OAR 411-048-0160
Definitions

Unless the context indicates otherwise, the following definitions apply to the rules in OAR chapter 411, division 048:
(1) “AAA” means the Area Agency on Aging designated by the Department that is responsible for providing a comprehensive and coordinated system of services to older adults and adults with disabilities in a designated planning and service area.
(2) “Abuse” means:
(a) Abuse of a child:
(A) As defined in ORS 419B.005 (Definitions); and
(B) As defined in OAR 407-045-0260 (Adult Developmental Disabilities Abuse Rules: Definitions), when a child resides in a foster home licensed by the Department to provide residential services to a child with intellectual or developmental disabilities.
(b) Abuse of an adult or older adult:
(A) As defined in ORS 124.050 (Definitions for ORS 124.050 to 124.095) through 124.095 (Spiritual treatment not abuse) and ORS 430.735 (Definitions for ORS 430.735 to 430.765) through 430.765 (Duty of officials to report abuse); and
(B) As defined in OAR 407-045-0260 (Adult Developmental Disabilities Abuse Rules: Definitions) for individuals 18 years or older with intellectual or developmental disabilities that reside in a Department licensed adult foster home; or
(C) As defined in OAR 411-020-0002 (Definitions) for older adults and adults with a physical disability who are 18 years of age or older that reside in a Department licensed adult foster home.
(3) “Acute Care Nursing” means nursing services provided on an intermittent or time limited basis such as those provided by a hospice program as defined in ORS 443.850 (Definitions for ORS 443.850 to 443.869), or a home health agency as defined in ORS 443.014 (Definitions for ORS 443.014 to 443.105). Acute care nursing may include direct service and is designed to address a specific task of nursing or a short term health condition.
(4) “Business Day” means the day that the “Local Office” is open for business.
(5) “Care Coordination” means the email, faxes, phone calls, meetings and other types of information exchange, consultation, and advocacy provided by a registered nurse on behalf of an individual that is necessary for the registered nurse to conduct assessments, complete medication reviews, provide for individual safety needs, and implement an individual’s Nursing Service Plan.
(6) “Caregiver” means any person responsible for providing services to an eligible individual in a Medicaid-funded home and community-based setting. A caregiver may include an unlicensed person defined as a designated caregiver in OAR chapter 851, division 048.
(7) “Case Manager” means a person employed by the Department, Community Developmental Disability Program, Support Services Brokerage, or Area Agency on Aging who assesses the service needs of an applicant, determines eligibility, and offers service choices to the eligible individual. The case manager authorizes and implements an individual’s plan for services and monitors the services delivered.
(8) “CDDP” means the Community Developmental Disability Program responsible for plan authorization, delivery, and monitoring of services for individuals with intellectual or developmental disabilities according to OAR chapter 411, division 320.
(9) “Community Nursing Services” means “long term care community nursing services” as defined in this rule.
(10) “Day Support Activities” as defined in OAR 411-317-0000 (General Definitions and Acronyms for Developmental Disabilities Services).
(11) “Delegation” means the standards and processes described in OAR chapter 851, division 047.
(12) “Department” means the Oregon Department of Human Services or the Department’s designee.
(13) “Department Approved Form” means forms used by registered nurses and case managers to support these rules. The Department maintains these documents on the Department’s website (https:/­/­www.oregon.gov/­dhs/­SENIORS-DISABILITIES/­PROVIDERS-PARTNERS/­LTCCN/­Pages/­forms.aspx). Printed copies may be obtained by contacting the Oregon Department of Human Services, ATTN: Rule Coordinator, 500 Summer Street NE, E-02, Salem, OR 97301.
(14) “Direct Hands-on Nursing” means a registered nurse providing treatment or therapies directly to an individual instead of teaching or delegating the tasks of nursing to the individual’s caregiver. Payment for direct hands-on nursing services is not reimbursed unless an exception has been granted by the Department as described in OAR 411-048-0170 (Eligibility and Limitations).
(15) “Documentation” means a written record of all services provided to, and for, an individual and an individual’s caregiver that is maintained by the registered nurse as described in OAR 411-048-0200 (Additional Documentation Requirements).
(16) “Employment Services” as defined in OAR 411-317-0000 (General Definitions and Acronyms for Developmental Disabilities Services).
(17) “Enrolled Medicaid Provider” means an entity or individual that meets and completes all the requirements in these rules, OAR 407-120-0300 (Definitions) to 0400, and OAR chapter 410, division 120, as applicable.
(18) “Foster Home” means any Department licensed or certified family home in which residential services are provided as described in:
(a) OAR chapter 411, divisions 049 through 052 for adult foster homes for older adults and adults with physical disabilities;
(b) OAR chapter 411, division 346 for foster homes for children with intellectual or developmental disabilities; and
(c) OAR chapter 411, division 360 for adult foster homes for individuals with intellectual or developmental disabilities.
(19) “Healthcare Provider” means a licensed provider providing services such as but not limited to home health, hospice, mental health, primary care, specialty care, durable medical equipment, pharmacy, or hospitalization to an eligible individual.
(20) “Home” means a non-licensed setting where an individual is receiving Medicaid home and community-based services.
(21) “Home and Community-Based Services” mean the services approved and funded by the Centers for Medicare and Medicaid Services for eligible individuals who are aged and physically disabled and for eligible individuals with intellectual disabilities and developmental disabilities in accordance with Title XIX of the Social Security Act.
(22) “Home Health Agency” has the meaning given that term in ORS 443.443 (Information provided upon application for admission).014.
(23) “Individual” means a person eligible for community nursing services under these rules.
(24) “In-Home Care Agency” has the meaning given that term in ORS 443.305 (Definitions for ORS 443.305 to 443.350).
(25) “Local Office” means the Department office, Area Agency on Aging, Community Developmental Disability Program, or Support Services Brokerage, responsible for Medicaid services including case management, referral, authorization, and oversight of long term care community nursing services in the region where the individual lives and where the community nursing services are delivered.
(26) “Long Term Care Community Nursing Services” mean a distinct set of services that focus on an individual’s chronic and ongoing health and activity of daily living needs. Long term care community nursing services include an assessment, monitoring, delegation, teaching, and coordination of services that addresses an individual’s health and safety needs in a Nursing Service Plan that supports individual choice and autonomy. The requirements in these rules are provided in addition to any nursing related requirements stipulated in the licensing rules governing the individual’s place of residence.
(27) “Medication Review” means a review focused on an individual’s medication regime that includes examination of the prescriber’s orders and related administration records, consultation with a pharmacist or the prescriber, clarification of PRN (as needed) parameters, and the development of a teaching plan based upon the needs of the individual or the individual’s caregiver. In an unlicensed setting, the medication review may include observation and teaching related to administration methods and storage systems.
(28) “Nursing Assessment” means one of the following assessments selected by the registered nurse based on an individual’s need and situation:
(a) A “nursing assessment” as defined in OAR 851-047-0010; or
(b) A “comprehensive assessment” or “focused assessment” as defined in OAR 851-045-0030 (Purpose of Standards and Scope of Practice).
(29) “Nursing Service Plan” means the plan that is developed by a registered nurse based on an individual’s initial nursing assessment, reassessment, or updates made to a nursing assessment as a result of monitoring visits.
(a) The Nursing Service Plan is specific to the individual and identifies the individual’s diagnoses and health needs, the caregiver’s teaching needs, and any care coordination, teaching, or delegation activities.
(b) The Nursing Service Plan is separate from the case manager’s service plan, the foster home provider’s service plan, and any service plans developed by other health professionals.
(c) Nursing service plans must meet the standards in OAR chapter 851, division 045.
(30) “OSBN” means the Oregon State Board of Nursing. OSBN is the agency responsible for regulating nursing practice and education for the purpose of protecting the public’s health, safety, and well-being.
(31) “Rate Schedule” means the rate schedule maintained by the Department in OAR 411-027-0170 (Rate Schedule for Home and Community-Based Services) and posted at http://www.dhs.state.or.us/spd/tools/program/osip/rateschedule.pdf.
(32) “RN” means a registered nurse licensed by the Oregon State Board of Nursing. An RN providing long term care community nursing services under these rules is either an independent contractor who is an enrolled Medicaid provider or an employee of an organization that is an enrolled Medicaid provider.
(33) “Support Services Brokerage” means an entity, or distinct operating unit within an existing entity, that uses the principles of self-determination to perform the functions associated with planning and implementation of services for individuals with intellectual or developmental disabilities.
(34) “These Rules” mean the rules in OAR chapter 411, division 048.

Source: Rule 411-048-0160 — Definitions, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=411-048-0160.

Last Updated

Jun. 8, 2021

Rule 411-048-0160’s source at or​.us