Current through all regulations passed and filed through March 18, 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.