Or. Admin. Code § 411-071-0100 - Responsibilities of Nursing Facilities
(1) A Medicaid eligible individual must have
an AAA/Seniors and People with Disabilities Pre-Admission Screening and prior
authorization of payment prior to admission to a nursing facility. A nursing
facility must not admit a Medicaid eligible individual based on a Private
Admission Assessment.
(2) A nursing
facility receiving an application for admission from an individual who is
subject to the admission assessment requirement but has not had an assessment
performed within the preceding 90 days must provide the individual with
information on the admission assessment process and a list of certified
programs provided by the Department or the area agency on aging/Seniors and
People with Disabilities office.
(3) Except as provided in section (4) of this
rule, nursing facilities must not admit an individual without a completed and
signed assessment form in the client record. Such forms are to be maintained as
a permanent part of the client record.
(4) A nursing facility may admit an
individual without a completed and signed assessment form in the client record
provided the facility has received verbal confirmation from a certified program
that an assessment has been completed for the individual within the preceding
90 days and a copy of the assessment form will be sent to the facility as soon
as is reasonably possible. The facility must note in the client record the name
of the certified program, the name and title of the person providing the verbal
confirmation, and the date and time confirmation was provided.
(5) If a nursing facility admits an
individual under an exempted hospital discharge set forth in OAR
411-071-0015(3)(a)
for the purpose of rehabilitative and/or nursing services for 30 days or less,
the nursing facility must contact a certified program to ensure a Private
Admission Assessment is completed within seven days after the 30th day of
admission.
(6) If a nursing
facility admits an individual under an emergency exemption set forth in OAR
411-071-0015(3)(e),
the nursing facility must contact a certified program and must ensure a Private
Admission Assessment is completed within seven days of admission.
(7) A nursing facility receiving an
application from an individual who is not an Oregon resident, or from an
individual who is being discharged from a hospital that is not a certified
program, or from an individual currently residing in a nursing facility outside
the state of Oregon must immediately notify the local Area Agency on
Aging/Seniors and People with Disabilities unit of the need for the individual
to receive an admission assessment. The nursing facility must contact a
certified program to ensure a Private Admission Assessment is completed within
seven days of admission.
(8) The
nursing facility is responsible for assuring that an individual subject to the
Level II pre-admission screening evaluation required by the federal
pre-admission screening requirements has been referred to the Seniors and
People with Disabilities of the Department of Human Services.
(9) The Department may disallow payment for
nursing services provided to an individual who has not been screened in
compliance with the federal pre-admission screening requirements or an
individual who is subject to the Level II evaluation and determination but who
has not received such a determination within the time limits established in the
federal pre-admission requirements.
(10) A nursing facility failing to comply
with these rules may be subject to administrative sanctions as provided in ORS
410.540 and/or civil penalties
as provided in OAR 411-071-0105.
Notes
Stat. Auth.: ORS 410.070
Stats. Implemented: ORS 410.515 & 410.540
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