Ohio Code 5124.42 – Additional penalties
In addition to the other penalties authorized by this chapter, the department of developmental disabilities may impose the following penalties on an ICF/IID provider:
Terms Used In Ohio Code 5124.42
- Addition: means an increase in an ICF/IID's square footage. See Ohio Code 5124.01
- Entering operator: means the person or government entity that will become the operator of an ICF/IID when a change of operator occurs or following an involuntary termination. See Ohio Code 5124.01
- Exiting operator: means any of the following:
(1) An operator that will cease to be the operator of an ICF/IID on the effective date of a change of operator;
(2) An operator that will cease to be the operator of an ICF/IID on the effective date of a facility closure;
(3) An operator of an ICF/IID that is undergoing or has undergone a voluntary termination;
(4) An operator of an ICF/IID that is undergoing or has undergone an involuntary termination. See Ohio Code 5124.01
- facility closure: means either of the following:
(a) Discontinuance of the use of the building, or part of the building, that houses the facility as an ICF/IID that results in the relocation of all of the facility's residents;
(b) Conversion of the building, or part of the building, that houses an ICF/IID to a different use with any necessary license or other approval needed for that use being obtained and one or more of the facility's residents remaining in the facility to receive services under the new use. See Ohio Code 5124.01
- Operator: means the person or government entity responsible for the daily operating and management decisions for an ICF/IID. See Ohio Code 5124.01
- Owner: means any person or government entity that has at least five per cent ownership or interest, either directly, indirectly, or in any combination, in any of the following regarding an ICF/IID:
(a) The land on which the ICF/IID is located;
(b) The structure in which the ICF/IID is located;
(c) Any mortgage, contract for deed, or other obligation secured in whole or in part by the land or structure on or in which the ICF/IID is located;
(d) Any lease or sublease of the land or structure on or in which the ICF/IID is located. See Ohio Code 5124.01
- Provider: means an operator with a valid provider agreement. See Ohio Code 5124.01
- Voluntary termination: means an operator's voluntary election to terminate the participation of an ICF/IID in the medicaid program but to continue to provide service of the type provided by a residential facility as defined in section 5123. See Ohio Code 5124.01
(A) If the provider does not furnish invoices or other documentation that the department requests during an audit within sixty days after the request, a fine of not more than the greater of the following:
(1) One thousand dollars per audit;
(2) Twenty-five per cent of the cumulative amount by which the costs for which documentation was not furnished increased the total medicaid payments to the provider during the fiscal year for which the costs were used to determine a rate.
(B) If an exiting operator or owner fails to provide notice of a facility closure or voluntary termination as required by section 5124.50 of the Revised Code, or an exiting operator or owner and entering operator fail to provide notice of a change of operator as required by section 5124.51 of the Revised Code, a fine of not more than the current average bank prime rate plus four per cent of the last two monthly payments.