Or. Admin. Code § 411-073-0110

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

Section 411-073-0110 - Termination of Provider Agreement/Resident Transfer

(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.

(2) Required Action.

(a) Transfer. The Division may transfer Medicaid and Medicare residents when required to protect resident health and safety. The Division shall attempt to minimize stress related to such a transfer by involving the resident and, if appropriate, the resident's family and friends to the greatest extent feasible.

(b) Provider Agreement.

(A) The Division shall terminate the Provider Agreement if it determines no feasible alternative to termination exists.

(B) When a Provider Agreement is terminated the Division shall provide for the safe and orderly transfer of residents.

(C) The Division shall terminate the Provider Agreement within 23 days of the survey exit date unless immediate jeopardy is removed, regardless of any other remedies imposed.

(D) If there is no immediate jeopardy, the Division may allow the facility to continue to participate for up to 6 months from the survey exit date if:

(i) The Division concludes it is more appropriate to impose alternative remedies than to terminate the Provider Agreement;

(ii) The facility's Plan of Correction is approved by HCFA; and

(iii) The facility agrees to repay the Division (or the federal government, as appropriate) all payments made to the facility following the survey which identified the deficiencies. Such repayment shall be requested by the Division if the Division determines that the facility failed to implement their Plan of Correction.

(E) The Division may deny payment for new Medicaid admissions if the facility is not in substantial compliance three months after the last day of the survey.

Or. Admin. Code § 411-073-0110

SSD 11-1995, f. 9-29-95, cert. f. 10-1-95

Stat. Auth.: ORS 410.070

Stats. Implemented: ORS 410.070