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07/29/2026

Member Questions

Question:

Can CMAs in Ohio sign off with another CMA to destroy narcotics in an Assisted Living community?

Answer:

No. Even though CMAs in Ohio Assisted Living communities are permitted to administer controlled substances, they cannot sign off on the destruction or wasting of narcotics. Controlled substance destruction falls under drug accountability rules, which are governed by the Ohio Board of Pharmacy, not the CMA regulations.

CMA authority is limited to medication administration under OAC 4723‑27. Narcotic destruction is a separate regulated act that requires two licensed individuals, such as:

  • RN + RN
  • RN + LPN
  • LPN + LPN
  • RN + Administrator (if permitted by facility policy)

CMAs are not licensed clinicians, and therefore cannot legally witness, verify, or co‑sign the disposal of controlled substances — either with another CMA or with a nurse.

Bottom line:

CMAs may administer controlled substances in Ohio Assisted Living communities, but they cannot participate in or sign off on narcotic waste or destruction. Only licensed nursing personnel may do so.

Question:

We have a private pay resident that is transitioning to the Medicaid Waiver program. Do we need to move this resident to a Medicaid certified room for them to be considered for approval for the waiver?

Answer:

No, Ohio's Assisted Living Waiver allows an existing private-pay resident in an RCF to transition to waiver status if the resident becomes eligible, and a designated waiver unit is available. The rules are generally structured around the availability of an approved/designated unit, not around a requirement that the resident must have already been occupying a Medicaid-certified unit before becoming waiver eligible.

Question: 

When billing for a resident that is has  MyCare Anthem Medicaid, which Payer do you choose in the drop down? There are several options for Anthem.

Answer: 

In the drop down, you will choose ANTHEM BCBS (OHIO MYCARE).

Question: 

What can we as an RCF charge for record requests?

Answer: 

MEDICAL RECORD ACCESS REQUIREMENTS (OHIO LAW)

1. Turnaround Time

Statute: ORC 3701.74

Ohio law requires facilities to provide medical records “within a reasonable time.” The statute does not specify an exact number of days, but Ohio providers and legal guidance consistently interpret this as within 30 days, consistent with HIPAA.

Policy language: Records must be provided within a reasonable time, not to exceed 30 days.

2. Fees for Medical Records

Statute: ORC 3701.714 (current law)

Ohio uses two different fee systems depending on who is requesting the records.

A. When the Resident, Personal Representative, or POA Requests the Records

Statute: ORC 3701.714(B)(1)(a) and (b)

These individuals do not pay the higher “third‑party” fee schedule.

Instead, the law requires:

  • Fees must be reasonable and cost‑based, consistent with federal HIPAA rules.
  • Facilities cannot charge the search fee.
  • Per‑page charges cannot exceed the maximums listed in ORC 3701.714(B)(2)(b) and (c).
  • If the records are digital or electronically transmitted, the total cost cannot exceed $50.

Maximum per‑page caps for residents/POA (paper records):

  • $1.11 per page for the first 10 pages
  • $0.57 per page for pages 11–50
  • $0.23 per page for pages 51+
  • $1.87 per page for X‑ray/MRI/CAT scan images
  • Postage may be charged at actual cost

Summary: Residents and their representatives pay HIPAA cost‑based fees, capped by Ohio’s per‑page limits, with a $50 maximum for electronic records.

B. When a Third Party Requests the Records

(Examples: attorneys, insurance companies, outside agencies) Statute: ORC 3701.714(B)(2)

Third parties pay the full Ohio fee schedule, which includes:

  • $16.84 search fee (adjusted annually under ORC 3701.742)
  • Per‑page fees: • $1.11 per page for the first 10 pages • $0.57 per page for pages 11–50 • $0.23 per page for pages 51+
  • X‑ray/MRI/CAT scan images: $1.87 per page
  • Postage: actual cost

Summary: Third parties pay the statutory search fee plus the full per‑page schedule.

C. Required Free Copies

Statute: ORC 3701.714(C)

Facilities must provide one free copy of the medical record when requested by:

  • Bureau of Workers’ Compensation
  • Industrial Commission
  • Department of Medicaid or County JFS
  • Ohio Attorney General
  • Resident/personal representative when records are needed for a Social Security disability claim (with documentation)      

3. Applicability to Assisted Living and SNFs

Both ORC 3701.74 (turnaround time) and ORC 3701.714 (fees) apply to all health care providers, including:

  • Residential Care Facilities (Assisted Living)
  • Skilled Nursing Facilities

There is no separate statute for SNFs. The requirements are identical for both settings.

4. Summary for Policy

  • Turnaround Time: Records must be provided within a reasonable time, not to exceed 30 days (ORC 3701.74).
  • Resident/POA Fees: HIPAA cost‑based fees, capped by Ohio per‑page limits; electronic records capped at $50 (ORC 3701.714(B)(1)).
  • Third‑Party Fees: Full statutory fee schedule including search fee (ORC 3701.714(B)(2)).
  • Free Copies: Required for Workers’ Compensation, Medicaid/JFS, the Attorney General, and Social Security disability claims (ORC 3701.714(C)).
  • Applicability: Requirements are the same for Assisted Living and Skilled Nursing Facilities.

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