Ohio Revised Code
Chapter 5123 | Department of Developmental Disabilities
Section 5123.021 | Determining Need for Nursing Facility Care.

Effective: September 29, 2013
Latest Legislation: House Bill 59 - 130th General Assembly
(A) As used in this section, "mentally retarded individual" and "specialized services" have the same meanings as in section 5165.03 of the Revised Code.
(B)(1) Except as provided in division (B)(2) of this section and rules adopted under division (E)(3) of this section, for purposes of section 5165.03 of the Revised Code, the department of developmental disabilities shall determine in accordance with section 1919(e)(7) of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended, and regulations adopted under section 1919(f)(8)(A) of that act whether, because of the individual's physical and mental condition, a mentally retarded individual seeking admission to a nursing facility requires the level of services provided by a nursing facility and, if the individual requires that level of services, whether the individual requires specialized services for mental retardation.
(2) A determination under this division is not required for any of the following:
(a) An individual seeking readmission to a nursing facility after having been transferred from a nursing facility to a hospital for care;
(b) An individual who meets all of the following conditions:
(i) The individual is admitted to the nursing facility directly from a hospital after receiving inpatient care at the hospital;
(ii) The individual requires nursing facility services for the condition for which the individual received care in the hospital;
(iii) The individual's attending physician has certified, before admission to the nursing facility, that the individual is likely to require less than thirty days of nursing facility services.
(c) An individual transferred from one nursing facility to another nursing facility, with or without an intervening hospital stay.
(C) Except as provided in rules adopted under division (F)(3) of this section, the department of developmental disabilities shall review and determine, for each resident of a nursing facility who is mentally retarded, whether the resident, because of the resident's physical and mental condition, requires the level of services provided by a nursing facility and whether the resident requires specialized services for mental retardation. The review and determination shall be conducted in accordance with section 1919(e)(7) of the "Social Security Act" and the regulations adopted under section 1919(f)(8)(A) of the act. The review and determination shall be completed promptly after a nursing facility has notified the department that there has been a significant change in the resident's mental or physical condition.
(D)(1) In the case of a nursing facility resident who has continuously resided in a nursing facility for at least thirty months before the date of a review and determination under division (C) of this section, if the resident is determined not to require the level of services provided by a nursing facility, but is determined to require specialized services for mental retardation, the department, in consultation with the resident's family or legal representative and care givers, shall do all of the following:
(a) Inform the resident of the institutional and noninstitutional alternatives covered under the state plan for medical assistance;
(b) Offer the resident the choice of remaining in the nursing facility or receiving covered services in an alternative institutional or noninstitutional setting;
(c) Clarify the effect on eligibility for services under the state plan for medical assistance if the resident chooses to leave the facility, including its effect on readmission to the facility;
(d) Provide for or arrange for the provision of specialized services for the resident's mental retardation in the setting chosen by the resident.
(2) In the case of a nursing facility resident who has continuously resided in a nursing facility for less than thirty months before the date of the review and determination under division (C) of this section, if the resident is determined not to require the level of services provided by a nursing facility, but is determined to require specialized services for mental retardation, or if the resident is determined to require neither the level of services provided by a nursing facility nor specialized services for mental retardation, the department shall act in accordance with its alternative disposition plan approved by the United States department of health and human services under section 1919(e)(7)(E) of the "Social Security Act."
(3) In the case of an individual who is determined under division (B) or (C) of this section to require both the level of services provided by a nursing facility and specialized services for mental retardation, the department of developmental disabilities shall provide or arrange for the provision of the specialized services needed by the individual or resident while residing in a nursing facility.
(E) The department of developmental disabilities shall adopt rules in accordance with Chapter 119. of the Revised Code that do all of the following:
(1) Establish criteria to be used in making the determinations required by divisions (B) and (C) of this section. The criteria shall not exceed the criteria established by regulations adopted by the United States department of health and human services under section 1919(f)(8)(A) of the "Social Security Act."
(2) Specify information to be provided by the individual or nursing facility resident being assessed;
(3) Specify any circumstances, in addition to circumstances listed in division (B) of this section, under which determinations under divisions (B) and (C) of this section are not required to be made.

Structure Ohio Revised Code

Ohio Revised Code

Title 51 | Public Welfare

Chapter 5123 | Department of Developmental Disabilities

Section 5123.01 | Department of Developmental Disabilities Definitions.

Section 5123.011 | Adoption of Rules.

Section 5123.012 | Eligibility Determinations.

Section 5123.013 | Application of Chapter.

Section 5123.014 | Reference to Department or Director and Other Terms.

Section 5123.02 | Duties of Department.

Section 5123.021 | Determining Need for Nursing Facility Care.

Section 5123.022 | State Policy Regarding Community Employment for Individuals With Developmental Disabilities.

Section 5123.023 | Employment First Task Force.

Section 5123.024 | Implementation of Early Intervention Services Program.

Section 5123.025 | Technology First Policy.

Section 5123.026 | Technology First Task Force.

Section 5123.03 | Management of Institutions and Facilities.

Section 5123.031 | Nonpartisan Management.

Section 5123.032 | Closure of a Developmental Center.

Section 5123.033 | Department Program Fee Fund.

Section 5123.034 | Developmental Centers Services and Cost Recovery.

Section 5123.04 | Director of Department - Powers and Duties.

Section 5123.042 | Plans for Development or Modification of Residential Services; Rules.

Section 5123.043 | Complaint Resolution.

Section 5123.044 | Determination of Violation of Rights; Assistance to Individuals.

Section 5123.045 | Certification and Licensing of Providers.

Section 5123.047 | Department Payment of Nonfederal Share of Certain Expenditures.

Section 5123.048 | Payment of Nonfederal Share of County Medicaid Expenditures.

Section 5123.049 | Rules Governing the Authorization and Payment of Home and Community-Based Services, Medicaid Case Management Services, and Habilitation Center Services.

Section 5123.0410 | Individual Receiving Services Moving to New County.

Section 5123.0411 | Mandamus.

Section 5123.0412 | Oddd Administration and Oversight Fund.

Section 5123.0413 | Rules to Applicable in Event County Tax Levy for Services for Individuals With Developmental Disabilities Fails.

Section 5123.0414 | Methods of Notice by Department.

Section 5123.0415 | Notification of Change of Address.

Section 5123.0416 | Expenditure and Allocation of Appropriated Fees.

Section 5123.0417 | Programs for Person Under 22 With Intensive Behavioral Needs.

Section 5123.0418 | Additional Uses of Funds.

Section 5123.0419 | Interagency Workgroup on Autism.

Section 5123.0420 | Training and Certification Program for Individuals Who Provide Evidence-Based Interventions to Individuals With an Autism Spectrum Disorder.

Section 5123.0421 | Rules to Implement Part C Early Intervention Services Program.

Section 5123.0422 | Early Intervention Services Advisory Council.

Section 5123.0423 | Request for Student Data Verification Code.

Section 5123.0424 | Reimbursement of Travel Expenses of Official Members of Workgroups.

Section 5123.05 | Audits of Services and Programs.

Section 5123.051 | Payment Agreements With Providers.

Section 5123.06 | Divisions of Department.

Section 5123.07 | Bureau of Research - Duties.

Section 5123.08 | Classified and Unclassified Appointments.

Section 5123.081 | Criminal Records Check.

Section 5123.09 | Managing Officer of Institution - Powers and Duties.

Section 5123.091 | Changing Purpose and Use of Institutions.

Section 5123.092 | Citizen's Advisory Council.

Section 5123.093 | Duties of Citizen's Advisory Council.

Section 5123.10 | Bond of Employees.

Section 5123.11 | Residency Medical and Psychological Training Programs.

Section 5123.12 | Residency Training Programs for Students Enrolled in Appropriate Care Programs.

Section 5123.122 | Support Rate.

Section 5123.13 | Special Police Officers.

Section 5123.14 | Investigations.

Section 5123.15 | Appointing Special Agents and Persons.

Section 5123.16 | Valid Supported Living Certificate Required.

Section 5123.161 | Application for Supported Living Certificate.

Section 5123.162 | Applicant Survey to Determine if Standards Met.

Section 5123.163 | Term of Supported Living Certificate.

Section 5123.164 | Renewal of Supported Living Certificate.

Section 5123.165 | Provision of Supported Living and Residence.

Section 5123.166 | Adjudication Order Against Certificate Applicant or Holder.

Section 5123.167 | Reapplication After Negative Adjudication on Certificate.

Section 5123.168 | Termination of Certificate for Failure to Bill for Services.

Section 5123.169 | Issuance of Supported Living Certificate.

Section 5123.1610 | Termination or Refusal of Provider Agreement for Supported Living.

Section 5123.1611 | Rules Governing Supported Living Program.

Section 5123.1612 | Summary Order Suspending Supported Living Certificate Holder's Authority to Provide Supported Living.

Section 5123.17 | Care Outside Institution.

Section 5123.171 | Respite Care Services.

Section 5123.18 | Contracts With Person or Agency to Provide Services.

Section 5123.19 | Operation of Residential Facilities.

Section 5123.191 | Appointing Receiver to Operate Residential Facility.

Section 5123.192 | Licensing for Icf/iid After 7/1/2013.

Section 5123.193 | Searchable Database of Vacancies in Licensed Residential Facilities.

Section 5123.194 | Waiving Support Collection Requirements to Facilitate Independent Living.

Section 5123.195 | Reporting Implementation of Amendments to Statute.

Section 5123.196 | Maximum Number of Beds.

Section 5123.197 | Initial Residential Facility License or Modification of Existing Facility License Not Required in Certain Instances.

Section 5123.198 | Reduction in Number of Residents.

Section 5123.20 | Prohibiting Operation Without License.

Section 5123.21 | Transfers.

Section 5123.22 | Appropriating Property.

Section 5123.221 | Cultivating Land - Purchases From Other Institutions.

Section 5123.24 | Businesses Located Near Institutions.

Section 5123.25 | Purchasing Supplies.

Section 5123.26 | Funds.

Section 5123.27 | Holding Property in Trust.

Section 5123.28 | Handling Funds Belonging to Residents.

Section 5123.29 | Industrial and Entertainment Fund - Commissary Fund.

Section 5123.30 | Books and Accounts.

Section 5123.31 | Confidentiality.

Section 5123.33 | Annual Report.

Section 5123.34 | Liberal Construction of Chapter.

Section 5123.35 | Ohio Developmental Disabilities Council.

Section 5123.351 | Eligibility for State Reimbursement of Expenses Incurred by Facilities and Programs.

Section 5123.352 | Community Developmental Disabilities Trust Fund.

Section 5123.36 | State Participation in Developmental Disability Construction Programs.

Section 5123.37 | Application to Sell Facility and Acquire Replacement.

Section 5123.371 | Payment to Director After Sale of Facility.

Section 5123.372 | Deadline for Acquisition of Replacement Facility.

Section 5123.373 | Agreement to Pay Percentage of Cost of Acquisition.

Section 5123.374 | Rescission of Approval of Application.

Section 5123.375 | Developmental Disabilities Community Capital Replacement Fund.

Section 5123.376 | Changing Terms of Agreement Regarding Construction, Acquisition, or Renovation of Residential Facility.

Section 5123.377 | Authority to Change Terms of Agreement Regarding the Construction, Acquisition, or Renovation of Community Adult Facility.

Section 5123.378 | Authority to Change Terms of Agreement Regarding the Construction, Acquisition, or Renovation of Community Early Childhood Facility.

Section 5123.38 | Effect of Transfer From Supported Services to Commitment to Icf/iid.

Section 5123.39 | Patient Clothing.

Section 5123.40 | Services Fund for Individuals With Developmental Disabilities.

Section 5123.41 | Administration of Prescribed Medications, Performance of Health-Related Activities, Tube Feeding Definitions.

Section 5123.42 | Authorization for Workers to Administer Prescribed Medications, Perform Health-Related Activities, or Perform Tube Feedings.

Section 5123.421 | Complaints and Investigations.

Section 5123.422 | Immunity.

Section 5123.43 | Training Courses for Administration of Prescribed Medications and Performance of Health-Related Activities.

Section 5123.44 | Training Registered Nurses to Provide Training Courses for Department Personnel.

Section 5123.441 | Certificates to Provide Training Courses.

Section 5123.45 | Program for Issuing of Certificates.

Section 5123.451 | Registry Listing Personnel and Registered Nurses Holding Valid Certificates.

Section 5123.452 | Adjudication Orders.

Section 5123.46 | Rules Adopted in Conjunction With Board of Nursing and the Ohio Nurses Association.

Section 5123.47 | Authorizing In-Home Worker to Perform Health Care Tasks.

Section 5123.50 | Registry of Employees Guilty of Abuse, Neglect or Misappropriation Definitions.

Section 5123.51 | Reviewing Report of Abuse, Neglect or Misappropriation.

Section 5123.52 | Registry of Employees Guilty of Abuse, Neglect or Misappropriation.

Section 5123.53 | Petitioning for Removal From Registry.

Section 5123.54 | Rehabilitation Standard Rules.

Section 5123.541 | Employees Engaging in Sexual Conduct or Contact With Individual Under Department Care.

Section 5123.542 | Notice Explaining Prohibited Conduct.

Section 5123.55 | Protective Services Definitions.

Section 5123.56 | Statewide System of Protective Service.

Section 5123.57 | Evaluation Before Guardianship or Trusteeship Begins.

Section 5123.58 | Nomination of Protective Services Agency as Guardian, Trustee or Protector.

Section 5123.59 | Bond.

Section 5123.60 | Ohio Protection and Advocacy System.

Section 5123.601 | Access to Information by Staff and Attorneys.

Section 5123.602 | Compensation in Class Action Cases.

Section 5123.603 | Joint Committee to Examine Protection and Advocacy System.

Section 5123.61 | Reporting Abuse, Neglect, and Other Major Unusual Incidents.

Section 5123.611 | Reviewing Report of Abuse, Neglect, or a Major Unusual Incident.

Section 5123.612 | Reporting Unusual Incidents.

Section 5123.613 | Subject of Report or Representative Has Right to Report and Related Records.

Section 5123.614 | Procedure Following Report of Major Unusual Incident.

Section 5123.62 | Rights of Persons With a Developmental Disability.

Section 5123.621 | Legislative Intent Regarding Adult Day Services.

Section 5123.63 | Distributing Copies of Rights.

Section 5123.64 | Enforcement Duties.

Section 5123.65 | Self-Administration of Medication.

Section 5123.651 | Assistance in Self-Administration of Prescribed Medication.

Section 5123.67 | Liberal Construction of Chapter.

Section 5123.69 | Voluntary Admission.

Section 5123.691 | Admission to Specialized Treatment Unit for Minors.

Section 5123.70 | Requesting Release of Voluntary Resident.

Section 5123.701 | Application for Short-Term Care.

Section 5123.71 | Affidavit for Involuntary Institutionalization.

Section 5123.711 | Assessment of Individual's Needs.

Section 5123.72 | Presentation of Case for State.

Section 5123.73 | Notice of Hearing.

Section 5123.74 | Emergency Institutionalization by Probate Court.

Section 5123.75 | Probable Cause Hearing.

Section 5123.76 | Full Hearing.

Section 5123.77 | Temporary Holding.

Section 5123.79 | Discharging Involuntary Resident.

Section 5123.80 | Trial Visits.

Section 5123.801 | Expenses of Trial Visit or Discharge.

Section 5123.81 | Involuntarily Committed Resident Absent Without Leave.

Section 5123.811 | Reporting Change of Location, Death or Condition of Resident.

Section 5123.82 | Application for Habilitation and Care of Discharged Resident.

Section 5123.83 | Civil and Public or Private Employment Rights.

Section 5123.84 | Free Communication With Others by Residents.

Section 5123.85 | Habilitation Plan.

Section 5123.851 | Procedure Upon Discharge.

Section 5123.86 | Consent for Medical Treatment.

Section 5123.87 | Labor or Tasks Performed by Residents.

Section 5123.88 | Writ of Habeas Corpus.

Section 5123.89 | Confidentiality.

Section 5123.90 | Attorney General Duties.

Section 5123.91 | Immunity.

Section 5123.92 | Venue.

Section 5123.93 | Guardianship of Minor.

Section 5123.95 | Transmission of Court Papers.

Section 5123.96 | Payment of Costs, Fees, and Expenses of Proceedings.

Section 5123.97 | Record of Probate Judge.

Section 5123.99 | Penalty.