The provider must file annually with the Department, Financial Audit Unit, the
Nursing Facility Financial Statement (NFFS) covering actual costs based on the
facility's fiscal reporting period for the period ending June 30. A NFFS must
be filed for other than a year only when necessitated by termination of a
provider agreement with the Department, or by a change in ownership, or when
directed by the Department. Financial reports containing up to 15 months of
financial data are accepted for the reasons above or with the Department's
permission prior to filing.
NFFS is due on or before October 31 or within three months of a change of
ownership or withdrawal from the program.
A NFFS must be postmarked on or before the due date to be considered timely. An
extension may not be obtained.
A penalty is assessed and collected when a NFFS is not postmarked within the
due date. The amount of the penalty is $5 per licensed nursing facility bed per
day for each State of Oregon business day the NFFS is late. The total penalty
may not exceed $50,000 per fiscal reporting period. For purposes of this
section, the number of licensed nursing facility beds is the number of beds
licensed on the last day of the fiscal reporting period that the facility
failed to submit a NFFS.
Department may assess interim penalties and deduct the amount of the interim
penalties from the next Medicaid payment payable to the facility. Each interim
penalty is the amount of the penalty that has accrued under subsection (2)(b)
of this section to the date of assessment, and has not already been assessed as
an interim penalty.
may request an informal conference or contested case hearing pursuant to ORS
within 30 days of
receiving a letter from the Department informing the facility of assessment of
an interim penalty or a penalty under this rule. OAR 411-070-0435
such requests and sets forth the procedures to be followed. If no request for
an informal conference or contested case hearing is made within 30 days of
receiving such a letter, the interim penalty or penalty becomes final in all
respects, including liability for payment of and the amount of the interim
penalty or penalty.
An improperly completed or incomplete NFFS is returned to the facility for
(a) Form SPD 35 is a uniform cost report to
be used by all nursing facility providers, except those that are hospital
(b) Form SPD 35A is a
uniform cost report to be used by all nursing facility providers that are
(c) Forms SPD 35
and SPD 35A must be completed in accordance with the Medicaid Nursing Facility
Services Provider Guide and Audit Manual.
(5) If a provider knowingly or with reason to
know files a NFFS containing false information, such action constitutes cause
for termination of its agreement with the Department. Providers filing false
reports may be referred for prosecution under applicable statutes.
(6) Each required NFFS must be signed by a
company or corporate officer or a person designated by the corporate officers
to sign. If a NFFS is prepared by someone other than an employee of the
provider, the individual preparing the NFFS must also sign and indicate his or
her status with the provider.
Facilities with fewer than 1000 Medicaid resident days during a twelve-month
reporting period or fewer than 2.74 Medicaid resident days per calendar day,
for facilities with reporting periods of less than a year, are not required to
submit a SPD 35 or SPD 35A but must submit a letter to the Department
indicating the nursing facility is not submitting a NFFS. This letter is due
the same day a NFFS would have been due.
(8) A NFFS must be filed annually by each
facility for the fiscal reporting period that ends June 30. The NFFS filed for
the period that ends June 30 is required to cover actual costs during the
previous state fiscal year from July 1 through June 30.
Or. Admin. R.
PWC 866(Temp), f.
12-30-77, ef. 1-1-78; AFS 19-1978, f. & ef. 5-1-78; Renumbered from
461-017-0300 by Ch. 784, OL 1981 & AFS 69-1981, f. 9-30-81, ef. 10-1-81;
SSD 6-1985, f. 5-31-85, ef. 6-1-85; SSD 10-1986, f. & ef. 7-1-86; SSD
8-1988, f. & cert. ef. 7-1-88; SSD 8-1991, f. & cert. ef. 4-1-91; SSD
14-1991(Temp), f. 6-28-91, cert. ef. 7-1-91; SSD 18-1991, f. 9-27-91, cert. ef.
10-1-91; SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93; SSD 8-1994, f. & cert.
ef. 12-1-94; 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 15-2009, f. 11-30-09, cert. ef. 12-1-09; SPD
37-2013(Temp), f. 10-4-13, cert. ef. 10-7-13 thru 4-5-14; APD 2-2014, f.
3-13-14, cert. ef. 4-1-14
Forms referenced are available from the agency.
Publications: Publications referenced are available from the
Stat. Auth.: ORS
Stats. Implemented: ORS
410.070 & 2013 OL Ch.