§ 5165.15 — Calculation of payments to nursing facility providers

Ohio § 5165.15

• Jurisdiction: Ohio
• Title 51: Public Welfare
• Ch. 5165: Medicaid Coverage of Nursing Facility Services

Text

Except as otherwise provided by sections5165.151to5165.158and5165.34of the Revised Code, the total per medicaid day payment rate that the department of medicaid shall pay a nursing facility provider for nursing facility services the provider's nursing facility provides during a state fiscal year shall be determined as follows:

(A) Determine the sum of all of the following:

(1) The per medicaid day payment rate for ancillary and support costs determined for the nursing facility under section5165.16of the Revised Code;

(2) The per medicaid day payment rate for capital costs determined for the nursing facility under section5165.17of the Revised Code;

(3) The per medicaid day payment rate for direct care costs determined for the nursing facility under section5165.19of the Revised Code;

(4) The per medicaid day payment rate for tax costs determined for the nursing facility under section5165.21of the Revised Code;

(5) If the nursing facility qualifies as a critical access nursing facility, the nursing facility's critical access incentive payment paid under section5165.23of the Revised Code.

(B) To the sum determined under division (A) of this section, add sixteen dollars and forty-four cents.

(C) To the sum determined under division (B) of this section, add the per medicaid day quality incentive payment rate determined for the nursing facility under section5165.26of the Revised Code.

(D) If the nursing facility qualifies as a low occupancy nursing facility, subtract from the sum determined under division (C) of this section the nursing facility's low occupancy deduction determined under section5165.23of the Revised Code.

Last updated October 5, 2023 at 3:27 PM

Legislative History

Effective: July 4, 2023 | Latest Legislation: House Bill 33 - 135th General Assembly