As Introduced
134th General Assembly
Regular Session H. B. No. 753
2021-2022
Representatives Seitz, Ray
A BILL
To amend sections 3702.511, 3702.59, and 3721.03 of 1
the Revised Code regarding regulatory 2
proceedings against certain long-term care 3
facilities. 4
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 3702.511, 3702.59, and 3721.03 of 5
the Revised Code be amended to read as follows: 6
Sec. 3702.511. (A) Except as provided in division (B) of 7
this section and section 3702.512 of the Revised Code, the 8
following activities are reviewable under sections 3702.51 to 9
3702.62 of the Revised Code: 10
(1) Establishment, development, or construction of a new 11
long-term care facility; 12
(2) Replacement of an existing long-term care facility; 13
(3) Renovation of or addition to a long-term care facility 14
that involves a capital expenditure of four million dollars or 15
more, not including expenditures for equipment, staffing, or 16
operational costs; 17
(4) An increase in long-term care bed capacity; 18
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(5) A relocation of long-term care beds from one physical 19
facility or site to another, excluding relocation of beds within 20
a long-term care facility or among buildings of a long-term care 21
facility at the same site; 22
(6) A transfer of ownership of long-term care beds while 23
retaining the beds at the same site, as a result of an action 24
permitted by division (F) of section 3721.03 of the Revised 25
Code; 26
(7) Expenditure of more than one hundred ten per cent of 27
the maximum expenditure specified in a certificate of need 28
concerning long-term care beds; 29
(7) (8) Any failure to conduct a reviewable activity in 30
substantial accordance with the approved application for which a 31
certificate of need was granted, including a change in the site, 32
if the failure occurs within five years after implementation of 33
the reviewable activity for which the certificate was granted. 34
(B) The following activities are not subject to review 35
under sections 3702.51 to 3702.62 of the Revised Code: 36
(1) Acquisition of computer hardware or software; 37
(2) Acquisition of a telephone system; 38
(3) Construction or acquisition of parking facilities; 39
(4) Correction of cited deficiencies that constitute an 40
imminent threat to public health or safety and are in violation 41
of federal, state, or local fire, building, or safety statutes, 42
ordinances, rules, or regulations; 43
(5) Acquisition of an existing long-term care facility 44
that does not involve a change in the number of the beds; 45
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(6) Mergers, consolidations, or other corporate 46
reorganizations of long-term care facilities that do not involve 47
a change in the number of beds; 48
(7) Construction, repair, or renovation of bathroom 49
facilities; 50
(8) Construction of laundry facilities, waste disposal 51
facilities, dietary department projects, heating and air 52
conditioning projects, administrative offices, and portions of 53
medical office buildings used exclusively for physician 54
services; 55
(9) Removal of asbestos from a health care facility. 56
Only that portion of a project that is described in this 57
division is not reviewable. 58
Sec. 3702.59. (A) The director of health shall accept for 59
review certificate of need applications as provided in sections 60
3702.592, 3702.593, and 3702.594 of the Revised Code. 61
(B)(1) The director shall not approve an application for a 62
certificate of need for the addition of long-term care beds to 63
an existing long-term care facility or for the development of a 64
new long-term care facility if any of the following apply: 65
(a) The existing long-term care facility in which the beds 66
are being placed has one or more waivers for life safety code 67
deficiencies, one or more state fire code violations, or one or 68
more state building code violations, and the project identified 69
in the application does not propose to correct all life safety 70
code deficiencies for which a waiver has been granted, all state 71
fire code violations, and all state building code violations at 72
the existing long-term care facility in which the beds are being 73
placed; 74
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(b) During the sixty-month period preceding the filing of 75
the application, a notice of proposed license revocation was 76
issued under section 3721.03 of the Revised Code for the 77
existing long-term care facility in which the beds are being 78
placed or a nursing home owned or operated by the applicant or a 79
principal participant, unless, in the case of such a nursing 80
home, either of the following applies: 81
(i) The notice was issued solely because the nursing home 82
had already closed or ceased operations. 83
(ii) An application is submitted as described in division 84
(H)(3) of section 3721.03 of the Revised Code. 85
(c) During the period that precedes the filing of the 86
application and is encompassed by the three most recent standard 87
surveys of the existing long-term care facility in which the 88
beds are being placed, any of the following occurred: 89
(i) The facility was cited on three or more separate 90
occasions for final, nonappealable actual harm but not immediate 91
jeopardy deficiencies. 92
(ii) The facility was cited on two or more separate 93
occasions for final, nonappealable immediate jeopardy 94
deficiencies. 95
(iii) The facility was cited on two separate occasions for 96
final, nonappealable actual harm but not immediate jeopardy 97
deficiencies and on one occasion for a final, nonappealable 98
immediate jeopardy deficiency. 99
(d) More than two nursing homes owned or operated in this 100
state by the applicant or a principal participant or, if the 101
applicant or a principal participant owns or operates more than 102
twenty nursing homes in this state, more than ten per cent of 103
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those nursing homes, were each cited during the period that 104
precedes the filing of the application for the certificate of 105
need and is encompassed by the three most recent standard 106
surveys of the nursing homes that were so cited in any of the 107
following manners: 108
(i) On three or more separate occasions for final, 109
nonappealable actual harm but not immediate jeopardy 110
deficiencies; 111
(ii) On two or more separate occasions for final, 112
nonappealable immediate jeopardy deficiencies; 113
(iii) On two separate occasions for final, nonappealable 114
actual harm but not immediate jeopardy deficiencies and on one 115
occasion for a final, nonappealable immediate jeopardy 116
deficiency. 117
(2) In applying divisions (B)(1)(a) to (d) of this 118
section, the director shall not consider deficiencies or 119
violations cited before the applicant or a principal participant 120
acquired or began to own or operate the long-term care facility 121
at which the deficiencies or violations were cited. The director 122
may disregard deficiencies and violations cited after the long- 123
term care facility was acquired or began to be operated by the 124
applicant or a principal participant if the deficiencies or 125
violations were attributable to circumstances that arose under 126
the previous owner or operator and the applicant or principal 127
participant has implemented measures to alleviate the 128
circumstances. In the case of an application proposing 129
development of a new long-term care facility by relocation of 130
beds, the director shall not consider deficiencies or violations 131
that were solely attributable to the physical plant of the 132
existing long-term care facility from which the beds are being 133
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As Introduced
relocated. 134
(C) The director also shall accept for review any 135
application for the conversion of infirmary beds to long-term 136
care beds if the infirmary meets all of the following 137
conditions: 138
(1) Is operated exclusively by a religious order; 139
(2) Provides care exclusively to members of religious 140
orders who take vows of celibacy and live by virtue of their 141
vows within the orders as if related; 142
(3) Was providing care exclusively to members of such a 143
religious order on January 1, 1994. 144
(D) Notwithstanding division (C)(2) of this section, a 145
facility that has been granted a certificate of need under 146
division (C) of this section may provide care to any of the 147
following family members of the individuals described in 148
division (C)(2) of this section: mothers, fathers, brothers, 149
sisters, brothers-in-law, sisters-in-law, or children. Such a 150
facility may also provide care to any individual who has been 151
designated an associate member by the religious order that 152
operates the facility. 153
The long-term care beds in a facility that have been 154
granted a certificate of need under division (C) of this section 155
may not be relocated pursuant to sections 3702.592 to 3702.594 156
of the Revised Code. 157
Sec. 3721.03. (A) As used in this section, "person" has 158
the same meaning as in section 1.59 of the Revised Code. 159
(B) The director of health shall enforce the provisions of 160
sections 3721.01 to 3721.13 and 3721.99 of the Revised Code and 161
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may issue orders to secure compliance with the provisions of 162
these sections and the rules adopted under them. The director 163
may hold hearings, issue subpoenas, compel testimony, and make 164
adjudications. 165
The director may issue an order revoking a license in the 166
event the director finds, upon hearing or opportunity afforded 167
pursuant to Chapter 119. of the Revised Codeas provided in 168
division (D) of this section, that any of the following apply to 169
a person, county home, or district home licensed under section 170
3721.07 of the Revised Code: 171
(1) Has violated any of the provisions of Chapter 3721. of 172
the Revised Code or rules adopted by the director under it; 173
(2) Has violated any order issued by the director; 174
(3) Is not, or any of its principals are not suitable, 175
morally or financially to operate such an institution; 176
(4) Is not furnishing humane, kind, and adequate treatment 177
and care; 178
(5) Has had a long-standing pattern of violations of this 179
chapter or the rules adopted under it that has caused physical, 180
emotional, mental, or psychosocial harm to one or more 181
residents. 182
Upon the issuance of any order of revocation, the person 183
whose license is revoked, or the county home or district home 184
that has its license revoked, may appeal in accordance with 185
Chapter 119. of the Revised Code. 186
(C) Once If the director notifies a home's license holder 187
that the license may be revoked or that an order to secure 188
compliance is being issued, the director also shall notify both 189
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of the following persons, as applicable, who have ownership 190
interests in the home but are not the license holder: 191
(1) The owner of the property rights associated with the 192
home's beds; 193
(2) The owner of the building housing the home, unless 194
that owner is the same person as the owner described in division 195
(C)(1) of this section. 196
(D) On issuance of a notice or order as described in 197
division (C) of this section, the license holder and any of the 198
persons with ownership interests in a home who are notified 199
under that division may appeal in accordance with Chapter 119. 200
of the Revised Code. In an appeal, both of the following apply 201
with respect to a person with ownership interests who was 202
notified: 203
(1) The person with ownership interests may participate in 204
any hearing held as part of an appeal made by the license 205
holder. 206
(2) If the person with ownership interests was the person 207
who requested a hearing, the director shall hold the hearing not 208
later than sixty days after the date the director receives the 209
person's request, notwithstanding any conflicting provision of 210
Chapter 119. of the Revised Code. 211
(E) Except as provided in division (F) of this section, 212
both of the following apply with respect to assigning or 213
transferring the right to operate a home following issuance of a 214
notice or order as described in division (C) of this section: 215
(1) Once the director notifies a person, county home, or 216
district home licensed to operate a home that the license may be 217
revoked or issues any order under this section provides the 218
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As Introduced
notice as described in division (C) of this section, the person, 219
cou