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To amend sections 173.401, 173.501, 3702.51, 3702.59, | 1 |
5111.65, 5111.651, 5111.68, 5111.681, 5111.685, | 2 |
5111.686, 5111.688, 5111.874, 5111.875, and | 3 |
5111.894; to amend, for the purpose of adopting a | 4 |
new section number as indicated in parentheses, | 5 |
section 5111.688 (5111.689); and to enact new | 6 |
section 5111.688 and section 173.404 of the | 7 |
Revised Code; and to amend Section 209.20 of Am. | 8 |
Sub. H.B. 1 of the 128th General Assembly to | 9 |
revise the waiting list provisions of the | 10 |
PASSPORT, PACE, and Assisted Living programs, to | 11 |
revise the law governing the collection of | 12 |
long-term care facilities' Medicaid debts, and to | 13 |
revise the law governing the reasons for denying a | 14 |
Certificate of Need application. | 15 |
Section 1. That sections 173.401, 173.501, 3702.51, 3702.59, | 16 |
5111.65, 5111.651, 5111.68, 5111.681, 5111.685, 5111.686, | 17 |
5111.688, 5111.874, 5111.875, and 5111.894 be amended; section | 18 |
5111.688 (5111.689) be amended for the purpose of adopting a new | 19 |
section number as indicated in parentheses; and new section | 20 |
5111.688 and section 173.404 of the Revised Code be enacted to | 21 |
read as follows: | 22 |
Sec. 173.401. (A) As used in this section: | 23 |
"Area agency on aging" has the same meaning as in section | 24 |
173.14 of the Revised Code. | 25 |
"Long-term care consultation program" means the program the | 26 |
department of aging is required to develop under section 173.42 of | 27 |
the Revised Code. | 28 |
"Long-term care consultation program administrator" or | 29 |
"administrator" means the department of aging or, if the | 30 |
department contracts with an area agency on aging or other entity | 31 |
to administer the long-term care consultation program for a | 32 |
particular area, that agency or entity. | 33 |
"Nursing facility" has the same meaning as in section 5111.20 | 34 |
of the Revised Code. | 35 |
"PASSPORT waiver" means the federal medicaid waiver granted | 36 |
by the United States secretary of health and human services that | 37 |
authorizes the PASSPORT program. | 38 |
(B) | 39 |
40 | |
41 | |
42 | |
43 | |
44 | |
shall establish a home first component of the PASSPORT program | 45 |
under which eligible individuals may be enrolled in the PASSPORT | 46 |
program in accordance with this section. An individual is eligible | 47 |
for the PASSPORT program's home first component if all of the | 48 |
following apply: | 49 |
(1) The individual is eligible for the PASSPORT program. | 50 |
(2) The individual is on the unified waiting list established | 51 |
under section 173.404 of the Revised Code. | 52 |
(3) At least one of the following applies: | 53 |
(a) The individual has been admitted to a nursing facility. | 54 |
(b) A physician has determined and documented in writing that | 55 |
the individual has a medical condition that, unless the individual | 56 |
is enrolled in home and community-based services such as the | 57 |
PASSPORT program, will require the individual to be admitted to a | 58 |
nursing facility within thirty days of the physician's | 59 |
determination. | 60 |
(c) The individual has been hospitalized and a physician has | 61 |
determined and documented in writing that, unless the individual | 62 |
is enrolled in home and community-based services such as the | 63 |
PASSPORT program, the individual is to be transported directly | 64 |
from the hospital to a nursing facility and admitted. | 65 |
(d) Both of the following apply: | 66 |
(i) The individual is the subject of a report made under | 67 |
section 5101.61 of the Revised Code regarding abuse, neglect, or | 68 |
exploitation or such a report referred to a county department of | 69 |
job and family services under section 5126.31 of the Revised Code | 70 |
or has made a request to a county department for protective | 71 |
services as defined in section 5101.60 of the Revised Code. | 72 |
(ii) A county department of job and family services and an | 73 |
area agency on aging have jointly documented in writing that, | 74 |
unless the individual is enrolled in home and community-based | 75 |
services such as the PASSPORT program, the individual should be | 76 |
admitted to a nursing facility. | 77 |
(C) Each month | 78 |
79 | |
area that the | 80 |
81 | |
82 | |
on aging | 83 |
84 | |
long-term care consultation program administrator serving the area | 85 |
in which the individual resides
| 86 |
administrator shall determine whether the PASSPORT program is | 87 |
appropriate for the individual and whether the individual would | 88 |
rather participate in the PASSPORT program than continue | 89 |
or begin to reside in
| 90 |
administrator determines that the PASSPORT program is appropriate | 91 |
for the individual and the individual would rather participate in | 92 |
the PASSPORT program than continue | 93 |
94 | |
department of aging. On receipt of the notice from the | 95 |
administrator, the department | 96 |
individual's enrollment in the PASSPORT program regardless of the | 97 |
98 | |
99 | |
100 | |
the Revised Code, unless the enrollment would cause the PASSPORT | 101 |
program to exceed any limit on the number of individuals who may | 102 |
be enrolled in the program as set by the United States secretary | 103 |
of health and human services in the PASSPORT waiver. | 104 |
(D) Each quarter, the department of aging shall certify to | 105 |
the director of budget and management the estimated increase in | 106 |
costs of the PASSPORT program resulting from enrollment of | 107 |
individuals in the PASSPORT program pursuant to this section. | 108 |
Sec. 173.404. (A) As used in this section: | 109 |
(1) "Department of aging-administered medicaid waiver | 110 |
component" means each of the following: | 111 |
(a) The PASSPORT program created under section 173.40 of the | 112 |
Revised Code; | 113 |
(b) The choices program created under section 173.403 of the | 114 |
Revised Code; | 115 |
(c) The assisted living program created under section 5111.89 | 116 |
of the Revised Code. | 117 |
(2) "PACE program" means the component of the medicaid | 118 |
program the department of aging administers pursuant to section | 119 |
173.50 of the Revised Code. | 120 |
(B) The department of aging shall establish a unified waiting | 121 |
list for department of aging-administered medicaid waiver | 122 |
components and the PACE program. Only individuals eligible for a | 123 |
department of aging-administered medicaid waiver component or the | 124 |
PACE program may be placed on the unified waiting list. | 125 |
Sec. 173.501. (A) As used in this section: | 126 |
"Nursing facility" has the same meaning as in section 5111.20 | 127 |
of the Revised Code. | 128 |
"PACE provider" has the same meaning as in 42 U.S.C. | 129 |
1396u-4(a)(3). | 130 |
(B) The department of aging shall establish a home first | 131 |
component of the PACE program under which eligible individuals may | 132 |
be enrolled in the PACE program in accordance with this section. | 133 |
An individual is eligible for the PACE program's home first | 134 |
component if all of the following apply: | 135 |
(1) The individual is eligible for the PACE program. | 136 |
(2) The individual is on the unified waiting list established | 137 |
under section 173.404 of the Revised Code. | 138 |
(3) At least one of the following applies: | 139 |
(a) The individual has been admitted to a nursing facility. | 140 |
(b) A physician has determined and documented in writing that | 141 |
the individual has a medical condition that, unless the individual | 142 |
is enrolled in home and community-based services such as the PACE | 143 |
program, will require the individual to be admitted to a nursing | 144 |
facility within thirty days of the physician's determination. | 145 |
(c) The individual has been hospitalized and a physician has | 146 |
determined and documented in writing that, unless the individual | 147 |
is enrolled in home and community-based services such as the PACE | 148 |
program, the individual is to be transported directly from the | 149 |
hospital to a nursing facility and admitted. | 150 |
(d) Both of the following apply: | 151 |
(i) The individual is the subject of a report made under | 152 |
section 5101.61 of the Revised Code regarding abuse, neglect, or | 153 |
exploitation or such a report referred to a county department of | 154 |
job and family services under section 5126.31 of the Revised Code | 155 |
or has made a request to a county department for protective | 156 |
services as defined in section 5101.60 of the Revised Code. | 157 |
(ii) A county department of job and family services and an | 158 |
area agency on aging have jointly documented in writing that, | 159 |
unless the individual is enrolled in home and community-based | 160 |
services such as the PACE program, the individual should be | 161 |
admitted to a nursing facility. | 162 |
(C) Each month, the department of aging shall | 163 |
164 | |
for the home first component of the PACE program
| 165 |
166 | |
167 | |
168 | |
the area in which the individual resides | 169 |
The PACE provider shall determine whether the PACE program is | 170 |
appropriate for the individual and whether the individual would | 171 |
rather participate in the PACE program than continue | 172 |
begin to reside in
| 173 |
determines that the PACE program is appropriate for the individual | 174 |
and the individual would rather participate in the PACE program | 175 |
than continue
| 176 |
facility, the PACE provider shall so notify the department of | 177 |
aging. On receipt of the notice from the PACE provider, the | 178 |
department of aging shall approve the individual's enrollment in | 179 |
the PACE program in accordance with priorities established in | 180 |
rules adopted under section 173.50 of the Revised Code. | 181 |
(D) Each quarter, the department of aging shall certify to | 182 |
the director of budget and management the estimated increase in | 183 |
costs of the PACE program resulting from enrollment of individuals | 184 |
in the PACE program pursuant to this section. | 185 |
Sec. 3702.51. As used in sections 3702.51 to 3702.62 of the | 186 |
Revised Code: | 187 |
(A) "Applicant" means any person that submits an application | 188 |
for a certificate of need and who is designated in the application | 189 |
as the applicant. | 190 |
(B) "Person" means any individual, corporation, business | 191 |
trust, estate, firm, partnership, association, joint stock | 192 |
company, insurance company, government unit, or other entity. | 193 |
(C) "Certificate of need" means a written approval granted by | 194 |
the director of health to an applicant to authorize conducting a | 195 |
reviewable activity. | 196 |
(D) "Health service area" means a geographic region | 197 |
designated by the director of health under section 3702.58 of the | 198 |
Revised Code. | 199 |
(E) "Health service" means a clinically related service, such | 200 |
as a diagnostic, treatment, rehabilitative, or preventive service. | 201 |
(F) "Health service agency" means an agency designated to | 202 |
serve a health service area in accordance with section 3702.58 of | 203 |
the Revised Code. | 204 |
(G) "Health care facility" means: | 205 |
(1) A hospital registered under section 3701.07 of the | 206 |
Revised Code; | 207 |
(2) A nursing home licensed under section 3721.02 of the | 208 |
Revised Code, or by a political subdivision certified under | 209 |
section 3721.09 of the Revised Code; | 210 |
(3) A county home or a county nursing home as defined in | 211 |
section 5155.31 of the Revised Code that is certified under Title | 212 |
XVIII or XIX of the "Social Security Act," 49 Stat. 620 (1935), 42 | 213 |
U.S.C.A. 301, as amended; | 214 |
(4) A freestanding dialysis center; | 215 |
(5) A freestanding inpatient rehabilitation facility; | 216 |
(6) An ambulatory surgical facility; | 217 |
(7) A freestanding cardiac catheterization facility; | 218 |
(8) A freestanding birthing center; | 219 |
(9) A freestanding or mobile diagnostic imaging center; | 220 |
(10) A freestanding radiation therapy center. | 221 |
A health care facility does not include the offices of | 222 |
private physicians and dentists whether for individual or group | 223 |
practice, residential facilities licensed under section 5123.19 of | 224 |
the Revised Code, or an institution for the sick that is operated | 225 |
exclusively for patients who use spiritual means for healing and | 226 |
for whom the acceptance of medical care is inconsistent with their | 227 |
religious beliefs, accredited by a national accrediting | 228 |
organization, exempt from federal income taxation under section | 229 |
501 of the Internal Revenue Code of 1986, 100 Stat. 2085, 26 | 230 |
U.S.C.A. 1, as amended, and providing twenty-four hour nursing | 231 |
care pursuant to the exemption in division (E) of section 4723.32 | 232 |
of the Revised Code from the licensing requirements of Chapter | 233 |
4723. of the Revised Code. | 234 |
(H) "Medical equipment" means a single unit of medical | 235 |
equipment or a single system of components with related functions | 236 |
that is used to provide health services. | 237 |
(I) "Third-party payer" means a health insuring corporation | 238 |
licensed under Chapter 1751. of the Revised Code, a health | 239 |
maintenance organization as defined in division (K) of this | 240 |
section, an insurance company that issues sickness and accident | 241 |
insurance in conformity with Chapter 3923. of the Revised Code, a | 242 |
state-financed health insurance program under Chapter 3701., | 243 |
4123., or 5111. of the Revised Code, or any self-insurance plan. | 244 |
(J) "Government unit" means the state and any county, | 245 |
municipal corporation, township, or other political subdivision of | 246 |
the state, or any department, division, board, or other agency of | 247 |
the state or a political subdivision. | 248 |
(K) "Health maintenance organization" means a public or | 249 |
private organization organized under the law of any state that is | 250 |
qualified under section 1310(d) of Title XIII of the "Public | 251 |
Health Service Act," 87 Stat. 931 (1973), 42 U.S.C. 300e-9. | 252 |
(L) "Existing health care facility" means either of the | 253 |
following: | 254 |
(1) A health care facility that is licensed or otherwise | 255 |
authorized to operate in this state in accordance with applicable | 256 |
law, including a county home or a county nursing home that is | 257 |
certified as of February 1, 2008, under Title XVIII or Title XIX | 258 |
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, | 259 |
as amended, is staffed and equipped to provide health care | 260 |
services, and is actively providing health services; | 261 |
(2) A health care facility that is licensed or otherwise | 262 |
authorized to operate in this state in accordance with applicable | 263 |
law, including a county home or a county nursing home that is | 264 |
certified as of February 1, 2008, under Title XVIII or Title XIX | 265 |
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, | 266 |
as amended, or that has beds registered under section 3701.07 of | 267 |
the Revised Code as skilled nursing beds or long-term care beds | 268 |
and has provided services for at least three hundred sixty-five | 269 |
consecutive days within the twenty-four months immediately | 270 |
preceding the date a certificate of need application is filed with | 271 |
the director of health. | 272 |
(M) "State" means the state of Ohio, including, but not | 273 |
limited to, the general assembly, the supreme court, the offices | 274 |
of all elected state officers, and all departments, boards, | 275 |
offices, commissions, agencies, institutions, and other | 276 |
instrumentalities of the state of Ohio. "State" does not include | 277 |
political subdivisions. | 278 |
(N) "Political subdivision" means a municipal corporation, | 279 |
township, county, school district, and all other bodies corporate | 280 |
and politic responsible for governmental activities only in | 281 |
geographic areas smaller than that of the state to which the | 282 |
sovereign immunity of the state attaches. | 283 |
(O) "Affected person" means: | 284 |
(1) An applicant for a certificate of need, including an | 285 |
applicant whose application was reviewed comparatively with the | 286 |
application in question; | 287 |
(2) The person that requested the reviewability ruling in | 288 |
question; | 289 |
(3) Any person that resides or regularly uses health care | 290 |
facilities within the geographic area served or to be served by | 291 |
the health care services that would be provided under the | 292 |
certificate of need or reviewability ruling in question; | 293 |
(4) Any health care facility that is located in the health | 294 |
service area where the health care services would be provided | 295 |
under the certificate of need or reviewability ruling in question; | 296 |
(5) Third-party payers that reimburse health care facilities | 297 |
for services in the health service area where the health care | 298 |
services would be provided under the certificate of need or | 299 |
reviewability ruling in question; | 300 |
(6) Any other person who testified at a public hearing held | 301 |
under division (B) of section 3702.52 of the Revised Code or | 302 |
submitted written comments in the course of review of the | 303 |
certificate of need application in question. | 304 |
(P) "Osteopathic hospital" means a hospital registered under | 305 |
section 3701.07 of the Revised Code that advocates osteopathic | 306 |
principles and the practice and perpetuation of osteopathic | 307 |
medicine by doing any of the following: | 308 |
(1) Maintaining a department or service of osteopathic | 309 |
medicine or a committee on the utilization of osteopathic | 310 |
principles and methods, under the supervision of an osteopathic | 311 |
physician; | 312 |
(2) Maintaining an active medical staff, the majority of | 313 |
which is comprised of osteopathic physicians; | 314 |
(3) Maintaining a medical staff executive committee that has | 315 |
osteopathic physicians as a majority of its members. | 316 |
(Q) "Ambulatory surgical facility" has the same meaning as in | 317 |
section 3702.30 of the Revised Code. | 318 |
(R) Except as provided in division (S) of this section, | 319 |
"reviewable activity" means any of the following activities: | 320 |
(1) The establishment, development, or construction of a new | 321 |
long-term care facility; | 322 |
(2) The replacement of an existing long-term care facility; | 323 |
(3) The renovation of a long-term care facility that involves | 324 |
a capital expenditure of two million dollars or more, not | 325 |
including expenditures for equipment, staffing, or operational | 326 |
costs; | 327 |
(4) Either of the following changes in long-term care bed | 328 |
capacity: | 329 |
(a) An increase in bed capacity; | 330 |
(b) A relocation of beds from one physical facility or site | 331 |
to another, excluding the relocation of beds within a long-term | 332 |
care facility or among buildings of a long-term care facility at | 333 |
the same site. | 334 |
(5) Any change in the health services, bed capacity, or site, | 335 |
or any other failure to conduct the reviewable activity in | 336 |
substantial accordance with the approved application for which a | 337 |
certificate of need concerning long-term care beds was granted, if | 338 |
the change is made within five years after the implementation of | 339 |
the reviewable activity for which the certificate was granted; | 340 |
(6) The expenditure of more than one hundred ten per cent of | 341 |
the maximum expenditure specified in a certificate of need | 342 |
concerning long-term care beds. | 343 |
(S) "Reviewable activity" does not include any of the | 344 |
following activities: | 345 |
(1) Acquisition of computer hardware or software; | 346 |
(2) Acquisition of a telephone system; | 347 |
(3) Construction or acquisition of parking facilities; | 348 |
(4) Correction of cited deficiencies that are in violation of | 349 |
federal, state, or local fire, building, or safety laws and rules | 350 |
and that constitute an imminent threat to public health or safety; | 351 |
(5) Acquisition of an existing health care facility that does | 352 |
not involve a change in the number of the beds, by service, or in | 353 |
the number or type of health services; | 354 |
(6) Correction of cited deficiencies identified by | 355 |
accreditation surveys of the joint commission on accreditation of | 356 |
healthcare organizations or of the American osteopathic | 357 |
association; | 358 |
(7) Acquisition of medical equipment to replace the same or | 359 |
similar equipment for which a certificate of need has been issued | 360 |
if the replaced equipment is removed from service; | 361 |
(8) Mergers, consolidations, or other corporate | 362 |
reorganizations of health care facilities that do not involve a | 363 |
change in the number of beds, by service, or in the number or type | 364 |
of health services; | 365 |
(9) Construction, repair, or renovation of bathroom | 366 |
facilities; | 367 |
(10) Construction of laundry facilities, waste disposal | 368 |
facilities, dietary department projects, heating and air | 369 |
conditioning projects, administrative offices, and portions of | 370 |
medical office buildings used exclusively for physician services; | 371 |
(11) Acquisition of medical equipment to conduct research | 372 |
required by the United States food and drug administration or | 373 |
clinical trials sponsored by the national institute of health. Use | 374 |
of medical equipment that was acquired without a certificate of | 375 |
need under division (S)(11) of this section and for which | 376 |
premarket approval has been granted by the United States food and | 377 |
drug administration to provide services for which patients or | 378 |
reimbursement entities will be charged shall be a reviewable | 379 |
activity. | 380 |
(12) Removal of asbestos from a health care facility. | 381 |
Only that portion of a project that meets the requirements of | 382 |
this division is not a reviewable activity. | 383 |
(T) "Small rural hospital" means a hospital that is located | 384 |
within a rural area, has fewer than one hundred beds, and to which | 385 |
fewer than four thousand persons were admitted during the most | 386 |
recent calendar year. | 387 |
(U) "Children's hospital" means any of the following: | 388 |
(1) A hospital registered under section 3701.07 of the | 389 |
Revised Code that provides general pediatric medical and surgical | 390 |
care, and in which at least seventy-five per cent of annual | 391 |
inpatient discharges for the preceding two calendar years were | 392 |
individuals less than eighteen years of age; | 393 |
(2) A distinct portion of a hospital registered under section | 394 |
3701.07 of the Revised Code that provides general pediatric | 395 |
medical and surgical care, has a total of at least one hundred | 396 |
fifty registered pediatric special care and pediatric acute care | 397 |
beds, and in which at least seventy-five per cent of annual | 398 |
inpatient discharges for the preceding two calendar years were | 399 |
individuals less than eighteen years of age; | 400 |
(3) A distinct portion of a hospital, if the hospital is | 401 |
registered under section 3701.07 of the Revised Code as a | 402 |
children's hospital and the children's hospital meets all the | 403 |
requirements of division (U)(1) of this section. | 404 |
(V) "Long-term care facility" means any of the following: | 405 |
(1) A nursing home licensed under section 3721.02 of the | 406 |
Revised Code or by a political subdivision certified under section | 407 |
3721.09 of the Revised Code; | 408 |
(2) The portion of any facility, including a county home or | 409 |
county nursing home, that is certified as a skilled nursing | 410 |
facility or a nursing facility under Title XVIII or XIX of the | 411 |
"Social Security Act"; | 412 |
(3) The portion of any hospital that contains beds registered | 413 |
under section 3701.07 of the Revised Code as skilled nursing beds | 414 |
or long-term care beds. | 415 |
(W) "Long-term care bed" means a bed in a long-term care | 416 |
facility. | 417 |
(X) "Freestanding birthing center" means any facility in | 418 |
which deliveries routinely occur, regardless of whether the | 419 |
facility is located on the campus of another health care facility, | 420 |
and which is not licensed under Chapter 3711. of the Revised Code | 421 |
as a level one, two, or three maternity unit or a limited | 422 |
maternity unit. | 423 |
(Y)(1) "Reviewability ruling" means a ruling issued by the | 424 |
director of health under division (A) of section 3702.52 of the | 425 |
Revised Code as to whether a particular proposed project is or is | 426 |
not a reviewable activity. | 427 |
(2) "Nonreviewability ruling" means a ruling issued under | 428 |
that division that a particular proposed project is not a | 429 |
reviewable activity. | 430 |
(Z)(1) "Metropolitan statistical area" means an area of this | 431 |
state designated a metropolitan statistical area or primary | 432 |
metropolitan statistical area in United States office of | 433 |
management and budget bulletin no. 93-17, June 30, 1993, and its | 434 |
attachments. | 435 |
(2) "Rural area" means any area of this state not located | 436 |
within a metropolitan statistical area. | 437 |
(AA) "County nursing home" has the same meaning as in section | 438 |
5155.31 of the Revised Code. | 439 |
(BB) "Principal participant" means both of the following: | 440 |
(1) A person who has an ownership or controlling interest of | 441 |
at least five per cent in an applicant, in a health care facility | 442 |
that is the subject of an application for a certificate of need, | 443 |
or in the owner or operator of the applicant or such a facility; | 444 |
(2) An officer, director, trustee, or general partner of an | 445 |
applicant, of a health care facility that is the subject of an | 446 |
application for a certificate of need, or of the owner or operator | 447 |
of the applicant or such a facility. | 448 |
(CC) "Actual harm but not immediate jeopardy deficiency" | 449 |
means a deficiency that, under 42 C.F.R. 488.404, either | 450 |
constitutes a pattern of deficiencies resulting in actual harm | 451 |
that is not immediate jeopardy or represents widespread | 452 |
deficiencies resulting in actual harm that is not immediate | 453 |
jeopardy. | 454 |
(DD) "Immediate jeopardy deficiency" means a deficiency that, | 455 |
under 42 C.F.R. 488.404, either constitutes a pattern of | 456 |
deficiencies resulting in immediate jeopardy to resident health or | 457 |
safety or represents widespread deficiencies resulting in | 458 |
immediate jeopardy to resident health or safety. | 459 |
Sec. 3702.59. (A) The director of health shall accept for | 460 |
review certificate of need applications as provided in sections | 461 |
3702.592, 3702.593, and 3702.594 of the Revised Code. | 462 |
(B)(1) The director shall not approve an application for a | 463 |
certificate of need for the addition of long-term care beds to an | 464 |
existing health care facility or for the development of a new | 465 |
health care facility if any of the following apply: | 466 |
| 467 |
are being placed has one or more waivers for life safety code | 468 |
deficiencies, one or more state fire code violations, or one or | 469 |
more state building code violations, and the project identified in | 470 |
the application does not propose to correct all life safety code | 471 |
deficiencies for which a waiver has been granted, all state fire | 472 |
code violations, and all state building code violations at the | 473 |
existing health care facility in which the beds are being placed; | 474 |
| 475 |
the application, a notice of proposed license revocation was | 476 |
issued under section 3721.03 of the Revised Code for the existing | 477 |
health care facility in which the beds are being placed or a | 478 |
nursing home owned or operated by the applicant or | 479 |
480 | |
481 | |
participant. | 482 |
| 483 |
application and is encompassed by the three most recent standard | 484 |
surveys of the existing health care facility in which the beds are | 485 |
being placed, | 486 |
(i) The facility was cited on three or more separate | 487 |
occasions for final, nonappealable actual harm but not immediate | 488 |
jeopardy deficiencies | 489 |
490 | |
491 | |
492 |
| 493 |
494 | |
495 | |
496 | |
separate occasions for final, nonappealable immediate jeopardy | 497 |
deficiencies | 498 |
499 | |
500 | |
501 |
| 502 |
503 | |
504 | |
505 | |
occasions for final, nonappealable actual harm but not immediate | 506 |
jeopardy deficiencies and on one occasion for a final, | 507 |
nonappealable immediate jeopardy deficiency. | 508 |
(d) More than two nursing homes owned or operated in this | 509 |
state by the applicant or | 510 |
511 | |
applicant or | 512 |
than twenty nursing homes in this state, more than ten per cent of | 513 |
those nursing homes, were each cited | 514 |
precedes the filing of the application for the certificate of need | 515 |
and is encompassed by the three most recent standard surveys of | 516 |
the nursing homes that were so cited in any of the following | 517 |
manners: | 518 |
(i) On three or more separate occasions for final, | 519 |
nonappealable actual harm but not immediate jeopardy deficiencies | 520 |
521 | |
522 | |
523 | |
524 |
| 525 |
526 | |
527 | |
528 | |
529 | |
530 | |
531 | |
532 |
(ii) On two or more separate occasions for final, | 533 |
nonappealable immediate jeopardy deficiencies
| 534 |
535 | |
536 | |
537 | |
538 |
(iii) On two separate occasions for final, nonappealable | 539 |
actual harm but not immediate jeopardy deficiencies and on one | 540 |
occasion for a final, nonappealable immediate jeopardy deficiency. | 541 |
| 542 |
543 | |
544 |
(2) In applying divisions (B)(1)(a) to | 545 |
section, the director shall not consider deficiencies or | 546 |
violations cited before the
| 547 |
principal participant acquired or began to own or operate the | 548 |
health care facility at which the deficiencies or violations were | 549 |
cited. The director may disregard deficiencies and violations | 550 |
cited after the health care facility was acquired or began to be | 551 |
operated by the | 552 |
participant if the deficiencies or violations were attributable to | 553 |
circumstances that arose under the previous owner or operator and | 554 |
the
| 555 |
implemented measures to alleviate the circumstances. In the case | 556 |
of an application proposing development of a new health care | 557 |
facility by relocation of beds, the director shall not consider | 558 |
deficiencies or violations that were solely attributable to the | 559 |
physical plant of the existing health care facility from which the | 560 |
beds are being relocated. | 561 |
(C) The director also shall accept for review any application | 562 |
for the conversion of infirmary beds to long-term care beds if the | 563 |
infirmary meets all of the following conditions: | 564 |
(1) Is operated exclusively by a religious order; | 565 |
(2) Provides care exclusively to members of religious orders | 566 |
who take vows of celibacy and live by virtue of their vows within | 567 |
the orders as if related; | 568 |
(3) Was providing care exclusively to members of such a | 569 |
religious order on January 1, 1994. | 570 |
At no time shall individuals other than those described in | 571 |
division (C)(2) of this section be admitted to a facility to use | 572 |
beds for which a certificate of need is approved under this | 573 |
division. | 574 |
Sec. 5111.65. As used in sections 5111.65 to | 575 |
5111.689 of the Revised Code: | 576 |
(A) "Affiliated operator" means an operator affiliated with | 577 |
either of the following: | 578 |
(1) The exiting operator for whom the affiliated operator is | 579 |
to assume liability for the entire amount of the exiting | 580 |
operator's debt under the medicaid program or the portion of the | 581 |
debt that represents the franchise permit fee the exiting operator | 582 |
owes; | 583 |
(2) The entering operator involved in the change of operator | 584 |
with the exiting operator specified in division (A)(1) of this | 585 |
section. | 586 |
(B) "Change of operator" means an entering operator becoming | 587 |
the operator of a nursing facility or intermediate care facility | 588 |
for the mentally retarded in the place of the exiting operator. | 589 |
(1) Actions that constitute a change of operator include the | 590 |
following: | 591 |
(a) A change in an exiting operator's form of legal | 592 |
organization, including the formation of a partnership or | 593 |
corporation from a sole proprietorship; | 594 |
(b) A transfer of all the exiting operator's ownership | 595 |
interest in the operation of the facility to the entering | 596 |
operator, regardless of whether ownership of any or all of the | 597 |
real property or personal property associated with the facility is | 598 |
also transferred; | 599 |
(c) A lease of the facility to the entering operator or the | 600 |
exiting operator's termination of the exiting operator's lease; | 601 |
(d) If the exiting operator is a partnership, dissolution of | 602 |
the partnership; | 603 |
(e) If the exiting operator is a partnership, a change in | 604 |
composition of the partnership unless both of the following apply: | 605 |
(i) The change in composition does not cause the | 606 |
partnership's dissolution under state law. | 607 |
(ii) The partners agree that the change in composition does | 608 |
not constitute a change in operator. | 609 |
(f) If the operator is a corporation, dissolution of the | 610 |
corporation, a merger of the corporation into another corporation | 611 |
that is the survivor of the merger, or a consolidation of one or | 612 |
more other corporations to form a new corporation. | 613 |
(2) The following, alone, do not constitute a change of | 614 |
operator: | 615 |
(a) A contract for an entity to manage a nursing facility or | 616 |
intermediate care facility for the mentally retarded as the | 617 |
operator's agent, subject to the operator's approval of daily | 618 |
operating and management decisions; | 619 |
(b) A change of ownership, lease, or termination of a lease | 620 |
of real property or personal property associated with a nursing | 621 |
facility or intermediate care facility for the mentally retarded | 622 |
if an entering operator does not become the operator in place of | 623 |
an exiting operator; | 624 |
(c) If the operator is a corporation, a change of one or more | 625 |
members of the corporation's governing body or transfer of | 626 |
ownership of one or more shares of the corporation's stock, if the | 627 |
same corporation continues to be the operator. | 628 |
| 629 |
the entering operator becomes the operator of the nursing facility | 630 |
or intermediate care facility for the mentally retarded. | 631 |
| 632 |
day that the last of the residents of the nursing facility or | 633 |
intermediate care facility for the mentally retarded resides in | 634 |
the facility. | 635 |
| 636 |
day the intermediate care facility for the mentally retarded | 637 |
ceases to accept medicaid patients. | 638 |
| 639 |
participation" means the day the nursing facility ceases to accept | 640 |
new medicaid patients other than the individuals who reside in the | 641 |
nursing facility on the day before the effective date of the | 642 |
voluntary withdrawal of participation. | 643 |
| 644 |
entity that will become the operator of a nursing facility or | 645 |
intermediate care facility for the mentally retarded when a change | 646 |
of operator occurs. | 647 |
| 648 |
(1) An operator that will cease to be the operator of a | 649 |
nursing facility or intermediate care facility for the mentally | 650 |
retarded on the effective date of a change of operator; | 651 |
(2) An operator that will cease to be the operator of a | 652 |
nursing facility or intermediate care facility for the mentally | 653 |
retarded on the effective date of a facility closure; | 654 |
(3) An operator of an intermediate care facility for the | 655 |
mentally retarded that is undergoing or has undergone a voluntary | 656 |
termination; | 657 |
(4) An operator of a nursing facility that is undergoing or | 658 |
has undergone a voluntary withdrawal of participation. | 659 |
| 660 |
of the building, or part of the building, that houses the facility | 661 |
as a nursing facility or intermediate care facility for the | 662 |
mentally retarded that results in the relocation of all of the | 663 |
facility's residents. A facility closure occurs regardless of any | 664 |
of the following: | 665 |
(a) The operator completely or partially replacing the | 666 |
facility by constructing a new facility or transferring the | 667 |
facility's license to another facility; | 668 |
(b) The facility's residents relocating to another of the | 669 |
operator's facilities; | 670 |
(c) Any action the department of health takes regarding the | 671 |
facility's certification under Title XIX of the "Social Security | 672 |
Act," 79 Stat. 286 (1965), 42 U.S.C. 1396, as amended, that may | 673 |
result in the transfer of part of the facility's survey findings | 674 |
to another of the operator's facilities; | 675 |
(d) Any action the department of health takes regarding the | 676 |
facility's license under Chapter 3721. of the Revised Code; | 677 |
(e) Any action the department of developmental disabilities | 678 |
takes regarding the facility's license under section 5123.19 of | 679 |
the Revised Code. | 680 |
(2) A facility closure does not occur if all of the | 681 |
facility's residents are relocated due to an emergency evacuation | 682 |
and one or more of the residents return to a medicaid-certified | 683 |
bed in the facility not later than thirty days after the | 684 |
evacuation occurs. | 685 |
| 686 |
care facility for the mentally retarded," "nursing facility," | 687 |
"operator," "owner," and "provider agreement" have the same | 688 |
meanings as in section 5111.20 of the Revised Code. | 689 |
| 690 |
election to terminate the participation of an intermediate care | 691 |
facility for the mentally retarded in the medicaid program but to | 692 |
continue to provide service of the type provided by a residential | 693 |
facility as defined in section 5123.19 of the Revised Code. | 694 |
| 695 |
operator's voluntary election to terminate the participation of a | 696 |
nursing facility in the medicaid program but to continue to | 697 |
provide service of the type provided by a nursing facility. | 698 |
Sec. 5111.651. Sections 5111.65 to | 699 |
Revised Code do not apply to a nursing facility or intermediate | 700 |
care facility for the mentally retarded that undergoes a facility | 701 |
closure, voluntary termination, voluntary withdrawal of | 702 |
participation, or change of operator on or before September 30, | 703 |
2005, if the exiting operator provided written notice of the | 704 |
facility closure, voluntary termination, voluntary withdrawal of | 705 |
participation, or change of operator to the department of job and | 706 |
family services on or before June 30, 2005. | 707 |
Sec. 5111.68. (A) On receipt of a written notice under | 708 |
section 5111.66 of the Revised Code of a facility closure, | 709 |
voluntary termination, or voluntary withdrawal of participation or | 710 |
a written notice under section 5111.67 of the Revised Code of a | 711 |
change of operator, the department of job and family services | 712 |
shall | 713 |
the medicaid program to the exiting operator, including | 714 |
overpayments the exiting operator disputes, and other actual and | 715 |
potential debts the exiting operator owes or may owe to the | 716 |
department and United States centers for medicare and medicaid | 717 |
services under the medicaid program, including a franchise permit | 718 |
fee. | 719 |
(B) In estimating the exiting operator's other actual and | 720 |
potential debts to the department and the United States centers | 721 |
for medicare and medicaid services under the medicaid program, the | 722 |
department shall | 723 |
director of job and family services shall establish in rules | 724 |
adopted under section 5111.689 of the Revised Code. The | 725 |
methodology shall provide for estimating all of the following that | 726 |
the department determines | 727 |
(1) Refunds due the department under section 5111.27 of the | 728 |
Revised Code; | 729 |
(2) Interest owed to the department and United States centers | 730 |
for medicare and medicaid services; | 731 |
(3) Final civil monetary and other penalties for which all | 732 |
right of appeal has been exhausted; | 733 |
(4) Money owed the department and United States centers for | 734 |
medicare and medicaid services from any outstanding final fiscal | 735 |
audit, including a final fiscal audit for the last fiscal year or | 736 |
portion thereof in which the exiting operator participated in the | 737 |
medicaid program; | 738 |
(5) Other amounts the department determines are applicable. | 739 |
| 740 |
741 | |
742 | |
743 | |
744 | |
745 | |
746 | |
747 | |
748 |
(C) The department shall provide the exiting operator written | 749 |
notice of the department's estimate under division (A) of this | 750 |
section not later than thirty days after the department receives | 751 |
the notice under section 5111.66 of the Revised Code of the | 752 |
facility closure, voluntary termination, or voluntary withdrawal | 753 |
of participation or the notice under section 5111.67 of the | 754 |
Revised Code of the change of operator. The department's written | 755 |
notice shall include the basis for the estimate. | 756 |
Sec. 5111.681. (A) Except as provided in | 757 |
(B) and (C) of this section, the department of job and family | 758 |
services | 759 |
payment due an exiting operator under the medicaid program | 760 |
| 761 |
762 | |
763 | |
764 | |
provided under division (C) of section 5111.68 of the Revised Code | 765 |
that the exiting operator owes or may owe to the department and | 766 |
United States centers for medicare and medicaid services under the | 767 |
medicaid program | 768 |
| 769 |
770 | |
771 | |
772 | |
773 | |
774 |
(B) | 775 |
division (D) of this section, the following shall apply regarding | 776 |
a withholding under division (A) of this section if the exiting | 777 |
operator or entering operator or an affiliated operator executes a | 778 |
successor liability agreement meeting the requirements of division | 779 |
(E) of this section: | 780 |
(1) If the exiting operator, entering operator, or affiliated | 781 |
operator assumes liability for the total, actual amount of debt | 782 |
the exiting operator owes the department and the United States | 783 |
centers for medicare and medicaid services under the medicaid | 784 |
program as determined under section 5111.685 of the Revised Code, | 785 |
the department | 786 |
787 | |
788 |
| 789 |
790 | |
791 |
| 792 |
793 | |
794 |
(2) If the exiting operator, entering operator, or affiliated | 795 |
operator assumes liability for only the portion of the amount | 796 |
specified in division (B)(1) of this section that represents the | 797 |
franchise permit fee the exiting operator owes, the department | 798 |
shall withhold not more than the difference between the total | 799 |
amount specified in the notice provided under division (C) of | 800 |
section 5111.68 of the Revised Code and the amount for which the | 801 |
exiting operator, entering operator, or affiliated operator | 802 |
assumes liability. | 803 |
(C) In the case of a voluntary termination, voluntary | 804 |
withdrawal of participation, or facility closure and subject to | 805 |
division (D) of this section, the following shall apply regarding | 806 |
a withholding under division (A) of this section if the exiting | 807 |
operator or an affiliated operator executes a successor liability | 808 |
agreement meeting the requirements of division (E) of this | 809 |
section: | 810 |
(1) If the exiting operator or affiliated operator assumes | 811 |
liability for the total, actual amount of debt the exiting | 812 |
operator owes the department and the United States centers for | 813 |
medicare and medicaid services under the medicaid program as | 814 |
determined under section 5111.685 of the Revised Code, the | 815 |
department shall not make the withholding. | 816 |
(2) If the exiting operator or affiliated operator assumes | 817 |
liability for only the portion of the amount specified in division | 818 |
(C)(1) of this section that represents the franchise permit fee | 819 |
the exiting operator owes, the department shall withhold not more | 820 |
than the difference between the total amount specified in the | 821 |
notice provided under division (C) of section 5111.68 of the | 822 |
Revised Code and the amount for which the exiting operator or | 823 |
affiliated operator assumes liability. | 824 |
(D) For an exiting operator or affiliated operator to be | 825 |
eligible to enter into a successor liability agreement under | 826 |
division (B) or (C) of this section, both of the following must | 827 |
apply: | 828 |
(1) The exiting operator or affiliated operator must have one | 829 |
or more valid provider agreements, other than the provider | 830 |
agreement for the nursing facility or intermediate care facility | 831 |
for the mentally retarded that is the subject of the voluntary | 832 |
termination, voluntary withdrawal of participation, facility | 833 |
closure, or change of operator; | 834 |
(2) During the twelve-month period preceding the month in | 835 |
which the department receives the notice of the voluntary | 836 |
termination, voluntary withdrawal of participation, or facility | 837 |
closure under section 5111.66 of the Revised Code or the notice of | 838 |
the change of operator under section 5111.67 of the Revised Code, | 839 |
the average monthly medicaid payment made to the exiting operator | 840 |
or affiliated operator pursuant to the exiting operator's or | 841 |
affiliated operator's one or more provider agreements, other than | 842 |
the provider agreement for the nursing facility or intermediate | 843 |
care facility for the mentally retarded that is the subject of the | 844 |
voluntary termination, voluntary withdrawal of participation, | 845 |
facility closure, or change of operator, must equal at least | 846 |
ninety per cent of the sum of the following: | 847 |
(a) The average monthly medicaid payment made to the exiting | 848 |
operator pursuant to the exiting operator's provider agreement for | 849 |
the nursing facility or intermediate care facility for the | 850 |
mentally retarded that is the subject of the voluntary | 851 |
termination, voluntary withdrawal of participation, facility | 852 |
closure, or change of operator; | 853 |
(b) Whichever of the following apply: | 854 |
(i) If the exiting operator or affiliated operator has | 855 |
assumed liability under one or more other successor liability | 856 |
agreements, the total amount for which the exiting operator or | 857 |
affiliated operator has assumed liability under the other | 858 |
successor liability agreements; | 859 |
(ii) If the exiting operator or affiliated operator has not | 860 |
assumed liability under any other successor liability agreements, | 861 |
zero. | 862 |
(E) A successor liability agreement executed under this | 863 |
section must comply with all of the following: | 864 |
(1) It must provide for the operator who executes the | 865 |
successor liability agreement to assume liability for either of | 866 |
the following as specified in the agreement: | 867 |
(a) The total, actual amount of debt the exiting operator | 868 |
owes the department and the United States centers for medicare and | 869 |
medicaid services under the medicaid program as determined under | 870 |
section 5111.685 of the Revised Code; | 871 |
(b) The portion of the amount specified in division (E)(1)(a) | 872 |
of this section that represents the franchise permit fee the | 873 |
exiting operator owes. | 874 |
(2) It may not require the operator who executes the | 875 |
successor liability agreement to furnish a surety bond. | 876 |
(3) It must provide that the department, after determining | 877 |
under section 5111.685 of the Revised Code the actual amount of | 878 |
debt the exiting operator owes the department and United States | 879 |
centers for medicare and medicaid services under the medicaid | 880 |
program, may deduct the lesser of the following from medicaid | 881 |
payments made to the operator who executes the successor liability | 882 |
agreement: | 883 |
(a) The total, actual amount of debt the exiting operator | 884 |
owes the department and the United States centers for medicare and | 885 |
medicaid services under the medicaid program as determined under | 886 |
section 5111.685 of the Revised Code; | 887 |
(b) The amount for which the operator who executes the | 888 |
successor liability agreement assumes liability under the | 889 |
agreement. | 890 |
(4) It must provide that the deductions authorized by | 891 |
division (E)(3) of this section are to be made for a number of | 892 |
months, not to exceed six, agreed to by the operator who executes | 893 |
the successor liability agreement and the department or, if the | 894 |
operator who executes the successor liability agreement and | 895 |
department cannot agree on a number of months that is less than | 896 |
six, a greater number of months determined by the attorney general | 897 |
pursuant to a claims collection process authorized by statute of | 898 |
this state. | 899 |
(5) It must provide that, if the attorney general determines | 900 |
the number of months for which the deductions authorized by | 901 |
division (E)(3) of this section are to be made, the operator who | 902 |
executes the successor liability agreement shall pay, in addition | 903 |
to the amount collected pursuant to the attorney general's claims | 904 |
collection process, the part of the amount so collected that, if | 905 |
not for division (G) of this section, would be required by section | 906 |
109.081 of the Revised Code to be paid into the attorney general | 907 |
claims fund. | 908 |
(F) Execution of a successor liability agreement does not | 909 |
waive an exiting operator's right to contest the amount specified | 910 |
in the notice the department provides the exiting operator under | 911 |
division (C) of section 5111.68 of the Revised Code. | 912 |
(G) Notwithstanding section 109.081 of the Revised Code, the | 913 |
entire amount that the attorney general, whether by employees or | 914 |
agents of the attorney general or by special counsel appointed | 915 |
pursuant to section 109.08 of the Revised Code, collects under a | 916 |
successor liability agreement, other than the additional amount | 917 |
the operator who executes the agreement is required by division | 918 |
(E)(5) of this section to pay, shall be paid to the department of | 919 |
job and family services for deposit into the appropriate fund. The | 920 |
additional amount that the operator is required to pay shall be | 921 |
paid into the state treasury to the credit of the attorney general | 922 |
claims fund created under section 109.081 of the Revised Code. | 923 |
Sec. 5111.685. The department of job and family services | 924 |
shall determine the actual amount of debt an exiting operator owes | 925 |
the department and the United States centers for medicare and | 926 |
medicaid services under the medicaid program by completing all | 927 |
final fiscal audits not already completed and performing all other | 928 |
appropriate actions the department determines to be necessary. The | 929 |
department shall issue | 930 |
matter not later than | 931 |
operator files the properly completed cost report required by | 932 |
section 5111.682 of the Revised Code with the department or, if | 933 |
the department waives the cost report requirement for the exiting | 934 |
operator, | 935 |
the cost report requirement.
| 936 |
937 | |
938 | |
939 | |
940 | |
941 | |
942 | |
summary report becomes the final debt summary report thirty-one | 943 |
days after the department issues the initial debt summary report | 944 |
unless the exiting operator, or an affiliated operator who | 945 |
executes a successor liability agreement under section 5111.681 of | 946 |
the Revised Code, requests a review before that date. | 947 |
The exiting operator, and an affiliated operator who executes | 948 |
a successor liability agreement under section 5111.681 of the | 949 |
Revised Code, may request a review to contest any of the | 950 |
department's findings included in the initial debt summary report. | 951 |
The request for the review must be submitted to the department not | 952 |
later than thirty days after the date the department issues the | 953 |
initial debt summary report. The department shall conduct the | 954 |
review on receipt of a timely request and issue a revised debt | 955 |
summary report. If the department has withheld money from payment | 956 |
due the exiting operator under division (A) of section 5111.681 of | 957 |
the Revised Code, the department shall issue the revised debt | 958 |
summary report not later than ninety days after the date the | 959 |
department receives the timely request for the review unless the | 960 |
department and exiting operator or affiliated operator agree to a | 961 |
later date. The exiting operator or affiliated operator may submit | 962 |
information to the department explaining what the operator | 963 |
contests before and during the review, including documentation of | 964 |
the amount of any debt the department owes the operator. The | 965 |
exiting operator or affiliated operator may submit additional | 966 |
information to the department not later than thirty days after the | 967 |
department issues the revised debt summary report. The revised | 968 |
debt summary report becomes the final debt summary report | 969 |
thirty-one days after the department issues the revised debt | 970 |
summary report unless the exiting operator or affiliated operator | 971 |
timely submits additional information to the department. If the | 972 |
exiting operator or affiliated operator timely submits additional | 973 |
information to the department, the department shall consider the | 974 |
additional information and issue a final debt summary report not | 975 |
later than sixty days after the department issues the revised debt | 976 |
summary report unless the department and exiting operator or | 977 |
affiliated operator agree to a later date. | 978 |
Each debt summary report the department issues under this | 979 |
section shall include the department's findings and the amount of | 980 |
debt the department determines the exiting operator owes the | 981 |
department and United States centers for medicare and medicaid | 982 |
services under the medicaid program. The department shall explain | 983 |
its findings and determination in each debt summary report. | 984 |
The exiting operator, and an affiliated operator who executes | 985 |
a successor liability agreement under section 5111.681 of the | 986 |
Revised Code, may request, in accordance with Chapter 119. of the | 987 |
Revised Code, an adjudication regarding a finding in a final debt | 988 |
summary report that pertains to an audit or alleged overpayment | 989 |
made under the medicaid program to the exiting operator. The | 990 |
adjudication shall be consolidated with any other uncompleted | 991 |
adjudication that concerns a matter addressed in the final debt | 992 |
summary report. | 993 |
Sec. 5111.686. The department of job and family services | 994 |
shall release the actual amount withheld under division (A) of | 995 |
section 5111.681 of the Revised Code, less any amount the exiting | 996 |
operator owes the department and United States centers for | 997 |
medicare and medicaid services under the medicaid program, as | 998 |
follows: | 999 |
(A) | 1000 |
1001 | |
1002 | |
debt summary report required by section 5111.685 of the Revised | 1003 |
Code not later than | 1004 |
operator files the properly completed cost report required by | 1005 |
section 5111.682 of the Revised Code, sixty-one days after the | 1006 |
date the exiting operator files the properly completed cost | 1007 |
report; | 1008 |
(B) | 1009 |
1010 | |
1011 | |
issues the initial debt summary report required by section | 1012 |
5111.685 of the Revised Code not later than | 1013 |
after the date the exiting operator files a properly completed | 1014 |
cost report required by section 5111.682 of the Revised Code, not | 1015 |
later than the following: | 1016 |
(1) Thirty days after the deadline for requesting an | 1017 |
adjudication under section 5111.685 of the Revised Code regarding | 1018 |
the final debt summary report if the exiting operator, and an | 1019 |
affiliated operator who executes a successor liability agreement | 1020 |
under section 5111.681 of the Revised Code, fail to request the | 1021 |
adjudication on or before the deadline; | 1022 |
(2) Thirty days after the completion of an adjudication of | 1023 |
the final debt summary report if the exiting operator, or an | 1024 |
affiliated operator who executes a successor liability agreement | 1025 |
under section 5111.681 of the Revised Code, requests the | 1026 |
adjudication on or before the deadline for requesting the | 1027 |
adjudication. | 1028 |
(C) | 1029 |
1030 | |
1031 | |
report required by section 5111.685 of the Revised Code not later | 1032 |
than | 1033 |
cost report requirement of section 5111.682 of the Revised Code, | 1034 |
sixty-one days after the date the department waives the cost | 1035 |
report requirement; | 1036 |
(D) | 1037 |
1038 | |
1039 | |
issues the initial debt summary report required by section | 1040 |
5111.685 of the Revised Code not later than | 1041 |
after the date the department waives the cost report requirement | 1042 |
of section 5111.682 of the Revised Code, not later than the | 1043 |
following: | 1044 |
(1) Thirty days after the deadline for requesting an | 1045 |
adjudication under section 5111.685 of the Revised Code regarding | 1046 |
the final debt summary report if the exiting operator, and an | 1047 |
affiliated operator who executes a successor liability agreement | 1048 |
under section 5111.681 of the Revised Code, fail to request the | 1049 |
adjudication on or before the deadline; | 1050 |
(2) Thirty days after the completion of an adjudication of | 1051 |
the final debt summary report if the exiting operator, or an | 1052 |
affiliated operator who executes a successor liability agreement | 1053 |
under section 5111.681 of the Revised Code, requests the | 1054 |
adjudication on or before the deadline for requesting the | 1055 |
adjudication. | 1056 |
Sec. 5111.688. (A) All amounts withheld under section | 1057 |
5111.681 of the Revised Code from payment due an exiting operator | 1058 |
under the medicaid program shall be deposited into the medicaid | 1059 |
payment withholding fund created by the controlling board pursuant | 1060 |
to section 131.35 of the Revised Code. Money in the fund shall be | 1061 |
used as follows: | 1062 |
(1) To pay an exiting operator when a withholding is released | 1063 |
to the exiting operator under section 5111.686 or 5111.687 of the | 1064 |
Revised Code; | 1065 |
(2) To pay the department of job and family services and | 1066 |
United States centers for medicare and medicaid services the | 1067 |
amount an exiting operator owes the department and United States | 1068 |
centers under the medicaid program. | 1069 |
(B) Amounts paid from the medicaid payment withholding fund | 1070 |
pursuant to division (A)(2) of this section shall be deposited | 1071 |
into the appropriate department fund. | 1072 |
| 1073 |
services shall adopt rules under section 5111.02 of the Revised | 1074 |
Code to implement sections 5111.65 to | 1075 |
Revised Code, including rules applicable to an exiting operator | 1076 |
that provides written notification under section 5111.66 of the | 1077 |
Revised Code of a voluntary withdrawal of participation. Rules | 1078 |
adopted under this section shall comply with section 1919(c)(2)(F) | 1079 |
of the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C. | 1080 |
1396r(c)(2)(F), regarding restrictions on transfers or discharges | 1081 |
of nursing facility residents in the case of a voluntary | 1082 |
withdrawal of participation. The rules may prescribe a medicaid | 1083 |
reimbursement methodology and other procedures that are applicable | 1084 |
after the effective date of a voluntary withdrawal of | 1085 |
participation that differ from the reimbursement methodology and | 1086 |
other procedures that would otherwise apply. | 1087 |
Sec. 5111.874. (A) As used in sections 5111.874 to 5111.8710 | 1088 |
of the Revised Code: | 1089 |
"Home and community-based services" has the same meaning as | 1090 |
in section 5123.01 of the Revised Code. | 1091 |
"ICF/MR services" means intermediate care facility for the | 1092 |
mentally retarded services covered by the medicaid program that an | 1093 |
intermediate care facility for the mentally retarded provides to a | 1094 |
resident of the facility who is a medicaid recipient eligible for | 1095 |
medicaid-covered intermediate care facility for the mentally | 1096 |
retarded services. | 1097 |
"Intermediate care facility for the mentally retarded" means | 1098 |
an intermediate care facility for the mentally retarded that is | 1099 |
certified as in compliance with applicable standards for the | 1100 |
medicaid program by the director of health in accordance with | 1101 |
Title XIX of the "Social Security Act," 79 Stat. 286 (1965), 42 | 1102 |
U.S.C. 1396, as amended, and licensed as a residential facility | 1103 |
under section 5123.19 of the Revised Code. | 1104 |
"Residential facility" has the same meaning as in section | 1105 |
5123.19 of the Revised Code. | 1106 |
(B) For the purpose of increasing the number of slots | 1107 |
available for home and community-based services and subject to | 1108 |
sections 5111.877 and 5111.878 of the Revised Code, the operator | 1109 |
of an intermediate care facility for the mentally retarded may | 1110 |
convert all of the beds in the facility from providing ICF/MR | 1111 |
services to providing home and community-based services if all of | 1112 |
the following requirements are met: | 1113 |
(1) The operator provides the directors of health, job and | 1114 |
family services, and developmental disabilities at least ninety | 1115 |
days' notice of the operator's intent to relinquish the facility's | 1116 |
certification as an intermediate care facility for the mentally | 1117 |
retarded and to begin providing home and community-based services. | 1118 |
(2) The operator complies with the requirements of sections | 1119 |
5111.65 to | 1120 |
voluntary termination as defined in section 5111.65 of the Revised | 1121 |
Code if those requirements are applicable. | 1122 |
(3) The operator notifies each of the facility's residents | 1123 |
that the facility is to cease providing ICF/MR services and inform | 1124 |
each resident that the resident may do either of the following: | 1125 |
(a) Continue to receive ICF/MR services by transferring to | 1126 |
another facility that is an intermediate care facility for the | 1127 |
mentally retarded willing and able to accept the resident if the | 1128 |
resident continues to qualify for ICF/MR services; | 1129 |
(b) Begin to receive home and community-based services | 1130 |
instead of ICF/MR services from any provider of home and | 1131 |
community-based services that is willing and able to provide the | 1132 |
services to the resident if the resident is eligible for the | 1133 |
services and a slot for the services is available to the resident. | 1134 |
(4) The operator meets the requirements for providing home | 1135 |
and community-based services, including the following: | 1136 |
(a) Such requirements applicable to a residential facility if | 1137 |
the operator maintains the facility's license as a residential | 1138 |
facility; | 1139 |
(b) Such requirements applicable to a facility that is not | 1140 |
licensed as a residential facility if the operator surrenders the | 1141 |
facility's residential facility license under section 5123.19 of | 1142 |
the Revised Code. | 1143 |
(5) The director of developmental disabilities approves the | 1144 |
conversion. | 1145 |
(C) The notice to the director of developmental disabilities | 1146 |
under division (B)(1) of this section shall specify whether the | 1147 |
operator wishes to surrender the facility's license as a | 1148 |
residential facility under section 5123.19 of the Revised Code. | 1149 |
(D) If the director of developmental disabilities approves a | 1150 |
conversion under division (B) of this section, the director of | 1151 |
health shall terminate the certification of the intermediate care | 1152 |
facility for the mentally retarded to be converted. The director | 1153 |
of health shall notify the director of job and family services of | 1154 |
the termination. On receipt of the director of health's notice, | 1155 |
the director of job and family services shall terminate the | 1156 |
operator's medicaid provider agreement that authorizes the | 1157 |
operator to provide ICF/MR services at the facility. The operator | 1158 |
is not entitled to notice or a hearing under Chapter 119. of the | 1159 |
Revised Code before the director of job and family services | 1160 |
terminates the medicaid provider agreement. | 1161 |
Sec. 5111.875. (A) For the purpose of increasing the number | 1162 |
of slots available for home and community-based services and | 1163 |
subject to sections 5111.877 and 5111.878 of the Revised Code, a | 1164 |
person who acquires, through a request for proposals issued by the | 1165 |
director of developmental disabilities, a residential facility | 1166 |
that is an intermediate care facility for the mentally retarded | 1167 |
and for which the license as a residential facility was previously | 1168 |
surrendered or revoked may convert some or all of the facility's | 1169 |
beds from providing ICF/MR services to providing home and | 1170 |
community-based services if all of the following requirements are | 1171 |
met: | 1172 |
(1) The person provides the directors of health, job and | 1173 |
family services, and developmental disabilities at least ninety | 1174 |
days' notice of the person's intent to make the conversion. | 1175 |
(2) The person complies with the requirements of sections | 1176 |
5111.65 to | 1177 |
voluntary termination as defined in section 5111.65 of the Revised | 1178 |
Code if those requirements are applicable. | 1179 |
(3) If the person intends to convert all of the facility's | 1180 |
beds, the person notifies each of the facility's residents that | 1181 |
the facility is to cease providing ICF/MR services and informs | 1182 |
each resident that the resident may do either of the following: | 1183 |
(a) Continue to receive ICF/MR services by transferring to | 1184 |
another facility that is an intermediate care facility for the | 1185 |
mentally retarded willing and able to accept the resident if the | 1186 |
resident continues to qualify for ICF/MR services; | 1187 |
(b) Begin to receive home and community-based services | 1188 |
instead of ICF/MR services from any provider of home and | 1189 |
community-based services that is willing and able to provide the | 1190 |
services to the resident if the resident is eligible for the | 1191 |
services and a slot for the services is available to the resident. | 1192 |
(4) If the person intends to convert some but not all of the | 1193 |
facility's beds, the person notifies each of the facility's | 1194 |
residents that the facility is to convert some of its beds from | 1195 |
providing ICF/MR services to providing home and community-based | 1196 |
services and inform each resident that the resident may do either | 1197 |
of the following: | 1198 |
(a) Continue to receive ICF/MR services from any provider of | 1199 |
ICF/MR services that is willing and able to provide the services | 1200 |
to the resident if the resident continues to qualify for ICF/MR | 1201 |
services; | 1202 |
(b) Begin to receive home and community-based services | 1203 |
instead of ICF/MR services from any provider of home and | 1204 |
community-based services that is willing and able to provide the | 1205 |
services to the resident if the resident is eligible for the | 1206 |
services and a slot for the services is available to the resident. | 1207 |
(5) The person meets the requirements for providing home and | 1208 |
community-based services at a residential facility. | 1209 |
(B) The notice provided to the directors under division | 1210 |
(A)(1) of this section shall specify whether some or all of the | 1211 |
facility's beds are to be converted. If some but not all of the | 1212 |
beds are to be converted, the notice shall specify how many of the | 1213 |
facility's beds are to be converted and how many of the beds are | 1214 |
to continue to provide ICF/MR services. | 1215 |
(C) On receipt of a notice under division (A)(1) of this | 1216 |
section, the director of health shall do the following: | 1217 |
(1) Terminate the certification of the intermediate care | 1218 |
facility for the mentally retarded if the notice specifies that | 1219 |
all of the facility's beds are to be converted; | 1220 |
(2) Reduce the facility's certified capacity by the number of | 1221 |
beds being converted if the notice specifies that some but not all | 1222 |
of the beds are to be converted. | 1223 |
(D) The director of health shall notify the director of job | 1224 |
and family services of the termination or reduction under division | 1225 |
(C) of this section. On receipt of the director of health's | 1226 |
notice, the director of job and family services shall do the | 1227 |
following: | 1228 |
(1) Terminate the person's medicaid provider agreement that | 1229 |
authorizes the person to provide ICF/MR services at the facility | 1230 |
if the facility's certification was terminated; | 1231 |
(2) Amend the person's medicaid provider agreement to reflect | 1232 |
the facility's reduced certified capacity if the facility's | 1233 |
certified capacity is reduced. | 1234 |
The person is not entitled to notice or a hearing under | 1235 |
Chapter 119. of the Revised Code before the director of job and | 1236 |
family services terminates or amends the medicaid provider | 1237 |
agreement. | 1238 |
Sec. 5111.894. | 1239 |
1240 | |
1241 | |
1242 | |
a home first component of the assisted living program under which | 1243 |
eligible individuals may be enrolled in the assisted living | 1244 |
program in accordance with this section. An individual is eligible | 1245 |
for the assisted living program's home first component if all of | 1246 |
the following apply: | 1247 |
(1) The individual is eligible for the assisted living | 1248 |
program. | 1249 |
(2) The individual is on the unified waiting list established | 1250 |
under section 173.404 of the Revised Code. | 1251 |
(3) At least one of the following applies: | 1252 |
(a) The individual has been admitted to a nursing facility. | 1253 |
(b) A physician has determined and documented in writing that | 1254 |
the individual has a medical condition that, unless the individual | 1255 |
is enrolled in home and community-based services such as the | 1256 |
assisted living program, will require the individual to be | 1257 |
admitted to a nursing facility within thirty days of the | 1258 |
physician's determination. | 1259 |
(c) The individual has been hospitalized and a physician has | 1260 |
determined and documented in writing that, unless the individual | 1261 |
is enrolled in home and community-based services such as the | 1262 |
assisted living program, the individual is to be transported | 1263 |
directly from the hospital to a nursing facility admitted. | 1264 |
(d) Both of the following apply: | 1265 |
(i) The individual is the subject of a report made under | 1266 |
section 5101.61 of the Revised Code regarding abuse, neglect, or | 1267 |
exploitation or such a report referred to a county department of | 1268 |
job and family services under section 5126.31 of the Revised Code | 1269 |
or has made a request to a county department for protective | 1270 |
services as defined in section 5101.60 of the Revised Code. | 1271 |
(ii) A county department of job and family services and an | 1272 |
area agency on aging have jointly documented in writing that, | 1273 |
unless the individual is enrolled in home and community-based | 1274 |
services such as the assisted living program, the individual | 1275 |
should be admitted to a nursing facility. | 1276 |
(e) The individual resided in a residential care facility for | 1277 |
at least six months immediately before applying for the assisted | 1278 |
living program and is at risk of imminent admission to a nursing | 1279 |
facility because the costs of residing in the residential care | 1280 |
facility have depleted the individual's resources such that the | 1281 |
individual is unable to continue to afford the cost of residing in | 1282 |
the residential care facility. | 1283 |
(B) Each month, each area agency on aging shall | 1284 |
1285 | |
in the area that the area agency on aging serves | 1286 |
1287 | |
assisted living program | 1288 |
1289 | |
an individual | 1290 |
determines that there is a vacancy in a residential care facility | 1291 |
participating in the assisted living program that is acceptable to | 1292 |
the individual, the agency shall notify the long-term care | 1293 |
consultation program administrator serving the area in which the | 1294 |
individual resides | 1295 |
shall determine whether the assisted living program is appropriate | 1296 |
for the individual and whether the individual would rather | 1297 |
participate in the assisted living program than continue
| 1298 |
or begin to reside in | 1299 |
determines that the assisted living program is appropriate for the | 1300 |
individual and the individual would rather participate in the | 1301 |
assisted living program than continue
| 1302 |
in | 1303 |
state administrative | 1304 |
| 1305 |
the state administrative agency shall approve the individual's | 1306 |
enrollment in the assisted living program regardless of | 1307 |
unified waiting list | 1308 |
under section 173.404 of the Revised Code, unless the enrollment | 1309 |
would cause the assisted living program to exceed any limit on the | 1310 |
number of individuals who may participate in the program as set by | 1311 |
the United States secretary of health and human services when the | 1312 |
medicaid waiver authorizing the program is approved. | 1313 |
(C) Each quarter, the state administrative agency shall | 1314 |
certify to the director of budget and management the estimated | 1315 |
increase in costs of the assisted living program resulting from | 1316 |
enrollment of individuals in the assisted living program pursuant | 1317 |
to this section. | 1318 |
Section 2. That existing sections 173.401, 173.501, 3702.51, | 1319 |
3702.59, 5111.65, 5111.651, 5111.68, 5111.681, 5111.685, 5111.686, | 1320 |
5111.688, 5111.874, 5111.875, and 5111.894 of the Revised Code are | 1321 |
hereby repealed. | 1322 |
Section 3. That Section 209.20 of Am. Sub. H.B. 1 of the | 1323 |
128th General Assembly be amended to read as follows: | 1324 |
Sec. 209.20. LONG-TERM CARE | 1325 |
Pursuant to an interagency agreement, the Department of Job | 1326 |
and Family Services shall designate the Department of Aging to | 1327 |
perform assessments under section 5111.204 of the Revised Code. | 1328 |
The Department of Aging shall provide long-term care consultations | 1329 |
under section 173.42 of the Revised Code to assist individuals in | 1330 |
planning for their long-term health care needs. The foregoing | 1331 |
appropriation items 490423, Long Term Care Budget – State, and | 1332 |
490623, Long Term Care Budget, may be used to provide the | 1333 |
preadmission screening and resident review (PASRR), which includes | 1334 |
screening, assessments, and determinations made under sections | 1335 |
5111.02, 5111.204, 5119.061, and 5123.021 of the Revised Code. | 1336 |
The foregoing appropriation items 490423, Long Term Care | 1337 |
Budget - State, and 490623, Long Term Care Budget, may be used to | 1338 |
assess and provide long-term care consultations to clients | 1339 |
regardless of Medicaid eligibility. | 1340 |
The Director of Aging shall adopt rules under section 111.15 | 1341 |
of the Revised Code governing the nonwaiver funded PASSPORT | 1342 |
program, including client eligibility. The foregoing appropriation | 1343 |
item 490423, Long Term Care Budget - State, may be used by the | 1344 |
Department of Aging to provide nonwaiver funded PASSPORT services | 1345 |
to persons the Department has determined to be eligible to | 1346 |
participate in the nonwaiver funded PASSPORT Program, including | 1347 |
those persons not yet determined to be financially eligible to | 1348 |
participate in the Medicaid waiver component of the PASSPORT | 1349 |
Program by a county department of job and family services. | 1350 |
The Department of Aging shall administer the Medicaid | 1351 |
waiver-funded PASSPORT Home Care Program, the Choices Program, the | 1352 |
Assisted Living Program, and the PACE Program as delegated by the | 1353 |
Department of Job and Family Services in an interagency agreement. | 1354 |
The foregoing appropriation item 490423, Long Term Care Budget - | 1355 |
State, shall be used to provide the required state match for | 1356 |
federal Medicaid funds supporting the Medicaid Waiver-funded | 1357 |
PASSPORT Home Care Program, the Choices Program, the Assisted | 1358 |
Living Program, and the PACE Program. The foregoing appropriation | 1359 |
items 490423, Long Term Care Budget - State, and 490623, Long Term | 1360 |
Care Budget, may also be used to support the Department of Aging's | 1361 |
administrative costs associated with operating the PASSPORT, | 1362 |
Choices, Assisted Living, and PACE programs. | 1363 |
The foregoing appropriation item 490623, Long Term Care | 1364 |
Budget, shall be used to provide the federal matching share for | 1365 |
all program costs determined by the Department of Job and Family | 1366 |
Services to be eligible for Medicaid reimbursement. | 1367 |
HOME FIRST PROGRAM | 1368 |
(A) As used in this section, "Long Term Care Budget Services" | 1369 |
includes the following existing programs: PASSPORT, Assisted | 1370 |
Living, Residential State Supplement, and PACE. | 1371 |
(B) On | 1372 |
expenditures related to sections 173.401, 173.351, 173.501, and | 1373 |
5111.894 of the Revised Code, the Director of Budget and | 1374 |
Management, in consultation with the Directors of Aging and Job | 1375 |
and Family Services, may do all of the following for fiscal years | 1376 |
2010 and 2011: | 1377 |
(1) Transfer cash from the Nursing Facility Stabilization | 1378 |
Fund (Fund 5R20), used by the Department of Job and Family | 1379 |
Services, to the PASSPORT/Residential State Supplement Fund (Fund | 1380 |
4J40), used by the Department of Aging. The | 1381 |
| 1382 |
item 490610, PASSPORT/Residential State Supplement. | 1383 |
(2) | 1384 |
PASSPORT Fund (Fund 3C40) for amounts that exceed the amounts | 1385 |
appropriated from receipts credited to the fund | 1386 |
1387 | |
1388 | |
1389 | |
1390 | |
appropriated. | 1391 |
(3) | 1392 |
Interagency Reimbursement Fund (Fund 3G50) for amounts that exceed | 1393 |
the amounts appropriated from receipts credited to the fund | 1394 |
1395 | |
1396 | |
1397 | |
1398 | |
amounts are hereby appropriated. | 1399 |
(C) Not later than thirty days after the Director of Budget | 1400 |
and Management receives certification of expenditures specified in | 1401 |
division (B) of this section, the Executive Director of Executive | 1402 |
Medicaid Management Administration shall submit a report to the | 1403 |
General Assembly in accordance with section 101.68 of the Revised | 1404 |
Code and to the chairs and ranking minority members of the | 1405 |
committees of the House of Representatives and Senate to which the | 1406 |
biennial budget bill is referred. The report shall describe and | 1407 |
document the criteria and data the Department of Aging, Department | 1408 |
of Job and Family Services, and Office of Budget and Management | 1409 |
use to justify a transfer of funds under division (B) of this | 1410 |
section, including spending and utilization trends for PASSPORT, | 1411 |
PACE, assisted living, and nursing facility services. In addition | 1412 |
to providing the information for the transfer of funds, the report | 1413 |
shall include the following: | 1414 |
(1) In the case of reports for transfers that occur during | 1416 |
fiscal year 2010, the descriptions and documents of the criteria | 1417 |
and data used to justify other such transfers that previously | 1418 |
occurred during that fiscal year; | 1419 |
(2) In the case of reports for transfers that occur during | 1420 |
fiscal year 2011, the descriptions and documents of the criteria | 1421 |
and data used to justify other such transfers that previously | 1422 |
occurred during that fiscal year and fiscal year 2010. | 1423 |
The Directors of Aging, Job and Family Services, and Budget | 1424 |
and Management shall provide the Executive Director of the | 1425 |
Executive Medicaid Management Administration with all information | 1426 |
the Executive Director needs to prepare the reports required by | 1427 |
this division. | 1428 |
(D) The individuals placed in Long Term Care Budget Services | 1429 |
pursuant to this section shall be in addition to the individuals | 1430 |
placed in Long Term Care Budget Services during fiscal years 2010 | 1431 |
and 2011 before any transfers to appropriation item 490423, Long | 1432 |
Term Care Budget-State, are made under this section. | 1433 |
ALLOCATION OF PACE SLOTS | 1434 |
In order to effectively administer and manage growth within | 1435 |
the PACE Program, the Director of Aging may, as the director deems | 1436 |
appropriate and to the extent funding is available, expand the | 1437 |
PACE Program to regions of Ohio beyond those currently served by | 1438 |
the PACE Program. In implementing the expansion, the Director may | 1439 |
not decrease the number of residents of Cuyahoga and Hamilton | 1440 |
counties and parts of Butler, Clermont, and Warren counties who | 1441 |
are participating in the PACE Program below the number of | 1442 |
residents of those counties and parts of counties who were | 1443 |
enrolled in the PACE Program on July 1, 2008. | 1444 |
Section 4. That existing Section 209.20 of Am. Sub. H.B. 1 of | 1445 |
the 128th General Assembly is hereby repealed. | 1446 |
Section 5. During fiscal years 2012 and 2013, on receipt of | 1447 |
certified expenditures related to sections 173.401, 173.351, | 1448 |
173.501, and 5111.894 of the Revised Code, the Director of Budget | 1449 |
and Management shall transfer cash from the Nursing Facility | 1450 |
Stabilization Fund (Fund 5R20), used by the Department of Job and | 1451 |
Family Services, to the PASSPORT/Residential State Supplement Fund | 1452 |
(Fund 4J40), used by the Department of Aging. | 1453 |
If receipts credited to the PASSPORT Fund (Fund 3C40) exceed | 1454 |
the amounts appropriated from the fund in fiscal years 2012 and | 1455 |
2013, the Director of Aging shall request the Director of Budget | 1456 |
and Management to authorize expenditures from the fund in excess | 1457 |
of the amounts appropriated. | 1458 |
If receipts credited to the Interagency Reimbursement Fund | 1459 |
(Fund 3G50) exceed the amounts appropriated from the fund in | 1460 |
fiscal years 2012 and 2013, the Director of Job and Family | 1461 |
Services shall request the Director of Budget and Management to | 1462 |
authorize expenditures from the fund in excess of the amounts | 1463 |
appropriated. | 1464 |
Section 6. (A) As used in this section, "population" means | 1465 |
that shown by the 2000 regular federal census. | 1466 |
(B) Until December 31, 2010, the Director of Health shall | 1467 |
accept, for review under section 3702.52 of the Revised Code, | 1468 |
certificate of need applications for an increase in beds in an | 1469 |
existing nursing home if all of the following conditions are met: | 1470 |
(1) The proposed increase is attributable solely to a | 1471 |
relocation of beds registered under section 3701.07 of the Revised | 1472 |
Code as long-term care beds from an existing hospital located in a | 1473 |
county with a population of at least forty thousand persons and | 1474 |
not more than forty-five thousand persons to an existing nursing | 1475 |
home located in a county that has a population of at least one | 1476 |
million persons and not more than one million one hundred thousand | 1477 |
persons and is contiguous to the county from which the beds are to | 1478 |
be relocated. | 1479 |
(2) Not more than fifteen beds are proposed for relocation. | 1480 |
(3) After the proposed relocation, there will be existing | 1481 |
long-term care beds, as defined in section 3702.51 of the Revised | 1482 |
Code, remaining in the county from which the beds are relocated. | 1483 |
(4) The beds are proposed to be licensed as nursing home beds | 1484 |
under Chapter 3721. of the Revised Code. | 1485 |
(C) In reviewing a certificate of need application accepted | 1486 |
under this section, the Director shall not deny the application on | 1487 |
the grounds that the existing hospital from which the beds are to | 1488 |
be relocated is not providing services in all or part of the | 1489 |
long-term care beds at the hospital or has not provided services | 1490 |
in all or part of those long-term care beds for at least three | 1491 |
hundred sixty-five days within the twenty-four months immediately | 1492 |
preceding the date the certificate of need application is filed | 1493 |
with the Director, as otherwise required by a rule adopted under | 1494 |
section 3702.57 of the Revised Code. | 1495 |