Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 71 - PRIVATE ADMISSION ASSESSMENT › Section 411-071-0100 - Responsibilities of Nursing Facilities

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A Medicaid eligible individual must have
			 an AAA/Seniors and People with Disabilities Pre-Admission Screening and prior
			 authorization of payment prior to admission to a nursing facility. A nursing
			 facility must not admit a Medicaid eligible individual based on a Private
			 Admission Assessment.
(2) A nursing
			 facility receiving an application for admission from an individual who is
			 subject to the admission assessment requirement but has not had an assessment
			 performed within the preceding 90 days must provide the individual with
			 information on the admission assessment process and a list of certified
			 programs provided by the Department or the area agency on aging/Seniors and
			 People with Disabilities office.
(3) Except as provided in section (4) of this
			 rule, nursing facilities must not admit an individual without a completed and
			 signed assessment form in the client record. Such forms are to be maintained as
			 a permanent part of the client record.
(4) A nursing facility may admit an
			 individual without a completed and signed assessment form in the client record
			 provided the facility has received verbal confirmation from a certified program
			 that an assessment has been completed for the individual within the preceding
			 90 days and a copy of the assessment form will be sent to the facility as soon
			 as is reasonably possible. The facility must note in the client record the name
			 of the certified program, the name and title of the person providing the verbal
			 confirmation, and the date and time confirmation was provided.
(5) If a nursing facility admits an
			 individual under an exempted hospital discharge set forth in OAR
			 411-071-0015(3)(a)
			 for the purpose of rehabilitative and/or nursing services for 30 days or less,
			 the nursing facility must contact a certified program to ensure a Private
			 Admission Assessment is completed within seven days after the 30th day of
			 admission.
(6) If a nursing
			 facility admits an individual under an emergency exemption set forth in OAR
			 411-071-0015(3)(e),
			 the nursing facility must contact a certified program and must ensure a Private
			 Admission Assessment is completed within seven days of admission.
(7) A nursing facility receiving an
			 application from an individual who is not an Oregon resident, or from an
			 individual who is being discharged from a hospital that is not a certified
			 program, or from an individual currently residing in a nursing facility outside
			 the state of Oregon must immediately notify the local Area Agency on
			 Aging/Seniors and People with Disabilities unit of the need for the individual
			 to receive an admission assessment. The nursing facility must contact a
			 certified program to ensure a Private Admission Assessment is completed within
			 seven days of admission.
(8) The
			 nursing facility is responsible for assuring that an individual subject to the
			 Level II pre-admission screening evaluation required by the federal
			 pre-admission screening requirements has been referred to the Seniors and
			 People with Disabilities of the Department of Human Services.
(9) The Department may disallow payment for
			 nursing services provided to an individual who has not been screened in
			 compliance with the federal pre-admission screening requirements or an
			 individual who is subject to the Level II evaluation and determination but who
			 has not received such a determination within the time limits established in the
			 federal pre-admission requirements.
(10) A nursing facility failing to comply
			 with these rules may be subject to administrative sanctions as provided in ORS
			 410.540 and/or civil penalties
			 as provided in OAR 411-071-0105.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.515 &
				  410.540