Ohio § 5165.154 Calculating prospective rates for facilities with residents whose care costs are not adequately measured

Ohio Statutes

§ 5165.154 — Calculating prospective rates for facilities with residents whose care costs are not adequately measured

Ohio § 5165.154

Title 51Public Welfare

Ch. 5165Medicaid Coverage of Nursing Facility Services

This text of Ohio § 5165.154 (Calculating prospective rates for facilities with residents whose care costs are not adequately measured) is published on Counsel Stack Legal Research, covering Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ohio Rev. Code Ann. § 5165.154 (2026).

Text

(A)To the extent, if any, provided for in rules authorized by this section, the total per medicaid day payment rate determined under section5165.15of the Revised Code shall not be paid for nursing facility services that a nursing facility not designated as an outlier nursing facility or unit provides to a resident who meets the criteria for admission to a designated outlier nursing facility or unit, as specified in rules authorized by section5165.153of the Revised Code. Instead, the provider of a nursing facility providing nursing facility services to such a resident shall be paid each state fiscal year a total per medicaid day payment rate that the department of medicaid shall prospectively determine in accordance with a methodology established in rules authorized by this section.

(B)T

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(A) To the extent, if any, provided for in rules authorized by this section, the total per medicaid day payment rate determined under section5165.15of the Revised Code shall not be paid for nursing facility services that a nursing facility not designated as an outlier nursing facility or unit provides to a resident who meets the criteria for admission to a designated outlier nursing facility or unit, as specified in rules authorized by section5165.153of the Revised Code. Instead, the provider of a nursing facility providing nursing facility services to such a resident shall be paid each state fiscal year a total per medicaid day payment rate that the department of medicaid shall prospectively determine in accordance with a methodology established in rules authorized by this section.

(B) The medicaid director may adopt rules under section5165.02of the Revised Code to implement this section. The rules may require that a nursing facility receive authorization from the department before admitting or retaining a resident who meets the criteria for admission to a designated outlier nursing facility or unit. If the director adopts such rules, the rules shall specify the criteria and procedures the department will apply when granting the authorization.