Ohio Administrative Code › Title 5123 - Department of Developmental Disabilities › Chapter 5123-3 - Medications; R&D and Demonstration Projects › Section 5123-3-11 - Licensed residential facilities - room and board

Current through all regulations passed and filed through July 1, 2024
(A)
								Purpose
This rule identifies components of room
				and board and establishes standards and procedures for determining the amount
				of earned income and unearned income retained by an individual as personal
				funds and the amount of room and board for which an individual is responsible
				when residing in a residential facility licensed in accordance with section
				5123.19
				of the Revised Code other than an intermediate care facility for individuals
				with intellectual disabilities.
(B)
								Definitions
For the purposes of this rule, the
				following definitions apply:
(1)
									"County board" means a county board of developmental
			 disabilities.
(2)
									"Department" means the Ohio department of developmental
			 disabilities.
(3)
									"Earned income" means wages and net earnings from
			 employment or selfemployment.
(4)
									"Home and
			 community-based services" has the same meaning as in section
			 5123.01
			 of the Revised Code.
(5)
									"Individual" means a person with a developmental
			 disability.
(6)
									"Individual service plan" means the written description
			 of services, supports, and activities to be provided to an
			 individual.
(7)
									"Intermediate care facility for individuals with
			 intellectual disabilities" has the same meaning as in section
			 5124.01 of the
			 Revised Code.
(8)
									"Licensee" has the same meaning as in section
			 5123.19
			 of the Revised Code.
(9)
									"Patient liability" means the individual's financial
			 obligation toward the medicaid cost of care. Patient liability will be
			 satisfied in accordance with rule 5160:1-6-07.1 of the Administrative
			 Code.
(10)
									"Personal funds" means earned income and unearned
			 income retained by an individual after satisfying obligations such as rent,
			 individual-specific expenses, or medical co-payments; satisfying state
			 requirements including patient liability and/or monthly premiums for services
			 funded by a home and community-based services waiver; and satisfying federal
			 requirements including adherence to income restrictions necessary to maintain
			 medicaid eligibility.
(11)
									"Residential facility" has the same meaning as in
			 section
			 5123.19
			 of the Revised Code, except that for purposes of this rule, "residential
			 facility" does not include an intermediate care facility for individuals with
			 intellectual disabilities.
(12)
									"Room and board"
			 means items, costs, and/or expenses, which are not reimbursable through
			 medicaid or another payer, incurred by the licensee in order to provide needed
			 supports and services to an individual residing in a residential facility. Room
			 and board reflects the licensee's actual and reasonable costs and includes
			 individual-specific expenses based on the support provided to each individual
			 who resides in the residential facility to implement the individual's
			 individual service plan and residential facility costs.
(a)
										Individual-specific expenses include:
(i)
											Adaptive minor
			 equipment, routine medical supplies, and over-the-counter
			 medications.
(ii)
											Healthcare-related expenses and medical equipment such
			 as dental services, eyeglasses, wheelchairs, and catheters.
(iii)
											Personal
			 hygiene supplies such as hair and nail care items, lotions, powder, dental
			 hygiene supplies, shaving items, and the cost of haircuts.
(iv)
											The cost of
			 recreational and/or social activities such as an admission ticket and travel
			 (but never staff wages) for an individual and for staff, as specified in the
			 individual service plan, necessary to accompany the individual to recreational
			 and/or social activities.
(v)
											An individual's clothing.
(vi)
											Atypical
			 supplies required for the protection of an individual and staff while
			 performing procedures that involve potential contact with bodily fluids
			 including, but not limited to, gowns, goggles, and eye wash.
(b)
										Residential facility costs include:
(i)
											Administrative
			 overhead expenses directly related to property management of the residential
			 facility.
(ii)
											Utilities including fuel oil, natural and propane gas,
			 metered electrical service, water and sewage expenses, local and long distance
			 telephone service, equipment purchased or leased for use by residents, and the
			 cost of security services provided for the benefit of
			 residents.
(iii)
											The cost of basic television and internet services
			 provided for the benefit of residents.
(iv)
											The cost of
			 food, after food stamps and other available resources are expended, including
			 all raw, prepackaged, and prepared food (meals and/or snack items) eaten inside
			 or outside the home (e.g., at restaurants) by the residents and like expenses
			 for staff if consumed while providing supervision or services to the
			 residents.
(v)
											Rental or lease costs for building and land limited to
			 the lesser of actual cost or fair market value and insurance on
			 contents.
(vi)
											Depreciation for a residential facility owned by the
			 licensee (excluding the value of the land) using the straight line method of
			 depreciation over forty years and interest expense as incurred, real property
			 taxes, and insurance on contents and property. Excludes amortization expense
			 over the life of state property grants received by the licensee for
			 renovations.
(vii)
											Maintenance and repair of the residential facility
			 including, but not limited to, lawn care, trash removal, pest control, carpet
			 cleaning, and repair to minor equipment or structure.
(viii)
											Depreciation
			 and current interest expense of residential facility equipment, furniture, and
			 other furnishings that meet the licensee's capitalization policy, using the
			 straight line method of depreciation. Guidelines established by the internal
			 revenue service will be used to determine the number of years of useful life of
			 the asset to be depreciated.
(ix)
											Lease or rental
			 of residential facility equipment, furniture, and other furnishings and/or the
			 cost of equipment, furniture, and other furnishings under the capitalization
			 policy of the licensee.
(x)
											Major maintenance to a residential facility owned by
			 the licensee to improve and/or maintain the structural integrity of the
			 facility and to maintain a safe and healthy living environment including, but
			 not limited to, roof replacement; repairs to the foundation, walls, floors,
			 electrical, heating and cooling, plumbing, or septic and sewer systems;
			 additions or renovations that benefit the residents; and interest expense if
			 funds were borrowed to complete the work. The straight line method of
			 depreciation will be used for depreciating all improvements. Improvements will
			 be depreciated over a period not less than the remaining useful life of the
			 property and not more than the useful life of the improvement as determined by
			 the internal revenue service.
(xi)
											Non-food
			 supplies and minor equipment used in the storage, preparation, serving, and
			 delivery of food such as dishes, dish washing detergent, cooking utensils,
			 silverware, wraps and containers to preserve food, and propane gas for
			 grills.
(xii)
											Household costs including, but not limited to, trash
			 cans and bags, general household cleaning supplies, paper products, towels,
			 bedding, laundry, and minor equipment used for laundry and
			 housekeeping.
(13)
									"Unearned
			 income" means all income that is not earned income, including, but not limited
			 to, social security disability income, supplemental security income, other
			 benefits an individual receives, and monetary gifts.