Effective: September 30, 2021
Latest Legislation: House Bill 110 - 134th General Assembly
(A) As used in sections 5124.191 to 5124.193 of the Revised Code, "ICF/IID resident" includes an individual who is on hospital or therapeutic leave from an ICF/IID.
(B) In accordance with rules adopted under section 5124.03 of the Revised Code, the department of developmental disabilities shall assess each ICF/IID resident regardless of payment source and compile complete assessment data on the residents. The department shall perform the initial assessment of an ICF/IID resident. The department may perform a subsequent assessment of an ICF/IID resident under any of the following circumstances:
(1) The provider of the ICF/IID in which the resident resides or from which the resident is on hospital or therapeutic leave has submitted to the department under division (D) of this section revised assessment data for the resident or an attestation of no changes in the resident's assessment data and the department has reason to believe that the revised assessment data or attestation is inaccurate;
(2) The department has reason to believe that the resident's most recent assessment no longer accurately reflects the resident's condition;
(3) The department determines that the resident's most recent assessment should be updated because of the passage of time since that assessment was performed.
(C) If an ICF/IID provider disagrees with the results of an assessment performed by the department under this section, the provider may request that the department reconsider the results in accordance with rules adopted under section 5124.03 of the Revised Code.
(D) After the department assesses an ICF/IID resident under this section, the provider of the ICF/IID in which the resident resides or from which the resident is on hospital or therapeutic leave shall submit to the department, not later than fifteen days after the end of each subsequent calendar quarter and through the medium or media specified in rules adopted under section 5124.03 of the Revised Code, either of the following:
(1) Revised assessment data for the resident if there are changes in the resident's assessment data;
(2) An attestation that there are no changes in the resident's assessment data.
(E) A resident assessment instrument specified in rules adopted under section 5124.03 of the Revised Code shall be used to compile or revise assessment data of ICF/IID residents under this section.
Last updated August 24, 2021 at 2:54 PM
Structure Ohio Revised Code
Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services
Section 5124.01 | Definitions.
Section 5124.05 | Scope of Coverage.
Section 5124.06 | Eligibility to Enter Into Provider Agreements.
Section 5124.07 | Department Provider Agreements; Contents.
Section 5124.071 | Agreements With More Than One Icf/iid.
Section 5124.072 | Revalidation of Agreements.
Section 5124.08 | Provider Agreements With Icf/iid Providers.
Section 5124.081 | Resident's Cause of Action for Breach.
Section 5124.10 | Cost Reports.
Section 5124.101 | Cost Reports for Downsized or Partially Converted Provider.
Section 5124.102 | Fines Paid Excluded From Reports.
Section 5124.103 | Form of Cost Reports.
Section 5124.104 | Duties of Department.
Section 5124.105 | Addendum for Disputed Costs.
Section 5124.106 | Failure to Timely File Report; Consequences.
Section 5124.107 | Amendments to Reports.
Section 5124.108 | Desk Review.
Section 5124.15 | Amount of Payments.
Section 5124.151 | Initial Rates for Services Provided by a New Icf/iid.
Section 5124.152 | Payment Rate for Service Provided by Outlier Icf/iid or Unit.
Section 5124.154 | Computing Rate for Services Provided by Developmental Centers.
Section 5124.17 | Icf/iid's per Medicaid Day Capital Component Rate.
Section 5124.19 | Icf/iid's per Medicaid Day Direct Care Costs Component Rate.
Section 5124.191 | Definition of Icf/iid Resident; Assessment of Residents.
Section 5124.192 | Acuity Groups for Purpose of Assigning Case-Mix Scores.
Section 5124.193 | Quarterly Determination of Case-Mix Scores.
Section 5124.194 | Changes to Instructions, Guidelines, or Methodology.
Section 5124.21 | Per Medicaid Day Indirect Care Costs Component Rate.
Section 5124.23 | Per Medicaid Day Other Protected Costs Component Rate.
Section 5124.24 | Determination of per Medicaid Day Quality Incentive Payment.
Section 5124.26 | Payment of Medicaid Rate Add-on for Outlier Icf/iid Services.
Section 5124.30 | Costs of Goods Furnished by Related Party.
Section 5124.31 | Adjustment of Payment Rates.
Section 5124.32 | Reduction in Rate Not Permitted.
Section 5124.33 | No Payment for Day of Discharge.
Section 5124.34 | Payment for Reserving Beds.
Section 5124.35 | Timing of Payments After Involuntary Termination.
Section 5124.37 | Timing of Payments; Calculations.
Section 5124.38 | Process for Reconsideration of Rates.
Section 5124.39 | Recoupment in Case of Delay in Downsizing.
Section 5124.40 | Adjustment of Rates.
Section 5124.41 | Redetermination of Rates.
Section 5124.42 | Additional Penalties.
Section 5124.43 | Determination of Interest Rate.
Section 5124.45 | Deposits to General Revenue Fund.
Section 5124.46 | Adjudications Under the Administrative Procedure Act.
Section 5124.50 | Notice of Facility Closure or Voluntary Termination.
Section 5124.51 | Notice of Change of Operator.
Section 5124.511 | Agreements With Entering Operators Effective on Date of Change of Operator.
Section 5124.512 | Agreements With Entering Operators Effective at a Later Date.
Section 5124.513 | Entering Operator Duties Under Provider Agreement.
Section 5124.514 | Exiting Operator Deemed Operator Pending Change.
Section 5124.515 | Provider Agreement With Operator Not Complying With Prior Agreement.
Section 5124.516 | Medicaid Reimbursement Adjustments; Change of Operator.
Section 5124.517 | Determination That a Change of Operator Has or Has Not Occurred; Effect.
Section 5124.52 | Overpayment Amounts Determined Following Notice of Closure, Etc.
Section 5124.521 | Withholding From Medicaid Payment Due Exiting Operator.
Section 5124.522 | Cost Report by Exiting Operator; Waiver.
Section 5124.523 | Failure to File Cost Report; Payments Deemed Overpayments.
Section 5124.524 | Final Payment Withheld Pending Receipt of Cost Reports.
Section 5124.525 | Determination of Debt of Exiting Operator; Summary Report.
Section 5124.526 | Release of Amount Withheld Less Amounts Owed.
Section 5124.527 | Release of Amount Withheld on Postponement of Change of Operator.
Section 5124.528 | Disposition of Amounts Withheld From Payment Due an Exiting Operator.
Section 5124.53 | Adoption of Rules for Implementation of Sections 5124.50 to 5124.53.
Section 5124.60 | Conversion of Beds to Home and Community-Based Services.
Section 5124.61 | Conversion of Beds in Acquired Icf/iid.
Section 5124.62 | Request for Federal Approval of Conversion of Beds.
Section 5124.65 | Reconversion of Beds to Icf/iid Use.
Section 5124.69 | Informational Pamphlet.
Section 5124.70 | Maximum Number of Residents per Sleeping Room.
Section 5124.99 | Penalty for Violation of Cost Reporting Provisions.