411-069-0040 Long Term Care Facility Assessment: Calculation, Report, Due Date (1) The assessment is assessed upon each patient day, including Medicaid patient day, at a long term care facility. The amount of the assessment equals the assessment rate times the number of patient days, including Medicaid patient days, at the long term care facility for the calendar quarter. The rate of the assessment shall be determined in accordance with these rules. (2) The facility must pay the assessment and file the report on a form approved by the Department on or before the last day of the month following the end of the calendar quarter for which the assessment is being reported, unless the Department permits a later payment date. If a facility requests an extension, the Department, in its sole discretion, shall determine whether to grant an extension. (3) Each long term care facility must submit a revenue report on a form prescribed by the Department by September 30 of each year and pay any assessment amount due. Long term care facilities with a Medicaid contract with the Department that provide more than 1,000 Medicaid patient days must submit the nursing facility financial statement (cost report) annually as required by OAR 411-070-0300 which contains the revenue report. Long term care facilities that are not required to submit the annual cost report must submit the revenue report. Either a revenue report or a nursing facility financial statement, where applicable, must be filed by October 31 of each year regardless of whether any additional assessment is owed as a result of that filing. (4) Revenue reports submitted late are subject to penalty as set forth in OAR 411-069-0080. Nursing facility financial statements submitted late are subject to a penalty as set forth in OAR 411-070-0300, where applicable. (5) Any assessment amount due based on the cost report or revenue report as a reconciliation of the previously filed quarterly reports must be paid by the due date specified. Payments submitted late are subject to penalty as set forth in OAR 411-069-0080. (6) Any refund due to the provider based on the cost report or revenue report may be requested in writing with the submission of the report. (7) Any report, statement, or other document required to be filed under any provision of these rules shall be certified by the chief financial officer of the facility or an individual with delegated authority to sign for the facility's chief financial officer. The certification must attest, based on best knowledge, information, and belief, to the accuracy, completeness, and truthfulness of the document. (8) Payments may be made electronically and the accompanying report may either be faxed to the Department at the fax number provided on the report form or mailed to the Department at the address provided on the report form. (9) The Department may charge the facility a fee of $100 if, for any reason, the check, draft, order, or electronic funds transfer request is dishonored. This charge is in addition to any penalty for nonpayment of the assessments that may also be due. Statutory/Other Authority: ORS 409.050, 410.070 & 411.060 Statutes/Other Implemented: ORS 409.750 & OL 2003 Ch. 736 History: APD 17-2018, amend filed 06/28/2018, effective 07/01/2018 APD 7-2014, f. & cert. ef. 4-1-14 SPD 41-2013(Temp), f. & cert. ef. 10-7-13 thru 4-5-14 Renumbered from 410-050-0451, SDP 3-2011, f. & cert. ef. 2-1-11 DMAP 2-2008, f. & cert. ef. 1-25-08 OMAP 3-2005, f. & cert. ef. 2-1-05