Or. Admin. Code § 411-071-0005

Current through Register Vol. 63, No. 12, December 1, 2024

Section 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 includes eating, dressing/grooming, bathing/personal hygiene, mobility, bowel and bladder management, and cognition..

(3) "Admission Assessment" means a professional program that provides an assessment of the long-term care needs of an individual applying for or considering admission to a nursing facility who is not or does not appear to be Medicaid eligible. The admission assessment includes mandatory services necessary to comply with the federal pre-admission screening requirements and optional information regarding appropriate care settings and services, including nursing facilities and community-based options.

(4) "Adult Foster Home" means any family home or other facility in which care is provided for compensation to five or fewer elderly or disabled adults who are not related to the provider by blood or marriage.

(5) "Applicant" means a hospital or private agency applying for certification to conduct admission assessments according to the provisions of the Act.

(6) "Application for Certification" means the application form designated and distributed by the Department to applicants.

(7) "Area Agency on Aging (AAA)" means the agency designated by the Department and charged with the responsibility of providing a comprehensive and coordinated system of services to the elderly and people with disabilities in a planning and service area.

(8) "Assessment Fee" means the amount of money charged by a certified program to the Department or to an individual for admission assessment services.

(9) "Assisted Living Facility" means a program approach, within a physical structure that provides or coordinates a range of services, available on a 24-hour basis, for support of an individual's independence in a residential setting. Assisted living promotes resident self-direction and participation in decisions and emphasizes choice, dignity, privacy, individuality, independence and home-like surroundings.

(10) "Certification" means the process of being certified by the Department to conduct admission assessments for non-Medicaid individuals. Hospitals and private agencies wishing to conduct admission assessments must be certified by the Department.

(11) "Certification Fee" means a fee charged to an applicant program to become certified under ORS 410.505 et seq.

(12) "Certified Program" means a hospital, private agency, an Area Agency on Aging, or an individual certified by the Department to conduct admission assessments in accordance with ORS 410.530.

(13) "Continuing Care Retirement Community" means a facility as defined in ORS 101.020.

(14) "Civil Penalty" means a penalty imposed on a nursing facility by the Department in the manner provided in ORS 441.705 to 745.

(15) "Community-Based Care" means services provided in local communities including, but not limited to, adult foster care, assisted living, residential care, and in-home services.

(16) "Decertify" means to revoke the certification to conduct admission assessments.

(17) "Department" means the Department of Human Services/Seniors and People with Disabilities.

(18) "Exception" means a variance from the provisions of these rules granted by the Department to a certified program.

(19) "Exemption" means an individual who does not have a diagnosis of mental illness or mental retardation and is not subject to the requirement for an admission assessment prior to admission to a nursing facility in accordance with ORS 410.520(2).

(20) "Facility" means, unless otherwise indicated, a nursing facility as defined under these Rules.

(21) "Financial Interest" means ownership in any nursing facility or other facility licensed by the Department, or receiving placement fee from a facility. This includes ownership as an individual or as a fiduciary, a relationship in a capacity as a director, or an advisor or any other participant holding legal or equitable interest.

(22) "Hospital" means an acute care facility, as defined in ORS 442.015(13)(a), licensed by the Health Services under 441.020 - 441.097.

(23) "Individual" means the person applying for or considering admission to a nursing facility and who is not or does not appear to be Medicaid eligible.

(24) "Legally Designated Representative" means a legal guardian or a person holding the power of attorney for health care as defined in ORS 127.305(10).

(25) "Level II Evaluation" means a comprehensive assessment implemented by the Department of individuals with mental illness or mental retardation/developmental disabilities to evaluate and determine whether nursing facility services and Specialized Services are needed.

(26) "Long-Term Care" means community-based services and nursing facility care funded by public and/or private money.

(27) "New Admission" for pre-admission screening means an individual admitted to any nursing facility for the first time. With the exception of certain hospital discharges in accordance with OAR 411-071-0015, new admissions are subject to Pre-Admission Screening.

(28) "Nursing Facility" means a facility licensed to provide nursing care. Unless indicated otherwise, "nursing facility" means a Medicaid certified nursing facility.

(29) "Placement" means a nursing facility or community-based care setting where an individual will reside and receive services.

(30) "Program" means a certified program as defined under these rules.

(31) "Recommend Placement" means to communicate to an individual information about a specific facility and/or service(s) that have been determined to be most appropriate to the individual's needs and preferences.

(32) "Referral" means the process by which an individual may receive assessment services from a different assessment source.

(33) "Resident" means any individual who is residing in a hospital or nursing facility.

(34) "Residential Care Facility" means a facility that provides care for six or more persons over the age of 18 on a 24-hour basis in one or more buildings on contiguous property.

Or. Admin. Code § 411-071-0005

SSD 3-1991, f. & cert. ef. 2-1-91; SSD 1-1994, f. 3-11-94, cert. ef. 3-15-94; SDSD 1-1998, f. 1-30-98, cert. ef. 2-1-98; SPD 30-2004, f. 8-27-04, cert. ef. 9-1-04

Stat. Auth.: ORS 410.070

Stats. Implemented: ORS 410.505