Or. Admin. R. 411-018-0000

Current through Register Vol. 63, No. 8, August 1, 2024

Section 411-018-0000 - Purpose and Definitions

Purpose: These rules establish standards and procedures for a long-term care facility that will be certified by the Department as an essential community provider long-term care facility.

(1) "Adult Foster Home" defined in ORS 443.705 means any family home or facility in which residential care is provided in a home like environment for five or fewer adults who are not related to the provider by blood or marriage.

(2) "Certification" means a written statement by the Department that the facility is an essential community provider long-term care facility.

(3) "Department" means the Department of Human Services, Seniors and People with Disabilities Division.

(4) "Disqualification" means a written statement by the Department that informs the facility of the reasons for disqualification.

(5) "Essential community provider long-term care facility" means a long-term care facility in which the average residency rate is 50% or more eligible for Medicaid during the calendar year immediately preceding the calendar year in which the Department is making certification; except that in adult foster homes the average residency rate will be 60%.

(6) "Long term care facility" means a nursing facility, assisted living facility, residential care facility or an adult foster home that is licensed by the Department.

(7) "Medicaid" means Title XIX of the Social Security Act.

(8) "Medicaid eligible residency rate" means the days of facility occupancy in the calendar year for which Medicaid is responsible for payment either paid or accrued (or would have been paid by or accrued to Medicaid except that another payment source was available and used) divided by all days of facility occupancy in the calendar year for which payment has been made or a liability for payment accrued.

(9) "Medicare" means Title XVIII of the Social Security Act.

Or. Admin. R. 411-018-0000

SDSD 11-1999, f. 12-30-99 cert. ef. 1-1-00; SDSD 7-2000, f. 12-29-00 cert. ef. 1-1-01; SPD 17-2005, f. & cert. ef. 12-12-05

Stat. Auth.: ORS 410.070

Stats. Implemented: ORS 307.808 - 307.815, 443.888 & 410.070