411-050-0730 Operational Standards (1) A licensee must own, rent, or lease the home to be licensed, however, the LLA may grant a variance to churches, hospitals, non-profit associations, or similar organizations. If a licensee rents or leases the premises where the AFH is located, the licensee may not enter into a contract that requires anything other than a flat rate for the lease or rental. The licensee of a building where an AFH is located may not allow the owner, landlord, or lessor to interfere with the admission, transfer, or voluntary or involuntary move of any resident in the AFH unless the owner, landlord, or lessor is named on the license. (2) Each AFH licensee must comply with: (a) All applicable local business license, zoning, building, and housing codes. (b) The Fair Housing Act. (c) State and local fire and safety regulations for a single-family residence, and Oregon Fire Code, Appendix R. (d) Federal regulations governing HCB Settings (OAR chapter 411, division 004). (3) ZONING. AFHs are subject to applicable sections of ORS 197.660 to 197.670. (4) COOPERATION AND ACCESS. The licensee or administrator must cooperate with the Department, Centers for Medicare and Medicaid Services (CMS), Oregon Health Authority (OHA) and local licensing and investigative personnel in inspections, complaint investigations, planning for resident care, application procedures, and other necessary activities. (a) Department, CMS, OHA, local licensing, and investigative personnel must be provided access to all resident and facility records and may conduct private interviews with residents. (b) The State Long-Term Care Ombudsman must be provided access to all resident and facility records. Deputy Ombudsman and Certified Ombudsman Volunteers must be provided access to facility records, and with written permission from the resident or the resident's legal representative, may have access to resident records. (See OAR 114-005-0030). (5) CONFIDENTIALITY. Licensees and AFH staff must keep personal and healthcare information related to residents confidential and private as required by all applicable confidentiality and privacy laws, except as may be necessary in the planning or provision of care or medical treatment, or related to an inspection, investigation, or sanction action under these rules. Applicable confidentiality and privacy laws include, but are not limited to: (a) For medical information: (A) Health Insurance Portability and Accountability Act (HIPAA). (B) ORS 192.553 to 192.581, confidentiality of protected health information. (b) Unless required by state or federal law, a care facility shall not disclose any personally identifiable information. This applies to all resident records including records regarding: (A) A resident’s sexual orientation; (B) Whether a resident is LGBTQIA2S+; (C) A resident’s gender transition status; or (D) A resident’s human immunodeficiency virus status. (c) The AFH shall take appropriate steps to minimize the likelihood of inadvertent or accidental disclosure of information described in subsection (b) of this section to other residents, visitors or AFH caregivers, except to the minimum extent necessary for AFH caregivers to perform their duties. The AFH must notify the resident or resident’s representative if the AFH inadvertently or accidentally discloses such information to unauthorized persons. (d) For resident records generally: (A) ORS 410.150, Use of files, confidentiality, and privileged communications. (B) OAR chapter 411, division 005, Privacy of protected information. (6) TRANSPORTATION. A licensee or administrator must arrange for or provide appropriate transportation for residents when needed. (7) COMMUNICATION. (a) Applicants for an initial license must obtain and provide to the LLA a current, active business address for electronic mail before obtaining a license. (b) A licensee or administrator must notify the LLA within 24 hours upon a change in the home's business address for electronic mail. (c) A licensee or administrator must notify the LLA, the residents and the resident's family members, representatives, and case managers, as applicable, of any change in the telephone number for the licensee or the AFH within 24 hours of the change. (d) A licensee must notify the LLA in writing before any change of the licensee's residence or mailing address. (8) MEALS. (a) Three nutritious meals must be served daily at times consistent with those in the community. Each meal must include food from the basic food groups according to the United States Department of Agriculture (USDA's) My Plate and include fresh fruit and vegetables when in season. (b) Meals must reflect consideration of a resident's preferences and cultural and ethnic background. This does not mean the licensee or administrator must prepare multiple, unique meals for the residents at the same time. (c) A schedule of mealtimes and menus for the coming week must be prepared and posted weekly in a location accessible to residents and families. (A) Meal substitutions for scheduled menu items in compliance with (8)(a) of this rule are acceptable and must be documented on, or attached to, the weekly menu. (B) The licensee or administrator must maintain the weekly menus for a minimum of the most recent six months during which the home has conducted business. (C) The licensee or administrator must support the resident's right to access food at any time. Limitations may only be used when there is a health or safety risk, as stated in OAR 411-051-0105, and when a written informed consent is obtained. Licensees have until June 30, 2020 to fully comply with this HCB Settings requirement, OAR 411-051-0105(3). (D) If a resident misses a meal at a scheduled time, an alternative meal must be made available. (d) There must be no more than a 14-hour span between the evening and morning meals. Snacks do not substitute for a meal in determining the 14-hour span. Nutritious snacks and liquids must be offered to fulfill each resident's nutritional requirements. (e) Food may not be used as an inducement to control the behavior of a resident. (f) Home-canned foods must be processed according to the guidelines of the Oregon State University Extension Service. Freezing is the most acceptable method of food preservation. Milk must be pasteurized. (g) Special consideration must be given to a resident with chewing difficulties or other eating limitations. Special diets must be followed, as prescribed in writing, by the resident's physician, nurse practitioner, or physician assistant. (h) Adequate storage must be available to maintain food at a proper temperature, including a properly working refrigerator. Storage and food preparation areas must be free from food that is spoiled or expired. (i) The household utensils, dishes, glassware, and household food may not be stored in bedrooms, bathrooms, or living areas. (j) Meals must be prepared and served in the home where the residents live. Payment for meals eaten away from the home for the convenience of the licensee or administrator (e.g., restaurants, senior meal sites) is the responsibility of the licensee. (A) Meals and snacks, as part of an individual recreational outing by choice, are the responsibility of the resident. (B) Payment for food beyond the required three meals and snacks are the responsibility of the resident. (k) Utensils, dishes, and glassware must be washed in hot soapy water, rinsed, and stored to prevent contamination. A dishwasher with a sani-cycle is recommended. (l) Food preparation areas and equipment, including utensils and appliances, must be clean, free of offensive odors, and in good repair. (9) TELEPHONE. (a) The home must have a working landline and corded telephone with a listed number that is separate from any other number the home has, such as, but not limited to, internet or fax lines, unless the system includes features that notify the caregiver of an incoming call, or automatically switches to the appropriate mode. If a licensee has a caller identification service on the home number, the blocking feature must be disabled to allow incoming calls to be received unhindered. A licensee may have only one phone line if the phone line complies with the requirements of these rules. Voice over internet protocol (VoIP), voice over broadband (VoBB), or cellular telephone service may not be used in place of a landline. (b) The licensee must make a telephone that is in good working order available and accessible for the residents use with reasonable accommodation for privacy during telephone conversations. A resident with a hearing impairment, to the extent the resident may not hear a normal telephone conversation, must be provided with a telephone that is amplified with a volume control or a telephone that is hearing aid compatible. (c) Restrictions on the use of the telephone by the residents must be specified in the written Residency Agreement and may not violate the residents' rights. Individual restrictions must be well documented in the resident's care plan. Statutory/Other Authority: ORS 409.050, 410.070, 413.085, 441.122, 443.001, 443.004, 443.725, 443.730, 443.735, 443.738, 443.742, 443.760, 443.767, 443.775, 443.790 & 443.880 Statutes/Other Implemented: ORS 197.660 - 197.670, 409.050, 410.070, 413.085, 441.114, 441.373, 443.001 - 443.004, 443.705 - 443.825, 443.875 & 443.991 History: APD 57-2024, amend filed 09/23/2024, effective 09/25/2024 APD 14-2024, temporary amend filed 03/28/2024, effective 04/01/2024 through 09/27/2024 APD 16-2022, temporary suspends temporary APD 65-2021, filed 03/18/2022, effective 03/21/2022 through 06/29/2022 APD 65-2021, temporary amend filed 12/28/2021, effective 01/01/2022 through 06/29/2022 APD 62-2021, amend filed 12/27/2021, effective 01/01/2022 APD 57-2021, temporary amend filed 12/10/2021, effective 12/15/2021 through 03/29/2022 APD 19-2020, amend filed 06/16/2020, effective 06/24/2020 APD 19-2019, adopt filed 06/20/2019, effective 07/01/2019