​ICFOpeningProviderChecklist

An ICF opening can occur for multiple reasons, but most are related to the downsizing efforts, but some can be replacement facilities. This process outlines what is needed for the opening of a new ICF.

ICF Opening: Pre-move

 

 

Complete

Activity

Completed by

Sent to

 1 If the opening of new facility is part of larger downsizing plan or if any unique circumstances exist, contact DODD to discuss plans for development. Please contact Ann Weisent at 614-949-8792 or Ann.Weisent@dodd.ohio.gov.ProviderDODD
 2 Provider contacts OPSR to get development application, and completes development application at least 60 days prior to when the home will be ready for inspection and sends to DODD. Please contact Ann Weisent at 614-949-8792 or Ann.Weisent@dodd.ohio.gov.ProviderDODD
 3 

Provider completes application for new Medicaid provider agreement in MITS (www.medicaid.ohio.gov/Providers

/EnrollmentandSupport/ProviderEnrollment

.aspx)

ProviderMedicaid/ MITS
 4 Medicaid sends new provider application to the Ohio Department of Health (ODH) and DODD.MedicaidODH, DODD
 5 Medicaid begins reviewing the new provider application and attached documents.Medicaid 
 6 DODD will review, research, and, when able, approve the development application and notify Provider, Medicaid, and ODH. OAC 5123:2-3-26(F) (2) gives DODD 60 days to respond to a development application.DODDProvider, Medicaid, ODH
7 Provider contacts DODD to schedule feasibility study when home is ready for inspection to ensure that the home meets all requirements according to Licensure rules. Provider can contact Ann Weisent at 614-949-8792 or Ann.Weisent@dodd.ohio.gov.ProviderDODD
8 DODD conducts on site feasibility study for licensure survey (per OAC 5123:2-3-02) typically within 30 days of notification from provider that facility is ready for the feasibility study.DODD 
9 DODD issues a 30-day interim license as a residential facility (per OAC 5123:2-3-23). The interim license is made effective, and issued to the provider based on the date that the provider informs DODD that they will be moving individuals into the home. It may be renewed for up to an additional 150 days.DODDProvider
10 Once provider is ready to be in compliance with all certification requirements, provider submits readiness letter[1] to ODH. Letter can be emailed to LicCert@odh.ohio.gov with a copy to Brian.Jackson@odh.ohio.gov.ProviderODH
11 Provider calls EIDC help desk at 614-995-4263 to set up account for new facility. This allows the provider to see their report and submit plan of correction (POC) online, if needed. Provider should include an email address to receive notification when reports are available.ProviderODH
12 ODH schedules initial certification survey (approximately 30 days from date the readiness letter is received).ODHProvider
13 Provider must have at least one individual living in the residence when ODH comes for initial certification surveyProvider 
14 ODH performs initial certification survey; this is an on-site survey.ODH 
15 ODH issues results of initial certification survey (statement of deficiencies) via EIDC (approximately 10 days after survey is conducted). Provider will receive an email notification of results if they included an email address when the EIDC account was created.ODHProvider
 16 If there are deficiencies listed, provider can submit a Plan of Correction (POC) if they intend to be certified. POC must include an Allegation of compliance date (which is the date by which the provider will come into compliance).ProviderODH
 17 ODH reviews and accepts POC (approximately 10 days after receiving POC). Provider will be notified of acceptance through EIDC.ODHProvider
 18 ODH schedules provider for re-visit to ensure deficiencies are corrected (typically less than 30 days from allegation of compliance date included in POC).ODHProvider
 19 ODH completes re-visit and, if deficiencies are corrected, recommends initial certification with effective certification date. Facilities cannot be certified until they are in compliance.ODHProvider
 20 If there are no deficiencies, ODH recommends initial certification with effective certification date.ODH

Provider, Medicaid

& DODD

 21 ODH sends initial certification letter to provider and copies DODD and Medicaid.ODH

Provider, DODD, &

Medicaid

 22 After receiving notification from ODH, DODD contacts provider and informs them that they can move individuals into the residence (typically within 1 business day).DODDProvider








 

 

 

 

 

 

 

 

 


 

ICF Opening: Post-move

 

Complete

Activity

Completed by

Sent to

23 After receipt of ODH notification of certification, Medicaid begins provider enrollment process and sends provider agreement, including new provider number, to provider for signature.MedicaidProvider
24 After receipt of initial certification letter, DODD issues one-year term license for new facility (typically within one business day).DODDProvider
25 DODD runs new facility rate and sends rate package to provider.DODDProvider
26 Provider signs provider agreement and returns to Medicaid (within 10 days of receipt).ProviderMedicaid
27 Once Medicaid receives the signed agreement, they will activate the new provider number.Medicaid 
28 

Provider contacts Ohio Shared Services to get a vendor account created which will allow for payment. Follow the instructions

media.obm.ohio.gov/oss/documents/Dear_State_of_Ohio_Potential_Vendor_Letter(OBM-7502)+REV+12+10+2014.pdf

ProviderCDJFS
29 Provider completes 9401 to discharge individuals from old provider number and to admit individuals to new provider number and submits to the County Department of Job and Family Services (CDJFS).ProviderCDJFS
30 Provider completes Level of Care (JFS 3697) and submits to DODD. LOC requests need to be complete (physician signature, psychological, etc.) and submitted within 30 days of the date of admission. LOC can be submitted via fax to 614-466-0652, or via email to ICFDOC@dodd.ohio.gov.ProviderDODD
31 DODD receives LOC, reviews, and approves or denies (typically within one-two weeks). An email is sent to provider acknowledging completion of LOC.DODDProvider
32 CDJFS reviews 9401 and looks for LOC. If LOC is complete, CDJFS processes 9401. CDJFS may contact provider if LOC is not complete in CRISE.CDJFS 
33 Once the 9401 is completely processed, the CDJFS sends the 9401 back to the provider.CDJFSProvider
34 Provider completes 9400s for payment changes, as needed, and faxes it to Medicaid LTC Payment Unit at 614-995-5959. Including a copy of the 9401 received back from the CDJFS is helpful.ProviderMedicaid
35 Medicaid reviews and processes payment adjustments or sends notice of inability to process to provider.MedicaidProvider
36 

Provider reviews and reconciles remittance on a monthly basis to ensure payment adjustments occurred. Provider may submit a second JFS 9400 to the LTC Payment Unit via fax to 614-995-5959 marked "Second Request" if they have not received payment adjustments 30 days after submitting the initial JFS 9400. Providers may call the LTC

Payment Unit with questions at 614-466-7575.

ProviderMedicaid
37 

A new provider must have an IAF submission agent associated to them to submit IAFs on their behalf.  To associate a submission agent to a provider, the provider must submit the form doddportal.dodd.ohio.gov/PRV/IAFprov/Documents/IAF.pdf

If the person completing IAFs on behalf of the provider is not already a submission agent, they can become one by completing the security affidavit to become an IAF submission agent: sra.prodapps.dodd.ohio.gov/default2.aspx

ProviderDODD
38 DODD conducts an initial survey of the new facility approximately 45 days from the date of occupancy.DODDProvider
39 Provider completes 90 day cost report for new facility and submits to DODD. If provider is eligible for rate adjustments due to downsizing efforts, provider complete cost report type 4.8 in addition to the 4.2 required cost report.ProviderDODD
40 DODD performs desk audit of cost report. DODD may contact provider with questions and may ask for resubmission of cost report if needed.DODDProvider
41 If provider files a 4.8 cost report and is eligible for a rate adjustment, DODD calculates adjusted rates for retroactive payment through MITS. Rate package is sent to provider indicating new rate.DODDProvider

 

 Readiness Letter: When the provider sends their readiness letter to ODH, it is expected that the provider is in compliance with all certification requirements.  Some important aspects include:

  • The provider meets all health and safety requirements.
  • The building is furnished: common areas should have enough furniture for expected capacity, bedroom furniture for person currently receiving services and provider will need to show ability to provide bedroom furniture for capacity (procedure, PO,  etc.).
  • The provider is ready to provide goods and services: should have ability to store goods for capacity and have enough goods on hand for at least four individuals (since this is the minimum ICF capacity) for approximately one week and be able to show procurement process.
  • Staff are available.
  • All policies, procedure manuals, and other documents that need to be revised are ready to go and available for review.
  • The provider has at least one resident on site receiving services.
  • The IP for the resident and all necessary services for that person should be in place.
  • The provider must have been issued an interim license by DODD.