Current through Register Vol. 63, No. 9, September 1, 2024
(1)
The Division shall employ review procedures deemed adequate to determine
applicant or provider compliance with applicable administrative rules,
statutes, other applicable regulations, and as necessary, contractual
obligations. These procedures may include but are not limited to:
(a) Entry and inspection of any service
delivery location;
(b) Review of
documents pursuant to this rule; and
(c) Interviews with or a request for
completion of a questionnaire by individuals knowledgeable about the provider
or applicant. Individuals interviewed may include program staff, managers,
governing or advisory board members, allied agencies, individuals, their family
members, and significant others.
(2) Program staff must cooperate with
Division staff during a licensure review.
(3) Within 30 days following the completion
of each discretionary review, the Division may at their discretion issue a
report and require a Plan of Correction (POC) congruent with section (4) of
this rule.
(4) Within 30 days
following the completion of each initial or renewal licensure review, the
Division shall issue a report that includes:
(a) A statement of any deficiency including a
description of the review findings related to non-compliance with applicable
administrative rules, statutes, other applicable regulations, and any required
corrective actions where applicable;
(b) Pursuant to a licensure review when the
Division determines a provider or applicant is not operating in substantial
compliance with all applicable statutes, administrative rules, and other
regulations, and the POC process is appropriate, the Division may require the
provider or applicant to submit a POC. The Division shall provide written
notice of the requirement to submit a POC, and the provider or applicant shall
prepare and submit a POC according to the following terms:
(A) The provider or applicant shall submit
the POC to the Division within 30 days of receiving the final onsite review
report. The Division may issue up to a 90-day extension to the existing
licensure to allow the provider or applicant to complete the POC
process;
(B) The POC shall address
each finding of non-compliance and shall include:
(i) The planned action already taken or to be
taken to correct each finding of non-compliance;
(ii) The anticipated or requested timeframe
for the completion of each corrective action not yet complete at the time of
POC submission to the Division;
(iii) A description of and plan for quality
assurance activities intended to ensure ongoing compliance; and
(iv) The name of the individual responsible
for ensuring the implementation of each corrective action within the POC.
(c) If the
Division finds that clarification or supplementation to the POC is required
prior to approval, Division staff shall contact the provider or applicant to
provide notice of requested clarification or supplementation, and the provider
or applicant shall submit an amended POC within 14 calendars days of
notification;
(d) The provider
shall submit a sufficient POC approved by the Division prior to receiving a
license. Upon the Division's approval of the POC, the Division shall issue the
appropriate licensure;
(e) The
Division may deny or revoke an applicant or provider's licensure if the
provider fails to submit an adequate POC within the timeframes established in
this rule.
Statutory/Other Authority: ORS
413.042 & ORS
430.256
Statutes/Other Implemented: ORS
430.010-430.030, ORS
430.306, ORS
430.397,
ORs
430.405,
ORS
430.450,
ORs
430.630,
ORS
430.850 & ORS
443.400
