{"data":{"id":"us-oh/ohio-rev.-code-5165.1010","jurisdiction":"us-oh","citation":"Ohio Rev. Code § 5165.1010","heading":"Nursing facility fines.","body":"(A) Subject to division (D) of this section, the department of medicaid shall fine the provider of a nursing facility if the report of an audit conducted under section 5165.109 of the Revised Code regarding a cost report for the nursing facility includes either of the following:\n(1) Adverse findings that exceed three per cent of the total amount of medicaid-allowable costs reported in the cost report;\n(2) Adverse findings that exceed twenty per cent of medicaid-allowable costs for a particular cost center reported in the cost report.\n(B) A fine issued under this section shall equal the greatest of the following:\n(1) If the adverse findings exceed three per cent but do not exceed ten per cent of the total amount of medicaid-allowable costs reported in the cost report, the greater of three per cent of those reported costs or ten thousand dollars;\n(2) If the adverse findings exceed ten per cent but do not exceed twenty per cent of the total amount of medicaid-allowable costs reported in the cost report, the greater of six per cent of those reported costs or twenty-five thousand dollars;\n(3) If the adverse findings exceed twenty per cent of the total amount of medicaid-allowable costs reported in the cost report, the greater of ten per cent of those reported costs or fifty thousand dollars;\n(4) If the adverse findings exceed twenty per cent but do not exceed twenty-five per cent of medicaid-allowable costs for a particular cost center reported in the cost report, the greater of three per cent of the total amount of medicaid-allowable costs reported in the cost report or ten thousand dollars;\n(5) If the adverse findings exceed twenty-five per cent but do not exceed thirty per cent of medicaid-allowable costs for a particular cost center reported in the cost report, the greater of six per cent of the total amount of medicaid-allowable costs reported in the cost report or twenty-five thousand dollars;\n(6) If the adverse findings exceed thirty per cent of medicaid-allowable costs for a particular cost center reported in the cost report, the greater of ten per cent of the total amount of medicaid-allowable costs reported in the cost report or fifty thousand dollars.\n(C) Fines paid under this section shall be deposited into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code.\n(D) The department may not collect a fine under this section until all appeal rights relating to the audit report that is the basis for the fine are exhausted.","path":["Title 51 Public Welfare","Chapter 5165 Medicaid Coverage of Nursing Facility Services"],"source_url":"https://codes.ohio.gov/ohio-revised-code/section-5165.1010","current_through":"2017-09-29 (House Bill 49 - 132nd General Assembly)","vintage":"","retrieved_at":"2026-09-14T19:24:40Z","sha256":"f23fbaad3aba2cbdd7c656e0a415e4aa79ad2a819f762d4019f71e70962c2418","source_id":"us-oh","stale":false,"prev":"us-oh/ohio-rev.-code-5165.109","next":"us-oh/ohio-rev.-code-5165.15"},"notice":"GroundRules: Original legal text. Not legal advice."}