PAYMENT. APD may provide payment for a
complex medical add-on (in addition to the basic rate) when the resident
requires one or more of the treatments, procedures, and services listed in OAR
, for the additional licensed nursing services needed to meet the
resident's increased needs.
APD may pay the complex medical add-on only as long as the resident's needs
meet one or more of the treatments, procedures, and services listed in OAR
and the facility maintains the required documentation.
DOCUMENTATION. The licensed nursing staff
of the nursing facility must keep sufficient documentation pertinent to the
qualified complex medical add-on procedure codes in the resident's clinical
record to justify the complex medical add-on payment determination in
accordance with these rules (refer to OAR 411-070-0091
) and must make it
available to APD upon request.
COMPLEX MEDICAL ADD-ONS PROHIBITED. APD may not provide complex medical add-on
payments for a facility with a waiver that allows a reduction of eight or more
hours per week from required licensed nurse staffing hours.
Or. Admin. R.
SSD 20-1990, f. & cert.
ef. 10-4-90; SSD 21-1990(Temp), f. & cert. ef. 10-5-90; SSD 6-1991, f.
& cert. ef. 3-25-91; SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93; SSD 1-1997,
f. 6-30-97, cert. ef. 7-1-97; SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06; SPD
15-2007(Temp), f. & cert. ef. 9-10-07 thru 3-8-08; SPD 2-2008, f. 2-29-08,
cert. ef. 3-1-08; SPD 15-2009, f. 11-30-09, cert. ef. 12-1-09
6-2015, f. 3-4-15, cert. ef.
Stat. Auth.: ORS
Stats. Implemented: ORS