411-090-0120 Endorsement Requirements and Approval (1) ENDORSEMENT REQUIRED. Any Title XVIII and XIX certified nursing facility that provides care to residents as a Ventilator Assisted Program must be endorsed pursuant to these rules. (2) The facility may not admit any ventilator dependent residents until they receive an approved endorsement from the Department. (3) Application for Endorsement. At least 60 days prior to the anticipated unit opening, the applicant must submit, to the Department, a completed Ventilator Assisted Program endorsement application and any other information or documentation determined necessary by the Department to assess whether the applicant qualifies for program endorsement, including, but not limited to: (a) Staffing plan for the Ventilator Assisted Program. (b) Staff training plan specific to ventilator care, including, but not limited to: (A) Cardiopulmonary Resuscitation. (B) Basic Life Support. (C) Mechanical Ventilation. (D) Tracheostomy management. (E) Pulmonary Hygiene. (F) Emergency Response. (c) Name of the physicians who will provide oversight of the ventilator dependent residents and their current Medicaid provider number. (d) Name of the Ventilator Assisted Program Unit Director and current license number. (e) Valid written addendums to nursing facility agreements that support appropriate care for residents in the Ventilator Assisted Program with the following, a local: (A) Emergency transportation provider; and (B) Hospital capable of providing 24 hours a day, seven days a week care that is necessary for Ventilator Assisted Program participants. (f) A copy of the contract with a Ventilator Assisted Program unit contractor, if the facility is using a contractor to provide their Ventilator Assisted Program services. If a licensee contracts with an agency to provide the VAP services, the contract shall include: (A) An outline of the services the contractor shall provide. (B) The contractor's responsibilities for determining the VAP plan of care. (C) How communication between the facility and the contractor will be documented. (g) A statement on the Ventilator Assisted Program's mission, commitment to person-centered care, weaning, and the promotion of Ventilator Assisted Program residents to be as independent in respiratory function as medically feasible. (h) Plans including, but not limited to: (A) Infection Control. (i) Actions to investigate, control, and prevent infections; (ii) Isolation procedures; and (iii) Standard precautions. (B) Maintenance and care requirements of equipment and disposal of supplies. (C) Emergency Plan. (D) Floor plan of the Ventilator Assisted Program unit designated area. (E) Copy of the care planning tool. (i) Copies of brochures or advertisements used to advertise the facility and the facility's services. (j) Endorsement application fee as described in section (6) of this rule. (4) The Department shall notify the applicant within 60 days after receiving the completed application for endorsement of the decision to approve or deny the endorsement for a Ventilator Assisted Program. (5) The Department shall return incomplete applications to the applicant. (6) Endorsement Fee. The non-refundable endorsement application fee is due upon receipt of the application for an initial endorsement and whenever the facility's license and endorsement are renewed. Endorsement application fees are in addition to the fees required for licensure. Fees shall be as follows: (a) $1000 for each facility applying for endorsement of a Ventilator Assisted Program. (b) $500 for each facility applying for re-endorsement of a Ventilator Assisted Program. (7) DEMONSTRATED CAPACITY. In addition to the application requirements described in these rules, the applicant must demonstrate to the satisfaction of the Department, the ability to provide services in a manner consistent with the requirements of these rules. The Department shall consider the following criteria, including, but not limited to: (a) The long-term care experience of the applicant. (b) The compliance history of the applicant for endorsement, of the management company in the operation of any care facility licensed, certified, or registered under federal or state laws, to the extent the compliance history may indicate the applicant is not able to comply with these rules or provide quality care to residents in the Ventilator Assisted Program. (c) If the Department identifies compliance issues, the applicant must submit a plan to the Department addressing the compliance issues and the Department may require the applicant to employ a consultant or management company for a specified period. (8) Prior to issuing the endorsement, the Department shall conduct an on-site inspection to ensure the facility complies with the physical plant requirements outlined in these rules. (9) Even if an applicant meets the application requirements described in this rule, the Department may deny approval of an application for endorsement based on: (a) Existing geographic coverage of nursing facility ventilator services; (b) Market saturation; or (c) The ability of the facility to demonstrate and maintain compliance with requirements that apply to endorsed facilities. (10) The Department shall conduct an on-site inspection within 90 days of the admission of the first resident in a Ventilator Assisted Program to ensure quality of care. (11) The licensee shall be responsible for the operation of the unit and quality of care rendered in the unit. (12) The endorsement shall be identified on the facility's license. Statutory/Other Authority: ORS 409.050, 410.070, 441.055, 441.615 Statutes/Other Implemented: ORS 409.050, 410.070, 441.055, 441.087, 441.615 History: APD 9-2019, adopt filed 01/31/2019, effective 02/01/2019