Oregon Administrative Code

411-070-0302 Filing of Revised Financial Statements (1) Revised Nursing Facility Financial Statements may only be filed with prior written authorization from the Department. (2) An amended report must be postmarked within six months of the end of the fiscal reporting period. Stat…

411-070-0305 Accounting and Record Keeping (1) Nursing Facility Financial Statements are to be prepared in conformance with generally accepted accounting principles and the provisions of these rules. The Department has the option to prescribe and interpret these rules in conforma…

411-070-0310 Auditing (1) All Nursing Facility Financial Statements are subject to desk review and analysis within six months after proper completion and filing. (2) The desk review will determine, to the extent possible: (a) That the provider has properly included its costs on t…

411-070-0315 Maximum Allowable Compensation of Administrator and Assistant Administrator (1) The maximum compensation of a full-time (40 hours per week) licensed administrator to a nursing facility may be allowable at the lower of compensation actually received or the maximum all…

411-070-0320 Consultants (1) Costs for direct care and dietitian consultant services to the staff of the facility will be allowed. (2) No other consultant costs will be allowed. (3) Payment for treatment and evaluation provided directly to an individual resident by medical provid…

411-070-0330 Owner Compensation (1) Reasonable compensation for services performed by owners (whether sole proprietors, partners, or stockholders) is an allowable cost, provided the services are actually performed, documented, and are necessary, and the provisions of this rule ar…

411-070-0335 Related Party Transactions (1) Costs applicable to services and supplies furnished to a provider by organizations related to the provider by common ownership or control are allowable at the lower of cost excluding profits and markups to the related party or charge to…

411-070-0340 Chain Operations (1) A chain organization consists of a group of two or more health care facilities that are owned, leased, or through any other device controlled by one business entity. This includes not only proprietary chains but also chains operated by various re…

411-070-0345 Allocation of Home Office and Regional Office Costs (1) The initial step in the allocation of home office and regional office costs is direct allocation of all allowable costs directly attributable to a particular nursing facility (such as construction interest, sala…

411-070-0350 Management Fees Management fees are an allowable expense if they are necessary, reasonable, non-duplicative of facility personnel and functions, and documented by a binding contract with a non-related party defining the items, services, and activities provided. If th…

411-070-0359 Allowable Costs (1) ALLOWABLE COSTS. Allowable costs are the necessary costs incurred for the customary and normal operation of a facility, to the extent that they are reasonable and related to resident services. (a) Accounting, Auditing, and Data Processing -- The c…

411-070-0365 Capital Assets (1) The following costs must be capitalized and depreciated: Expenses for depreciable assets with historical cost in excess of $1,000 per unit, or in aggregate, and a useful life greater than one year from the date of purchase. (2) Repair costs in exce…

411-070-0370 Depreciable Assets (1) Tangible assets of the following types in which a provider has an economic interest through ownership are subject to depreciation: (a) Buildings — The basic structure or shell and additions thereto; (b) Building Fixed Equipment — Attachments to…

411-070-0375 Depreciation Basis (1) Purchase of a Nursing Home: (a) New Facility — The depreciation basis of a new facility must be the historical cost of building the facility, including preparation for use, or the purchase price from an unrelated organization not to exceed the …

411-070-0385 Depreciation Lives (1) The provider must use the "Estimated Useful Lives of Depreciable Hospital Assets" Revised 2004 guidelines for asset lives when computing depreciation. (2) For assets not covered by the guidelines and with costs of more than $1,000 per unit, or …

411-070-0400 Equity Equity is not an allowable expense for reimbursement but must be reported. Equity capital is the net worth of the provider (owner's equity in the net assets as determined under these rules), adjusted for those assets and liabilities that are not related to the…

411-070-0415 Offset Income (1) Income is offset against expenses unless specifically excluded in section (2) of this rule. If an adjustment is for a revenue producing activity representing a non-allowable cost, the revenue must be offset against the appropriate expense if the rev…

411-070-0417 Treatment of Complex Medical Add-Ons (1) The complex medical add-on reflects the additional costs of providing skilled nursing services for certain residents due to their needs. (2) The complex medical add-on is added to the basic rate. (3) When calculating per resid…

411-070-0420 Base Year Cost Finding (1) The provider must report its gross costs and must make reclassifications and adjustments to costs as provided in these rules. This process will determine net allowable costs on the Nursing Facility Financial Statement that includes a unifor…

411-070-0425 Resident Days The provider must keep census records on all residents. Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.070 History: SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06 SSD 1-1997, f. 6-30-97, cert. ef. 7-1-97 SSD 6-1993, f. 6-30-93, cer…

411-070-0430 Allocation Methods (1) The provider must use the allocation methods designated on the NFFS: COST -- ALLOCATION METHOD: (a) Property -- Resident Days or Square Footage. (b) Administrative and General -- Resident Days. (c) Other Operating Support -- Resident Days. (d) …

411-070-0435 Appeals (1) The Department will send letters to a provider that inform the provider of any changes made by the Department from the provider Nursing Facility Financial Statement. A provider is entitled to an informal conference or a contested case hearing pursuant to …

411-070-0436 Employee Retention Payment Reimbursement Program (1) ESTABLISHMENT. The Department establishes the Employee Retention Payment Reimbursement Program (Program). The Program is designed to promote the availability of nursing home level of care to Oregonians through the …

411-070-0437 Quality and Efficiency Incentive Program (1) ESTABLISHMENT. Effective October 7, 2013 through June 30, 2016, the Department establishes the Quality and Efficiency Incentive Program (Program) in order to implement Enrolled House Bill 2216 (Chapter 608, 2013 Oregon Law…

411-070-0438 Enhanced Wage Add-on Program (1) ESTABLISHMENT. The Department establishes the Enhanced Wage Add-on Program (Program). The Program is designed to support nursing facilities with retention of Certified Nursing Assistants (CNAs) by paying a starting wage of $17 per hou…

411-070-0439 COVID-19 Emergency Response Incentive Program (1) ESTABLISHMENT. The Department establishes the COVID Response Incentive Program (Program). The Program is designed to support nursing facilities in adopting employment policies that protect employees during the COVID-1…

411-070-0442 Calculation of the Basic Rate, Complex Medical Rate, Bariatric Rate and Ventilator Assisted Program Rate (1) The rates are determined annually and referred to as the Rebasing Year. (a) The basic rate is based on the statements received by the Department by October 31…

411-070-0452 Pediatric Nursing Facilities (1) PEDIATRIC NURSING FACILITY. (a) A pediatric nursing facility is a licensed nursing facility at least 50 percent of whose residents entered the facility before the age of 14 and all of whose residents are under the age of 21. (b) A nur…

411-070-0464 Final Report (1) FINAL REPORTS. When a provider agreement is terminated for any reason, the provider must submit final reports in accordance with OAR 411-070-0300. Full payment for the month during which the provider agreement is terminated will not be made by the De…

411-070-0465 Uniform Chart of Accounts The following account definitions will be used to classify the dollar amounts on the Nursing Facility Financial Statement (NFFS). The account balance is to be reported in whole dollars under the facility gross column on the NFFS and referenc…

411-070-0470 Nursing Assistant Training and Competency Evaluation Programs Request for Reimbursement (1) The Omnibus Budget Reconciliation Act (OBRA) of 1987 and 1990 requires that any nursing assistant employed in a nursing facility completes a competency evaluation program. Med…

411-071-0000 Purpose (1) The purpose of Private Admission Assessment is to ensure that non-Medicaid eligible individuals applying for or considering admission to a Medicaid certified nursing facility receive information regarding appropriate service and placement alternatives. (2…

411-071-0005 Definitions (1) "Act" means the provisions of ORS 410.505 to 410.545 and ORS 410.890. (2) "Activities of Daily Living (ADL)" means those personal functional activities required by an individual for continued well being and are essential for health and safety. This in…

411-071-0010 Assessment Requirements (1) An admission assessment must be provided prior to admission for all non-Medicaid eligible individuals applying as new admissions to a Medicaid certified nursing facility except as provided in OAR 411-071-0015. The admission assessment must…

411-071-0015 Exemptions (1) The criteria under which an individual is exempted must be clearly indicated on the form designated by the Department. (2) An exemption from the full assessment process may be granted for an individual who meets one of the following criteria: (a) An in…

411-071-0020 Assessment Process (1) The Department must develop and provide to certified programs an assessment instrument to be used for all admission assessments. (2) The admission assessment must consist of: (a) Information necessary to comply with federal pre-admission screen…

411-071-0025 Recommendations for Placement/Prohibition on Conflict of Interest (1) If the individual chooses to have long-term care information provided by a certified program, the certified program must provide information about appropriate care settings and services. (2) A cert…

411-071-0027 Confidentiality of Assessment Information (1) Any records, forms, or information collected during the assessment process that identify an individual by name or address must be confidential and subject to the Department's rules on confidentiality set forth in OAR 411,…

411-071-0030 Assessment Fees A certified program must not charge an individual for any portion of the assessment. Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.515, 410.525 & 410.530 History: SPD 30-2004, f. 8-27-04, cert. ef. 9-1-04 SDSD 1-1998, f. 1…

411-071-0035 Certification Process (1) Any hospital, agency, program, or Area Agency on Aging must obtain certification from the Department before providing admission assessment services. (2) The certification issued to a program is not valid for use by any other program. (3) Cer…

411-071-0040 Application Process (1) Application for certification must be submitted in writing on a form provided by the Department. The application must include but not be limited to: (a) The name, address, phone number and other descriptive information about the applicant; (b)…

411-071-0043 Qualifications for Personnel Performing Admission Assessments (1) Except as provided in section (2) of this rule, all persons performing admission assessments shall meet one of the following criteria: (a) Be a registered nurse licensed by the State of Oregon; (b) Hav…

411-071-0045 Issuance of the Certificate for Private Admission Assessment Within 60 days of receipt of a completed application, the Department must issue a Certificate for Private Admission Assessment to the applicant if the applicant meets all the requirements of ORS 410.505 to …

411-071-0050 Contracts, Reimbursements, and Certification Fees (1) Certified programs eligible for reimbursement must enter into a contract with the Department regarding provision of admission assessment services. Certified hospital programs that only provide inpatient admission …

411-071-0055 Renewal (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 pr…

411-071-0060 Exceptions (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…

411-071-0070 Orientation Requirement (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 c…

411-071-0075 Record Keeping 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 …

411-071-0080 Complaints Against Certified Programs (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) T…

411-071-0085 Procedures for Corrections of Violations (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 Viola…