Ohio Admin. Code 5122-41-01 - Purpose, definitions and general standards
(A)
The purpose of
this chapter is to describe the standards for a psychiatric residential
treatment facility (PRTF).
(B)
Definitions:
(1)
"Ancillary services" means services that supplement and
support the clinical services provided by the PRTF staff and are not considered
direct care. An example of an ancillary service in the context of the PRTF
setting would be time set aside for personal meditation or
reflection.
(2)
"Caregiver" means the person identified in the
individual plan of care that will ultimately support the timely and effective
transition of the youth into the community.
(3)
"CMS" means the
centers for medicare and medicaid services.
(4)
"Department"
means the Ohio department of mental health and addiction
services.
(5)
"Discharge" means a youth is leaving the PRTF without
meeting treatment goals.
(6)
"Home-like environment" or "home-like" means a living
environment that provides for positive, nurturing interactions between
caregivers and youth which may reduce the tensions of living in a group
setting. Home-like environments provide softness and challenge, stability and
flexibility, space for shared living and for private moments. Furnishings
should be chosen for comfort as well as for durability. The home-like
environment should include items such as artwork, artifacts, plants, pillows,
and area rugs to add softness. The selection of wall colors, lighting fixtures,
furniture, window treatments, floor coverings, and decorative accessories
should also enhance the home-like environment. The home-like environment should
not compromise the health and safety considerations of the youth residing in
the PRTF.
(7)
"Provider agreement" means a contract between the Ohio
department of medicaid and an operator of a PRTF for the provision of PRTF
services under the medicaid program, pursuant to rule
5160-1-17.2 of the
Administrative Code. The signature of the operator or the operator's authorized
agent binds the operator to the terms of the Agreement.
(8)
"PRTF" means a
psychiatric residential treatment facility as defined by
42 C.F.R.
483.354, as authorized under section 1905
(a)(16) and (h) of the Social Security Act.
(9)
"Sensory room"
means a designated therapeutic space that provides a safe and controlled
environment designed to stimulate the senses and promote self-regulation. The
room is equipped with various sensory equipment and materials, such as soft
lighting, comfortable seating, tactile objects, and calming music, to help
individuals manage sensory processing difficulties, reduce stress, and promote
relaxation. A sensory room cannot be used for seclusion or
restraint.
(10)
"Serious injury" means any significant impairment of
the physical condition of the youth as determined by qualified medical
personnel. This includes, but is not limited to burns, lacerations, bone
fractures, substantial hematoma, and injuries to internal organs, whether
self-inflicted or inflicted by someone else.
(11)
"Transition"
means a youth has met their treatment goals and is transitioning to a community
setting or a lower level of residential care including a group
home.
(12)
"Youth" means a person under the age of
twenty-one.
(C)
A PRTF will:
(1)
Be licensed as a
class one residential facility pursuant to Chapter 5122-30 of the
Administrative Code, but is not required to meet the qualified residential
treatment program (QRTP) standards pursuant to rule
5122-30-32 of the Administrative
Code. The PRTF license will be congruent with the class one residential
facility.
(2)
Be selected by the Ohio department of medicaid or its
designee to provide PRTF services to Ohio medicaid recipients and obtain and
maintain an active provider agreement with the Ohio department of
medicaid.
(3)
Document PRTF services in accordance with Chapter
5122-27 of the Administrative Code.
(4)
Maintain
compliance with applicable state and federal laws and
regulations.
(5)
Hold and maintain other licenses or certificates as
applicable, e.g. school, dietary, etc.
(6)
Meet the federal
emergency preparedness standards of
42 C.F.R.
441.184.
(7)
Ensure youths
receive equitable access to education.
(8)
File an
application with the department documenting compliance with the standards of
this paragraph.
(D)
PRTF psychiatric services for individuals under the age
of twenty-one are to be:
(1)
Provided under the direction of a
physician;
(2)
Provided by a psychiatric facility that is not a
hospital and is accredited by the joint commission, the commission on
accreditation of rehabilitation facilities, or the council on accreditation as
a behavioral health residential treatment facility.
(3)
Provided before
the individual reaches the age of twenty-one, or, if the individual was
receiving the services immediately before they reached the age of twenty-one,
before the earlier of:
(a)
The date the individual no longer needs the services;
or,
(b)
The date the individual reaches the age of
twenty-two.
(4)
Documented as necessary with a certification of need,
as described in 42 C.F.R.
441.152.
(E)
A PRTF will
comply with the rules for restraint and seclusion, in accordance with rules
5122-26-16 and
5122-26-16.1 of the
Administrative Code.
(F)
Serious occurrence incident notification.
(1)
A PRTF will meet
the incident reporting standards of rule
5122-30-16 of the Administrative
Code for residential facilities.
(2)
In addition to
the incident notification standards of rule
5122-30-16 of the Administrative
Code, a PRTF will also report the following serious occurrences in writing to
the department, the Ohio department of medicaid if the individual is medicaid
eligible, and disability rights Ohio by the close of business the next business
day following the incident:
(a)
Youth death, which will also be reported to the CMS
regional office.
(b)
Suicide attempt.
(c)
Serious
injury.
(d)
Substantiated abuse or neglect.
(3)
The
report will include the name of the youth; a description of the occurrence; and
the name, street address, and telephone number of the facility.
(4)
In the case of a
minor, the facility will notify the youth's parents, custodian, or legal
guardian as soon as possible, and in no case later than twenty-four hours after
the incident.
(5)
Staff will document in the youth's record that the
serious occurrence was reported in accordance with this paragraph, including
the name of the person with the Ohio department of medicaid and disability
rights Ohio and the name of the parents, custodian, or legal guardian to whom
the incident was reported. A copy of the report will be maintained in the
youth's record, as well as in the incident and accident report logs kept by the
facility.
(G)
Each PRTF will collect and analyze PRTF performance
improvement and outcomes data to identify areas of focus and performance
improvement.
Notes
Promulgated Under: 119.03
Statutory Authority: 5119.141
Rule Amplifies: 5119.141, 5119.34
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