(A) In addition to providing accommodations, supervision, and personal care services to its residents, a residential care facility may do the following:

1. (1) Provide the following skilled nursing care to its residents:

   1. (a) Supervision of special diets;
   2. (b) Application of dressings, in accordance with rules adopted under section 3721.04 of the Revised Code;
   3. (c) Subject to division (B)(1) of this section, administration of medication.
2. (2) Subject to division (C) of this section, provide other skilled nursing care on a part-time, intermittent basis for not more than a total of one hundred twenty days in a twelve-month period;
3. (3) Provide skilled nursing care for more than one hundred twenty days in a twelve-month period to a resident when the requirements of division (D) of this section are met. A residential care facility may not admit or retain an individual requiring skilled nursing care that is not authorized by this section. A residential care facility may not provide skilled nursing care beyond the limits established by this section.

(B)

1. (1) A residential care facility may admit or retain an individual requiring medication, including biologicals, only if the individual's personal physician has determined in writing that the individual is capable of self-administering the medication or the facility provides for the medication to be administered to the individual by a home health agency certified under Title XVIII of the "Social Security Act," 79 Stat. 620 (1965), 42 U.S.C. 1395, as amended; a hospice care program licensed under Chapter 3712. of the Revised Code; or a member of the staff of the residential care facility who is qualified to perform medication administration. Medication may be administered in a residential care facility only by the following persons authorized by law to administer medication:

   1. (a) A registered nurse licensed under Chapter 4723. of the Revised Code;
   2. (b) A licensed practical nurse licensed under Chapter 4723. of the Revised Code who holds proof of successful completion of a course in medication administration approved by the board of nursing and who administers the medication only at the direction of a registered nurse or a physician authorized under Chapter 4731. of the Revised Code to practice medicine and surgery or osteopathic medicine and surgery;
   3. (c) A medication aide certified under Chapter 4723. of the Revised Code;
   4. (d) A physician authorized under Chapter 4731. of the Revised Code to practice medicine and surgery or osteopathic medicine and surgery.

2. (2) In assisting a resident with self-administration of medication, any member of the staff of a residential care facility may do the following:

   1. (a) Remind a resident when to take medication and watch to ensure that the resident follows the directions on the container;
   2. (b) Assist a resident by taking the medication from the locked area where it is stored, in accordance with rules adopted pursuant to section 3721.04 of the Revised Code, and handing it to the resident. If the resident is physically unable to open the container, a staff member may open the container for the resident.
   3. (c) Assist a physically impaired but mentally alert resident, such as a resident with arthritis, cerebral palsy, or Parkinson's disease, in removing oral or topical medication from containers and in consuming or applying the medication, upon request by or with the consent of the resident. If a resident is physically unable to place a dose of medicine to the resident's mouth without spilling it, a staff member may place the dose in a container and place the container to the mouth of the resident.

(C) Except as provided in division (D) of this section, a residential care facility may admit or retain individuals who require skilled nursing care beyond the supervision of special diets, application of dressings, or administration of medication, only if the care will be provided on a part-time, intermittent basis for not more than a total of one hundred twenty days in any twelve-month period. In accordance with Chapter 119. of the Revised Code, the director of health shall adopt rules specifying what constitutes the need for skilled nursing care on a part-time, intermittent basis. The director shall adopt rules that are consistent with rules pertaining to home health care adopted by the medicaid director for the medicaid program. Skilled nursing care provided pursuant to this division may be provided by a home health agency certified for participation in the medicare program, a hospice care program licensed under Chapter 3712. of the Revised Code, or a member of the staff of a residential care facility who is qualified to perform skilled nursing care. A residential care facility that provides skilled nursing care pursuant to this division shall do both of the following:

1. (1) Evaluate each resident receiving the skilled nursing care at least once every seven days to determine whether the resident should be transferred to a nursing home;
2. (2) Meet the skilled nursing care needs of each resident receiving the care.

(D)

1. (1) A residential care facility may admit or retain an individual who requires skilled nursing care for more than one hundred twenty days in any twelve-month period only if the facility has entered into a written agreement with each of the following:

   1. (a) The individual or individual's sponsor;
   2. (b) The individual's personal physician;
   3. (c) Unless the individual's personal physician oversees the skilled nursing care, the provider of the skilled nursing care;
   4. (d) If the individual is a hospice patient as defined in section 3712.01 of the Revised Code, a hospice care program licensed under Chapter 3712. of the Revised Code.

2. (2) The agreement required by division (D)(1) of this section shall include all of the following provisions:

   1. (a) That the individual will be provided skilled nursing care in the facility only if a determination has been made that the individual's needs can be met at the facility;
   2. (b) That the individual will be retained in the facility only if periodic redeterminations are made that the individual's needs are being met at the facility;
   3. (c) That the redeterminations will be made according to a schedule specified in the agreement;
   4. (d) If the individual is a hospice patient, that the individual has been given an opportunity to choose the hospice care program that best meets the individual's needs;
   5. (e) Unless the individual is a hospice patient, that the individual's personal physician has determined that the skilled nursing care the individual needs is routine.