To amend sections 3701.83 and 5111.20 and to enact sections 3721.60, 3721.61, 3721.611, 3721.62, 3721.63, 3721.64, 3721.65, 3721.651, 3721.66, 3721.67, 3721.671, and 3721.68 to 3721.70 of the Revised Code to require the publication of the Ohio Nursing Facility Consumer Guide and to make an appropriation.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Sec. 3701.83. (A) There is hereby created in the state treasury the general operations fund. Moneys in the fund shall be used for the purposes specified in sections 3701.04, 3701.344, 3701.88, 3702.20, 3710.15, 3711.021, 3721.02, 3721.671, 3722.04, 3732.04, 3733.04, 3733.25, 3733.43, 3748.04, 3748.05, 3748.07, 3748.12, 3748.13, 3749.04, 3749.07, 4747.04, 4751.04, and 4769.09 of the Revised Code.

(B) The alcohol testing program fund is hereby created in the state treasury. The director of health shall use the fund to administer and enforce the alcohol testing and permit program authorized by section 3701.143 of the Revised Code.

The fund shall receive transfers from the liquor control fund created under section 4301.12 of the Revised Code. All investment earnings of the alcohol testing program fund shall be credited to the fund.

Sec. 3721.60. AS USED IN THIS SECTION AND SECTIONS 3721.61 TO 3721.70 OF THE REVISED CODE:

(A) "CLINICAL QUALITY INDICATOR" MEANS A MEASURE OF AN ASPECT OF THE PHYSICAL OR MENTAL CONDITIONS OF THE RESIDENTS OF A NURSING FACILITY THAT IS DERIVED FROM DATA TAKEN FROM RESIDENT ASSESSMENT INSTRUMENTS SUBMITTED BY NURSING FACILITIES FOR PURPOSES OF THE MEDICARE AND MEDICAID PROGRAMS.

(B) "MEDICAID" HAS THE SAME MEANING AS IN SECTION 5111.01 OF THE REVISED CODE.

(C) "MEDICARE" MEANS THE PROGRAM OPERATED PURSUANT TO TITLE XVIII OF THE "SOCIAL SECURITY ACT," 49 STAT. 620 (1935), 42 U.S.C.A. 301, AS AMENDED.

(D) "NURSING FACILITY" MEANS A FACILITY, OR A DISTINCT PART OF A FACILITY, THAT IS CERTIFIED AS A NURSING FACILITY OR A SKILLED NURSING FACILITY FOR PURPOSES OF THE MEDICARE OR MEDICAID PROGRAM.

(E) "STANDARD SURVEY" AND "DEFICIENCY" HAVE THE SAME MEANINGS AS IN SECTION 5111.35 OF THE REVISED CODE.

(F) "SURVEY DATA TAG" MEANS ANY OF THE DATA TAGS USED IN THE MEDICARE AND MEDICAID PROGRAMS FOR IDENTIFICATION OF SPECIFIC REGULATORY REQUIREMENTS.

Sec. 3721.61. THE DEPARTMENT OF HEALTH SHALL DEVELOP AND PUBLISH A GUIDE TO NURSING FACILITIES IN THIS STATE FOR USE BY INDIVIDUALS CONSIDERING NURSING FACILITY PLACEMENT AND THEIR FAMILIES, FRIENDS, AND ADVISORS. THE GUIDE SHALL BE TITLED THE OHIO NURSING FACILITY CONSUMER GUIDE.

THE CONSUMER GUIDE SHALL BE PUBLISHED BOTH IN COMPUTERIZED FORM FOR DISTRIBUTION OVER THE INTERNET AND IN PRINTED FORM FOR DISTRIBUTION AS A PAMPHLET, BOOKLET, OR BOOK. THE COMPUTERIZED FORM OF THE GUIDE SHALL BE MADE AVAILABLE NOT LATER THAN EIGHT MONTHS AFTER THE EFFECTIVE DATE OF THIS SECTION AND SHALL BE UPDATED IN ACCORDANCE WITH SECTION 3721.651 of the Revised Code. THE PRINTED FORM SHALL BE MADE AVAILABLE NOT LATER THAN NINE MONTHS AFTER THE EFFECTIVE DATE OF THIS SECTION. THEREAFTER, UPDATED VERSIONS SHALL BE PUBLISHED SEMIANNUALLY.

Sec. 3721.611. THE DEPARTMENT OF HEALTH MAY CONTRACT WITH ANY PERSON OR GOVERNMENT ENTITY TO PERFORM ANY FUNCTION RELATED TO THE PUBLICATION OF THE OHIO NURSING FACILITY CONSUMER GUIDE OR THE COLLECTION AND PREPARATION OF DATA AND OTHER MATERIAL FOR THE GUIDE, EXCEPT THAT THE DEPARTMENT SHALL CONTRACT TO HAVE THE CUSTOMER SATISFACTION SURVEYS CONDUCTED UNDER SECTION 3721.67 OF THE REVISED CODE. IN AWARDING THE CONTRACT TO HAVE THE SURVEYS CONDUCTED, THE DEPARTMENT SHALL CONTRACT WITH A PERSON OR GOVERNMENT ENTITY THAT HAS EXPERIENCE IN SURVEYING THE CUSTOMER SATISFACTION OF NURSING FACILITY RESIDENTS AND THEIR FAMILIES. THE DEPARTMENT'S CONTRACT SHALL PERMIT THE PERSON OR GOVERNMENT ENTITY TO SUBCONTRACT WITH OTHER PERSONS OR GOVERNMENT ENTITIES FOR PURPOSES OF CONDUCTING ALL OR PART OF THE SURVEYS.

Sec. 3721.62. IN DEVELOPING AND PUBLISHING THE OHIO NURSING FACILITY CONSUMER GUIDE, THE DEPARTMENT OF HEALTH SHALL ADHERE TO THE FOLLOWING PRINCIPLES:

(A) THE GUIDE SHOULD BE DESIGNED TO PROVIDE USERS WITH A VARIETY OF MEASURES OF NURSING FACILITY QUALITY AND WITH OTHER INFORMATION USEFUL IN COMPARING AND SELECTING NURSING FACILITIES.

(B) THE GUIDE SHOULD PRESENT THE INFORMATION SPECIFIED IN DIVISION (A) OF THIS SECTION IN A MANNER THAT IS EASY TO USE AND UNDERSTAND.

(C) THE GUIDE SHOULD ALLOW USERS TO DETERMINE WHICH MEASURES ARE MOST IMPORTANT TO THEM BUT SHALL NOT ESTABLISH A RANKING OR GRADING SYSTEM.

(D) THE INFORMATION IN THE GUIDE SHOULD BE KEPT AS CURRENT AS PRACTICABLE.

Sec. 3721.63. WITH REGARD TO THE ACCESSIBILITY OF THE OHIO NURSING FACILITY CONSUMER GUIDE, THE FOLLOWING SHALL APPLY:

(A) THE DEPARTMENT OF HEALTH SHALL MAKE THE GUIDE AVAILABLE TO ANY PERSON OR GOVERNMENT ENTITY AND SHALL NOT RESTRICT ACCESS BY REQUIRING PAYMENT OF A FEE, USE OF A PASSWORD, OR FULFILLMENT OF ANY OTHER CONDITION.

(B) THE DEPARTMENT OF HEALTH, THE DEPARTMENT OF HUMAN SERVICES, AND THE DEPARTMENT OF AGING SHALL DEVELOP AND IMPLEMENT PROGRAMS AND OTHER STRATEGIES TO ENCOURAGE USE OF THE GUIDE BY INDIVIDUALS CONSIDERING NURSING FACILITY PLACEMENT AND THEIR FAMILIES, FRIENDS, AND ADVISORS.

Sec. 3721.64. THE OHIO NURSING FACILITY CONSUMER GUIDE SHALL INCLUDE INFORMATION ON EACH NURSING FACILITY IN THIS STATE. FOR EACH FACILITY, THE GUIDE SHALL INCLUDE, TO THE EXTENT IT IS AVAILABLE TO THE DEPARTMENT OF HEALTH, ALL OF THE FOLLOWING INFORMATION:

(A) CUSTOMER SATISFACTION DATA OBTAINED UNDER SECTION 3721.67 OF THE REVISED CODE;

(B) CLINICAL QUALITY INDICATOR DATA OBTAINED UNDER SECTION 3721.68 OF THE REVISED CODE;

(C) DATA DERIVED FROM STANDARD SURVEYS OF EACH FACILITY, AS SPECIFIED IN DIVISION (C)(3) OF SECTION 3721.65 AND DIVISION (B)(3) OF SECTION 3721.66 OF THE REVISED CODE;

(D) ANY OTHER INFORMATION SPECIFIED IN SECTIONS 3721.60 TO 3721.70 OF THE REVISED CODE OR THE RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE.

Sec. 3721.65. THE OHIO NURSING FACILITY CONSUMER GUIDE, AS PUBLISHED IN COMPUTERIZED FORM, SHALL BE STRUCTURED IN ACCORDANCE WITH THIS SECTION AND ANY APPLICABLE RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE.

(A) THE OPENING ELECTRONIC PAGE OF THE CONSUMER GUIDE SHALL INCLUDE ALL OF THE FOLLOWING GENERAL INFORMATION:

(1) A DESCRIPTION OF THE GUIDE;

(2) DISCLAIMERS STATING THE LIMITATIONS OF THE DATA INCLUDED IN THE GUIDE. THE DISCLAIMERS SHALL INCLUDE A STATEMENT THAT STANDARD SURVEYS OF NURSING FACILITIES ARE CONDUCTED AT PERIODIC INTERVALS AND A STATEMENT THAT CONDITIONS AT A FACILITY CAN CHANGE SIGNIFICANTLY BETWEEN STANDARD SURVEYS.

(3) A RECOMMENDATION THAT INDIVIDUALS CONSIDERING NURSING FACILITY PLACEMENT VISIT ANY FACILITIES THEY ARE CONSIDERING;

(4) ELECTRONIC LINKS TO OTHER INFORMATION ON THE INTERNET ABOUT SELECTING NURSING FACILITIES, INCLUDING INFORMATION MAINTAINED BY PERTINENT GOVERNMENT AGENCIES AND PRIVATE ORGANIZATIONS AND TELEPHONE NUMBERS FOR THOSE AGENCIES AND ORGANIZATIONS;

(5) ANY OTHER INFORMATION THE DEPARTMENT SPECIFIES IN RULES ADOPTED UNDER SECTION 3721.69 of the Revised Code.

(B) THE CONSUMER GUIDE SHALL BE STRUCTURED IN A MANNER THAT ALLOWS THE USER TO SEARCH FOR INFORMATION IN THE GUIDE IN MULTIPLE WAYS, INCLUDING SEARCHES BY FACILITY NAME, COUNTY, AND MUNICIPALITY.

(C) THE FIRST INFORMATION TO APPEAR ON THE COMPUTER SCREEN FOLLOWING A SEARCH SHALL BE A LIST OF ALL FACILITIES IDENTIFIED BY THE SEARCH. FOR ALL OF THE FACILITIES LISTED, THE CONSUMER GUIDE SHALL PRESENT THE USER WITH SUMMARIZED COMPARATIVE INFORMATION, AS FOLLOWS:

(1) THE RESPONSES MADE BY FAMILIES TO TWO SEPARATE MEASURES OF CUSTOMER SATISFACTION INCLUDED IN THE SURVEYS CONDUCTED UNDER SECTION 3721.67 OF THE REVISED CODE. THE TWO MEASURES SHALL BE SPECIFIED IN RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE. FOR EACH MEASURE, THE GUIDE SHALL COMPARE THE RESPONSES FOR THE FACILITY TO THE STATEWIDE AVERAGE. THE RESPONSES SHALL BE EXPRESSED AS PERCENTAGES OF FAMILIES THAT ARE SATISFIED OR VERY SATISFIED WITH THE FACILITY.

(2) THE SCORES ON TWO SEPARATE CLINICAL QUALITY INDICATORS CALCULATED UNDER SECTION 3721.68 OF THE REVISED CODE. THE TWO INDICATORS SHALL BE SPECIFIED IN RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE. FOR EACH INDICATOR, THE GUIDE SHALL COMPARE THE FACILITY'S SCORE TO THE STATEWIDE AVERAGE. THE SCORES SHALL BE EXPRESSED AS PERCENTAGES.

(3) THE DATE OF THE FACILITY'S MOST RECENT STANDARD SURVEY, THE PERCENTAGE OF THE TOTAL NUMBER OF SURVEY DATA TAGS WITH RESPECT TO WHICH THE FACILITY WAS FOUND TO BE IN COMPLIANCE DURING THE SURVEY, THE STATEWIDE AVERAGE PERCENTAGE OF THE TOTAL NUMBER OF SURVEY DATA TAGS WITH RESPECT TO WHICH FACILITIES WERE FOUND TO BE IN COMPLIANCE DURING THE MOST RECENT STANDARD SURVEYS, AND THE DATE THE FACILITY ACHIEVED SUBSTANTIAL COMPLIANCE WITH MEDICARE AND MEDICAID CERTIFICATION REQUIREMENTS;

(4) AN ELECTRONIC LINK ALLOWING THE USER TO GAIN ACCESS TO THE FACILITY-SPECIFIC INFORMATION MAINTAINED UNDER DIVISION (D) OF THIS SECTION.

(D) IN ADDITION TO THE SUMMARIZED INFORMATION PROVIDED BY THE GUIDE PURSUANT TO DIVISION (C) OF THIS SECTION, THE GUIDE SHALL PROVIDE SPECIFIC COMPARATIVE INFORMATION ON EACH NURSING FACILITY. WHEN THE GUIDE'S USER OPENS AN ELECTRONIC LINK TO FACILITY-SPECIFIC INFORMATION, THE FIRST INFORMATION TO APPEAR ON THE COMPUTER SCREEN SHALL INCLUDE ALL OF THE FOLLOWING:

(1) THE NAME OF THE FACILITY AND ITS OWNER, THE FACILITY'S TELEPHONE NUMBER, AND THE FACILITY'S ADDRESS, INCLUDING THE COUNTY IN WHICH THE FACILITY IS LOCATED. THE GUIDE SHALL INCLUDE A COMPUTER FUNCTION THAT PINPOINTS ON A MAP THE FACILITY'S LOCATION.

(2) THE FACILITY'S STATUS WITH REGARD TO MEDICARE AND MEDICAID CERTIFICATION AND PRIVATE ACCREDITATION;

(3) THE NUMBER OF BEDS IN THE FACILITY;

(4) THE DIRECT CARE STAFFING LEVEL FOR THE FACILITY, COMPARED TO THE AVERAGE STAFFING LEVEL FOR FACILITIES IN THE FACILITY'S PEER GROUP, AS SPECIFIED IN RULES ADOPTED UNDER SECTION 3721.69 of the Revised Code. STAFFING LEVELS SHALL BE EXPRESSED ON A PER RESIDENT, PER DAY BASIS AND SHALL BE CALCULATED BY ADDING THE HOURS OF STAFFING PERFORMED BY NURSE AIDES, LICENSED PRACTICAL NURSES, AND REGISTERED NURSES, AS REPORTED ON THE MOST RECENT COST REPORTS FILED UNDER SECTION 5111.26 OF THE REVISED CODE, AND DIVIDING THE SUM BY THE NUMBER OF INPATIENT DAYS REPORTED ON THE COST REPORTS.

(5) AN ELECTRONIC LINK ALLOWING THE USER OF THE GUIDE TO GAIN ACCESS TO A LISTING OF SERVICES PROVIDED BY THE FACILITY. THE LISTING SHALL BE PRESENTED IN THE FORMAT SPECIFIED IN RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE.

(6) AT THE FACILITY'S OPTION, A PICTURE OF THE FACILITY, A BRIEF STATEMENT PROVIDED BY THE FACILITY, AND AN ELECTRONIC LINK TO ANY INFORMATION THE FACILITY MAINTAINS ABOUT ITSELF ON THE INTERNET;

(7) THE SUMMARIZED INFORMATION SPECIFIED IN DIVISION (C) OF THIS SECTION FOR THE FACILITY, WITH ELECTRONIC LINKS ALLOWING THE USER TO GAIN ACCESS TO ADDITIONAL INFORMATION PRESENTED AS FOLLOWS:

(a) FOR EACH QUESTION ASKED ON THE QUESTIONNAIRES USED IN THE RESIDENT AND FAMILY SURVEYS CONDUCTED UNDER SECTION 3721.67 OF THE REVISED CODE, THE GUIDE SHALL PRESENT THE CUSTOMER SATISFACTION RESPONSES TO THE FOUR-LEVEL SCALE USED IN ASKING THE QUESTION. THE RESPONSES FOR THE FACILITY SHALL BE COMPARED TO THE STATEWIDE AVERAGE AND SHALL BE EXPRESSED IN PERCENTAGES.

(b) FOR EACH CLINICAL QUALITY INDICATOR CALCULATED UNDER SECTION 3721.68 OF THE REVISED CODE, THE GUIDE SHALL PRESENT THE FACILITY'S SCORE COMPARED TO THE STATEWIDE AVERAGE SCORE. THE SCORES SHALL BE EXPRESSED AS PERCENTAGES.

(c) THE GUIDE SHALL PRESENT A LIST OF ALL SURVEY DATA TAGS FOR WHICH DEFICIENCIES WERE ISSUED DURING THE FACILITY'S MOST RECENT STANDARD SURVEY, A BRIEF DESCRIPTION PERTAINING TO EACH DATA TAG, DIRECTIONS OR ELECTRONIC LINKS FOR OBTAINING MORE INFORMATION ABOUT THE FACILITY'S SURVEY HISTORY AND, AT THE FACILITY'S OPTION, A BRIEF STATEMENT FROM THE FACILITY RESPONDING TO THE DATA TAGS FOR WHICH DEFICIENCIES WERE ISSUED.

Sec. 3721.651. THE DEPARTMENT OF HEALTH SHALL UPDATE INFORMATION IN THE COMPUTERIZED VERSION OF THE OHIO NURSING FACILITY CONSUMER GUIDE AS FOLLOWS:

(A) THE CUSTOMER SATISFACTION DATA OBTAINED UNDER SECTION 3721.67 OF THE REVISED CODE SHALL BE UPDATED SEMIANNUALLY FOLLOWING THE SURVEYS CONDUCTED UNDER THAT SECTION.

(B) THE CLINICAL QUALITY INDICATOR DATA OBTAINED UNDER SECTION 3721.68 OF THE REVISED CODE SHALL BE UPDATED IN JANUARY, APRIL, JULY, AND OCTOBER OF EACH YEAR, USING THE MOST RECENT RESIDENT ASSESSMENT DATA AVAILABLE TO THE DEPARTMENT.

(C) THE DATA DERIVED FROM STANDARD SURVEYS OF EACH FACILITY, AS SPECIFIED IN DIVISION (C)(3) OF SECTION 3721.65 AND DIVISION (B)(3) OF SECTION 3721.66 OF THE REVISED CODE, SHALL BE UPDATED WEEKLY, USING THE MOST RECENT STANDARD SURVEY DATA AVAILABLE TO THE DEPARTMENT. THE DEPARTMENT SHALL IMMEDIATELY MODIFY THE DATA INCLUDED IN THE CONSUMER GUIDE TO REFLECT EITHER OF THE FOLLOWING:

(1) ANY CHANGE IN THE SURVEY DATA RESULTING FROM INFORMAL DISPUTE RESOLUTION, APPEAL, OR ANY OTHER PROCESS;

(2) THE DATE OF CORRECTION OF ANY DEFICIENCY.

(D) ANY OTHER INFORMATION SPECIFIED IN SECTIONS 3721.60 TO 3721.70 OF THE REVISED CODE OR THE RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE SHALL BE UPDATED AT THE TIME SPECIFIED IN THOSE SECTIONS OR THE RULES.

Sec. 3721.66. THE OHIO NURSING FACILITY CONSUMER GUIDE, AS PUBLISHED IN PRINTED FORM, SHALL BE STRUCTURED IN ACCORDANCE WITH THIS SECTION AND ANY APPLICABLE RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE.

(A) THE CONSUMER GUIDE SHALL INCLUDE THE FOLLOWING GENERAL INFORMATION:

(1) A DESCRIPTION OF THE GUIDE, INCLUDING A REFERENCE TO THE COMPUTERIZED VERSION OF THE GUIDE MAINTAINED ON THE INTERNET;

(2) DISCLAIMERS STATING THE LIMITATIONS OF THE DATA INCLUDED IN THE GUIDE. THE DISCLAIMERS SHALL INCLUDE A STATEMENT THAT STANDARD SURVEYS OF NURSING FACILITIES ARE CONDUCTED AT PERIODIC INTERVALS AND A STATEMENT THAT CONDITIONS AT A FACILITY CAN CHANGE SIGNIFICANTLY BETWEEN STANDARD SURVEYS.

(3) A RECOMMENDATION THAT INDIVIDUALS CONSIDERING NURSING FACILITY PLACEMENT VISIT ANY FACILITY THEY ARE CONSIDERING;

(4) INFORMATION ABOUT SELECTING NURSING FACILITIES, INCLUDING REFERENCES TO INFORMATION MAINTAINED BY PERTINENT GOVERNMENT AGENCIES AND PRIVATE ORGANIZATIONS AND TELEPHONE NUMBERS FOR THOSE AGENCIES AND ORGANIZATIONS;

(5) ANY OTHER INFORMATION THE DEPARTMENT SPECIFIES IN RULES ADOPTED UNDER SECTION 3721.69 of the Revised Code.

(B) THE CONSUMER GUIDE SHALL PRESENT A LIST OF ALL NURSING FACILITIES IN THIS STATE, BY COUNTY. IN THE COUNTY LISTING, THE GUIDE SHALL INCLUDE FOR EACH NURSING FACILITY ALL OF THE FOLLOWING SUMMARIZED COMPARATIVE INFORMATION:

(1) THE RESPONSES MADE BY FAMILIES TO TWO SEPARATE MEASURES OF CUSTOMER SATISFACTION INCLUDED IN THE SURVEYS CONDUCTED UNDER SECTION 3721.67 OF THE REVISED CODE. THE TWO MEASURES SHALL BE SPECIFIED IN RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE. FOR EACH MEASURE, THE GUIDE SHALL COMPARE THE RESPONSES FOR THE FACILITY TO THE STATEWIDE AVERAGE. THE RESPONSES SHALL BE EXPRESSED AS PERCENTAGES OF FAMILIES THAT ARE SATISFIED OR VERY SATISFIED WITH THE FACILITY.

(2) THE SCORES ON TWO SEPARATE CLINICAL QUALITY INDICATORS CALCULATED UNDER SECTION 3721.68 OF THE REVISED CODE. THE TWO INDICATORS SHALL BE SPECIFIED IN RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE. FOR EACH INDICATOR, THE GUIDE SHALL COMPARE THE FACILITY'S SCORE TO THE STATEWIDE AVERAGE. THE SCORES SHALL BE EXPRESSED AS PERCENTAGES.

(3) THE DATE OF THE FACILITY'S MOST RECENT STANDARD SURVEY, THE PERCENTAGE OF THE TOTAL NUMBER OF SURVEY DATA TAGS WITH RESPECT TO WHICH THE FACILITY WAS FOUND TO BE IN COMPLIANCE DURING THE SURVEY, THE STATEWIDE AVERAGE PERCENTAGE OF THE TOTAL NUMBER OF SURVEY DATA TAGS ISSUED DURING THE MOST RECENT STANDARD SURVEYS WITH RESPECT TO WHICH FACILITIES WERE FOUND TO BE IN COMPLIANCE, AND THE DATE THE FACILITY ACHIEVED SUBSTANTIAL COMPLIANCE WITH MEDICARE AND MEDICAID CERTIFICATION REQUIREMENTS.

(C) FOLLOWING THE SUMMARIZED INFORMATION PROVIDED BY THE GUIDE PURSUANT TO DIVISION (B) OF THIS SECTION, THE GUIDE SHALL PROVIDE SPECIFIC COMPARATIVE INFORMATION ON EACH NURSING FACILITY. THE INFORMATION SHALL INCLUDE ALL OF THE FOLLOWING:

(1) THE NAME OF THE FACILITY AND ITS OWNER, THE FACILITY'S TELEPHONE NUMBER, AND THE FACILITY'S ADDRESS, INCLUDING THE COUNTY IN WHICH THE FACILITY IS LOCATED;

(2) THE FACILITY'S STATUS WITH REGARD TO MEDICARE AND MEDICAID CERTIFICATION AND PRIVATE ACCREDITATION;

(3) THE NUMBER OF BEDS IN THE FACILITY;

(4) THE DIRECT CARE STAFFING LEVEL FOR THE FACILITY, COMPARED TO THE AVERAGE STAFFING LEVEL FOR FACILITIES IN THE FACILITY'S PEER GROUP, AS SPECIFIED IN RULES ADOPTED UNDER SECTION 3721.69 of the Revised Code. STAFFING LEVELS SHALL BE EXPRESSED ON A PER RESIDENT, PER DAY BASIS AND SHALL BE CALCULATED BY ADDING THE HOURS OF STAFFING PERFORMED BY NURSE AIDES, LICENSED PRACTICAL NURSES, AND REGISTERED NURSES, AS REPORTED ON THE MOST RECENT COST REPORTS FILED UNDER SECTION 5111.26 OF THE REVISED CODE, AND DIVIDING THE SUM BY THE NUMBER OF INPATIENT DAYS REPORTED ON THE COST REPORTS.

(5) A LIST OF SERVICES PROVIDED BY THE FACILITY. THE LIST SHALL BE PRESENTED IN THE FORMAT SPECIFIED IN RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE.

(6) AT THE FACILITY'S OPTION, A PICTURE OF THE FACILITY, A BRIEF STATEMENT PROVIDED BY THE FACILITY, AND A REFERENCE TO ANY COMPUTERIZED INFORMATION THE FACILITY MAINTAINS ABOUT ITSELF ON THE INTERNET;

(7) THE SUMMARIZED INFORMATION SPECIFIED IN DIVISION (B) OF THIS SECTION FOR THE FACILITY.

Sec. 3721.67. (A) THROUGH THE CONTRACT REQUIRED UNDER SECTION 3721.611 of the Revised Code, THE DEPARTMENT OF HEALTH SHALL PROVIDE FOR THE CONDUCT OF CUSTOMER SATISFACTION SURVEYS FOR USE IN PUBLISHING THE OHIO NURSING FACILITY CONSUMER GUIDE. THE DEPARTMENT SHALL ENSURE THAT THE CUSTOMER SATISFACTION SURVEYS ARE CONDUCTED AS FOLLOWS:

(1) THE SURVEYS SHALL BE CONDUCTED SEMIANNUALLY.

(2) THE SURVEYS SHALL CONSIST OF STANDARDIZED QUESTIONNAIRES, ONE FOR NURSING FACILITY RESIDENTS AND ONE FOR FAMILIES OF NURSING FACILITY RESIDENTS. EACH QUESTIONNAIRE SHALL BE STRUCTURED IN A MANNER THAT USES A SCALE ALLOWING FOR FOUR POSSIBLE ANSWERS TO EACH QUESTION CONCERNING CUSTOMER SATISFACTION. EACH QUESTIONNAIRE SHALL ASK THE RESIDENT'S AGE AND GENDER. THE RESIDENT QUESTIONNAIRE SHALL ASK WHO, IF ANYONE, ASSISTED THE RESIDENT IN COMPLETING THE QUESTIONNAIRE. THE FAMILY QUESTIONNAIRE SHALL ASK THE RELATIONSHIP OF THE PERSON COMPLETING THE QUESTIONNAIRE TO THE RESIDENT.

(3) THE RESIDENT SURVEY SHALL BE CONDUCTED IN PERSON, USING A STANDARDIZED SURVEY PROTOCOL. THE SURVEY SHALL BE CONDUCTED IN A MANNER DESIGNED TO PRESERVE THE RESIDENT'S CONFIDENTIALITY AS MUCH AS POSSIBLE.

(4) THE FAMILY SURVEY SHALL BE CONDUCTED USING ANONYMOUS QUESTIONNAIRES DISTRIBUTED TO FAMILIES AND RETURNED TO A PERSON OTHER THAN THE NURSING FACILITY.

(B) IN ADDITION TO BEING USED FOR THE CONSUMER GUIDE, THE RESULTS OF THE SURVEYS CONDUCTED UNDER THIS SECTION SHALL BE PROVIDED TO THE NURSING FACILITIES TO WHICH THEY PERTAIN. EACH NURSING FACILITY IN THIS STATE SHALL PARTICIPATE AS NECESSARY FOR SUCCESSFUL COMPLETION OF THE SURVEYS.

Sec. 3721.671. THE DEPARTMENT OF HEALTH MAY CHARGE A FEE, NOT TO EXCEED TWO HUNDRED DOLLARS, FOR EACH OF THE SEMIANNUAL CUSTOMER SATISFACTION SURVEYS CONDUCTED UNDER SECTION 3721.67 OF THE REVISED CODE. THE FEE SHALL BE PAID BY THE NURSING FACILITY AND IS SUBJECT TO REIMBURSEMENT THROUGH THE MEDICAID PROGRAM PURSUANT TO SECTIONS 5111.20 TO 5111.32 OF THE REVISED CODE.

ALL FEES COLLECTED UNDER THIS SECTION SHALL BE DEPOSITED INTO THE STATE TREASURY TO THE CREDIT OF THE GENERAL OPERATIONS FUND CREATED UNDER SECTION 3701.83 OF THE REVISED CODE AND USED FOR COSTS ASSOCIATED WITH THE PUBLISHING OF THE OHIO NURSING FACILITY CONSUMER GUIDE, INCLUDING THE COST OF CONTRACTING WITH PERSONS AND GOVERNMENT ENTITIES UNDER SECTION 3721.611 OF THE REVISED CODE. AS THE DEPARTMENT'S CONTRACTOR, THE DEPARTMENT MAY AUTHORIZE A PERSON OR GOVERNMENT ENTITY TO COLLECT THE FEES ON BEHALF OF THE DEPARTMENT.

Sec. 3721.68. THE DEPARTMENT OF HEALTH SHALL CALCULATE CLINICAL QUALITY INDICATORS FOR EACH NURSING FACILITY FOR USE IN PUBLISHING THE OHIO NURSING FACILITY CONSUMER GUIDE. THE INDICATORS SHALL BE CALCULATED BY USING THE MEASURES AND THE CALCULATION METHODOLOGY THAT HAVE BEEN APPROVED OR RECOMMENDED FOR USE IN THE MEDICARE OR MEDICAID PROGRAMS, EXCEPT THAT THE DEPARTMENT MAY ADOPT RULES UNDER SECTION 3721.69 OF THE REVISED CODE SPECIFYING DIFFERENT MEASURES OR A DIFFERENT CALCULATION METHODOLOGY. THE CALCULATIONS SHALL BE MADE, AT A MINIMUM, AT THE TIMES SPECIFIED IN RULES ADOPTED UNDER SECTION 3721.69 OF THE REVISED CODE.

Sec. 3721.69. (A) EXCEPT AS PROVIDED IN DIVISION (B) OF THIS SECTION, THE DEPARTMENT OF HEALTH SHALL ADOPT RULES TO IMPLEMENT AND ADMINISTER SECTIONS 3721.60 TO 3721.68 OF THE REVISED CODE. THE RULES SHALL SPECIFY ALL OF THE FOLLOWING:

(1) THE CONTENT OF THE COMPUTERIZED FORM OF THE OHIO NURSING FACILITY CONSUMER GUIDE MAINTAINED ON THE INTERNET, INCLUDING ANY INFORMATION IN ADDITION TO THE INFORMATION SPECIFIED IN SECTION 3721.65 OF THE REVISED CODE;

(2) THE CONTENT OF THE PRINTED FORM OF THE CONSUMER GUIDE, INCLUDING ANY INFORMATION IN ADDITION TO THE INFORMATION SPECIFIED IN SECTION 3721.66 OF THE REVISED CODE;

(3) THE TWO CUSTOMER SATISFACTION MEASURES TO BE PUBLISHED IN THE CONSUMER GUIDE PURSUANT TO DIVISION (C)(1) OF SECTION 3721.65 AND DIVISION (B)(1) OF SECTION 3721.66 OF THE REVISED CODE;

(4) THE TWO CLINICAL QUALITY INDICATORS TO BE PUBLISHED IN THE CONSUMER GUIDE PURSUANT TO DIVISION (C)(2) OF SECTION 3721.65 AND DIVISION (B)(2) OF SECTION 3721.66 OF THE REVISED CODE;

(5) FOR PURPOSES OF EXPRESSING AVERAGE STAFFING LEVELS UNDER DIVISION (D)(4) OF SECTION 3721.65 AND DIVISION (C)(4) OF SECTION 3721.66 of the Revised Code, CRITERIA TO BE USED IN CLASSIFYING NURSING FACILITIES INTO PEER GROUPS, WHICH MAY BE BASED ON CASE-MIX SCORES CALCULATED FOR NURSING FACILITIES UNDER SECTION 5111.231 of the Revised Code, THE SIZE OF NURSING FACILITIES, THE LOCATION OF FACILITIES, OR OTHER PERTINENT FACTORS;

(6) THE FORMAT FOR LISTING OF NURSING FACILITY SERVICES IN THE CONSUMER GUIDE AND THE MANNER IN WHICH THAT INFORMATION IS TO BE COLLECTED FROM NURSING FACILITIES;

(7) IF CLINICAL QUALITY INDICATORS ARE TO BE CALCULATED USING MEASURES AND METHODOLOGIES THAT ARE DIFFERENT FROM THOSE THAT HAVE BEEN APPROVED OR RECOMMENDED FOR USE IN THE MEDICARE OR MEDICAID PROGRAMS, THE ALTERNATIVE MEASURES AND METHODOLOGIES TO BE USED IN MAKING THE CALCULATIONS;

(8) FEES THAT MAY BE COLLECTED UNDER SECTION 3721.671 OF THE REVISED CODE FOR THE CONDUCT OF CUSTOMER SATISFACTION SURVEYS;

(9) A METHOD OF INCLUDING ADDITIONAL LONG-TERM CARE FACILITIES IN THE CONSUMER GUIDE PURSUANT TO CONSIDERATIONS MADE UNDER DIVISION (B)(4) OF SECTION 3721.70 OF THE REVISED CODE;

(10) ANY OTHER REQUIREMENTS NECESSARY TO IMPLEMENT AND ADMINISTER SECTIONS 3721.60 TO 3721.68 OF THE REVISED CODE.

(B) THE DEPARTMENT SHALL NOT ADOPT RULES UNDER THIS SECTION UNLESS THE RULES FIRST HAVE BEEN RECOMMENDED BY THE NURSING FACILITY CONSUMER GUIDE ADVISORY COUNCIL CREATED UNDER SECTION 3721.70 OF THE REVISED CODE. IF THE COUNCIL DOES NOT MAKE A RECOMMENDATION FOR RULES ADDRESSING ANY MATTER LISTED IN DIVISION (A) OF THIS SECTION, THE DEPARTMENT IS NOT REQUIRED TO ADOPT RULES ON THAT MATTER.

(C) ALL RULES ADOPTED UNDER THIS SECTION SHALL BE ADOPTED IN ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE. INITIAL RULES SHALL BE ADOPTED NOT LATER THAN SIX MONTHS AFTER THE EFFECTIVE DATE OF THIS SECTION.

Sec. 3721.70. (A) THERE IS HEREBY CREATED THE NURSING FACILITY CONSUMER GUIDE ADVISORY COUNCIL. THE COUNCIL SHALL BE CONVENED BY THE DIRECTOR OF HEALTH AND SHALL CONSIST OF THE FOLLOWING MEMBERS:

(1) A REPRESENTATIVE OF THE DEPARTMENT OF HEALTH, APPOINTED BY THE DIRECTOR OF HEALTH;

(2) A REPRESENTATIVE OF THE DEPARTMENT OF AGING, APPOINTED BY THE DIRECTOR OF AGING;

(3) A REPRESENTATIVE OF THE OHIO HEALTH CARE ASSOCIATION, APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ASSOCIATION;

(4) A REPRESENTATIVE OF THE ASSOCIATION OF OHIO PHILANTHROPIC HOMES, HOUSING, AND SERVICES FOR THE AGING, APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ASSOCIATION;

(5) A REPRESENTATIVE OF THE OHIO ACADEMY OF NURSING HOMES, APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ACADEMY;

(6) A REPRESENTATIVE OF THE OHIO ASSOCIATION OF REGIONAL LONG-TERM CARE OMBUDSMEN, APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ASSOCIATION;

(7) A REPRESENTATIVE OF THE OHIO CHAPTER OF THE AMERICAN ASSOCIATION OF RETIRED PERSONS, APPOINTED BY THE CHIEF ADMINISTRATOR OF THE CHAPTER;

(8) A REPRESENTATIVE OF A RESEARCH ORGANIZATION, APPOINTED BY THE CHIEF ADMINISTRATOR OF THE ORGANIZATION. THE RESEARCH ORGANIZATION REPRESENTED SHALL BE SELECTED BY THE DIRECTOR OF HEALTH FROM AMONG RESEARCH ORGANIZATIONS IN THIS STATE THAT HAVE EXPERIENCE IN LONG-TERM CARE POLICY MATTERS.

EACH COUNCIL MEMBER SHALL SERVE AT THE DISCRETION OF THE PERSON WHO APPOINTED THE MEMBER. EACH MEMBER SHALL SERVE WITHOUT COMPENSATION OR REIMBURSEMENT FOR EXPENSES, EXCEPT TO THE EXTENT THAT SERVING AS A MEMBER OF THE COUNCIL IS PART OF THE MEMBER'S REGULAR DUTIES OF EMPLOYMENT.

THE MEMBER SERVING AS THE REPRESENTATIVE OF THE DEPARTMENT OF HEALTH SHALL SERVE AS THE COUNCIL'S CHAIRPERSON. THE DEPARTMENT SHALL SUPPLY MEETING SPACE AND STAFF SUPPORT FOR THE COUNCIL.

(B) THE COUNCIL'S DUTIES INCLUDE ALL OF THE FOLLOWING:

(1) TO RECOMMEND RULES TO BE ADOPTED BY THE DEPARTMENT OF HEALTH UNDER SECTION 3721.69 OF THE REVISED CODE;

(2) TO RECOMMEND ADMINISTRATIVE PRACTICES TO THE DEPARTMENT FOR IMPROVING THE OPERATION AND THE CONTENT OF THE OHIO NURSING FACILITY CONSUMER GUIDE;

(3) TO RECOMMEND LEGISLATIVE CHANGES NEEDED TO IMPROVE THE CONSUMER GUIDE;

(4) TO CONSIDER WHETHER IT IS FEASIBLE TO INCLUDE IN THE CONSUMER GUIDE OTHER LONG-TERM CARE FACILITIES, SUCH AS RESIDENTIAL CARE FACILITIES, INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED, AND NURSING HOMES LICENSED UNDER SECTION 3721.02 OF THE REVISED CODE THAT ARE NOT NURSING FACILITIES OR SKILLED NURSING FACILITIES.

(C) THE NURSING FACILITY CONSUMER GUIDE ADVISORY COUNCIL IS NOT SUBJECT TO SECTION 101.84 OF THE REVISED CODE.

Sec. 5111.20. As used in sections 5111.20 to 5111.32 of the Revised Code:

(A) "Allowable costs" are those costs determined by the department of human services to be reasonable and do not include fines paid under sections 5111.35 to 5111.61 and section 5111.99 of the Revised Code.

(B) "Capital costs" means costs of ownership and nonextensive renovation.

(1) "Cost of ownership" means the actual expense incurred for all of the following:

(a) Depreciation and interest on any capital assets that cost five hundred dollars or more per item, including the following:

(i) Buildings;

(ii) Building improvements that are not approved as nonextensive renovations under section 5111.25 or 5111.251 of the Revised Code;

(iii) Equipment;

(iv) Extensive renovations;

(v) Transportation equipment.

(b) Amortization and interest on land improvements and leasehold improvements;

(c) Amortization of financing costs;

(d) Except as provided in division (I) of this section, lease and rent of land, building, and equipment.

The costs of capital assets of less than five hundred dollars per item may be considered costs of ownership in accordance with a provider's practice.

(2) "Costs of nonextensive renovation" means the actual expense incurred for depreciation or amortization and interest on renovations that are not extensive renovations.

(C) "Capital lease" and "operating lease" shall be construed in accordance with generally accepted accounting principles.

(D) "Case-mix score" means the measure determined under section 5111.231 of the Revised Code of the relative direct-care resources needed to provide care and habilitation to a resident of a nursing facility or intermediate care facility for the mentally retarded.

(E) "Date of licensure," for a facility originally licensed as a nursing home under Chapter 3721. of the Revised Code, means the date specific beds were originally licensed as nursing home beds under that chapter, regardless of whether they were subsequently licensed as residential facility beds under section 5123.19 of the Revised Code. For a facility originally licensed as a residential facility under section 5123.19 of the Revised Code, "date of licensure" means the date specific beds were originally licensed as residential facility beds under that section.

(1) If nursing home beds licensed under Chapter 3721. of the Revised Code or residential facility beds licensed under section 5123.19 of the Revised Code were not required by law to be licensed when they were originally used to provide nursing home or residential facility services, "date of licensure" means the date the beds first were used to provide nursing home or residential facility services, regardless of the date the present provider obtained licensure.

(2) If a facility adds nursing home beds or residential facility beds or extensively renovates all or part of the facility after its original date of licensure, it will have a different date of licensure for the additional beds or extensively renovated portion of the facility, unless the beds are added in a space that was constructed at the same time as the previously licensed beds but was not licensed under Chapter 3721. or section 5123.19 of the Revised Code at that time.

(F) "Desk-reviewed" means that costs as reported on a cost report submitted under section 5111.26 of the Revised Code have been subjected to a desk review under division (A) of section 5111.27 of the Revised Code and preliminarily determined to be allowable costs.

(G) "Direct care costs" means all of the following:

(1)(a) Costs for registered nurses, licensed practical nurses, and nurse aides employed by the facility;

(b) Costs for direct care staff, administrative nursing staff, medical directors, social services staff, activities staff, psychologists and psychology assistants, social workers and counselors, habilitation staff, qualified mental retardation professionals, program directors, respiratory therapists, habilitation supervisors, and except as provided in division (G)(2) of this section, other persons holding degrees qualifying them to provide therapy;

(c) Costs of purchased nursing services;

(d) Costs of quality assurance;

(e) Costs of training and staff development, employee benefits, payroll taxes, and workers' compensation premiums or costs for self-insurance claims and related costs as specified in rules adopted by the department of human services in accordance with Chapter 119. of the Revised Code, for personnel listed in divisions (G)(1)(a), (b), and (d) of this section;

(f) Costs of consulting and management fees related to direct care;

(g) Allocated direct care home office costs.

(2) In addition to the costs specified in division (G)(1) of this section, for intermediate care facilities for the mentally retarded only, direct care costs include both of the following:

(a) Costs for physical therapists and physical therapy assistants, occupational therapists and occupational therapy assistants, speech therapists, and audiologists;

(b) Costs of training and staff development, employee benefits, payroll taxes, and workers' compensation premiums or costs for self-insurance claims and related costs as specified in rules adopted by the department of human services in accordance with Chapter 119. of the Revised Code, for personnel listed in division (G)(2)(a) of this section.

(3) Costs of other direct-care resources that are specified as direct care costs in rules adopted by the department of human services in accordance with Chapter 119. of the Revised Code.

(H) "Fiscal year" means the fiscal year of this state, as specified in section 9.34 of the Revised Code.

(I) "Indirect care costs" means all reasonable costs other than direct care costs, other protected costs, or capital costs. "Indirect care costs" includes but is not limited to costs of habilitation supplies, pharmacy consultants, medical and habilitation records, program supplies, incontinence supplies, food, enterals, dietary supplies and personnel, laundry, housekeeping, security, administration, liability insurance, bookkeeping, purchasing department, human resources, communications, travel, dues, license fees, subscriptions, home office costs not otherwise allocated, legal services, accounting services, minor equipment, maintenance and repairs, help-wanted advertising, informational advertising, start-up costs, organizational expenses, other interest, property insurance, employee training and staff development, employee benefits, payroll taxes, and workers' compensation premiums or costs for self-insurance claims and related costs as specified in rules adopted by the department of human services in accordance with Chapter 119. of the Revised Code, for personnel listed in this division. Notwithstanding division (B)(1) of this section, "indirect care costs" also means the cost of equipment, including vehicles, acquired by operating lease executed before December 1, 1992, if the costs are reported as administrative and general costs on the facility's cost report for the cost reporting period ending December 31, 1992.

(J) "Inpatient days" means all days during which a resident, regardless of payment source, occupies a bed in a nursing facility or intermediate care facility for the mentally retarded that is included in the facility's certified capacity under Title XIX of the "Social Security Act," 49 Stat. 610 (1935), 42 U.S.C.A. 301, as amended. Therapeutic or hospital leave days for which payment is made under section 5111.33 of the Revised Code are considered inpatient days proportionate to the percentage of the facility's per resident per day rate paid for those days.

(K) "Intermediate care facility for the mentally retarded" means an intermediate care facility for the mentally retarded certified as in compliance with applicable standards for the medical assistance program by the director of health in accordance with Title XIX of the "Social Security Act."

(L) "Maintenance and repair expenses" means, except as provided in division (X)(2) of this section, expenditures that are necessary and proper to maintain an asset in a normally efficient working condition and that do not extend the useful life of the asset two years or more. "Maintenance and repair expenses" includes but is not limited to the cost of ordinary repairs such as painting and wallpapering.

(M) "Nursing facility" means a facility, or a distinct part of a facility, that is certified as a nursing facility by the director of health in accordance with Title XIX of the "Social Security Act," and is not an intermediate care facility for the mentally retarded. "Nursing facility" includes a facility, or a distinct part of a facility, that is certified as a nursing facility by the director of health in accordance with Title XIX of the "Social Security Act," and is certified as a skilled nursing facility by the director in accordance with Title XVIII of the "Social Security Act."

(N) "Other protected costs" means costs for medical supplies; real estate, franchise, and property taxes; natural gas, fuel oil, water, electricity, sewage, and refuse and hazardous medical waste collection; allocated other protected home office costs; FEES PAID UNDER SECTION 3721.671 OF THE REVISED CODE; and any additional costs defined as other protected costs in rules adopted by the department of human services in accordance with Chapter 119. of the Revised Code.

(O) "Owner" means any person or government entity that has at least five per cent ownership or interest, either directly, indirectly, or in any combination, in a nursing facility or intermediate care facility for the mentally retarded.

(P) "Patient" includes "resident."

(Q) Except as provided in divisions (Q)(1) and (2) of this section, "per diem" means a nursing facility's or intermediate care facility for the mentally retarded's actual, allowable costs in a given cost center in a cost reporting period, divided by the facility's inpatient days for that cost reporting period.

(1) When calculating indirect care costs for the purpose of establishing rates under section 5111.24 or 5111.241 of the Revised Code, "per diem" means a facility's actual, allowable indirect care costs in a cost reporting period divided by the greater of the facility's inpatient days for that period or the number of inpatient days the facility would have had during that period if its occupancy rate had been eighty-five per cent.

(2) When calculating capital costs for the purpose of establishing rates under section 5111.25 or 5111.251 of the Revised Code, "per diem" means a facility's actual, allowable capital costs in a cost reporting period divided by the greater of the facility's inpatient days for that period or the number of inpatient days the facility would have had during that period if its occupancy rate had been ninety-five per cent.

(R) "Provider" means a person or government entity that operates a nursing facility or intermediate care facility for the mentally retarded under a provider agreement.

(S) "Provider agreement" means a contract between the department of human services and a nursing facility or intermediate care facility for the mentally retarded for the provision of nursing facility services or intermediate care facility services for the mentally retarded under the medical assistance program.

(T) "Purchased nursing services" means services that are provided in a nursing facility by registered nurses, licensed practical nurses, or nurse aides who are not employees of the facility.

(U) "Reasonable" means that a cost is an actual cost that is appropriate and helpful to develop and maintain the operation of patient care facilities and activities, including normal standby costs, and that does not exceed what a prudent buyer pays for a given item or services. Reasonable costs may vary from provider to provider and from time to time for the same provider.

(V) "Related party" means an individual or organization that, to a significant extent, has common ownership with, is associated or affiliated with, has control of, or is controlled by, the provider.

(1) An individual who is a relative of an owner is a related party.

(2) Common ownership exists when an individual or individuals possess significant ownership or equity in both the provider and the other organization. Significant ownership or equity exists when an individual or individuals possess five per cent ownership or equity in both the provider and a supplier. Significant ownership or equity is presumed to exist when an individual or individuals possess ten per cent ownership or equity in both the provider and another organization from which the provider purchases or leases real property.

(3) Control exists when an individual or organization has the power, directly or indirectly, to significantly influence or direct the actions or policies of an organization.

(4) An individual or organization that supplies goods or services to a provider shall not be considered a related party if all of the following conditions are met:

(a) The supplier is a separate bona fide organization.

(b) A substantial part of the supplier's business activity of the type carried on with the provider is transacted with others than the provider and there is an open, competitive market for the types of goods or services the supplier furnishes.

(c) The types of goods or services are commonly obtained by other nursing facilities or intermediate care facilities for the mentally retarded from outside organizations and are not a basic element of patient care ordinarily furnished directly to patients by the facilities.

(d) The charge to the provider is in line with the charge for the goods or services in the open market and no more than the charge made under comparable circumstances to others by the supplier.

(W) "Relative of owner" means an individual who is related to an owner of a nursing facility or intermediate care facility for the mentally retarded by one of the following relationships:

(1) Spouse;

(2) Natural parent, child, or sibling;

(3) Adopted parent, child, or sibling;

(4) Step-parent, step-child, step-brother, or step-sister;

(5) Father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, or sister-in-law;

(6) Grandparent or grandchild;

(7) Foster parent, foster child, foster brother, or foster sister.

(X) "Renovation" and "extensive renovation" mean:

(1) Any betterment, improvement, or restoration of a nursing facility or intermediate care facility for the mentally retarded started before July 1, 1993, that meets the definition of a renovation or extensive renovation established in rules adopted by the department of human services in effect on December 22, 1992.

(2) In the case of betterments, improvements, and restorations of nursing facilities and intermediate care facilities for the mentally retarded started on or after July 1, 1993:

(a) "Renovation" means the betterment, improvement, or restoration of a nursing facility or intermediate care facility for the mentally retarded beyond its current functional capacity through a structural change that costs at least five hundred dollars per bed. A renovation may include betterment, improvement, restoration, or replacement of assets that are affixed to the building and have a useful life of at least five years. A renovation may include costs that otherwise would be considered maintenance and repair expenses if they are an integral part of the structural change that makes up the renovation project. "Renovation" does not mean construction of additional space for beds that will be added to a facility's licensed or certified capacity.

(b) "Extensive renovation" means a renovation that costs more than sixty-five per cent and no more than eighty-five per cent of the cost of constructing a new bed and that extends the useful life of the assets for at least ten years.

For the purposes of division (X)(2) of this section, the cost of constructing a new bed shall be considered to be forty thousand dollars, adjusted for the estimated rate of inflation from January 1, 1993, to the end of the calendar year during which the renovation is completed, using the consumer price index for shelter costs for all urban consumers for the north central region, as published by the United States bureau of labor statistics.

The department of human services may treat a renovation that costs more than eighty-five per cent of the cost of constructing new beds as an extensive renovation if the department determines that the renovation is more prudent than construction of new beds.

State Special Revenue Fund Group

470	440-618	General Operations	$	700,000	$	700,000
TOTAL SSR State Special Revenue
Fund Group			$	700,000	$	700,000
TOTAL ALL BUDGET FUND GROUPS			$	700,000	$	700,000

The foregoing appropriation item 440-618, General Operations, shall be used by the Department of Health to administer sections 3721.60 to 3721.69 of the Revised Code.

Of the foregoing appropriation item 440-618, General Operations, not more than $200,000 in each fiscal year shall be used to contract under section 3721.611 of the Revised Code with a person or government entity to conduct the customer satisfaction surveys required under section 3721.67 of the Revised Code.

Within the limits set forth in this act, the Director of Budget and Management shall establish accounts indicating the source and amount of funds for each appropriation made in this act and shall determine the form and manner in which appropriation accounts shall be maintained. Expenditures from appropriations contained in this act shall be accounted for as though made in Am. Sub. H.B. 283 of the 123rd General Assembly.

The appropriations made in this act are subject to all provisions of Am. Sub. H.B. 283 of the 123rd General Assembly that are generally applicable to such approprations.