516
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SECTION, SUBJECT TO THE REGULATORY REQUIREMENTS, PROCEDURES, AND 517
GUIDELINES OF THE UNITED STATES HEALTH CARE FINANCING 518
ADMINISTRATION.
Sec. 173.53. IN ADDITION TO THE COMPUTERIZED OHIO 520
LONG-TERM CARE CONSUMER GUIDE, THE DEPARTMENT OF AGING SHALL 522
PREPARE AND MAKE AVAILABLE TO THE PUBLIC PRINTED INFORMATION TO 523
ASSIST CONSUMERS IN MAKING LONG-TERM CARE AND NURSING FACILITY 524
PLACEMENT DECISIONS, PARTICULARLY CONSUMERS WHO DO NOT HAVE 525
ACCESS TO THE INTERNET. THE PRINTED INFORMATION SHALL SPECIFY 526
ORGANIZATIONS THAT WILL PROVIDE CONSUMERS FREE ON-SITE ACCESS TO 527
THE CONSUMER GUIDE AND WILL MAIL TO CONSUMERS FREE PAPER COPIES 528
OF ELECTRONIC PAGES OF THE GUIDE.
Sec. 173.54. (A) THROUGH THE CONTRACT REQUIRED UNDER 530
SECTION 173.47 OF THE REVISED CODE, THE DEPARTMENT OF AGING SHALL 531
PROVIDE FOR CUSTOMER SATISFACTION SURVEYS FOR USE IN PUBLISHING 532
THE OHIO LONG-TERM CARE CONSUMER GUIDE. THE DEPARTMENT SHALL 533
ENSURE THAT THE CUSTOMER SATISFACTION SURVEYS ARE CONDUCTED AS 534
FOLLOWS: 535
(1) THE SURVEYS SHALL BE CONDUCTED ANNUALLY. 537
(2) THE SURVEYS SHALL CONSIST OF STANDARDIZED, 539
STATISTICALLY VALID AND RELIABLE QUESTIONNAIRES FOR NURSING 541
FACILITY RESIDENTS AND FOR FAMILIES OF NURSING FACILITY 542
RESIDENTS. EACH QUESTIONNAIRE SHALL BE STRUCTURED IN A MANNER 543
THAT PRODUCES STATISTICALLY TESTED VALID AND RELIABLE RESPONSES, 544
AS SPECIFIED IN RULES ADOPTED BY THE DEPARTMENT. EACH 545
QUESTIONNAIRE SHALL ASK THE RESIDENT'S AGE AND GENDER. THE 546
RESIDENT QUESTIONNAIRE SHALL ASK WHO, IF ANYONE, ASSISTED THE 547
RESIDENT IN COMPLETING THE QUESTIONNAIRE. THE FAMILY 548
QUESTIONNAIRE SHALL ASK THE RELATIONSHIP OF THE PERSON COMPLETING 549
THE QUESTIONNAIRE TO THE RESIDENT. 550
(3) THE RESIDENT SURVEY SHALL BE CONDUCTED IN PERSON, 552
USING A STANDARDIZED SURVEY PROTOCOL DEVELOPED BY THE DEPARTMENT 553
IN CONSULTATION WITH THE LONG-TERM CARE CONSUMER GUIDE ADVISORY 554
COUNCIL. THE SURVEY SHALL BE CONDUCTED IN A MANNER DESIGNED TO 556
13
PRESERVE THE RESIDENT'S CONFIDENTIALITY AS MUCH AS POSSIBLE. 557
(4) THE FAMILY SURVEY SHALL BE CONDUCTED USING ANONYMOUS 559
QUESTIONNAIRES DISTRIBUTED TO FAMILIES AND RETURNED TO A PERSON 560
OTHER THAN THE NURSING FACILITY, IN ACCORDANCE WITH A 561
STANDARDIZED SURVEY PROTOCOL DEVELOPED BY THE DEPARTMENT IN 563
CONSULTATION WITH THE LONG-TERM CARE CONSUMER GUIDE ADVISORY 564
COUNCIL.
(B) IN ADDITION TO BEING USED FOR THE CONSUMER GUIDE, THE 566
RESULTS OF THE SURVEYS CONDUCTED UNDER THIS SECTION SHALL BE 567
PROVIDED TO THE NURSING FACILITIES TO WHICH THEY PERTAIN. EACH 569
NURSING FACILITY IN THIS STATE SHALL PARTICIPATE AS NECESSARY FOR 570
SUCCESSFUL COMPLETION OF THE SURVEYS. 571
Sec. 173.55. THE DEPARTMENT OF AGING MAY CHARGE A FEE, NOT 573
TO EXCEED FOUR HUNDRED DOLLARS, FOR EACH OF THE ANNUAL CUSTOMER 574
SATISFACTION SURVEYS CONDUCTED UNDER SECTION 173.54 OF THE 576
REVISED CODE. THE FEE SHALL BE PAID BY THE NURSING FACILITY AND 577
IS SUBJECT TO REIMBURSEMENT THROUGH THE MEDICAID PROGRAM PURSUANT 578
TO SECTIONS 5111.20 TO 5111.32 OF THE REVISED CODE. 579
ALL FEES COLLECTED UNDER THIS SECTION SHALL BE DEPOSITED TO 582
THE CREDIT OF THE LONG-TERM CARE CONSUMER GUIDE FUND, WHICH IS
HEREBY CREATED IN THE STATE TREASURY. THE FUND SHALL BE USED FOR 585
COSTS ASSOCIATED WITH PUBLISHING THE OHIO LONG-TERM CARE CONSUMER 586
GUIDE, INCLUDING THE COST OF CONTRACTING WITH PERSONS AND 587
GOVERNMENT ENTITIES UNDER SECTION 173.47 OF THE REVISED CODE. 588
THE DEPARTMENT MAY CONTRACT WITH A PERSON OR GOVERNMENT ENTITY TO 590
COLLECT THE FEES ON BEHALF OF THE DEPARTMENT. 591
Sec. 173.56. FOR PURPOSES OF THE LONG-TERM CARE CONSUMER 593
GUIDE, THE DEPARTMENT OF AGING SHALL USE, SUBJECT TO FEDERAL 595
REGULATORY REQUIREMENTS, PROCEDURES, AND GUIDELINES, THE CLINICAL 596
QUALITY INDICATORS CALCULATED FOR EACH NURSING FACILITY BY THE 598
UNITED STATES HEALTH CARE FINANCING ADMINISTRATION FOR THE 599
PURPOSES OF THE MEDICARE AND MEDICAID PROGRAMS. 600
Sec. 173.57. (A) THE DEPARTMENT OF AGING SHALL ADOPT 602
RULES TO IMPLEMENT AND ADMINISTER SECTIONS 173.45 TO 173.59 OF 605
14
THE REVISED CODE. THE RULES SHALL SPECIFY ALL OF THE FOLLOWING: 607
(1) THE CONTENT OF THE OHIO LONG-TERM CARE CONSUMER GUIDE, 610
INCLUDING ANY INFORMATION IN ADDITION TO THE INFORMATION 612
SPECIFIED IN SECTION 173.51 OF THE REVISED CODE; 613
(2) THE CONTENT OF THE COMPUTERIZED AND PRINTED FORMS OF 616
THE EXECUTIVE SUMMARY OF THE CONSUMER GUIDE;
(3) THE CUSTOMER SATISFACTION MEASURES TO BE PUBLISHED IN 618
THE CONSUMER GUIDE PURSUANT TO DIVISION (C)(1) OF SECTION 173.51 619
OF THE REVISED CODE; 621
(4) THE CLINICAL QUALITY INDICATORS TO BE PUBLISHED IN THE 623
CONSUMER GUIDE PURSUANT TO DIVISION (C)(2) OF SECTION 173.51 OF 625
THE REVISED CODE; 626
(5) FOR PURPOSES OF STAFFING COMPARISONS UNDER DIVISION 629
(D)(4) OF SECTION 173.51 OF THE REVISED CODE, CRITERIA TO BE USED
IN CLASSIFYING NURSING FACILITIES INTO PEER GROUPS, WHICH MAY BE 631
BASED ON CASE-MIX SCORES CALCULATED UNDER SECTION 5111.231 OF THE 632
REVISED CODE, THE SIZE OF NURSING FACILITIES, THE LOCATION OF 633
FACILITIES, OR OTHER PERTINENT FACTORS;
(6) THE FORMAT FOR LISTING NURSING FACILITY SERVICES IN 635
THE CONSUMER GUIDE AND THE MANNER IN WHICH THAT INFORMATION IS TO 636
BE COLLECTED FROM NURSING FACILITIES; 637
(7) A METHOD OF INCLUDING ADDITIONAL LONG-TERM CARE 639
FACILITIES AND SERVICE PROVIDERS IN THE CONSUMER GUIDE PURSUANT 641
TO CONSIDERATIONS MADE UNDER DIVISION (B)(4) OF SECTION 173.58 OF 642
THE REVISED CODE;
(8) ANY OTHER REQUIREMENTS NECESSARY TO IMPLEMENT AND 644
ADMINISTER SECTIONS 173.45 TO 173.59 OF THE REVISED CODE. 645
(B) THE DEPARTMENT SHALL DEVELOP RULES UNDER THIS SECTION 647
IN CONSULTATION WITH THE LONG-TERM CARE CONSUMER GUIDE ADVISORY 649
COUNCIL CREATED UNDER SECTION 173.58 OF THE REVISED CODE. BEFORE 651
FILING A RULE UNDER SECTION 119.03 OF THE REVISED CODE, THE 652
DEPARTMENT SHALL PRESENT IT TO THE ADVISORY COUNCIL AND PROVIDE 653
THE COUNCIL A REASONABLE TIME TO COMMENT ON IT. 654
(C) ALL RULES ADOPTED UNDER THIS SECTION SHALL BE ADOPTED 656
15
IN ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE. INITIAL 658
RULES SHALL BE ADOPTED NOT LATER THAN SIX MONTHS AFTER THE 659
EFFECTIVE DATE OF THIS SECTION. 660
Sec. 173.58. (A) THERE IS HEREBY CREATED THE LONG-TERM 662
CARE CONSUMER GUIDE ADVISORY COUNCIL. THE COUNCIL SHALL BE 663
CONVENED BY THE DIRECTOR OF AGING AND SHALL CONSIST OF THE 665
FOLLOWING MEMBERS:
(1) A REPRESENTATIVE OF THE DEPARTMENT OF AGING, APPOINTED 667
BY THE DIRECTOR OF AGING; 668
(2) A REPRESENTATIVE OF THE DEPARTMENT OF HEALTH, 670
APPOINTED BY THE DIRECTOR OF HEALTH; 671
(3) A REPRESENTATIVE OF THE DEPARTMENT OF JOB AND FAMILY 673
SERVICES, APPOINTED BY THE DIRECTOR OF JOB AND FAMILY SERVICES; 674
(4) THE STATE LONG-TERM CARE OMBUDSPERSON; 676
(5) A FAMILY MEMBER OF A NURSING FACILITY RESIDENT, 678
APPOINTED BY THE GOVERNOR; 679
(6) A REPRESENTATIVE OF THE OHIO ASSOCIATION OF AREA 681
AGENCIES ON AGING, APPOINTED BY THE PRESIDENT OF THE ASSOCIATION; 682
(7) TWO REPRESENTATIVES OF THE OHIO HEALTH CARE 684
ASSOCIATION, APPOINTED BY THE CHIEF ADMINISTRATOR OF THE 685
ASSOCIATION;
(8) TWO REPRESENTATIVES OF THE ASSOCIATION OF OHIO 687
PHILANTHROPIC HOMES, HOUSING, AND SERVICES FOR THE AGING, 688
APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ASSOCIATION; 690
(9) TWO REPRESENTATIVES OF THE OHIO ACADEMY OF NURSING 692
HOMES, APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ACADEMY; 693
(10) A REPRESENTATIVE OF THE OHIO ASSOCIATION OF REGIONAL 695
LONG-TERM CARE OMBUDSMEN, APPOINTED BY THE CHIEF ADMINISTRATOR OF 696
THE ASSOCIATION; 697
(11) A REPRESENTATIVE OF THE OHIO CHAPTER OF THE AMERICAN 700
ASSOCIATION OF RETIRED PERSONS, APPOINTED BY THE CHIEF 701
ADMINISTRATOR OF THE CHAPTER; 702
(12) A REPRESENTATIVE OF A CONSUMER GROUP OR OTHER 705
NOT-FOR-PROFIT ENTITY THAT IS ORGANIZED FOR THE PURPOSE OF 706
16
PROMOTING IMPROVED CARE FOR NURSING HOME RESIDENTS, APPOINTED BY 707
THE GOVERNOR;
(13) A REPRESENTATIVE OF A RESEARCH ORGANIZATION, 709
APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ORGANIZATION. THE 710
RESEARCH ORGANIZATION REPRESENTED SHALL BE SELECTED BY THE 711
DIRECTOR OF AGING FROM AMONG RESEARCH ORGANIZATIONS IN THIS STATE 712
THAT HAVE EXPERIENCE IN LONG-TERM CARE POLICY MATTERS. 713
EACH COUNCIL MEMBER SHALL SERVE AT THE DISCRETION OF THE 715
AUTHORITY THAT APPOINTED THE MEMBER. EACH MEMBER SHALL SERVE 716
WITHOUT COMPENSATION OR REIMBURSEMENT FOR EXPENSES, EXCEPT TO THE 717
EXTENT THAT SERVING AS A MEMBER OF THE COUNCIL IS PART OF THE 718
MEMBER'S REGULAR DUTIES OF EMPLOYMENT. 719
THE MEMBER SERVING AS THE REPRESENTATIVE OF THE DEPARTMENT 721
OF AGING SHALL SERVE AS THE COUNCIL'S CHAIRPERSON. THE 722
DEPARTMENT SHALL SUPPLY MEETING SPACE AND STAFF SUPPORT FOR THE 723
COUNCIL.
(B) THE COUNCIL'S DUTIES INCLUDE ALL OF THE FOLLOWING: 725
(1) TO HELP DEVELOP AND REVIEW RULES TO BE ADOPTED BY THE 727
DEPARTMENT OF AGING UNDER SECTION 173.57 OF THE REVISED CODE; 729
(2) TO RECOMMEND ADMINISTRATIVE PRACTICES TO THE 731
DEPARTMENT FOR IMPROVING THE OPERATION AND CONTENT OF THE OHIO 732
LONG-TERM CARE CONSUMER GUIDE; 733
(3) TO RECOMMEND LEGISLATIVE CHANGES TO THE DEPARTMENT 735
NEEDED TO IMPROVE THE CONSUMER GUIDE; 737
(4) TO CONSIDER WHETHER IT IS FEASIBLE TO INCLUDE IN THE 739
CONSUMER GUIDE OTHER LONG-TERM CARE FACILITIES, SUCH AS 740
RESIDENTIAL CARE FACILITIES AND INTERMEDIATE CARE FACILITIES FOR 741
THE MENTALLY RETARDED, AND LONG-TERM CARE SERVICE PROVIDERS, SUCH 742
AS HOME HEALTH AGENCIES AND ADULT DAY SERVICE PROVIDERS; 743
(5) TO CONSIDER WHETHER IT IS FEASIBLE TO INCLUDE IN THE 745
CONSUMER GUIDE MEASUREMENTS OF QUALITY OF LIFE STANDARDS. 746
(C) THE LONG-TERM CARE CONSUMER GUIDE ADVISORY COUNCIL IS 748
NOT SUBJECT TO SECTION 101.84 OF THE REVISED CODE. 749
Sec. 173.59. (A) THE DEPARTMENT OF AGING SHALL INCLUDE NO 751
17
ADVERTISING IN THE OHIO LONG-TERM CARE CONSUMER GUIDE THAT SHALL 752
CAUSE A CONFLICT OF INTEREST. 753
(B) THIS SECTION DOES NOT AFFECT INFORMATION INCLUDED IN 755
THE OHIO LONG-TERM CARE CONSUMER GUIDE UNDER DIVISION (D)(6) OF 757
SECTION 173.51 OF THE REVISED CODE. 758
Sec. 3702.525. (A) Not later than twenty-four months 768
after the date the director of health mails the notice that the 769
certificate of need has been granted or, if the grant or denial 770
of the certificate of need is appealed under section 3702.60 of 771
the Revised Code, not later than twenty-four months after 772
issuance of an order granting the certificate that is not subject 773
to further appeal, each person holding a certificate of need 774
granted on or after the effective date of this section APRIL 20, 775
1995, shall:
(1) If the project for which the certificate of need was 778
granted primarily involves construction and is to be financed
primarily through external borrowing of funds, secure financial 779
commitment for the stated purpose of developing the project and 780
commence construction that continues uninterrupted except for 781
interruptions or delays that are unavoidable due to reasons 782
beyond the person's control, including labor strikes, natural 783
disasters, material shortages, or comparable events; 784
(2) If the project for which the certificate of need was 787
granted primarily involves construction and is to be financed
primarily internally, receive formal approval from the holder's 788
board of directors or trustees or other governing authority to 789
commit specified funds for implementation of the project and 790
commence construction that continues uninterrupted except for 791
interruptions or delays that are unavoidable due to reasons 792
beyond the person's control, including labor strikes, natural 793
disasters, material shortages, or comparable events; 794
(3) If the project for which the certificate of need was 797
granted primarily involves acquisition of medical equipment,
enter into a contract to purchase or lease the equipment and to 798
18
accept the equipment at the site for which the certificate was 799
granted; 800
(4) If the project for which the certificate of need was 803
granted involves no capital expenditure or only minor renovations 804
to existing structures, provide the health service or activity by 805
the means specified in the approved application for the 806
certificate;
(5) If the project for which the certificate of need was 809
granted primarily involves leasing a building or space that
requires only minor renovations to the existing space, execute a 810
lease and provide the health service or activity by the means 811
specified in the approved application for the certificate; 812
(6) If the project for which the certificate of need was 815
granted primarily involves leasing a building or space that has 816
not been constructed or requires substantial renovations to
existing space, commence construction for the purpose of 817
implementing the reviewable activity that continues uninterrupted 818
except for interruptions or delays that are unavoidable due to 819
reasons beyond the person's control, including labor strikes, 820
natural disasters, material shortages, or comparable events. 821
(B) The twenty-four-month period specified in division (A) 824
of this section shall not be extended by any means, including the 825
transfer of a certificate of need under division (C) of section 826
3702.524 of the Revised Code or granting of a subsequent or
replacement certificate of need. Each person holding a 828
certificate of need granted on or after the effective date of 829
this section APRIL 20, 1995, shall provide the director of health 831
documentation of compliance with that division not later than the 832
earlier of thirty days after complying with that division or five 833
days after the twenty-four-month period expires. Not later than 834
the earlier of fifteen days after he receives RECEIVING the 835
documentation or fifteen days after the twenty-four-month period 836
expires, the director shall send by certified mail a notice to 837
the holder of the certificate of need specifying whether the 838
19
holder has complied with division (A) of this section. 839
(C) NOTWITHSTANDING DIVISION (B) OF THIS SECTION, THE 841
TWENTY-FOUR-MONTH PERIOD SPECIFIED IN DIVISION (A) OF THIS 842
SECTION SHALL BE EXTENDED FOR AN ADDITIONAL TWENTY-FOUR MONTHS 843
FOR ANY CERTIFICATE OF NEED GRANTED FOR THE PURCHASE AND 844
RELOCATION OF LICENSED NURSING HOME BEDS ON FEBRUARY 26, 1999. 845
(D) A certificate of need granted on or after the 848
effective date of this section APRIL 20, 1995, expires, 849
regardless of whether the director sends a notice under division 850
(B) of this section, if the holder fails to comply with division 851
(A) OR (C) of this section or to provide information under 853
division (B) of this section as necessary for the director to 854
determine compliance. 855
Sec. 3721.026. (A) AS USED IN THIS SECTION AND SECTION 857
3721.027 OF THE REVISED CODE, "CERTIFICATION REQUIREMENTS," 859
"COMPLIANCE," "NURSING FACILITY," AND "SURVEY" HAVE THE SAME 860
MEANINGS AS IN SECTION 5111.35 OF THE REVISED CODE.
(B) THE DIRECTOR OF HEALTH SHALL ESTABLISH A UNIT WITHIN 862
THE DEPARTMENT OF HEALTH TO PROVIDE ADVICE AND TECHNICAL 863
ASSISTANCE TO NURSING FACILITIES FOR THE PURPOSE OF IMPROVING 864
COMPLIANCE WITH CERTIFICATION REQUIREMENTS. THE DIRECTOR SHALL 865
ASSIGN TO THE UNIT EMPLOYEES WHO HAVE TRAINING OR EXPERIENCE IN 866
CONDUCTING OR SUPERVISING SURVEYS, BUT EMPLOYEES ASSIGNED TO THE 867
UNIT SHALL NOT CONDUCT SURVEYS. THE DIRECTOR SHALL ADOPT RULES 868
IN ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE TO IMPLEMENT 869
THIS SECTION. 870
(C) ON OR BEFORE THE LAST DAY OF DECEMBER EACH YEAR, THE 872
DIRECTOR SHALL SUBMIT A REPORT TO THE GOVERNOR AND THE GENERAL 875
ASSEMBLY DESCRIBING THE UNIT'S ACTIVITIES THAT YEAR AND ITS
EFFECTIVENESS IN IMPROVING COMPLIANCE WITH CERTIFICATION 876
REQUIREMENTS. 877
Sec. 3721.027. THE DEPARTMENT OF HEALTH SHALL INVESTIGATE 879
WITHIN TEN WORKING DAYS AFTER REFERRAL, IN ACCORDANCE WITH 880
PROCEDURES AND CRITERIA TO BE ESTABLISHED BY THE DEPARTMENT OF 881
20
HEALTH AND THE DEPARTMENT OF AGING, ANY UNRESOLVED COMPLAINT THAT 882
THE OFFICE OF THE STATE LONG-TERM CARE OMBUDSPERSON HAS 883
INVESTIGATED AND FOUND TO BE VALID AND HAS REFERRED TO THE 884
DEPARTMENT UNDER SECTION 173.19 OF THE REVISED CODE. THIS 885
REQUIREMENT DOES NOT SUPERSEDE FEDERAL REQUIREMENTS FOR SURVEY 887
AGENCY COMPLAINT INVESTIGATIONS.
Sec. 3721.21. As used in sections 3721.21 to 3721.34 of 896
the Revised Code: 897
(A) "Long-term care facility" means either of the 899
following: 900
(1) A nursing home as defined in section 3721.01 of the 902
Revised Code, other than a nursing home or part of a nursing home 903
certified as an intermediate care facility for the mentally 904
retarded under Title XIX of the "Social Security Act," 49 Stat. 905
620 (1935), 42 U.S.C.A. 301, as amended; 906
(2) A facility or part of a facility that is certified as 908
a skilled nursing facility or a nursing facility under Title 909
XVIII or XIX of the "Social Security Act." 910
(B) "Residential care facility" has the same meaning as in 912
section 3721.01 of the Revised Code. 913
(C) "Abuse" means knowingly causing physical harm or 915
recklessly causing serious physical harm to a resident by 916
physical contact with the resident or by use of physical or 917
chemical restraint, medication, or isolation as punishment, for 918
staff convenience, excessively, as a substitute for treatment, or 919
in amounts that preclude habilitation and treatment. 920
(D) "Neglect" means recklessly failing to provide a 922
resident with any treatment, care, goods, or service necessary to 923
maintain the health or safety of the resident when the failure 924
results in serious physical harm to the resident. "NEGLECT" DOES 925
NOT INCLUDE ALLOWING A RESIDENT, AT THE RESIDENT'S OPTION, TO 926
RECEIVE ONLY TREATMENT BY SPIRITUAL MEANS THROUGH PRAYER IN 928
ACCORDANCE WITH THE TENETS OF A RECOGNIZED RELIGIOUS
DENOMINATION. 929
21
(E) "Misappropriation" means depriving, defrauding, or 931
otherwise obtaining the real or personal property of a resident 932
by any means prohibited by the Revised Code, including violations 933
of Chapter 2911. or 2913. of the Revised Code. 934
(F) "Resident" includes a resident, patient, former 937
resident or patient, or deceased resident or patient of a
long-term care facility or a residential care facility. 938
(G) "Physical restraint" has the same meaning as in 940
section 3721.10 of the Revised Code. 941
(H) "Chemical restraint" has the same meaning as in 943
section 3721.10 of the Revised Code. 944
(I) "Nursing and nursing-related services" means the 947
personal care services and other services not constituting
skilled nursing care that are specified in rules the public 948
health council shall adopt in accordance with Chapter 119. of the 950
Revised Code.
(J) "Personal care services" has the same meaning as in 952
section 3721.01 of the Revised Code. 953
(K) "Nurse aide" means an individual, other than a 955
licensed health professional practicing within the scope of the 956
professional's license, who provides nursing and nursing-related 958
services to residents in a long-term care facility, either as a 959
member of the staff of the facility for monetary compensation or 960
as a volunteer without monetary compensation. 961
(L) "Licensed health professional" means all of the 963
following: 964
(1) An occupational therapist or occupational therapy 966
assistant licensed under Chapter 4755. of the Revised Code; 967
(2) A physical therapist or physical therapy assistant 969
licensed under Chapter 4755. of the Revised Code; 970
(3) A physician authorized under Chapter 4731. of the 972
Revised Code to practice medicine and surgery, osteopathic 973
medicine and surgery, or podiatry; 974
(4) A physician assistant authorized under Chapter 4730. 977
22
of the Revised Code to practice as a physician assistant;
(5) A registered nurse or licensed practical nurse 979
licensed under Chapter 4723. of the Revised Code; 980
(6) A social worker or independent social worker licensed 983
under Chapter 4757. of the Revised Code or a social work
assistant registered under that chapter; 984
(7) A speech-language pathologist or audiologist licensed 986
under Chapter 4753. of the Revised Code; 987
(8) A dentist or dental hygienist licensed under Chapter 989
4715. of the Revised Code; 990
(9) An optometrist licensed under Chapter 4725. of the 992
Revised Code; 993
(10) A pharmacist licensed under Chapter 4729. of the 995
Revised Code; 996
(11) A psychologist licensed under Chapter 4732. of the 998
Revised Code; 999
(12) A chiropractor licensed under Chapter 4734. of the 1,001
Revised Code; 1,002
(13) A nursing home administrator licensed or temporarily 1,004
licensed under Chapter 4751. of the Revised Code; 1,005
(14) A professional counselor or professional clinical 1,007
counselor licensed under Chapter 4757. of the Revised Code. 1,008
(M) "Competency evaluation program" means a program 1,010
through which the competency of a nurse aide to provide nursing 1,011
and nursing-related services is evaluated. 1,012
(N) "Training and competency evaluation program" means a 1,014
program of nurse aide training and evaluation of competency to 1,015
provide nursing and nursing-related services. 1,016
Sec. 5111.20. As used in sections 5111.20 to 5111.32 of 1,025
the Revised Code: 1,026
(A) "Allowable costs" are those costs determined by the 1,028
department of job and family services to be reasonable and do not 1,029
include fines paid under sections 5111.35 to 5111.61 and section 1,031
5111.99 of the Revised Code. 1,032
23
(B) "Capital costs" means costs of ownership and 1,034
nonextensive renovation. 1,035
(1) "Cost of ownership" means the actual expense incurred 1,037
for all of the following: 1,038
(a) Depreciation and interest on any capital assets that 1,040
cost five hundred dollars or more per item, including the 1,041
following: 1,042
(i) Buildings; 1,044
(ii) Building improvements that are not approved as 1,046
nonextensive renovations under section 5111.25 or 5111.251 of the 1,047
Revised Code; 1,048
(iii) Equipment; 1,050
(iv) Extensive renovations; 1,052
(v) Transportation equipment. 1,054
(b) Amortization and interest on land improvements and 1,056
leasehold improvements; 1,057
(c) Amortization of financing costs; 1,059
(d) Except as provided in division (I) of this section, 1,061
lease and rent of land, building, and equipment. 1,062
The costs of capital assets of less than five hundred 1,064
dollars per item may be considered costs of ownership in 1,065
accordance with a provider's practice.
(2) "Costs of nonextensive renovation" means the actual 1,067
expense incurred for depreciation or amortization and interest on 1,068
renovations that are not extensive renovations. 1,069
(C) "Capital lease" and "operating lease" shall be 1,071
construed in accordance with generally accepted accounting 1,072
principles.
(D) "Case-mix score" means the measure determined under 1,074
section 5111.231 of the Revised Code of the relative direct-care 1,075
resources needed to provide care and habilitation to a resident 1,076
of a nursing facility or intermediate care facility for the 1,077
mentally retarded. 1,078
(E) "Date of licensure," for a facility originally 1,080
24
licensed as a nursing home under Chapter 3721. of the Revised 1,081
Code, means the date specific beds were originally licensed as 1,082
nursing home beds under that chapter, regardless of whether they 1,083
were subsequently licensed as residential facility beds under 1,084
section 5123.19 of the Revised Code. For a facility originally 1,085
licensed as a residential facility under section 5123.19 of the 1,086
Revised Code, "date of licensure" means the date specific beds 1,087
were originally licensed as residential facility beds under that 1,088
section.
(1) If nursing home beds licensed under Chapter 3721. of 1,090
the Revised Code or residential facility beds licensed under 1,091
section 5123.19 of the Revised Code were not required by law to 1,092
be licensed when they were originally used to provide nursing 1,093
home or residential facility services, "date of licensure" means 1,094
the date the beds first were used to provide nursing home or
residential facility services, regardless of the date the present 1,095
provider obtained licensure. 1,096
(2) If a facility adds nursing home beds or residential 1,098
facility beds or extensively renovates all or part of the 1,099
facility after its original date of licensure, it will have a 1,100
different date of licensure for the additional beds or 1,101
extensively renovated portion of the facility, unless the beds 1,102
are added in a space that was constructed at the same time as the 1,103
previously licensed beds but was not licensed under Chapter 3721. 1,104
or section 5123.19 of the Revised Code at that time. 1,105
(F) "Desk-reviewed" means that costs as reported on a cost 1,107
report submitted under section 5111.26 of the Revised Code have 1,108
been subjected to a desk review under division (A) of section 1,109
5111.27 of the Revised Code and preliminarily determined to be 1,110
allowable costs. 1,111
(G) "Direct care costs" means all of the following: 1,113
(1)(a) Costs for registered nurses, licensed practical 1,115
nurses, and nurse aides employed by the facility; 1,116
(b) Costs for direct care staff, administrative nursing 1,118
25
staff, medical directors, social services staff, activities 1,119
staff, psychologists and psychology assistants, social workers 1,120
and counselors, habilitation staff, qualified mental retardation 1,121
professionals, program directors, respiratory therapists, 1,122
habilitation supervisors, and except as provided in division 1,123
(G)(2) of this section, other persons holding degrees qualifying 1,124
them to provide therapy; 1,125
(c) Costs of purchased nursing services; 1,127
(d) Costs of quality assurance; 1,129
(e) Costs of training and staff development, employee 1,131
benefits, payroll taxes, and workers' compensation premiums or 1,132
costs for self-insurance claims and related costs as specified in 1,133
rules adopted by the director of job and family services in 1,135
accordance with Chapter 119. of the Revised Code, for personnel 1,137
listed in divisions (G)(1)(a), (b), and (d) of this section; 1,138
(f) Costs of consulting and management fees related to 1,140
direct care;
(g) Allocated direct care home office costs. 1,142
(2) In addition to the costs specified in division (G)(1) 1,144
of this section, for intermediate care facilities for the 1,145
mentally retarded only, direct care costs include both of the 1,146
following: 1,147
(a) Costs for physical therapists and physical therapy 1,149
assistants, occupational therapists and occupational therapy 1,150
assistants, speech therapists, and audiologists; 1,151
(b) Costs of training and staff development, employee 1,153
benefits, payroll taxes, and workers' compensation premiums or 1,154
costs for self-insurance claims and related costs as specified in 1,155
rules adopted by the director of job and family services in 1,157
accordance with Chapter 119. of the Revised Code, for personnel 1,158
listed in division (G)(2)(a) of this section. 1,159
(3) Costs of other direct-care resources that are 1,161
specified as direct care costs in rules adopted by the director 1,163
of job and family services in accordance with Chapter 119. of the 1,164
26
Revised Code. 1,165
(H) "Fiscal year" means the fiscal year of this state, as 1,167
specified in section 9.34 of the Revised Code. 1,168
(I) "Indirect care costs" means all reasonable costs other 1,170
than direct care costs, other protected costs, or capital costs. 1,171
"Indirect care costs" includes but is not limited to costs of 1,172
habilitation supplies, pharmacy consultants, medical and 1,173
habilitation records, program supplies, incontinence supplies, 1,174
food, enterals, dietary supplies and personnel, laundry, 1,175
housekeeping, security, administration, liability insurance, 1,176
bookkeeping, purchasing department, human resources, 1,177
communications, travel, dues, license fees, subscriptions, home 1,178
office costs not otherwise allocated, legal services, accounting 1,179
services, minor equipment, maintenance and repairs, help-wanted 1,181
advertising, informational advertising, start-up costs, 1,182
organizational expenses, other interest, property insurance, 1,183
employee training and staff development, employee benefits, 1,184
payroll taxes, and workers' compensation premiums or costs for 1,185
self-insurance claims and related costs as specified in rules 1,186
adopted by the director of job and family services in accordance 1,187
with Chapter 119. of the Revised Code, for personnel listed in 1,189
this division. Notwithstanding division (B)(1) of this section, 1,190
"indirect care costs" also means the cost of equipment, including 1,191
vehicles, acquired by operating lease executed before December 1, 1,192
1992, if the costs are reported as administrative and general 1,193
costs on the facility's cost report for the cost reporting period 1,194
ending December 31, 1992.
(J) "Inpatient days" means all days during which a 1,196
resident, regardless of payment source, occupies a bed in a 1,197
nursing facility or intermediate care facility for the mentally 1,198
retarded that is included in the facility's certified capacity 1,199
under Title XIX of the "Social Security Act," 49 Stat. 610 1,200
(1935), 42 U.S.C.A. 301, as amended. Therapeutic or hospital 1,201
leave days for which payment is made under section 5111.33 of the 1,202
27
Revised Code are considered inpatient days proportionate to the 1,203
percentage of the facility's per resident per day rate paid for 1,204
those days. 1,205
(K) "Intermediate care facility for the mentally retarded" 1,207
means an intermediate care facility for the mentally retarded 1,208
certified as in compliance with applicable standards for the 1,209
medical assistance program by the director of health in 1,210
accordance with Title XIX of the "Social Security Act." 1,211
(L) "Maintenance and repair expenses" means, except as 1,213
provided in division (X)(2) of this section, expenditures that 1,214
are necessary and proper to maintain an asset in a normally 1,215
efficient working condition and that do not extend the useful 1,216
life of the asset two years or more. "Maintenance and repair 1,217
expenses" includes but is not limited to the cost of ordinary 1,218
repairs such as painting and wallpapering. 1,219
(M) "Nursing facility" means a facility, or a distinct 1,221
part of a facility, that is certified as a nursing facility by 1,222
the director of health in accordance with Title XIX of the 1,223
"Social Security Act," and is not an intermediate care facility 1,224
for the mentally retarded. "Nursing facility" includes a 1,225
facility, or a distinct part of a facility, that is certified as 1,226
a nursing facility by the director of health in accordance with 1,227
Title XIX of the "Social Security Act," and is certified as a 1,228
skilled nursing facility by the director in accordance with Title 1,229
XVIII of the "Social Security Act." 1,230
(N) "Other protected costs" means costs for medical 1,232
supplies; real estate, franchise, and property taxes; natural 1,233
gas, fuel oil, water, electricity, sewage, and refuse and 1,234
hazardous medical waste collection; allocated other protected 1,235
home office costs; FEES PAID UNDER SECTION 173.55 OF THE REVISED 1,236
CODE; and any additional costs defined as other protected costs 1,238
in rules adopted by the director of job and family services in 1,240
accordance with Chapter 119. of the Revised Code. 1,241
(O) "Owner" means any person or government entity that has 1,243
28
at least five per cent ownership or interest, either directly, 1,244
indirectly, or in any combination, in a nursing facility or 1,245
intermediate care facility for the mentally retarded. 1,246
(P) "Patient" includes "resident." 1,248
(Q) Except as provided in divisions (Q)(1) and (2) of this 1,250
section, "per diem" means a nursing facility's or intermediate 1,251
care facility for the mentally retarded's actual, allowable costs 1,252
in a given cost center in a cost reporting period, divided by the 1,253
facility's inpatient days for that cost reporting period. 1,254
(1) When calculating indirect care costs for the purpose 1,256
of establishing rates under section 5111.24 or 5111.241 of the 1,257
Revised Code, "per diem" means a facility's actual, allowable 1,258
indirect care costs in a cost reporting period divided by the 1,259
greater of the facility's inpatient days for that period or the 1,260
number of inpatient days the facility would have had during that 1,261
period if its occupancy rate had been eighty-five per cent. 1,262
(2) When calculating capital costs for the purpose of 1,264
establishing rates under section 5111.25 or 5111.251 of the 1,265
Revised Code, "per diem" means a facility's actual, allowable 1,266
capital costs in a cost reporting period divided by the greater 1,267
of the facility's inpatient days for that period or the number of 1,268
inpatient days the facility would have had during that period if 1,269
its occupancy rate had been ninety-five per cent. 1,270
(R) "Provider" means a person or government entity that 1,272
operates a nursing facility or intermediate care facility for the 1,273
mentally retarded under a provider agreement. 1,274
(S) "Provider agreement" means a contract between the 1,276
department of job and family services and a nursing facility or 1,277
intermediate care facility for the mentally retarded for the 1,278
provision of nursing facility services or intermediate care 1,279
facility services for the mentally retarded under the medical 1,280
assistance program. 1,281
(T) "Purchased nursing services" means services that are 1,283
provided in a nursing facility by registered nurses, licensed 1,284
29
practical nurses, or nurse aides who are not employees of the 1,285
facility. 1,286
(U) "Reasonable" means that a cost is an actual cost that 1,288
is appropriate and helpful to develop and maintain the operation 1,289
of patient care facilities and activities, including normal 1,290
standby costs, and that does not exceed what a prudent buyer pays 1,291
for a given item or services. Reasonable costs may vary from 1,292
provider to provider and from time to time for the same provider. 1,293
(V) "Related party" means an individual or organization 1,295
that, to a significant extent, has common ownership with, is 1,296
associated or affiliated with, has control of, or is controlled 1,297
by, the provider. 1,298
(1) An individual who is a relative of an owner is a 1,300
related party. 1,301
(2) Common ownership exists when an individual or 1,303
individuals possess significant ownership or equity in both the 1,304
provider and the other organization. Significant ownership or 1,305
equity exists when an individual or individuals possess five per 1,306
cent ownership or equity in both the provider and a supplier. 1,307
Significant ownership or equity is presumed to exist when an 1,308
individual or individuals possess ten per cent ownership or 1,309
equity in both the provider and another organization from which 1,310
the provider purchases or leases real property. 1,311
(3) Control exists when an individual or organization has 1,313
the power, directly or indirectly, to significantly influence or 1,314
direct the actions or policies of an organization. 1,315
(4) An individual or organization that supplies goods or 1,317
services to a provider shall not be considered a related party if 1,318
all of the following conditions are met: 1,319
(a) The supplier is a separate bona fide organization. 1,321
(b) A substantial part of the supplier's business activity 1,323
of the type carried on with the provider is transacted with 1,324
others than the provider and there is an open, competitive market 1,325
for the types of goods or services the supplier furnishes. 1,326
30
(c) The types of goods or services are commonly obtained 1,328
by other nursing facilities or intermediate care facilities for 1,329
the mentally retarded from outside organizations and are not a 1,330
basic element of patient care ordinarily furnished directly to 1,331
patients by the facilities. 1,332
(d) The charge to the provider is in line with the charge 1,334
for the goods or services in the open market and no more than the 1,335
charge made under comparable circumstances to others by the 1,336
supplier. 1,337
(W) "Relative of owner" means an individual who is related 1,339
to an owner of a nursing facility or intermediate care facility 1,340
for the mentally retarded by one of the following relationships: 1,341
(1) Spouse; 1,343
(2) Natural parent, child, or sibling; 1,345
(3) Adopted parent, child, or sibling; 1,347
(4) Step-parent, step-child, step-brother, or step-sister; 1,349
(5) Father-in-law, mother-in-law, son-in-law, 1,351
daughter-in-law, brother-in-law, or sister-in-law; 1,352
(6) Grandparent or grandchild; 1,354
(7) Foster parent, foster child, foster brother, or foster 1,356
sister. 1,357
(X) "Renovation" and "extensive renovation" mean: 1,359
(1) Any betterment, improvement, or restoration of a 1,361
nursing facility or intermediate care facility for the mentally 1,362
retarded started before July 1, 1993, that meets the definition 1,363
of a renovation or extensive renovation established in rules 1,364
adopted by the director of job and family services in effect on 1,366
December 22, 1992.
(2) In the case of betterments, improvements, and 1,368
restorations of nursing facilities and intermediate care 1,369
facilities for the mentally retarded started on or after July 1, 1,370
1993: 1,371
(a) "Renovation" means the betterment, improvement, or 1,373
restoration of a nursing facility or intermediate care facility 1,374
31
for the mentally retarded beyond its current functional capacity 1,375
through a structural change that costs at least five hundred 1,376
dollars per bed. A renovation may include betterment, 1,377
improvement, restoration, or replacement of assets that are 1,378
affixed to the building and have a useful life of at least five 1,379
years. A renovation may include costs that otherwise would be 1,380
considered maintenance and repair expenses if they are an 1,381
integral part of the structural change that makes up the 1,382
renovation project. "Renovation" does not mean construction of 1,383
additional space for beds that will be added to a facility's 1,384
licensed or certified capacity. 1,385
(b) "Extensive renovation" means a renovation that costs 1,387
more than sixty-five per cent and no more than eighty-five per 1,388
cent of the cost of constructing a new bed and that extends the 1,389
useful life of the assets for at least ten years. 1,390
For the purposes of division (X)(2) of this section, the 1,392
cost of constructing a new bed shall be considered to be forty 1,393
thousand dollars, adjusted for the estimated rate of inflation 1,394
from January 1, 1993, to the end of the calendar year during 1,395
which the renovation is completed, using the consumer price index 1,396
for shelter costs for all urban consumers for the north central 1,397
region, as published by the United States bureau of labor 1,398
statistics. 1,399
The department of job and family services may treat a 1,401
renovation that costs more than eighty-five per cent of the cost 1,402
of constructing new beds as an extensive renovation if the 1,403
department determines that the renovation is more prudent than 1,404
construction of new beds. 1,405
Sec. 5111.25. (A) The department of job and family 1,415
services shall pay each eligible nursing facility a per resident 1,416
per day rate for its reasonable capital costs established 1,417
prospectively each fiscal year for each facility. Except as 1,418
otherwise provided in sections 5111.20 to 5111.32 of the Revised 1,419
Code, the rate shall be based on the facility's capital costs for 1,420
32
the calendar year preceding the fiscal year in which the rate
will be paid. The rate shall equal the sum of divisions (A)(1) 1,421
to (3) of this section: 1,422
(1) The lesser of the following: 1,424
(a) Eighty-eight and sixty-five one-hundredths per cent of 1,426
the facility's desk-reviewed, actual, allowable, per diem cost of 1,427
ownership and eighty-five per cent of the facility's actual, 1,428
allowable, per diem cost of nonextensive renovation determined 1,429
under division (F) of this section; 1,430
(b) Eighty-eight and sixty-five one-hundredths per cent of 1,432
the following limitation: 1,433
(i) For the fiscal year beginning July 1, 1993, sixteen 1,435
dollars per resident day; 1,436
(ii) For the fiscal year beginning July 1, 1994, sixteen 1,438
dollars per resident day, adjusted to reflect the rate of 1,439
inflation for the twelve-month period beginning July 1, 1992, and 1,440
ending June 30, 1993, using the consumer price index for shelter 1,441
costs for all urban consumers for the north central region, 1,442
published by the United States bureau of labor statistics; 1,443
(iii) For subsequent fiscal years, the limitation in 1,445
effect during the previous fiscal year, adjusted to reflect the 1,446
rate of inflation for the twelve-month period beginning on the 1,447
first day of July for the calendar year preceding the calendar 1,448
year that precedes the fiscal year and ending on the following 1,449
thirtieth day of June, using the consumer price index for shelter 1,450
costs for all urban consumers for the north central region, 1,451
published by the United States bureau of labor statistics. 1,452
(2) Any efficiency incentive determined under division (D) 1,454
of this section; 1,455
(3) Any amounts for return on equity determined under 1,457
division (H) of this section. 1,458
Buildings shall be depreciated using the straight line 1,460
method over forty years or over a different period approved by 1,461
the department. Components and equipment shall be depreciated 1,462
33
using the straight-line method over a period designated in rules 1,463
adopted by the director of job and family services in accordance 1,465
with Chapter 119. of the Revised Code, consistent with the 1,466
guidelines of the American hospital association, or over a 1,467
different period approved by the department. Any rules adopted 1,468
under this division that specify useful lives of buildings, 1,469
components, or equipment apply only to assets acquired on or 1,470
after July 1, 1993. Depreciation for costs paid or reimbursed by 1,471
any government agency shall not be included in cost of ownership 1,472
or renovation unless that part of the payment under sections 1,473
5111.20 to 5111.32 of the Revised Code is used to reimburse the 1,474
government agency.
(B) The capital cost basis of nursing facility assets 1,476
shall be determined in the following manner: 1,477
(1) For purposes of calculating the rate to be paid for 1,479
the fiscal year beginning July 1, 1993, for facilities with dates 1,481
of licensure on or before June 30, 1993, the capital cost basis 1,482
shall be equal to the following: 1,483
(a) For facilities that have not had a change of ownership 1,485
during the period beginning January 1, 1993, and ending June 30, 1,486
1993, the desk-reviewed, actual, allowable capital cost basis 1,487
that is listed on the facility's cost report for the cost 1,488
reporting period ending December 31, 1992, plus the actual, 1,489
allowable capital cost basis of any assets constructed or 1,490
acquired after December 31, 1992, but before July 1, 1993, if the 1,491
aggregate capital costs of those assets would increase the 1,492
facility's rate for capital costs by twenty or more cents per 1,493
resident per day. 1,494
(b) For facilities that have a date of licensure or had a 1,496
change of ownership during the period beginning January 1, 1993, 1,497
and ending June 30, 1993, the actual, allowable capital cost 1,498
basis of the person or government entity that owns the facility 1,499
on June 30, 1993. 1,500
Capital cost basis shall be calculated as provided in 1,502
34
division (B)(1) of this section subject to approval by the United 1,503
States health care financing administration of any necessary 1,504
amendment to the state plan for providing medical assistance. 1,505
The department shall include the actual, allowable capital 1,507
cost basis of assets constructed or acquired during the period 1,508
beginning January 1, 1993, and ending June 30, 1993, in the 1,509
calculation for the facility's rate effective July 1, 1993, if 1,510
the aggregate capital costs of the assets would increase the 1,511
facility's rate by twenty or more cents per resident per day and 1,512
the facility provides the department with sufficient 1,513
documentation of the costs before June 1, 1993. If the facility 1,514
provides the documentation after that date, the department shall 1,515
adjust the facility's rate to reflect the costs of the assets one 1,516
month after the first day of the month after the department 1,517
receives the documentation. 1,518
(2) Except as provided in division (B)(4) of this section, 1,521
for purposes of calculating the rates to be paid for fiscal years 1,522
beginning after June 30, 1994, for facilities with dates of 1,523
licensure on or before June 30, 1993, the capital cost basis of 1,524
each asset shall be equal to the desk-reviewed, actual, 1,525
allowable, capital cost basis that is listed on the facility's 1,526
cost report for the calendar year preceding the fiscal year 1,527
during which the rate will be paid.
(3) For facilities with dates of licensure after June 30, 1,530
1993, the capital cost basis shall be determined in accordance 1,531
with the principles of the medicare program established under 1,532
Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 42 1,533
U.S.C.A. 301, as amended, except as otherwise provided in 1,534
sections 5111.20 to 5111.32 of the Revised Code. 1,535
(4) Except as provided in division (B)(5) of this section, 1,538
if a provider transfers an interest in a facility to another 1,539
provider after June 30, 1993, there shall be no increase in the 1,540
capital cost basis of the asset if the providers are related 1,541
parties. If the providers are not related parties or if they are 1,542
35
related parties and division (B)(5) of this section requires the 1,543
adjustment of the capital cost basis under this division, the 1,544
basis of the asset shall be adjusted by the lesser of the 1,545
following:
(a) One-half of the change in construction costs during 1,547
the time that the transferor held the asset, as calculated by the 1,548
department of job and family services using the "Dodge building 1,550
cost indexes, northeastern and north central states," published
by Marshall and Swift; 1,551
(b) One-half of the change in the consumer price index for 1,553
all items for all urban consumers, as published by the United 1,554
States bureau of labor statistics, during the time that the 1,555
transferor held the asset. 1,556
(5) If a provider transfers an interest in a facility to 1,559
another provider who is a related party, the capital cost basis
of the asset shall be adjusted as specified in division (B)(4) of 1,562
this section for a transfer to a provider that is not a related 1,563
party if all of the following conditions are met:
(a) The related party is a relative of owner; 1,566
(b) The provider making the transfer retains no ownership 1,569
interest in the facility;
(c) The United States internal revenue service has issued 1,572
a ruling that the transfer is an arm's length transaction for 1,573
purposes of federal income taxation;
(d) Except in the case of hardship caused by a 1,576
catastrophic event, as determined by the department, or in the 1,577
case of a provider making the transfer who is at least sixty-five
years of age, not less than twenty years have elapsed since, for 1,579
the same facility, the capital cost basis was adjusted most 1,580
recently under division (B)(5) of this section or actual, 1,582
allowable cost of ownership was determined most recently under
division (C)(9) of this section. 1,584
(C) As used in this division, "lease expense" means lease 1,586
payments in the case of an operating lease and depreciation 1,587
36
expense and interest expense in the case of a capital lease. As 1,588
used in this division, "new lease" means a lease, to a different 1,589
lessee, of a nursing facility that previously was operated under 1,590
a lease. 1,591
(1) Subject to the limitation specified in division (A)(1) 1,593
of this section, for a lease of a facility that was effective on 1,594
May 27, 1992, the entire lease expense is an actual, allowable 1,595
cost of ownership during the term of the existing lease. The 1,596
entire lease expense also is an actual, allowable cost of 1,597
ownership if a lease in existence on May 27, 1992, is renewed 1,598
under either of the following circumstances: 1,599
(a) The renewal is pursuant to a renewal option that was 1,601
in existence on May 27, 1992; 1,602
(b) The renewal is for the same lease payment amount and 1,604
between the same parties as the lease in existence on May 27, 1,605
1992. 1,606
(2) Subject to the limitation specified in division (A)(1) 1,608
of this section, for a lease of a facility that was in existence 1,609
but not operated under a lease on May 27, 1992, actual, allowable 1,610
cost of ownership shall include the lesser of the annual lease 1,611
expense or the annual depreciation expense and imputed interest 1,612
expense that would be calculated at the inception of the lease 1,613
using the lessor's entire historical capital asset cost basis, 1,614
adjusted by the lesser of the following amounts: 1,615
(a) One-half of the change in construction costs during 1,617
the time the lessor held each asset until the beginning of the 1,618
lease, as calculated by the department using the "Dodge building 1,619
cost indexes, northeastern and north central states," published 1,620
by Marshall and Swift; 1,621
(b) One-half of the change in the consumer price index for 1,623
all items for all urban consumers, as published by the United 1,624
States bureau of labor statistics, during the time the lessor 1,625
held each asset until the beginning of the lease. 1,626
(3) Subject to the limitation specified in division (A)(1) 1,628
37
of this section, for a lease of a facility with a date of 1,629
licensure on or after May 27, 1992, that is initially operated 1,630
under a lease, actual, allowable cost of ownership shall include 1,631
the annual lease expense if there was a substantial commitment of 1,632
money for construction of the facility after December 22, 1992, 1,633
and before July 1, 1993. If there was not a substantial 1,634
commitment of money after December 22, 1992, and before July 1, 1,635
1993, actual, allowable cost of ownership shall include the 1,636
lesser of the annual lease expense or the sum of the following: 1,637
(a) The annual depreciation expense that would be 1,639
calculated at the inception of the lease using the lessor's 1,640
entire historical capital asset cost basis; 1,641
(b) The greater of the lessor's actual annual amortization 1,643
of financing costs and interest expense at the inception of the 1,644
lease or the imputed interest expense calculated at the inception 1,645
of the lease using seventy per cent of the lessor's historical 1,646
capital asset cost basis. 1,647
(4) Subject to the limitation specified in division (A)(1) 1,649
of this section, for a lease of a facility with a date of 1,650
licensure on or after May 27, 1992, that was not initially 1,651
operated under a lease and has been in existence for ten years, 1,652
actual, allowable cost of ownership shall include the lesser of 1,653
the annual lease expense or the annual depreciation expense and 1,654
imputed interest expense that would be calculated at the 1,655
inception of the lease using the entire historical capital asset 1,656
cost basis of the lessor, adjusted by the lesser of the 1,657
following: 1,658
(a) One-half of the change in construction costs during 1,660
the time the lessor held each asset until the beginning of the 1,661
lease, as calculated by the department using the "Dodge building 1,662
cost indexes, northeastern and north central states," published 1,663
by Marshall and Swift; 1,664
(b) One-half of the change in the consumer price index for 1,666
all items for all urban consumers, as published by the United 1,667
38
States bureau of labor statistics, during the time the lessor 1,668
held each asset until the beginning of the lease. 1,669
(5) Subject to the limitation specified in division (A)(1) 1,671
of this section, for a new lease of a facility that was operated 1,672
under a lease on May 27, 1992, actual, allowable cost of 1,673
ownership shall include the lesser of the annual new lease 1,674
expense or the annual old lease payment. If the old lease was in 1,675
effect for ten years or longer, the old lease payment from the 1,676
beginning of the old lease shall be adjusted by the lesser of the 1,677
following: 1,678
(a) One-half of the change in construction costs from the 1,680
beginning of the old lease to the beginning of the new lease, as 1,681
calculated by the department using the "Dodge building cost 1,682
indexes, northeastern and north central states," published by 1,683
Marshall and Swift; 1,684
(b) One-half of the change in the consumer price index for 1,686
all items for all urban consumers, as published by the United 1,687
States bureau of labor statistics, from the beginning of the old 1,688
lease to the beginning of the new lease. 1,689
(6) Subject to the limitation specified in division (A)(1) 1,691
of this section, for a new lease of a facility that was not in 1,692
existence or that was in existence but not operated under a lease 1,693
on May 27, 1992, actual, allowable cost of ownership shall 1,694
include the lesser of annual new lease expense or the annual 1,695
amount calculated for the old lease under division (C)(2), (3), 1,696
(4), or (6) of this section, as applicable. If the old lease was 1,697
in effect for ten years or longer, the lessor's historical 1,698
capital asset cost basis shall be adjusted by the lesser of the 1,699
following for purposes of calculating the annual amount under 1,700
division (C)(2), (3), (4), or (6) of this section: 1,701
(a) One-half of the change in construction costs from the 1,703
beginning of the old lease to the beginning of the new lease, as 1,704
calculated by the department using the "Dodge building cost 1,705
indexes, northeastern and north central states," published by 1,706
39
Marshall and Swift; 1,707
(b) One-half of the change in the consumer price index for 1,709
all items for all urban consumers, as published by the United 1,710
States bureau of labor statistics, from the beginning of the old 1,711
lease to the beginning of the new lease. 1,712
In the case of a lease under division (C)(3) of this 1,714
section of a facility for which a substantial commitment of money 1,715
was made after December 22, 1992, and before July 1, 1993, the 1,716
old lease payment shall be adjusted for the purpose of 1,717
determining the annual amount. 1,718
(7) For any revision of a lease described in division 1,720
(C)(1), (2), (3), (4), (5), or (6) of this section, or for any 1,721
subsequent lease of a facility operated under such a lease, other 1,722
than execution of a new lease, the portion of actual, allowable 1,723
cost of ownership attributable to the lease shall be the same as 1,724
before the revision or subsequent lease. 1,725
(8) Except as provided in division (C)(9) of this section, 1,728
if a provider leases an interest in a facility to another 1,729
provider who is a related party, the related party's actual, 1,731
allowable cost of ownership shall include the lesser of the 1,732
annual lease expense or the reasonable cost to the lessor. 1,733
(9) If a provider leases an interest in a facility to 1,735
another provider who is a related party, regardless of the date 1,737
of the lease, the related party's actual, allowable cost of 1,738
ownership shall include the annual lease expense, subject to the 1,739
limitations specified in divisions (C)(1) to (7) of this section, 1,740
if all of the following conditions are met: 1,741
(a) The related party is a relative of owner; 1,743
(b) If the lessor retains an ownership interest, it is in 1,746
only the real property and any improvements on the real property; 1,747
(c) The United States internal revenue service has issued 1,750
a ruling that the lease is an arm's length transaction for 1,751
purposes of federal income taxation;
(d) Except in the case of hardship caused by a 1,754
40
catastrophic event, as determined by the department, or in the 1,755
case of a lessor who is at least sixty-five years of age, not
less than twenty years have elapsed since, for the same facility, 1,757
the capital cost basis was adjusted most recently under division 1,758
(B)(5) of this section or actual, allowable cost of ownership was 1,760
determined most recently under division (C)(9) of this section. 1,762
(10) This division does not apply to leases of specific 1,764
items of equipment. 1,765
(D)(1) Subject to division (D)(2) of this section, the 1,767
department shall pay each nursing facility an efficiency 1,768
incentive that is equal to fifty per cent of the difference 1,769
between the following:
(a) Eighty-eight and sixty-five one-hundredths per cent of 1,771
the facility's desk-reviewed, actual, allowable, per diem cost of 1,772
ownership;
(b) The applicable amount specified in division (E) of 1,774
this section. 1,775
(2) The efficiency incentive paid to a nursing facility 1,778
shall not exceed the greater of the following:
(a) The efficiency incentive the facility was paid during 1,781
the fiscal year ending June 30, 1994;
(b) Three dollars per resident per day, adjusted annually 1,784
for rates paid beginning July 1, 1994, for the inflation rate for 1,785
the twelve-month period beginning on the first day of July of the 1,786
calendar year preceding the calendar year that precedes the 1,787
fiscal year for which the efficiency incentive is determined and 1,788
ending on the thirtieth day of the following June, using the 1,789
consumer price index for shelter costs for all urban consumers 1,790
for the north central region, as published by the United States 1,791
bureau of labor statistics. 1,792
(3) For purposes of calculating the efficiency incentive, 1,795
depreciation for costs that are paid or reimbursed by any 1,796
government agency shall be considered as costs of ownership, and 1,797
renovation costs that are paid under division (F) of this section 1,798
41
shall not be considered costs of ownership. 1,799
(E) The following amounts shall be used to calculate 1,801
efficiency incentives for nursing facilities under this section: 1,802
(1) For facilities with dates of licensure prior to 1,804
January 1, 1958, four dollars and twenty-four cents per patient 1,805
day; 1,806
(2) For facilities with dates of licensure after December 1,808
31, 1957, but prior to January 1, 1968: 1,809
(a) Five dollars and twenty-four cents per patient day if 1,811
the cost of construction was three thousand five hundred dollars 1,812
or more per bed; 1,813
(b) Four dollars and twenty-four cents per patient day if 1,815
the cost of construction was less than three thousand five 1,816
hundred dollars per bed. 1,817
(3) For facilities with dates of licensure after December 1,819
31, 1967, but prior to January 1, 1976: 1,820
(a) Six dollars and twenty-four cents per patient day if 1,822
the cost of construction was five thousand one hundred fifty 1,823
dollars or more per bed; 1,824
(b) Five dollars and twenty-four cents per patient day if 1,826
the cost of construction was less than five thousand one hundred 1,827
fifty dollars per bed, but exceeded three thousand five hundred 1,828
dollars per bed; 1,829
(c) Four dollars and twenty-four cents per patient day if 1,831
the cost of construction was three thousand five hundred dollars 1,832
or less per bed. 1,833
(4) For facilities with dates of licensure after December 1,835
31, 1975, but prior to January 1, 1979: 1,836
(a) Seven dollars and twenty-four cents per patient day if 1,838
the cost of construction was six thousand eight hundred dollars 1,839
or more per bed; 1,840
(b) Six dollars and twenty-four cents per patient day if 1,842
the cost of construction was less than six thousand eight hundred 1,843
dollars per bed but exceeded five thousand one hundred fifty 1,844
42
dollars per bed; 1,845
(c) Five dollars and twenty-four cents per patient day if 1,847
the cost of construction was five thousand one hundred fifty 1,848
dollars or less per bed, but exceeded three thousand five hundred 1,849
dollars per bed; 1,850
(d) Four dollars and twenty-four cents per patient day if 1,852
the cost of construction was three thousand five hundred dollars 1,853
or less per bed. 1,854
(5) For facilities with dates of licensure after December 1,856
31, 1978, but prior to January 1, 1981: 1,857
(a) Seven dollars and seventy-four cents per patient day 1,859
if the cost of construction was seven thousand six hundred 1,860
twenty-five dollars or more per bed; 1,861
(b) Seven dollars and twenty-four cents per patient day if 1,863
the cost of construction was less than seven thousand six hundred 1,864
twenty-five dollars per bed but exceeded six thousand eight 1,865
hundred dollars per bed; 1,866
(c) Six dollars and twenty-four cents per patient day if 1,868
the cost of construction was six thousand eight hundred dollars 1,869
or less per bed but exceeded five thousand one hundred fifty 1,870
dollars per bed; 1,871
(d) Five dollars and twenty-four cents per patient day if 1,873
the cost of construction was five thousand one hundred fifty 1,874
dollars or less but exceeded three thousand five hundred dollars 1,875
per bed; 1,876
(e) Four dollars and twenty-four cents per patient day if 1,878
the cost of construction was three thousand five hundred dollars 1,879
or less per bed. 1,880
(6) For facilities with dates of licensure in 1981 or any 1,882
year thereafter prior to December 22, 1992, the following amount: 1,883
(a) For facilities with construction costs less than seven 1,885
thousand six hundred twenty-five dollars per bed, the applicable 1,886
amounts for the construction costs specified in divisions 1,887
(E)(5)(b) to (e) of this section; 1,888
43
(b) For facilities with construction costs of seven 1,890
thousand six hundred twenty-five dollars or more per bed, six 1,891
dollars per patient day, provided that for 1981 and annually 1,892
thereafter prior to December 22, 1992, department shall do both 1,893
of the following to the six-dollar amount: 1,894
(i) Adjust the amount for fluctuations in construction 1,896
costs calculated by the department using the "Dodge building cost 1,897
indexes, northeastern and north central states," published by 1,898
Marshall and Swift, using 1980 as the base year; 1,899
(ii) Increase the amount, as adjusted for inflation under 1,901
division (E)(6)(b)(i) of this section, by one dollar and 1,902
seventy-four cents. 1,903
(7) For facilities with dates of licensure on or after 1,905
January 1, 1992, seven dollars and ninety-seven cents, adjusted 1,906
for fluctuations in construction costs between 1991 and 1993 as 1,907
calculated by the department using the "Dodge building cost 1,908
indexes, northeastern and north central states," published by 1,909
Marshall and Swift, and then increased by one dollar and 1,910
seventy-four cents. 1,911
For the fiscal year that begins July 1, 1994, each of the 1,913
amounts listed in divisions (E)(1) to (7) of this section shall 1,914
be increased by twenty-five cents. For the fiscal year that 1,915
begins July 1, 1995, each of those amounts shall be increased by 1,916
an additional twenty-five cents. For subsequent fiscal years, 1,917
each of those amounts, as increased for the prior fiscal year, 1,918
shall be adjusted to reflect the rate of inflation for the 1,919
twelve-month period beginning on the first day of July of the 1,920
calendar year preceding the calendar year that precedes the 1,921
fiscal year and ending on the following thirtieth day of June, 1,922
using the consumer price index for shelter costs for all urban 1,923
consumers for the north central region, as published by the 1,924
United States bureau of labor statistics. 1,925
If the amount established for a nursing facility under this 1,927
division is less than the amount that applied to the facility 1,928
44
under division (B) of former section 5111.25 of the Revised Code, 1,929
as the former section existed immediately prior to December 22, 1,930
1992, the amount used to calculate the efficiency incentive for 1,931
the facility under division (D)(2) of this section shall be the 1,932
amount that was calculated under division (B) of the former 1,933
section. 1,934
(F) Beginning July 1, 1993, regardless of the facility's 1,936
date of licensure or the date of the nonextensive renovations, 1,937
the rate for the costs of nonextensive renovations for nursing 1,938
facilities shall be eighty-five per cent of the desk-reviewed, 1,939
actual, allowable, per diem, nonextensive renovation costs. This 1,940
division applies to nonextensive renovations regardless of 1,941
whether they are made by an owner or a lessee. If the tenancy of 1,942
a lessee that has made nonextensive renovations ends before the 1,943
depreciation expense for the renovation costs has been fully 1,944
reported, the former lessee shall not report the undepreciated 1,945
balance as an expense. 1,946
(1) For a nonextensive renovation made after July 1, 1993, 1,948
to qualify for payment under this division, both of the following 1,949
conditions must be met: 1,950
(a) At least five years have elapsed since the date of 1,952
licensure of the portion of the facility that is proposed to be 1,953
renovated, except that this condition does not apply if the 1,954
renovation is necessary to meet the requirements of federal, 1,955
state, or local statutes, ordinances, rules, or policies. 1,956
(b) The provider has obtained prior approval from the 1,958
department of job and family services, and if required the 1,960
director of health has granted a certificate of need for the
renovation under section 3702.52 of the Revised Code. The 1,961
provider shall submit a plan that describes in detail the changes 1,962
in capital assets to be accomplished by means of the renovation 1,963
and the timetable for completing the project. The time for 1,964
completion of the project shall be no more than eighteen months 1,965
after the renovation begins. The DEPARTMENT of job and family 1,966
45
services shall adopt rules in accordance with Chapter 119. of the 1,967
Revised Code that specify criteria and procedures for prior 1,968
approval of renovation projects. No provider shall separate a 1,969
project with the intent to evade the characterization of the 1,970
project as a renovation or as an extensive renovation. No 1,971
provider shall increase the scope of a project after it is 1,972
approved by the department of job and family services unless the 1,973
increase in scope is approved by the department. 1,974
(2) The payment provided for in this division is the only 1,976
payment that shall be made for the costs of a nonextensive 1,977
renovation. Nonextensive renovation costs shall not be included 1,978
in costs of ownership, and a nonextensive renovation shall not 1,979
affect the date of licensure for purposes of calculating the 1,980
efficiency incentive under divisions (D) and (E) of this section. 1,981
(G) The owner of a nursing facility operating under a 1,983
provider agreement shall provide written notice to the department 1,984
of job and family services at least forty-five days prior to 1,986
entering into any contract of sale for the facility or
voluntarily terminating participation in the medical assistance 1,987
program. After the date on which a transaction of sale is 1,988
closed, the owner shall refund to the department the amount of 1,989
excess depreciation paid to the facility by the department for 1,990
each year the owner has operated the facility under a provider
agreement and prorated according to the number of medicaid 1,991
patient days for which the facility has received payment. If a 1,992
nursing facility is sold after five or fewer years of operation 1,993
under a provider agreement, the refund to the department shall be 1,995
equal to the excess depreciation paid to the facility. If a 1,996
nursing facility is sold after more than five years but less than
ten years of operation under a provider agreement, the refund to 1,997
the department shall equal the excess depreciation paid to the 1,998
facility multiplied by twenty per cent, multiplied by the 1,999
difference between ten and the number of years that the facility 2,000
was operated under a provider agreement. If a nursing facility 2,001
46
is sold after ten or more years of operation under a provider 2,002
agreement, the owner shall not refund any excess depreciation to 2,003
the department. The owner of a facility that is sold or that 2,004
voluntarily terminates participation in the medical assistance 2,005
program also shall refund any other amount that the department 2,006
properly finds to be due after the audit conducted under this 2,007
division. For the purposes of this division, "depreciation paid 2,008
to the facility" means the amount paid to the nursing facility 2,009
for cost of ownership pursuant to this section less any amount 2,010
paid for interest costs, amortization of financing costs, and 2,012
lease expenses. For the purposes of this division, "excess 2,013
depreciation" is the nursing facility's depreciated basis, which 2,014
is the owner's cost less accumulated depreciation, subtracted 2,015
from the purchase price net of selling costs but not exceeding 2,016
the amount of depreciation paid to the facility. 2,017
A cost report shall be filed with the department within 2,019
ninety days after the date on which the transaction of sale is 2,020
closed or participation is voluntarily terminated. The report 2,021
shall show the accumulated depreciation, the sales price, and 2,022
other information required by the department. The amount of the 2,023
last two monthly payments to a nursing facility made pursuant to 2,024
division (A)(1) of section 5111.22 of the Revised Code before a 2,025
sale or termination of participation shall be held in escrow by a 2,026
bank, trust company, or savings and loan association, except that 2,027
if the amount the owner will be required to refund under this 2,028
section is likely to be less than the amount of the last two 2,029
monthly payments, the department shall take one of the following 2,030
actions instead of withholding the amount of the last two monthly 2,031
payments: 2,032
(1) In the case of an owner that owns other facilities 2,034
that participate in the medical assistance program, obtain a 2,035
promissory note in an amount sufficient to cover the amount 2,036
likely to be refunded; 2,037
(2) In the case of all other owners, withhold the amount 2,039
47
of the last monthly payment to the nursing facility. 2,040
The department shall, within ninety days following the 2,042
filing of the cost report, audit the cost report and issue an 2,043
audit report to the owner. The department also may audit any 2,044
other cost report that the facility has filed during the previous 2,045
three years. In the audit report, the department shall state its 2,046
findings and the amount of any money owed to the department by 2,047
the nursing facility. The findings shall be subject to 2,048
adjudication conducted in accordance with Chapter 119. of the 2,049
Revised Code. No later than fifteen days after the owner agrees 2,050
to a settlement, any funds held in escrow less any amounts due to 2,051
the department shall be released to the owner and amounts due to 2,052
the department shall be paid to the department. If the amounts 2,053
in escrow are less than the amounts due to the department, the 2,054
balance shall be paid to the department within fifteen days after 2,055
the owner agrees to a settlement. If the department does not 2,056
issue its audit report within the ninety-day period, the 2,057
department shall release any money held in escrow to the owner. 2,058
For the purposes of this section, a transfer of corporate stock, 2,059
the merger of one corporation into another, or a consolidation 2,060
does not constitute a sale. 2,061
If a nursing facility is not sold or its participation is 2,063
not terminated after notice is provided to the department under 2,064
this division, the department shall order any payments held in 2,065
escrow released to the facility upon receiving written notice 2,066
from the owner that there will be no sale or termination. After 2,067
written notice is received from a nursing facility that a sale or 2,068
termination will not take place, the facility shall provide 2,069
notice to the department at least forty-five days prior to 2,070
entering into any contract of sale or terminating participation 2,071
at any future time. 2,072
(H) The department shall pay each eligible proprietary 2,074
nursing facility a return on the facility's net equity computed 2,075
at the rate of one and one-half times the average interest rate 2,076
48
on special issues of public debt obligations issued to the 2,077
federal hospital insurance trust fund for the cost reporting 2,078
period, except that no facility's return on net equity shall 2,079
exceed one dollar per patient day. 2,080
When calculating the rate for return on net equity, the 2,082
department shall use the greater of the facility's inpatient days 2,083
during the applicable cost reporting period or the number of 2,084
inpatient days the facility would have had during that period if 2,085
its occupancy rate had been ninety-five per cent. 2,086
(I) If a nursing facility would receive a lower rate for 2,088
capital costs for assets in the facility's possession on July 1, 2,089
1993, under this section than it would receive under former 2,090
section 5111.25 of the Revised Code, as the former section 2,091
existed immediately prior to December 22, 1992, the facility 2,092
shall receive for those assets the rate it would have received 2,093
under the former section for each fiscal year beginning on or 2,094
after July 1, 1993, until the rate it would receive under this 2,095
section exceeds the rate it would have received under the former 2,096
section. Any facility that receives a rate calculated under the 2,097
former section 5111.25 of the Revised Code for assets in the 2,098
facility's possession on July 1, 1993, also shall receive a rate 2,099
calculated under this section for costs of any assets it 2,100
constructs or acquires after July 1, 1993. 2,101
Sec. 5111.251. (A) The department of job and family 2,110
services shall pay each eligible intermediate care facility for 2,111
the mentally retarded for its reasonable capital costs, a per 2,112
resident per day rate established prospectively each fiscal year 2,113
for each intermediate care facility for the mentally retarded. 2,114
Except as otherwise provided in sections 5111.20 to 5111.32 of 2,115
the Revised Code, the rate shall be based on the facility's 2,116
capital costs for the calendar year preceding the fiscal year in 2,117
which the rate will be paid. The rate shall equal the sum of the 2,118
following:
(1) The facility's desk-reviewed, actual, allowable, per 2,120
49
diem cost of ownership for the preceding cost reporting period, 2,121
limited as provided in divisions (C) and (F) of this section; 2,122
(2) Any efficiency incentive determined under division (B) 2,124
of this section; 2,125
(3) Any amounts for renovations determined under division 2,127
(D) of this section; 2,128
(4) Any amounts for return on equity determined under 2,130
division (I) of this section. 2,131
Buildings shall be depreciated using the straight line 2,133
method over forty years or over a different period approved by 2,134
the department. Components and equipment shall be depreciated 2,135
using the straight line method over a period designated by the 2,136
director of job and family services in rules adopted in 2,138
accordance with Chapter 119. of the Revised Code, consistent with 2,139
the guidelines of the American hospital association, or over a 2,140
different period approved by the department of job and family 2,141
services. Any rules adopted under this division that specify 2,142
useful lives of buildings, components, or equipment apply only to 2,143
assets acquired on or after July 1, 1993. Depreciation for costs 2,144
paid or reimbursed by any government agency shall not be included 2,145
in costs of ownership or renovation unless that part of the 2,146
payment under sections 5111.20 to 5111.32 of the Revised Code is 2,147
used to reimburse the government agency. 2,148
(B) The department of job and family services shall pay to 2,151
each intermediate care facility for the mentally retarded an
efficiency incentive equal to fifty per cent of the difference 2,153
between any desk-reviewed, actual, allowable cost of ownership 2,154
and the applicable limit on cost of ownership payments under 2,155
division (C) of this section. For purposes of computing the 2,156
efficiency incentive, depreciation for costs paid or reimbursed 2,157
by any government agency shall be considered as a cost of
ownership, and the applicable limit under division (C) of this 2,158
section shall apply both to facilities with more than eight beds 2,159
and facilities with eight or fewer beds. The efficiency 2,160
50
incentive paid to a facility with eight or fewer beds shall not 2,161
exceed three dollars per patient day, adjusted annually for the 2,162
inflation rate for the twelve-month period beginning on the first 2,163
day of July of the calendar year preceding the calendar year that 2,164
precedes the fiscal year for which the efficiency incentive is 2,165
determined and ending on the thirtieth day of the following June, 2,166
using the consumer price index for shelter costs for all urban 2,167
consumers for the north central region, as published by the 2,168
United States bureau of labor statistics. 2,169
(C) Cost of ownership payments to intermediate care 2,171
facilities for the mentally retarded with more than eight beds 2,172
shall not exceed the following limits: 2,173
(1) For facilities with dates of licensure prior to 2,175
January 1, l958, not exceeding two dollars and fifty cents per 2,176
patient day; 2,177
(2) For facilities with dates of licensure after December 2,179
31, l957, but prior to January 1, l968, not exceeding: 2,180
(a) Three dollars and fifty cents per patient day if the 2,182
cost of construction was three thousand five hundred dollars or 2,183
more per bed; 2,184
(b) Two dollars and fifty cents per patient day if the 2,186
cost of construction was less than three thousand five hundred 2,187
dollars per bed. 2,188
(3) For facilities with dates of licensure after December 2,190
31, l967, but prior to January 1, l976, not exceeding: 2,191
(a) Four dollars and fifty cents per patient day if the 2,193
cost of construction was five thousand one hundred fifty dollars 2,194
or more per bed; 2,195
(b) Three dollars and fifty cents per patient day if the 2,197
cost of construction was less than five thousand one hundred 2,198
fifty dollars per bed, but exceeds three thousand five hundred 2,199
dollars per bed; 2,200
(c) Two dollars and fifty cents per patient day if the 2,202
cost of construction was three thousand five hundred dollars or 2,203
51
less per bed. 2,204
(4) For facilities with dates of licensure after December 2,206
31, l975, but prior to January 1, l979, not exceeding: 2,207
(a) Five dollars and fifty cents per patient day if the 2,209
cost of construction was six thousand eight hundred dollars or 2,210
more per bed; 2,211
(b) Four dollars and fifty cents per patient day if the 2,213
cost of construction was less than six thousand eight hundred 2,214
dollars per bed but exceeds five thousand one hundred fifty 2,215
dollars per bed; 2,216
(c) Three dollars and fifty cents per patient day if the 2,218
cost of construction was five thousand one hundred fifty dollars 2,219
or less per bed, but exceeds three thousand five hundred dollars 2,220
per bed; 2,221
(d) Two dollars and fifty cents per patient day if the 2,223
cost of construction was three thousand five hundred dollars or 2,224
less per bed. 2,225
(5) For facilities with dates of licensure after December 2,227
31, l978, but prior to January 1, l980, not exceeding: 2,228
(a) Six dollars per patient day if the cost of 2,230
construction was seven thousand six hundred twenty-five dollars 2,231
or more per bed; 2,232
(b) Five dollars and fifty cents per patient day if the 2,234
cost of construction was less than seven thousand six hundred 2,235
twenty-five dollars per bed but exceeds six thousand eight 2,236
hundred dollars per bed; 2,237
(c) Four dollars and fifty cents per patient day if the 2,239
cost of construction was six thousand eight hundred dollars or 2,240
less per bed but exceeds five thousand one hundred fifty dollars 2,241
per bed; 2,242
(d) Three dollars and fifty cents per patient day if the 2,244
cost of construction was five thousand one hundred fifty dollars 2,245
or less but exceeds three thousand five hundred dollars per bed; 2,246
(e) Two dollars and fifty cents per patient day if the 2,248
52
cost of construction was three thousand five hundred dollars or 2,249
less per bed. 2,250
(6) For facilities with dates of licensure after December 2,253
31, 1979, but prior to January 1, 1981, not exceeding: 2,254
(a) Twelve dollars per patient day if the beds were 2,256
originally licensed as residential facility beds by the 2,257
department of mental retardation and developmental disabilities; 2,258
(b) Six dollars per patient day if the beds were 2,260
originally licensed as nursing home beds by the department of 2,261
health.
(7) For facilities with dates of licensure after December 2,263
31, 1980, but prior to January 1, 1982, not exceeding: 2,264
(a) Twelve dollars per patient day if the beds were 2,266
originally licensed as residential facility beds by the 2,267
department of mental retardation and developmental disabilities; 2,268
(b) Six dollars and forty-five cents per patient day if 2,270
the beds were originally licensed as nursing home beds by the 2,271
department of health.
(8) For facilities with dates of licensure after December 2,273
31, 1981, but prior to January 1, 1983, not exceeding: 2,274
(a) Twelve dollars per patient day if the beds were 2,276
originally licensed as residential facility beds by the 2,277
department of mental retardation and developmental disabilities; 2,278
(b) Six dollars and seventy-nine cents per patient day if 2,280
the beds were originally licensed as nursing home beds by the 2,281
department of health.
(9) For facilities with dates of licensure after December 2,283
31, 1982, but prior to January 1, 1984, not exceeding: 2,284
(a) Twelve dollars per patient day if the beds were 2,286
originally licensed as residential facility beds by the 2,287
department of mental retardation and developmental disabilities; 2,288
(b) Seven dollars and nine cents per patient day if the 2,290
beds were originally licensed as nursing home beds by the 2,291
department of health.
53
(10) For facilities with dates of licensure after December 2,293
31, 1983, but prior to January 1, 1985, not exceeding: 2,294
(a) Twelve dollars and twenty-four cents per patient day 2,296
if the beds were originally licensed as residential facility beds 2,298
by the department of mental retardation and developmental 2,299
disabilities;
(b) Seven dollars and twenty-three cents per patient day 2,301
if the beds were originally licensed as nursing home beds by the 2,303
department of health.
(11) For facilities with dates of licensure after December 2,305
31, 1984, but prior to January 1, 1986, not exceeding: 2,306
(a) Twelve dollars and fifty-three cents per patient day 2,308
if the beds were originally licensed as residential facility beds 2,310
by the department of mental retardation and developmental 2,311
disabilities;
(b) Seven dollars and forty cents per patient day if the 2,313
beds were originally licensed as nursing home beds by the 2,315
department of health.
(12) For facilities with dates of licensure after December 2,317
31, 1985, but prior to January 1, 1987, not exceeding: 2,318
(a) Twelve dollars and seventy cents per patient day if 2,320
the beds were originally licensed as residential facility beds by 2,322
the department of mental retardation and developmental 2,323
disabilities;
(b) Seven dollars and fifty cents per patient day if the 2,325
beds were originally licensed as nursing home beds by the 2,327
department of health.
(13) For facilities with dates of licensure after December 2,329
31, 1986, but prior to January 1, 1988, not exceeding: 2,330
(a) Twelve dollars and ninety-nine cents per patient day 2,332
if the beds were originally licensed as residential facility beds 2,334
by the department of mental retardation and developmental 2,335
disabilities;
(b) Seven dollars and sixty-seven cents per patient day if 2,337
54
the beds were originally licensed as nursing home beds by the 2,339
department of health.
(14) For facilities with dates of licensure after December 2,341
31, 1987, but prior to January 1, 1989, not exceeding thirteen 2,342
dollars and twenty-six cents per patient day; 2,343
(15) For facilities with dates of licensure after December 2,345
31, 1988, but prior to January 1, 1990, not exceeding thirteen 2,346
dollars and forty-six cents per patient day; 2,347
(16) For facilities with dates of licensure after December 2,349
31, 1989, but prior to January 1, 1991, not exceeding thirteen 2,350
dollars and sixty cents per patient day; 2,351
(17) For facilities with dates of licensure after December 2,353
31, 1990, but prior to January 1, 1992, not exceeding thirteen 2,354
dollars and forty-nine cents per patient day; 2,355
(18) For facilities with dates of licensure after December 2,357
31, 1991, but prior to January 1, 1993, not exceeding thirteen 2,358
dollars and sixty-seven cents per patient day; 2,359
(19) For facilities with dates of licensure after December 2,361
31, 1992, not exceeding fourteen dollars and twenty-eight cents 2,362
per patient day.
(D) Beginning January 1, 1981, regardless of the original 2,364
date of licensure, the department of job and family services 2,366
shall pay a rate for the per diem capitalized costs of 2,367
renovations to intermediate care facilities for the mentally 2,368
retarded made after January 1, l981, not exceeding six dollars 2,369
per patient day using 1980 as the base year and adjusting the 2,370
amount annually until June 30, 1993, for fluctuations in 2,371
construction costs calculated by the department using the "Dodge 2,372
building cost indexes, northeastern and north central states," 2,373
published by Marshall and Swift. The payment provided for in 2,374
this division is the only payment that shall be made for the 2,375
capitalized costs of a nonextensive renovation of an intermediate 2,376
care facility for the mentally retarded. Nonextensive renovation 2,377
costs shall not be included in cost of ownership, and a 2,378
55
nonextensive renovation shall not affect the date of licensure 2,379
for purposes of division (C) of this section. This division 2,380
applies to nonextensive renovations regardless of whether they 2,381
are made by an owner or a lessee. If the tenancy of a lessee 2,382
that has made renovations ends before the depreciation expense 2,383
for the renovation costs has been fully reported, the former 2,384
lessee shall not report the undepreciated balance as an expense. 2,385
For a nonextensive renovation to qualify for payment under 2,387
this division, both of the following conditions must be met: 2,388
(1) At least five years have elapsed since the date of 2,390
licensure or date of an extensive renovation of the portion of 2,391
the facility that is proposed to be renovated, except that this 2,392
condition does not apply if the renovation is necessary to meet 2,393
the requirements of federal, state, or local statutes, 2,394
ordinances, rules, or policies. 2,395
(2) The provider has obtained prior approval from the 2,397
department of job and family services. The provider shall submit 2,399
a plan that describes in detail the changes in capital assets to 2,400
be accomplished by means of the renovation and the timetable for 2,401
completing the project. The time for completion of the project 2,402
shall be no more than eighteen months after the renovation 2,403
begins. The director of job and family services shall adopt 2,405
rules in accordance with Chapter 119. of the Revised Code that 2,407
specify criteria and procedures for prior approval of renovation 2,408
projects. No provider shall separate a project with the intent 2,409
to evade the characterization of the project as a renovation or 2,410
as an extensive renovation. No provider shall increase the scope 2,411
of a project after it is approved by the department of job and 2,412
family services unless the increase in scope is approved by the 2,413
department.
(E) The amounts specified in divisions (C) and (D) of this 2,415
section shall be adjusted beginning July 1, 1993, for the 2,416
estimated inflation for the twelve-month period beginning on the 2,417
first day of July of the calendar year preceding the calendar 2,418
56
year that precedes the fiscal year for which rate will be paid 2,419
and ending on the thirtieth day of the following June, using the 2,420
consumer price index for shelter costs for all urban consumers 2,421
for the north central region, as published by the United States 2,422
bureau of labor statistics. 2,423
(F)(1) For facilities of eight or fewer beds that have 2,425
dates of licensure or have been granted project authorization by 2,426
the department of mental retardation and developmental 2,427
disabilities before July 1, 1993, and for facilities of eight or 2,428
fewer beds that have dates of licensure or have been granted 2,429
project authorization after that date if the facilities 2,430
demonstrate that they made substantial commitments of funds on or 2,431
before that date, cost of ownership shall not exceed eighteen 2,432
dollars and thirty cents per resident per day. The 2,433
eighteen-dollar and thirty-cent amount shall be increased by the 2,434
change in the "Dodge building cost indexes, northeastern and 2,435
north central states," published by Marshall and Swift, during 2,436
the period beginning June 30, 1990, and ending July 1, 1993, and 2,437
by the change in the consumer price index for shelter costs for 2,438
all urban consumers for the north central region, as published by 2,439
the United States bureau of labor statistics, annually 2,440
thereafter. 2,441
(2) For facilities with eight or fewer beds that have 2,443
dates of licensure or have been granted project authorization by 2,444
the department of mental retardation and developmental 2,445
disabilities on or after July 1, 1993, for which substantial 2,446
commitments of funds were not made before that date, cost of 2,447
ownership payments shall not exceed the applicable amount 2,448
calculated under division (F)(1) of this section, if the 2,449
department of job and family services gives prior approval for 2,451
construction of the facility. If the department does not give
prior approval, cost of ownership payments shall not exceed the 2,452
amount specified in division (C) of this section. 2,453
(3) Notwithstanding divisions (D) and (F)(1) and (2) of 2,455
57
this section, the total payment for cost of ownership, cost of 2,456
ownership efficiency incentive, and capitalized costs of 2,457
renovations for an intermediate care facility for the mentally 2,458
retarded with eight or fewer beds shall not exceed the sum of the 2,459
limitations specified in divisions (C) and (D) of this section. 2,461
(G) Notwithstanding any provision of this section or 2,463
section 5111.24 of the Revised Code, the director of job and 2,465
family services may adopt rules in accordance with Chapter 119. 2,466
of the Revised Code that provide for a calculation of a combined 2,467
maximum payment limit for indirect care costs and cost of 2,468
ownership for intermediate care facilities for the mentally 2,469
retarded with eight or fewer beds.
(H) After June 30, 1980, the owner of an intermediate care 2,471
facility for the mentally retarded operating under a provider 2,472
agreement shall provide written notice to the department of job 2,474
and family services at least forty-five days prior to entering
into any contract of sale for the facility or voluntarily 2,476
terminating participation in the medical assistance program. 2,477
After the date on which a transaction of sale is closed, the 2,478
owner shall refund to the department the amount of excess 2,479
depreciation paid to the facility by the department for each year 2,480
the owner has operated the facility under a provider agreement 2,481
and prorated according to the number of medicaid patient days for 2,482
which the facility has received payment. If an intermediate care 2,483
facility for the mentally retarded is sold after five or fewer 2,484
years of operation under a provider agreement, the refund to the 2,485
department shall be equal to the excess depreciation paid to the 2,486
facility. If an intermediate care facility for the mentally 2,487
retarded is sold after more than five years but less than ten 2,488
years of operation under a provider agreement, the refund to the 2,489
department shall equal the excess depreciation paid to the 2,490
facility multiplied by twenty per cent, multiplied by the number 2,491
of years less than ten that a facility was operated under a 2,492
provider agreement. If an intermediate care facility for the 2,493
58
mentally retarded is sold after ten or more years of operation 2,494
under a provider agreement, the owner shall not refund any excess 2,495
depreciation to the department. For the purposes of this 2,496
division, "depreciation paid to the facility" means the amount 2,497
paid to the intermediate care facility for the mentally retarded 2,498
for cost of ownership pursuant to this section less any amount 2,499
paid for interest costs. For the purposes of this division, 2,500
"excess depreciation" is the intermediate care facility for the 2,501
mentally retarded's depreciated basis, which is the owner's cost 2,502
less accumulated depreciation, subtracted from the purchase price 2,503
but not exceeding the amount of depreciation paid to the 2,504
facility.
A cost report shall be filed with the department within 2,506
ninety days after the date on which the transaction of sale is 2,507
closed or participation is voluntarily terminated for an 2,508
intermediate care facility for the mentally retarded subject to 2,509
this division. The report shall show the accumulated 2,510
depreciation, the sales price, and other information required by 2,511
the department. The amount of the last two monthly payments to 2,512
an intermediate care facility for the mentally retarded made 2,513
pursuant to division (A)(1) of section 5111.22 of the Revised 2,514
Code before a sale or voluntary termination of participation 2,515
shall be held in escrow by a bank, trust company, or savings and 2,516
loan association, except that if the amount the owner will be 2,517
required to refund under this section is likely to be less than 2,518
the amount of the last two monthly payments, the department shall 2,519
take one of the following actions instead of withholding the 2,520
amount of the last two monthly payments: 2,521
(1) In the case of an owner that owns other facilities 2,523
that participate in the medical assistance program, obtain a 2,524
promissory note in an amount sufficient to cover the amount 2,525
likely to be refunded; 2,526
(2) In the case of all other owners, withhold the amount 2,528
of the last monthly payment to the intermediate care facility for 2,529
59
the mentally retarded. 2,530
The department shall, within ninety days following the 2,532
filing of the cost report, audit the report and issue an audit 2,533
report to the owner. The department also may audit any other 2,534
cost reports for the facility that have been filed during the 2,535
previous three years. In the audit report, the department shall 2,536
state its findings and the amount of any money owed to the 2,537
department by the intermediate care facility for the mentally 2,538
retarded. The findings shall be subject to an adjudication 2,539
conducted in accordance with Chapter 119. of the Revised Code. 2,540
No later than fifteen days after the owner agrees to a 2,541
settlement, any funds held in escrow less any amounts due to the 2,542
department shall be released to the owner and amounts due to the 2,543
department shall be paid to the department. If the amounts in 2,544
escrow are less than the amounts due to the department, the 2,545
balance shall be paid to the department within fifteen days after 2,546
the owner agrees to a settlement. If the department does not 2,547
issue its audit report within the ninety-day period, the 2,548
department shall release any money held in escrow to the owner. 2,549
For the purposes of this section, a transfer of corporate stock, 2,550
the merger of one corporation into another, or a consolidation 2,551
does not constitute a sale. 2,552
If an intermediate care facility for the mentally retarded 2,554
is not sold or its participation is not terminated after notice 2,555
is provided to the department under this division, the department 2,556
shall order any payments held in escrow released to the facility 2,557
upon receiving written notice from the owner that there will be 2,558
no sale or termination of participation. After written notice is 2,559
received from an intermediate care facility for the mentally 2,560
retarded that a sale or termination of participation will not 2,561
take place, the facility shall provide notice to the department 2,562
at least forty-five days prior to entering into any contract of 2,563
sale or terminating participation at any future time. 2,564
(I) The department of job and family services shall pay 2,566
60
each eligible proprietary intermediate care facility for the 2,567
mentally retarded a return on the facility's net equity computed 2,568
at the rate of one and one-half times the average of interest 2,569
rates on special issues of public debt obligations issued to the 2,570
federal hospital insurance trust fund for the cost reporting 2,571
period. No facility's return on net equity paid under this 2,572
division shall exceed one dollar per patient day. 2,573
In calculating the rate for return on net equity, the 2,575
department shall use the greater of the facility's inpatient days 2,576
during the applicable cost reporting period or the number of 2,577
inpatient days the facility would have had during that period if 2,578
its occupancy rate had been ninety-five per cent. 2,579
(J)(1) Except as provided in division (J)(2) of this 2,582
section, if a provider leases or transfers an interest in a 2,583
facility to another provider who is a related party, the related 2,585
party's allowable cost of ownership shall include the lesser of 2,586
the following:
(a) The annual lease expense or actual cost of ownership, 2,589
whichever is applicable;
(b) The reasonable cost to the lessor or provider making 2,592
the transfer.
(2) If a provider leases or transfers an interest in a 2,594
facility to another provider who is a related party, regardless 2,595
of the date of the lease or transfer, the related party's 2,597
allowable cost of ownership shall include the annual lease 2,598
expense or actual cost of ownership, whichever is applicable, 2,599
subject to the limitations specified in divisions (B) to (I) of 2,601
this section, if all of the following conditions are met: 2,602
(a) The related party is a relative of owner; 2,605
(b) In the case of a lease, if the lessor retains any 2,607
ownership interest, it is in only the real property and any 2,608
improvements on the real property; 2,609
(c) In the case of a transfer, the provider making the 2,612
transfer retains no ownership interest in the facility; 2,613
61
(d) The United States internal revenue service has issued 2,616
a ruling that the lease or transfer is an arm's length
transaction for purposes of federal income taxation; 2,617
(e) Except in the case of hardship caused by a 2,620
catastrophic event, as determined by the department, or in the 2,621
case of a lessor or provider making the transfer who is at least
sixty-five years of age, not less than twenty years have elapsed 2,622
since, for the same facility, allowable cost of ownership was 2,623
determined most recently under this division. 2,624
Sec. 5111.62. The proceeds of all fines, including 2,633
interest, collected under sections 5111.35 to 5111.62 of the 2,634
Revised Code shall be deposited in the state treasury to the 2,635
credit of the residents protection fund, which is hereby created. 2,636
Moneys in the fund shall be used solely for the protection of the 2,637
health or property of residents of nursing facilities in which 2,638
the department of health finds deficiencies, including payment 2,639
for the costs of relocation of residents to other facilities, 2,640
maintenance of operation of a facility pending correction of 2,641
deficiencies or closure, and reimbursement of residents for the 2,642
loss of money managed by the facility under section 3721.15 of 2,643
the Revised Code. The fund shall be maintained and administered 2,645
by the department of job and family services under rules 2,646
developed in consultation with the departments of health and 2,647
aging and adopted by the director of job and family services 2,649
under Chapter 119. of the Revised Code. 2,650
Section 2. That existing sections 173.19, 3702.525, 2,652
3721.21, 5111.20, 5111.25, 5111.251, and 5111.62 of the Revised 2,654
Code are hereby repealed.
Section 3. Notwithstanding the fourteen-month publishing 2,656
deadline established in section 173.46 of the Revised Code, the 2,657
Department of Aging shall not publish the Ohio Long-term Care 2,658
Consumer Guide unless it includes in the guide the results of 2,659
customer satisfaction surveys conducted under section 173.54 of 2,660
the Revised Code. For the purposes of this condition, the 2,661
62
department may publish the guide if it includes in the guide the 2,662
results of surveys of families of nursing facility residents 2,663
covering at least twenty-five per cent of the nursing facilities 2,664
in this state and it has established a process for conducting 2,665
both family and resident satisfaction surveys under section 2,666
173.54 of the Revised Code.
Section 4. All items in this section are hereby 2,668
appropriated as designated out of any moneys in the state 2,669
treasury to the credit of the designated fund group. For all 2,670
appropriations made in this act, those in the first column are 2,671
for fiscal year 2000 and those in the second column are for 2,672
fiscal year 2001. The appropriations made in this act are in 2,673
addition to any other appropriations made for the 1999-2001 2,674
biennium.
JFS DEPARTMENT OF JOB AND FAMILY SERVICES 2,676
General Revenue Fund 2,679
GRF 400-525 Health Care/Medicaid 2,682
State $ 0 $ 8,150,410 2,686
Federal $ 0 $ 11,699,590 2,689
Health Care Total $ 0 $ 19,850,000 2,692
Total GRF General Revenue Fund 2,693
Group
State $ 0 $ 8,150,410 2,697
Federal $ 0 $ 11,699,590 2,700
GRF Total $ 0 $ 19,850,000 2,703
TOTAL ALL BUDGET FUND GROUPS $ 0 $ 19,850,000 2,706
Health Care/Medicaid 2,709
Of the foregoing appropriation item 600-525, Health 2,711
Care/Medicaid, $3,650,000 shall be used in fiscal year 2001 to 2,712
support additional slots for the Department of Job and Family 2,713
Services' Ohio Home Care Waiver Program.
DMR DEPARTMENT OF MENTAL RETARDATION AND DEVELOPMENTAL 2,715
DISABILITIES
General Revenue Fund 2,717
63
GRF 322-413 Residential and 2,719
Support Services $ 0 $ 4,500,000 2,721
TOTAL GRF General Revenue Fund $ 0 $ 4,500,000 2,723
Federal Special Revenue Fund Group 2,726
3G6 322-639 Medicaid Waiver $ 0 $ 6,460,000 2,730
TOTAL FSR Federal Special Revenue $ 0 $ 6,460,000 2,733
Fund Group
TOTAL ALL BUDGET FUND GROUPS $ 0 $ 10,960,000 2,735
Residential and Support Services 2,738
Of the foregoing appropriation item 322-413, Residential 2,740
and Support Services, $4,500,000 shall be used in fiscal year 2,741
2001 as state matching funds to support additional slots for the 2,742
Individual Options Home and Community-based waiver program 2,743
operated pursuant to Title XVIII of the "Social Security Act," 49 2,744
Stat. 620 (1935), 42 U.S.C. 301, as amended.
Medicaid Waiver 2,746
Of the foregoing appropriation item 322-639, Medicaid 2,748
Waiver (Fund 3G6), $6,460,000 shall be used in fiscal year 2001 2,749
to support additional slots for the Individual Options Home and 2,750
Community-based waiver program operated pursuant to Title XVIII 2,751
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, 2,752
as amended.
AGE DEPARTMENT OF AGING 2,753
State Special Revenue Fund Group 2,754
5K9 490-613 Long-Term Care 2,757
Consumer Guide $ 0 $ 807,000 2,759
TOTAL SSR State Special Revenue 2,760
Fund Group $ 0 $ 807,000 2,763
TOTAL ALL BUDGET FUND GROUPS $ 0 $ 807,000 2,765
Long-Term Care Consumer Guide 2,768
Notwithstanding section 5111.62 of the Revised Code, not 2,770
later than July 15, 2000, the Director of Budget and Management 2,772
shall transfer $407,000 cash from Fund 4E3, Resident Protection 2,773
Fund, to Fund 5K9, Long-Term Care Consumer Guide Fund.
64
The foregoing appropriation item 490-613, Long-Term Care 2,775
Consumer Guide, shall be used by the Department of Aging for 2,776
costs associated with publishing the Ohio Long-Term Care Consumer 2,777
Guide.
DOH DEPARTMENT OF HEALTH 2,779
State Special Revenue Fund Group 2,781
5L1 440-623 Nursing Facility 2,783
Technical Assistance
Program $ 0 $ 1,400,000 2,785
TOTAL SSR State Special Revenue 2,786
Fund Group $ 0 $ 1,400,000 2,789
TOTAL ALL BUDGET FUND GROUPS $ 0 $ 1,400,000 2,792
Nursing Facility Technical Assistance Program 2,795
Notwithstanding section 5111.62 of the Revised Code, not 2,797
later than July 15, 2000, the Director of Budget and Management 2,799
shall transfer $1,400,000 cash from Fund 4E3, Resident Protection 2,800
Fund, to Fund 5L1, Nursing Facility Technical Assistance Fund, to 2,801
be used in accordance with section 3721.026 of the Revised Code. 2,802
Within the limits set forth in this act, the Director of 2,804
Budget and Management shall establish accounts indicating source 2,805
and amount of funds for each appropriation made in this act, and 2,806
shall determine the form and manner in which appropriation 2,807
accounts shall be maintained. Expenditures from appropriations 2,808
contained in this act shall be accounted for as though made in 2,809
Am. Sub. H.B. 283 of the 123rd General Assembly. 2,810
The appropriations made in this act are subject to all 2,812
provisions of Am. Sub. H.B. 283 of the 123rd General Assembly. 2,813
Section 5. (A) Notwithstanding division (Q)(1) of section 2,816
5111.20 of the Revised Code, when calculating indirect care costs 2,817
for the purpose of establishing rates under section 5111.24 or 2,818
5111.241 of the Revised Code for fiscal year 2001, "per diem," as 2,819
used in sections 5111.20 to 5111.32 of the Revised Code, means a 2,820
nursing facility's or intermediate care facility for the mentally 2,821
retarded's actual, allowable indirect care costs in the cost 2,822
65
reporting period divided by the greater of the facility's 2,823
inpatient days for that period or the number of inpatient days 2,824
the facility would have had during that period if its occupancy 2,825
rate had been seventy-five per cent.
(B) Notwithstanding division (Q)(2) of section 5111.20 of 2,827
the Revised Code, when calculating capital costs for the purpose 2,828
of establishing rates under section 5111.25 or 5111.251 of the 2,829
Revised Code for fiscal year 2001, "per diem," as used in 2,830
sections 5111.20 to 5111.32 of the Revised Code, means a nursing 2,831
facility's or intermediate care facility for the mentally 2,832
retarded's actual, allowable capital costs in the cost reporting 2,833
period divided by the greater of the facility's inpatient days 2,834
for that period or the number of inpatient days the facility 2,835
would have had during that period if its occupancy rate had been 2,836
eighty-five per cent.
(C) Notwithstanding section 5111.261 and division (C) of 2,838
section 5111.262 of the Revised Code, for costs incurred during 2,839
calendar year 1999, costs reported in a nursing facility's cost 2,840
report for purchased nursing services shall be allowable direct 2,841
care costs up to seventeen per cent of the nursing facility's 2,842
cost specified in the cost report for services provided that year 2,843
by registered nurses, licensed practical nurses, and nurse aides 2,844
who are employees of the facility, plus one-half of the amount by 2,845
which the reported costs for purchased nursing services exceed 2,846
that percentage. 2,847
(D) As soon as practicable, the Department of Job and 2,849
Family Services shall follow this section for the purpose of 2,850
calculating nursing facilities' and intermediate care facilities 2,851
for the mentally retarded's Medicaid reimbursement rates for 2,852
indirect care and capital costs for fiscal year 2001. If the 2,853
Department is unable to calculate the rates before it makes 2,854
payments for services provided during fiscal year 2001, the 2,855
Department shall pay a nursing facility or intermediate care 2,856
facility for the mentally retarded the difference between the 2,857
66
amount it pays the facility and the amount that would have been 2,858
paid had the Department made the calculation in time. 2,859
Section 6. Except for sections 3702.525, 5111.25, and 2,862
5111.251 of the Revised Code as amended by this act, the codified 2,863
and uncodified sections of law contained in this act are not 2,864
subject to the referendum and take effect on the later of July 1, 2,865
2000, or the day this act becomes law. The amendments to
sections 3702.525, 5111.25, and 5111.251 of the Revised Code made 2,866
by this act constitute items of law that are subject to the 2,867
referendum. Therefore, under Article II, Section 1c of the Ohio 2,868
Constitution and section 1.471 of the Revised Code, these items 2,869
of law take effect on the 91st day after this act is filed with 2,870
the Secretary of State. If, however, a referendum petition is 2,871
filed against these items of law, these items of law, unless 2,872
rejected at the referendum, take effect at the earliest time 2,873
permitted by law.