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DEPARTMENT OF HUMAN SERVICES,

AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES




 

DIVISION 54
RESIDENTIAL CARE AND ASSISTED LIVING FACILITIES

411-054-0000
Purpose
The purpose of these rules is to establish standards for assisted living and residential care facilities that promote the availability of a wide range of individualized services for elderly and persons with disabilities, in a homelike environment. The standards are designed to enhance the dignity, independence, individuality and decision making ability of the resident in a safe and secure environment while addressing the needs of the resident in a manner that supports and enables the individual to maximize abilities to function at the highest level possible.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0005
Definitions
For the purpose of these rules, the
following definitions apply:
(1) "Abuse" means abuse as
defined in OAR 411-020-0002 (Adult Protective Services).
(2) "Activities of Daily
Living (ADL)" mean those personal functional activities required by an individual
for continued well-being, health, and safety. Activities consist of eating, dressing,
grooming, bathing, personal hygiene, mobility (ambulation and transfer), elimination
(toileting, bowel, and bladder management), and cognition/behavior.
(3) "Acute Sexual Assault"
means any non-consensual or unwanted sexual contact that warrants medical treatment
or forensic collection.
(4) "Administrator" means
the individual who is designated by the licensee that is responsible for the daily
operation and maintenance of the facility as described in OAR 411-054-0065.
(5) "Advance Directive" means
a document that contains a health care instruction or a power of attorney for health
care.
(6) "Aging and People with
Disabilities" means the program area of Aging and People with Disabilities, within
the Department of Human Services.
(7) "APD" means "Aging and
People with Disabilities".
(8) "Applicant" means the
individual, individuals, or entity, required to complete a facility application
for license.
(a) Except as set forth in
OAR 411-054-0013(1)(b), applicant includes a sole proprietor, each partner in a
partnership, and each member with a 10 percent or more ownership interest in a limited
liability company, corporation, or entity that:
(A) Owns the residential
care or assisted living facility business; or
(B) Operates the residential
care or assisted living facility on behalf of the facility business owner.
(b) Except as set forth in
OAR 411-054-0013(1)(b), for those who serve the Medicaid population, applicant includes
a sole proprietor, each partner in a partnership, and each member with a 5 percent
or more ownership interest in a limited liability company, corporation, or entity
that:
(A) Owns the residential
care or assisted living facility business; or
(B) Operates the residential
care or assisted living facility on behalf of the facility business owner.
(9) "Area Agency on Aging
(AAA)" as defined in ORS 410.040 means the Department designated agency charged
with the responsibility to provide a comprehensive and coordinated system of services
to seniors or individuals with disabilities in a planning and service area. For
the purpose of these rules, the term Area Agency on Aging is inclusive of both Type
A and B Area Agencies on Aging that contract with the Department to perform specific
activities in relation to residential care and assisted living facilities including:
(a) Conducting inspections
and investigations regarding protective service, abuse, and neglect;
(b) Monitoring; and
(c) Making recommendations
to the Department regarding facility license approval, denial, revocation, suspension,
non-renewal, and civil penalties.
(10) "Assisted Living Facility
(ALF)" means a building, complex, or distinct part thereof, consisting of fully,
self-contained, individual living units where six or more seniors and adult individuals
with disabilities may reside in homelike surroundings. The assisted living facility
offers and coordinates a range of supportive services available on a 24-hour basis
to meet the activities of daily living, health, and social needs of the residents
as described in these rules. A program approach is used to promote resident self-direction
and participation in decisions that emphasize choice, dignity, privacy, individuality,
and independence.
(11) "Building Codes" are
comprised of the set of specialty codes, including the Oregon Structural Specialty
Code (OSSC), Oregon Mechanical Specialty Code (OMSC), Oregon Electrical Specialty
Code (OESC), Oregon Plumbing Specialty Code (OPSC) and their reference codes and
standards.
(12) "Caregiver" means a
facility employee who is trained in accordance with OAR 411-054-0070 to provide
personal care services to residents. The employee may be either a direct care staff
or universal worker.
(13) "Change in Use" means
altering the purpose of an existing room, within the facility, that requires structural
changes.
(14) "Change of Condition
— Short Term" means a change in the resident’s health or functioning,
that is expected to resolve or be reversed with minimal intervention, or is an established,
predictable, cyclical pattern associated with a previously diagnosed condition.
(15) "Change of Condition
— Significant" means a major deviation from the most recent evaluation, that
may affect multiple areas of functioning or health, that is not expected to be short
term, and imposes significant risk to the resident. Examples of significant change
of condition include, but are not limited to:
(a) Broken bones;
(b) Stroke, heart attack,
or other acute illness or condition onset;
(c) Unmanaged high blood
sugar levels;
(d) Uncontrolled pain;
(e) Fast decline in activities
of daily living;
(f) Significant unplanned
weight loss;
(g) Pattern of refusing to
eat;
(h) Level of consciousness
change; and
(i) Pressure ulcers (stage
2 or greater).
(16) "Choice" means a resident
has viable options that enable the resident to exercise greater control over his
or her life. Choice is supported by the provision of sufficient private and common
space within the facility that allows residents to select where and how to spend
time and receive personal assistance.
(17) "Condition" means a
provision attached to a new or existing license that limits or restricts the scope
of the license or imposes additional requirements on the licensee.
(18) "Department" means the
Department of Human Services (DHS).
(19) "Dignity" means providing
support in such a way as to validate the self-worth of the individual. Dignity is
supported by creating an environment that allows personal assistance to be provided
in privacy and by delivering services in a manner that shows courtesy and respect.
(20) "Direct Care Staff"
means a facility employee whose primary responsibility is to provide personal care
services to residents. These personal care services may include:
(a) Medication administration;
(b) Resident-focused activities;
(c) Assistance with activities
of daily living;
(d) Supervision and support
of residents; and
(e) Serving meals, but not
meal preparation.
(21) "Directly Supervised"
means a qualified staff member maintains visual contact with the supervised staff.
(22) "Director" means the
Director of the Department's Licensing and Regulatory Oversight, or that individual's
designee. The term "Director" is synonymous with "Assistant Director".
(23) "Disaster" means a sudden
emergency occurrence beyond the control of the licensee, whether natural, technological,
or manmade, that renders the licensee unable to operate the facility or makes the
facility uninhabitable.
(24) "Disclosure" means the
written information the facility is required to provide to consumers to enhance
the understanding of facility costs, services, and operations.
(25) "Entity" means an individual,
a trust or estate, a partnership, a corporation (including associations, joint stock
companies, and insurance companies), a state, or a political subdivision or instrumentality,
including a municipal corporation of a state.
(26) "Exception" means a
written variance granted by the Department from a regulation or provision of these
rules.
(27) "Facility" means the
residential care or assisted living facility licensee and the operations, policies,
procedures, and employees of the residential care or assisted living facility.
(28) "FPS" means the Facilities,
Planning, and Safety Program within the Public Health Division.
(29) "Homelike Environment"
means a living environment that creates an atmosphere supportive of the resident's
preferred lifestyle. Homelike environment is also supported by the use of residential
building materials and furnishings.
(30) "Incident of Ownership"
means an ownership interest, an indirect ownership interest, or a combination of
direct and indirect ownership interest.
(31) "Independence" means
supporting resident capabilities and facilitating the use of those abilities. Creating
barrier free structures and careful use of assistive devices supports independence.
(32) "Indirect Ownership
Interest" means an ownership interest in an entity that has an ownership interest
in another entity. Indirect ownership interest includes an ownership interest in
an entity that has an indirect ownership interest in another entity.
(33) "Individuality" means
recognizing variability in residents' needs and preferences and having flexibility
to organize services in response to different needs and preferences.
(34) "Licensed Nurse" means
an Oregon licensed practical or registered nurse.
(35) "Licensee" means the
entity that owns the residential care or assisted living facility business, and
to whom an assisted living or residential care facility license has been issued.
(36) "Major Alteration":
(a) Means:
(A) Any structural change
to the foundation, floor, roof, exterior or load bearing wall of a building;
(B) The addition of floor
area to an existing building; or
(C) The modification of an
existing building that results in a change in use where such modification affects
resident services or safety.
(b) Does not include cosmetic
upgrades to the interior or exterior of an existing building (for example: changes
to wall finishes, floor rings, or casework).
(37) "Managed Risk" means
a process by which a resident’s high-risk behavior or choices are reviewed
with the resident. Alternatives to and consequences of the behavior or choices are
explained to the resident and the resident’s decision to modify behavior or
accept the consequences is documented.
(38) "Management" or "Operator"
means possessing the right to exercise operational or management control over, or
directly or indirectly conduct, the day-to-day operation of a facility.
(39) "Modified Special Diet"
means a diet ordered by a physician or other licensed health care professional that
may be required to treat a medical condition (for example: heart disease or diabetes).
(a) Modified special diets
include, but are not limited to:
(A) Small frequent meals;
(B) No added salt;
(C) Reduced or no added sugar;
and
(D) Simple textural modifications.
(b) Medically complex diets
are not included.
(40) "New Construction" means:
(a) A new building;
(b) An existing building
or part of a building that is not currently licensed;
(c) A major alteration to
an existing building; or
(d) Additions, conversions,
renovations, or remodeling of existing buildings.
(41) "Nursing Care" means
the practice of nursing as governed by ORS Chapter 678 and OAR chapter 851.
(42) "Owner" means an individual
with an ownership interest.
(43) "Ownership Interest"
means the possession of equity in the capital, the stock, or the profits of an entity.
(44) "Personal Incidental
Funds (PIF)" means the monthly amount allowed each Medicaid resident for personal
incidental needs. For purposes of this definition, personal incidental funds include
monthly payments, as allowed, and previously accumulated resident savings.
(45) "Privacy" means a specific
area or time over which the resident maintains a large degree of control. Privacy
is supported with services that are delivered with respect for the resident's civil
rights.
(46) "P.R.N." means those
medications and treatments that have been ordered by a qualified practitioner to
be administered as needed.
(47) "Psychoactive Medications"
mean medications used to alter mood, level of anxiety, behavior, or cognitive processes.
Psychoactive medications include antidepressants, anti-psychotics, sedatives, hypnotics,
and anti-anxiety medications.
(48) "Remodel" means a renovation
or conversion of a building that requires a building permit and meets the criteria
for review by the Facilities Planning and Safety Program as described in OAR 333-675-0000.
(49) "Renovate" means to
restore to good condition or to repair.
(50) "Resident" means any
individual who is receiving room, board, care, and services on a 24-hour basis in
a residential care or assisted living facility for compensation.
(51) "Residential Care Facility
(RCF)" means a building, complex, or distinct part thereof, consisting of shared
or individual living units in a homelike surrounding, where six or more seniors
and adult individuals with disabilities may reside. The residential care facility
offers and coordinates a range of supportive services available on a 24-hour basis
to meet the activities of daily living, health, and social needs of the residents
as described in these rules. A program approach is used to promote resident self-direction
and participation in decisions that emphasize choice, dignity, individuality, and
independence.
(52) "Restraint" means any
physical device the resident cannot manipulate that is used to restrict movement
or normal access to the resident’s body.
(53) "Retaliation" means
to threaten, intimidate, or take an action that is detrimental to an individual
(for example, harassment, abuse, or coercion).
(54) "Service Plan" means
a written, individualized plan for services, developed by a service planning team
and the resident or the resident’s legal representative, that reflects the
resident's capabilities, choices, and if applicable, measurable goals, and managed
risk issues. The service plan defines the division of responsibility in the implementation
of the services.
(55) "Service Planning Team"
means two or more individuals, as set forth in OAR 411-054-0036, that assist the
resident in determining what services and care are needed, preferred, and may be
provided to the resident.
(56) "Services" mean supervision
or assistance provided in support of a resident’s needs, preferences, and
comfort, including health care and activities of daily living, that help develop,
increase, maintain, or maximize the resident’s level of independent, psychosocial,
and physical functioning.
(57) "Subject Individual"
means any individual 16 years of age or older on whom the Department may conduct
a background check as defined in OAR 407-007-0210 and from whom the Department may
require fingerprints for the purpose of conducting a national background check.
(a) For the purpose of these
rules, subject individual includes:
(A) All applicants, licensees,
and operators of a residential care or assisted living facility;
(B) All individuals employed
or receiving training in an assisted living or residential care facility; and
(C) Volunteers, if allowed
unsupervised access to residents.
(b) For the purpose of these
rules, subject individual does not apply to:
(A) Residents and visitors
of residents; or
(B) Individuals that provide
services to residents who are employed by a private business not regulated by the
Department.
(58) "Supportive Device"
means a device that may have restraining qualities that supports and improves a
resident’s physical functioning.
(59) "These Rules" mean the
rules in OAR chapter 411, division 054.
(60) "Underserved" means
services are significantly unavailable within the service area in a comparable setting
for:
(a) The general public; or
(b) A specific population,
for example, residents with dementia or traumatic brain injury.
(61) "Unit" means an individual
living space constructed as a completely private apartment, including living and
sleeping space, kitchen area, bathroom, and adequate storage areas.
(62) "Universal Worker" means
a facility employee whose assignments include other tasks (for example, housekeeping,
laundry, or food service) in addition to providing direct resident services. Universal
worker does not include administrators, clerical or administrative staff, building
maintenance staff, or licensed nurses who provide services as specified in OAR 411-054-0034.
Stat. Auth.: ORS 410.070 & 443.450
Stats. Implemented: ORS 443.400
- 443.455 & 443.991
Hist.: SPD 14-2007, f. 8-31-07,
cert. ef. 11-1-07; SPD 16-2008, f. 12-31-08, cert. ef. 1-1-09; SPD 13-2009, f. 9-30-09,
cert. ef. 10-1-09; SPD 23-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10;
SPD 10-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 24-2010(Temp), f. & cert. ef.
10-5-10 thru 4-2-11; SPD 7-2011, f. 3-31-11, cert. ef. 4-1-11; SPD 23-2011(Temp),
f. & cert. ef. 11-10-11 thru 5-7-12; SPD 4-2012, f. 4-30-12, cert. ef. 5-1-12;
SPD 11-2012, f. 8-31-12, cert. ef. 9-1-12; APD 1-2015, f. 1-14-15, cert. ef. 1-15-15
411-054-0010
Licensing
Standard
(1) No individual,
entity, or governmental unit acting individually or jointly with any other individual,
entity, or governmental unit may establish, maintain, conduct, or operate a residential
care or assisted living facility, use the term residential care or assisted living
facility, or hold itself out as being a residential care or assisted living facility
or as providing residential care or assisted living services, without being duly
licensed as such.
(2) Each
license to operate a residential care or assisted living facility shall expire two
years following the date of issuance unless revoked, suspended, terminated earlier,
or issued for a shorter specified period.
(3) Each
residential care and assisted living facility must be licensed, maintained, and
operated as a separate and distinct facility.
(4) A license
may not be required for a building, complex, or distinct part thereof, where six
or more individuals reside where activities of daily living assistance and health
services are not offered or provided by the facility.
(a) Facility
representatives and written materials may not purport that such care and services
are offered or provided by the facility.
(b) Prospective
and actual tenants must have no expectations that such care and services are offered
or shall be provided by the facility.
(c) The Department's
Director shall determine whether a residential care or assisted living facility
license is required in cases where the definition of a facility's operations is
in dispute.
(5) NOT TRANSFERABLE.
No residential care or assisted living facility license is transferable or applicable
to any location, facility, management agent, or ownership other than that indicated
on the application and license.
(6) SEPARATE
BUILDINGS. Separate licenses are not required for separate buildings of the same
license type located contiguously and operated as an integrated unit by the same
licensee. Distinct staffing plans are required for each building.
(7) IDENTIFICATION.
Every facility must have distinct identification or name and must notify the Department
of any intention to change such identification.
(8) DESCRIPTIVE
TITLE. A residential care or assisted living facility licensed by the Department
may neither assume a descriptive title nor be held under any descriptive title other
than what is permitted within the scope of its license.
(9) RESIDENT
DISPLACEMENT DUE TO REMODELING. The licensee must notify the Department 90 days
prior to a remodel or renovation of part of a facility if there shall be a disruption
to residents in the facility (for example: residents must be temporarily moved to
another room overnight). During a non-emergent remodel, if any residents need to
be moved from their rooms, the residents must continue to be housed in another area
of the facility and may not be moved to another care setting.
(a) NON-EMERGENT
REMODEL.
(A) For a
non-emergent remodel, the licensee must submit a written proposal for remodeling
or renovation to the Department. The proposal must include:
(i) A specific
plan as to where residents shall be housed within the existing facility. For those
providers who have several buildings on the same campus, a move to a different building
of the same license type within the campus setting is allowed, as long as the resident
agrees to the move;
(ii) A specific
plan outlining the extended details of the renovation or remodeling; and
(iii) A timeline
for completion of the project. If the project is expected to take longer than three
months, the licensee must provide a monthly update to the Department. The maximum
time allowed for a renovation or remodel is one year from the date of the Department's
approval. The Department may approve renovations that exceed one year.
(B)The licensee
must give the residents written notice 60 days prior to beginning any non-emergent
remodel that shall displace the residents. The notice must include:
(i) Where
the residents shall be moved;
(ii) The
approximate length of time of the remodel; and
(iii) Assurance
that the residents shall be able to return to their own rooms when the remodel is
completed, if the residents choose to do so.
(C) The licensee
must submit an outline of the work to be completed, construction documents, and
any necessary drawings if required by the scope of work, to the Facilities Planning
and Safety Program (FPS). FPS has 15 business days for review.
(D) The licensee
must comply with the rules in OAR chapter 333, division 675 (Project Plans and Construction
Review) and all other structural requirements when remodeling.
(E) Nothing
in this rule is intended to preclude the Department from taking other regulatory
action on a violation of the licensing requirements in these rules during the time
of remodeling or renovation.
(b) EMERGENT
REMODEL OR CLOSURE.
(A) When
an emergency or disaster requires all residents of a facility or part of a facility
to be immediately evacuated while remodeling occurs, the licensee must:
(i) Provide
the Department written details regarding the transfer of residents within two working
days of the emergency or disaster;
(ii) Submit
a plan regarding the details for remodel or if necessary, a plan for permanent closure,
to the Department within two weeks;
(iii) Contact
FPS to determine if drawings need to be submitted based on the scope of the remodel;
and
(iv) Assure
that any residents who were transferred out of the facility shall be moved back
to the facility when compliance with all building requirements of these rules is
met.
(B) All residents
who have been transferred out of the facility must be notified in writing, at the
last address known to the facility, as to when the residents shall be able to return
to the facility.
(C) The facility
must ensure the safe transfer of residents from and back to the facility and bear
all costs of the moves.
(D) A refusal
by a facility to allow a resident to return after the resident has been transferred
out of the facility due to an emergent closure shall be regarded as an involuntary
move out:
(i) For an
involuntary move out, the facility must comply with the requirements of OAR 411-054-0080;
and
(ii) The
resident shall have all rights provided in OAR 411-054-0080.
(E) In the
event of an emergent closure, the Department may renew the existing license for
a period not to exceed two years from the renewal date.
(10) PERMANENT
FACILITY CLOSURE. A facility is considered closed if the licensee is no longer providing
services and the residents have moved out or must be moved from the facility.
(a) The licensee
must submit a written proposal for approval to the Department 60 days prior to permanent
closure. The proposal must specify the plan for safe transfer of all residents.
(b) The licensee
must notify the residents at least 60 days prior to facility closure.
(c) If the
facility is closed and no residents are in the facility, the facility is considered
unlicensed.
(11) NOTICE
OF BANKRUPTCY OR FORECLOSURE. The licensee must notify the Department in writing
within 10 days after receipt of any notice of foreclosure or trustee notification
of sale with respect to a real estate contract, trust deed, mortgage, or other security
interest affecting the property of the licensee, as defined in OAR 411-054-0005.
The written notice to the Department must include a copy of the notice provided
to the licensee.
(a) The licensee
must update the Department in writing not less often than every 90 days thereafter
until the matter is resolved and the default has been resolved and no additional
defaults have been declared or actions threatened. The update must include:
(A) The latest
status on what action has been or is about to be taken by the licensee with respect
to the notice received;
(B) What
action is being demanded or threatened by the holder of the security interest; and
(C) Any other
information reasonably requested by the Department related to maintaining resident
health and safety.
(b) The licensee
must update the Department upon final resolution of the matters leading up to or
encompassed by the notice of foreclosure or trustee notification of sale.
(c) The licensee
must notify the Department and all residents of the facility in writing immediately
upon:
(A) The filing
of any litigation regarding such security interest, including the filing of a bankruptcy
petition by or against the licensee or an entity owning any property occupied or
used by the licensee;
(B) The entry
of any judgment with respect to such litigation; or
(C) The outcome
of the judgment or settlement.
Stat. Auth.: ORS
410.070 & 443.450

Stats. Implemented:
ORS 443.400 - 443.455, 443.991

Hist.: SPD
14-2007, f. 8-31-07, cert. ef. 11-1-07; SPD 13-2009, f. 9-30-09, cert. ef. 10-1-09;
SPD 11-2012, f. 8-31-12, cert. ef. 9-1-12
411-054-0012
Requirements for New Construction or Initial Licensure
(1) An applicant requesting approval
of a potential license for new construction or licensing of an existing building
that is not operating as a licensed facility, must communicate with the Department
before submitting a letter of intent as described in section (3) of this rule.
(2) Prior to beginning new
construction of a building, or purchase of an existing building with intent to request
a license, the applicant must provide the following information for consideration
by the Department for a potential license:
(a) Demonstrate a past history,
if any, of substantial compliance with all applicable state and local laws, rules,
codes, ordinances, and permit requirements in Oregon, and the ability to deliver
quality services to citizens of Oregon; and
(b) Provide a letter of intent
as set forth in section (3) of this rule.
(3) LETTER OF INTENT. Prior
to application for a building permit, a prospective applicant, with intent to build
or operate a facility, must submit to the Department a letter of intent that includes
the following:
(a) Identification of the
potential applicant;
(b) Identification of the
city and street address of the intended facility;
(c) Intended facility type
(for example, RCF, ALF, or memory care), the intended number of units, and maximum
resident capacity;
(d) Statement of whether
the applicant is willing to provide care and services for an underserved population
and a description of any underserved population the applicant is willing to serve;
(e) Indication of whether
the applicant is willing to provide services through the state medical assistance
program;
(f) Identification of operations
within Oregon or within other states that provide a history of the applicant's ability
to serve the intended population; and
(g) An independent market
analysis completed by a third party professional that meets the requirements of
section (4) of this rule.
(4) MARKET ANALYSIS. The
applicant must submit a current market analysis to the Department for review and
consideration prior to application for a building permit. A market analysis is not
required for change of owner applicants of existing licensed buildings. The market
analysis must show the need for the services offered by the license applicant and
must include:
(a) A description of the
intended population to be served, including underserved populations and those eligible
to receive services through the state medical assistance program, as applicable;
(b) A current demographic
overview of the area to be served;
(c) A description of the
area and regional economy and the effect on the market for the project;
(d) Identification of the
number of individuals in the area to be served who are potential residents;
(e) A description of available
amenities (for example, transportation, hospital, shopping center, or traffic conditions);
(f) A description of the
extent, types, and availability of existing and proposed facilities, as described
in ORS 443.400 to 443.455, located in the area to be served; and
(g) The rate of occupancy,
including waiting lists, for existing and recently completed developments competing
for the same market segment.
(5) The Department shall
issue a written decision of a potential license within 60 days of receiving all
required information from the applicant.
(a) If the applicant is dissatisfied
with the decision of the Department, the applicant may request a contested case
hearing in writing within 14 calendar days from the date of the decision.
(b) The contested case hearing
shall be in accordance with ORS chapter 183.
(6) Prior to issuing a license,
the Department shall consider the applicant's stated intentions and compliance with
the requirements of this rule and all structural and other licensing requirements
as stated in these rules.
(7) BUILDING DRAWINGS. After
the letter of intent has been submitted to the Department, one set of building drawings
and specifications must be submitted to FPS and must comply with OAR chapter 333,
division 675.
(a) Building drawings must
be submitted to FPS:
(A) Prior to beginning construction
of any new building;
(B) Prior to beginning construction
of any addition to an existing building;
(C) Prior to beginning any
remodeling, modification, or conversion of an existing building that requires a
building permit; or
(D) Subsequent to application
for an initial license of a facility not previously licensed under this rule.
(b) Drawings must comply
with the building codes and the Oregon Fire Code (OFC) as required for the occupancy
classification and construction type.
(c) Drawings submitted for
a licensed assisted living or residential facility must be prepared by and bear
the stamp of an Oregon licensed architect or engineer.
(8) SIXTY-DAYS PRIOR. At
least 60 days prior to anticipated licensure the applicant must submit to the Department:
(a) A completed application
form with the required fee;
(b) A copy of the facility’s
written rental agreements;
(c) Disclosure information;
and
(d) Facility policies and
procedures to ensure the facility’s administrative staff, personnel, and resident
care operations are conducted in compliance with these rules.
(9) THIRTY-DAYS PRIOR. Thirty
days prior to anticipated licensure the applicant must submit:
(a) To the Department, a
completed and signed Administrator Reference Sheet that reflects the qualifications
and training of the individual designated as facility administrator and a background
check request; and
(b) To FPS, a completed and
signed Project Substantial Completion Notice that attests substantial completion
of the building project and requests the scheduling of an onsite licensing inspection.
(10) TWO-DAYS PRIOR. At least
two working days prior to the scheduled onsite licensing inspection of the facility,
the applicant must submit, to the Department and FPS, a completed and signed Project
Completion/Inspection Checklist that confirms the building project is complete and
fully in compliance with these rules.
(a) The scheduled, onsite
licensing inspection may not be conducted until the Project Completion/Inspection
Checklist has been received by both FPS and the Department.
(b) The onsite licensing
inspection may be rescheduled at the Department's convenience if the scheduled,
onsite licensing inspection reveals the building is not in compliance with these
rules as attested to on the Project Completion/Inspection Checklist.
(11) CERTIFICATE OF OCCUPANCY.
The applicant must submit to the Department and FPS a copy of the Certificate of
Occupancy issued by the building codes agency having jurisdiction that indicates
the intended occupancy classification and construction type.
(12) CONFIRMATION OF LICENSURE.
The applicant, prior to admitting any resident into the facility, must receive a
written confirmation of licensure issued by the Department.
Stat. Auth.: ORS 410.070 & 443.450
Stats. Implemented: ORS 443.400
- 443.455 & 443.991
Hist.: SPD 14-2007, f. 8-31-07,
cert. ef. 11-1-07; SPD 16-2008, f. 12-31-08, cert. ef. 1-1-09; SPD 24-2010(Temp),
f. & cert. ef. 10-5-10 thru 4-2-11; SPD 7-2011, f. 3-31-11, cert. ef. 4-1-11;
SPD 11-2012, f. 8-31-12, cert. ef. 9-1-12; APD 1-2015, f. 1-14-15, cert. ef. 1-15-15
411-054-0013
Application
for Initial Licensure and License Renewal
(1) APPLICATION.
Applicants for initial licensure and license renewal must complete an application
on a form provided by the Department. A licensing fee, as described in ORS 443.415,
is required and must be submitted according to Department policy.
(a) The application
form must be signed by the applicant’s legally authorized representative,
dated, and contain all information requested by the Department.
(b) Applicants
must provide all information and documentation as required by the Department including
but not limited to identification of financial interest of any individual, including
stockholders who have an incident of ownership in the applicant representing an
interest of 10 percent or more. For purposes of rule, an individual with a 10 percent
or more incident of ownership is presumed to have an effect on the operation of
the facility with respect to factors affecting the care or training provided, unless
the individual establishes the individual has no involvement in the operation of
the facility. For those who serve the Medicaid population, the applicant must identify
any individual with a 5 percent or more incident of ownership, regardless of the
individual's effect on the operation of the facility.
(c) If the
owner of the facility is a different entity from the operator or management company
of the facility, both the operator and the owner must complete an application for
licensure. Only one license fee is required.
(d) The application
shall require the identification of any individual with a 10 percent or more incident
of ownership that has ever been convicted of a crime associated with the operation
of a long-term, community-based, or health care facility or agency under federal
law or the laws of any state. For those who serve the Medicaid population, any individual
with a 5 percent or more incident of ownership must be identified, regardless of
the individual's effect on the operation of the facility.
(e) The application
shall require the identification of all states where the applicant, or individual
having a 10 percent or more incident of ownership in the applicant, currently or
previously has been licensed as owner or operator of a long-term, community-based,
or health care facility or agency under the laws of any state including any facility,
currently or previously owned or operated, that had its license denied or revoked
or received notice of the same under the laws of any state. For those who serve
the Medicaid population, all states where the applicant or any individual having
a 5 percent or more incident of ownership must be identified, regardless of the
individual's effect on the operation of the facility.
(f) The Department
may deny, revoke, or refuse to renew the license if the applicant fails to provide
complete and accurate information on the application and the Department concludes
that the missing or corrected information is needed to determine if a license shall
be granted.
(g) Each
application for a new license must include a completed background check request
form for the applicant and for each individual with 10 percent or more incident
of ownership in the applicant. For those who serve the Medicaid population, a background
check request form is required for the applicant and for each individual with a
5 percent or more incident of ownership, regardless of the individual's effect on
the operation of the facility.
(h) The Department
may require financial information as stated in OAR 411-054-0016 (New Applicant Qualifications),
when considering an applicant’s request for renewal of a license.
(i) Applicants
must provide other information and documentation as the Department may reasonably
require for the proper administration of these rules, including but not limited
to information about incident of ownership and involvement in the operation of the
facility or other business enterprises, as relevant.
(j) For facilities
that serve the Medicaid population and are managed by a Board of Directors, the
Centers for Medicare and Medicaid Services (CMS) require a social security number
and date of birth for each board member.
(2) LICENSE
RENEWAL. Application for a license renewal must be made at least 45 days prior to
the expiration date of the existing license. Filing of an application for renewal
and submission of the required non-refundable fee before the date of expiration
extends the effective date of expiration until the Department takes action upon
such application.
(a) The Department
shall refuse to renew a license if the facility is not substantially in compliance
with all applicable laws and rules or if the State Fire Marshal or authorized representative
has given notice of noncompliance.
(b) An applicant
for license renewal must provide the Department with a completed background check
request form for the applicant and for each individual with incident of ownership
of 10 percent or more in the applicant when required by the Department. For those
who serve the Medicaid population, a background check request form is required for
the applicant and each individual with a 5 percent or more incident of ownership,
regardless of the individual's effect on the operation of the facility.
(c) A building
inspection may be requested at the Department's discretion. The Department may require
physical improvements if the health or safety of residents is negatively impacted.
(3) DEMONSTRATED
CAPABILITY.
(a) Prior
to issuance of a license or a license renewal, the applicant must demonstrate to
the satisfaction of the Department that the applicant is capable of providing services
in a manner consistent with the requirements of these rules.
(b) The Department
may consider the background and qualifications of any individual with a 10 percent
or more incident of ownership in the applicant when determining whether an applicant
may be licensed. For those who serve the Medicaid population, the background and
qualifications of any individual with a 5 percent or more incident of ownership,
regardless of the individual's effect on the operation of the facility, may be considered.
(c) The Department
may consider the applicant’s history of compliance with Department rules and
orders including the history of compliance of any individual with a 10 percent or
more incident of ownership in the applicant. For those who serve the Medicaid population,
the history of compliance of the applicant and any individual with a 5 percent or
more incident of ownership, regardless of the individual's effect on the operation
of the facility, may be considered.
Stat. Auth.: ORS
410.070 & 443.450

Stats. Implemented:
ORS 443.400 - 443.455 & 443.991

Hist.: SPD
14-2007, f. 8-31-07, cert. ef. 11-1-07; SPD 10-2010, f. 6-30-10, cert. ef. 7-1-10;
SPD 23-2011(Temp), f. & cert. ef. 11-10-11 thru 5-7-12; SPD 4-2012, f. 4-30-12,
cert. ef. 5-1-12; SPD 11-2012, f. 8-31-12, cert. ef. 9-1-12
411-054-0016
New Applicant Qualifications
For the purpose
of this rule, "applicant" means each entity, as defined in OAR 411-054-0005, who
holds 10 percent or more incident of ownership in the applicant as described in
OAR 411-054-0013(1)(b). For those who serve the Medicaid population, "applicant"
means each entity, as defined in OAR 411-054-0005, who holds 5 percent or more incident
of ownership regardless of the individual's effect on the operation of the facility.
Applicants for licensure (excluding license renewal but including all changes of
ownership, management, or operator) must meet the following criteria:
(1) BACKGROUND
CHECK. Each applicant may not have convictions of any of the crimes listed in OAR
407-007-0275 and must complete a background check conducted by the Department in
accordance with OAR 407-007-0200 to 407-007-0370.
(2) PERFORMANCE
HISTORY. The Department shall consider an applicant’s performance history,
including repeat sanctions or rule violations, before issuing a license.
(a) Each
applicant must be free of incident of ownership history in any facility in Oregon
that provides or provided (at the time of ownership) care to children, elderly,
ill, or individuals with disabilities that had its license or certification involuntarily
suspended or voluntarily terminated during any state or federal sanction process
during the past five years.
(b) Applicants
must be free of incident of ownership history in any facility in any state that
had its license or certification involuntarily suspended or voluntarily terminated
during any state or federal sanction process during the past five years.
(c) Failure
to provide accurate information or demonstrate required performance history may
result in the Department's denial of a license.
(3) FINANCIAL
HISTORY. Each applicant must:
(a) Be free
of incident of ownership history in any facility or business that failed to reimburse
any state for Medicaid overpayments or civil penalties during the past five years.
(b) Be free
of incident of ownership history in any facility or business that failed to compensate
employees or pay worker's compensation, food supplies, utilities, or other costs
necessary for facility operation during the past five years.
(c) Submit
proof of fiscal responsibility, including an auditor's certified financial statement,
and other verifiable documentary evidence of fiscal solvency documenting that the
prospective licensee has sufficient resources to operate the facility for 60 days.
Proof of fiscal responsibility must include liquid assets sufficient to operate
the facility for 45 days. Anticipated Medicaid income is not considered "liquid
assets," but may be considered "financial resources." Liquid assets may be demonstrated
by:
(A) An unencumbered
line of credit;
(B) A performance
bond; or
(C) Any other
method satisfactory to the Department.
(d) Provide
a pro forma (revenues, expenditures, and resident days) by month for the first 12
months of operation of the facility and demonstrate the ability to cover any cash
flow problems identified by the pro forma.
(4) EXPERIENCE.
If an applicant does not have experience in the management of nursing facilities,
assisted living, or residential care, the applicant must employ the services of
a consultant or management company with experience in the provision of assisted
living or residential care for a period of at least six months. The consultant and
the terms and length of employment are subject to the approval of the Department.
Stat. Auth.: ORS
410.070 & 443.450

Stats. Implemented:
ORS 443.400 - 443.455 & 443.991

Hist.: SPD
14-2007, f. 8-31-07, cert. ef. 11-1-07; SPD 23-2009(Temp), f. 12-31-09, cert. ef.
1-1-10 thru 6-30-10; SPD 10-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 23-2011(Temp),
f. & cert. ef. 11-10-11 thru 5-7-12; SPD 4-2012, f. 4-30-12, cert. ef. 5-1-12;
SPD 11-2012, f. 8-31-12, cert. ef. 9-1-12
411-054-0019
Change of
Ownership or Management
(1) The licensee
and the prospective licensee must each notify the Department in writing of a contemplated
change in ownership or management entity. The written notification must be received
at least 60 days prior to the proposed date of change.
(a) The prospective
licensee or management entity must submit at least 60 days in advance of the proposed
date change:
(A) A completed
application form;
(B) A copy
of policies, procedures, rental agreements, service plans, and required disclosure
information; and
(C) A licensing
fee, as described in ORS 443.415, submitted according to Department policy.
(b) The prospective
licensee must notify the residents in writing 30 days in advance of a change in
ownership or management entity. The notice to residents must include any changes
to rates or policies.
(c) The prospective
licensee or operator may not assume possession or control of the facility until
the Department has notified the prospective licensee or operator that the license
application has been approved.
(d) The licensee
is responsible for the operation of the facility and resident services until a new
license is issued to the new owner.
(2) A building
inspection may be requested at the Department's discretion. The Department may require
physical improvements if the health or safety of residents is negatively impacted.
(3) Resident
records maintained by the licensee must be turned over to the new owner when the
license application is approved and the new licensee assumes possession or control
of the facility.
Stat. Auth.: ORS
410.070 & 443.450

Stats. Implemented:
ORS 443.400 - 443.455, 443.991

Hist.: SPD
14-2007, f. 8-31-07, cert. ef. 11-1-07; SPD 11-2012, f. 8-31-12, cert. ef. 9-1-12
411-054-0025
Facility
Administration
(1) FACILITY OPERATION.
(a) The licensee
is responsible for the operation of the facility and the quality of services rendered
in the facility.
(b) The licensee
is responsible for the supervision, training, and overall conduct of staff when
acting within the scope of their employment duties.
(c) The licensee
is responsible for obtaining background checks on all subject individuals.
(A) Background
checks must be submitted to the Department for a criminal fitness determination
on all subject individuals in accordance with OAR chapter 407-007-0200 to 407-007-0370,
including prior to a subject individual’s change in position (for example,
change from caregiver to med aide).
(B) PORTABILITY
OF BACKGROUND CHECK APPROVAL. A subject individual may be approved to work in multiple
facilities under the same operational entity. The Department's Background Check
Request form must be completed by the subject individual to show intent to work
at various facilities.
(d) The licensee
is responsible for ensuring that the facility complies with the tuberculosis screening
recommendations in OAR 333-019-0041.
(2) BACKGROUND
CHECK REQUIREMENTS.
(a) On or
after July 28, 2009, no individual may be a licensee, or employed in any capacity
in a facility, who has been convicted of any of the disqualifying crimes listed
in OAR 407-007-0275.
(b) Subject
individuals who are employees and hired prior to July 28, 2009 are exempt from subsection
(a) of this section provided that the employee remains in the same position working
for the same employer after July 28, 2009. This exemption is not applicable to licensees.
(3) EMPLOYMENT
APPLICATION. An application for employment in any capacity at a facility must include
a question asking whether the applicant has been found to have committed abuse.
The licensee must check all potential employees against the Oregon State Board of
Nursing and inquire whether the individual is licensed or certified by the Board
and whether there has been any disciplinary action by the Board against the individual
or any substantiated abuse findings against a nursing assistant.
(4) Reasonable
precautions must be exercised against any condition that may threaten the health,
safety, or welfare of residents.
(5) REQUIRED
POSTINGS. Required postings must be posted in a routinely accessible and conspicuous
location to residents and visitors and must be available for inspection at all times.
The licensee is responsible for posting the following:
(a) Facility
license;
(b) The name
of the administrator or designee in charge. The designee in charge must be posted
by shift or whenever the administrator is out of the facility;
(c) The current
facility staffing plan;
(d) A copy
of the most recent re-licensure survey, including all revisits and plans of correction
as applicable;
(e) The Ombudsman
Notification Poster; and
(f) Other
notices relevant to residents or visitors required by state or federal law.
(6) NOTIFICATION.
The facility must notify the Department's Central Office immediately by telephone,
fax, or email, (if telephone communication is used the facility must follow-up within
72 hours by written or electronic confirmation) of the following:
(a) Any change
of the administrator of record;
(b) Severe
interruption of physical plant services in which the health or safety of residents
is endangered, such as the provision of heat, light, power, water, or food;
(c) Occurrence
of epidemic disease in the facility. The facility must also notify the Local Public
Health Authority as applicable;
(d) Facility
fire or any catastrophic event that requires residents to be evacuated from the
facility;
(e) Unusual
resident death or suicide; or
(f) A resident
who has eloped from the facility and has not been found within 24 hours.
(7) POLICIES
AND PROCEDURES. The facility must develop and implement written policies and procedures
that promote high quality services, health and safety for residents, and incorporate
the community-based care principles of individuality, independence, dignity, privacy,
choice, and a homelike environment. The facility must develop and implement:
(a) A policy
on the possession of firearms and ammunition within the facility. The policy must
be disclosed in writing and by one other means of communication commonly used by
the resident or potential resident in their daily living.
(b) A written
policy that prohibits sexual relations between any facility employee and a resident
who did not have a pre-existing relationship.
(c) Effective
methods of responding to and resolving resident complaints.
(d) All additional
requirements for written policies and procedures as established in OAR 411-054-0012
(Requirements for New Construction or Initial Licensure), OAR 411-054-0040 (Change
of Condition and Monitoring), OAR 411-054-0045 (Resident Health Services), and OAR
411-054-0085 (Refunds and Financial Management).
(e) A policy
on smoking.
(A) The smoking
policy must be in accordance with:
(i) The Oregon
Indoor Clean Air Act, ORS 433.835 to 433.875;
(ii) The
rules in OAR chapter 333, division 015; and
(iii) Any
other applicable state and local laws.
(B) The facility
may designate itself as non-smoking.
(f) A policy
for the referral of residents who may be victims of acute sexual assault to the
nearest trained sexual assault examiner. The policy must include information regarding
the collection of medical and forensic evidence that must be obtained within 86
hours of the incident.
(g) A policy
on facility employees not receiving gifts or money from residents.
(8) RECORDS.
The facility must ensure the preparation, completeness, accuracy, and preservation
of resident records.
(a) The facility
must develop and implement a written policy that prohibits the falsification of
records.
(b) Resident
records must be kept for a minimum of three years after the resident is no longer
in the facility.
(c) Upon
closure of a facility, the licensee must provide the Department with written notification
of the location of all records.
(9) QUALITY
IMPROVEMENT PROGRAM. The facility must develop and conduct an ongoing quality improvement
program that evaluates services, resident outcomes, and resident satisfaction.
(10) DISCLOSURE
- RESIDENCY AGREEMENT. The facility must provide a Department designated Uniform
Disclosure Statement (form SDS 9098A) to each individual who requests information
about the facility. The residency agreement and the disclosure information described
in subsection (a) of this section must be provided to all potential residents prior
to move-in. All disclosure information and residency agreements must be written
in compliance with these rules.
(a) The residency
agreement and the following disclosure information must be reviewed by the Department
prior to distribution and must include the following:
(A) Terms
of occupancy, including policy on the possession of firearms and ammunition;
(B) Payment
provisions including the basic rental rate and what it includes, cost of additional
services, billing method, payment system and due dates, deposits, and non-refundable
fees, if applicable;
(C) The method
for evaluating a resident’s service needs and assessing the costs for the
services provided;
(D) Policy
for increases, additions, or changes to the rate structure. The disclosure must
address the minimum requirement of 30 days prior written notice of any facility-wide
increases or changes and the requirement for immediate written notice for individual
resident rate changes that occur as a result of changes in the service plan;
(E) Refund
and proration conditions;
(F) A description
of the scope of resident services available according to OAR 411-054-0030;
(G) A description
of the service planning process;
(H) Additional
available services;
(I) The philosophy
of how health care and ADL services are provided to the resident;
(J) Resident
rights and responsibilities;
(K) The facility's
system for packaging medications including the option for residents to choose a
pharmacy that meets the requirements of ORS 443.437;
(L) Criteria,
actions, circumstances, or conditions that may result in a move-out notification
or intra-facility move;
(M) Resident
rights pertaining to notification of involuntary move-out;
(N) Notice
that the Department has the authority to examine resident records as part of the
evaluation of the facility; and
(O) The facility's
staffing plan.
(b) The facility
may not include any provision in the residency agreement or disclosure information
that is in conflict with these rules and may not ask or require a resident to waive
any of the resident’s rights or the facility’s liability for negligence.
(c) The facility
must retain a copy of the original and any subsequent signed and dated residency
agreements and must provide copies to the resident or to the resident's designated
representative.
(d) The facility
must give residents 30 days prior written notice of any additions or changes to
the residency agreement. Changes to the residency agreement must be faxed or mailed
to the Department before distribution.
Stat. Auth.: ORS
181.534, 410.070, 443.004 & 443.450

Stats. Implemented:
ORS 181.534, 443.004, 443.400 - 443.455 & 443.991

Hist.: SPD
14-2007, f. 8-31-07, cert. ef. 11-1-07; SPD 13-2009, f. 9-30-09, cert. ef. 10-1-09;
SPD 23-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10; SPD 1-2010(Temp),
f. & cert. ef. 3-11-10 thru 6-30-10; SPD 10-2010, f. 6-30-10, cert. ef. 7-1-10;
SPD 11-2012, f. 8-31-12, cert. ef. 9-1-12
411-054-0027
Resident Rights and Protections
(1) The facility
must implement a residents’ Bill of Rights. Each resident or the resident’s
designated representative must be given a copy of the resident's rights and responsibilities
prior to moving into the facility. The Bill of Rights must state that residents
have the right:
(a) To be
treated with dignity and respect;
(b) To be
given informed choice and opportunity to select or refuse service and to accept
responsibility for the consequences;
(c) To participate
in the development of their initial service plan and any revisions or updates at
the time those changes are made;
(d) To receive
information about the method for evaluating their service needs and assessing costs
for the services provided;
(e) To exercise
individual rights that do not infringe upon the rights or safety of others;
(f) To be
free from neglect, financial exploitation, verbal, mental, physical, or sexual abuse;
(g) To receive
services in a manner that protects privacy and dignity;
(h) To have
prompt access to review all of their records and to purchase photocopies. Photocopied
records must be promptly provided, but in no case require more than two business
days (excluding Saturday, Sunday, and holidays);
(i) To have
medical and other records kept confidential except as otherwise provided by law;
(j) To associate
and communicate privately with any individual of choice, to send and receive personal
mail unopened, and to have reasonable access to the private use of a telephone;
(k) To be
free from physical restraints and inappropriate use of psychoactive medications;
(l) To manage
personal financial affairs unless legally restricted;
(m) To have
access to and participate in social activities;
(n) To be
encouraged and assisted to exercise rights as a citizen;
(o) To be
free of any written contract or agreement language with the facility that purports
to waive their rights or the facility’s liability for negligence;
(p) To voice
grievances and suggest changes in policies and services to either staff or outside
representatives without fear of retaliation;
(q) To be
free of retaliation after they have exercised their rights provided by law or rule;
(r) To have
a safe and homelike environment;
(s) To be
free of discrimination in regard to race, color, national origin, gender, sexual
orientation, or religion; and
(t) To receive
proper notification if requested to move out of the facility, and to be required
to move out only for reasons stated in OAR 411-054-0080 (Involuntary Move-out Criteria)
and have the opportunity for an administrative hearing, if applicable.
(2) Licensees
and facility personnel may not act as a resident’s guardian, conservator,
trustee, or attorney in fact unless related by birth, marriage, or adoption to the
resident as follows: parent, child, brother, sister, grandparent, grandchild, aunt
or uncle, or niece or nephew. An owner, administrator, or employee may act as a
representative payee for the resident or serve in other roles as provided by law.
(3) Licensees
and facility personnel may not spend resident funds without the resident’s
consent.
(a) If the
resident is not capable of consenting, the resident's representative must give consent.
(b) If the
resident has no representative and is not capable of consenting, licensees and facility
personnel must follow the requirements described in OAR 411-054-0085 and may not
spend resident funds for items or services that are not for the exclusive benefit
of the resident.
Stat. Auth.: ORS
410.070 & 443.450

Stats. Implemented:
ORS 443.400 - 443.455, 443.991

Hist.: SPD
14-2007, f. 8-31-07, cert. ef. 11-1-07; SPD 11-2012, f. 8-31-12, cert. ef. 9-1-12
411-054-0028
Abuse Reporting and Investigation
(1) The facility must have policies and procedures in place to assure the prevention and appropriate response to any incident. In the case of incidents of abuse, suspected abuse, or injury of unknown cause, policies and procedures must follow the requirements outlined below. In the case of incidents that are not abuse or injuries of unknown cause where abuse has been ruled out, the facility must have policies and procedures in place to respond appropriately, which may include such things as re-assessment, monitoring, or medication review.
(2) ABUSE REPORTING. Abuse is prohibited. The facility employees, agents and licensee must not permit, aid, or engage in abuse of residents who are under their care.
(a) STAFF REPORTING. All facility employees are required to immediately report abuse and suspected abuse to the local SPD office, or the local AAA, the facility administrator, or to the facility administrator's designee.
(b) FACILITY REPORTING. The facility administrator, or designee, must immediately notify the local SPD office, or the local AAA, of any incident of abuse or suspected abuse, including events overheard or witnessed by observation.
(c) LAW ENFORCEMENT AGENCY. The local law enforcement agency must be called first when the suspected abuse is believed to be a crime (e.g., rape, murder, assault, burglary, kidnapping, theft of controlled substances, etc.).
(d) INJURY OF UNKNOWN CAUSE. Physical injury of unknown cause must be reported to the local SPD office, or the local AAA, as suspected abuse, unless an immediate facility investigation reasonably concludes and documents that the physical injury is not the result of abuse.
(3) FACILITY INVESTIGATION. In addition to immediately reporting abuse or suspected abuse to SPD, AAA, or the law enforcement agency, the facility must promptly investigate all reports of abuse and suspected abuse and take measures necessary to protect residents and prevent the reoccurrence of abuse. Investigation of suspected abuse must document:
(a) Time, date, place and individuals present;
(b) Description of the event as reported;
(c) Response of staff at the time of the event;
(d) Follow-up action; and
(e) Administrator's review.
(4) IMMUNITY AND PROHIBITION OF RETALIATION.
(a) The facility licensee, employees and agents must not retaliate in any way against anyone who participates in the making of an abuse complaint, including but not limited to restricting otherwise lawful access to the facility or to any resident, or if an employee, dismissal or harassment.
(b) Anyone who, in good faith, reports abuse or suspected abuse shall have immunity from any liability that might otherwise be incurred or imposed with respect to the making or content of an abuse complaint.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0030
Resident Services
(1) The residential care or assisted living facility must provide a minimum scope of services as follows:
(a) Three daily nutritious, palatable meals with snacks available seven days a week, in accordance with the recommended dietary allowances found in the United States Department of Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables;
(A) Modified special diets that are appropriate to residents' needs and choices. The facility must encourage residents' involvement in developing menus.
(B) Menus must be prepared at least one week in advance, and must be made available to all residents. Meal substitutions must be of similar nutritional value if a resident refuses a food that is served. Residents must be informed in advance of menu changes.
(C) Food must be prepared and served in accordance with OAR 333-150-0000 (Food Sanitation Rules).
(b) Personal and other laundry services;
(c) A daily program of social and recreational activities that are based upon individual and group interests, physical, mental, and psychosocial needs, and creates opportunities for active participation in the community at large;
(d) Equipment, supplies and space to meet individual and group activity needs;
(e) Services to assist the resident in performing all activities of daily living, on a 24-hour basis, including:
(A) Assistance with mobility, including one-person transfers;
(B) Assistance with bathing and washing hair;
(C) Assistance with personal hygiene (e.g., shaving and caring for the mouth);
(D) Assistance with dressing and undressing;
(E) Assistance with grooming (e.g., nail care and brushing/combing hair);
(F) Assistance with eating (e.g., supervision of eating, cueing, or the use of special utensils);
(G) Assistance with toileting and bowel and bladder management;
(H) Intermittent cuing, redirecting and environmental cues for cognitively impaired residents; and
(I) Intermittent intervention, supervision and staff support for residents who exhibit behavioral symptoms.
(f) Medication administration; and
(g) Household services essential for the health and comfort of the resident that are based upon the resident's needs and preferences (e.g., floor cleaning, dusting, bed making, etc.)
(2) The facility must provide or arrange for the following:
(a) Transportation for medical and social purposes; and
(b) Ancillary services for medically related care (e.g., physician, pharmacist, therapy, podiatry, barber or beauty services, social or recreational opportunities, hospice, and home health) and other services necessary to support the resident.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0034
Resident Move-In and Evaluation
(1) INITIAL SCREENING
AND MOVE-IN.
(a) The facility
must determine whether a potential resident meets the facility’s admission
requirements.
(b) Prior
to the resident moving in, the facility must conduct an initial screening to determine
the prospective resident’s service needs and preferences. The screening must
determine the ability of the facility to meet the potential resident’s needs
and preferences while considering the needs of the other residents and the facility's
overall service capability.
(c) Prior
to move-in and updated as needed, each resident record must include the following
information:
(A) Prior
living arrangements;
(B) Emergency
contacts;
(C) Service
plan involvement - resident, family, and social supports;
(D) Financial
and other legal relationships if applicable, including but not limited to:
(i) Advance
directives;
(ii) Guardianship;
(iii) Conservatorship;
and
(iv) Power
of attorney.
(E) Primary
language;
(F) Community
connections; and
(G) Health
and social service providers.
(2) RESIDENT
EVALUATION -- GENERAL. The resident evaluation is the foundation that a facility
uses to develop the service plan and reflects the resident’s current health
and mental status. The evaluation information may be collected using tools and protocols
established by the facility, but must contain the elements stated in this rule.
(a) Resident
evaluations must be performed:
(A) Before
the resident moves into the facility, with updates and changes as appropriate within
the first 30 days; and
(B) At least
quarterly, to correspond with the quarterly service plan updates.
(b) Resident
evaluations must be reviewed and updates documented each time a resident has a significant
change in condition.
(c) The resident
evaluation must be done in person and the facility must gather data that is relevant
to the needs and current condition of the resident.
(d) Resident
evaluations must be documented, dated, and indicate who was involved in the evaluation
process.
(e) Twenty-four
months of past evaluations must be kept in the resident’s files in an accessible,
on-site location.
(f) The facility
administrator is responsible for assuring that only trained and experienced staff
perform resident evaluations.
(3) EVALUATION
REQUIREMENTS AT MOVE-IN.
(a) The resident
evaluation must be completed before the resident moves into the facility. This evaluation
provides baseline information of the resident’s physical and mental condition
at move-in.
(b) If there
is an urgent need and the evaluation is not completed prior to move-in, the facility
must document the reasons and complete the evaluation within eight hours of move-in.
(c) The initial
evaluation must contain the elements specified in section (5) of this rule, and
address sufficient information to develop an initial service plan to meet the resident’s
needs.
(d) The initial
evaluation must be updated and modified as needed during the 30 days following the
resident’s move into the facility.
(e) After
the initial 30 day move-in period, the initial evaluation must be retained in the
resident’s file for 24 months. Future evaluations must be separate and distinct
from the initial evaluation.
(4) QUARTERLY
EVALUATION REQUIREMENTS.
(a) Resident
evaluations must be performed quarterly after the resident moves into the facility.
(b) The quarterly
evaluation is the basis of the resident’s quarterly service plan.
(c) The most
recent quarterly evaluation, with documented change of condition updates, must be
in the resident’s current record and available to staff.
(d) If the
evaluation is revised and updated at the quarterly review, changes must be dated
and initialed and prior historical information must be maintained.
(5) The resident
evaluation must address the following elements:
(a) Resident
routines and preferences including:
(A) Customary
routines -- sleep, dietary, social, and leisure; and
(B) Spiritual,
cultural preferences.
(b) Physical
health status including:
(A) List
of current diagnoses;
(B) List
of medications and PRN use;
(C) Visits
to health practitioners, emergency room, hospital, or nursing facility in the past
year; and
(D) Vital
signs if indicated by diagnoses, health problems, or medications.
(c) Mental
health issues including:
(A) Presence
of depression, thought disorders, or behavioral or mood problems;
(B) History
of treatment; and
(C) Effective
non drug interventions.
(d) Cognition,
including:
(A) Memory;
(B) Orientation;
(C) Confusion;
and
(D) Decision
making abilities.
(e) Communication
and sensory including:
(A) Hearing;
(B) Vision;
(C) Speech;
(D) Assistive
devices; and
(E) Ability
to understand and be understood.
(f) Activities
of daily living including:
(A) Toileting,
bowel, and bladder management;
(B) Dressing,
grooming, bathing, and personal hygiene;
(C) Mobility
-- ambulation, transfers, and assistive devices; and
(D) Eating,
dental status, and assistive devices.
(g) Independent
activities of daily living including:
(A) Ability
to manage medications;
(B) Ability
to use call system;
(C) Housework
and laundry; and
(D) Transportation.
(h) Pain
-- pharmaceutical and non-pharmaceutical interventions.
(i) Skin
condition.
(j) Nutrition
habits, fluid preferences, and weight if indicated.
(k) List
of treatments -- type, frequency, and level of assistance needed.
(l) Indicators
of nursing needs, including potential for delegated nursing tasks.
(m) Review
of risk indicators including:
(A) Fall
risk or history;
(B) Emergency
evacuation ability;
(C) Complex
medication regimen;
(D) History
of dehydration or unexplained weight loss or gain;
(E) Recent
losses;
(F) Unsuccessful
prior placements;
(G) Elopement
risk or history;
(H) Smoking.
The resident’s ability to smoke without causing burns or injury to themselves
or others or damage to property must be evaluated and addressed in the resident's
service plan; and
(I) Alcohol
and drug use. The resident’s use of alcohol or the use of drugs not prescribed
by a physician must be evaluated and addressed in the resident's service plan,
(6) If the
information has not changed from the previous evaluation period, the information
does not need to be repeated. A dated and initialed notation of no changes is sufficient.
The prior evaluation must then be kept in the current resident record for reference.
Stat. Auth.: ORS
410.070 & 443.450

Stats. Implemented:
ORS 443.400 - 443.455, 443.991

Hist.: SPD
14-2007, f. 8-31-07, cert. ef. 11-1-07; SPD 13-2009, f. 9-30-09, cert. ef. 10-1-09;
SPD 11-2012, f. 8-31-12, cert. ef. 9-1-12
411-054-0036
Service Plan -- General
(1) SERVICE PLAN. The service plan must reflect the resident's needs as identified in the evaluation and include resident preferences that support the principles of dignity, privacy, choice, individuality and independence.
(a) The service plan must be completed:
(A) Prior to resident move-in, with updates and changes as appropriate within the first 30-days; and
(B) Following quarterly evaluations.
(b) The service plan must be readily available to staff and provide clear direction regarding the delivery of services.
(c) The service plan must include a written description of who will provide the services and what, when, how and how often the services will be provided.
(d) Changes and entries made to the service plan must be dated and initialed.
(e) When the resident experiences a significant change of condition the service plan must be reviewed and updated as needed.
(f) A copy of the service plan, including each update, must be offered to the resident or to the resident's legal representative.
(g) The facility administrator is responsible for ensuring the implementation of services.
(2) SERVICE PLAN REQUIREMENTS PRIOR TO MOVE-IN.
(a) Based on the resident evaluation performed prior to move-in, an initial service plan must be developed prior to move-in that reflects the identified needs and preferences of the resident.
(b) The initial service plan must be reviewed within 30-days of move-in to ensure that any changes made to the plan during the initial 30-days, accurately reflect the resident's needs and preferences.
(c) Staff must document and date adjustments or changes as applicable.
(3) QUARTERLY SERVICE PLAN REQUIREMENTS.
(a) Service plans must be completed quarterly after the resident moves into the facility.
(b) The quarterly evaluation is the basis of the resident's quarterly service plan.
(c) If the resident's service plan is revised and updated at the quarterly review, changes must be dated and initialed and prior historical information must be maintained.
(4) SERVICE PLANNING TEAM. The service plan must be developed by a Service Planning Team that consists of the resident, the resident's legal representative if applicable, any person of the resident's choice, the facility administrator or designee and at least one other staff person who is familiar with, or who will provide services to the resident. Involved family members and case managers must be notified in advance of the service-planning meeting.
(a) As applicable, the Service Planning Team must also include:
(A) Local SPD or AAA case managers and family members, as available;
(B) A licensed nurse if the resident will be, or is, receiving nursing services or experiences a significant change of condition as required in 411-054-0045(1)(f)(D) (Resident Health Services); and
(C) The resident's physician or other health practitioner.
(b) Each resident must actively participate in the development of the service plan to the extent of the resident's ability and willingness to do so. If resident participation is not possible, documentation must reflect the facility's attempts to determine the resident's preferences.
(5) MANAGED RISK. When a resident's actions or choices pose a potential risk to that resident's health or well-being, the facility may utilize a managed risk agreement to explore alternatives and potential consequences with the resident.
(a) The facility must identify the need for and develop a written managed risk plan following the facility's established guidelines and procedures. A managed risk plan must include:
(A) An explanation of the cause(s) of concern;
(B) The possible negative consequences to the resident or others;
(C) A description of the resident's preference(s);
(D) Possible alternatives or interventions to minimize the potential risks associated with the resident's current preferences and actions;
(E) A description of the services the facility will provide to accommodate the resident's choice or minimize the potential risk; and
(F) The final agreement, if any, reached by all involved parties, must be included in the service plan.
(b) The facility will involve the resident, the resident's designated representative and others as indicated, to develop, implement and review the managed risk plan. The resident's preferences will take precedence over those of a family member(s).
(c) A managed risk plan will not be entered into or continued with or on behalf of a resident who is unable to recognize the consequences of their behavior or choices.
(d) The managed risk plan must be reviewed at least quarterly.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0040
Change of Condition and Monitoring
(1) CHANGE OF CONDITION. These rules define a resident's change of condition as either short term or significant with the following meanings:
(a) Short term change of condition means a change in the resident's health or functioning that is expected to resolve or be reversed with minimal intervention or is an established, predictable, cyclical pattern associated with a previously diagnosed condition.
(b) Significant change of condition means a major deviation from the most recent evaluation that may affect multiple areas of functioning or health that is not expected to be short term and imposes significant risk to the resident.
(c) If a resident experiences a significant change of condition that is a major deviation in the resident's health or functional abilities, the facility must evaluate the resident, refer to the facility nurse, document the change, and update the service plan as needed.
(d) If a resident experiences a short-term change of condition that is expected to resolve or reverse with minimal intervention, the facility must determine and document what action or intervention is needed for the resident.
(A) The determined action or intervention must be communicated to staff on each shift.
(B) The documentation of staff instructions or interventions must be resident specific and made part of the resident record with weekly progress noted until the condition resolves.
(2) MONITORING. The facility must have written policies to ensure a resident monitoring and reporting system is implemented 24-hours a day. The policies must specify staff responsibilities and identify criteria for notifying the administrator, registered nurse, or healthcare provider. The facility must:
(a) Monitor each resident consistent with his or her evaluated needs and service plan;
(b) Train staff to identify changes in the resident's physical, emotional and mental functioning and document and report on the resident's changes of condition;
(c) Have a reporting protocol with access to a designated staff person, 24-hours a day, seven days a week, who can determine if a change in the resident's condition requires further action; and
(d) Provide written communication of a resident's change of condition, and any required interventions, for caregivers on each shift.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0045
Resident Health Services
(1) RESIDENT HEALTH SERVICES. The facility must provide health services and have systems in place to respond to the 24-hour care needs of residents. The system must:
(a) Include written policies and procedures on medical emergency response for all shifts.
(b) Include an Oregon licensed nurse(s) who is regularly scheduled for onsite duties at the facility and who is available for phone consultation.
(c) Assure an adequate number of nursing hours relevant to the census and acuity of the resident population.
(d) Ensure that the facility's licensed nurse is notified of nursing needs as identified in OAR 411-054-0034 (Resident Move-In and Evaluation) or 411-054-0036 (Service Plan -- General).
(e) Define the duties, responsibilities and limitations of the facility nurse in policy and procedures, admission, and disclosure material.
(f) Licensed nurses must deliver the following nursing services:
(A) Registered nurse (RN) assessment in accordance with facility policy and resident condition. At minimum the RN must assess all residents with a significant change of condition. The assessment may be a full or problem focused assessment as determined by the RN. A chart review or phone consultation may be performed as part of this assessment. The RN must document findings, resident status, and interventions made as a result of this assessment. The assessment must be timely, but is not required prior to emergency response in acute situations.
(B) Delegation and Teaching. Delegation and teaching must be provided and documented by a RN in accordance with the Oregon Administrative Rules adopted by the Oregon State Board of Nursing in chapter 851, division 047.
(C) Monitoring of Resident Condition. The facility must specify the role of the licensed nurse in the facility's monitoring and reporting system.
(D) Participation on Service Planning Team. If the resident experiences a significant change of condition and the service plan is updated, the licensed nurse must participate on the Service Planning Team, or must review the service plan with date and signature within 48 hours.
(E) Health Care Teaching and Counseling. A licensed nurse must provide individual and group education activities as required by individual service plans and facility policies.
(F) Intermittent Direct Nursing Services. If a resident requires nursing services that are not available through hospice, home health, a third party referral, or the task cannot be delegated to facility staff, the facility must arrange to have such services provided on an intermittent or temporary basis. Such services may be of a temporary nature as defined in facility policy, admission agreements and disclosure information.
(2) ON-SITE AND OFF-SITE HEALTH SERVICES. The facility must assist residents in accessing health care services and benefits to which they are entitled from outside providers. When benefits are no longer available, or if the resident is not eligible for benefits, the facility must provide or coordinate the required services, as defined in facility disclosure information, for residents whose health status is stable and predictable.
(a) On-site Health Services. The facility must coordinate on-site health services with outside service providers such as hospice, home health, or other privately paid supplemental health care providers, etc.
(A) The facility management or licensed nurse must be notified of the services provided by the outside provider to ensure that staff are informed of new interventions, and that the service plan is adjusted if necessary, and reporting protocols are in place.
(B) The facility nurse must review the resident's health related service plan changes made as a result of the provision of on-site health services noted in section (2)(a)(A) of this rule.
(C) The facility must have policies to ensure that outside service providers leave written information in the facility that addresses the on-site services being provided to the resident and any clinical information necessary for facility staff to provide supplemental care.
(b) Off-site Health Services. The facility must coordinate off-site health services for residents who cannot or choose not to self-manage their health services.
(A) The facility must assist the resident by coordinating appointments, with outside providers, that are necessary to support the resident's health needs.
(B) Transportation for medical purposes must be arranged or provided for by the facility.
(C) Following a resident's visit to an outside medical provider, if information is obtained from said provider, it must be included in the resident's record. Adjustments to the resident's services and service plan must be made as applicable.
(D) The facility must provide relevant information to the off-site provider and must have a protocol to facilitate the receipt of information from the provider.
(c) The facility is exempt from the coordination of outside health services for residents who are capable and choose to independently arrange and manage their health care needs.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0055
Medications and Treatments
(1) MEDICATION AND TREATMENT ADMINISTRATION SYSTEMS. The facility must have safe medication and treatment administration systems in place that are approved by a pharmacist consultant, registered nurse, or physician.
(a) The administrator is responsible for ensuring adequate professional oversight of the medication and treatment administration system.
(b) Medications administered by the facility must be set-up or poured and documented by the same person who administers the medications.
(c) The staff person who administers the medication must visually observe the resident take (e.g., ingest, inhale, apply, etc.) the medication unless the prescriber's order for that specific medication states otherwise.
(d) Medications must be kept secure between set-up and administration of medications.
(e) The facility must have a system approved by a pharmacist consultant or registered nurse for tracking controlled substances and for disposal of all unused, outdated or discontinued medications administered by the facility.
(f) Medication and treatment orders must be carried out as prescribed.
(g) Written, signed physician or other legally recognized practitioner orders must be documented in the resident's facility record for all medications and treatments that the facility is responsible to administer.
(h) Only a physician or other legally recognized prescribing practitioner is authorized to make changes in a medication or treatment order.
(i) A registered pharmacist or registered nurse must review all medications and treatments administered by the facility to a resident at least every ninety days. The facility must provide documentation related to the recommendations made by the reviewer.
(j) The resident or the person legally authorized to make health care decisions for the resident has the right to consent to, or refuse, medications and treatments.
(k) The physician/practitioner must be notified if a resident refuses consent to an order. Subsequent refusals to consent to an order will be reported as requested by the prescriber.
(2) MEDICATION ADMINISTRATION. An accurate Medication Administration Record (MAR) must be kept of all medications, including over-the-counter medications that are ordered by a legally recognized prescriber and are administered by the facility.
(a) Documentation of the MAR must be completed using one of the following processes. An alternative process may be used only with a written exception from SPD.
(A) The MAR may be signed as the medications are set-up or poured. Medications must not be set-up in advance for more than one administration time. If a medicine cup or other individual container is used to set-up the medications, it must be placed in a closed compartment labeled with the resident's name. Changes to the MAR that occur after the medication is delivered, must be documented by the same staff person who administered the medication; or
(B) The facility may choose to sign the MAR after the medication is administered to a specific resident and prior to the next resident-specific medication or treatment.
(b) MEDICATION RECORD. At minimum, the medication record for each resident that the facility administers medications to, must include:
(A) Current month, day and year;
(B) Name of medication(s), reason for use, dosage, route and date/time given;
(C) Any medication specific instructions, if applicable (e.g., significant side effects, time sensitive dosage, when to call the prescriber or nurse);
(D) Resident allergies and sensitivities, if any;
(E) Resident specific parameters and instructions for p.r.n. medications; and
(F) Initials of the person administering the medication.
(3) TREATMENT ADMINISTRATION.
(a) An accurate treatment record for each resident must be kept of all treatments ordered by a legally recognized practitioner and administered by the facility to that resident.
(b) The treatment record must include:
(A) Current month, day and year;
(B) Type of treatment (e.g., dressing change, ointment application etc.), treatment instructions and if applicable, significant side effects or when to call the prescriber or nurse;
(C) Date and time administered;
(D) Resident allergies and sensitivities, applicable to treatments;
(E) Instructions for p.r.n. treatments, including resident specific parameters;
(F) Initials of person administering the treatments; and
(G) Any deviation from instructions or refusal of treatment must be documented.
(4) MEDICATION AND TREATMENT -- GENERAL. The facility must maintain legible signatures of staff that administer medications and treatments, either on the MAR or on a separate signature page, filed with the MAR.
(a) If the facility administers or assists a resident with medication, all medication obtained through a pharmacy must be clearly labeled with the pharmacist's label, in the original container, in accordance with the facility's established medication delivery system.
(b) Over-the-counter medication or samples of medications must have the original manufacturer's label(s) if the facility administers or assists a resident with medication.
(c) All medications administered by the facility must be stored in a locked container(s) in a secured environment such as a medication room or medication cart.
(d) Medications that have to be refrigerated must be stored at the appropriate temperature in a locked, secure location.
(e) Order changes obtained by telephone must be documented in the resident's record and the MAR must be updated prior to administering the new medication stated on the order. Telephone orders must be followed-up with written, signed orders.
(f) The facility must not require residents to purchase prescriptions from a pharmacy that contracts with the facility.
(5) SELF ADMINISTRATION OF MEDICATION.
(a) Residents who choose to self-administer their medications must be evaluated upon move-in and at least quarterly thereafter, to assure ability to safely self-administer medications.
(b) Residents must have a physician's or other legally recognized practitioner's written order of approval for self-administration of prescription medications.
(c) Residents able to administer their own medication regimen may keep prescription medications in their unit.
(d) If more than one resident resides in the unit, an evaluation must be made of each person and the resident's ability to safely have medications in the unit. If safety is a factor, the medications must be kept in a locked container in the unit.
(e) Unless contraindicated by a physician or resident evaluation, residents may keep and use over-the-counter medications in their unit without a written order.
(6) PSYCHOACTIVE MEDICATION. Psychoactive medications may be used only pursuant to a prescription that specifies the circumstances, dosage and duration of use.
(a) Facility administered psychoactive medication(s) will be used only when required to treat a resident's medical symptoms or to maximize a resident's functioning.
(b) The facility must not request psychoactive medication to treat a resident's behavioral symptoms without a consultation from a physician, nurse practitioner, registered nurse or mental health professional.
(c) Prior to administering any psychoactive medication(s) to treat a resident's behavior, all caregivers administering medications for the resident must know:
(A) The specific reasons for the use of the psychoactive medication for that resident;
(B) The common side effects of the medication(s); and
(C) When to contact a health professional regarding side effects.
(d) Medications that are administered p.r.n. that are given to treat a resident's behavior must have written, resident-specific parameters.
(A) These p.r.n. medication(s) may be used only after documented; non-pharmacological interventions have been tried with ineffective results.
(B) All caregivers must have knowledge of non-pharmacological interventions.
(e) Psychoactive medications must not be given to discipline a resident, or for the convenience of the facility.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0060
Restraints and Supportive Devices
Residential care and assisted living facilities are intended to be restraint free environments.
(1) Restraints are not permitted except when a resident's actions present an imminent danger to self or others and only until immediate action is taken by medical, emergency, or police personnel.
(2) Supportive devices with restraining qualities are permitted under the following documented circumstances:
(a) The resident specifically requests or approves of the device and the facility has informed the individual of the risks and benefits associated with the device; and
(b) The facility registered nurse, a physical therapist or occupational therapist has conducted a thorough assessment; and
(c) The facility has documented other less restrictive alternatives evaluated prior to the use of the device; and
(d) The facility has instructed caregivers on the correct use and precautions related to use of the device.
(3) Supportive devices with restraining qualities may be utilized for residents who are unable to evaluate the risks and benefits of the device when sections (2)(b), (2)(c) and (2)(d) have been met.
(4) Documentation of the use of supportive devices with restraining qualities must be included in the resident service plan and evaluated on a quarterly basis.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0065
Administrator Qualifications and Requirements
(1) FULL-TIME ADMINISTRATOR. Each licensed residential care and assisted living facility must employ a full-time administrator. The administrator must be scheduled to be on-site in the facility at least 40 hours per week.
(2) ADMINISTRATOR QUALIFICATIONS. The administrator must:
(a) Be at least 21 years of age:
(b) Possess a high school diploma or equivalent; and
(A) Have at least two years professional or management experience that has occurred within the last five years, in a health or social service related field or program, or have a combination of experience and education; or
(B) Possess an accredited Bachelors Degree in a health or social service related field.
(3) ADMINISTRATOR REQUIREMENTS.
(a) Facility administrators must meet the following training requirements prior to employment:
(A) Complete a Division approved classroom administrator training program of at least 40 hours;
(B) Complete a Division approved administrator training program that includes both a classroom training of less than 40 hours and a Division approved 40-hour internship program with a Division approved administrator; or
(C) Complete another Division approved administrator training program.
(b) CONTINUING EDUCATION. Administrators must have 20 hours of documented Division approved continuing education credits each year. The approved administrator-training program fulfills the 20-hour continuing education requirement for the first year.
(c) Persons who have met Division approved training program requirements but have been absent from an administrator position for five years or less, do not have to re-take the administrator training but must provide evidence of 20 hours of continuing education annually.
(d) Prior to employment as administrator of a facility, persons must complete the criminal records check requirements of OAR 407-007-0200 to 407-007-0370 and comply with the tuberculosis screening recommendations in OAR 333-019-0041. An administrator of a facility may not have convictions of any of the crimes described in OAR 407-007-0275.
(e) ADMINISTRATOR REFERENCE SUMMARY. Newly hired administrators are responsible for the completion of form SDS 0566, Administrator Reference Summary, and are required to fax the completed form to the Division upon hire. The Division may reject a form that has been falsified or is incomplete.
(f) DESIGNEE. The administrator must appoint a staff member as designee to oversee the operation of the facility in the administrator’s absence. The administrator or a designee must be in charge on site at all times and ensure there are sufficient, qualified staff and that the care, health, and safety needs of the residents are met at all times.
(4) ADMINISTRATOR TRAINING COURSE STANDARDS.
(a) The training curriculum for the administrator training must be approved by the Division and shall be re-evaluated by the Division at periodic intervals.
(b) Individuals, companies, or organizations providing the administrator training course must be approved by the Division. The Division may withdraw approval under the following conditions:
(A) Failure to follow Division approved curriculum;
(B) The trainer demonstrates lack of competency in training;
(C) There is insufficient frequency of training to meet the need; or
(D) Facilities owned or operated by the training entity have a pattern of substantial non-compliance with these rules.
(c) Approved training must be open and available to all applicants and may not be used to orient trainees to a specific company’s management or operating procedures.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07; SPD 23-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10; SPD 10-2010, f. 6-30-10, cert. ef. 7-1-10
411-054-0070
Staffing Requirements and Training
(1) STAFFING REQUIREMENTS. Facilities must have qualified awake caregivers, sufficient in number, to meet the 24-hour scheduled and unscheduled needs of each resident. Caregivers provide services for residents that include assistance with activities of daily living, medication administration, resident-focused activities, supervision, and support.
(a) If a facility employs universal workers whose duties include other tasks (e.g., housekeeping, laundry, food service, etc.), in addition to direct resident care, staffing must be increased to maintain adequate resident care and services.
(b) Prior to providing care and services to residents, caregivers must be trained as required in sections (2) and (3) of this rule.
(c) The following facility employees are ancillary to the caregiver requirements in this section:
(A) Individuals whose duties are exclusively housekeeping, building maintenance, clerical/administrative or food preparation;
(B) Licensed nurses who provide services as specified in OAR 411-054-0045 (Resident Health Services); and
(C) Administrators.
(d) SPD retains the right to require minimum staffing standards based on acuity, complaint investigation or survey inspection.
(e) Based on resident acuity and facility structural design there must be adequate caregivers present at all times, to meet the fire safety evacuation standards as required by the fire authority or SPD.
(f) The licensee is responsible for assuring that staffing is increased to compensate for the evaluated care and service needs of residents at move-in and for the changing physical or mental needs of the residents.
(g) A minimum of two caregivers must be scheduled and available at all times whenever a resident requires the assistance of two caregivers for scheduled and unscheduled needs.
(h) In facilities where residents are housed in two or more detached buildings, or if a building has distinct and segregated areas, a designated caregiver must be awake and available in each building and each segregated area at all times.
(i) Facilities must have a written, defined system to determine appropriate numbers of caregivers and general staffing based on resident acuity and service needs. Such systems may be either manual or electronic.
(A) Guidelines for systems must also consider physical elements of a building, use of technology if applicable and staff experience.
(B) Facilities must be able to demonstrate how their staffing system works.
(2) TRAINING REQUIREMENTS.
(a) EMPLOYEE PRE-SERVICE ORIENTATION. Prior to beginning their job responsibilities all employees must complete an orientation that includes:
(A) Residents' rights and the values of community-based care;
(B) Abuse and reporting requirements;
(C) Standard precautions for infection control; and
(D) Fire safety and emergency procedures.
(b) If the staff member's duties include preparing food, they must have a food handler's certificate.
(c) All staff must receive a written description of their job responsibilities.
(3) CAREGIVER REQUIREMENTS AND TRAINING.
(a) The facility must have a training program that has a method to determine performance capability through a demonstration and evaluation process.
(b) The facility is responsible to assure that caregivers have demonstrated satisfactory performance in any duty they are assigned. Knowledge and performance must be demonstrated in all areas within the first 30 days of hire, including, but not limited to:
(A) The role of service plans in providing individualized resident care;
(B) Providing assistance with the activities of daily living;
(C) Changes associated with normal aging;
(D) Identification of changes in the resident's physical, emotional and mental functioning and documentation and reporting on the resident's changes of condition;
(E) Conditions that require assessment, treatment, observation and reporting;
(F) Understanding resident actions and behavior as a form of communication;
(G) Understanding and providing support for a person with dementia or related condition;
(H) General food safety, serving and sanitation; and
(I) If the caregiver's duties include the administration of medication or treatments, appropriate facility staff, in accordance with OAR 411-054-0055 (Medications and Treatments) must document that they have observed and evaluated the individual's ability to perform safe medication and treatment administration unsupervised.
(c) Prior to providing personal care services for resident, caregivers must receive an orientation to the resident, including the resident's service plan. Staff members must be directly supervised by a qualified person until they have successfully demonstrated satisfactory performance in any task assigned and the provision of individualized resident services, as applicable.
(d) Documentation must be maintained regarding training and demonstrated ability.
(e) All direct caregivers must complete and document a minimum of 12 hours of in-service training annually on topics related to the provision of care for persons in a community-based care setting, including training on chronic diseases in the facility population.
(f) Staff under 18 years of age must not perform medication administration or delegated nursing tasks. Staff under the age of 18 must be directly supervised when providing bathing, toileting, incontinence care or transferring services.
(g) Staff must be trained in the use of the abdominal thrust and First Aid. Cardiopulmonary resuscitation (CPR) training is recommended, but not required.
(h) Staff must have sufficient communication and language skills to enable them to perform their duties and communicate with residents, other staff, family members, health care professionals, etc., as needed.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0080
Involuntary Move-out Criteria
The Department of Human Services, Seniors and People with Disabilities Division encourages facilities to support a resident's choice to remain in his or her living environment while recognizing that some residents may no longer be appropriate for the community-based care setting due to safety and medical limitations.
(1) Information must be specified in the facility's disclosure information that describes the types of health, nursing, behavior and care services the facility is unable to provide. The minimum required services identified in OAR 411-054-0030 (Resident Services) must be provided before a resident can be asked to move-out. In addition, facilities that are indorsed under OAR chapter 411, division 057 (Indorsement of Alzheimer's Care Units) must provide services to support residents with the progressive symptoms of the disease.
(2) The facility must give written notification on form number SDS 0567 to the resident, the resident's legal representative and case manager, if applicable, when the facility requests a resident to move from the facility. The resident must be given 30 days advance written notice to move from the facility unless criteria in section (6) of this rule are met.
(3) The facility must demonstrate through service plan modification and documentation, attempts to resolve the reason for the move out.
(4) A resident may be asked to move from a facility if one or more of the following circumstances exists:
(a) The resident's needs exceed the level of ADL services the facility provides as specified in the facility's disclosure information;
(b) The resident engages in behavior or actions that repeatedly and substantially interferes with the rights, health, or safety of residents or others;
(c) The resident has a medical or nursing condition that is complex, unstable or unpredictable and exceeds the level of health services the facility provides as specified in the facility's disclosure information;
(d) The facility is unable to accomplish resident evacuation in accordance with OAR 411-054-0090 (Fire and Life Safety);
(e) The resident exhibits behavior that poses a danger to self or others;
(f) The resident engages in illegal drug use, or commits a criminal act that causes potential harm to the resident or others; or
(g) Non-payment of charges.
(5) The facility must fax a copy of the move-out notice to SPD's central office in Salem. Where a resident lacks capacity and there is no legal representative, a copy of the notice to move-out must be faxed to the State Long-Term Care Ombudsman who may request an informal conference and administrative hearing for the resident.
(6) LESS THAN 30-DAY NOTICE. The resident must be given 30 days advance written notice before being moved from the facility, except in the following unusual circumstances:
(a) A resident who leaves the facility to receive urgent medical or psychiatric care may return to the facility unless, at the time the resident is to return, facility staff have re-evaluated the resident's needs and have determined that the resident's needs cannot be met at the facility.
(A) An appropriate facility staff person must re-evaluate the resident's condition prior to determining that the facility cannot meet the resident's needs.
(B) A written notice on form number SDS 0568 must be given to the resident or the resident's legal representative on the date the facility makes its determination. The written notice will contain the specific reasons the facility is unable to meet the resident's needs, as determined by the facility's evaluation.
(C) If the resident or resident's designee requests an administrative hearing, the facility must hold the resident's room or unit and may charge room and board payment pending resolution of the administrative hearing.
(b) If the health or safety of the resident or others is in jeopardy and undue delay in moving the resident increases the risk of harm, the facility may give less than 30 days advance written notice on form number SDS 0568.
(A) SPD's central office in Salem must be consulted and alternatives reviewed prior to the resident receiving this notice.
(B) The resident is entitled to request an administrative hearing, as stated in section (7) of this rule.
(C) If the resident is moved out of the facility and requests an administrative hearing; the facility must hold the resident's room, without charge for room and board or services, pending resolution of the administrative hearing.
(c) The facility must fax a copy of the move-out notice to SPD's central office in Salem and the State Long-Term Care Ombudsman Office on the same day the notice is delivered to the resident or the resident's legal representative.
(7) ADMINISTRATIVE HEARING. Except when a facility has had its license revoked, not renewed, voluntarily surrendered, or terminates its Medicaid contract, a resident who receives an involuntary move-out notice is entitled to an administrative hearing, provided the resident or resident's designee requests a hearing in a timely manner.
(a) A resident who receives a 30-day notice to move has ten working days to request an administrative hearing after receipt of the notice. SPD's central office in Salem must be notified of all hearing requests.
(b) SPD's central office in Salem will notify the Office of Administrative Hearings of the resident's request for a formal administrative hearing.
(c) SPD may hold an informal conference to resolve the matter without a formal hearing. If a resolution is reached at the informal conference, no formal hearing will be held.
(d) A resident who is not allowed to return to the facility after receiving medical or psychiatric care, or who is immediately moved out of the facility to protect the health or safety of the resident or others, as specified in section (6) of this rule, has five working days to request an administrative hearing after receiving the move-out notice.
(A) SPD's central office in Salem must be notified by telephone or fax of a resident's request for hearing.
(B) When the resident is not allowed to remain in the facility, SPD's central office in Salem will request an expedited administrative hearing.
(e) The facility may not rent the resident's unit pending resolution of the administrative hearing.
(8) A resident who was admitted January 1, 2006 or later may be moved without advance notice if all of the following are met:
(a) The facility was not notified prior to admission that the resident is on probation, parole or post-prison supervision after being convicted of a sex crime; and
(b) The facility learns that the resident is on probation, parole or post-prison supervision after being convicted of a sex crime; and
(c) The resident presents a current risk of harm to another resident, staff or visitor in the facility, as evidenced by:
(A) Current or recent sexual inappropriateness, aggressive behavior of a sexual nature or verbal threats of a sexual nature; or
(B) Current communication from the State Board of Parole and Post-Prison Supervision, Department of Corrections or community corrections agency parole or probation officer that the individual's Static 99 score or other assessment indicates a probable sexual re-offense risk to others in the facility.
(d) Prior to the move, the facility must contact SPD's central office in Salem by telephone and review the criteria in sections (8)(c)(A) and (B) of this rule. SPD will respond within one working day of contact by the facility. The Department of Corrections parole or probation officer must be included in the review, if available. SPD will advise the facility if rule criteria for immediate move out are not met. DHS will assist in locating placement options.
(e) A written move-out notice must be completed on form number SDS 0568A. The form must be filled out in its entirety and a copy of the notice delivered in person, to the resident, or the resident's legal representative, if applicable. Where a person lacks capacity and there is no legal representative, a copy of the notice to move-out must be immediately faxed to the State Long Term Care Ombudsman.
(f) Prior to the move, the facility must orally review the notice and right to object with the resident or legal representative and determine if a hearing is requested. A request for hearing does not delay the involuntary move-out. The facility will immediately telephone SPD's central office in Salem when a hearing is requested. The hearing will be held within five business days of the resident's move. No informal conference will be held prior to the hearing.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0085
Refunds and Financial Management
(1) RESIDENT DEATH.
If a resident dies, the licensee may not require payment for more than 15 days,
or the time specified in the admission agreement, whichever is less, after the date
of the resident’s death.
(2) RESIDENT
UNABLE TO RETURN. If a resident must leave the facility for medical reasons and
the resident or the resident's representative indicates the intent not to return,
the facility may not charge the resident for more than 15 days after the date notification
is received from the resident or the resident's representative, or the time specified
in the admission agreement, whichever is less.
(a) If the
resident’s personal belongings are not removed from the facility within the
15-day timeframe, the facility may charge the resident as specified in the admission
agreement. However, the facility may not charge for more than 30 days after receiving
notification that the resident is unable to return.
(b) A reasonable
storage fee may be charged for storage of the resident’s belongings beyond
30 days if the admission agreement includes fees for storage.
(3) SUBSTANTIATED
ABUSE. If a resident dies or leaves a facility due to substantiated neglect, substantiated
abuse, or due to conditions of imminent danger of life, health, or safety, as substantiated
by the Department, the facility may not charge the resident beyond the resident's
last day in the facility.
(4) INVOLUNTARY
MOVE-OUT. If the facility gives written notice for the resident to leave, the facility
waives the right to charge for services or room and board beyond the date of the
resident’s departure. If applicable, the facility may pursue past due charges
that the resident incurred prior to move-out.
(5) REFUNDS.
The provider must refund any advance payments within 30 days after the resident
leaves the facility.
(6) RATE
INCREASES. The facility must provide 30 days written notice prior to any facility-wide
increases, additions, or changes.
(7) SERVICE
RATE INCREASES. The facility must provide immediate written notice to the resident
at the time the facility determines the resident’s service rates shall increase
due to increased service provision, as negotiated in the resident's service plan.
(8) MEDICAID
PERSONAL INCIDENTAL FUNDS. The facility must have written policies, procedures,
and accounting records for handling residents’ personal incidental funds that
are managed in the resident’s own best interest.
(a) The resident
may manage their personal financial resources, or may authorize another individual
or the facility to manage their personal incidental funds.
(b) The facility
must hold, manage, and account for the personal incidental funds of the resident
when requested in writing by the resident.
(c) Records
must include the Resident Account Record (SDS 713) or other comparable expenditure
form if the facility manages or handles a resident’s personal incidental funds.
(A) The resident
account record must show in detail, with supporting documentation, all monies received
on behalf of the resident and the disposition of all funds received.
(B) Individuals
shopping for residents must provide a list showing description and price of items
purchased, along with payment receipts for these items.
(C) The facility
must provide a copy of the individual Resident Account Record to the resident on
a quarterly basis.
(d) Resident
personal incidental fund accounts may not be co-mingled with facility funds.
(e) Residents
must have reasonable access to their personal incidental funds. At minimum, requests
to access personal incidental funds must be acted upon by the facility within one
day of the request, excluding weekends and holidays.
(f) Upon
the death of a Medicaid resident with no known surviving spouse, personal incidental
funds held by the facility for the resident must be forwarded within 10 business
days of the death of the resident to the Department of Human Services, Estate Administration
Unit, P.O. Box 14021, Salem OR 97309.
(g) The facility
must maintain documentation of the action taken and the amount of personal incidental
funds conveyed.
Stat. Auth.: ORS
410.070 & 443.450

Stats. Implemented:
ORS 443.400 - 443.455, 443.991

Hist.: SPD
14-2007, f. 8-31-07, cert. ef. 11-1-07; SPD 11-2012, f. 8-31-12, cert. ef. 9-1-12
411-054-0090
Fire and Life Safety
(1) FIRE DRILLS. All fire drills shall
be conducted according to the Oregon Fire Code (OFC).
(a) Unannounced fire drills
must be conducted and recorded every other month at different times of the day,
evening, and night shifts.
(b) Fire and life safety
instruction to staff must be provided on alternate months.
(c) The Fire Authority may
develop an alternative fire drill plan for the facility. Any such plan must be submitted
to the Department.
(d) A written fire drill
record must be kept to document fire drills that include:
(A) Date and time of day;
(B) Location of simulated
fire origin;
(C) The escape route used;
(D) Problems encountered
and comments relating to residents who resisted or failed to participate in the
drills;
(E) Evacuation time period
needed;
(F) Staff members on duty
and participating; and
(G) Number of occupants evacuated.
(e) Alternate exit routes
must be used during fire drills to react to varying potential fire origin points.
(f) The evacuation capability
of the residents and staff is a function of both the ability of the residents to
evacuate and the assistance provided by the staff.
(g) Staff must provide fire
evacuation assistance to residents from the building to a designated point of safety
as determined by the Fire Authority having jurisdiction. Points of safety may include,
outside the building, through a horizontal exit, or other areas as determined by
the Fire Authority having jurisdiction.
(h) The fire alarm system
shall be activated during each fire drill, unless otherwise directed by the Fire
Authority having jurisdiction.
(2) If the facility is unable
to meet the applicable evacuation level, the facility must make an immediate effort
to make changes to ensure the evacuation standard is met. Changes must include,
but not be limited to:
(a) Increasing staff levels,
(b) Changing staff assignments,
(c) Requesting change in
resident rooms, and
(d) Arranging for special
equipment.
After making necessary changes,
if the facility fails to meet the applicable evacuation level, the facility must
issue an involuntary move-out notice to the residents in accordance with OAR 411-054-0080.
(3) Fire detection and protection
equipment, including visual signals with alarms for hearing impaired residents,
must be maintained in accordance with the OFC and the manufacturer’s instructions.
(a) The facility must provide
and maintain one or more 2A:10B:C fire extinguishers on each floor in accordance
with the OFC.
(b) Flammable and combustible
liquids and hazardous materials must be safely and properly stored in original containers
in accordance with the fire authority having jurisdiction.
(4) SAFETY PROGRAM. A safety
program must be developed and implemented to avoid hazards to residents, such as
dangerous substances, sharp objects, unprotected electrical outlets, slippery floors
or stairs, exposed heating devices, broken glass, water temperatures, and fire prevention.
(5) TRAINING FOR RESIDENTS.
Residents must be instructed about the facility's fire and life safety procedures
per OFC.
(a) Each resident must be
instructed within 24 hours of admission and re-instructed, at least annually, in
general safety procedures, evacuation methods, responsibilities during fire drills,
and designated meeting places outside the building or within the fire safe area
in the event of an actual fire. This requirement does not apply to residents whose
mental capability does not allow for following such instruction.
(b) A written record of fire
safety training, including content of the training sessions and the residents attending,
must be kept.
(6) UNOBSTRUCTED EGRESS.
Stairways, halls, doorways, passageways, and exits from rooms and the building must
be unobstructed.
(7) FIRST AID SUPPLIES. First
aid supplies must be provided, properly labeled, and readily accessible.
Stat. Auth.: ORS 410.070 & 443.450
Stats. Implemented: ORS 443.400
- 443.455, 443.991
Hist.: SPD 14-2007, f. 8-31-07,
cert. ef. 11-1-07; SPD 13-2009, f. 9-30-09, cert. ef. 10-1-09; APD 1-2015, f. 1-14-15,
cert. ef. 1-15-15
411-054-0093
Emergency and Disaster Planning
An emergency preparedness plan is a
written procedure that identifies a facility's response to an emergency or disaster
for the purpose of minimizing loss of life, mitigating trauma, and to the extent
possible, maintaining services for residents, and preventing or reducing property
loss.
(1) The facility must prepare
and maintain a written emergency preparedness plan in accordance with the OFC.
(2) The emergency preparedness
plan must:
(a) Include analysis and
response to potential emergency hazards, including, but not limited to:
(A) Evacuation of a facility;
(B) Fire, smoke, bomb threat,
and explosion;
(C) Prolonged power failure,
water, and sewer loss;
(D) Structural damage;
(E) Hurricane, tornado, tsunami,
volcanic eruption, flood, and earthquake;
(F) Chemical spill or leak;
and
(G) Pandemic.
(b) Address the medical needs
of the residents, including:
(A) Access to medical records
necessary to provide services and treatment; and
(B) Access to pharmaceuticals,
medical supplies, and equipment during and after an evacuation.
(c) Include provisions and
supplies sufficient to shelter in place for a minimum of three days without electricity,
running water, or replacement staff.
(3) The facility must notify
the Department, the local AAA office, or designee, of the facility's status in the
event of an emergency that requires evacuation and during any emergent situation
when requested.
(4) The facility must conduct
a drill of the emergency preparedness plan at least twice a year in accordance with
the OFC and other applicable state and local codes as required. One of the practice
drills may consist of a walk-through of the duties or a discussion exercise with
a hypothetical event, commonly known as a tabletop exercise. These simulated drills
may not take the place of the required fire drills.
(5) The facility must annually
review or update the emergency preparedness plan as required by the OFC and the
emergency preparedness plan must be available on-site for review upon request.
Stat. Auth.: ORS 410.070 & 443.450
Stats. Implemented: ORS 443.400
- 443.455, 443.991 & OL 2007 Ch. 205
Hist.: SPD 14-2007, f. 8-31-07,
cert. ef. 11-1-07; SPD 13-2009, f. 9-30-09, cert. ef. 10-1-09; SPD 11-2012, f. 8-31-12,
cert. ef. 9-1-12; APD 1-2015, f. 1-14-15, cert. ef. 1-15-15
411-054-0100
Exceptions and Waivers
(1) SPD may grant exceptions to these rules as provided herein. Exceptions will not be granted that are determined, in the discretion of SPD, to be detrimental to the residents. The facility seeking an exception must submit to SPD, in writing, reasons for the exception request.
(2) No exception will be granted from a regulation or provision of these rules pertaining to the monitoring of the facility, resident rights, and inspection of the public files.
(3) Exceptions granted by SPD must be in writing and be reviewed periodically. Exceptions and waivers may be rescinded at any time if SPD determines that continuance of the waiver has a potential adverse impact on resident well-being, privacy, or dignity. SPD will send written notice to the provider with reason(s) why a waiver is denied or rescinded.
(4) If applicable, exceptions will not be granted by SPD without prior consultation with other agencies involved.
(5) For assisted living facilities: an individual exception is required for each resident who chooses to share a unit with someone other than his/her spouse or partner.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0105
Inspections and Investigations
(1) The facility must cooperate with Division personnel in inspections, complaint investigations, planning for resident care, application procedures, and other necessary activities.
(a) Records must be made available to the Division upon request. Division personnel must have access to all resident and facility records and may conduct private interviews with residents. Failure to comply with this requirement shall result in regulatory action.
(b) The State Long Term Care Ombudsman must have access to all resident and facility records that relate to an investigation. Certified Ombudsman volunteers may have access to facility records that relate to an investigation and access to resident records with written permission from the resident or guardian.
(c) The State Fire Marshal or authorized representative must be permitted access to the facility and records pertinent to resident evacuation and fire safety.
(2) Staff of the Division shall visit and inspect every facility at least but not limited to once every two years to determine whether the facility is maintained and operated in accordance with these rules.
(a) Facilities not in compliance with these rules must submit, within ten days of receipt of the inspection report, a plan of correction that satisfies the Division.
(b) The Division may impose sanctions for failure to comply with these rules.
(3) Division staff may consult with and advise the facility administrator concerning methods of care, records, housing, equipment, and other areas of operation.
(4) A copy of the most current inspection report and any conditions placed upon the license must be posted with the facility’s license in public view near the main entrance to the facility.
(5) COMPLAINT INVESTIGATIONS. The Division, through the Division's local offices, shall provide, by written communication or email, a copy of the investigation report to the licensee and complainant within seven working days of the completion of the investigation.
(a) The investigation report shall be accompanied by a notice informing the licensee of the right to provide additional information about the content of the report to the local office within 10 calendar days of receipt of the report.
(b) The Division's local office must review the licensee's responses and reopen the investigation or amend the report if the additional evidence warrants a change.
(6) ABUSE OR RULE VIOLATION. Upon completion of substantiation of abuse or rule violation, the Division shall immediately provide written notification to the facility.
(a) WRITTEN NOTICE. The written notice shall:
(A) Explain the nature of each allegation;
(B) Include the date and time of each occurrence;
(C) For each allegation, include a determination of whether the allegation is substantiated, unsubstantiated, or inconclusive;
(D) For each substantiated allegation, state whether the violation was abuse or another rule violation;
(E) Include a copy of the complaint investigation report;
(F) State that the complainant, any person reported to have committed wrongdoing, and the facility have 15 days to provide additional or different information; and
(G) For each allegation, explain the applicable appeal rights available.
(b) APPORTIONMENT. If the Division determines there is substantiated abuse, the Division may determine that the facility, an individual, or both the facility and an individual are responsible for the abuse. In determining responsibility, the Division shall consider intent, knowledge and ability to control, and adherence to professional standards as applicable.
(A) FACILITY. Examples of when the Division shall determine the facility is responsible for the abuse include but are not limited to:
(i) Failure to provide minimum staffing in accordance with these rules without reasonable effort to correct;
(ii) Failure to check for or act upon relevant information available from a licensing board;
(iii) Failure to act upon information from any source regarding a possible history of abuse by any staff or prospective staff;
(iv) Failure to adequately provide oversight, training, or orientation of staff;
(v) Failure to allow sufficient time to accomplish assigned tasks;
(vi) Failure to provide adequate services;
(vii) Failure to provide adequate equipment or supplies; or
(viii) Failure to follow orders for treatment or medication.
(B) INDIVIDUAL. Examples of when the Division shall determine the individual is responsible for the abuse include but are not limited to:
(i) Intentional acts against a resident including assault, rape, kidnapping, murder, sexual abuse, or verbal or mental abuse;
(ii) Acts contradictory to clear instructions from the facility, unless the act is determined by the Division to be caused by the facility as identified in paragraph (A) above;
(iii) Callous disregard for resident rights or safety; or
(iv) Intentional acts against a resident's property (e.g., theft, misuse of funds).
(C) An individual may not be considered responsible for the abuse if the individual demonstrates the abuse was caused by factors beyond the individual's control. "Factors beyond the individual's control" are not intended to include such factors as misuse of alcohol or drugs or lapses in sanity.
(c) DUE PROCESS RIGHTS.
(A) NON-NURSING ASSISTANT. The written notice in cases of substantiated abuse by a person other than a nursing assistant shall explain the person’s right to:
(i) File a petition for reconsideration pursuant to OAR 137-004-0080; and
(ii) Petition for judicial review pursuant to ORS 183.484.
(B) NURSING ASSISTANT. The written notice in cases of substantiated abuse by a nursing assistant shall explain:
(i) The Division's intent to enter the finding of abuse into the Nursing Assistant Registry following the procedure set out in OAR 411-089-0140; and
(ii) The nursing assistant’s right to provide additional information and request a contested case hearing as provided in OAR 411-089-0140.
(C) FACILITY. The written notice shall advise the facility of the facility's due process rights as appropriate.
(d) DISTRIBUTION.
(A) The written notice shall be mailed to the facility, any person reported to have committed wrongdoing, the complainant (if known), and the Division or Type B AAA office; and
(B) A copy of the written notice shall be placed in the Division's facility complaint file.
(7) Upon receipt of a notice of abuse for victims covered by ORS 430.735, the facility shall provide written notice of the findings to the person found to have committed abuse, the residents of the facility, the residents’ case managers, and the residents’ guardians.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07; SPD 16-2008, f. 12-31-08, cert. ef. 1-1-09; SPD 23-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10; SPD 10-2010, f. 6-30-10, cert. ef. 7-1-10
411-054-0110
Conditions
(1) Conditions may be attached to a license upon a finding that:
(a) Information on the application or inspection requires a condition to protect the health and safety of residents;
(b) There exists a threat to the health, safety, and welfare of a resident;
(c) There is reliable evidence of abuse, neglect, or exploitation; or
(d) The facility is not being operated in compliance with these rules.
(2) Conditions that may be imposed on a licensee include, but are not limited to:
(a) Restricting the total number of residents;
(b) Restricting the number and impairment level of residents based upon the capacity of the licensee and staff to meet the health and safety needs of all residents;
(c) Requiring additional staff or staff qualifications;
(d) Requiring additional training for staff;
(e) Requiring additional documentation; or
(f) Restriction of admissions.
(3) IMPENDING IMPOSITION OF LICENSE CONDITION. Except where the threat to residents is so imminent that SPD determines that it is not safe or practical to give the facility advance notice, SPD will provide the licensee with a Notice of Impending Imposition of License Condition (Notice) at least 48 hours prior to issuing an Order Imposing License Condition (Order). The Notice may be provided in writing, sent by certified or registered mail to the licensee, or provided orally in person or by telephone to the licensee or to the person represented by facility staff to be in charge at the facility. When the Notice is delivered orally, SPD must subsequently provide written notice to the licensee by registered or certified mail. The Notice must:
(a) Generally describe the acts or omissions of the licensee and the circumstances that led to the finding that the imposition of a license condition is warranted;
(b) Generally describe why the acts or omissions and the circumstances create a situation for which the imposition of a condition is warranted;
(c) Provide a brief statement identifying the nature of the impending condition;
(d) Identify a person at SPD whom the licensee may contact and who is authorized to enter the Order or to make recommendations regarding issuance of the Order;
(e) Specify the date and time an informal conference will be held, if requested by the licensee; and
(f) Specify the date and time the Order will take effect.
(4) INFORMAL CONFERENCE. If an informal conference is requested, the conference will be held at a location designated by SPD. If determined to be appropriate by SPD, the conference may be held by telephone.
(a) With Notice. If a Notice is issued, the licensee must be provided with an opportunity for an informal conference to object to SPD's proposed action before the condition is scheduled to take effect. The Order Imposing License Condition may be issued at any time after the informal conference.
(b) Without Notice. If an Order is issued without a prior Notice, the licensee may request an immediate informal conference to object to SPD's action.
(c) Licensees may also request a contested case hearing as set forth in section (5) of this rule.
(5) ORDER IMPOSING LICENSE CONDITION. When an Order is issued, SPD must serve the Order to the licensee either personally or by registered or certified mail. The Order must include the following statements:
(a) The authority and jurisdiction under which the condition is being issued;
(b) A reference to the particular sections of the statute and administrative rules involved;
(c) The effective date of the condition;
(d) A short and plain statement of the nature of the matters asserted or charged;
(e) The specific terms of the license condition;
(f) Statement of the licensee's right to request a hearing;
(g) That the licensee may elect to be represented by counsel and to respond and present evidence and argument on all issues involved. If the licensee is to be represented by counsel, the licensee must notify SPD;
(h) That, if a request for hearing is not received by SPD within 21 days of the date of the Order, the licensee will have waived the right to a hearing under ORS Chapter 183;
(i) Findings of specific acts or omissions of the licensee that are grounds for the condition, and the reasons these acts or omissions create a situation for which the imposition of a license condition is warranted; and
(j) That SPD may combine the hearing on the Order with any other SPD proceeding affecting the licensee. The procedures for the combined proceeding must be those applicable to the other proceedings affecting the license.
(6) A licensee who has been ordered to restrict admissions to a facility must immediately post a "Restriction of Admissions Notice" that is provided by SPD, on both the inside and outside faces of each door of the facility through which any person enters or exits a facility. The notices must not be removed, altered or obscured until SPD has lifted the restriction.
(7) HEARING.
(a) Right to Hearing. If SPD imposes an Order, the licensee is entitled to a contested case hearing pursuant to ORS Chapter 183.
(b) Hearing Request. SPD must receive the licensee's request for a hearing within 21 days of the date of Order. If a request for hearing is not received by SPD within 21 days of the date of the Order, the licensee will have waived the right to a hearing under ORS Chapter 183.
(c) Date of Hearing. When a timely request for hearing is received, the hearing will be held as soon as practical.
(8) REQUEST FOR REINSPECTION. When the licensee determines the circumstances leading to imposition of the condition no longer exist, and that effective systems are in place to help ensure similar deficiencies do not recur, the licensee may make written request to SPD for a reinspection. SPD must conduct the reinspection within fifteen working days following receipt of the written request.
(9) REINSPECTION.
(a) If SPD finds that the situation for which the condition was imposed has been corrected, and finds that systems are in place to ensure similar deficiencies do not recur, the condition will be withdrawn. SPD will notify the facility by telephone, within five working days from the completion of the reinspection, of the decision to withdraw the condition. Telephone notification will be followed by written notification.
(b) If SPD determines, after a reinspection, that the situation for which the condition was imposed continues to exist, the license condition will not be withdrawn and SPD is not obligated to reinspect again for at least 45 days. A decision not to withdraw the Order must be given to the licensee in writing and the licensee must be informed of the right to a contested case hearing pursuant to ORS Chapter 183. Nothing in this rule is intended to limit SPD's authority to visit or inspect the facility at any time.
(10) EXCEPTIONS TO ORDER IMPOSING LICENSE CONDITION. When a restriction of admissions is in effect pursuant to an Order, SPD, in its sole discretion, may authorize the facility to admit new residents for whom SPD determines that alternate placement is not feasible.
(11) Conditions may be imposed for the duration of the licensure period (two years) or limited to some other shorter period of time. If the condition corresponds to the licensing period, the reasons for the condition will be considered at the time of renewal to determine if the conditions are still appropriate. The effective date and expiration date of the condition will be indicated on the attachment to the license.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0120
Civil Penalties
(1) For purposes of imposing civil penalties,
facilities licensed under ORS 443.400 to 443.455 and subsection (2) of ORS 443.991
are considered to be long-term care facilities subject to ORS 441.705 to 441.745.
(2) For purposes of this
rule, "person" means a licensee under ORS 443.420 or a person who the Assistant
Director of the Department finds shall be so licensed but is not, but does not include
any employee of such licensee or person.
(3) For purposes of this
rule, "resident rights" means that each resident must be assured the same civil
and human rights accorded to other citizens as described in OAR 411-054-0027.
(4) The Department shall
exercise the powers under ORS 441.705 to 441.745 and thereby issues the following
schedule of penalties applicable to residential care and assisted living facilities:
(a) A Class I violation exists
when there is non-compliance involving direct resident care or feeding, adequate
staff, or sanitation involving direct resident care or resident rights.
(b) The Department shall
impose a civil penalty of not less than $2,500 for each occurrence of substantiated
abuse that resulted in the death, serious injury, rape, or sexual abuse of a resident.
The civil penalty may not exceed $15,000 in any 90-day period.
(A) To impose this civil
penalty, the Department shall establish that:
(i) The abuse arose from
deliberate or other than accidental action or inaction;
(ii) The conduct resulting
in the abuse was likely to cause death, serious injury, rape, or sexual abuse of
a resident; and
(iii) The person substantiated
for the abuse had a duty of care toward the resident.
(B) For the purposes of this
civil penalty, the following definitions apply:
(i) "Serious injury" means
a physical injury that creates a substantial risk of death or that causes serious
disfigurement, prolonged impairment of health, or prolonged loss or impairment of
the function of any bodily organ.
(ii) "Rape" means rape in
the first, second, or third degree as described in ORS 163.355, 163.365, and 163.375.
(iii) "Sexual Abuse" means
abuse as defined under ORS 443.455.
(iv) "Other than accidental"
means failure on the part of the licensee, or licensee's employees, agents, or volunteers
for whose conduct the licensee is responsible, to comply with applicable Oregon
Administrative Rules.
(c) A Class II violation
exists when there is non-compliance with the license requirements relating to a
license required, the license requirements relating to administrative management,
or personal care services and activities. Class II violations may result in imposition
of a fine for violations found on two consecutive monitorings of the facility.
(d) A Class III violation
exists when there is non-compliance with the license requirements relating to building
requirements and resident furnishings. Class III violations may result in imposition
of a fine for violations found on two consecutive monitorings of the facility.
(5) For purposes of this
rule, a monitoring occurs when a residential care or assisted living facility is
surveyed, inspected, or investigated by an employee or designee of the Department
or an employee or designee of the State Fire Marshal.
(6) In imposing a penalty
pursuant to section (4) of this rule, the Assistant Director of the Department shall
consider the following factors:
(a) The past history of the
person incurring a penalty in taking all feasible steps or procedures necessary
or appropriate to correct any violation;
(b) Any prior violations
of statutes or rules pertaining to residential care or assisted living facilities;
(c) The economic and financial
conditions of the person incurring the penalty; and
(d) The immediacy and extent
the violation threatens the health, safety, and well being of residents.
(7) Any civil penalty imposed
under ORS 443.455 and 441.710 shall become due and payable when the person incurring
the penalty receives a notice in writing from the Assistant Director of the Department.
The notice shall be sent by registered or certified mail and shall include:
(a) A reference to the particular
sections of the statute, rule, standard, or order involved;
(b) A short and plain statement
of the matters asserted or charged;
(c) A statement of the amount
of the penalty or penalties imposed; and
(d) A statement of the party's
right to request a hearing.
(8) The person to whom the
notice is addressed shall have 10 days from the date of postmark to make written
application for a hearing before the Department.
(9) All hearings shall be
conducted pursuant to the applicable provisions of ORS chapter 183.
(10) If the person notified
fails to request a hearing within 10 days, an order may be entered by the Department
assessing a civil penalty.
(11) If, after a hearing,
the person is found to be in violation of a license, rule, or order listed in ORS
441.710(1), an order may be entered by the Department assessing a civil penalty.
(12) A civil penalty imposed
under ORS 443.455 or 441.710 may be remitted or reduced upon such terms and conditions
as the Assistant Director of the Department considers proper and consistent with
the public health and safety.
(13) If the order is not
appealed, the amount of the penalty is payable within 10 days after the order is
entered. If the order is appealed and is sustained, the amount of the penalty is
payable within 10 days after the court decision. The order, if not appealed or sustained
on appeal, shall constitute a judgment and may be filed in accordance with the provisions
of ORS 18.005 to 18.428. Execution may be issued upon the order in the same manner
as execution upon a judgment of a court of record.
(14) A violation of any general
order or final order pertaining to a residential care or assisted living facility
issued by the Assistant Director of the Department is subject to a civil penalty
in the amount of not less than $5 and not more than $500 for each and every violation.
(15) Judicial review of civil
penalties imposed under ORS 441.710 shall be as provided under ORS 183.480, except
that the court may, in its discretion, reduce the amount of the penalty.
(16) All penalties recovered
under ORS 443.455 and 441.710 to 441.740 shall be paid to the Quality Care Fund.
Stat. Auth.: ORS 410.070 & 443.450
Stats. Implemented: ORS 441.705
- 441.745, 443.400 - 443.455 & 443.991
Hist.: SPD 14-2007, f. 8-31-07,
cert. ef. 11-1-07; SPD 23-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10;
SPD 10-2010, f. 6-30-10, cert. ef. 7-1-10; APD 3-2015(Temp), f. & cert. ef.
1-29-15 thru 7-27-15; APD 14-2015, f. 6-24-15, cert. ef. 6-28-15
411-054-0130
Non-Renewal, Denial, Suspension or Revocation of License
(1) SPD may deny, suspend, revoke, or refuse to renew a license under the following conditions:
(a) Where SPD finds there has been substantial failure to comply with these rules;
(b) Where the State Fire Marshal or authorized representative certifies there is failure to comply with all applicable ordinances and rules relating to safety from fire;
(c) If the licensee fails to implement a plan of correction or comply with a final order of SPD imposing an administrative sanction, including the imposition of a civil penalty;
(d) Failure to disclose requested information on the application or provision of incomplete or incorrect information on the application;
(e) Where imminent danger to the health or safety of residents exists;
(f) Abandonment of facility operation;
(g) Loss of physical possession of the premise;
(h) Loss of operational control of the facility; or
(i) Appointment of a receiver, trustee, or other fiduciary by court order.
(2) Such revocation, suspension, denial, or non-renewal shall be done in accordance with the rules of SPD and ORS Chapter 183.
(3) Nothing in this rule is intended to preclude SPD from taking other regulatory action on a suspended licensee for violation of the licensing regulations in these rules.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07; SPD 13-2009, f. 9-30-09, cert. ef. 10-1-09
411-054-0133
Temporary Manager
(1) APPOINTMENT. The Division, with the consent of the licensee, may appoint a temporary manager to assume control of the day-to-day operation of the facility in accordance with Oregon Laws 2009, chapter 539, sections 14 through 18. The appointment may be for a period not to exceed six months.
(2) CRITERIA. A temporary manager may be appointed if the Division determines that the health or safety of residents in the facility are, or in the immediate future shall be, in jeopardy based upon:
(a) The licensee’s unwillingness or inability to comply with Department rules in the operation of the facility;
(b) The imminent insolvency of the facility;
(c) The Division's revocation or suspension of the license of the facility; or
(d) The Division's determination that the licensee intends to cease operations and to close the facility without adequate arrangements for the relocation of the residents.
(3) DUTIES AND POWERS. The temporary manager has all of the duties and powers, as agreed upon between the Division and the licensee that are necessary to ensure the safety and well-being of the residents and the continued operation of the facility.
(4) QUALIFICATIONS. In order to qualify for appointment as temporary manager, the prospective appointee must:
(a) Be, or employ a person who is, qualified to serve as administrator for the type of facility being served;
(b) Be familiar with the Division’s rules for the operation of the facility to be served;
(c) Be familiar with the needs of the resident population in the facility to be served; and
(d) Have a demonstrated history (five year minimum) of operating and managing a similar facility in substantial compliance with Department rules.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 to 443.455 & 443.991

Hist.: SPD 23-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10; SPD 10-2010, f. 6-30-10, cert. ef. 7-1-10
411-054-0135
Criminal Penalties
(1) Violation of any provision of ORS 443.400 to 443.455 is a Class B misdemeanor.
(2) Violation of any provision of ORS 443.881 is a Class C misdemeanor.
Stat. Auth.: ORS 443.455

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07
411-054-0140
Additional Authority
SPD may commence a suit in equity to enjoin operation of a facility when:
(1) A facility is operated without a valid license; or
(2) Notice of revocation has been given and a reasonable time has been allowed for placement of individuals in other facilities.
Stat. Auth.: ORS 410.070 & 443.450

Stats. Implemented: ORS 443.400 - 443.455, 443.991

Hist.: SPD 14-2007, f. 8-31-07, cert. ef. 11-1-07

Residential Care Facility Building Requirements

411-054-0200
Residential Care Facility Building Requirements
A residential care facility (RCF), as
defined by OAR 411-054-0005, shall be built to the following requirements and may
have individual or shared living units.
(1) Applicability for 411-054-0200
shall apply to the following;
(a) A RCF not licensed prior
to 01/15/2015,with the exception of 411-054-0200 (5)(a) related to lockable doors
. This will apply to all existing and new construction on the effective date as
indicated.
(b) A major alteration to
a RCF for which plans were not submitted to Facilities, Planning, and Safety (FPS)
prior to 01/15/2015; or
(c) OAR 411-054-0200 shall
apply only to the major alteration and shall not apply to any other area of the
facility.
(2) BUILDING CODES. Each
RCF must meet the requirements of the facility standards set forth in these rules
and with the building codes in effect at the time of original licensure.
(a) Subsequent modifications
made to a RCF after original licensure, including, but not limited to demolition,
remodeling, construction, maintenance, repair, or replacement must comply with all
applicable state and local building, electrical, plumbing, and zoning codes in place
at the time of the modification.
(b) If a change in use and
building code occupancy classification occurs, license approval shall be contingent
on meeting the requirements of the building codes.
(c) A RCF must comply with
FPS program requirements for submission of building drawings and specifications
as described in OAR 333-675-0000 through 333-675-0050.
(3) GENERAL BUILDING EXTERIOR.
(a) All exterior pathways
and accesses to the RCF common- use areas, entrance, and exit ways must be made
of hard, smooth material, be accessible, and maintained in good repair.
(b) A RCF must take measures
to prevent the entry of rodents, flies, mosquitoes, and other insects. There must
be locked storage for all poisons, chemicals, rodenticides, and other toxic materials.
All materials must be properly labeled.
(c) RCF grounds must be kept
orderly and free of litter and refuse. Garbage must be stored in covered refuse
containers.
(d) As described in OAR 411,
division 057, memory care communities licensed as a RCF must be located on the ground
floor.
(e) A RCF must provide storage
for all maintenance equipment, including yard maintenance tools, if not provided
by a third party contract.
(f) A RCF must provide an
accessible outdoor recreation area. The outdoor recreation area must be available
to all residents. Lighting must be equal to a minimum of five foot candles. Memory
Care Communities must provide residents with direct access to a secure outdoor recreation
area as described in OAR chapter 411, division 057.
(g) Outdoor perimeter fencing
may not be secured to prevent exit unless the RCF has written approval from the
Department or the RCF is in compliance with OAR chapter 411, division 057 (Memory
Care Communities) or OAR 309-032-1500 through 309-032-1565(Enhanced Care Services).
(h) A RCF must have an entry
and exit drive to and from the main building entrance that allows for a vehicle
to pick up and drop off residents and mail deliveries without the need for vehicles
to back up.
(4) GENERAL BUILDING INTERIOR.
The design of a RCF must emphasize a residential appearance while retaining the
features required to support special resident needs as outlined in this rule.
(a) RECEPTION AREA. A reception
area must be visible and accessible to residents and visitors when entering the
doors of the main entrance to the RCF.
(b) CORRIDORS. Resident-use
areas and units must be connected through temperature controlled common corridors.
(A) Resident-use corridors
exceeding 20 feet in length to an exit or common-use area, must have a minimum width
of 72 inches.
(B) Corridors shall not exceed
150 feet in length from any resident unit to a seating or other common-use area.
(C) Handrails must be installed
at one or both sides of resident-use corridors.
(c) FLOORS.
(A) Hard surface floors and
base must be free from cracks and breaks.
(B) Carpeting and other floor
materials must be constructed and installed to minimize resistance for passage of
wheelchairs and other ambulation aids.
(C) Thresholds and floor
junctures must be maintained to allow for the passage of wheelchairs and to prevent
a tripping hazard.
(d) INTERIOR DOORS. Lever-type
door handles must be provided on all doors used by residents.
(e) EXIT DOORS. Exit doors
may not include locks that delay evacuation except as specified by the building
codes. Such locks may not be installed except with written approval of the Department.
(A) Exit doors may not include
locks that prevent evacuation.
(B) If an electronic code
must be entered to use an exit door that code must be clearly posted for residents,
visitors, and staff use.
(f) WALLS AND CEILINGS. Walls
and ceilings must be cleanable in kitchen, laundry, and bathing areas. Kitchen walls
must be finished smooth per OAR 333-150-0000 (Food Sanitation Rules).
(g) ELEVATORS. A RCF with
residents on more than one floor must provide at least one elevator that meets Oregon
Elevator Specialty Code (OESC) requirements.
(h) The interior of the facility
must be free from unpleasant odors.
(i) All interior and exterior
materials and surfaces (e.g., floors, walls, roofs, ceilings, windows, and furniture)
and all equipment necessary for the health, safety, and comfort of the resident
will be kept clean and in good repair.
(5) RESIDENT UNITS. Resident
units may be limited to a bedroom only, with bathroom facilities centrally located
off common corridors. Each resident unit shall be limited to not more than two residents.
(a) Resident units must have
a lockable door with lever type handles, effective 01/15/2017. This applies to all
existing and new construction.
(b) For bedroom units, the
door must open to an indoor, temperature controlled common-use area or common corridor.
Residents may not enter a room through another resident's bedroom.
(c) Resident units must include
a minimum of 80 square feet per resident, exclusive of closets, vestibules, and
bathroom facilities and allow for a minimum of three feet between beds;
(d) All resident bedrooms
must be accessible for individuals with disabilities and meet the requirements of
the building codes. Adaptable units are not acceptable.
(e) A lockable storage space
(e.g., drawer, cabinet, or closet) must be provided for the safekeeping of a resident’s
small valuable items and funds. Both the administrator and resident may have keys.
(f) WARDROBE CLOSET. A separate
wardrobe closet must be provided for each resident's clothing and personal belongings.
Resident wardrobe and storage space must total a minimum volume of 64 cubic feet
for each resident. The rod must be adjustable for height or fixed for reach ranges
per building codes. In calculating useable space closet height may not exceed eight
feet and a depth of two feet.
(g) WINDOWS.
(A) Each sleeping and living
unit must have an exterior window that has an area at least one tenth of the floor
area of the room.
(B) Unit windows must be
equipped with curtains or blinds for privacy and control of sunlight.
(C) Operable windows must
be designed to prevent accidental falls when sill heights are lower than 36 inches
and above the first floor.
(h) RESIDENT UNIT BATHROOMS.
If resident bathrooms are provided within a resident unit, the bathroom must be
a separate room and include a toilet, hand wash sink, mirror, towel bar, and storage
for toiletry items. The bathrooms must be accessible for individuals who use wheelchairs.
(i) UNIT KITCHENS. If cooking
facilities are provided in resident units, cooking appliances must be readily removable
or disconnect-able and the RCF must have and carry out a written safety policy regarding
resident-use and nonuse. A microwave is considered a cooking appliance.
(6) COMMON-USE AREAS.
(a) BATHING FACILITIES. Centralized
bathing fixtures must be provided at a minimum ratio of one tub or shower for each
ten residents not served by fixtures within their own unit.
(A) At least one centralized
shower or tub must be designed for disabled access without substantial lifting by
staff.
(B) Bathing facilities must
be located or screened to allow for resident privacy while bathing and provide adequate
space for an attendant.
(C) A slip-resistant floor
surface in bathing areas is required.
(D) Grab bars must be provided
in all resident showers.
(E) Showers must be equipped
with a hand-held showerhead and a cleanable shower curtain.
(b) TOILET FACILITIES. Toilet
facilities must be located for resident-use at a minimum ratio of one to six residents
for all residents not served by toilet facilities within their own unit. Toilet
facilities must include a toilet, hand wash sink, and mirror.
(A) Toilet facilities for
all of the licensed resident capacity must be accessible to individuals with disabilities
in accordance with the building codes.
(B) A RCF licensed for more
than 16 residents must provide at least one separate toilet and hand wash lavatory
for staff and visitor use.
(c) DINING AREA. The dining
area must be provided with the capacity to seat 100 percent of the residents. The
dining area must provide a minimum of 22 square feet per resident for seating, exclusive
of serving carts and other equipment or items that take up space in the dining area.
A RCF must have policies and equipment to assure food is served fresh and at proper
temperatures.
(d) SOCIAL AND RECREATION
AREAS. A RCF must include lounge and activity areas for social and recreational
use totaling a minimum of 15 square feet per resident.
(e) COOKING STOVE. If a stove
is provided in the activities or common-use area, and is available for resident-use,
a keyed, remote switch, or other safety device must be provided to ensure staff
control.
(7) SUPPORT SERVICE AREAS.
(a) MEDICATION STORAGE. A
RCF must have a locked and separate closed storage area for medications, supportive
of the distribution system utilized including:
(A) A method for refrigeration
of perishable medications that provides for locked separation from stored food items;
(B) Medications must be stored
in an area that is separate from any poisons, hazardous material, or toxic substance;
and
(C) A RCF licensed for more
than 16 residents must provide a medication sink.
(b) HOUSEKEEPING AND SANITATION.
(A) A RCF must have a secured
janitor closet for storing supplies and equipment, with a floor or service sink.
(B) The wall base shall be
continuous and coved with the floor, tightly sealed to the wall, and constructed
without voids that can harbor insects or moisture.
(c) LAUNDRY FACILITIES. Laundry
facilities may be located to allow for both resident and staff use, when a time
schedule for resident-use is provided and equipment is of residential type. When
the primary laundry is not in the building or suitable for resident-use, a RCF must
provide separate resident-use laundry facilities.
(A) Laundry facilities must
be operable and at no additional cost to the resident.
(B) Laundry facilities must
have space and equipment to handle laundry-processing needs. Laundry facilities
must be separate from food preparation and other resident-use areas.
(C) On-site laundry facilities,
used by staff for facility and resident laundry, must have capacity for locked storage
of chemicals and equipment.
(D) The wall base shall be
continuous and coved with the floor, tightly sealed to the wall, and constructed
without voids that can harbor insects or moisture.
(d) SOILED LINEN PROCESSING.
For the purpose of this rule, "soiled linens and soiled clothing," means linens
or clothing contaminated by an individual’s bodily fluids (for example, urine,
feces, or blood).
(A) There must be a separate
area with closed containers that ensure the separate storage and handling of soiled
linens and soiled clothing. There must be space and equipment to handle soiled linen
and soiled clothing processing needs that is separate from regular linens and clothing.
(B) Arrangement must provide
a one-way flow of soiled linens and soiled clothing from the soiled area to the
clean area and preclude potential for contamination of clean linens and clothing.
(C) The soiled linen room
or area, must include a flushing rim clinical sink with a handheld rinsing device
and a hand wash sink or lavatory.
(D) When washing soiled linens
and soiled clothing, washers must have a minimum rinse temperature of 140 degrees
Fahrenheit unless a chemical disinfectant is used.
(E) Personnel handling soiled
laundry must be provided with waterproof gloves.
(F) Covered or enclosed clean
linen storage must be provided and may be on shelves or carts. Clean linens may
be stored in closets outside the laundry area.
(G) The wall base shall be
continuous and coved with the floor, tightly sealed to the wall, and constructed
without voids that can harbor insects or moisture.
(e) KITCHEN AND FOOD STORAGE.
Kitchen facilities and equipment in residential care facilities with a capacity
of 16 or fewer may be of residential type except as required by the building codes.
Residential care facilities licensed for a capacity of more than 16, must comply
with OAR 333-150-0000 (Food Sanitation Rules). The following are required:
(A) Dry storage space, not
subject to freezing, for a minimum one-week supply of staple foods.
(B) Refrigeration and freezer
space at proper temperature to store a minimum two days' supply of perishable foods.
(C) Storage for all dishware,
utensils, and cooking utensils used by residents must meet OAR 333-150-0000 (Food
Sanitation Rules).
(D) In facilities licensed
to serve 16 or fewer residents, a dishwasher must be provided (may be residential
type) with a minimum final rinse temperature of 140 degrees Fahrenheit (160 degrees
recommended), unless a chemical disinfectant is used in lieu of the otherwise required
water temperature. In facilities of 17 or more capacity, a commercial dishwasher
is required meeting OAR 333-150-0000 (Food Sanitation Rules).
(E) In residential care facilities
with a capacity of 16 or fewer, a two compartment sink or separate food preparation
sink and hand wash lavatory must be provided. In residential care facilities with
17 or more capacity, a triple pot wash sink (unless all pots are sanitized in the
dishwasher), a food prep sink, and separate hand wash lavatory must be provided.
(F) Food preparation and
serving areas must have smooth and cleanable counters.
(G) Stove and oven equipment
for cooking and baking needs.
(H) Storage in the food preparation
area for garbage must be enclosed and separate from food storage.
(I) Storage for a mop and
other cleaning tools and supplies used for dietary areas must be separate from those
used in toilet rooms, resident rooms, and other support areas. In residential care
facilities with a capacity of 17 or more, a separate janitor closet or alcove must
be provided with a floor or service sink and storage for cleaning tools and supplies.
(J) Storage must be available
for cookbooks, diet planning information, and records.
(K) The wall base shall be
continuous and coved with the floor, tightly sealed to the wall, and constructed
without voids that can harbor insects or moisture.
(8) HEATING AND VENTILATION
SYSTEMS. A RCF must have heating and ventilation systems that comply with the building
codes in effect at the time of facility construction.
(a) TEMPERATURE. For all
areas occupied by residents, design temperature for construction must be 75 degrees
Fahrenheit.
(A) A RCF must provide heating
systems capable of maintaining 70 degrees Fahrenheit in resident areas. Required
minimum temperatures are no less than 70 degrees Fahrenheit during the day and 60
degrees Fahrenheit during sleeping hours.
(B) During times of extreme
summer heat, fans must be made available when air conditioning is not provided.
(b) EXHAUST SYSTEMS. All
toilet and shower rooms must be equipped with a mechanical exhaust fan or central
exhaust system that discharges to the outside.
(c) FIREPLACES, FURNACES,
WOODSTOVES, AND BOILERS. Where used, installation must meet standards of the building
codes in effect at the time of construction. The glass and area surrounding the
fireplace must not exceed 120 degrees Fahrenheit.
(d) WALL HEATERS. Covers,
grates, or screens of wall heaters and associated heating elements may not exceed
120 degrees Fahrenheit when they are installed in locations that are subject to
incidental contact by people or with combustible material. Effective 01/15/2015,
wall heaters are not acceptable in new construction or remodeling.
(9) PLUMBING SYSTEMS. Plumbing
systems must conform to the building codes in effect at the time of facility construction.
(a) Hot water temperature
in residents' units must be maintained within a range of 110 - 120 degrees Fahrenheit.
(b) Hot water temperatures
serving dietary areas must meet OAR 333-150-0000 (Food Sanitation Rules).
(c) An outside area drain
and hot and cold water hose bibs must be provided for sanitizing laundry carts,
food carts, and garbage cans.
(10) ELECTRICAL REQUIREMENTS.
(a) WIRING SYSTEMS. All wiring
systems must meet the building codes in effect at the date of installation and shall
be maintained and in good repair.
(b) The use of extension
cords and other special taps is not allowed.
(c) LIGHTING. Lighting fixtures
must be provided in each resident bedroom and bathroom, and be switchable and near
the entry door.
(A) Each resident bedroom
must have illumination of at least 20-foot candles measured at three feet above
the floor for way finding from the room entrance, to each bed, and to the adjoining
toilet room, if one exists.
(B) Lighting in toilet rooms
and bathing facilities used by residents must be at least 50-foot candles, measured
at the hand wash sink and three feet above the shower floor with the curtain open.
(C) Corridor lighting must
equal a minimum of 20-foot candles measured from the floor.
(D) Table height lighting
in dining rooms must equal a minimum of 25-foot candles, without light from windows.
(11) CALL SYSTEM. A RCF must
provide a call system that connects resident units to the care staff center or staff
pagers. Wireless call systems are allowed.
(a) A manually operated emergency
call system must be provided in each toilet and bathing facility used by residents
and visitors.
(b) EXIT DOOR ALARMS. An
exit door alarm or other acceptable system must be provided for security purposes
and to alert staff when residents exit the RCF. The door alarm system may be integrated
with the call system.
(c) Security devices intended
to alert staff of an individual resident’s potential elopement may include,
but not be limited to, electronic pendants, bracelets, pins.
(12) TELEPHONES. Adequate
telephones must be available for resident, staff, and visitor use, including those
individuals who have physical disabilities. If the only telephone is located in
a staff area, it must be posted that the telephone is available for normal resident-use
at any time and that staff shall ensure the resident's uninterrupted privacy. Staff
may provide assistance when necessary or requested.
(13) TELEVISION ANTENNA OR
CABLE SYSTEM. A RCF must provide a television antenna or cable system with an outlet
in each resident unit.
Stat. Auth.: ORS 410.070 & 443.450
Stats. Implemented: ORS 443.400
- 443.455 & 443.991
Hist.: SPD 14-2007, f. 8-31-07,
cert. ef. 11-1-07; SPD 13-2009, f. 9-30-09, cert. ef. 10-1-09; APD 1-2015, f. 1-14-15,
cert. ef. 1-15-15; APD 12-2015, f. & cert. ef. 6-24-15

Assisted Living Facility Building Requirements

411-054-0300
Assisted Living Facility Building Requirements
An assisted living facility (ALF), as
defined by OAR 411-054-0005, shall be built to the following requirements and have
individual living units that have a lockable door, private bathroom, and kitchenette.
(1) Applicability for 411-054-0300
shall apply to the following:
(a) An ALF not licensed prior
to 01/15/2015; or
(b) A major alteration to
an ALF for which plans were not submitted to Facilities, Planning, and Safety prior
to 01/15/2015;
(c) OAR 411-054-0300 shall
apply only to the major alteration and shall not apply to any other area of the
facility.
(2) BUILDING CODES. Each
ALF must meet the requirements of the facility standards set forth in these rules
and with the building codes in effect at the time of original licensure.
(a) Subsequent modifications
made to an ALF after original licensure, including, but not limited to, demolition,
remodeling, construction, maintenance, repair, or replacement must comply with all
applicable state and local building, electrical, plumbing, and zoning codes in place
at the time of the modification.
(b) If a change in use and
building code occupancy classification occurs, license approval shall be contingent
on meeting the requirements of the building codes.
(c) An ALF must comply with
FPS program requirements for submission of building drawings and specifications
as described in OAR 333-675-0000 through 333-675-0050.
(3) GENERAL BUILDING EXTERIOR.
(a) All exterior pathways
and accesses to the ALF’s common-use areas, entrance, and exit ways must be
made of hard, smooth material, be accessible, and maintained in good repair.
(b) An ALF must take measures
to prevent the entry of rodents, flies, mosquitoes, and other insects. There must
be locked storage for all poisons, chemicals, rodenticides, and other toxic materials.
All materials must be properly labeled.
(c) ALF grounds must be kept
orderly and free of litter and refuse. Garbage must be stored in covered refuse
containers.
(d) As described in OAR chapter
411, division 057, memory care communities licensed as an ALF must be located on
the ground floor.
(e) An ALF must provide storage
for all maintenance equipment, including yard maintenance tools, if not provided
by third party contract.
(f) An ALF must provide an
accessible outdoor recreation area. The outdoor recreation area must be available
to all residents. Lighting must be equal to a minimum of five foot candles. Memory
care communities must provide residents with direct access to a secure outdoor recreation
area as described in OAR chapter 411, division 57.
(g) Outdoor perimeter fencing
may not be secured to prevent exit unless the ALF has received written approval
from the Department or the ALF is in compliance with OAR chapter 411, division 57
(Memory Care Communities) or OAR 309-032-1500 through 309-032-1565(Enhanced Care
Services).
(h) An ALF must have an entry
and exit drive to and from the main building entrance that allows for a vehicle
to pick up and drop off residents and mail deliveries without the need for vehicles
to back up.
(4) GENERAL BUILDING INTERIOR.
The design of an ALF must emphasize a residential appearance while retaining the
features required to support special resident needs as outlined in this rule.
(a) RECEPTION AREA. A reception
area must be visible and accessible to residents and visitors when entering the
doors of the main entrance to the ALF.
(b) CORRIDORS. Resident-use
areas and units must be connected through temperature controlled common corridors.
(A) Resident-use corridors
exceeding 20 feet in length to an exit or common-use area, must have a minimum width
of 72 inches.
(B) Corridors shall not exceed
150 feet in length from any resident unit to a seating or other common-use area.
(C) Handrails must be installed
at one or both sides of resident-use corridors.
(c) FLOORS.
(A) Hard surface floors and
base must be free from cracks and breaks.
(B) Carpeting and other floor
materials must be constructed and installed to minimize resistance for passage of
wheelchairs and other ambulation aids.
(C) Thresholds and floor
junctures must be maintained to allow for the passage of wheelchairs and to prevent
a tripping hazard.
(d) INTERIOR DOORS. Lever-type
door handles must be provided on all doors used by residents.
(e) EXIT DOORS. Exit doors
may not include locks that delay evacuation except as specified by building codes.
Such locks may not be installed except with written approval of the Department.
(A) Exit doors may not include
locks that prevent evacuation.
(B) If an electronic code
must be entered to use an exit door that code must be clearly posted for residents,
visitors, and staff use.
(f) WALLS AND CEILINGS. Walls
and ceilings must be cleanable in kitchen, laundry, and bathing areas. Kitchen walls
must be finished smooth per OAR 333-150-0000 (Food Sanitation Rules).
(g) ELEVATORS. An ALF with
residents on more than one floor must provide at least one elevator that meets Oregon
Elevator Specialty Code (OESC) requirements.
(h) The interior of the facility
must be free from unpleasant odors.
(i) All interior and exterior
materials and surfaces (e.g. floors, walls, roofs, ceilings, windows, and furniture)
and all equipment necessary for the health, safety, and comfort of the resident
must be kept clean and in good repair.
(5) RESIDENT UNITS. All resident
units must be accessible per building codes. These apartments must have a lockable
entry door with lever type handle, a private bathroom, and kitchenette facilities.
Adaptable units are not acceptable.
(a) UNIT DIMENSIONS. New
construction units must have a minimum of 220 net square feet, not including the
bathroom. Units in pre-existing structures being remodeled must have a minimum of
160 square feet, not including the bathroom.
(b) RESIDENT STORAGE SPACE.
(A) Each unit must provide
usable space totaling at least 100 cubic feet for resident clothing and belongings
and include one clothes closet with a minimum of four linear feet of hanging space.
(B) The rod must be adjustable
for reach ranges per building codes. In calculating useable space, closet height
may not exceed eight feet and a depth of two feet.
(C) Kitchen cabinets must
not be included when measuring storage space.
(D) A lockable storage space
(e.g., drawer, cabinet, or closet) must be provided for the safekeeping of a resident’s
small valuable items and funds. Both the administrator and resident may have keys.
(c) WINDOWS.
(A) Each resident's living
room and bedroom must have an exterior window that has an area at least one-tenth
of the floor area of the room.
(B) Unit windows must be
equipped with curtains or blinds for privacy and control of sunlight.
(C) Operable windows must
be designed to prevent accidental falls when sill heights are lower than 36 inches
and above the first floor.
(d) DOORS. Each unit must
have an entry door that does not swing into the exit corridor.
(A) A locking device must
be included that is released with action of the inside lever. Locks for the entry
door must be individually keyed, master keyed, and a key supplied to the resident.
(B) The unit exit door must
open to an indoor, temperature controlled, common-use area or common corridor.
(e) BATHROOM. The unit bathroom
must be a separate room with a toilet, sink, a roll-in curbless shower, towel bar,
toilet paper holder, mirror, and storage for toiletry items.
(A) The door to the bathroom
must open outward or slide into the wall.
(B) Showers must have a slip-resistant
floor surface in front of roll-in showers, a hand-held showerhead, cleanable shower
curtains, and appropriate grab bar.
(f) KITCHENS OR KITCHENETTES.
Each unit must have a kitchen area equipped with the following:
(A) A sink, refrigerator,
and cooking appliance that may be removed or disconnected. A microwave is considered
a cooking appliance.
(B) Adequate space for food
preparation.
(C) Storage space for utensils
and supplies.
(D) Counter heights may not
be higher than 34 inches.
(6) COMMON-USE AREAS.
(a) PUBLIC RESTROOMS. There
must be accessible public restrooms for visitor, staff, and resident-use, convenient
to dining and recreation areas.
(A) The public restroom must
contain a toilet, sink, waste container, and a hand drying means that cannot be
reused.
(B) There must be a manually
operated emergency call system in the public restrooms.
(b) DINING AREA. The building
must have a dining area with the capacity to seat 100 percent of the residents.
The dining area must provide 22 square feet per resident for seating, exclusive
of service carts and other equipment or items that take up space in the dining area.
This rule is exclusive of any separate private dining areas.
(c) SOCIAL AND RECREATION
AREAS. An ALF must include lunge and activity areas for social and recreational-use
totaling a minimum of 15 square feet per resident.
(d) COOKING STOVE. If a stove
is provided in the activities or common-use area, and is available for resident-use,
a keyed, remote switch, or other safety device must be provided to ensure staff
control.
(e) RESIDENT LAUNDRY FACILITIES.
Laundry facilities must be operable and at no additional cost to the resident. Resident
laundry facilities must have at least one washer and dryer.
(f) MAILBOX. Each resident
or unit must be provided a mailbox that meets US Postal Service requirements.
(7) SUPPORT SERVICE AREAS.
(a) MEDICATION STORAGE. An
ALF must provide a secure space for medication storage, with access to a sink and
cold storage in the same area. Space for necessary medical supplies and equipment
must be provided.
(b) HOUSEKEEPING AND SANITATION.
(A) An ALF must have a secured
janitor closet for storing supplies and equipment, with a floor or service sink.
(B) The wall base shall be
continuous and coved with the floor, tightly sealed to the wall, and constructed
without voids that can harbor insects or moisture.
(c) LAUNDRY FACILITIES. Laundry
facilities may be located to allow for both resident and staff use when a time schedule
for resident-use is provided and equipment is of residential type.
(A) If the primary laundry
facility is not suitable for resident-use, an ALF must provide separate resident
laundry facilities.
(B) Laundry facilities must
be separate from food preparation and other resident-use areas.
(C) On-site laundry facilities,
used by staff for facility and resident laundry, must have capacity for locked storage
of chemicals and equipment.
(D) An ALF must provide covered
or enclosed clean linen storage that may be on shelves or carts. Clean linens may
be stored in closets outside the laundry area.
(E) The wall base of the
laundry facilities must be continuous and coved with the floor, tightly sealed to
the wall and constructed without voids that may harbor insects or moisture.
(d) SOILED LINEN PROCESSING.
For the purpose of this rule, "soiled linens and soiled clothing," means linens
or clothing contaminated by an individual’s bodily fluids (for example, urine,
feces, and blood).
(A) There must be a separate
area with closed containers that ensure the separate storage and handling of soiled
linens and soiled clothing. There must be space and equipment to handle soiled linen
and soiled clothing processing needs that is separate from regular linen and clothing.
(B) Arrangement must provide
a one-way flow of soiled linens and soiled clothing from the soiled area to the
clean area and preclude potential for contamination of clean linens and clothing.
(C) The soiled linen area
must include a flushing rim clinical sink with a handheld rinsing device and a hand
wash sink or lavatory.
(D) When washing soiled linens
and soiled clothing, washers must have a minimum rinse temperature of 140 degrees
Fahrenheit unless a chemical disinfectant is used.
(E) Personnel handling soiled
laundry must be provided with waterproof gloves.
(F) Covered or enclosed clean
linen storage must be provided and may be on shelves or carts. Clean linens may
be stored in closets outside the laundry area.
(G) The wall base of the
laundry facilities must be continuous and coved with the floor, tightly sealed to
the wall and constructed without voids that may harbor insects or moisture.
(e) KITCHEN AND FOOD STORAGE.
An ALF must comply with OAR 333-150-0000 (Food Sanitation Rules), for food handling
and primary meal preparation areas. Each ALF must have:
(A) Dry storage space, not
subject to freezing, for a minimum one-week supply of staple foods.
(B) Refrigeration and freezer
space at the proper temperature to store a minimum two days' supply of perishable
foods.
(C) Storage for all dishware,
utensils, and cooking utensils used by residents must meet OAR 333-150-0000 (Food
Sanitation Rules).
(D) Storage for a mop, other
cleaning tools, and supplies used for dietary areas. Such tools must be separate
from those used in toilet rooms, resident rooms, and other support areas.
(E) A separate janitor closet
or alcove with a floor or service sink and storage for cleaning tools and supplies.
(F) Storage in the food preparation
area for garbage must be enclosed and separate from food storage.
(G) Storage must be available
for cookbooks, diet planning information, and records.
(H) All kitchen and food
storage areas must have a wall base that is continuous and coved with the floor,
tightly sealed to the wall, and constructed without voids that can harbor insects
or moisture.
(8) HEATING AND VENTILATION
SYSTEMS. An ALF must have heating and ventilation systems that comply with the building
codes in effect at the time of facility construction.
(a) TEMPERATURE. For all
areas occupied by residents, design temperature for construction must be 75 degrees
Fahrenheit.
(A) An ALF must provide heating
systems capable of maintaining 70 degrees Fahrenheit in resident areas. Required
minimum temperatures are no less than 70 degrees Fahrenheit during the day and 60
degrees Fahrenheit during sleeping hours.
(B) During times of extreme
summer heat, fans must be made available when air conditioning is not provided.
(C) Each unit must have individual
thermostatic heating controls.
(b) EXHAUST SYSTEMS. All
toilet and shower rooms must be equipped with a mechanical exhaust fan or central
exhaust system that discharges to the outside.
(c) WALL HEATERS. Covers,
grates, or screens of wall heaters and associated heating elements may not exceed
120 degrees Fahrenheit when they are installed in locations that are subject to
incidental contact by individuals or with combustible material. Effective 01/15/2015
wall heaters are not acceptable in new construction or remodeling.
(d) VENTILATION. Ventilation
in each unit must occur via an open window to the outside, or with a mechanical
venting system capable of providing two air changes per hour with one-fifth of the
air supply taken from the outside.
(9) PLUMBING SYSTEMS. Plumbing
systems must conform to the building codes in effect at the time of facility construction.
(a) Hot water temperature
in residents' units must be maintained within a range of 110 - 120 degrees Fahrenheit.
(b) Hot water temperatures
serving dietary areas must meet OAR 333-150-0000 (Food Sanitation Rules).
(c) An outside area drain
and hot and cold water hose bibs must be provided for sanitizing laundry carts,
food carts, and garbage cans.
(10) ELECTRICAL SYSTEMS.
(a) WIRING SYSTEMS. All wiring
systems must meet the building codes in effect at the date of installation and devices
shall be maintained and in good repair.
(b) The use of extension
cords and other special taps is not allowed.
(c) LIGHTING. Each unit must
have general illumination in the bath, kitchen, living space, and sleeping area.
The general lighting intensity in the unit for way finding must be at least 20-foot
candles measured from the floor.
(A) Lighting in the unit
bathroom must be at least 50-foot candles measured from the height of the hand-wash
basin and three feet above the shower floor with the curtain open.
(B) Task lighting at the
unit food preparation or cooking area must be at least 50-foot candles measured
from counter height.
(C) Corridor lighting must
equal a minimum of 20-foot candles measured from the floor.
(D) Table height lighting
in the dining room must equal a minimum of 25-foot candles without light from windows.
(11) CALL SYSTEM. An ALF
must provide a call system that connects resident units to the care staff center
or staff pagers. Wireless call systems are allowed.
(a) A manually operated emergency
call system must be provided at each resident bathroom, central bathing rooms, and
public-use restrooms.
(b) EXIT DOOR ALARMS. Exit
door alarms or other acceptable systems must be provided for security purposes and
to alert staff when residents exit the ALF. The door alarm system may be integrated
with the call system.
(c) Security devices intended
to alert staff of an individual resident’s potential elopement may include,
but not be limited to, electronic pendants, bracelets, pins.
(12) TELEPHONES.
(a) RESIDENT PHONES. Each
unit must have at least one telephone jack to allow for individual phone service.
(b) PUBLIC TELEPHONE. There
must be an accessible local access public telephone in a private area that allows
a resident or another individual to conduct a private conversation.
(13) TELEVISION ANTENNA OR
CABLE SYSTEM. An ALF must provide a television antenna or cable system with an outlet
in each resident unit.
Stat. Auth.: ORS 410.070 & 443.450
Stats. Implemented: ORS 443.400
- 443.455 & 443.991
Hist.: SPD 14-2007, f. 8-31-07,
cert. ef. 11-1-07; SPD 13-2009, f. 9-30-09, cert. ef. 10-1-09; APD 1-2015, f. 1-14-15,
cert. ef. 1-15-15

The official copy of an Oregon Administrative Rule is
contained in the Administrative Order filed at the Archives Division,
800 Summer St. NE, Salem, Oregon 97310. Any discrepancies with the
published version are satisfied in favor of the Administrative Order.
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