(A) For the purpose of increasing the number of slots available for home and community-based services, the operator of an ICF/IID may convert some or all of the beds in the ICF/IID from providing ICF/IID services to providing home and community-based services if all of the following requirements are met:

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Terms Used In Ohio Code 5124.60

  • Another: when used to designate the owner of property which is the subject of an offense, includes not only natural persons but also every other owner of property. See Ohio Code 1.02
  • Medicaid-certified capacity: means the number of an ICF/IID's beds that are certified for participation in medicaid as ICF/IID beds. 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
  • Provider: means an operator with a valid provider agreement. See Ohio Code 5124.01
  • Provider agreement: means a provider agreement, as defined in section 5164. 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

(1) The operator provides the directors of health and developmental disabilities at least ninety days’ notice of the operator’s intent to make the conversion.

(2) The operator complies with the requirements of sections 5124.50 to 5124.53 of the Revised Code regarding a voluntary termination if those requirements are applicable.

(3) If the operator intends to convert all of the ICF/IID’s beds, the operator notifies each of the ICF/IID’s residents that the ICF/IID is to cease providing ICF/IID services and inform each resident that the resident may do either of the following:

(a) Continue to receive ICF/IID services by transferring to another ICF/IID that is willing and able to accept the resident if the resident continues to qualify for ICF/IID services;

(b) Begin to receive home and community-based services instead of ICF/IID services from any provider of home and community-based services that is willing and able to provide the services to the resident if the resident is eligible for the services and a slot for the services is available to the resident.

(4) If the operator intends to convert some but not all of the ICF/IID’s beds, the operator notifies each of the ICF/IID’s residents that the ICF/IID is to convert some of its beds from providing ICF/IID services to providing home and community-based services and inform each resident that the resident may do either of the following:

(a) Continue to receive ICF/IID services from any ICF/IID that is willing and able to provide the services to the resident if the resident continues to qualify for ICF/IID services;

(b) Begin to receive home and community-based services instead of ICF/IID services from any provider of home and community-based services that is willing and able to provide the services to the resident if the resident is eligible for the services and a slot for the services is available to the resident.

(5) The operator meets the requirements for providing home and community-based services, including the following:

(a) Such requirements applicable to a residential facility if the operator maintains the facility’s license as a residential facility;

(b) Such requirements applicable to a facility that is not licensed as a residential facility if the operator surrenders the facility’s license as a residential facility under section 5123.19 of the Revised Code.

(6) The director of developmental disabilities approves the conversion.

(B) A decision by the director of developmental disabilities to approve or refuse to approve a proposed conversion of beds is final. In making a decision, the director shall consider all of the following:

(1) The fiscal impact on the ICF/IID if some but not all of the beds are converted;

(2) The fiscal impact on the medicaid program;

(3) The availability of home and community-based services.

(C) The notice provided to the directors under division (A)(1) of this section shall specify whether some or all of the ICF/IID’s beds are to be converted. If some but not all of the beds are to be converted, the notice shall specify how many of the ICF/IID’s beds are to be converted and how many of the beds are to continue to provide ICF/IID services. The notice to the director of developmental disabilities shall specify whether the operator wishes to surrender the ICF/IID’s license as a residential facility under section 5123.19 of the Revised Code.

(D)(1) If the director of developmental disabilities approves a conversion under division (B) of this section, the director of health shall do the following:

(a) Terminate the ICF/IID’s medicaid certification if the notice specifies that all of the ICF/IID’s beds are to be converted;

(b) Reduce the ICF/IID’s medicaid-certified capacity by the number of beds being converted if the notice specifies that some but not all of the beds are to be converted.

(2) The director of health shall notify the medicaid director of the termination or reduction. On receipt of the notice, the medicaid director shall do the following:

(a) Terminate the operator’s medicaid provider agreement that authorizes the operator to provide ICF/IID services at the ICF/IID if the ICF/IID’s certification was terminated;

(b) Amend the operator’s medicaid provider agreement to reflect the ICF/IID’s reduced medicaid-certified capacity if the ICF/IID’s medicaid-certified capacity is reduced.

(3) The medicaid director is not required to conduct an adjudication in accordance with Chapter 119 of the Revised Code when taking action under division (D)(2) of this section.

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