Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0010 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
As used in these rules (OAR Chapter 411, Division 73) unless
				the context requires otherwise, the definitions in OAR
				411-070-0005, OAR
				411-085-0005, and following
				definitions apply:
(1) "Deficiency"
			 means a facility's failure to meet a requirement of participation as specified
			 in
42 CFR Part 483
et.seq. (
Subpart B
).
(2) "Directed Plan of Correction" means a
			 course of action specified by the federal Health Care Financing Administration
			 (HCFA), the Division or person designated by the Division which requires a
			 facility to take specific actions to correct deficiencies within specified
			 timeframes.
(3) "Facility" means a
			 nursing facility licensed by the Division pursuant to OAR
			 411-085-0010 and certified for
			 Medicaid, Medicare or both, or, if the context suggests, an owner, employee or
			 other party acting (or failing to act) in behalf of the facility.
(4) "HCFA" means the federal Health Care
			 Financing Administration.
(5)
			 "Immediate Family" means a husband or wife; natural or adopted parent, child or
			 sibling; stepparent, stepchild, stepbrother or stepsister; father-in-law,
			 mother-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law;
			 grandparent or grandchild.
(6)
			 "Immediate Jeopardy" means a situation in which a facility's non-compliance
			 with one or more requirements of participation or conditions of participation
			 has caused, or is likely to cause, serious injury, harm, impairment, or death
			 to an individual receiving care in the facility.
(7) "New Admission" means a person admitted
			 on or after the effective date of a denial of payment remedy. A resident
			 temporarily absent from the facility to go to a general hospital, other health
			 care setting, or home, etc. and was not discharged from the facility, shall not
			 be considered to be a new admission.
(8) "Noncompliance" means any deficiency that
			 causes a facility to not be in substantial compliance.
(9) "Plan of Correction" means a written
			 description of the actions to be taken by a facility in order to correct
			 deficiencies, and which has been approved by the Division or HCFA. The Plan
			 shall include the dates by which the deficiencies will be corrected. Unless
			 otherwise provided by these rules, the Plan of Correction is prepared by the
			 facility.
(10) "Requirement of
			 Participation" means a provision under the
Code of Federal Regulations,
			 Title 42, Part 483 or 488
, or provision of the Social Security
			 Act.
(11) "Standard Survey" means a
			 periodic, resident-centered inspection which gathers information about the
			 quality of service furnished in a facility to determine compliance with the
			 requirements for participation.
(12) "Statement of Deficiencies" means a
			 written description of deficiencies prepared by HCFA or the Division.
(13) "Substandard Quality of Care" means one
			 or more deficiencies in
42 CFR § 483.13 Resident Behavior and
			 Facility Practices, 42 CFR
			 §
										483.15 Quality of Life
, or in
42 CFR §
										483.25 Quality of Care
, that
			 constitutes either immediate jeopardy to resident health and safety; or a
			 pattern of or widespread actual harm that is not immediate jeopardy; or a
			 widespread potential for more than minimal harm that is not immediate jeopardy
			 and with no actual harm.
NOTE
: See Exhibit 1 (OAR
				411-073-0040).
(14) "Survey Exit Date" means the last day of
			 a standard survey by the Division or HCFA.
(15) "Work Day" means Monday, Tuesday,
			 Wednesday, Thursday or Friday, excluding State holidays.
The Exhibit referenced in this rule is not printed in the OAR
				  Compilation. Copies are available from the
				  agency.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.070