173.501 [Effective Until 8/31/2010] Persons admitted to nursing facilities.
173.501 [Effective Until 8/31/2010] Persons admitted to nursing facilities.
(A) As used in this section:
“Nursing facility” has the same meaning as in section 5111.20 of the Revised Code.
“PACE provider” has the same meaning as in 42 U.S.C. 1396u-4 (a)(3 ).
(B) Each month, the department of aging shall determine whether individuals who are on a waiting list for the PACE program have been admitted to a nursing facility. If the department determines that such an individual has been admitted to a nursing facility, the department shall notify the PACE provider serving the area in which the individual resides about the determination. The PACE provider shall determine whether the PACE program is appropriate for the individual and whether the individual would rather participate in the PACE program than continue residing in the nursing facility. If the PACE provider determines that the PACE program is appropriate for the individual and the individual would rather participate in the PACE program than continue residing in the nursing facility, the PACE provider shall so notify the department of aging. On receipt of the notice from the PACE provider, the department of aging shall approve the individual’s enrollment in the PACE program in accordance with priorities established in rules adopted under section 173.50 of the Revised Code. Each quarter, the department of aging shall certify to the director of budget and management the estimated increase in costs of the PACE program resulting from enrollment of individuals in the PACE program pursuant to this section.
Added by 128th General Assembly File No. 9, HB 1, § 101.01, eff. 10/16/2009.
This section is set out twice. See also § 173.501, as amended by 128th General Assembly File No. 33, HB 398, § 1, eff. 8/31/2010.
173.501 [Effective 8/31/2010] Persons admitted to nursing facilities
(A) As used in this section:
“Nursing facility” has the same meaning as in section 5111.20 of the Revised Code.
“PACE provider” has the same meaning as in 42 U.S.C. 1396u-4(a)(3).
(B) The department of aging shall establish a home first component of the PACE program under which eligible individuals may be enrolled in the PACE program in accordance with this section. An individual is eligible for the PACE program’s home first component if all of the following apply:
(1) The individual is eligible for the PACE program.
(2) The individual is on the unified waiting list established under section 173.404 of the Revised Code.
(3) At least one of the following applies:
(a) The individual has been admitted to a nursing facility.
(b) A physician has determined and documented in writing that the individual has a medical condition that, unless the individual is enrolled in home and community-based services such as the PACE program, will require the individual to be admitted to a nursing facility within thirty days of the physician’s determination.
(c) The individual has been hospitalized and a physician has determined and documented in writing that, unless the individual is enrolled in home and community-based services such as the PACE program, the individual is to be transported directly from the hospital to a nursing facility and admitted.
(d) Both of the following apply:
(i) The individual is the subject of a report made under section 5101.61 of the Revised Code regarding abuse, neglect, or exploitation or such a report referred to a county department of job and family services under section 5126.31 of the Revised Code or has made a request to a county department for protective services as defined in section 5101.60 of the Revised Code.
(ii) A county department of job and family services and an area agency on aging have jointly documented in writing that, unless the individual is enrolled in home and community-based services such as the PACE program, the individual should be admitted to a nursing facility.
(C) Each month, the department of aging shall identify individuals who are eligible for the home first component of the PACE program . When the department identifies such an individual , the department shall notify the PACE provider serving the area in which the individual resides . The PACE provider shall determine whether the PACE program is appropriate for the individual and whether the individual would rather participate in the PACE program than continue or begin to reside in a nursing facility. If the PACE provider determines that the PACE program is appropriate for the individual and the individual would rather participate in the PACE program than continue or begin to reside in a nursing facility, the PACE provider shall so notify the department of aging. On receipt of the notice from the PACE provider, the department of aging shall approve the individual’s enrollment in the PACE program in accordance with priorities established in rules adopted under section 173.50 of the Revised Code.
(D) Each quarter, the department of aging shall certify to the director of budget and management the estimated increase in costs of the PACE program resulting from enrollment of individuals in the PACE program pursuant to this section.
Amended by 128th General Assembly File No. 33, HB 398, § 1, eff. 8/31/2010.
Added by 128th General Assembly File No. 9, HB 1, § 101.01, eff. 10/16/2009.
This section is set out twice. See also § 173.501, effective until 8/31/2010.