Ohio Code 5165.512 – Agreements with entering operators effective on a later date
(A) The department of medicaid may enter into a provider agreement with an entering operator that goes into effect at 12:01 a.m. on the date determined under division (B) of this section if all of the following are the case:
Terms Used In Ohio Code 5165.512
- Change of operator: includes circumstances in which an entering operator becomes the operator of a nursing facility in the place of the exiting operator or there is a change in owner of a nursing facility. See Ohio Code 5165.01
- Entering operator: means the person or government entity that will become the operator of a nursing facility when a change of operator occurs or following an involuntary termination. See Ohio Code 5165.01
- Exiting operator: means any of the following:
(1) An operator that will cease to be the operator of a nursing facility on the effective date of a change of operator;
(2) An operator that will cease to be the operator of a nursing facility on the effective date of a facility closure;
(3) An operator of a nursing facility that is undergoing or has undergone a voluntary withdrawal of participation;
(4) An operator of a nursing facility that is undergoing or has undergone an involuntary termination. See Ohio Code 5165.01
- Operator: means the person or government entity responsible for the daily operating and management decisions for a nursing facility. See Ohio Code 5165.01
- 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 a nursing facility:
(a) The land on which the nursing facility is located;
(b) The structure in which the nursing facility 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 nursing facility is located;
(d) Any lease or sublease of the land or structure on or in which the nursing facility is located. See Ohio Code 5165.01
- Provider: means an operator with a provider agreement. See Ohio Code 5165.01
- Provider agreement: means a provider agreement, as defined in section 5164. See Ohio Code 5165.01
(1) The department receives a properly completed written notice required by section 5165.51 of the Revised Code.
(2) The department receives, from the entering operator and in accordance with the method specified in rules authorized by section 5165.53 of the Revised Code, a completed application for a provider agreement and all other forms and documents specified in rules adopted under that section.
(3) The department receives, from the exiting operator or owner and in accordance with the method specified in rules authorized by section 5165.53 of the Revised Code, all forms and documents specified in rules adopted under that section.
(4) One or more of the following apply:
(a) The requirement of division (A)(1) of this section is met after the time required by section 5165.51 of the Revised Code;
(b) The requirement of division (A)(2) of this section is met more than ten days after the effective date of the change of operator;
(c) The requirement of division (A)(3) of this section is met more than ten days after the effective date of the change of operator.
(5) The entering operator is eligible for medicaid payments as provided in section 5165.06 of the Revised Code.
(B) The department shall determine the date a provider agreement entered into under this section is to go into effect as follows:
(1) The effective date shall give the department sufficient time to process the change of operator, assure no duplicate payments are made, and make the withholding required by section 5165.521 of the Revised Code.
(2) The effective date shall be not earlier than the latest of the following:
(a) The effective date of the change of operator;
(b) The date that the entering operator complies with section 5165.51 of the Revised Code and division (A)(2) of this section;
(c) The date that the exiting operator or owner complies with section 5165.51 of the Revised Code and division (A)(3) of this section.
(3) The effective date shall be not later than the following after the later of the dates specified in division (B)(2) of this section:
(a) Forty-five days if the change of operator does not entail the relocation of residents;
(b) Ninety days if the change of operator entails the relocation of residents.