reglab/statecodes huggingface dataset:
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-02.18 - ODA provider certification: non-medical transportation

Current through all regulations passed and filed through July 1, 2024
(A) Definitions for this rule:
(1) "Non-medical transportation"
			 (transportation) means using a provider's vehicle and driver to transport
			 individuals from one place to another for a non-medical purpose. "Non-medical
			 transportation" does not include the following:
(a) Transportation otherwise available, or
			 funded by, Ohio's medicaid program or another source.
(b) Transportation for a non-emergency
			 medical purpose.
(c) Transportation
			 being provided through a similar service in this chapter.
(d) Transportation that the individual's
			 family, neighbors, friends, or community agencies are willing or legally
			 responsible to provide to the individual free of charge.
(e) Escort or transportation by a
			 participant-directed provider. (See rule
			 173-39-02.4 of the Administrative
			 Code.)
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-02.20 - ODA provider certification: enhanced community living

Current through all regulations passed and filed through July 1, 2024
(A) Definitions for this rule:
(1) "Enhanced community living" (ECL) means a
			 service promoting aging in place, in multi-family affordable housing, through
			 access to on-site, individually- tailored, health-related, and supportive
			 interventions for individuals who have functional deficits resulting from one
			 or more chronic health conditions.
(a) ECL
			 includes the following activities:
(i) The
			 establishment of measurable health goals.
(ii) The identification of modifiable
			 healthcare risks.
(iii) The
			 provision of regular health-status monitoring interventions. "Health-status
			 monitoring interventions" mean taking and recording vital signs, weight,
			 nutrition, and hydration statuses.
(iv) Assistance with accessing additional
			 allied health services.
(v) The
			 provision of, or arrangement for, education on self-managing chronic diseases
			 or chronic health conditions.
(vi)
			 Daily wellness checks. "Daily wellness check" means an activity of ECL through
			 which a PCA observes any changes in the individual's level of functioning and
			 determine what, if any, modifications to the activity plan are
			 needed.
(vii) Access to planned and
			 intermittent personal care under rule
			 173-39-02.11 of the
			 Administrative Code.
(viii) Activities to
			 assist an individual who is returning home following a hospital or nursing
			 facility stay.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-02.22 - ODA provider certification: waiver nursing

Current through all regulations passed and filed through July 1, 2024
(A) "Waiver nursing
			 " means the service defined in rule
			 5160-44-22 of the Administrative
			 Code.
(B)
								Requirements for
								
								every
			 ODA-certified provider of  waiver nursing
			 :
(1)
									 The provider
			 
									is subject
			 to rule
			 173-39-02 of the Administrative
			 Code.
(2)
									 The provider 
									is subject to rule
			 5160-44-22 of the Administrative
			 Code.
(3) If a conflict exists
			 between a requirement in rule
			 173-39-02 of the Administrative
			 Code and a requirement in rule
			 5160-44-22 of the Administrative
			 Code, the provider shall comply with the requirement in rule
			 173-39-02 of the Administrative
			 Code instead of the conflicting requirement in rule
			 5160-44-22 of the Administrative
			 Code.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-02.23 - ODA provider certification: out-of-home respite

Current through all regulations passed and filed through July 1, 2024
(A) "Out-of-home respite" means the service
			 defined in rule
			 5160-44-17 of the Administrative
			 Code.
(B)
								Requirements for
								
								every
			 ODA-certified provider of out-of-home respite :
(1)
									 The provider 
									is subject to rule
			 173-39-02 of the Administrative
			 Code.
(2)
									 The provider 
									is subject to rule
			 5160-44-17 of the Administrative
			 Code.
(3) If a conflict exists
			 between a requirement in rule
			 173-39-02 of the Administrative
			 Code and a requirement in rule
			 5160-44-17 of the Administrative
			 Code, the provider shall comply with the requirement in rule
			 173-39-02 of the Administrative
			 Code instead of the conflicting requirement in rule
			 5160-44-17 of the Administrative
			 Code.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-02.24 - ODA provider certification: home care attendant service

Current through all regulations passed and filed through July 1, 2024
(A) "Home care attendant service" means the
			 service defined in rule
			 5160-44-27 of the Administrative
			 Code.
(B)
								Requirements for
								
								every
			 ODA-certified provider of a home care attendant service
			 :
(1)
									 The provider
			 
									is subject
			 to rule
			 173-39-02 of the Administrative
			 Code.
(2)
									 The provider 
									is subject to rule
			 5160-44-27 of the Administrative
			 Code.
(3) If a conflict exists
			 between a requirement in rule
			 173-39-02 of the Administrative
			 Code and a requirement in rule
			 5160-44-27 of the Administrative
			 Code, the provider shall comply with the requirement in rule
			 173-39-02 of the Administrative
			 Code instead of the conflicting requirement in rule
			 5160-44-27 of the Administrative
			 Code.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-02.25 - ODA provider certification: structured family caregiving

Current through all regulations passed and filed through July 1, 2024
(A)
								"Structured family caregiving" has the same meaning as
			 in rule 5160-44-33 of the Administrative Code.
(B)
								Requirements for
			 every ODA-certified provider of structured family caregiving:
(1)
									The provider is
			 subject to rule
			 173-39-02 of the Administrative
			 Code.
(2)
									The provider is subject to rule 5160-44-33 of the
			 Administrative Code.
(3)
									If a conflict exists between a requirement in rule
			 173-39-02 of the Administrative
			 Code and a requirement in rule 5160-44-33 of the Administrative Code, the
			 requirement in rule
			 173-39-02 of the Administrative
			 Code applies instead of the conflicting requirement in rule 5160-44-33 of the
			 Administrative Code.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-03 - ODA provider certification: applying for certification

Current through all regulations passed and filed through July 1, 2024
(A) Initial steps:
(1)
									A person
									
									may apply
			 for certification
									by completing an application in
			 the provider management system, which includes electronic submission of all
			 supporting records required as part of the application. An incomplete application expires
									
									if the
			 
									person does not complete the application within ninety
			 days.
(2) ODA shall review an application to
			 determine if the application meets the requirements for the certification the
			 provider is seeking.
(a) ODA shall initiate
			 the process for a pre-certification review if ODA determines that a provider
			 submitted a complete application.
(b)
										 ODA may
			 request supplemental information which the provider shall
			 
										provide within five business days.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-03.1 - ODA provider certification: federal heightened scrutiny of provider settings with institutional characteristics

Current through all regulations passed and filed through July 1, 2024
Introduction: In
				42 C.F.R.
				441.301(c)(5)(v), HHS
				requires heightened scrutiny by HHS's secretary to determine if a setting
				presumed to have the qualities of an institution meets HCBS settings
				requirements. This rule applies to settings subject to heightened scrutiny to
				become or remain an ODA-certified provider.
(A) Scope: A setting presumed to have the
			 qualities of an institution requires heightened scrutiny by HHS's secretary,
			 based on information presented by the state or other parties, to determine
			 whether the setting has the qualities of an institution or has the qualities of
			 a HCBS setting. A setting is presumed to have the qualities of an institution
			 if it has any of the following characteristics:
(1) The entire setting is located in a
			 building that is also a publicly or privately-operated facility that provides
			 inpatient institutional treatment.
(2) The setting is in a building on the
			 grounds of, or immediately adjacent to, a public institution.
(3) The setting has the effect of isolating
			 individuals receiving medicaid HCBS from the broader community of individuals
			 not receiving medicaid HCBS.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-03.2 - ODA provider certification: changes of ownership interest or organizational structure

Current through all regulations passed and filed through July 1, 2024
Introduction: Section
				173.39 of the Revised Code
				prohibits ODA from paying a provider for services provided to individuals
				enrolled in the PASSPORT or assisted living programs unless the provider is an
				ODA-certified provider. ODA-certification is assigned to a provider's federal
				taxpayer identification number (TIN) and is not transferable. This rule
				
								applies in all instances where there is a change of
				ownership interest involving an ODA-certified provider obtaining a new TIN
				according to any rule adopted by the internal revenue service (IRS) or any
				change in organizational structure of an ODA-certified provider involving a
				person with an ownership or management interest, including
				a non-profit 
								provider.
(A)
			 Requirements:
(1) Notification: The provider's
			 current owner(s) shall 
									email ODA at
			 provider_enrollment@age.ohio.gov with
									
									an
			 original signed statement that includes all the following information
									
									to
			 announce a change of ownership interest or change of organizational
			 structure (change) no later than forty-five days before the change, unless this
			 chapter requires notifying ODA sooner. 
									By sending the statement, the owner is certifying that
			 the following information is accurate, truthful, and complete:
(a) Name of the provider undergoing the
			 change.
(b) Name of each current
			 owner, and, if any, the name of each current owner's authorized
			 agent.
(c) Medicaid provider number
			 and NPI of the provider after the change, if known. ODA considers the notice to
			 be complete if the notice is complete except for indicating the provider's
			 number if ODM has not yet granted the provider a number, so long as the
			 provider provides the number to ODA as soon as it is available.
(d) The following information about each new
			 owner(s):
(i) Name.
(ii) Date of birth.
(iii) Social security number.
(iv) Percentage of ownership or control in
			 the provider.
(v) Whether each new
			 owner has been a resident of Ohio for the five-year period immediately
			 preceding the date of the change .
(e)
			 Date the change takes effect, as evidence by a bill of sale or purchase
			 contract executed by both parties.
(f) Statement indicating whether the provider
			 intends to seek payment from ODA for services it provides after the
			 change.
(g) Names and addresses of
			 the persons to whom ODA and its designee should send correspondence regarding
			 the change.
(h) Any information
			 required to show the ongoing compliance required by paragraph (B) of this
			 rule.
(i) Signatures of the current
			 and new owner(s).
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-03.3 - ODA provider certification: applying to be certified to provide

Current through all regulations passed and filed through July 1, 2024
Introduction: After ODA initially certifies a provider in a
				region, the provider may apply to become certified to provide an additional
				service in that region, including an ODA- certified
				provider of enhanced ADS applying for certification to provide intensive ADS
				and an ODA-certified provider of the basic assisted living service applying for
				certification to provide memory care.
(A)
								Application: A certified provider may apply for
			 certification to provide an additional service by completing an application in
			 the provider management system, including electronic submission of all
			 supporting records required as part of the application. An incomplete
			 application expires if the provider does not complete the application within
			 ninety days.
(B)
			 Pre-certification review: ODA's designee shall visit the provider's business
			 site to conduct an on-site pre-certification review to determine if the
			 provider meets the requirements of this chapter to be certified to provide the
			 additional service.  During a state of emergency declared by the
			 governor, a federal public health emergency, or during another time if
			 authorized by ODA, ODA's designee may conduct a desk review of the provider's
			 business site in lieu of a visit.
(C) Approved application: ODA and its
			 designee shall follow the process under paragraph 
								(F) of rule
			 173-39-03 of the Administrative
			 Code for an approved application .
(D) Denied
			 application: ODA and its designee shall follow the process under paragraph
			 
								(H) of
			 rule 173-39-03 of the Administrative
			 Code for a denied application .
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-03.4 - ODA provider certification: applying to be certified in an additional from an additional business site in the same region, or for confirmation that more designated resident units in an RCF qualify

Current through all regulations passed and filed through July 1, 2024
.
(A)
								Introduction:
(1)
									This rule applies
			 to the following scenarios:
(a)
										A provider certified to provide a service in a region
			 wants to be certified to provide the same service in another
			 region.
(b)
										A provider certified to provide a service in a region
			 wants to be certified to provide the same service from an additional business
			 site in the same region.
(c)
										A certified assisted living provider wants confirmation
			 that more designated resident units in its RCF qualify as resident units under
			 paragraph (C)(2) (c) of rule
			 173-39-02.16 of the
			 Administrative Code than ODA's designee previously confirmed.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-03.5 - ODA provider certification: military provisions

Current through all regulations passed and filed through July 1, 2024
(A) Applications: 
								Persons
			 who submit with their applications for ODA provider certification proof
			 that they are a service member or veteran, as section
			 5903.01 of the Revised Code
			 defines those terms, or the spouse or surviving spouse of a service member or
			 veteran, shall receive priority processing of their applications.
(1) If an applicant answers affirmatively
			 that he or she is a service member, veteran, or the spouse or surviving spouse
			 of a service member or veteran, the applicant shall submit supporting documents
			 along with their application. Acceptable forms of documentation include:
(a) A copy of a document issued by the armed
			 forces, such as an identification card or military discharge certificate;
			 and
(b) A marriage certificate or
			 other document showing the applicant and service member or veteran are
			 spouses.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-04 - ODA provider certification: structural compliance reviews

Current through all regulations passed and filed through July 1, 2024
Introduction: Each ODA-certified provider is subject to a
				regular structural compliance review (review) to ascertain if it complies with
				this chapter.
(A) Deadline for ODA's
			 designee to conduct the first review: The one-year anniversary of the
			 provider's certification date.
(B)
			 Deadlines for ODA's designee to conduct subsequent reviews:
(1) The one-year anniversary of the previous
			 review if the provider is one of the following:
(a) A provider of an adult day
			 service.
(b) A provider of an
			 assisted living service.
(c)
										
										A
			 provider of personal care, enhanced community living,
			 or waiver nursing that is neither certified by medicare nor accredited by
			 the accreditation commission for health care, the community health
			 accreditation partner, the joint commission, or another national accreditation
			 organization that is approved by CMS and ODH.
(d)
										A provider of the
			 choices home care attendant service.
(e)
										A provider of the
			 home care attendant service.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-39 - Certification of Community-Based Long-Term Care Service Providers › Section 173-39-05 - ODA provider certification: disciplinary actions

Current through all regulations passed and filed through July 1, 2024
(A) Introduction: Pursuant to section
			 173.391 of the Revised Code, ODA
			 or its designee may impose disciplinary action against an ODA-certified
			 provider (provider) for good cause, including misfeasance, malfeasance,
			 nonfeasance, confirmed abuse or neglect, financial irresponsibility, or other
			 conduct ODA determines is injurious, or poses a threat, to the health or safety
			 of individuals being served.
(B)
			 Disciplinary actions by ODA's designee:
(1)
			 Disciplinary actions imposed by ODA's designee may include any one or more of
			 the following:
(a) Plan of correction
			 or evidence of compliance: ODA's designee may
			 require the provider to provide a plan of correction or
			 evidence of compliance with all areas of non-compliance within
			 
										seven
			 business days after the disciplinary action is imposed.
(b) Suspending
			 referrals: ODA's designee may cease to refer individuals to the provider until
			 ODA's designee determines the provider complies with all requirements in this
			 chapter.
(c)
										Remove clients: ODA's designee may revise the
			 person-centered services plans for individuals to stop authorizing the
			 non-compliant provider as a provider for those individuals.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-40 - State-Funded PASSPORT Program › Section 173-40-01 - PASSPORT program (state-funded component): introduction and definitions

Current through all regulations passed and filed through July 1, 2024
(A) Introduction: This chapter regulates the
			 state-funded component of the PASSPORT program created under section
			 173.522 of the Revised Code.
			 (See Chapter 173-42 of the Administrative Code for rules on the medicaid-funded
			 component of the PASSPORT program.)
(B) Definitions for this chapter:
"Authorized representative" has the same meaning as in rule
				5160-1-33 of the Administrative
				Code.
"ODA" means the Ohio department of aging.
"ODA's designee" has the same meaning as in rule
				173-39-01 of the Administrative
				Code.
"ODM" means the Ohio department of medicaid.
"ODM's administrative agency" has the same meaning as
				"administrative agency" in rule
				5160:1-1-01 of the
				Administrative Code.
"Person-centered services plan" means the outline of services a
				case manager authorizes a provider to provide to an individual, regardless of
				the funding source for those services. It includes the person-centered planning
				in rule 5160-44-02 of the Administrative
				Code.
"Unique identifier" means an item
				belonging to a specific individual or caregiver which identifies only the
				individual or caregiver and which the individual or caregiver offers as an
				attestation to enrolling into the state-funded component of the PASSPORT
				program and agreeing to the requirements of that program. Examples of a unique
				identifier are a handwritten or electronic signature or initials, fingerprint,
				mark, stamp, password, barcode, or swipe card.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-40 - State-Funded PASSPORT Program › Section 173-40-03 - PASSPORT program (state-funded component): individual disenrollment and other actions

Current through all regulations passed and filed through July 1, 2024
(A) Presumptive: For each individual enrolled
			 in the state-funded component of the PASSPORT program on the basis of paragraph
			 (A) of rule
			 173-40-02 of the Administrative
			 Code:
(1) Disenrollment: ODA or its designee
			 shall disenroll any individual who no longer meets all requirements under
			 paragraph (A) of rule
			 173-40-02 of the Administrative
			 Code unless the only requirement the individual no longer meets is the PETI
			 (i.e., patient-liability or share of cost) requirement listed in paragraph
			 (A)(5) of that rule, during a state of emergency declared by the governor, or
			 during a federal public health emergency if federal financial participation
			 pays for all of the individual's services.
(2) Post-disenrollment limitations: After ODA
			 or its designee disenrolls an individual from the state-funded component of the
			 PASSPORT program, the following limits apply:
(a) The individual is not eligible to
			 re-enroll into the state-funded component of the PASSPORT program on the basis
			 of presumptive eligibility.
(b) The
			 individual is not eligible to enroll into the medicaid-funded component of the
			 PASSPORT program until ODM's administrative agency determines the individual
			 meets all medicaid financial eligibility requirements and ODA or its designee
			 determines the individual meets all non-financial eligibility requirements
			 under rule
			 5160-31-03 of the Administrative
			 Code.
(c) The individual is not
			 eligible to enroll into the state-funded component of the assisted living
			 program.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-40 - State-Funded PASSPORT Program › Section 173-40-04 - PASSPORT program (state-funded component): provider requirements

Current through all regulations passed and filed through July 1, 2024
The state-funded component of the
				PASSPORT program may pay a provider for providing a service covered under rule
				173-40-05 of the Administrative
				Code only if the provider is certified to provide the service under Chapter
				173-39 of the Administrative Code
				and section 173.39 of the Revised
				Code.
Replaces: 173-40-04
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-40 - State-Funded PASSPORT Program › Section 173-40-05 - PASSPORT program (state-funded component): covered services

Current through all regulations passed and filed through July 1, 2024
(A)
								The person-centered services plan for an individual
			 enrolled in the state-funded component of the PASSPORT program may authorize
			 any service allowed under rule
			 5160-31-05 of the Administrative
			 Code for the medicaid-funded component of the PASSPORT program.
(B)
								The state-funded
			 component of the PASSPORT program does not pay a provider for any service not
			 explicitly authorized in the individual's person-centered services plan.
Replaces: 173-40-05
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-40 - State-Funded PASSPORT Program › Section 173-40-06 - PASSPORT program (state-funded component): individuals' choices and responsibilities

Current through all regulations passed and filed through July 1, 2024
An individual enrolled in the state-funded component of the
				PASSPORT program has the same choices and responsibilities as rule
				173-42-06 of the Administrative
				Code 
								provides to an individual enrolled in the
				medicaid-funded component of the PASSPORT program.
ODA's designee has the same responsibilities
				
								with
				respect to an individual enrolled in the state-funded component of the
				PASSPORT program as rule
				173-42-06 of the Administrative
				Code 
								provides to ODA's designee 
								with respect
				to an individual enrolled in the medicaid-funded component of the
				PASSPORT program.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-42 - Medicaid-Funded PASSPORT Program › Section 173-42-01 - PASSPORT program (medicaid-funded component): introduction and definitions

Current through all regulations passed and filed through July 1, 2024
(A) Introduction: 
								This chapter regulates the medicaid-funded
			 component of the PASSPORT program created under section
			 173.52
			 of the Revised Code. (See Chapter 173-40 of the Administrative Code for rules
			 on the state-funded component of the PASSPORT program.)
(B) Definitions for this chapter:
"Authorized representative" has the same meaning as in rule
				5160-1-33
				of the Administrative Code.
"Nursing facility" has the same meaning as in section
				5165.01 of the
				Revised Code.
"ODA" means the Ohio department of
				aging.
"ODA's designee" has the same meaning as in rule
				173-39-01
				of the Administrative Code.
"ODM" means the Ohio
				department of medicaid.
"ODM's administrative agency" has the same meaning as
				"administrative agency" in rule
				5160:1-1-01
				of the Administrative Code.
"PASSPORT program" means the medicaid-funded component of the
				PASSPORT program created under section
				173.52
				of the Revised Code.
"Person-centered services plan" means the
				 outline of
				 services that a case manager authorizes
				a provider to provide to an individual, regardless of the funding source for
				those services. It includes the person-centered planning in rule
				5160-44-02
				of the Administrative Code.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-42 - Medicaid-Funded PASSPORT Program › Section 173-42-02 - PASSPORT program (medicaid-funded component): eligibility requirements for individuals

Current through all regulations passed and filed through July 1, 2024
A person is  eligible
				for the medicaid-funded component of the PASSPORT program
				only if 
								the person meets the eligibility
				requirements under rule
				5160-31-03 of the Administrative
				Code.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-42 - Medicaid-Funded PASSPORT Program › Section 173-42-03 - PASSPORT program (medicaid-funded component) enrollment and reassessment of individuals

Current through all regulations passed and filed through July 1, 2024
(A)
								Initial contact:
			 An individual may contact either ODM's administrative agency or ODA's designee
			 to apply for the medicaid-funded component of the PASSPORT program. The two
			 agencies coordinate processing applications for enrollment as follows:
(1)
									If the individual
			 makes initial contact with ODM's administrative agency, then ODM's
			 administrative agency shall help the individual apply and process the
			 applications for medicaid (unless already enrolled in medicaid) and the
			 medicaid-funded component of the PASSPORT program. If ODM's administrative
			 agency notifies ODA's designee that the individual meets all financial
			 eligibility requirements, then ODA's designee shall initiate contact with the
			 individual to conduct an assessment by telephone, video conference, or in
			 person to determine if the individual meets all non-financial eligibility
			 requirements in rule
			 5160-31-03 of the Administrative
			 Code.
(2)
									If the individual makes initial contact with ODA's
			 designee, then ODA's designee shall help the individual apply for medicaid
			 (unless already enrolled in medicaid) and the medicaid-funded component of the
			 PASSPORT program and conduct an assessment by telephone, video conference, or
			 in person to determine if the individual meets all non-financial eligibility
			 requirements in rule
			 5160-31-03 of the Administrative
			 Code.
(3)
									After the individual applies for the medicaid-funded
			 component of the PASSPORT program, ODA or its designee shall notify the
			 individual of the existence of the state-funded component of the PASSPORT
			 program in Chapter 173-40 of the Administrative Code and offer the individual
			 an opportunity to apply for enrollment in the state-funded component of the
			 program.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-42 - Medicaid-Funded PASSPORT Program › Section 173-42-06 - PASSPORT program (medicaid-funded component): individuals' choices and responsibilities

Current through all regulations passed and filed through July 1, 2024
(A) Person-centered planning:
(1) The individual is
			 subject to rule
			 5160-44-02 of the Administrative
			 Code. To comply with that rule, the individual and ODA's designee
			 
									have
			 flexibility to meet by telephone, video conference, or in person to
			 develop the individual's person-centered services plan (plan)
			 .
(2) ODA's designee
			 shall draft the plan 
									according to
			 the requirements in rule
			 5160-44-02 of the Administrative
			 Code.
(3) Choices
			 and responsibilities for the individual:
(a)
										
										The individual may choose a team of
			 people to join the individual and ODA's designee in the meeting
			  in paragraph (A)(1) of this
			 rule.
(b) The individual shall
			 cooperate with, and show respect to, ODA's designee to facilitate the
			 following:
(i) Assessing the individual and
			 visiting the individual's home to determine the individual's eligibility for
			 the PASSPORT program, enroll the individual into the PASSPORT program, and
			 determine the individual's service needs.
(ii) Recruiting, selecting, and dismissing
			 the individual's providers. 42 C.F.R. 431.51 allows an
			 individual to choose the providers from whom the individual wants to receive
			 services, so long as each provider the individual chooses is qualified and
			 willing to provide the services the individual needs.
(iii) Developing and maintaining back-up
			 plans that meet the individual's needs.
(c) After the plan is developed, the
			 individual shall do the following:
(i)
			 Understand the services authorized in the individual's person-centered services
			 plan.
(ii) Use the services ODA's
			 designee authorizes in the approved plan.
(iii) Notify ODA's designee if the individual
			 desires to change the provider from whom the individual receives
			 services.
(iv) Notify ODA's
			 designee of any significant change that may affect the individual's service
			 needs so that ODA's designee may update the plan. Significant changes include
			 the following:
(a)
												The
			 provider does not provide an authorized service at the time, or for the period
			 of time, authorized by ODA's designee.
(b) The individual
			 moves to another address.
(c)
												The individual repeatedly refuses to receive
			 services.
(4) The medicaid-funded
			 component of the PASSPORT program only pays for services authorized in the
			 plan.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-43 - Long Term Care Consultation Program › Section 173-43-01 - Long-term care consultation program: introduction and definitions

Current through all regulations passed and filed through July 1, 2024
(A)
								 The
			 long-term care consultation program provides
			 information to individuals and their representatives about options available to
			 meet their long-term care needs and factors to consider when making long-term
			 care decisions in accordance with section
			 173.42 of the Revised
			 Code.
(B) Definitions for
			 this chapter:
(1) "Individual" means a person
			 who may qualify to receive a long-term care consultation.
(2) "Level of care" means the review and
			 determination process under rule
			 5160-3-14 of the Administrative
			 Code.
(3) "Long-term care
			 consultation" and "consultation"
									
									have the
			 same 
									meanings as in section
			 173.42 of the Revised
			 Code.
(4) "Nursing facility" has
			 the same meaning as in section
			 5165.01 of the Revised
			 Code.
(5) "ODA" means
			 the Ohio department of aging.
(6)
			 "Pre-admission screening and resident review" has the same meaning as in rules
			 5160-3-15.1 and 5160-3-
			 15.2 of the Administrative
			 Code.
(7) "Program administrator"
			 has the same meaning as in section
			 173.42 of the Revised
			 Code.
(8) "Representative" has the
			 same meaning as in section
			 173.42 of the Revised
			 Code.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-43 - Long Term Care Consultation Program › Section 173-43-03 - Long-term care consultation program: required consultations and exemptions

Current through all regulations passed and filed through July 1, 2024
(A)
								The program
			 administrator shall provide a consultation to an individual satisfying one or
			 more of the following categories, unless paragraph (B) of this rule exempts the
			 individual:
(1)
									An individual who applies, or indicates an intention to
			 apply, for admission to a nursing facility.
(2)
									A nursing
			 facility resident who was admitted under a categorical determination under rule
			 5160-3-15.1, 5122-21-03, or 5123-14-01
			 of the Administrative Code, but has since been found to need a stay in a
			 nursing facility that will exceed the time limits in those
			 rules.
(3)
									An individual who contacts the program administrator to
			 seek information about options available to meet long-term care
			 needs.
(4)
									Any individual that ODA or the program administrator
			 identifies as being likely to benefit from a consultation.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-43 - Long Term Care Consultation Program › Section 173-43-04 - Long-term care consultation program: deadlines

Current through all regulations passed and filed through July 1, 2024
(A)
								The program
			 administrator shall complete every consultation no later than ten days after it
			 receives a request for the consultation, unless an exception under paragraph
			 (B) of this rule applies.
(B)
								Exceptions to the deadline in paragraph (A) of this
			 rule:
(1)
									If the
			 deadline in paragraph (A) of this rule falls on a Saturday, Sunday, or a legal
			 holiday listed in section
			 1.14 for the Revised Code, the
			 deadline is the next day that is not a Saturday, Sunday, or legal holiday
			 rather than the deadline in paragraph (A) of this rule.
(2)
									If an individual
			 or the individual's representative requests a consultation after the deadline
			 in paragraph (A) of this rule, the program administrator shall provide the
			 consultation at a time that is mutually agreed to between the individual, or
			 the individual's representative, and the program administrator and retain a
			 record on the reason why the program administrator was not able to provide the
			 consultation before the deadline.
(3)
									If the program
			 administrator cannot complete the consultation before the deadline in paragraph
			 (A) of this rule, the program administrator shall provide the longterm care
			 consultation as soon as is practicable and retain a record on the reason why
			 the program administrator was not able to provide the consultation before the
			 deadline.
Replaces: 173-43-04
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-43 - Long Term Care Consultation Program › Section 173-43-05 - Long-term care consultation program: staff certification

Current through all regulations passed and filed through July 1, 2024
(A)
								Section
			 173.42 of the Revised Code
			 permits a person to provide a consultation only if ODA certifies the
			 person.
(B)
								Qualifications for certification: ODA may certify a
			 person to provide consultations only if the person meets all of the following
			 qualifications:
(1)
									The person is an employee of the program
			 administrator.
(2)
									The person meets at least one of the following
			 qualifications:
(a)
										The person has a current, valid license to practice as
			 a registered nurse under Chapter 4723. of the Revised Code. Beginning on
			 January 1, 2023, "registered nurse" also includes a registered nurse with a
			 "multistate license" from another state with "multistate licensure privilege,"
			 as those terms are defined in section
			 4723.11 of the Revised
			 Code.
(b)
										The person has a current, valid license under Chapter
			 4757. of the Revised Code as a licensed independent social worker (LISW),
			 licensed social worker (LSW), an LISW or LSW with an unencumbered license in
			 another state that entered into the counseling compact with Ohio under section
			 4757.50 of the Revised Code, or
			 a current, valid license to practice in a related profession upon approval by
			 ODA.
(c)
										The person has a bachelor of arts degree or a bachelor
			 of science degree and also possesses at least one year of experience in one or
			 both of the following:
(i)
											Providing individuals with information about options
			 available to meet long-term care needs or providing individuals with related
			 information such as that which is provided through information and referral,
			 information and assistance.
(ii)
											Managed care
			 experience or other such healthcare experience related to individuals'
			 long-term care needs.
(d)
										The person has at
			 least three years of experience in one or both of the following:
(i)
											Providing
			 individuals with information about options available to meet long-term care
			 needs or providing individuals with related information such as that which is
			 provided through information and referral, information and
			 assistance.
(ii)
											Managed care experience or other such healthcare
			 experience related to individuals' long-term care needs.
(3)
									The person is not an employee of a provider of
			 long-term services and supports.
(4)
									The person is not
			 disqualified for a paid direct-care position under Chapter 173-9 of the
			 Administrative Code.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-44 - Unified Waiting List › Section 173-44-04 - Unified waiting list for the assisted living, PACE, and PASSPORT programs

Current through all regulations passed and filed through July 1, 2024
(A) The United States centers for medicare
			 and medicaid services limits the number of slots available for enrollment in
			 the medicaid-funded components of the assisted living and PASSPORT programs
			 which may cause a waiting list. A lack of capacity in PACE may also cause a
			 waiting list.  (This rule does not apply to the state-funded components
			 of the assisted living or PASSPORT programs.)
(B) Waiting list:
(1) If ODA's designee determines an
			 individual meets all non-financial eligibility requirements for the program to
			 which the individual applied, but a slot is not available for enrollment in the
			 program, ODA's designee or the PACE organization
			 shall place the individual on the unified waiting list established under
			 section 173.55 of the Revised Code
			 according to the latter of the date the individual applied for the program
			  or the date
			 the individual met all non-financial eligibility requirements for the program
			 to which the individual applied.
(2)
									 ODA's designee or
			 the PACE organization shall offer enrollment to any individual on the
			 unified waiting list for the assisted living, PACE, or PASSPORT programs who
			 meets all of the eligibility requirements for the program to which the
			 individual applied, in compliance with the enrollment rule for the program
			 , according
			 to the chronological order that ODA's designee placed
			 
									the
			 individual on the waiting list, unless prohibited
			 by rule 173-38-03,
			 173-50-03, or
			 173-42-03 of the Administrative
			 Code.
(a) The following rules present
			 the eligibility requirements:
(i) Assisted
			 living: See rule
			 5160-33-03 of the Administrative
			 Code.
(ii) PACE: See rule
			 173-50-02 of the Administrative
			 Code.
(iii) PASSPORT: See rule
			 5160-31-03 of the Administrative
			 Code.
(b) The following
			 rules present the enrollment process:
(i)
			 Assisted living: See rules
			 173-38-03 and
			 5160-33-04 of the Administrative
			 Code.
(ii) PACE: See rule
			 173-50-03 of the Administrative
			 Code.
(iii) PASSPORT: See rules
			 173-42-03 and
			 5160-31-04 of the Administrative
			 Code.
(3) If ODA's designee
			 offers enrollment to an individual from the unified waiting list, but the
			 individual declines enrollment, the individual may remain on the unified
			 waiting list and ODA's designee shall offer enrollment to the next individual
			 on the list according to the order this rule establishes.
(4) If
			 a slot is available in the program to which an eligible individual applied,
			 ODA's designee or the PACE organization shall not place the individual on the
			 unified waiting list.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-45 - Long Term Care Consumer Guide › Section 173-45-01 - Long-term care consumer guide: introduction and definitions

Current through all regulations passed and filed through July 1, 2024
(A) Introduction:
			 This chapter governs the Ohio long-term care consumer guide that ODA
			 electronically publishes to provide the public with detailed information on
			 Ohio's long-term care facilities, including
			 nursing homes, residential care facilities, skilled nursing facility units of
			 hospitals,  county homes certified to
			 receive medicare and medicaid reimbursement, and
			 residential facilities. The information includes a facility's size,
			 location, services offered, customer satisfaction data, regulatory compliance
			 performance data, and, in the case of nursing facilities, quality measures. The
			 guide's information allows the public to compare two or more facilities. The
			 guide may also include detailed information about other types of long-term care
			 providers.
(B) Definitions for
			 this chapter:
"CMS" means "centers for medicare and medicaid
				services."
"Facility" means a nursing facility.
									 residential
				care facility, or residential facility.
"Guide" means the "Ohio long-term care consumer guide," which
				was created by ODA in accordance with section
				173.46 of the Revised
				Code.
"Medicaid" has the same meaning as in section
				5162.01 of the Revised
				Code.
"Medicare" has the same meaning as in
				section
				5162.01 of the Revised
				Code.
"Nursing facility" means either of the following:
(1) A facility, or a distinct part of a
			 facility, that is certified a nursing facility or a skilled nursing facility
			 for purposes of the medicare or medicaid program.
(2) A nursing home licensed under section
			 3721.02 of the Revised Code that
			 is not certified as a nursing facility or skilled nursing facility.
"ODA" means "the Ohio department of aging."
"ODH" means "the Ohio department of health."
"Quality measure" means an aspect of the physical or mental
				conditions of the residents of a nursing facility that is derived from the
				resident assessment instruments submitted by nursing facilities to CMS for the
				purposes of the medicare and medicaid programs.
"Residential care facility" has the same meaning as in section
				3721.01 of the Revised
				Code.
"Residential facility" has the same
				meaning as in section
				173.45 of the Revised
				Code.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-45 - Long Term Care Consumer Guide › Section 173-45-03 - Long-term care consumer guide: consumer guide content

Current through all regulations passed and filed through July 1, 2024
(A) General information: ODA shall include
			 the following information in the guide:
(1) A
			 description of the guide.
(2)
			 Disclaimers stating the limitations of the data included in the
			 guide.
(3) A recommendation for
			 each individual who is considering an admission into a long-term care facility
			 to visit any facility that he or she is considering.
(4) Electronic links to other information on
			 the internet about selecting long-term care facilities and long-term care
			 service providers, including information maintained by pertinent government
			 agencies and private organizations and the telephone numbers for those agencies
			 and organizations.
Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-45 - Long Term Care Consumer Guide › Section 173-45-04 - Long-term care consumer guide: search queries

Current through all regulations passed and filed through July 1, 2024
(A) Nursing facilities: The search query page
			 allows the public to search for nursing facilities by using the following
			 
								parameters:
(1)
			 Geographic location by city, county, ZIP code, or radius.
(2) Source of payment accepted in addition to
			 private sources:
(a) Medicaid.
(b) Medicare.
(c) Veteran's administration.
(3) Services for nursing facility
			 residents:
(a) Alzheimer's disease/dementia
			 care (secured or unsecured).
(b)
			 Bariatric care.
(c) Behavioral
			 care.
(d) Dialysis on
			 site.
(e) Hospice care.
(f) Intensive rehabilitation
			 services.
(g) Respiratory care,
			 including ventilator care.
(h)
			 Respiratory care, not including ventilator care.
(i) Short-term stay for respite.
(j) Skin and wound care.
(k) Spinal cord injury care.
(l)  Traumatic brain injury care.
(4) A keyword search of nursing
			 facility page information.
(5)
			 Nursing facility name.