# Ohio Admin. Code 5160-3-04: Rule 5160-3-04. Nursing facilities (NFs): payment during the Ohio department of medicaid (ODM) administrative appeals process for denial or termination of a provider agreement

> Ohio · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_04

## Section

- **Citation:** Ohio Admin. Code 5160-3-04
- **Heading:** Rule 5160-3-04. Nursing facilities (NFs): payment during the Ohio department of medicaid (ODM) administrative appeals process for denial or termination of a provider agreement
- **Jurisdiction:** Ohio
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Ohio Administrative Code / Agency 5160 / Chapter 5160-3 / Rule 5160-3-04

## Text

119.03 (A) When ODM is required to provide an adjudicatory hearing pursuant to Chapter 119. of the Revised Code, payment shall continue for medicaid-covered services provided to eligible residents during the appeal of, and the proposed termination or non-revalidation of, a nursing facility (NF) provider agreement. Payment shall not be made under this provision for services rendered on or after the effective date of ODM issuance of a final order of adjudication pursuant to Chapter 119. of the Revised Code, except as provided in paragraph (B) of this rule. (B) Payment may be provided up to thirty days following the effective date of termination or non-revalidation of a NF provider agreement; or after an administrative hearing decision that upholds the ODM termination or non-revalidation action. Payment will be available if both of the following conditions are met: (1) Residents were admitted to the NF before the effective date of termination or expiration; and (2) The NF cooperates with the state, local, and federal entities in the effort to transfer residents to other NFs, institutions, or community programs that can meet the residents' needs. (C) When ODM acts under instructions from the United States department of health and human services, payment ends on the termination date specified by that agency. Last updated June 25, 2025 at 6:53 PM Supplemental Information Authorized By: 5165.02 Amplifies: 5164.38 , 5165.35 12/10/2022 1/1/1995, 7/1/2000, 7/1/2008, 10/3/2014

## Nearby sections

- [Ohio Admin. Code 5160-3-01 Rule 5160-3-01. Nursing facilities (NFs): definitions](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_01.md)
- [Ohio Admin. Code 5160-3-02 Rule 5160-3-02. Nursing facilities (NFs): provider agreements](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_02.md)
- [Ohio Admin. Code 5160-3-02.1 Rule 5160-3-02.1. Nursing facilities (NFs): length and type of provider agreements](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_02_1.md)
- [Ohio Admin. Code 5160-3-02.2 Rule 5160-3-02.2. Nursing facilities (NFs): termination, denial, and non-revalidation of provider agreements](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_02_2.md)
- [Ohio Admin. Code 5160-3-02.3 Rule 5160-3-02.3. Nursing facilities (NFs): institutions eligible to participate in medicaid as NFs](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_02_3.md)
- [Ohio Admin. Code 5160-3-02.4 Rule 5160-3-02.4. Nursing facilities (NFs): mandatory dual participation in the medicare program](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_02_4.md)
- [Ohio Admin. Code 5160-3-02.7 Rule 5160-3-02.7. Nursing facilities (NFs): emergency and disaster plan, resident relocation, and required notifications](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_02_7.md)
- [Ohio Admin. Code 5160-3-03.2 Rule 5160-3-03.2. Nursing facilities (NFs): resident protection fund and collection of fines](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_03_2.md)
- [Ohio Admin. Code 5160-3-04 Rule 5160-3-04. Nursing facilities (NFs): payment during the Ohio department of medicaid (ODM) administrative appeals process for denial or termination of a provider agreement](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_04.md)
- [Ohio Admin. Code 5160-3-04.1 Rule 5160-3-04.1. Nursing facilities (NFs): payment  during the survey agency's administrative appeals process for termination or non-renewal of medicaid certification](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_04_1.md)
- [Ohio Admin. Code 5160-3-05 Rule 5160-3-05. Level of care definitions](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_05.md)
- [Ohio Admin. Code 5160-3-06 Rule 5160-3-06. Criteria for the protective level of care](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_06.md)
- [Ohio Admin. Code 5160-3-06.1 Rule 5160-3-06.1. Institutions for mental diseases (IMDs)](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_06_1.md)
- [Ohio Admin. Code 5160-3-08 Rule 5160-3-08. Criteria for nursing facility-based level of care](https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_08.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_OH_ADC_5160_3_04. Check the current official text before relying on it. Not legal advice.