Oregon Administrative Rules
Chapter 309 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: BEHAVIORAL HEALTH SERVICES
Division 40 - ADULT FOSTER HOMES
Section 309-040-0305 - Definitions
Current through Register Vol. 64, No. 3, March 1, 2025
(1) "Abuse" means abuse as defined in ORS 430.735.
(2) "Abuse Investigation and Protective Services" means an investigation and any subsequent services or supports necessary to prevent further abuse as required by ORS 430.745 to 430.765 and OAR 943-045-0000, or any other rules established by the Authority applicable to allegations of abuse of residents residing at an AFH licensed by the Authority.
(3) "Activities of Daily Living (ADL)" means those personal and functional activities required by a resident for continued well-being, that are essential for health and safety. ADLs include eating, bathing, dressing, toileting, transferring (including mobility and ambulation) and maintaining continence.
(4) "Administration of Medication" means administration of medicine or a medical treatment to a resident as prescribed by a Licensed Medical Practitioner.
(5) "Adult" means a person 18 years of age or older with a severe and persistent mental illness who is receiving mental health treatment from a community program
(6) "Adult Foster Home (AFH)" means any home licensed by the Health Systems Division of the Authority in which residential care is provided to five or fewer residents who are not related to the provider by blood or marriage as described in ORS 443.705 through 443.825. An AFH or any person, organization, or business entity that advertises, including word-of-mouth advertising, to provide room, board, and care and services for adults is considered an AFH. For the purpose of these rules, an AFH does not include any house, institution, hotel or other similar place that supplies room and/or board only, if no resident thereof requires any element of care, or any residential facility as defined in ORS 443.400.
(7) "Advance Directive" or "Advance Directive for Health Care" means the legal document signed by a resident that provides health care instructions in the event the resident is no longer able to give directions regarding their wishes, as described in ORS 127.505 to 127.660. "Advance Directive for Health Care" does not include Physician Orders for Life-Sustaining Treatment (POLST).
(8) "Aid to egress" means an object used to access a window egress.
(9) "Aid to Physical Functioning" means any special equipment ordered for a resident by a Licensed Medical Professional (LMP) or other qualified health care professional that maintains or enhances the resident's physical functioning.
(10) "Applicant" means any individual or entity that applies for a license to operate and AFH that is also the owner of the business.
(11) "Authority" means the Oregon Health Authority (OHA) or designee.
(12) "Back-Up Provider Agreement" means an agreement between the AFH provider and another AFH provider or resident manager, including an AFH provider or resident manager licensed by Aging and People with Disabilities or Office of Developmental Disability Services, who does not live in the home, has satisfied the testing requirements as described in 309-040-0335(3), and has agreed to oversee the operation of an AFH in the event of an emergency (See "Succession Plan").
(13) "Background Check" means a criminal records check and an abuse check.
(14) "Bedroom" for the purposes of this rule means any room designated as the primary sleeping quarters of an individual, staff, guests, or any other person.
(15) "Behavioral Interventions" means interventions that are designed to modify the resident's behavior or the resident's environment.
(16) "Bill of Rights" means those rights delineated in the AFH Bill of Rights as outlined in OAR 309-040-0410.
(17) "Board of Nursing Rules" means the standards for Registered Nurse Teaching and Delegation and assignments to Unlicensed Persons according to the statutes and rule of the Oregon State Board of Nursing, chapter 851, division 047 and ORS 678.010 to 678.445.
(18) "Care" means the provision of, but is not limited to, services of room, board, services and assistance with ADLs, such as assistance with bathing, dressing, grooming, eating, money management, recreational activities, and medication management. "Care" also includes services that promote maximum resident independence and enhance quality of life.
(19) "Caregiver" means the provider, resident managers, or substitute caregivers who provide care and services to a resident.
(20) "Case Manager" means an individual employed by a local, regional, or state allied agency approved by the Division to provide case management services and assist in the development of the personal care plan. Case manager's evaluate the appropriateness of services in relation to the consumer's assessed need and review the residential care plan every 180 days.
(21) "Certificate of Occupancy" is a formal notice issued by a local building code authority confirming the building is allowed to be occupied for its intended use.
(22) "Change of Use" means a change in the use of a building or a portion of a building, within the same occupancy group classification, for which there is a change in application of the code requirements.
(23) "CMS" means the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.
(24) "Community Mental Health Program (CMHP)" means an entity that is responsible for planning and delivery of safety net services for persons with mental or emotional disturbances, drug abuse problems, and alcoholism and alcohol abuse in a specific geographic area of the state under a contract with the Division or a local mental health authority, as described in ORS 430.620 and 430.630.
(25) "Compensation" means payments made by or on behalf of a resident to a provider in exchange for room and board, care and services, including services described in the resident's residential care plan and person-centered service plan
(26) "Competitive Integrated Employment" means full-time or part-time work:
(27) "Complaint Investigation" means an investigation of any allegation that a provider has taken action, or inaction, that is perceived as contrary to law, rule, or policy but does not meet the criteria for an abuse investigation.
(28) "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 provider.
(29) "Contested Case Hearing" means a hearing under ORS chapter 183.411-183.417.
(30) "Controlled Substance" means any drug classified as schedules one through five under the Federal Controlled Substance Act.
(31) "Criminal Records Check" means the Oregon Criminal Records Check and when required, a National Criminal History check or a State-Specific Criminal History check, and the processes and procedures required by the rules OAR 943-007-0001 through 943-007-0501 (Criminal History Checks).
(32) "Critical Incident" means those incidents involving acts of physical aggression, serious illnesses or accidents, any injury or illness of a resident triggering a non-routine visit to a health care practitioner, suicide attempts, death of a resident, a fire requiring the services of a fire department, or any incident that triggers an abuse investigation.
(33) "Day Care" means care and services in an AFH for a person who is not a resident of the AFH.
(34) "Declaration for Mental Health Treatment" means a document that states the resident's preferences or instructions regarding mental health treatment as defined by ORS 127.700 through 127.737.
(35) "Delegation" means the process where a registered nurse teaches and supervises a nursing procedure to an unlicensed person. The Oregon State Board of Nursing defines an unlicensed person as any caregiver or certified nursing assistant (CNA). (See OAR chapter 851, division 047).
(36) "Designated Representative" means:
(37) "Director" means the Director of the Oregon Health Authority or designee.
(38) "Disaster" means a sudden emergency occurring beyond the control of the provider, whether natural, technological, or man-made, that renders the provider unable to operate the facility or renders the facility uninhabitable.
(39) "Discharge Summary" means a document that describes the conclusion of the planned course of services described in the resident's residential care plan and person-centered service plan, regardless of outcome or attainment of goals described in the resident's individualized personal care plan. In addition, the discharge summary addresses the resident's monies, financial assets and monies, medication, and personal belongings at the time of discharge.
(40) "Division" means the Health Systems Division of the Oregon Health Authority or designee.
(41) "Division Staff" means an employee of the Division, the Division's designee, or the designee of the local Community Mental Health Program.
(42) "Emergency Escape and Rescue Opening" means an operable exterior window or door that provides a means of escape and access for rescue in an emergency.
(43) "Emergency Preparedness Plan" means a written procedure that identifies a facility's response to an emergency or disaster for minimizing loss of life, mitigating trauma, and to the extent possible, maintaining services for residents, and preventing or reducing property loss.
(44) "Employee" means an individual employed by a licensed AFH and who receives wages, a salary, or is otherwise paid by the AFH for providing the service. The term also includes employees of other providers delivering direct services to a resident.
(45) "Evacuation Capability" means the ability to evacuate all residents from the facility within 3 minutes to a point of safety, which is exterior to and away from the structure, and has access to a public way.
(46) "Exclusion Lists" mean the following federal lists that exclude listed individuals from receiving federal awards, not limited to Medicaid and Medicare programs:
(47) "Exempt Area" means a county agency that provides similar programs for licensing and inspection of AFH's that the Director finds equal to or superior to the requirements of ORS 443.705 to 443.825 and that has entered into an agreement with the Division to license, inspect, and collect fees according to the provisions of 443.705 to 443.825.
(48) "Family Member" means a husband or wife, natural parent, child, sibling, adopted child, domestic partner, adopted parent, stepparent, stepchild, stepbrother, stepsister, father in law, mother in law, son in law, brother-in-law, sister-in-law, grandparent, grandchild, aunt, uncle, niece, nephew, or first cousin.
(49) "Gender expression" means a person's gender-related appearance and behavior, whether or not these are stereotypically associated with the sex the person was assigned at birth.
(50) "Gender identity" means a person's internal, deeply held knowledge or sense of the person's gender, regardless of physical appearance, surgical history, genitalia, legal sex, sex assigned at birth or name and sex as it appears in medical records or as it is described by any other person, including a family member, conservator, or legal representative of the person. A person's gender identity is the last gender identity conveyed by a person who lacks the present ability to communicate.
(51) "Gender nonconforming" means having a gender expression that does not conform to stereotypical expectations of one's gender.
(52) "Gender transition" means a process by which a person begins to live according to that person's gender identity rather than the sex the person was assigned at birth. The process may include changing the person's clothing, appearance, name or identification documents or undergoing medical treatments.
(53) "Harass" or "harassment" means to act in a manner that is unwanted, unwelcomed, or uninvited, or that demeans, threatens or offends a resident.
(54) "HCB" means Home and Community Based.
(55) "Home" means the Adult Foster Home (AFH) and as indicated by the context of its use may refer to the one or more buildings and adjacent grounds on contiguous properties used in the operation of the AFH.
(56) "Home and Community-Based Services" or "HCBS" means Home and Community Based Services as defined in OAR chapter 411, division 004 and OAR chapter 410, division 173. HCBS are services provided in the resident's home or community.
(57) "Homelike" means an environment that promotes the dignity, security, and comfort of residents through the provision of personalized care and services and encourages independence, choice, and decision-making by the residents.
(58) "House Rules" means the written standards governing house activities developed by the provider and approved by the Division. These standards may not conflict with the AFH Bill of Rights or other resident rights set out by these rules.
(59) "Imminent Danger" means a situation in which a facility's non-compliance with one or more licensing requirements has caused or is likely to cause serious injury, harm, impairment, or death to one or more residents in the near future if the facility does not take immediate action to correct and protect resident health and safety.
(60) "Incident Report" means a written description and account of any occurrence including but not limited to any injury, accident, acts of physical aggression, use of physical restraints, medication error, or any unusual incident involving an resident, the home, or provider.
(61) "Indirect Ownership Interest" means an ownership interest in an entity that has an ownership interest in the disclosing entity. This term includes an ownership interest in any entity that has an indirect -----ownership interest in the disclosing entity.
(62) "Individual Care Services" means services prescribed by a physician or other designated individual in accordance with the individual's plan of treatment. The services are provided by a caregiver that is qualified to provide the service and is not a member of the individual's immediate family. For those AFH individuals who are Medicaid eligible, personal care services are funded under Medicaid.
(63) "Individually Based Limitation" means a limitation to the qualities outlined in OAR 309-040-0393(1)(a) through (g), due to health and safety risks. An individually based limitation is based on a specific assessed need and implemented only with the informed consent of the resident or the resident's legal representative as outlined in 309-040-0393.
(64) "Informed Consent" means:
(65) "Initial License Application" or "New License" refers to a home or facility that is being licensed for the first time specific to a provider, setting type, and licensing authority.
(66) "Initial Residential Care Plan (IRCP)" means a written document developed for a resident, within 24 hours of admission to the home, that addresses the care and services to be provided for the resident during the first 30 days or less until the residential care plan can be developed.
(67) "Instrumental Activities of Daily Living (IADLs)" means those self-management activities performed by an individual on a day-to-day basis that are essential to basic self-care and independent living. IADLs include, but are not limited to, housekeeping, including laundry, shopping, transportation, medication management, and meal preparation.
(68) "Legal Representative" means an individual who has the legal authority to act for an individual and only within the scope and limits to the authority as designated by the court or other agreement. A legal representative may include the following:
(69) "LGBTQIA2S+" means lesbian, gay, bisexual, transgender, queer, intersex, asexual, Two Spirit, nonbinary or other minority gender identity or sexual orientation.
(70) "Medication" means any drug, chemical, compound, suspension, or preparation in suitable form for use as a curative or remedial substance either internally or externally by any individual.
(71) "License" means a document issued by the Division to applicants who are determined by the Division to be in substantial compliance with these rules.
(72) "Licensed Medical Practitioner (LMP)" means any individual who meets the following minimum qualifications as documented by the CMHP or designee and holds at least one of the following educational degrees and a valid license:
(73) "Living Quarters" means accessible, occupiable non-bedroom space in a home not including bathroom, utility, or storage spaces.
(74) "Local Mental Health Authority (LMHA)" means the county court or board of county commissioners of one or more counties who choose to operate a community mental health program, or in the case of a Native American reservation, the tribal council, or if the county declines to operate or contract for all or part of a community mental health program, the board of directors of a public or private corporation that directly contracts with the Division to operate a CMHP for that county.
(75) "Means of Egress" means a continuous and unobstructed path to exit from a home without requiring travel through a garage or carport to a public way.
(76) "Medication" means any drug, chemical, compound, suspension, or preparation in suitable form for use as a curative or remedial substance taken either internally or externally by any individual or resident.
(77) "Mental Health Assessment" means the process of obtaining sufficient information through interview, observation, testing and review of medical and treatment records to determine a diagnosis and to plan personal care and individualized services and supports. Mental health assessment must be completed, signed and dated by a provider meeting the qualifications of Qualified Mental Health Professional (QMHP) who performed the assessment.
(78) "Mental or Emotional Disturbances (MED)" means a disorder of emotional reactions, thought processes, or behavior that results in substantial subjective distress or impaired perceptions of reality or impaired ability to control or appreciate the consequences of the person's behavior and constitutes a substantial impairment of the resident's social, educational, or economic functioning. Medical diagnosis and classification must be consistent with the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-V). As used in these rules, this term is functionally equivalent to "serious and persistent mental illness."
(79) "Naloxone" means an FDA-approved short-acting, non-injectable, opioid antagonist medication used for the emergency treatment and temporary rapid reversal of known or suspected opioid overdose.
(80) "National Criminal History Check" means obtaining and reviewing criminal history outside Oregon's borders, such as information from the Federal Bureau of Investigation through the use of fingerprint cards and from other criminal information resources in accordance with OAR 943-007-0001 through 943-007-0501 (Criminal History Checks).
(81) "Nurse Practitioner" means a registered nurse who has been certified by the Oregon State Board of Nursing as qualified to practice in an expanded specialty role within the practice of nursing.
(82) "Nursing Care" means the practice of nursing by a licensed nurse, including tasks and functions relating to the provision of nursing care that are delegated under specified conditions by a registered nurse to individuals other than licensed nursing personnel, which is governed by ORS chapter 678 and rules adopted by the Oregon State Board of Nursing in OAR chapter 851.
(83) "Nursing Delegation" means the process where a registered nurse authorizes an unlicensed person to perform special tasks for residents in select situations and indicates that authorization in writing. The delegation process includes nursing assessment of a resident in a specific situation, evaluation of the ability of the unlicensed person, teaching the task, and ensuring supervision.
(84) "Occupancy Classification" means the formal building codes designation of the primary purpose of the building, structure, or portion thereof.
(85) "Occupant" includes any household member and anyone receiving or delivering services in the setting, including residents and staff.
(86) "Opioid" means natural, synthetic, or semi-synthetic chemicals prescribed to treat pain. This class of drugs includes, but is not limited to, illegal drugs such as heroin, natural drugs such as morphine and codeine, synthetic drugs such as fentanyl and tramadol, and semi-synthetic drugs such as oxycodone, hydrocodone, and hydromorphone.
(87) "Opioid Overdose" means a medical condition that causes depressed consciousness and mental functioning, decreased movement, depressed respiratory function and the impairment of the vital functions as a result of taking opiates in an amount larger than is physically tolerated.
(88) "Opioid Overdose Kit" means an ultraviolet light-protected hard case containing a minimum of two doses of an FDA-approved short-acting, non-injectable, opioid antagonist medication, one pair non-latex gloves, one face mask, one face shield for rescue breathing that is maintained according to manufacturer's recommendations, and a short-acting, non-injectable, opioid antagonist medication administration instruction card.
(89) "Ownership Interest" means the possession of equity in the capital, stock or profits of the adult foster home. Persons with an ownership or control interest mean a person or corporation that:
(90) Person-Centered Service Plan" means written documentation that includes the details of the supports, desired outcomes, activities, and resources required for a resident to achieve and maintain personal goals, health, and safety as described in OAR 411-004-0030.
(91) "Person-Centered Service Plan Coordinator" means the individual, which may be a case manager, service coordinator, personal agent, and other individual designated by the Division to provide person-centered service planning for and with residents.
(92) "Point of Safety" means a location where occupants evacuate in the event of an emergency and for the purpose of conducting of evacuation drills that is no less than 25 feet away from the home and has unobstructed direct access to a public street or sidewalk. The point of safety may not be in the backyard of the home unless the backyard directly accesses a public street or sidewalk.
(93) "Prescribing Practitioner" means a physician, nurse practitioner, physician assistant, dentist, ophthalmologist, pharmacist, or other healthcare practitioner with prescribing authority.
(94) "PRN (pro re nata) Medications and Treatments" mean those medications and treatments that have been ordered by a qualified practitioner to be administered as needed.
(95) "Program Staff" means an employee or individual who by contract with an AFH provides a service to a resident.
(96) "Provider" means a qualified person or an organizational entity operated by or contractually affiliated with a community mental health program or contracted directly with the Division for the direct delivery of mental health services and supports to adults receiving residential and supportive services in an AFH.
(97) "Provisional License" means a 60-day license issued to a qualified person or organizational entity in an emergency situation when the licensed provider is no longer overseeing the operation of the adult foster home. The qualified person or organizational entity must meet the standards of OAR 309-040-0360.
(98) "Psychiatric Security Review Board (PSRB)" means the Board consisting of five members appointed by the Governor and subject to confirmation by the Senate under Section Four, Article 111 of the Oregon Constitution and described in ORS 161.295 through 161.400.
(99) "Registered Nurse" means an individual licensed and registered to practice nursing by the State of Oregon Board of Nursing in accordance with ORS chapter 678 and OAR chapter 851.
(100) "Related" means the following relationships: Spouse, domestic partner, natural parent, child sibling, adopted child, adopted parent, stepparent, stepchild, stepbrother, stepsister, father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law, grandparent, grandchild, aunt, uncle, niece, nephew, or first cousin.
(101) "Relative" means any individual identified as a family member.
(102) "Representative" means both "Designated Representative" and "Legal Representative" as defined in these rules unless otherwise stated.
(103) "Residency Agreement" means the written, legally enforceable agreement between a provider and a resident or a resident's representative when the resident receives services from the provider.
(104) "Resident" means any person who currently resides in an adult foster home who is receiving personal care, services or supports on a 24-hour basis.
(105) "Resident Manager" means an employee of the provider who is approved by the Division to live in the AFH and is responsible for the care and services of residents on a day-to-day basis.
(106) "Residential Care" means the provision of room, board, and services that assist the resident in activities of daily living such as assistance with bathing, dressing, grooming, eating, medication management, money management, or recreation. Residential care includes 24-hour supervision; being aware of the resident's general whereabouts; monitoring the activities of the resident while on the premises of the AFH to ensure the resident's health, safety, and welfare; providing social and recreational activities; and assistance with money management as requested.
(107) "Residential Care Plan (RCP)" means a written plan outlining the care and services to be provided to an resident. The RCP is based upon the review of current assessment, referral, observations, resident preference, and input from members of the residential care plan team. The plan identifies the care, services, activities, and opportunities to be provided by the caregiver to promote the resident's recovery and independence.
(108) "Residential Care Plan Team (RCP Team)" means a group composed of the resident, the case manager or other designated representative, CMHP representative, the provider, resident manager, and others needed including the resident's legal guardian, representatives of all current service providers, advocates, or others determined appropriate by the resident receiving services. If the resident is unable or does not express a preference, other appropriate team membership will be determined by the RCP team members.
(109) "Residential Setting" includes homes licensed by the Department or the Authority to serve individuals in accordance with OARs 309-035; 309-040; 411-050; 411-325; and 411-360.
(110) "Residents' Bill of Rights" means the civil, legal, or human rights AFH residents have as set forth in ORS 443.739.
(111) "Respite Care" means the provision of room, board, care, and services in an AFH for a period of up to 14 days. Respite care is not crisis respite care.
(112) "Restraints" means any physical hold, device, or chemical substance that restricts or is meant to restrict the movement or normal functioning of a resident.
(113) "Room and Board" means the provision of meals, a place to sleep, laundry, and housekeeping.
(114) "Screening" means the assessment process used to identify a resident's ability to perform activities of daily living and address health and safety concerns.
(115) "Seclusion" means the involuntary confinement of a resident to a room or area where the resident is physically prevented from leaving.
(116) "Self-Administration of Medication" means the act of a resident placing a medication in or on the resident's own body. The resident identifies the medication and the times and manners of administration and places the medication internally or externally on the resident's own body without assistance.
(117) "Self-Preservation" means the ability of residents to respond to an alarm or emergent situation without additional cues and be able to reach a point of safety without assistance.
(118) "Services" means those activities that are intended to help the resident develop appropriate skills to increase or maintain their level of functioning and independence. Services include coordination and consultation with other service providers or entities to assure the resident's access to necessary medical care, treatment, or services identified in the resident's personal care plan.
(119) "Sexual orientation" means romantic or sexual attraction, or a lack of romantic or sexual attraction, to other people.
(120) "Staff" means any person responsible for care, services, and support of individuals. Staff includes providers, administrators, managers, supervisors, caregivers, and volunteers.
(121) "Substantial Compliance" means a level of compliance with these rules where any deficiencies pose no greater risk to resident health or safety than the potential for causing minor harm.
(122) "Succession Plan" means the provider or administrator's written plan addressing coverage, continuance of care and services for residents, and AFH operations should the provider or administrator be unable to fulfill their duties due to illness, death, or other unexpected absence (See "Back-up Provider Agreement").
(123) "Substitute Caregiver" means any person meeting the qualifications of a caregiver who provides care and services in an AFH under the Division's jurisdiction in the absence of the provider or resident manager. A resident may not be a substitute caregiver.
(124) "Transgender" means having a gender identity or gender expression that differs from the sex one was assigned at birth, regardless of whether one has undergone or is in the process of undergoing gender-affirming care. Being transgender does not imply any specific sexual orientation. Therefore, transgender people may identify as straight, gay, lesbian, bisexual, etc.
(125) "Unit" means the bedroom and sleeping space of an resident residing in an AFH as agreed to in the residency agreement. Unit includes the following:
(126) "Variance" means an exception from a regulation or provision of these rules granted in writing by the Division upon written application from the provider.
(127) "Volunteer" means a person who provides a service or who takes part in a service provided to individuals receiving services in an AFH or other provider and who is not a paid employee of the AFH or other provider. The services must be non-clinical unless the person has the required credentials to provide a clinical service.
Publications: Publications referenced are available from the agency.
Statutory/Other Authority: ORS 413.042 & 413.032
Statutes/Other Implemented: ORS 426.072 & 443.705 - 443.825