Or. Admin. Code § 411-018-0000 - Purpose and Definitions
Purpose: These rules establish standards and procedures for a long-term care facility that will be certified by the Department as an essential community provider long-term care facility.
(1) "Adult Foster Home" defined in ORS
443.705 means any family home or
facility in which residential care is provided in a home like environment for
five or fewer adults who are not related to the provider by blood or
marriage.
(2) "Certification" means
a written statement by the Department that the facility is an essential
community provider long-term care facility.
(3) "Department" means the Department of
Human Services, Seniors and People with Disabilities Division.
(4) "Disqualification" means a written
statement by the Department that informs the facility of the reasons for
disqualification.
(5) "Essential
community provider long-term care facility" means a long-term care facility in
which the average residency rate is 50% or more eligible for Medicaid during
the calendar year immediately preceding the calendar year in which the
Department is making certification; except that in adult foster homes the
average residency rate will be 60%.
(6) "Long term care facility" means a nursing
facility, assisted living facility, residential care facility or an adult
foster home that is licensed by the Department.
(7) "Medicaid" means Title XIX of the Social
Security Act.
(8) "Medicaid
eligible residency rate" means the days of facility occupancy in the calendar
year for which Medicaid is responsible for payment either paid or accrued (or
would have been paid by or accrued to Medicaid except that another payment
source was available and used) divided by all days of facility occupancy in the
calendar year for which payment has been made or a liability for payment
accrued.
(9) "Medicare" means Title
XVIII of the Social Security Act.
Notes
Stat. Auth.: ORS 410.070
Stats. Implemented: ORS 307.808 - 307.815, 443.888 & 410.070
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