5111.244 Quality incentive payment for qualifying nursing facilities. - Ohio Statutes

5111.244 Quality incentive payment for qualifying nursing facilities.

(A) As used in this section, “deficiency” and “standard survey” have the same meanings as in section 5111.35 of the Revised Code.

(B) Each fiscal year, the department of job and family services shall pay the provider of each nursing facility a quality incentive payment. The amount of a quality incentive payment paid to a provider for a fiscal year shall be based on the number of points the provider’s nursing facility is awarded under division (C) of this section for that fiscal year. The amount of a quality incentive payment paid to a provider of a nursing facility that is awarded no points may be zero. The mean payment for fiscal year 2007, weighted by medicaid days, shall be three dollars per medicaid day. The department shall adjust the mean payment for subsequent fiscal years by the same adjustment factors the department uses to adjust, pursuant to division (B) of section 5111.222 of the Revised Code, nursing facilities’ rates otherwise determined under divisions (A)(1), (2), (3), and (6) of that section.

(C)(1) Except as provided by division (C)(2) of this section, the department shall annually award each nursing facility participating in the medicaid program one point for each of the following accountability measures the facility meets:

(a) The facility had no health deficiencies on the facility’s most recent standard survey.

(b) The facility had no health deficiencies with a scope and severity level greater than E, as determined under nursing facility certification standards established under Title XIX, on the facility’s most recent standard survey.

(c) The facility’s resident satisfaction is above the statewide average.

(d) The facility’s family satisfaction is above the statewide average.

(e) The number of hours the facility employs nurses is above the statewide average.

(f) The facility’s employee retention rate is above the average for the facility’s peer group established in division (C) of section 5111.231 of the Revised Code.

(g) The facility’s occupancy rate is above the statewide average.

(h) The facility’s medicaid utilization rate is above the statewide average.

(i) The facility’s case-mix score is above the statewide average.

(2) The department shall award points pursuant to division (C)(1)(c) or (d) of this section only for a fiscal year immediately following a calendar year for which a survey of resident or family satisfaction has been conducted under section 173.47 of the Revised Code.

(D) The director of job and family services shall adopt rules under section 5111.02 of the Revised Code as necessary to implement this section. The rules shall include rules establishing the system for awarding points under division (C) of this section.

Effective Date: 07-01-2005; 06-30-2006