Ohio Administrative Code
Title 3701 - Department of Health - Administration and Director
Chapter 3701-83 - Licensing Provisions for Health Care Facilities
Section 3701-83-04 - License application and renewal procedures
Universal Citation: OH Admin Code 3701-83-04
Current through all regulations passed and filed through September 16, 2024
(A) A person or agency of state or local government seeking a license to operate an HCF shall submit to the director an application, on a form and in a manner prescribed by the director and shall include the following:
(1) A statement of ownership containing the
following information:
(a) The name, address,
and telephone number of the HCF.
(i) If the
owner is an individual, the owner's name, address, telephone number, business
address, and business telephone number.
(ii) If the owner is an association,
corporation, limited liability company, or partnership, the legal business
entity name, address, and telephone number of the entity and the name of every
person who has an ownership interest of five per cent or more in the entity.
The corporate name; if any, and the names, titles, addresses and telephone
numbers of its officers and statutory agent.
(iii) If the applicant is an agency of state
or local government, the name, address and telephone number of the individual
authorized to enter into agreements on behalf of the agency of state or local
government.
(b) The name
of the administrator;
(c) The name
and physician license number or dentist license number of the medical director
of the HCF;
(d) The name and
address of any of the following facilities which either the owner,
administrator or medical director has been affiliated through ownership or
employment in the five years prior to the date of the application:
(i) A nursing home, residential care
facility, or home for the aging as defined in section
3721.01 of the Revised
Code;
(ii) A residential facility
for the mentally ill licensed by the department of mental health under section
5119.22 of the Revised
Code;
(iii) A facility licensed to
provide methadone treatment under section
3793.11 of the Revised
Code;
(iv) A residential facility
licensed under section
5123.19 of the Revised Code or
otherwise regulated by the department of developmental disabilities;
(v) A terminal care facility for the homeless
that has entered into an agreement with a hospice care program under section
3712.07 of the Revised
Code;
(vi) A health insuring
corporation as defined by section
1751.01 of the Revised
Code;
(vii) A hospital;
or
(viii) An entity certified by
the United States centers for medicare and medicaid services for purposes of
reimbursement under Part B of the medicare program, Part B of Title XVIII of
the "Social Security Act," 49 Stat. 620 (1935),
42 U.S.C.A.
301, as amended (1981); or certified for the
purposes of reimbursement by medicaid, a state plan approved under Title XIX of
the Social Security Act," 49 Stat. 620 (1935),
42 U.S.C.A.
301, as amended (1981).
(e) Information about any criminal
conviction, civil judgment or administrative adjudication of the owner,
administrator or medical director for an offense related to the provision of
care or bearing a direct or substantial relationship to the job
responsibilities he or she is to carry out.
(2) If applicable, a copy of the fire
inspection report required under paragraph (C) of rule
3701-83-06 of the Administrative
Code and if applicable, the certificate of use and occupancy required under
rule 3701-83-10 of the Administrative
Code;
(3) The type of HCF license
for which the applicant is applying; in addition:
(a) An ASF shall specify the number of
operating rooms, or procedure rooms, or both;
(b) A freestanding dialysis center shall
specify the number of dialysis stations, including the number of hemodialysis
stations and peritoneal stations;
(c) A freestanding inpatient rehabilitation
facility shall specify the number of patient care beds;
(d) A freestanding birthing center shall
specify the number of birth rooms;
(e) A freestanding or mobile diagnostic
imaging center shall specify whether the radiopharmaceuticals being proposed
for use are for use as delineated in rule 3701:1-58-32, 3701:1-58-34,
3701:1-58-37 or
3701:1-58-53 of the
Administrative Code and the number and type of radiation-generating or
detecting equipment;
(f) A
freestanding radiation therapy center shall specify the number and type of
radiation-generating or detecting equipment being proposed for use and whether
radiopharmaceuticals or sealed sources being proposed for use are for use as
delineated in rule
3701:1-58-43 or
3701:1-58-55 of the
Administrative Code
(4) A
complete copy of the HCF's current accreditation award letter, if
applicable.
(B) A person or agency of state or local government seeking renewal of an HCF license shall submit to the director an application for renewal each year during the month specified on the HCF's license. A person or agency of state or local government seeking renewal of an HCF license, or an amended license under paragraph (F) of this rule, shall submit to the director an application on a form and in a manner prescribed by the director, and shall include the following:
(1) The name, address, and telephone number
of the facility;
(2) The type of
facility for which the applicant is seeking license renewal;
(3) Any changes or updates to the information
required by paragraph (A) of this rule, including a copy of the most recent
accreditation award letter, if applicable, unless the department has been
previously notified;
(4) Copies of
all inspections, agreements, or approvals required by Chapter 3701-83 of the
Administrative Code, that have been conducted since submittal of the HCF's
previous application;
(5) Any other
information the director may require regarding the owner's ability to operate
the facility.
(C) An application for an HCF license, license renewal or amended license shall include the following:
(1) Attestation that to
the best of the applicant's knowledge, the information in the application and
any accompanying material is true and accurate;
(2) Attestation by the medical director and
the administrator that to the best of their knowledge, the information in the
application submitted pursuant to paragraph (A)(1)(c) of this rule is true and
accurate;
(3) Attestation that the
applicant, if not the owner, is the authorized representative of the owner,
and
(4) A nonrefundable application
fee of three hundred dollars for an HCF license or license renewal or a
nonrefundable fee of one hundred and fifty dollars for an amended HCF license
payable to the "Treasurer, State of Ohio."
(D) The director at any time may request additional information the director determines to be necessary to assess compliance with the applicable criteria, standards, and requirements established by section 3702.30 of the Revised Code and Chapter 3701-83 of the Administrative Code. The applicant shall submit any additional information requested by the director within thirty days of the date of the director's request.
(1)
For an initial application for licensure, if the
director does not receive the requested information within sixty days of the
director's request for additional information, the director may consider the
application abandoned; and
(2)
Further
consideration for an initial license will require a new application accompanied
by another nonrefundable license fee as set forth in paragraph (C) (4) of this
rule.
(E) The HCF shall notify the director in writing no later than thirty days of:
(1) Any changes in the information contained
in the statement of ownership made pursuant to paragraph (A) of this rule;
and
(2) Any change in the HCF's
accreditation status.
(F) The HCF shall apply for an amended license if:
(1) In the case of an ASF, there is any
increase or a permanent decrease in the number of operating or procedure
rooms;
(2) In the case of a
freestanding dialysis center, there is any increase or a permanent decrease in
the number of dialysis stations;
(3) In the case of a freestanding inpatient
rehabilitation facility, there is any increase or a permanent decrease in the
number of patient care beds;
(4) In
the case of a freestanding birthing center, there is any increase or a
permanent decrease in the number of birthing rooms;
(5) In the case of a freestanding or mobile
diagnostic imaging center, there is any increase in the number or change in the
type of radiation-generating or detecting equipment or any change in the
radiopharmaceuticals being used pursuant to rule 3701:1-58-32, 3701:1-58-34,
3701:1-58-37, or
3701:1-58-53 of the
Administrative Code; and
(6) In the
case of a freestanding radiation therapy center, there is any increase in the
number or change in the type of radiation-generating or detecting equipment
being used or any change in the radiopharmaceuticals or sealed sources being
used pursuant to rule
3701:1-58-43 or
3701:1-58-55 of the
Administrative Code
(G) The HCF shall not use any additional room, station, bed or equipment until an amended HCF license has been issued, or the HCF has received other verifiable approval by the department.
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