reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 71 - PRIVATE ADMISSION ASSESSMENT › Section 411-071-0055 - Renewal

Current through Register Vol. 63, No. 7, July 1, 2024
(1) At least 30
			 days prior to the expiration of the Certificate for Private Admission
			 Assessment, a reminder notice and renewal application shall be sent by the
			 Division to the certified program. Submittal of a renewal application and the
			 certification fee prior to the expiration date will keep certification in
			 effect until the Division takes action. If the renewal application and fee are
			 not submitted prior to the expiration date, the program shall no longer be
			 considered certified by the Division.
(2) In making its renewal decision, the
			 Division may investigate any information in the renewal application and
			 evaluate past performance upon consultation with area agencies on aging/SPD
			 units. The Division may refuse to renew the certification if the renewal
			 application does not meet the requirements of these rules.
Stat. Auth.: ORS
				  410.535
Stats. Implemented: ORS410.505 -
				  410.545
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 71 - PRIVATE ADMISSION ASSESSMENT › Section 411-071-0060 - Exceptions

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A certified
			 program may make written request to the Department for an exception from the
			 provisions of these rules. An exception may be granted if the certified program
			 proves to the Department by clear and convincing evidence that such an
			 exception is in compliance with ORS
			 410.505 to
			 410.545 and the federal criteria
			 for pre-admission assessment, and will not jeopardize the health, safety, and
			 welfare of the individuals receiving the admission assessment.
(2) Exceptions will be granted in writing and
			 reviewed at each renewal period.
Stat. Auth.: ORS
				  410.535
Stats. Implemented: ORS410.505 -
				  410.545
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 71 - PRIVATE ADMISSION ASSESSMENT › Section 411-071-0070 - Orientation Requirement

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Management and supervisory personnel responsible for the admission assessment
			 activities of the program applying for certification must participate in
			 orientation or training sessions conducted by the Department.
(2) All personnel of the certified program,
			 who will be performing admission assessments, must participate in the earliest
			 available orientation or training session conducted by or approved by the
			 Department on the admission assessment process, the forms designated by the
			 Department and the continuum of long term care options available.
Stat. Auth.: ORS
				  410.535
Stats. Implemented: ORS410.505 -
				  410.545
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 71 - PRIVATE ADMISSION ASSESSMENT › Section 411-071-0075 - Record Keeping

Current through Register Vol. 63, No. 7, July 1, 2024
Certified programs must maintain records for three calendar
				years of the following materials:
(1)
			 Completed assessment forms for each individual assessed;
(2) Personnel records for all employees
			 engaged in performing admission assessments;
(3) Billing and financial records required by
			 the program's contract with the Department; and
(4) Any other information as required by the
			 Department and necessary for the implementation and enforcement of ORS
			 410.505 to
			 410.595 and these
			 rules.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.530 &
				  410.535
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 71 - PRIVATE ADMISSION ASSESSMENT › Section 411-071-0080 - Complaints Against Certified Programs

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Any person who believes these rules or
			 the provisions of ORS
			 410.505 to
			 410.545 have been violated may
			 file a complaint with the Department or with a local Area Agency on
			 Aging/Seniors and People with Disabilities unit.
(2) The Department or its representative must
			 notify the certified program that a complaint has been filed.
(3) After consultation with the local area
			 agency on aging/Seniors and People with Disabilities unit, the Department or
			 its designee will investigate the complaint. Department investigators may
			 interview employees of the certified program and must have access to pertinent
			 documents and records of the program. The Department will notify the program of
			 the results of the investigation and any proposed action or sanction.
(4) Any complainant, witness or employee of a
			 certified program must not be subject to retaliation by a program for making a
			 report, for being interviewed about a complaint, or for being a
			 witness.
(5) The certified program
			 is responsible for violation of these rules by its employees, subcontractors or
			 agents.
Stat. Auth.: ORS
				  410.535
Stats. Implemented: ORS410.505 -
				  410.545
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 71 - PRIVATE ADMISSION ASSESSMENT › Section 411-071-0085 - Procedures for Corrections of Violations

Current through Register Vol. 63, No. 7, July 1, 2024
(1) After investigation, if the Department
			 has determined that a certified program has violated the Act or these rules,
			 the Department or its authorized representative must so notify the program in
			 writing. The Notice of Violation must include:
(a) A description of the matters asserted or
			 charged;
(b) A reference to the
			 particular section of the statute, rule or order involved;
(c) A specific time frame for correction,
			 that must be no later than 60 days after receipt of the notice;
(d) A statement of the sanctions that may be
			 imposed against the program for failure to correct the violations;
			 and
(e) A statement of the right to
			 request a hearing if a sanction is imposed.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 71 - PRIVATE ADMISSION ASSESSMENT › Section 411-071-0090 - Complaint Records

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A record
			 must be maintained by the Department of all complaints and any action taken on
			 the complaint. Any information regarding the investigation of the complaint
			 must not be filed in the public file until the investigation has been
			 completed.
(2) The name, addresses
			 and other identifying information of the complainant, client and any witnesses
			 are confidential and must not be placed in the public record.
(3) Any person has the right to inspect and
			 photocopy the public complaint file maintained by the Department. Disclosure of
			 information of the public complaint file must be governed by relevant statutes
			 concerning public records and confidentiality.
Stat. Auth.: ORS
				  410.535
Stats. Implemented: ORS410.505 -
				  410.545
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 71 - PRIVATE ADMISSION ASSESSMENT › Section 411-071-0095 - Sanctions

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The Department
			 may suspend, revoke or refuse to renew the certification to provide admission
			 assessment if the Department finds that the program has violated any provision
			 of the Act or these rules, including:
(a)
			 Substantial failure to comply with these rules or with the Act;
(b) Refusal by a program or employee to allow
			 access and inspection of records by an authorized representative of the
			 Department;
(c) Fraudulent
			 information or material misrepresentations in the application or renewal for a
			 Certificate for Private Admission Assessment; or
(d) Failure to comply with a final order of
			 the Department imposing an administrative sanction.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 71 - PRIVATE ADMISSION ASSESSMENT › Section 411-071-0105 - Civil Penalties

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Civil
			 penalties, not to exceed $5,000, may be assessed to nursing facilities for
			 violation of the Act or these rules, and must be imposed in the manner provided
			 in ORS 441.705 to
			 441.745.
(2) Any civil penalty imposed must become due
			 and payable when the nursing facility incurring the penalty receives a notice
			 in writing from the Department. The notice must be sent by registered or
			 certified mail and shall include:
(a) A
			 reference to the particular sections of the Act involved;
(b) A short and plain statement of the
			 matters asserted or charged;
(c) A
			 statement of the amount of the penalty or penalties imposed; and
(d) A statement of the right to request a
			 hearing.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 71 - PRIVATE ADMISSION ASSESSMENT › Section 411-071-0110 - Responsibility of Certified Programs

Current through Register Vol. 63, No. 7, July 1, 2024
A certified program performing an admission assessment
				must:
(1) Transmit a copy of the
			 assessment form to the nursing facility upon admission of the
			 individual;
(2) Send a copy of the
			 completed assessment form to the Department;
(3) Provide a copy of the assessment form to
			 the individual who receives the assessment or exemption; and
(4) Refer to either Seniors and People with
			 Disabilities of the Department of Human Services, or Mental Health and
			 Addiction Services of Health Services, for an individual subject to the Level
			 II pre-admission screening evaluation required by the federal pre-admission
			 screening requirements.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.530 &
				  410.535
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 71 - PRIVATE ADMISSION ASSESSMENT › Section 411-071-0115 - Responsibility of Adult Foster Homes, Residential Care Facilities and Non-Medicaid Nursing Facilities

Current through Register Vol. 63, No. 7, July 1, 2024
(1) On or
			 after February 1, 1991, except as provided in section (2) of this rule, prior
			 to admission to an adult foster home, a residential care facility, or a
			 non-Medicaid certified nursing facility, the facility must advise the
			 individual seeking admission of the availability of admission assessment
			 services at their own expense.
(2)
			 An individual who is entering a non-Medicaid certified nursing facility that is
			 part of a closed system continuing care retirement community shall be exempt
			 from this requirement.
(3) The
			 facility must certify on a form provided by the Department that the individual
			 has been so advised. The facility shall maintain a copy of the form in the
			 individual's client record and make a copy available to the Area Agency on
			 Aging/Seniors and People with Disabilities unit upon request.
(4) Adult foster homes, residential care
			 facilities and non-Medicaid nursing facilities who fail to comply with these
			 rules will be subject to sanctions against their license as specified in: ORS
			 443.705 to 443.820 and OAR
			 chapter 411, division 50, for adult foster homes; ORS
			 443.400 to
			 443.455 and chapter OAR 411,
			 division 54, for residential care facilities; and ORS Chapter 441 and OAR
			 chapter 411, divisions 85 through 89, for non-Medicaid nursing
			 facilities.
Stat. Auth.: ORS
				  410.505 - ORS
				  410.545
Stats. Implemented: ORS410.515 & ORS
				  410.540
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0000 - Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
The purpose of these rules is to define the process through
				which the Seniors and People with Disabilities Division may impose remedies
				against Medicaid-only certified nursing facilities when such facilities fail to
				comply with the federal statute or Code of Federal Regulations (CFR). These
				rules are issued pursuant to
42 CFR 488.400
et. seq. and apply to all surveys performed on or after September 1,
				1995. The remedies are designed to correct nonconforming conditions and to
				ensure prompt facility compliance with the CFR and consistency in facility
				performance. The federal Health Care Financing Administration (HCFA) is
				responsible for implementing similar remedies for Medicare and
				Medicare/Medicaid (dually-certified) facilities.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0020 - Statement of Deficiencies/Plan of Correction

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Statement of Deficiencies. When the
			 Division identifies a facility's failure to comply with federal regulations,
			 the Division shall document such failure(s) on a federal Statement of
			 Deficiencies form HCFA 2567. The Statement of Deficiencies shall be accompanied
			 by a notification of the informal dispute resolution process.
(2) Plan of Correction.
(a) When Required. Except as otherwise
			 provided by this rule, the facility receiving a Statement of Deficiencies shall
			 develop, submit to the Division, and begin implementing a Plan of Correction
			 (POC) within 10 days of receiving the Statement of Deficiencies. A Plan of
			 Correction is required regardless of whether remedies are imposed. A Plan of
			 Correction is not an enforcement remedy.
(b) Form. The Plan shall be documented on the
			 federal Statement of Deficiencies form HCFA 2567.
(c) Isolated Deficiencies. A Plan of
			 Correction is not required if the Division declares on the Statement of
			 Deficiencies that "the deficiencies are isolated, no harm has resulted, and
			 there is no potential for anything more than minimal harm."
(d) Approval. All Plans of Correction
			 submitted by a facility are subject to approval by the Division. A facility
			 shall not delay implementation of its Plan of Correction because it has not yet
			 received approval from the Division. If approval is denied, the facility shall
			 have five days to submit an acceptable revised Plan of Correction.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0030 - Remedies Generally

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Remedied Available. In addition to the remedies which may be provided pursuant
			 to OAR Chapter 411, Division 89, one or more of the remedies listed in these
			 rules (OAR Chapter 411, Division 73) may be imposed by the Division when a
			 facility fails to comply with federal statute or regulations. The remedy(s)
			 issued by the Division may be based upon findings of noncompliance with one or
			 more requirements of participation.
(2) Factors To Be Considered. In order to
			 determine the seriousness of the deficiency, and the appropriate remedy to
			 pursue, if any, the Division:
(a) Shall
			 consider whether a facility's noncompliance resulted in harm, whether there was
			 a potential for harm, the degree of actual and/or potential harm, and/or
			 whether there was immediate jeopardy;
(b) Shall consider whether the deficiencies
			 are isolated, constitute a pattern, or are widespread; and
(c) May consider the relationship of the
			 deficiency to other deficiencies and the facility's history of
			 noncompliance.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0040 - Categories of Remedies

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Category 1 Remedies. Category 1 remedies include one or more of the following:
(a) Directed Plan of Correction (including
			 directed inservice training);
(b)
			 Directed inservice training; or
(c)
			 Division monitoring (state monitoring).
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0050 - Directed Plan of Correction

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 When Imposed. The Division may require a Directed Plan of Correction:
(a) When isolated deficiencies or a pattern
			 of deficiencies result in actual harm or a potential for more than minimal
			 harm, including immediate jeopardy; or
(b) In any other situation under which a
			 category 1 remedy is required or optional in Exhibit 1.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0060 - Directed Inservice Training

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 When Imposed. The Division may require Directed Inservice Training:
(a) When isolated deficiencies or a pattern
			 of deficiencies result in actual harm or a potential for more than minimal
			 harm, including immediate jeopardy; or
(b) In any other situation under which a
			 category 1 remedy is required or optional in Exhibit 1.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0070 - Monitoring by the State

Current through Register Vol. 63, No. 7, July 1, 2024
(1) When
			 Imposed. The Division may initiate state monitoring under these rules:
(a) When a facility is not in substantial
			 compliance with one or more requirements of participation and is in the process
			 of correcting deficiencies;
(b)
			 When a facility has corrected deficiencies and verification of continued
			 substantial compliance is needed;
(c) When the Division has reason to question
			 the substantial compliance of the facility with one or more requirements of
			 participation;
(d) When a facility
			 has been cited with substandard quality of care deficiencies on the last three
			 consecutive standard surveys; or
(e) In any other situation under which a
			 category 1 remedy is required or optional in Exhibit 73-1.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0080 - Denial of Payment for New Admissions

Current through Register Vol. 63, No. 7, July 1, 2024
(1) When Imposed. The Division may deny
			 payment for new Medicaid admissions:
(a) When
			 there are widespread deficiencies constituting no actual harm, but with a
			 potential for more than minimal harm;
(b) When there is at least one deficiency
			 constituting actual harm to a resident;
(c) When the Division finds that the facility
			 is not in substantial compliance three months after the last day of a survey in
			 which the facility was found to not be in substantial compliance;
(d) When the Division finds substandard
			 quality of care on the last three consecutive standard surveys;
(e) When there is immediate jeopardy;
			 or
(f) In any other situation under
			 which a category 2 remedy is required or optional in Exhibit 1.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0090 - Civil Money Penalties

Current through Register Vol. 63, No. 7, July 1, 2024
(1) When
			 Imposed. The Division may impose a civil money penalty for each day a facility
			 is or was not in substantial compliance with one or more requirements of
			 participation. The penalty may be imposed in any situation under which a
			 category 2 or 3 remedy is required or optional in Exhibit 1.
(2) Required Action.
(a) Amount.
(A) Except as otherwise provided by this
			 rule, if deficiencies do not constitute immediate jeopardy but cause actual
			 harm or have potential of causing more than minimal harm, the penalty shall be
			 an amount not less than $50 nor more than $3,000 per day of violation (amounts
			 set in $50 increments).
(B) If
			 deficiencies constitute immediate jeopardy, the penalty shall be an amount not
			 less than $3,050 nor more than $10,000 per day of violation (amounts set in $50
			 increments).
(C) Except as
			 otherwise provided by this rule, if deficiencies constituting immediate
			 jeopardy are resolved and immediate jeopardy is removed but noncompliance
			 continues, the daily penalty shall be reduced to an amount not less than $50
			 nor more than $3,000, as determined by the Division.
(D) If deficiencies not constituting
			 immediate jeopardy become more serious and immediate jeopardy exists, the daily
			 penalty shall be increased to an amount not less than $3,050 nor more than
			 $10,000, as determined by the Division.
(E) If the Division determines a facility is
			 not complying with a requirement of participation and a civil money penalty was
			 imposed during or subsequent to the previous standard survey for deficiencies
			 within the same requirement of participation, the Division shall issue another
			 civil money penalty for a higher amount. Penalties for such repeat deficiencies
			 may exceed the range established by paragraphs (2)(a)(A) and (C) of this
			 rule.
(F) The Division shall
			 discontinue accrual of the civil money penalty on the day the Provider
			 Agreement is terminated or on the day the Division determines substantial
			 compliance was achieved, whichever is sooner.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0100 - Temporary Management

Current through Register Vol. 63, No. 7, July 1, 2024
(1) When
			 Imposed. The Division may appoint a temporary manager to oversee facility
			 operation:
(a) When there is one or more
			 deficiencies constituting an immediate jeopardy or when there are widespread
			 deficiencies constituting actual harm; or
(b) In any other situation under which a
			 category 3 remedy is required or optional in Exhibit 1.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0110 - Termination of Provider Agreement/Resident Transfer

Current through Register Vol. 63, No. 7, July 1, 2024
(1) When Imposed. The Division may terminate
			 the Provider Agreement and/or transfer residents:
(a) When there is immediate jeopardy, when
			 the facility closes, or during an emergency;
(b) When the facility is not in substantial
			 compliance with requirements of participation, regardless of whether or not
			 immediate jeopardy is present;
(c)
			 When the facility fails to submit an acceptable Plan of Correction within the
			 time frame specified by the Division;
(d) When the facility fails to relinquish
			 control to a temporary manager appointed by the Division;
(e) When the facility fails to provide a
			 timely and adequate allegation of compliance required by federal rules
			 governing the survey process; or
(f) In any other situation under which a
			 category 1, 2 or 3 remedy is allowed in Exhibit 1.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0120 - Notice of Remedy, Excluding Civil Money Penalties

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Notice Time Frame. This rule sets forth
			 the notice requirements for remedies other than civil money penalties. The
			 notice requirements for civil money penalties are set forth in OAR
			 411-073-0140.
(a) No Notice Required. Prior notice is not
			 required when state monitoring is imposed pursuant to OAR
			 411-073-0070.
(b) Two Day Notice/Immediate Jeopardy.
(A) Provider Agreement. If there is immediate
			 jeopardy, the facility and the public shall receive at least 2 calendar days
			 prior written notice of Termination of Provider Agreement. This remedy shall be
			 effective within 23 days of the survey exit date unless the immediate jeopardy
			 is removed.
(B) Other Remedies. The
			 Division may issue any other remedy(s) provided for under these rules with two
			 calendar days prior written notice if there is immediate jeopardy. The
			 remedy(s) shall be effective no later than 20 days after the mailing of the
			 notice, unless otherwise provided by OAR
			 411-073-0130.
(c) Fifteen Day Notice. If
			 remedies are proposed but there is no immediate jeopardy, at least 15 calendar
			 days prior written notice shall be provided.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0130 - Notice of Civil Money Penalty/Hearing/Order for Payment

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Contents of Notice. The notice of intent
			 to impose a civil money penalty under these rules shall include:
(a) Nature of the noncompliance;
(b) Statutory basis for the
			 penalty;
(c) Amount of penalty per
			 day of noncompliance;
(d) Any
			 factors specified in OAR
			 411-073-0090(3)(b)
			 that were considered when the amount of the penalty was determined;
(e) Date upon which the penalty begins to
			 accrue;
(f) Date the penalty
			 stopped accruing or circumstances under which the penalty will stop accruing;
			 and
(g) Instructions for responding
			 to the notice, a statement of the facility's right to a hearing, and the
			 implication of waiving the hearing.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0140 - Dispute Resolution

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Informal Dispute Resolution. Upon receipt of a Statement of Deficiencies, the
			 facility shall be provided an opportunity to dispute the Division's survey
			 findings.
(a) If a facility wishes an
			 informal conference to dispute the Division's survey findings, the facility
			 shall advise the Division in writing within ten calendar days after receipt of
			 the Statement of Deficiencies.
(b)
			 The facility may not seek a delay of any enforcement action against it on the
			 grounds the informal dispute resolution has not been completed.
(c) If a facility is successful in
			 demonstrating the deficiencies should not have been cited, the Division shall
			 reissue the Statement of Deficiencies, removing such deficiencies and
			 rescinding or modifying any remedies issued for such deficiencies. The reissued
			 Statement of Deficiencies shall state that it supersedes the previous Statement
			 of Deficiencies, and shall clearly identify the date of the superseded
			 Statement of Deficiencies.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 73 - NURSING FACILITIES/MEDICAID - REMEDIES › Section 411-073-0150 - Change of Ownership

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A
			 facility may not avoid a remedy on the basis it underwent a change of
			 ownership.
(2) If a facility has
			 undergone a change of ownership the Division will not restart the count of
			 repeated substandard quality of care surveys unless the new owner can
			 demonstrate to the satisfaction of the Division that the poor past performance
			 is no longer a factor.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 74 - ESSENTIAL WORKFORCE HEALTH CARE PROGRAM › Section 411-074-0000 - Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
These rules establish the requirements for participation in the
				Essential Workforce Health Care Program (EWHP). The EWHP is established for
				participating employers to provide health care benefits to the employees of
				their facilities. Oregon Health Authority (OHA) will provide supplemental
				payments to support the funding of these benefits.
Statutory/Other Authority: ORS
				  410.070 &
				  413.042
Statutes/Other Implemented: ORS
				  410.070,
				  414.033 & OL 2021 ch.
				  595
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 74 - ESSENTIAL WORKFORCE HEALTH CARE PROGRAM › Section 411-074-0005 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
(1) "Employee
			 Retirement Income Security Act of 1974 (ERISA)" means the federal law that sets
			 minimum standards for most voluntarily established retirement and health plans
			 in private industry to provide protection for individuals in these
			 plans.
(2) "Essential Workforce
			 Health Care Fund (EWHF)" means a jointly administered employee welfare benefit
			 plan governed by ERISA and applicable law that has been established for the
			 purpose of providing health and related benefits to employees of participating
			 employers and their beneficiaries and under the conditions as specified in the
			 EWHF Plan.
(3) "Facility" means a
			 facility that is:
(a) A long-term care
			 facility licensed under ORS
			 441.020;
(b) A residential facility as defined in ORS
			 443.400; and
(c) An in-home care agency licensed under ORS
			 443.315.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 74 - ESSENTIAL WORKFORCE HEALTH CARE PROGRAM › Section 411-074-0010 - Eligibility

Current through Register Vol. 63, No. 7, July 1, 2024
To participate in the program, an eligible employer
				shall:
(1) Sign a memorandum of
			 understanding with the OHA that specifies how the supplemental payments will be
			 used;
(2) Agree to participate in
			 evidence-based workforce and quality of care improvements; and
(3) Annually report quality and other
			 metrics.
Statutory/Other Authority: ORS
				  410.070 &
				  413.042
Statutes/Other Implemented: ORS
				  410.070,
				  414.033 & OL 2021 ch.
				  595
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 74 - ESSENTIAL WORKFORCE HEALTH CARE PROGRAM › Section 411-074-0020 - Memorandum of Understanding

Current through Register Vol. 63, No. 7, July 1, 2024
All participating employers that receive a supplemental payment
				must sign a Memorandum of Understanding with OHA. The Memorandum of
				Understanding will document the requirements and responsibilities for using the
				supplemental payments to provide health care benefits to their
				employees.
Statutory/Other Authority: ORS
				  410.070 &
				  413.042
Statutes/Other Implemented: ORS
				  410.070,
				  414.033 & OL 2021 ch.
				  595
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 74 - ESSENTIAL WORKFORCE HEALTH CARE PROGRAM › Section 411-074-0025 - Use of Supplemental Payments

Current through Register Vol. 63, No. 7, July 1, 2024
Participating employers who receive supplemental payments under
				this program will use the payments to participate in the Essential Workforce
				Health Care Program.
(1) Payments
			 under this program will be used to provide health care benefits to employees of
			 the participating facilities through the Essential Workforce Health Care Fund
			 (EWHF).
(2) Participating employers
			 use of the supplemental payments are subject to the requirements established by
			 the Essential Workforce Health Care Fund (EWHF).
Statutory/Other Authority: ORS
				  410.070 &
				  413.042
Statutes/Other Implemented: ORS
				  410.070,
				  414.033 & OL 2021 ch.
				  595
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 74 - ESSENTIAL WORKFORCE HEALTH CARE PROGRAM › Section 411-074-0030 - Evidence-based Workforce and Quality of Care Improvements

Current through Register Vol. 63, No. 7, July 1, 2024
Participating employers agree to participate in evidence-based
				workforce and quality of care improvements, including all of the
				following:
(1) Workforce input into
			 benefit design;
(2) Quantitative
			 and qualitative reporting on impact of health care benefit on
			 workforce;
(3) Retention strategies
			 for workforce; and
(4) Others as
			 mutually agreed upon by OHA and participating employers.
Statutory/Other Authority: ORS
				  410.070 &
				  413.042
Statutes/Other Implemented: ORS
				  410.070,
				  414.033 & OL 2021 ch.
				  595
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 74 - ESSENTIAL WORKFORCE HEALTH CARE PROGRAM › Section 411-074-0040 - Annual Reporting of Quality Metrics

Current through Register Vol. 63, No. 7, July 1, 2024
(1) EWHF will
			 annually provide reports on all of the following metrics related to quality
			 health benefits:
(a) Health benefits design,
			 including total premium, employer/employee premium split, deductible,
			 out-of-pocket maximum, co-pays, co-insurance;
(b) Services covered by benefit;
(c) Number of employees and their dependents
			 enrolled in the health benefit;
(d)
			 Network adequacy;
(e) Waiting times
			 for select services;
(f) Other
			 measures of employee health and wellness as mutually agreed upon between OHA
			 and participating employers;
(g)
			 Narrative description of significant changes from the past year or anticipated
			 future changes;
(h) Workforce
			 retention metrics; and
(i) Equity
			 metrics.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 74 - ESSENTIAL WORKFORCE HEALTH CARE PROGRAM › Section 411-074-0050 - Supplemental Payments Methodology

Current through Register Vol. 63, No. 7, July 1, 2024
Supplemental payments are determined using the following
				methods:
(1) The aggregate available
			 supplemental payment amount for privately-owned Nursing Facilities (NFs) is
			 calculated for each aggregate Medicaid supplemental payment limit calculation
			 period by taking the difference between the aggregate upper payment limit (UPL)
			 from paragraph (a) of this subsection and the aggregate Medicaid payment from
			 paragraph (b) of this subsection.
(a) The
			 aggregate upper payment limit for privately-owned NFs, as presented in the most
			 recently completed Medicaid NF UPL calculation submitted to CMS, will be
			 calculated in accordance with the Medicaid UPL provisions codified at Title
			 42 CFR
			 §
										447.272 as follows:
(A) Determine aggregate costs under Medicare
			 cost principles using the most recently filed or settled CMS 2540 skilled
			 nursing facility cost reports for privately-owned NFs.
(B) Determine the per diem cost by dividing
			 the aggregate costs from subparagraph (A) of this paragraph by total days of
			 service associated with the same cost reports.
(C) Extract Medicaid days of service for
			 privately-owned NFs from the state's Medicaid Management Information System
			 (MMIS) for the cost reporting periods associated with the cost reports
			 described in clause (A) of this subparagraph.
(D) Determine aggregate Medicaid costs by
			 multiplying the per diem Medicaid cost from subparagraph (B) of this paragraph
			 by Medicaid days of service from subparagraph (C) of this paragraph.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 74 - ESSENTIAL WORKFORCE HEALTH CARE PROGRAM › Section 411-074-0060 - Oversight

Current through Register Vol. 63, No. 7, July 1, 2024
All payments authorized for this Program are subject to audit
				at the discretion of the OHA.
Statutory/Other Authority: ORS
				  410.070 &
				  413.042
Statutes/Other Implemented: ORS
				  410.070,
				  414.033 & OL 2021 ch.
				  595
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 85 - NURSING FACILITIES/LICENSING - GENERALLY › Section 411-085-0000 - Statement of Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
The purpose of these rules (OAR 411, divisions 85-89) is to
				establish requirements for nursing facilities that promote quality care and
				maximization of personal choice and independence for residents. Whenever
				possible, care shall be directed toward returning the resident to his/her own
				residence or to the least restrictive alternative environment within the
				shortest time possible.
Stat. Auth.: ORS
				  410.070 &
				  441.055
Stats. Implemented: ORS
				  441.055 &
				  441.615
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 85 - NURSING FACILITIES/LICENSING - GENERALLY › Section 411-085-0005 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
Unless the context requires otherwise, the following
				definitions apply to the rules in OAR chapter 411, divisions 70, 85, 86, and
				89:
(1) "AAA" means "Area Agency on
			 Aging" as defined in this rule.
(2)
			 "Abuse" means:
(a) Any physical injury to a
			 resident that has been caused by other than accidental means. This includes
			 injuries a reasonable and prudent individual is able to prevent, such as
			 hitting, pinching or striking, or injury resulting from rough
			 handling.
(b) Failure to provide
			 basic care or services to a resident that results in physical harm,
			 unreasonable discomfort, or serious loss of human dignity.
(c) Sexual contact with a resident, including
			 fondling, caused by an employee, agent, or other resident of a long-term care
			 facility by force, threat, duress or coercion, or sexual contact where the
			 resident has no ability to consent.
(d) Illegal or improper use of a resident's
			 resources for the personal profit or gain of another individual, borrowing
			 resident funds, spending resident funds without the resident's consent, or if
			 the resident is not capable of consenting, spending resident funds for items or
			 services from which the resident is unable to benefit or appreciate, or
			 spending resident funds to acquire items for use in common areas when such
			 purchase is not initiated by the resident.
(e) Verbal abuse as prohibited by federal
			 law, including the use of oral, written, or gestured communication to a
			 resident or visitor that describes a resident in disparaging or derogatory
			 terms.
(f) Mental abuse as
			 prohibited by law including humiliation, harassment, threats of punishment, or
			 deprivation, directed toward the resident.
(g) Corporal punishment.
(h) Involuntary seclusion for convenience or
			 discipline.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 85 - NURSING FACILITIES/LICENSING - GENERALLY › Section 411-085-0013 - New Applicant Qualifications

Current through Register Vol. 63, No. 7, July 1, 2024
For the purpose of this rule, "applicant" means each person, as
				defined in ORS 442.015, who holds 10 percent or
				greater incident of ownership in the facility. Applicants for licensure
				(excluding license renewal, but including all changes of ownership) must meet
				the following criteria:
(1) CRIMINAL
			 HISTORY. Each applicant must complete a Criminal History Clearance conducted by
			 the Department in accordance with OAR chapter 407, division 007. The Department
			 conducts the fitness determination. If determined "unfit," applicants may
			 appeal as described in OAR
			 407-007-0330.
(2) PERFORMANCE HISTORY. Each applicant must:
(a) Be free of incident of ownership history
			 in any facility in Oregon that provides or provided (at the time of ownership)
			 care to children, elderly, ill or disabled persons and was involuntarily
			 terminated from licensure or certification, or voluntarily terminated during
			 any state or federal termination process, during the past five years.
(b) Be free of incident of
			 ownership history in any nursing facility in any state that was involuntarily
			 terminated from licensure or certification, or voluntarily terminated during
			 any state or federal termination process, during the past five years.
(c) Be free of history of
			 termination of licensure as a nursing facility administrator or health care
			 provider during the past five years.
(d) Failure to demonstrate required
			 performance history may result in the Department's denial of a license.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 85 - NURSING FACILITIES/LICENSING - GENERALLY › Section 411-085-0015 - License Expiration, Termination of Operation, License Return

Current through Register Vol. 63, No. 7, July 1, 2024
(1) EXPIRATION.
			 Effective May 16, 2011, unless revoked or terminated earlier, or issued for a
			 shorter specified period, each license to operate a nursing facility expires
			 annually, following the date of issue.
(2) TERMINATION OF OPERATION. Except as
			 otherwise provided in this rule, if facility operation is discontinued for any
			 reason, the license shall expire. The licensee has appeal rights under ORS
			 chapter 183.
(3) INACTIVE LICENSE.
(a) When the licensee proposes to replace an
			 existing (original) licensed nursing facility with a new building, the
			 Department may grant the licensee an inactive license for up to 24 months after
			 closure of the original facility (departure of the last resident) under the
			 following conditions:
(A) The existing
			 facility may not meet the physical environment requirements for new
			 construction in OAR chapter 411, division 087;
(B) The licensee must comply with the Oregon
			 Health Authority's certificate of need process, including the physical
			 environment requirements for new construction;
(C) The licensee must submit to the
			 Department a written request for an extension to continue the license, an
			 application for license renewal, and the license fee before the annual renewal
			 date;
(D) The licensee must comply
			 with plan review as described in OAR
			 411-087-0010 and all other
			 applicable requirements; and
(E)
			 The licensee's written request must include information that assures the
			 Department that the new facility shall provide an improved quality of care that
			 is needed in the community and is determined by the Department to be in the
			 public's interest.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 85 - NURSING FACILITIES/LICENSING - GENERALLY › Section 411-085-0020 - License Fees, Special Assessment

Current through Register Vol. 63, No. 7, July 1, 2024
(1) LICENSE APPLICATION FEES.
(a) License application fees may not be
			 prorated for a partial year. The amount of the application fee or annual
			 license renewal fee is paid according to number of beds, as established in Or
			 Laws 2017, ch 679, §11:
(A) For 1 to 15
			 beds: application fee shall be $2,000 and the annual renewal fee shall be
			 $1,000.
(B) For 16 to 49 beds:
			 application fee shall be $3,000 and the annual renewal fee shall be
			 $1,500.
(C) For 50 to 99 beds:
			 application fee shall be $4,000 and the annual renewal fee shall be
			 $2,000.
(D) For 100 to 150 beds:
			 application fee shall be $5,000 and the annual renewal fee shall be
			 $2,500.
(E) For more than 150 beds:
			 application fee shall be $6,000 and the annual renewal fee shall be
			 $3,000.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 85 - NURSING FACILITIES/LICENSING - GENERALLY › Section 411-085-0025 - Change of Ownership or Operator and Closure

Current through Register Vol. 63, No. 7, July 1, 2024
(1) CHANGE OF OWNERSHIP OR OPERATOR.
(a) When a change of ownership or a change of
			 operator is contemplated, a licensee and a prospective licensee must each
			 notify the Department in writing of the contemplated change. The notice of
			 change of ownership or operator must be received by the Department at least 45
			 days prior to the proposed date of transfer. A shorter timeframe may be allowed
			 at the sole discretion of the Department. The notice of change of ownership or
			 operator must be in writing and must include the following:
(A) Name and signature of the current
			 licensee;
(B) The name of the
			 prospective licensee;
(C) The
			 proposed date of the transfer;
(D)
			 Type of transfer (e.g., sale, lease, rental, etc.); and
(E) A complete, signed nursing facility
			 application from the prospective licensee.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 85 - NURSING FACILITIES/LICENSING - GENERALLY › Section 411-085-0030 - Required Postings

Current through Register Vol. 63, No. 7, July 1, 2024
(1) PUBLIC NOTICES:
(a) Content. Public notices required to be
			 posted include:
(A) The most recent licensing
			 and, if applicable, certification survey reports;
(B) The placard provided by the Department
			 that includes information on reporting of abuse and summarizes the nursing
			 facility rules. In addition to the location specified in subsection (1)(b) of
			 this rule, this placard must also be prominently and conspicuously posted in
			 close proximity to each nursing station and in any area where residents are
			 admitted;
(C) The current week's
			 menu and activities schedule;
(D)
			 The facility license and the administrator's license. (It is recommended the
			 titles and names of the administrator, the DNS, the Social Services Director,
			 the Activities Director, the Dietary Services Supervisor and the RN Care
			 Manager(s) are also posted);
(E)
			 Waivers received from the Department pursuant to OAR
			 411-085-0040 and
			 411-087-0030, and waivers of any
			 federal regulations;
(F) The
			 LGBTQIA2S+ Protections, as described in OAR
			 411-085-0310(21);
(G) The facility's non-discrimination policy
			 notice, as described in OAR
			 411-085-0210(1)(w);
			 and
(H) Any other notice relevant
			 to residents or visitors required by state or federal law.