Ohio Admin. Code 5123-9-28 - Home and community-based services waivers - nutrition services under the individual options waiver
(A)
Purpose
This rule defines nutrition services and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.
(B)
Definitions
For the purposes of this rule, the following definitions apply:
(1)
"Agency provider" has the same meaning as in rule
5123-2-08 of the Administrative
Code.
(2)
"County board" means a county board of developmental
disabilities.
(3)
"Department" means the Ohio department of developmental
disabilities.
(4)
"Independent provider" has the same meaning as in rule
5123-2-09 of the Administrative
Code.
(5)
"Individual" means a person with a developmental
disability or for purposes of giving, refusing to give, or withdrawing consent
for services, the person's guardian in accordance with section
5126.043 of the Revised
Code.
(6)
"Individual service plan" means the written description
of services, supports, and activities to be provided to an
individual.
(7)
"Nutrition services" means a nutritional assessment and
intervention for individuals who are identified as being at nutritional risk
and includes development of a nutrition care plan, including appropriate means
of nutrition intervention (i.e., nutrition required, feeding modality,
nutrition education, and nutrition counseling). Nutrition services shall not
supplant existing services provided by the federal women, infants, and children
program.
(8)
"Service documentation" means all records and
information on one or more documents, including documents that may be created
or maintained in electronic software programs, created and maintained
contemporaneously with the delivery of services, and kept in a manner as to
fully disclose the nature and extent of services delivered that shall include
the items delineated in paragraph (E) of this rule to validate payment for
medicaid services.
(C)
Provider
qualifications
(1)
Nutrition services shall be provided by a dietitian
licensed by the state pursuant to section
4759.06 of the Revised Code who
is either an independent provider or the employee of an agency provider that
meets the requirements of this rule and that has a medicaid provider agreement
with the Ohio department of medicaid.
(2)
Nutrition
services shall not be provided by a county board or a regional council of
governments formed under section
5126.13 of the Revised Code by
two or more county boards.
(3)
An applicant
seeking approval to provide nutrition services shall complete and submit an
application through the department's website (http://dodd.ohio.gov/
).
(D)
Requirements for service delivery
(1)
Nutrition
services shall be provided pursuant to an individual service plan that conforms
to the requirements of rule
5123-4-02 of the Administrative
Code.
(2)
A dietitian providing nutrition services shall:
(a)
Perform
nutritional assessments and evaluations in accordance with the individual
service plan;
(b)
Develop dietary programs, if indicated by the
nutritional assessment and the individual service plan; and
(c)
Train the
individual, family members, professionals, paraprofessionals, direct care
workers, habilitation specialists, and vocational/school staff regarding the
dietary program.
(E)
Documentation of
services
Service documentation for nutrition services shall include each of the following to validate payment for medicaid services:
(1)
Type of service.
(2)
Date of
service.
(3)
Place of service.
(4)
Name of
individual receiving service.
(5)
Medicaid
identification number of individual receiving service.
(6)
Name of
provider.
(7)
Provider identifier/contract number.
(8)
Written or
electronic signature of the person delivering the service, or initials of the
person delivering the service if a signature and corresponding initials are on
file with the provider.
(9)
Group size in which the service was
provided.
(10)
Description and details of the services delivered that
directly relate to the services specified in the approved individual service
plan as the services to be provided.
(11)
Number of units
of the delivered service.
(12)
Times the
delivered service started and stopped.
(F)
Payment
standards
(1)
The billing unit, service codes, and payment rates for
nutrition services are contained in appendix A to this rule.
(2)
Payment rates for
nutrition services are based on the county cost-of-doing-business category. The
cost-of-doing-business categories are contained in appendix B to this
rule.
(3)
Payment rates for nutrition services are established
separately for services provided by independent providers and services provided
through agency providers.
(4)
Payment rates for nutrition services are based on the
number of individuals receiving services.
Replaces: 5123:2-9-28
Notes
Promulgated Under: 119.03
Statutory Authority: 5123.04, 5123.049, 5123.1611
Rule Amplifies: 5123.04, 5123.045, 5123.049, 5123.16, 5123.161, 5123.1611, 5166.21
Prior Effective Dates: 11/03/2011, 07/01/2017
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