MedicaidAdministrativeMedium impact
5160-3-14 - Process and timeframes for a level of care determination for nursing facility-based level of care programs. (Amend/Final File)
Ohio Medicaid·OH · Family Medicine, Internal Medicine, Geriatrics·Specialty Services
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
Ohio Department of Medicaid updated Rule 5160-3-14 governing the process and timeframes for nursing facility level of care determinations. This amendment affects how level of care assessments are conducted for patients requiring nursing facility services under Ohio Medicaid programs.
Action Required
By July 1, 2025: Billing and case management teams working with nursing facility placements must review updated Ohio Medicaid procedures for level of care determinations. Update internal workflows to align with new assessment timeframes and documentation requirements. Contact Ohio Department of Medicaid at 614-752-3877 for specific procedural changes affecting patient eligibility determinations.