Ohio Revised Code
Title 51 | Public Welfare
Chapter 5165 | Medicaid Coverage of Nursing Facility Services

Section 5165.073 | Termination for Non-Compliance With Installation of Fire Extinguishing and Fire Alarm Systems. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.08 | Nursing Facilities' Provider Agreement Terms. - Effective: January 1, 2015 Latest Legislation: Senate Bill 276 -...

Section 5165.081 | Action Against Facility for Breach of Provider Agreement or Other Duties. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.082 | Qualification of Beds. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.10 | Annual Cost Report. - Effective: September 15, 2014 Latest Legislation: House Bill 483 -...

Section 5165.101 | Cost of Franchise Permit Fee Not Reimbursable Expense. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.102 | Fines Excluded From Cost Report. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.103 | Completion of Cost Reports. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.104 | Form of Cost Reports; Guidelines. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.105 | Addendum for Disputed Costs. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.106 | Termination for Failure to File Report. - Effective: November 22, 2017 Latest Legislation: House Bill 49 -...

Section 5165.107 | Amendments to Cost Reports. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.108 | Desk Review of Cost Report. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.109 | Audit. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.1010 | Nursing Facility Fines. - Effective: September 29, 2017 Latest Legislation: House Bill 49 -...

Section 5165.15 | Calculation of Payments to Nursing Facility Providers. - Effective: June 30, 2021 Latest Legislation: House Bill 110 -...

Section 5165.151 | Initial Rates for New Nursing Facilities. - Effective: June 30, 2021 Latest Legislation: House Bill 110 -...

Section 5165.152 | Payments for Services Provided to Low Resource Utilization Residents. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5165.153 | Rates for Outlier Facilities or Units. - Effective: November 22, 2017 Latest Legislation: House Bill 49 -...

Section 5165.154 | Calculating Prospective Rates for Facilities With Residents Whose Care Costs Are Not Adequately Measured. - Effective: November 22, 2017 Latest Legislation: House Bill 49 -...

Section 5165.155 | Amount of Payments for Dual Eligible Individuals. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.156 | Centers of Excellence Component. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.157 | Alternative Purchasing Model for Nursing Facility Services. - Effective: September 29, 2017 Latest Legislation: House Bill 49 -...

Section 5165.16 | Per Medicaid Day Payment Rate for Ancillary and Support Costs; Peer Groups. - Effective: September 30, 2021 Latest Legislation: House Bill 110 -...

Section 5165.17 | Per Medicaid Day Payment Rate for Reasonable Capital Costs. - Effective: September 30, 2021 Latest Legislation: House Bill 110 -...

Section 5165.19 | Per Medicaid Day Payment Rate for Direct Care Costs. - Effective: June 19, 2020 Latest Legislation: House Bill 481 -...

Section 5165.191 | Resident Assessment Data. - Effective: September 30, 2021 Latest Legislation: House Bill 110 -...

Section 5165.192 | Case-Mix Scores for Nursing Facilities. - Effective: November 22, 2017 Latest Legislation: House Bill 49 -...

Section 5165.193 | Exception Review of Assessment Data. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.21 | Per Medicaid Day Payment Rate for Tax Costs. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5165.23 | Critical Access Incentive Payments to Qualified Facilities. - Effective: November 22, 2017 Latest Legislation: House Bill 49 -...

Section 5165.26 | Nursing Facility's per Medicaid Day Quality Incentive Payment Rate. - Effective: June 30, 2021 Latest Legislation: House Bill 110 -...

Section 5165.261 | Nursing Facility Payment Commission. - Effective: September 30, 2021 Latest Legislation: House Bill 110 -...

Section 5165.28 | Rate for Added, Replaced, or Renovated Beds. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.29 | Cost of Operating Rights for Relocated Beds Not Allowable Cost. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.30 | Related Party Costs to Pass Through. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.32 | Reduction in Rate Not Permitted. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.33 | No Payment for Discharge Date. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.34 | Payments Made to Reserve Bed During Temporary Absence. - Effective: November 22, 2017 Latest Legislation: House Bill 49 -...

Section 5165.35 | Payments Made to Facility for Services Provided After Involuntary Termination. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.36 | Rebasing. - Effective: June 30, 2021 Latest Legislation: House Bill 110 -...

Section 5165.37 | Calculating Rates and Making Payments. - Effective: November 22, 2017 Latest Legislation: House Bill 49 -...

Section 5165.38 | Reconsideration of Rate. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.40 | Adjustment of Rates. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.41 | Redetermination of Rates. - Effective: November 22, 2017 Latest Legislation: House Bill 49 -...

Section 5165.42 | Additional Penalties. - Effective: November 22, 2017 Latest Legislation: House Bill 49 -...

Section 5165.43 | Determination of Interest Rate. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.44 | Deductions. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.45 | Deposits to General Revenue Fund. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.46 | Administrative Adjudication. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.47 | Claim for Medicaid Payment for Service Provided to Nursing Facility Resident. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.48 | Nursing Facility Not Required to Submit Medicaid Claim for Medicare Cost-Sharing Expenses Under Certain Circumstances. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.49 | Post-Payment Reviews of Nursing Facility Medicaid Claims. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.50 | Notice of Facility Closure or Withdrawal of Participation. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.501 | Compliance With Social Security Act Required. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.51 | Notice of Change of Operator. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.511 | Agreements With Entering Operators Effective on Date of Change of Operator. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.512 | Agreements With Entering Operators Effective on a Later Date. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.513 | Entering Operator Duties Under Provider Agreement. - Effective: January 1, 2015 Latest Legislation: Senate Bill 276 -...

Section 5165.514 | Exiting Operator Deemed Operator Pending Change. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.515 | Provider Agreement With Operator Not Complying With Prior Agreement. - Effective: January 1, 2015 Latest Legislation: Senate Bill 276 -...

Section 5165.516 | Medicaid Reimbursement Adjustments; Change of Operator. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.517 | Determination of Change of Operator for Purposes of Licensure Not Controlling. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.52 | Overpayment Amounts Determined Following Notice of Closure, Etc. - Effective: November 22, 2017 Latest Legislation: House Bill 49 -...

Section 5165.521 | Withholding Amounts Owed From Medicaid Payments to Exiting Operator. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.522 | Cost Report by Exiting Operator; Waiver. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.523 | Failure to File Cost Report; Payments Deemed Overpayments. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.524 | Final Payment Withheld Pending Receipt of Cost Reports. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.525 | Determination of Debt of Exiting Operator; Summary Report. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.526 | Release of Amount Withheld Less Amounts Owed. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.527 | Release of Amount Withheld on Postponement of Change of Operator. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.528 | Disposition of Amounts Withheld From Payment Due an Exiting Operator. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.53 | Adoption of Rules Regarding Change in Operators. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.60 | Definitions for Sections 5165.60 to 5165.89. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.61 | Adoption of Rules. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.62 | Enforcement of Provisions. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.63 | Contracts With State Agencies for Enforcement. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.64 | Annual Standard Surveys. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.65 | Exit Interview With Administrator. - Effective: September 15, 2014 Latest Legislation: House Bill 483 -...

Section 5165.66 | Citations for Failure to Comply With One or More Certification Requirements. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.67 | Survey Results. - Effective: March 23, 2015 Latest Legislation: House Bill 290 -...

Section 5165.68 | Statement of Deficiencies. - Effective: September 15, 2014 Latest Legislation: House Bill 483 -...

Section 5165.69 | Plan of Correction. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.70 | On-Site Monitoring. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.71 | Deficiencies Not Substantially Corrected. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.72 | Uncorrected Deficiencies Constituting Severity Level Four Findings. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.73 | Uncorrected Deficiencies Constituting Severity Level Three and Scope Level Three or Four Findings. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.74 | Uncorrected Deficiencies Constituting Severity Level One or Two or Severity Level Three, Scope Level Two Finding. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.75 | Imposing Remedies and Fines. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.76 | Fine Collected if Termination Order Does Not Take Effect. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.77 | Emergency Remedies. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.771 | Special Focus Facility Program. - Effective: September 30, 2021 Latest Legislation: House Bill 110 -...

Section 5165.78 | Appointment of Temporary Resident Safety Assurance Manager. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.79 | Terminating Provider Agreements. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.80 | Transfer of Residents to Other Appropriate Care Settings. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.81 | Qualifications of Temporary Manager of Nursing Facility. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.82 | Residents to Whom Denial of Medicaid Payments Applies. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.83 | Fines. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.84 | Order Denying Payment When Deficiency Is Not Corrected Within Time Limits. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.85 | Termination of Participation for Failure to Correct Deficiency Within Six Months. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.86 | Delivery of Notices. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.87 | Appeals. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.88 | Confidentiality. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.89 | Hearing on Transfer or Discharge of Resident Who Medicaid or Medicare Beneficiary. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5165.99 | Penalty. - Effective: January 1, 2015 Latest Legislation: Senate Bill 276 -...

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Ohio Revised Code Title 51 | Public Welfare Chapter 5165 | Medicaid Coverage of Nursing Facility Services

Ohio Revised Code
Title 51 | Public Welfare
Chapter 5165 | Medicaid Coverage of Nursing Facility Services