These Oregon rules establish minimum care and service standards for licensed Adult Foster Homes (AFHs) that serve five or fewer adults with severe and persistent mental illness in a community-based, homelike residential setting. Operators must promote resident independence, choice, and decision-making while ensuring safety and access to the broader community consistent with CMS home and community-based services requirements. The rules cover licensing, caregiver qualifications, background checks, medication management, emergency preparedness, and resident rights. Compliance applies regardless of whether the provider receives public funds.
View official sourceOregon Health Authority Health Systems Division: Behavioral Health Services - Chapter 309 Division 40 ADULT FOSTER HOMES 309-040-0300 Purpose and Scope (1) These rules prescribe minimum care and service standards by which the Health Systems Division (Division) of the Oregon Health Authority (Authority) licenses community-based Adult Foster Homes (AFHs) for adults with mental health conditions. The care and services standards are designed to promote the resident’s right to independence, choice, and decision making while providing a safe, secure, homelike environment. The provider must address the resident’s needs in a manner that enables the resident to function at the highest level of independence possible: (a) These rules incorporate and implement the requirements of the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services for home and community-based services authorized under section 1915(i) of the Social Security Act; and (b) These rules establish requirements to ensure residents receive services in settings that are integrated in and support the same degree of access to the greater community as people not receiving these services consistent with the standards set out in Oregon Administrative Rule (OAR) chapter 411, division 004. (2) These rules apply to adult foster homes providing care and services to five or fewer adults with mental health conditions, regardless of whether the provider receives public funds. Statutory/Other Authority: ORS 413.042, 413.032 & 413.085 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHS 4-2012, f. 5-3-12, cert. ef. 5-4-12 MHS 11-2011(Temp), f. & cert. ef. 12-5-11 thru 5-31-12 Renumbered from 309-040-0000, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0305 Temporary rule language in effect until 12/01/2026. Definitions (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: (a) At minimum wage or higher, at a rate that is not less than the customary rate paid by the employer for the same or similar work performed by other employees who are not residents with disabilities, and who are similarly situated in similar occupations by the same employer, and who have similar training, experience, and skill; (b) With eligibility for the level of benefits provided to other employees; (c) At a location where the employee interacts with other persons who are not individuals with disabilities (not including supervisory personnel or individuals who are providing services to such employee) to the same extent that individuals who are not individuals with disabilities and who are in comparable positions interact with other persons; and (d) As appropriate, presents opportunities for advancement that are similar to those for other employees who are not individuals with disabilities and who have similar positions. (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: (a) Any adult who is not the resident’s paid provider, who: (A) The resident has authorized to serve as his or her representative; or (B) The resident’s legal representative is authorized to serve as the resident’s representative. (b) The power to act as a designated representative is valid until the resident or the resident’s legal representative modifies the authorization and notifies the Division of the modification, the resident or the resident’s legal representative notifies the provider that the designated representative is no longer authorized to act the resident’s behalf, or there is a change in the legal authority upon which the designation was based. Notice must include the resident’s or the resident’s legal representative’s signature as appropriate; and (c) A resident or the resident’s legal representative is not required to appoint a designated representative. (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: (a) The U.S. Office of Inspector General's Exclusion List at www.exclusions.oig.hhs.gov/; and (b) The U.S. General Services Administration's System for Award Management Exclusion List at www.sam.gov. (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, step-brother, step-sister, 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. (a) This includes bullying, denigrating, or threatening a resident based on a resident’s actual or perceived status as a member of one of the protected classes in Oregon, as provided: (A) Race. (B) Color. (C) National origin. (D) Religion. (E) Disability. (F) Sex (includes pregnancy). (G) Sexual orientation. (H) Gender identity. (I) Age. (J) Marital status (b) An example of “harassment” includes, but is not limited to, requiring a resident to show identity documents in order to gain entrance to a restroom or other area of a care facility that is available to other person of the same gender identity as the 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: (a) Options, risks, and benefits of the services outlined in these rules have been explained to a resident and in a manner that the resident comprehends; and (b) The resident consents to a person-centered service plan of action, including any individually based limitations to the rules, prior to implementation of the initial or updated person-centered service plan or any individually based limitation. (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: (a) For a resident under the age of 18, the parent, unless a court appoints another person or agency to act as the guardian; or (b) For a resident 18 years of age or older, a guardian appointed by a court order or an agent legally designated as the health care representative. (69) “LGBTQIA2S+” means lesbian, gay, bisexual, transgender, queer, intersex, asexual, Two Spirit, nonbinary or other minority gender identity or sexual orientation. (a) "Lesbian" means the sexual orientation of an individual who is female, feminine, or nonbinary and who is physically, romantically, or emotionally attracted to other women. Some lesbians may prefer to identify as gay, a gay woman, queer, or in other ways. (b) "Gay" means the sexual orientation of an individual attracted to people of the same gender. Although often used as an umbrella term, it is used more specifically to describe men attracted to men. (c) "Bisexual" means an individual who has the potential to be physically, romantically, or emotionally attracted to people of more than one gender, not necessarily at the same time, in the same way, or to the same degree. (d) "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. (e) "Queer" means individuals who do not identify as exclusively straight or an individual who has non-binary or gender-expansive identities: (A) Queer is often used as a catch-all to refer to the LGBTQIA2S+ population as a whole. (B) This term was previously used as a slur but has been reclaimed by many parts of the LGBTQIA2S+ movement. It can also include transgender people who identify as male or female. The term should only be used to refer to a specific person if that person self-identifies as queer. (f) "Intersex" means someone born with a variety of differences in their sex traits and reproductive anatomy. Intersex traits greatly vary, including differences in, but not limited to, hormone production and reproductive anatomy. (g) "Asexual" or "Ace" means a complete or partial lack of sexual attraction or lack of interest in sexual activity with others. Asexuality exists on a spectrum, and asexual people may experience no, little, or conditional sexual attraction. Many people who are asexual still identify with a specific romantic orientation. (h) "2S" or "Two-Spirit" is a term used within some Indigenous communities, encompassing cultural, spiritual, sexual, and gender identity. The term reflects complex indigenous understandings of gender roles, spirituality, and the long history of sexual and gender diversity in Indigenous cultures. The definition and common use of the term two-spirit may vary among Tribes and Tribal communities. (i) The "+" means other identities and expressions of gender, romantic and sexual orientation, including minority gender identities. (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: (a) Physician licensed to practice in the State of Oregon; or (b) Nurse practitioner licensed to practice in the State of Oregon; or (c) Physician’s assistant licensed to practice in the State of Oregon. (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) “Owner” means a: (a) Shareholder of a corporation or of a professional corporation; (b) Member or shareholder of a cooperative; (c) Member of a limited liability company; (d) Partner of a partnership; or (e) General partner or limited partner of a limited partnership. (90) “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: (a) Has an ownership interest totaling five percent or more; (b) Has an indirect ownership interest equal to five percent or more; (c) Has a combination of direct and indirect ownership interests equal to five percent or more; (d) Owns an interest of 5 percent or more in any mortgage, deed of trust, note, or other obligation secured by the disclosing entity if that interest equals at least five percent of the value of the property or assets of the disclosing entity; (e) Is an officer or director of an entity that is organized as a corporation; or (f) Is a partner in an entity that is organized as a partnership. (91) 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. (92) "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. (93) “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. (94) “Prescribing Practitioner” means a physician, nurse practitioner, physician assistant, dentist, ophthalmologist, pharmacist, or other healthcare practitioner with prescribing authority. (95) "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. (96) “Program Staff” means an employee or individual who by contract with an AFH provides a service to a resident. (97) "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. (98) "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. (99) "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. (100) "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. (101) "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. (102) "Relative" means any individual identified as a family member. (103) “Representative” means both “Designated Representative” and “Legal Representative” as defined in these rules unless otherwise stated. (104) "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. (105) “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. (106) "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. (107) "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. (108) "Residential Care Plan (RCP)" means a written plan outlining the care and services to be provided to a 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. (109) "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. (110) “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. (111) "Residents' Bill of Rights" means the civil, legal, or human rights AFH residents have as set forth in ORS 443.739. (112) "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. (113) "Restraints" means any physical hold, device, or chemical substance that restricts or is meant to restrict the movement or normal functioning of a resident. (114) "Room and Board" means the provision of meals, a place to sleep, laundry, and housekeeping. (115) “Screening” means the assessment process used to identify a resident’s ability to perform activities of daily living and address health and safety concerns. (116) "Seclusion" means the involuntary confinement of a resident to a room or area where the resident is physically prevented from leaving. (117) "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. (118) "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. (119) "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. (120) “Sexual orientation” means romantic or sexual attraction, or a lack of romantic or sexual attraction, to other people. (121) “Staff” means any person responsible for care, services, and support of individuals. Staff includes providers, administrators, managers, supervisors, caregivers, and volunteers. (122) "Substantial Compliance" means a level of compliance with federal and state law, and with these rules, such that any identified deficiencies pose no more than negligible harm to the health or safety of residents. (123) “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”). (124) "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. (125) “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. (126) "Unit" means the bedroom and sleeping space of a resident residing in an AFH as agreed to in the residency agreement. Unit includes the following: (a) Private single occupancy spaces; and (b) Shared units with roommates as allowed by these rules. (127) "Variance" means an exception from a regulation or provision of these rules granted in writing by the Division upon written application from the provider. (128) “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. Statutory/Other Authority: ORS 413.042 & 413.032 Statutes/Other Implemented: ORS 426.072 & 443.705 - 443.825 History: BHS 11-2026, temporary amend filed 05/28/2026, effective 06/05/2026 through 12/01/2026 BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 14-2024, amend filed 06/24/2024, effective 07/01/2024 BHS 2-2024, temporary amend filed 01/09/2024, effective 01/10/2024 through 07/07/2024 BHS 6-2018, amend filed 03/21/2018, effective 03/30/2018 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHS 4-2012, f. 5-3-12, cert. ef. 5-4-12 MHS 11-2011(Temp), f. & cert. ef. 12-5-11 thru 5-31-12 MHS 13-2007, f. & cert. ef. 8-31-07 MHS 6-2007(Temp), f. & cert. ef. 5-25-07 thru 11-21-07 MHD 3-2005, f. & cert. ef. 4-1-05, Renumbered from 309-040-0005 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 MHD 6-1986, f. & cert. ef. 7-2-86 MHD 19-1985(Temp), f. & cert. ef. 12-27-85 309-040-0307 Required Home-like Qualities (1) Each AFH must have all of the following: (a) The home must be integrated in and supports the same degree of access to the greater community as people not receiving HCBS, including opportunities for a resident to: (A) Seek employment and work in competitive integrated employment settings; (B) Engage in greater community life; (C) Control personal resources; and (D) Receive services in the greater community. (b) The resident or designated representative selects the AFH from among available setting options, including non-disability specific settings and an option for a private unit in a residential setting. The setting options must be: (A) Identified and documented in the resident’s person-centered service plan; (B) Based on the resident’s needs and preferences; and (C) Based on the resident’s available resources for room and board. (c) The AFH must ensure resident’s rights as described in ORS 443.739, including but not limited to rights of privacy, dignity, respect, and freedom from coercion and restraint; (d) The AFH must promote, but not require, resident initiative, autonomy, self-direction, and independence in making life choices including but not limited to daily activities, physical environment, and with whom to interact; (e) The AFH must facilitate resident choice regarding services and supports and who provides the services and supports. (f) The AFH must make available at least six hours of activities each week which are of interest to and selected by the residents, not including television or movies, as described in ORS 443.738. Activities must be oriented to individual preferences as indicated in the resident’s person centered service plan. Documentation of the activities offered to each resident, the resident’s engagement in those activities, and the reasons the resident did not engage in those activities must be recorded in the individual resident’s record. Resident progress notes must reflect staff efforts to engage residents, such as surveying their interests, during times of non-engagement in activities being made available. (2) The provider must maintain the AFH as follows: (a) The home must be physically accessible to each resident; (b) The provider must provide the resident with a unit of specific physical place that the resident may occupy under a legally enforceable residency agreement; (c) The provider must provide and include in the residency agreement that the resident has, at a minimum, the responsibilities and protections from an involuntary transfer or discharge as described in ORS 443.738(7), (8), (11), (12), and (13). (d) The provider must ensure that each resident has privacy in their own unit; (e) The provider must maintain units with entrance doors lockable by the resident and ensure that only the resident, the resident’s roommate, and only appropriate staff, as identified in the resident’s person-centered service plan, have keys to access the unit; (f) The provider must ensure that residents sharing units have a choice of roommates; (g) The provider must provide that resident’s have the freedom to decorate and furnish their unit as agreed to within the Residency Agreement; (h) The provider must permit each resident to have visitors of their choosing at any time; (i) The provider must ensure each resident has the freedom and support to control their own schedule and activities; (j) The provider must ensure each resident has the freedom and support to have access to a variety of food, condiments, snacks, and means of cooking/preparing food at any time, unless an individually based limitation applies. Providers may not restrict where food/beverages are consumed. (3) When a provider is unable to ensure the qualities as outlined in section (2)(d) through (2)(j) of this rule due to threats to the health and safety of the resident or others, the provider may seek an individually based limitation with the resident’s consent through the process outlined in OAR 309-040-0393. The provider may not apply an individually based limitation until the limitation is approved and documented as required by OAR 309-040-0393. Statutory/Other Authority: ORS 413.042 & 413.032 Statutes/Other Implemented: ORS 413.085 & 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 309-040-0310 License Required (1) In accordance with ORS 443.725, every provider of an adult foster home must be licensed by the Division before opening or operating an AFH or providing care for compensation to a resident. (a) The provider must live in the home that is to be licensed or hire a resident manager to reside in and manage the daily operations of the home at least five days per week live in the home. (b) There must be a provider, resident manager, or substitute caregiver on duty 24 hours per day in an AFH under the jurisdiction of the Division sufficient in number to meet the 24 hour needs of each resident. (c) The provider must have a written succession plan or back-up provider agreement addressing care and services for residents in the event that the provider is unable to fulfill their duties in the AFH. The succession plan must be readily available to the Division upon request. (2) A license is valid for one year unless the Division revokes the license, the provider relinquishes the license, or the provider stops operating the AFH. (3) Placement. An AFH may not accept placement of an resident without first being licensed by the Division under these rules. (4) Unlicensed AFH. No resident may be placed in an AFH that is not licensed. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0010, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0315 Temporary rule language in effect until 12/01/2026. License Application and Fees (1) A completed, written application must be submitted by the applicant in a form and manner required by the Division along with the required $20 per bed non-refundable fee. The application is not complete until all information is received by the Division. (2) Incomplete initial applications are void after 60 calendar days from the date the Division receives the application and non-refundable fee. The Division will deny the incomplete application if not withdrawn. (3) An applicant must submit a separate complete application packet for each location operated as an AFH (Adult Foster Home) (4) The application must include the following: (a) The location of the AFH; (b) A brief description of the physical characteristics of the home; (c) The name, address, telephone number, and email address of the provider; (d) The distinct name of the AFH; (e) The maximum capacity requested and a written statement describing family members needing care, residents who receive respite care, persons who receive day care, or residents who receive room and board only; (f) A written statement from a physician, nurse practitioner, or physician assistant regarding the mental and physical ability of the applicant to provide care and services to residents and to operate the AFH. If the applicant employs a resident manager, the applicant must provide a written statement from a physician, nurse practitioner, or physician assistant regarding the mental and physical ability of the resident manager to provide personal care and services to residents and to operate the AFH; (g) A completed financial information form provided demonstrating to the Division the applicant’s financial ability and resources necessary to operate the AFH. Demonstration of financial ability must include, but is not limited to, providing the Division with a current credit report, list of unsatisfied judgments, pending litigation, unpaid taxes, and notifying the Division if the applicant is in bankruptcy. If the applicant is unable to demonstrate the financial ability and resources required, the Division may require the applicant to furnish a financial guarantee as a condition of initial licensure in accordance with ORS 443.735(3)(e); (h) Certification in writing, under penalty of perjury, that to the best of the person’s knowledge the provider or owner is not in violation of any tax laws described in ORS 305.380 (i) A completed Tax Compliance Certification issued by the Oregon Department of Revenue for each owner with 20 percent or more ownership in the AFH, certifying the owner is not in violation of any tax laws described in ORS 305.380; (j) A signed letter of acknowledgment from the Community Mental Health Program or designee for the applicant to be licensed to operate the AFH; (k) Proof of experience providing direct care and services to adults with mental illness; (l) Documentation of an approved check in accordance with OAR Chapter 943 Division 007 for the provider, the resident manager, caregivers, volunteers, and other occupants 16 years of age or older, excluding residents and other persons as defined in ORS 443.735; (m) Written background information pertaining to any current or previous licensure or certification by a state agency, including those licenses or certificates granted to a business or person affiliated with the business, including: (A) Copies of all current licenses or certificates; (B) Disclosure of any adverse action taken or proposed on any current or previous license or certificate, and documentation showing the final disposition of any suspension, denial, revocation, or other disciplinary actions initiated on any current or previous license or certificate, including settlement agreements, where applicable; and (C) Documentation of any substantiated allegations of abuse or neglect pertaining to the applicant or anyone employed by or contracted with the applicant. (n) Verification of completion of all required trainings for the provider, resident manager if applicable, and all substitute caregivers including, but not limited to: (A) Division-approved AFH Provider Orientation; (B) All required training as outlined in OAR 309-040-0335(8) and (9). (o) Verification of home ownership or copy of current lease or rental agreement that includes; (A) The owner and landlord’s name; (B) Verification that the rent is a flat rate; and (C) Signatures of the landlord and applicant and the date signed. (p) A floor plan of the AFH containing the required components as outlined in OAR 309-040-0370(3). (q) One copy of written approved certificate of occupancy based on the change of use of the setting, issued by the city or county building codes authority having jurisdiction; (r) A completed AFH Self-Inspection related to HCBS compliance and Fire Safety, using division approved forms; (s) The AFH plan of operation, including: (A) The use of substitute caregivers and other staff; (B) A description of how the providers or substitute caregivers will be directly involved with residents daily; (C) How the providers and substitute caregivers will be prepared to communicate with all residents who live in the home including residents with limited English proficiency; and (D) Details of how transportation and community engagement will occur. (t) Proposed policies and procedures regarding: (A) Staff training, (B) Service planning, medication administration, food preparation and distribution; and (C) Safety, emergency response, succession planning and facility closure. (D) Communication and services for persons with limited English proficiency. (5) The Division must determine compliance with these rules based on receipt of the completed application material and fees, a review and investigation of information submitted, an in-person inspection of the AFH, and interviews with the applicant and other individuals as determined necessary by the Division. (6) The applicant may withdraw the application at any time during the application process by notifying the Division in writing. (7) The Division may elect to deny an application when the applicant, or any person with an ownership interest in the AFH, has: (a) Previously had any adverse action taken on a certificate or license by an oversight body or action taken on a certificate or license which may include but is not limited to denial, suspension, conditions, intent to revoke, nonrenewal, or revocation by the Division, the Authority, the Oregon Department of Human Services, or any other state agency in this or any other state; (b) The applicant fails to provide accurate information; (c) Has been sanctioned by the Oregon Health Authority or is excluded, terminated, or suspended from the Medicaid program in Oregon; (d) Is listed on any Office of Inspector General exclusion list under sections 1128 or 1128A of the Social Security Act; or (e) Has been convicted of a criminal offense in the last 10 years related to the person's involvement in any program established under Medicare, Medicaid, or Title XX. (8) The AFH must be in full compliance with all Home and Community Based required qualities of 42CFR §441.710(a)(1), OAR 410-173-0035, and OAR 411-004. Statutory/Other Authority: ORS 413.042, ORS 443.420 & SB 739 (2025) Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 11-2026, temporary amend filed 05/28/2026, effective 06/05/2026 through 12/01/2026 BHS 26-2025, amend filed 12/23/2025, effective 01/01/2026 BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 6-2018, amend filed 03/21/2018, effective 03/30/2018 MHS 12-2017, temporary amend filed 10/03/2017, effective 10/03/2017 through 03/30/2018 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0015, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) 309-040-0325 Capacity (1) The Division must determine the number of residents permitted to reside in an AFH based on the ability of the provider to meet the care needs of the residents, the fire and life safety standards, and compliance with the physical structure standards of these rules. Determination of maximum licensed capacity may include consideration of total household composition including children. Sleeping requirements for children are: (a) Sleeping arrangements for children must be safe and appropriate, based on the child's age, gender, special needs, behavior, and history of abuse and neglect ; (b) Each child must have a safe and adequate bed in which to sleep. (2) The following limits apply: (a) The maximum number of residents is limited to five; (b) In the determination of the Division, the following persons may be included in the licensed capacity of five: (A) Respite care residents; (B) Day care persons; (C) Adult family members of the provider or resident manager who need care; and (D) Child family members of the provider or resident manager who need care. (3) If the number of resident’s who receive care exceeds the ability of the provider to meet the care, health, life, and safety needs of the residents, the Division may reduce the AFH licensed capacity. (4) The Division may place conditions, restrictions, or limitations on the AFH license as necessary to maintain the health, life, and safety of the residents. (5) Providers may not exceed the licensed capacity of the AFH. However, respite care of no longer than two weeks duration may be provided an individual resident if the addition of the respite individual resident does not cause the total number of residents to exceed five. Thus, a provider may exceed the licensed number of residents by one respite individual resident for two weeks or less if approved by the CMHP or the Division, and if the total number of residents does not exceed five. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 6-2018, amend filed 03/21/2018, effective 03/30/2018 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0012, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) 309-040-0330 Zoning for Adult Foster Homes (1) An AFH is a residential use of property for zoning purposes. Under ORS 197.665, an AFH is a permitted use in any residential zone that allows a single family dwelling and in any commercial zone that allows a single family dwelling. (2) No city or county may impose any zoning requirement on the establishment and maintenance of an AFH in residential or commercial zones that is more restrictive than that imposed on a single-family dwelling in the same zone. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0100, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 309-040-0335 Temporary rule language in effect until 12/01/2026. Training Requirements for Providers, Resident Managers, and Substitute Caregivers (1) All providers, resident managers, and substitute caregivers must satisfactorily meet all educational requirements established by the Division. Providers and staff may not provide care to any resident prior to acquiring education or supervised training designed to impart the knowledge and skills necessary to maintain the health, safety, and welfare of the resident. (2) The provider, resident manager, and substitute caregivers must be able to understand and communicate in oral and written English in accordance with ORS 443.730. (3) Training for all licensees, resident managers, and substitute caregivers must comply with ORS 443.738. All providers must satisfactorily pass any testing requirements established by the Division before being licensed or becoming a resident manager or substitute caregiver. The test must be completed by the licensee, resident managers, and substitute caregivers without the help of any other person and must be proctored by the CMHP or Division. The licensee, resident manager, and substitute caregiver must have the ability to, but not be limited to, understand and respond appropriately to emergency situations, changes in medical conditions, physicians' orders and professional instructions, nutritional needs, and residents’ preferences and conflicts. (4) The Division may make exceptions to the training requirements for individuals who are appropriately licensed medical care professionals in Oregon or who possess sufficient education, training, or experience to warrant an exception. The Division may not make any exceptions to the testing requirements. (5) In accordance with ORS 443.738, the Division may permit a person who has not completed the training or passed the required test to act as a resident manager until the training and testing are completed or for 60 days, whichever is shorter, if the Division determines that an unexpected and urgent staffing need exists. The licensee must notify the Division of the situation and demonstrate that the licensee is unable to find a qualified resident manager, that the individual meets the requirements for a substitute caregiver for the AFH, and that the licensee must provide adequate supervision. (6) Prior to providing care to any resident, the provider or resident manager must orient all caregivers to the home and to the residents. Orientation includes, but is not limited to: (a) Location of all fire extinguishers; (b) Demonstration of evacuation procedures; (c) Instruction of the Emergency Preparedness Plan; (d) Location of and documentation within resident records; (e) Location of phone numbers for telephone numbers of the local fire department, police department, the poison control center, the provider, and the residents’ LMP; (f) Location of medications, proper medication administration and proper documentation in medication administration records; (g) Introduction to each resident; (h) Review of care and services required for each resident; and (i) Registered Nurse delegation necessary to provide care and services to residents. (7) The provides or resident manager must maintain current documentation of the training, testing, and qualifications of substitute caregivers including but not limited to: (a) Documentation of an approved background check in compliance with OAR Chapter 943 Division 007; (b) A new background check must be completed: (A) Every three years from the date of the subject individual’s last background check; (B) Prior to any subject individual’s change in employment position for which there are different criminal records check requirements; and (C) If the Division has reason to believe a new background check is needed. (c) Documentation that a substitute caregiver has successfully completed the training required by the Division; (d) Documentation that the provider has trained the caregiver to meet the routine and emergency needs of the residents; (e) Documentation that the provider has oriented the caregiver to the residents in the AFH, their care needs and skills training, personal care plan, and the physical characteristics of the AFH. (8) All providers, resident managers, and substitute caregivers of an AFH must complete required training directly related to care and services for residents with mental illness. The provider must document the training in the provider, resident manager, and substitute caregiver’s training records. This training is in addition to any orientation and must be completed prior to providing care to any resident. A minimum of twelve hours of training, directly related to care and services for residents with mental illness, is required annually. Pre-service and annual training content areas must include, but are not limited to: (a) Understanding mental and emotional conditions; (b) Understanding the mental health assessment and implementing the residential care plan (c) Medication management; (d) Cardiopulmonary Resuscitation (CPR) which includes in-person competency check by a qualified instructor, and First Aid; (A) Accepted CPR and First Aid courses must be provided by or meet the standards of the American Heart Association or the American Red Cross. (B) CPR or First Aid courses conducted online are only accepted by the Department when an in-person skills competency check is conducted by a qualified instructor meeting the standards of the American Heart Association, the American Red Cross. (e) Opioid overdose kits and administration of an FDA-approved short-acting, non-injectable, opioid antagonist medication. (f) Resident rights; (g) Safety, emergency, and emergency preparedness planning; (h) Behavior management including positive engagement, redirection, and de-escalation techniques; (i) Complaints, grievances, incident and abuse reporting; (j) Nutrition and food services; and (k) Other information relevant to the job description and scheduled shifts. (l) All caregivers, including licensees, resident managers, and substitute caregivers are required to complete the Authority-approved HCBS training, as provided below: (A) Effective June 30, 2025, all caregivers must have completed the required training. (B) All new caregivers, hired on or after July 1, 2025, must complete the required training prior to beginning job responsibilities. (9) Providers, resident managers, and substitute caregivers must complete the Authority approved LGBTQIA2S+ residents and residents living with human immunodeficiency virus training as mandated by ORS 441.111 to 441.122. The Authority approved training shall address the elements described in 309-040-0335(11)(c) of this rule. The following dates apply to the initial LGBTQIA2S+ residents and residents living with human immunodeficiency virus trainings: (a) Effective June 30, 2025, all staff must have completed the required training. (b) All new staff, hired on or after July 1, 2025, must complete the required training prior to beginning job responsibilities. (10) Providers, resident managers, and caregivers are required to complete biennial training addressing LGBTQIA2S+ residents and residents living with human immunodeficiency virus protections, as described in this section. Providers are responsible for the cost of providing this training to all staff. (a) The provider or administrator must select the LGBTQIA2S+ residents and residents living with human immunodeficiency virus training to be used by the AFH by either: (A) Choosing to use the standard Authority-approved biennial LGBTQIA2S+ residents and residents living with human immunodeficiency virus training; or (B) Applying to the Authority to request approval of a biennial LGBTQIA2S+ residents and residents living with human immunodeficiency virus training to be developed and provided by the licensee or administrator. (b) ORS 441.116 requires all LGBTQIA2S+ residents and residents living with human immunodeficiency virus trainings address: (A) Caring for LGBTQIA2S+ residents and residents living with human immunodeficiency virus; and (B) Preventing discrimination based on a resident’s sexual orientation, gender identity, gender expression or human immunodeficiency virus status. (C) The defined terms commonly associated with LGBTQIA2S+ individuals and human immunodeficiency virus status. (D) Best practices for communicating with or about LGBTQIA2S+ residents and residents living with human immunodeficiency virus, including the use of an individual’s chosen name and pronouns. (E) A description of the health and social challenges historically experienced by LGBTQIA2S+ residents and residents living with human immunodeficiency virus, including discrimination when seeking or receiving care at care facilities and the demonstrated physical and mental health effects within the LGBTQIA2S+ residents and residents living with human immunodeficiency virus community associated with such discrimination. (F) Strategies to create a safe and affirming environment for LGBTQIA2S+ residents and residents living with human immunodeficiency virus, including suggested changes to care facility policies and procedures, forms, signage, communication between residents and their families, activities, in-house services and staff training. (G) The individual or entity providing the training must demonstrate a commitment to advancing quality care for LGBTQIA2S+ residents and residents living with human immunodeficiency virus in this state. (c) The proposal for training submitted by a provider, administrator, entity, or individual shall include: (A) The regulatory criteria described in section 309-040-0335(11)(c). (B) The following elements must be included in the proposal: (i) A statement of the qualifications and training experience of the individual or entity providing the training. (ii) The proposed methodology for providing the training either online or in person. (iii) An outline of the training. (iv) Copies of the materials to be used in the training. (C) The Department will review the materials and determine whether to approve or deny the training. No later than 90 days after the request is received, the Department will inform the licensee or administrator in writing of the Department’s decision. (11) The Division may require a provider, resident manager, or substitute caregiver to obtain additional training, whether or not the twelve-hour annual training requirement has already been met. (12) Providers, resident managers, or substitute caregivers who perform delegated or assigned nursing care services as part of the residential care plan must receive training and appropriate monitoring from a registered nurse on performance and delivery of those services. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 11-2026, temporary amend filed 05/28/2026, effective 06/05/2026 through 12/01/2026 BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 14-2024, amend filed 06/24/2024, effective 07/01/2024 BHS 2-2024, temporary amend filed 01/09/2024, effective 01/10/2024 through 07/07/2024 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0030, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0340 Temporary rule language in effect until 12/01/2026. Issuance of a License (1) The license must include but is not limited to the name of the applicant, name of the AFH, address of the home to which the license applies, the maximum number of residents, the name of the resident manager if applicable, conditions if applicable, license number, effective date, expiration date, and the signature of the Division’s designee. The license must be prominently posted in the AFH and available for inspection at all times. (2) The Division may attach conditions to the license that limit, restrict, or specify other criteria for operation of the AFH. Conditions to a license may include but are not limited to care of a specifically identified resident. The conditions must be posted with the license in the AFH and be available for inspection at all times. (3) The Provider must: (a) Post the most recent inspection report in the entry of the home or an equally prominent place; and (b) Upon request, provide a copy of the report to each resident, person applying for admission to the home, or the authorized or legal representative, guardian, or conservator of a resident. (4) Each provider must report promptly to the Division any changes to information supplied in the application or subsequent correspondence. Changes include but are not limited to changes in the AFH name, owner entity, resident manager, telephone number, or mailing address, information discovered about past license or certification history, and staffing changes if those changes are significant or impact the health, safety, or well-being of residents. (5) Before an AFH is sold, the prospective new owner must apply for a license in accordance with OAR 309-040-0315 if the new owner intends to operate an AFH. (6) An AFH license is not transferable or applicable to any location or individuals other than those specified on the license. (7) A license is valid for one year from the effective date on the license unless sooner revoked or relinquished. (8) Applicants must be in substantial compliance with these rules before a license is issued. If cited deficiencies are not corrected within the time frames specified by the Division, the license application must be denied. (9) The Division may not issue an initial license unless: (a) The applicant and the AFH are in compliance with ORS 443.705 to 443.825 and the rules of the Division; (b) The Division has completed an inspection of the AFH. If cited deficiencies are not corrected within the time frames specified by the Division, the application must be denied; (c) The Division has received an approved background records check on the applicant, resident manager, substitute caregiver, and any occupant (other than a resident) 16 years of age or older or is identified in ORS 443.735 and who will be residing in or employed by the AFH, as identified in OAR chapter 943 division 007 and any other rules established by the Division;. (d) The Division has determined that the registry maintained under ORS 441.678 contains no finding that the applicant or any person employed by the applicant has been responsible for abuse. (e) The Division has determined the applicant is not excluded from receiving federal awards including: (A) The U.S. Office of Inspector General’s Exclusion List at www.exclusions.oig.hhs.gov and (B) The U.S. General Services Administration’s System for Award Management Exclusion List at www.sam.gov. (f) An applicant may not be licensed to operate any additional programs without first demonstrating a history of substantial compliance for previous and current licenses and certificates. (10) Notwithstanding any other provision of ORS 443.735, 443.725, or 443.738, the Division may issue a 60-day provisional license to a qualified applicant if the Division determines that an emergency situation exists after being notified that the licensed provider of an AFH is no longer overseeing operation of the AFH. (11) At or about 90 days after initial licensure, but no more than 120 days after an initial license is issued, the Division will inspect the AFH to ensure compliant operation. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 11-2026, temporary amend filed 05/28/2026, effective 06/05/2026 through 12/01/2026 BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHD 3-2005, f. & cert. ef. 4-1-05, Renumbered from 309-040-0020 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 309-040-0345 Temporary rule language in effect until 12/01/2026. Renewal (1) The licensee must submit a complete renewal application packet and the required fee, as applicable, at least 120 days prior to the expiration date of the license. If the completed renewal application and fee are not submitted prior to the expiration date, the AFH will be treated as an unlicensed home subject to civil penalties. (2) The renewal application must include the following: (a) A renewed physician's statement and financial information form, if this information has changed; (b) Certification in writing, under penalty of perjury, that to the best of the person’s knowledge the provider or owner is not in violation of any tax laws described in ORS 305.380 (c) A new Tax Compliance Certification issued by the Oregon Department of Revenue for each owner with 20 percent or more ownership in the AFH, certifying the owner is not in violation of any tax laws described in ORS 305.380; (d) Disclosure of any adverse action taken or proposed on any current or previous license or certificate, and documentation showing the final disposition of any suspension, denial, revocation, or other disciplinary actions initiated on any current or previous license or certificate, including settlement agreements, where applicable; (e) Updated floor plan and building permits for any physical changes to the home (f) A completed AFH Self-Inspection related to HCBS compliance and Fire Safety, using division approved forms; (g) Proposed policies and procedures regarding: (A) Staff training, (B) Service planning, medication administration, food preparation and distribution; (C) Safety, emergency response, succession planning and facility closure; and (D) Communication and services for persons with limited English proficiency. (h) Current residency agreement and house rules; (i) Current lease or rental agreement, as applicable; and (j) Variance requests, as applicable. (3) The Division may require the applicant to submit a current physician’s statement, a current approved background check, and a current financial information form if investigation by the Division for license renewal determines it is necessary. (4) The Division must investigate any information in the renewal application and must conduct an in-person inspection of the AFH. (5) The provider must be given a formal written report from the inspection citing any deficiencies and a time frame for correction that does not exceed 30 days from the date of the inspection report unless otherwise noted in the inspection report. (6) The AFH provider must correct cited deficiencies prior to the Division issuing a renewed license. If cited deficiencies are not corrected within the time frame specified by the Division, the renewal application must be denied and administrative sanctions may be imposed. (7) The Division must not renew a license unless: (a) The applicant and the AFH are in compliance with ORS 443.705 to 443.825 and these rules; (b) The Division has completed an inspection of the AFH; (c) The Division has confirmed a current back[RC1] ground check has been completed, as required by ORS 181A.195, ORS 443.735 and OAR chapter 943, division 007, on the applicant and any occupant, other than a resident, 16 years of age or older or is identified in ORS 443.735(4)(c) and who will be residing in or employed by or otherwise acting as a provider, resident manager, substitute caregiver, or volunteer for the AFH provider. (8) The Division will deny renewal of a license if the provider does not submit a complete renewal application packet and bed fee, if applicable, prior to the expiration of the license. (9) The provider, resident manager, substitute caregiver, volunteer, or occupant residing in the AFH may continue to work or reside in the home pending the final fitness determination in accordance with OAR 407-007-0315. (10) A background check must be completed for the applicant and any occupant, other than a resident, 16 years of age or older who must be residing in or employed by or otherwise acting as a provider, resident manager, substitute caregiver, or volunteer for the AFH provider if the Division believes there is reason to justify a new background check in accordance with OAR chapter 943, division 007. (11) An AFH provider seeking initial licensing or that has been in operation for less than 24 months has the burden of proof to establish compliance with ORS 443.705 to 443.825 and the Division rules. (12) The burden of proof is upon the Division to establish compliance with ORS 443.705 to 443.825 and the Division rules if an AFH provider is seeking renewal of a license and has been in continuous operation for more than 24 months. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 11-2026, temporary amend filed 05/28/2026, effective 06/05/2026 through 12/01/2026 BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0025, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0350 Variance (1) A provider or applicant may apply to the Division for a variance from a provision of these rules using the Division’s Variance Request form. The provider must provide clear and convincing evidence the variance does not jeopardize the health, life, or safety of the residents and would not violate or compromise an applicable ORS. (2) The Division may not grant a variance from a regulation or provision of these rules pertaining to: (a) License capacity of the AFH; (b) Minimum age of provider, resident manager and substitute caregivers; (c) Background checks; (d) Training requirements of the provider, resident manager and substitute caregivers (e) Standards and practices for care and services; (f) Inspections of the AFH; (g) Civil, legal, and human rights; and (h) Inspection of the public files. (3) The Division may not grant a variance related to fire and life safety without prior consultation with the local fire authority or designee. (4) The Division may not grant a variance related to Oregon Revised Statute 443.705 through 443.825. (5) A provider or applicant may apply to the Division for a variance specific to each resident under ORS 443.725, subject to the following requirements: (a) The variance is effective only for the specific resident who has been assessed and meets the safety requirements prescribed by the Division. This assessment must become part of the resident’s RCP; (b) A variance allowing a specific resident to be in the AFH alone may not exceed four hours in a 24-hour period; (c) No variance allows a provider to leave an resident alone in the AFH between the hours of 10 p.m. to 6 a.m.; (d) No variance allows more than one resident to be alone in the AFH at any one time; and (e) Twenty-four hour per day care must continue for any resident that does not qualify to be in the AFH alone. (6) The Division must consider the provider’s history of compliance with the rules governing AFHs and other programs serving residents with mental health or substance abuse issues. (7) Variances will be granted or denied in writing. Variances are not effective until granted in writing by the Division. All variances granted must be reviewed for continued approval with each license renewal under OAR 309-040-0345. A variance granted to one AFH provider or a variance granted regarding a specific resident does not constitute a precedent for any other AFH provider, applicant, or resident. (8) The AFH provider or applicant may appeal the denial of a variance request by submitting a request for reconsideration in writing to the Division. The Division must make a decision on the appeal within 30 days of receipt of the appeal. The decision of the Division will be final. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHS 12-2007, f. & cert. ef. 8-31-07 MHS 2-2007(Temp), f. & cert. ef. 5-4-07 thru 10-31-07 MHD 3-2005, f. & cert. ef. 4-1-05, Renumbered from 309-040-0035 MHD 1-1992, f. & cert. ef. 1-7-92 MHD 6-1986, f. & cert. ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0355 Contracts (1) Providers who care for residents who are or become eligible for Medicaid services must enter into a Medicaid Provider Enrollment Agreement with the Division and comply with Division rules and terms governing provider participation in the Oregon Medicaid program. Applicable Division rules in addition to these rules include, but are not limited to: (a) OAR 407-120; (b) OAR 410-120; (c) OAR 410-172; (d) OAR 410-173; and (e) OAR 943-120. (2) Providers must be qualified, professionally competent and actively licensed where required by law to perform work under the Medicaid Provider Enrollment Agreement. (3) The rate established by the Division is considered payment in full. The licensee may not request or accept additional funds or in-kind payment from any source. (4) An approved Medicaid provider enrollment agreement is valid so long as the license remains valid unless earlier terminated by the provider or the Division. (5) The Division may terminate a Medicaid provider enrollment agreement under the following circumstances: (a) The provider fails to maintain substantial compliance with all related federal, state and local laws, ordinances and regulations; or (b) The license to operate the adult foster home has been voluntarily surrendered, revoked or non-renewed. (6) The Division must terminate a Medicaid provider enrollment agreement under the following circumstances: (a) The provider fails to permit access by the Department, the local licensing authority or the Centers for Medicare and Medicaid Services to any adult foster home licensed to and operated by the provider; (b) The provider submits false or inaccurate information; (c) Any person with five percent or greater direct or indirect ownership interest in the adult foster home did not submit timely and accurate information on the Medicaid provider enrollment agreement form or fails to submit fingerprints if required under OAR 407-007-0200 to 407-007-0370; (d) Any person with five percent or greater direct or indirect ownership interest in the adult foster home has been convicted of a criminal offense related to the person’s involvement with Medicare, Medicaid or title XXI programs in the last 10 years; or (e) Any person with an ownership or control interest or who is an agent or managing employee of the adult foster home fails to submit timely and accurate information on the Medicaid provider enrollment agreement form. (7) If the provider submits notice of termination of the Medicaid provider enrollment agreement, the provider must concurrently issue the Division’s Notice of Involuntary Move, Transfer or Discharge of Resident form to each resident eligible for Medicaid services residing in the AFH and must issue written notification to all residents who pay with private funds. Provider must also immediately update the house policies. (8) If either the provider or the Division terminates the Medicaid provider enrollment agreement, a new Medicaid provider enrollment agreement will not be approved for a period of no less than 180 days. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0040, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0360 Temporary rule language in effect until 12/01/2026. Qualifications for AFH Providers, Resident Managers, and Other Caregivers (1) An AFH provider must meet the following qualifications: (a) Be at least 21 years of age; (b) Live in the AFH to be licensed, unless an approved resident manager lives in the AFH; (c) Provide evidence satisfactory to the Division regarding experience, training, knowledge, interest, and concern in providing care to persons with severe and persistent mental illness. Evidence may include, but is not limited to the following: (A) Certified nurse's aide training; (B) Nursing home, hospital, or institutional work experience; (C) Licensed practical nurse or registered nurse training and experience; (D) Division approved training; (E) Experience in caring for individuals with severe and persistent mental illness; and (F) Home management skills. (d) Have and maintain current CPR and First Aid certification. (A) Accepted CPR and First Aid courses must be provided by or meet the standards of the American Heart Association or the American Red Cross. (B) CPR or First Aid courses conducted online are only accepted by the Division when an in-person skills competency check is conducted by a qualified instructor meeting the standards of the American Heart Association or the American Red Cross. (e) Possess the physical health and mental health determined necessary by the Division to provide 24-hour care for adults who are mentally ill. Applicants must have a statement from a physician, nurse practitioner, or physician assistant on the Division approved form that they are physically, mentally, and emotionally capable of providing care; (f) Have an approved background check in accordance with OAR chapter 943 division 007; (A) All subject individuals must self-report to the provider any potentially disqualifying condition as described in OAR 407-007-0280 and OAR 407-007-0290; and (B) The provider must notify the Division of self-reported information within 24 hours. (g) Provide evidence of sufficient financial resources to operate an AFH for at least two months, unless the application is for renewal of an AFH that is already in operation; (h) Be proficient in the English language and capable of understanding and communicating orally and in writing with residents, medical professionals, case managers, and others involved in the care of residents; (i) Be able to respond appropriately to emergency situations at all times; (j) Not be listed on either of the Exclusion Lists. (k) If transporting residents by motorized conveyance, have a current driver's license in compliance with the Department of Motor Vehicles laws and vehicle insurance as required by the State of Oregon. (l) Provide evidence of completion of the approved course Mandatory Reporting for Individuals Working in Community Mental Health Programs, or another equivalent course; and (m) Have a clear understanding of job responsibilities, have knowledge of the resident’s Residential Care Plans RCPs, and be able to provide the care specified for each resident. (2) The resident manager must meet the provider qualifications listed in section (1) (a) through (l) of this rule. A resident manager applicant may work in the home pending outcome of the national criminal history check, if the Oregon background check was clear and no convictions were self-disclosed on the criminal record authorization. (3) Substitute caregivers must have access to resident records and must meet the following qualifications: (a) Be at least 18 years of age; (b) Have an approved background check in accordance with OAR chapter 943 division 007. A substitute caregiver may work in the home pending outcome of the national criminal history check providing the Oregon background check was clear and no convictions were self-disclosed on the criminal record authorization; (c) Be proficient in the English language and capable of understanding and communicating orally and in writing with residents, medical professionals, case managers, and others involved in the care of residents; (d) Know fire safety and emergency procedures and have the ability to respond appropriately to emergency situations at all times; (e) Have a clear understanding of job responsibilities, have knowledge of the resident’s Residential Care Plans, and be able to provide the care specified for each resident; (f) Possess the physical health and mental health determined necessary by the Division to provide 24-hour care for adults who are mentally ill. (g) Have and maintain current CPR and First Aid certification. (A) Accepted CPR and First Aid courses must be provided by or meet the standards of the American Heart Association or the American Red Cross. (B) CPR or First Aid courses conducted online are only accepted by the Division when an in-person skills competency check is conducted by a qualified instructor meeting the standards of the American Heart Association or the American Red Cross. (h) Not be a resident; and (i) Not be listed on either of the Exclusion Lists. (A) The provider must verify the substitute caregiver is not listed on either of the Exclusion Lists; and (B) Verification must be clearly documented in the facility’s records. (j) If transporting residents by motorized conveyance, have a current driver's license in compliance with Department of Motor Vehicles laws and vehicle insurance as required by the State of Oregon. (k) Provide evidence of completion of the approved course Mandatory Reporting for Individuals Working in Community Mental Health Programs, or another equivalent course. (4) The provider may not hire or continue to employ a resident manager or substitute caregiver who does not meet the requirements of this rule. (5) The provider must supervise and train resident managers and substitute caregivers and monitor their general conduct when acting within the scope of their employment or duties. (6) After receipt of the completed resident manager application, and Division approval, a revised license must be issued in accordance with ORS 443.738(1) through (4). (a) If a resident manager leaves during the period of the license, the provider must notify the Division immediately; (b) and identify a plan for providing care to the residents. (7) Volunteers, and occupants over the age of 16, excluding residents, must have documentation of an approved background check in accordance with ORS 181A.200, 443.735 and OAR 943-007-0001 through 0501. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 11-2026, temporary amend filed 05/28/2026, effective 06/05/2026 through 12/01/2026 BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0045, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0365 Facility Standards (1) In order to qualify for or maintain a license, an AFH must meet and maintain the following provisions: (a) Demonstrate compliance with Oregon Structural Specialty Code (OSSC) and Oregon Fire Code; (b) Maintain up-to-date documentation verifying they meet applicable local business license, zoning, and building and housing codes and state and local fire and safety regulations. It is the responsibility of the provider to check with local government to be sure all applicable local codes have been met; (c) For AFH's established on or after October 1, 2004, meet all applicable Americans with Disabilities Act standards, state building, mechanical, and housing codes for fire and life safety. The AFH must be inspected for fire safety by an inspector designated by the Division using the recommended standards established by the State Fire Marshal for facilities housing one to five persons as described in Chapter 49 of the Oregon Fire Code, the Oregon Residential Specialty Code, and the Oregon Structural Specialty Code. When deemed necessary by the Division, a request for fire inspection must be made to the State Fire Marshal; (d) The building and furnishings must be clean and in good repair and grounds must be maintained. Walls, ceilings, and floors must be of such character to permit frequent washing, cleaning, or painting. There must be no accumulation of garbage, debris, rubbish, or offensive odors; (e) Stairways must be provided with handrails. A functioning light must be provided in each room, stairway, and exit way; exterior light fixtures must be protected with appropriate covers as necessary. Yard and exterior steps must be accessible to residents; (f) The heating system must be in working order. Areas of the AFH used by residents must be maintained at no less than 68 degrees Fahrenheit during the day and 60 degrees Fahrenheit during sleeping hours. During times of extreme summer heat, the provider must make a reasonable effort to make the residents comfortable using available ventilation, fans, or air conditioning; (g) There must be at least 150 square feet of common space and sufficient comfortable furniture in the AFH to accommodate the recreational and socialization needs of all the occupants at one time. Common space must not be located in basements or garages unless such space was constructed for that purpose or has otherwise been legalized under permit. Additional space is required if wheelchairs are to be accommodated; (h) Pools, hot tubs, and ponds must be equipped with sufficient safety barriers or devices to prevent accidental injury in accordance with the Oregon Residential Specialty Code. (i) The address numbers of the adult foster home must be placed on the home or within 10 feet of the driveway to the home in a position that is legible and clearly visible from the street or road fronting the property. Address numbers must be a minimum of 4 inches in height, made of reflective material and contrast with their background. (j) The AFH must have a minimum of two unobstructed exits to the exterior of the home, the use of which is accessible within the capabilities of the persons residing in the home. (k) All doors in the means of egress must be maintained clear and unobstructed and have an obvious method of operation. Exterior exit doors must have latching-knob hardware. Hasp, sliding bolt, hook, and double-key dead bolts are not permitted. (l) Any locks used inside of the home to secure space large enough for a person to fit inside must be single action. The single action release function must be installed in a manner that prevents a person from being locked into the space. (m) Manufactured or mobile home units must have been built since 1976 and designed for use as a home rather than a travel trailer. The units must have a manufacturer’s label permanently affixed to the unit, which states it meets the requirements of the Department of Housing and Urban Development (HUD) or the authority having jurisdiction (AHJ). (2) Any accessibility improvements made to accommodate an identified resident must be in accordance with the specific needs of the resident and comply with the applicable building code. (3) An AFH must have an accessible outdoor area that must be made available to residents. (4) Storage of a reasonable size for a resident’s belongings beyond that of the resident’s unit must be made available (5) All yard maintenance equipment must be maintained in locked storage if such equipment poses a safety threat; (6) A locked storage area for resident medications separate from food, laundry, and toxic or hazardous materials must be made accessible to all caregivers. For residents who have a self-administration order, the provider must make a secured locked box available to assure the safety of all occupants of the home; (7) Nontoxic and nonhazardous materials must be used whenever possible. When necessary to the operation of the AHF, toxic or hazardous materials must be safely and properly stored in clearly labeled, original containers, separately from food and medications, and must be kept in locked storage. (8) All bathroom equipment must be clean and in good repair, provide resident privacy, and must have but is not limited to, the following: (a) A finished interior, a mirror, an operable window or other means of ventilation, and a window covering; (b) Tubs or showers, toilets and sinks. A sink must be located near each toilet. A toilet and sink must be provided on each floor where rooms of non-ambulatory residents or residents with limited mobility are located. There must be at least one toilet, one sink, and one tub or shower for each six household occupants, including the provider and family; (c) Hot and cold water in sufficient supply to meet the needs of residents for personal hygiene. Hot water temperature sources for bathing areas must not exceed 120 degrees Fahrenheit for residents identified as being at risk of personal injury associated with hot water access; (d) Shower enclosures with nonporous surfaces. Glass shower doors must be tempered safety glass. Shower curtains must be clean and in good condition. Non-slip floor surfaces must be provided in tubs and showers; (e) Grab bars for toilets, tubs, or showers for safety as required for by residents identified as having balance or mobility impairments. (f) The AFH may not be designed to allow a resident or employee to walk through another resident’s bedroom to get to a bathroom. Residents must have barrier-free access to toilet and bathing facilities with appropriate fixtures. (g) If there are non-ambulatory residents, alternative arrangements must be appropriate to meet the non-ambulatory resident’s needs for maintaining good personal hygiene. (h) Resident must have appropriate racks or hooks for drying bath linens. (9) All furniture and furnishings must be clean and in good repair. (10) Units for all household occupants must have been constructed as a bedroom when the home was built or remodeled under permit; be finished, with walls or partitions of standard construction that go from floor to ceiling, and a door which opens directly to a hallway or common use room without passage through another unit or common bathroom; be adequately ventilated, heated, and lighted. (a) Every sleeping room must have at least one operable window or door approved for emergency escape or rescue. Windows must have a net clear opening of not less than 5.7 square feet (0.53 m2) or 821 square inches (529 676 mm2). The net clear opening height of windows must be not less than 24 inches (610 mm). The net clear opening width of windows must be not less than 20 inches (508 mm). Where windows are provided as a means of egress, they must have a sill height of not more than 44 inches (1118 mm) above the floor. Grade floor windows with a clear opening of not less than 5 square feet (0.46 m2) or 720 square inches (464 515 mm2) with sill heights of 44 inches (1118 mm) may be accepted where approved by the local fire authority. (b) Bedrooms and living quarters must have a minimum of two unobstructed exits. (11) All units must include a minimum of 70 square feet of usable floor space for each resident or 120 square feet for two residents, have no more than two persons per room, and allow for a minimum of three feet between beds. In addition, the provider must ensure that: (a) Each unit has an entrance door with an interior lock for the resident’s privacy: (A) The locking device must release with a single-action lever on the inside of the unit and open to a hall or common use room; (B) The provider must provide each resident with a personalized key that operates only the door to his or her unit door from the corridor side; (C) The provider must maintain a master key to access all units that is quickly available to the provider and staff; (D) The provider may not disable or remove a lock to a unit without first obtaining consent from the resident through the individually based limitations process outlined in OAR 309-040-0393. (b) Providers, resident managers, or their family members must not sleep in areas designated as living areas or share units with residents; (c) In determining maximum capacity, consideration must be given to whether children over the age of five have a bedroom separate from their parents; (d) Units must be on ground level for residents who are non-ambulatory or have impaired mobility; (e) Resident units must be in close enough proximity to alert the provider or resident manager to nighttime needs or emergencies or be equipped with a call bell or intercom. Child monitoring devices may not be used as a substitute. (f) Bedrooms used by the provider, resident manager, and substitute caregiver, must be in the AFH and must have direct access to the individuals through an interior hallway or common use room. (12) AFH's established on or after October 1, 2004, must meet all applicable state building, residential, fire, mechanical, and housing codes for fire and life safety. The AFH must be inspected for fire safety by an inspector designated by the Division using the recommended standards established by the State Fire Marshal for facilities housing one to five residents. Refer to Chapter 49 of the Oregon Fire Code, the Oregon Residential Specialty Code, and the Oregon Structural Specialty Code. When deemed necessary by the Division, a request for fire inspection must be made to the State Fire Marshal. (13) Special hazards such as the following: (a) Noncombustible and nonhazardous materials must be used whenever possible. When necessary to the operation of the AFH, flammable and combustible liquids, and hazardous materials must be safely and properly stored in original, properly labeled containers, or safety containers and secured to prevent tampering by resident or others. (A) Firearms stored on the premises of an AFH must be stored in a locked gun safe, gun vault, or weapons locker. The firearms safe, vault or locker must be in an area of the home that is not readily accessible to residents; and (B) All ammunition must be stored in a separate, locked location that is not readily accessible to residents. (b) Smoking regulations must be adopted to allow smoking only in outside designated areas and in compliance with the Oregon Indoor Clean Air Act as outline in OAR 333-015-0035. Smoking must be prohibited in all indoor areas including sleeping rooms and on all outdoor upholstered furniture. Ashtrays of noncombustible material and safe design must be provided in areas where smoking is permitted; (c) Cleaning supplies, poisons, and insecticides must be properly stored in original, properly labeled containers in a safe area away from food, preparation and storage of food, dining areas, and medications. (14) All furniture and furnishings must be clean and in good repair. There must be at least 150 square feet of common space and sufficient comfortable furniture in the AFH to accommodate the recreational and socialization needs of all occupants at one time. Common space may not be located in basements or garages unless such space was constructed for that purpose or has otherwise been legalized under permit. Additional space must be required if wheelchairs are to be accommodated. (15) All laundry equipment must be clean and in good repair. Laundry facilities must be separate from food preparation and other resident use areas. The provider must maintain the following: (a) Locked storage area for chemicals that pose a safety threat to residents or family members identified to be at risk of personal injury; (b) Sufficient, separate storage and handling space to ensure that clean laundry is not contaminated by soiled laundry; and (c) Outlets, venting, and water hookups according to State Building Code requirements. (16) All kitchen equipment must be clean and in good repair. The provider must maintain an area for dry storage, not subject to freezing, in cabinets or a separate pantry with a minimum of one week’s supply of staple foods. The provider must maintain the following: (a) Sufficient refrigeration space maintained at 40 degrees Fahrenheit or less and freezer space maintained at 0 degrees Fahrenheit or less for a minimum of two days’ supply of perishable foods; (b) A dishwasher (c) Smooth, nonabsorbent and cleanable counters for food preparation and serving; (d) Appropriate storage for dishes and cooking utensils designed to be free from potential contamination; (e) Stove and oven equipment for cooking and baking needs; (f) Storage for a mop and other cleaning tools and supplies used for food preparation, dining, and adjacent areas. Such cleaning tools must be maintained separately from those used to clean other parts of the home; and (g) Dining Space where meals are served must be provided to seat all residents at the same seating. (17) Exit doors may not have locks that prevent evacuation except as permitted by the applicable building code. An exterior door alarm or other acceptable system may be provided for security purposes and alert the provider when residents or others enter or exit the home. (18) The heating and if applicable, air-conditioning system must be in good repair, used properly, and maintained according to the manufacturer’s or a qualified inspector’s recommendations: (a) Areas of the AFH used by residents must be maintained at no less than 68 degrees Fahrenheit during daytime hours and no less than 60 degrees Fahrenheit during sleeping hours. During times of extreme summer heat, maximum temperatures must not exceed 78 degrees Fahrenheit. The provider must make reasonable effort to make the residents comfortable using available ventilation or fans; (b) All toilets and shower rooms must be ventilated by a mechanical exhaust system or operable window; (c) Design and installation of fireplaces, furnaces, pellet stoves, and wood stoves must meet standards of the Oregon Mechanical, Residential Specialty Code, the manufacturer’s specifications, under permit where applicable, and have annual inspections to assure no safety hazard exists; (A) A provider who does not have a permit verifying proper installation of an existing wood stove, pellet stove, or gas fireplace must have it inspected by a qualified inspector, Certified Oregon Chimney Sweep Association member, National Fireplace Institute technician certified in wood or pellet stoves, or Oregon Hearth, Patio, and Barbecue Association member and follow the inspector’s recommended maintenance schedule. (B) Approved and listed protective glass screens or metal mesh screens anchored top and bottom must be installed on working fireplaces and solid-fuel-burning appliances. (C) Heat sources such as woodstoves, working fireplaces and solid-fuel-burning appliances must have a 36-inch buffer or barrier space. (D) Unvented oil, gas, or kerosene heaters must not be used. (19) Hot water temperatures must be maintained within a range of 110¼ to 140 120 degrees Fahrenheit. (20) All electrical systems must meet the standards of the Oregon Electrical Specialty Code in effect on the date of installation, electrical equipment and wiring must be in accordance with Chapter 6 of the Oregon Fire Code and other nationally recognized standards. and all electrical devices must be properly wired and in good repair: (a) When not fully grounded, GFI-type receptacles or circuit breakers as an acceptable alternative may protect circuits in resident areas; (b) Circuit breakers or non-interchangeable circuit-breaker-type fuses in fuse boxes must be used to protect all electrical circuits. There must be a minimum clear radius of not less than 36 inches around electrical panels to permit safe operation and maintenance. Nothing may be stored in front of electrical panels; (c) A sufficient supply of electrical outlets must be provided to meet resident and staff needs without the use of extension cords or outlet expander devices. Electrical outlets, light switches and other electrical box openings must have covers. Interior power outlets may not be sourced for power to exterior spaces. Listed and labeled re-locatable power strips or taps (RPTs) with circuit breaker protection are permitted for indoor use only and must be installed and used in accordance with the manufacturer's instructions. If RPTs are used, the RPT must be directly connected to an electrical outlet, never connected to another RPT (known as daisy-chaining or piggy-backing), never connected to an extension cord, and may not be used in place of permanent wiring; (d) A functioning light must be provided in each room, stairway, and exit way. Lighting fixtures must be provided in each resident bedroom and bathroom with a light switch near the entry door and in other areas as required to meet task illumination needs; (e) Incandescent light bulbs must be protected with appropriate covers, unless the bulb is designed by the manufacturer to be used without a cover. (21) All plumbing must meet the Oregon Plumbing Specialty Code in effect on the date of installation, and all plumbing fixtures must be properly installed and in good repair. (22) Telephones: (a) A telephone must be available and accessible in a common area of the home 24 hours a day for residents’ use for incoming and outgoing calls in the AFH; Resident restrictions to phone access can only be implemented with an individually based limitation. (b) A list of emergency telephone numbers and emergency contact information must be kept by the phone and must include: (A) The name and emergency contact number for the provider; (B) An alternate caregiver name and phone number if the provider is not available; (C) The street address of the AFH; (D) Emergency dispatch (911) and non-urgent police and fire contact numbers; (E) Poison control; (F) The local hospital; (G) The Office of Training, Investigations, and Safety; (H) Oregon SAFELINE [1-855-503-SAFE (7233)] and (I) Non-emergency numbers for contacting caseworkers, the CMHP, the HSD, Disability Rights Oregon, the local public health office and emotional support lines available in the area. (c) The provider may establish reasonable rules governing telephone use to ensure equal access by all residents. Each resident or guardian (as applicable) is responsible for payment of charges or fees associated with their phone use. Charges associated with phone use must be described in each resident’s residential agreement. (23) LGBTQIA2S+ Protections and the LGBTQIA2S+ Nondiscrimination Notice, as described in OAR 411-049-0135(1)(i), must be posted in all places and on all materials where that notice or those written materials are posted. Statutory/Other Authority: ORS 413.042 & SB 739 (2025) Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 26-2025, amend filed 12/23/2025, effective 01/01/2026 BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHD 3-2005, f. & cert. ef. 4-1-05, Renumbered from 309-040-0050 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92, Sec. (8)-(10), Renumbered to 309-040-0052 MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & cert. ef. 12-27-85 309-040-0370 Safety (1) The provider must train all program staff in staff safety procedures prior to beginning their first regular shift. All residents must be trained in resident safety procedures during their first 24 hours of residency. (2) Emergency Procedures: (a) An emergency evacuation procedure must be developed, posted, and rehearsed with the residents residing in the home occupants. The emergency evacuation procedure must include training on when and how to safely evacuate the home, where to meet after the evacuation, who to contact, how to get assistance with evacuating if needed, and instructions for how to respond specifically to a smoke alarm, carbon monoxide alarm, or other emergency devices or notifications. (b) A record must be maintained of evacuation drills. Evacuation drills must be scheduled at different times of the day, on different days of the week, with exit routes being varied, and with different locations designated as the origin of the fire for drill purposes: (A) Evacuation drills must be held at least once a every 90 calendar days, with at least one drill per year conducted between the hours of 10:00 P.M. and 6:00 A.M; (B) Evacuation drill records must include the date and time of the drill, the time for full evacuation and for each individual to evacuate, the location designated as the origin of the fire for drill purposes, the full names of all residents and staff present, comments on the drill results and any difficulties experienced, the names of residents requiring assistance for evacuation and the type of evacuation assistance provided by staff to individuals as specified in each individual's safety plan, and the signature of the staff person conducting the drill.; (C) Evacuation drill records will also document safety checks of fire extinguishers, emergency lights, smoke and carbon monoxide alarms, protection equipment, egress paths, secondary egress points and furnace filters (to be changed per manufacturer instructions), number of staff present; and (D) Evacuation drill records must be maintained for a minimum of three years. (c) The residential care plan must document that within 24 hours of arrival, each new resident has received an orientation to basic safety and has been shown how to respond to a fire alarm and how to exit from the AFH in an emergency; (d) The provider must demonstrate the ability to evacuate all residents from the facility to a point of safety exterior to and away from the structure, with access to a public way, within three minutes. If there are problems in demonstrating this evacuation time, the Division may apply conditions to the license that include, but may not be limited to, reduction of residents under care, additional staffing, or increased fire protection. (3) The provider must provide to the Division, maintain as current, and post a floor plan on each floor containing room sizes, location of each resident’s sleeping room, resident manager or provider's sleeping room, the location of any ramps, any designated smoking areas, the location of all exits on each level of the residential setting including emergency exits such as windows, smoke and carbon monoxide alarms , fire extinguishers, escape routes and point of safety, and a list of major fire hazards associated with the normal use and occupancy of the premises. A copy of this drawing must be submitted with the application and updated to reflect any change; (4) There must be at least one plug-in rechargeable flashlight available for emergency lighting in a readily accessible area on each floor including a basement. (5) Evacuation capability categories are based upon the ability of the residents and staff to evacuate the facility or relocate to the point of safety: (a) Documentation of a resident’s ability to safely evacuate from the facility, and the level of assistance needed to safely evacuate the home, must be maintained in the resident’s personal care plan; (b) The provider must assess the resident's ability to evacuate the home in response to an alarm or simulated emergency: (A) Prior to an individual's entry to the home; and (B) Annually, or when there is a change in a resident’s support needs that would likely impact a resident’s emergency evacuation abilities, whichever occurs more frequently. (c) Resident’s experiencing difficulty with evacuating in a timely manner must be provided assistance from staff and offered environmental and other accommodations, as practical. Under these circumstances, the provider must consider increasing staff levels, changing staff assignments, offering to change the resident’s room assignment, arranging for special equipment, and taking other actions that may assist the resident. The provider must document all actions and interventions attempted; (d) Resident who regularly decline to participate in evacuation drills will be evaluated for their evacuation capability to determine whether or not they need special assistance to evacuate. (e ) Resident who cannot evacuate the home safely within three minutes must be assisted with transferring to another program with an evacuation capability designation consistent with the resident’s documented evacuation capability; (f) Only ambulatory residents capable of self-preservation must be housed on a second floor or in a basement. Lifts or elevators must not be used as a substitute for a resident’s capability to ambulate stairs. (g)The provider must develop a written individual fire safety and evacuation plan for residents who are unable to evacuate the residence within the required evacuation time or who decline to participate in fire drills on more than two occasions that includes the following: (A) Documentation of the risk to the resident's medical and physical condition, and behavioral status; (B) Identification of how the resident evacuates his or her residence, including level of support needed; (C) The routes to be used to evacuate the resident to a point of safety; (D) Identification of assistive devices required for evacuation; (E) The frequency the plan is to be practiced and reviewed by the resident and staff; (F) The alternative practices; (G) Approval of the plan by the resident or resident's legal representative (as applicable), case manager, and the provider, licensee, or resident manager; and (H) A plan to encourage future participation. (h) The residential setting must maintain documentation of the practice and review of the individual fire evacuation safety plan by the individual and the staff. (6) All stairways, halls, doorways, passageways, and exits from rooms and from the home must be unobstructed. (7) At least one 2A-10BC rated fire extinguisher must be in a visible and readily accessible location within 75 feet of travel distance in the AFH, on each floor, including basements, and must be maintained in accordance with Section 906 of the Oregon Fire Code. (8) Fire extinguishers must: (a) Be serviced annually and tagged by a qualified company or technician. New extinguishers manufactured within the last 12 months are exempted from this requirement. (b) Be located in conspicuous locations along normal paths of travel where they will have ready access and be immediately available for use; (c) Not be obscured from view. In rooms or areas in which visual obstruction cannot be completely avoided, signage must be provided to indicate the locations of extinguishers; (d) Be installed on the hangers or brackets supplied. Hangers or brackets must be securely anchored to the mounting surface in accordance with the manufacturer’s installation instructions; (e) Be installed so that the tops are not more than 3.5 feet above the floor; (f) Be installed so that the bottoms are not less than 4 inches above the floor; and (g) Not be locked. (9) Approved smoke detector systems or smoke alarms, and carbon monoxide alarms must be UL- approved, and installed according to Oregon Residential Specialty Code, Oregon Fire Code requirements, and manufacturer’s instructions. These alarms must be inspected and tested at least monthly, and during each evacuation drill. The provider must provide approved signal devices for resident’s with disabilities who do not respond to the standard auditory alarms. If a resident is deaf or hard of hearing, smoke alarm(s) consistent with the resident’s support needs must be provided. All of these devices must be inspected and maintained in accordance with the requirements of the State Fire Marshal or local agency having jurisdiction. Ceiling placement of smoke alarms or detectors is recommended. Alarms must be installed in each bedroom, adjacent hallways, common living areas, basements and in multilevel homes, at the top of each stairway or attic spaces accessible by an interior stairway. Carbon monoxide alarms must be installed and maintained in all areas with a fuel-burning appliance or carbon monoxide source, including attached garages, and in each bedroom or within 15 feet (4572 mm) outside each bedroom door. Bedrooms on separate floor levels in a structure consisting of two or more stories must have separate carbon monoxide alarms serving each story. Alarms must be equipped with a device that warns of low battery when battery operated. All smoke detectors and alarms must be maintained in functional condition; (a) An AFH licensed on or after March 1, 2025 must have permanent, hard-wired, interconnected smoke alarms and carbon monoxide alarms with battery back-up. (b) Alarms must be replaced when any of the following occur: (A) The end-of-life signal is activated; (B) The manufacturer’s replacement date is reached; or (C) The alarm(s) fail to respond to operability tests. (10) Special hazards: (a) Flammable and combustible liquids and hazardous materials must be safely and properly stored in original, properly labeled containers or safety containers, and secured to prevent tampering by residents and vandals. (A) Flammables and combustibles must not be stored in unvented rooms or spaces, or closets. (B) Propane tanks must not be stored in the home interior (C) Measures, including locking materials and incendiary devices, must be implemented, as appropriate, to address individually-identified safety risks related to fire, flammables, and combustibles. (b) Oxygen and other gas cylinders in service or in storage must be adequately secured in accordance with the Oregon Fire Code to prevent the cylinders from falling or being knocked over. No smoking signs must be visibly posted on all doors leading to oxygen use and storage areas. In accordance with the Oregon Fire Code, oxygen cylinders must not be used or stored in rooms where wood stoves, fireplaces, or open flames are located. (c) Generators and generator fuel may not be stored or operated in the home interior. (A) A gasoline or propane generator may be stored in a garage when not in use. (B) Liquid propane gas must not be stored in an attached garage or enclosed storage space. Enclosed structures used for the storage of liquid propane gas may not share a wall or direct openings to the home. (d) Firearms stored on the premises of an AFH must be stored in a locked cabinet. The firearms cabinet must be located in an area of the home that is not readily accessible to clients, and all ammunition must be stored in a separate, locked location; (e) Smoking regulations shall be adopted to allow smoking only in safe designated areas away from the building. Ashtrays of noncombustible material and safe design must be provided in areas where smoking is permitted; and (f) Cleaning supplies, poisons, and insecticides must be properly stored in original, properly labeled containers in a safe area away from food, preparation and storage of food, dining areas, and medications. (11) Sprinkler systems, if used, must be installed in compliance with the Oregon Structural Specialty Code and Oregon Fire Code and maintained in accordance with rules adopted by the State Fire Marshal. (12) First aid supplies must be readily accessible to staff. All supplies must be properly labeled. (13) Portable heaters must be listed, labeled, and approved per Oregon Fire Code and must be plugged directly into an approved outlet without the use of an extension cord, power strip or expander device. Heaters must be equipped with tip-over, shut-off capacity. (14) Safety P lan s must be developed and implemented to identify and prevent the occurrence of hazards. A safety plan will be developed identifying common hazards in the facility and that describes how staff should respond when specific hazards are identified. A safety record will be kept documenting the actions taken by staff to mitigate hazards when safety risks are identified. The safety plan should identify both environmental hazards and actions or behaviors of staff, residents, or guests that create an unsafe situation in the home. Potential situations that could cause health or safety risks in the home may include, the identification of dangerous substances or items; broken, chipped, or sharp objects, exposed electrical wiring or unprotected electrical outlets; the overuse of extension cords or other special plug-in adapters; slippery floors or stairs, damaged decks or walkways, exposed heating devices, broken glass, unsafe smoking areas, unsafe ashtrays and ash disposal, and other potential fire hazards. The safety plan must also document monthly safety checks of fire extinguishers, emergency flashlights, smoke and carbon monoxide alarms, egress paths, secondary egress points and furnace filters. Monthly documentation of these checks must be maintained for a minimum of three years. Furnace filters must be changed per manufacturer instructions. (15) When hazards are identified concerning residents, the provider will determine if an incident report should be written or if behavior support plans need to be developed and included in the resident’s residential care plan. The Safety record should include a description of the identified concerns, and how staff resolved the concern and whether additional action may be needed. (16) The provider must develop and implement a written Emergency Preparedness plan. The plan must include when emergency services will be contacted and describe procedures for staff to follow during such emergencies and disasters as fires, missing persons, accidents, earthquakes, floods, and tsunamis. The program must be immediately available to the program administrator and program staff. The plan must include diagrams of evacuation routes, and these must be posted. The plan must specify where staff and residents will reside if the setting becomes uninhabitable. Shelter plans should not depend on the availability of public shelters that may or may not be available at the time of an emergency. The program must update the plan and must include: (a) Emergency instructions for employees; (b) The telephone numbers of the local fire department, police department, the poison control center, the local public health office, the administrator, the administrator's designee, and other persons to be contacted in emergencies; and (c) Instructions for the evacuation of residents and staff. (d) Resources for sheltering in place. (e) Alternative resources for utility outages. (f) Procedures for notifying public health when significant health risks are present, including but not limited to communicable and noncommunicable diseases and conditions, pest infestations, and other environmental hazards as described in OAR 333. (17) An Emergency Evacuation and Fire Safety Procedure shall be developed, posted, and practiced with all occupants. The procedure must: (a) Meet standards consistent with Oregon Fire Code; and (b) Be readily available at all times within the AFH in a prominent location with other postings and the license. (18) An Emergency Evacuation and Fire Safety Procedure must include the following: (a) Emergency egress and escape routes, including assembly point for occupants following egress; (b) Procedures for assisting individuals who require support to use means of egress; (c) Procedures for accounting for occupants of the home after evacuation has been completed; (d) Preferred and any alternative means for notifying occupants of a fire or emergency; (e) Preferred and any alternative means of reporting fires and other emergencies to the fire department or designated emergency response organization; (f) Identification and assignment of personnel who can be contacted for further information or explanation of duties under the plan; (g) A description of the emergency voice/alarm communication system alert tone and preprogrammed voice messages, where applicable. (19) All staff must be trained in safety procedures including emergency evacuation procedures, and proper use of portable fire extinguishers prior to providing care. (20) All staff must review their duties and responsibilities under the fire safety evacuation plan no less than every three months. Such review must be documented and maintained in the provider records. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHD 3-2005, f. & cert. ef. 4-1-05 309-040-0375 Sanitation (1) The water supply in the home must meet the requirements of the current Authority rules governing domestic water supplies: (a) A municipal water supply must be utilized if available; (b) When the home is not served by an approved municipal water system, a sanitarian or a technician from a laboratory accredited for well water testing must collect and test a sample for total coliform bacteria at least quarterly, and nitrate at least annually, and reported to the Division. For adverse test results, repeat samples and corrective action must be taken to assure compliance with water quality standards. Water testing and any necessary corrective action to ensure water is suitable for drinking must be completed at the provider’s expense. Public notice must be given whenever a violation of the water quality standards occurs, and records of water testing must be retained for three years. (2) All floors, walls, ceilings, windows, furniture, and equipment must be kept in good repair, clean, neat, and orderly. (3) Each bathtub, shower, lavatory, and toilet must be kept clean, in good repair, and regularly sanitized. (4) Kitchen sinks may not be used for the disposal of cleaning wastewater. (5) Soiled linens and clothing must be stored in an area or container separate from kitchens, dining areas, clean linens, clothing, and food. (a) All soiled linens designated for cleaning and sanitation must be stored separately from soiled linens designated for personal hygiene. (6) All necessary measures must be taken to prevent rodents and insects from entering the home. Should pests be found in the home, appropriate action must be taken to eliminate them. All occurrences of bedbugs must be reported to the local Public Health Division and the CMHP. (7) The grounds of the facility must be kept orderly and reasonably free of litter, unused articles, and refuse. (a) Outdoor walkways must be free of trip hazards. (b) Fencing, if present on the property, must meet minimum standards for safety. (c) Roofing and gutters must be free of debris and moss buildup (d) All decks, railing, and siding must have a weather resistant coating free of cracks and chips. (8) Garbage and refuse receptacles must be clean, durable, watertight, insect and rodent proof, and must be kept covered with tight-fitting lids. All garbage and solid waste must be disposed of at least weekly and in compliance with the current rules of the Department of Environmental Quality. (9) All sewage and liquid wastes must be disposed of in accordance with the Plumbing Code to a municipal sewage system where such facilities are available. If a municipal sewage system is not available, sewage and liquid wastes must be collected, treated, and disposed of in compliance with the current rules of the Department of Environmental Quality. Sewage lines and septic tanks or other non-municipal sewage disposal systems, where applicable, must be maintained in good working order. (10) Biohazard waste must be stored and disposed of in compliance with the rules of the Department of Environmental Quality as described in OAR 340-100-0002. (11) Precautions must be taken to prevent the spread of infectious or communicable diseases as defined by the Centers for Disease Control and to minimize or eliminate exposure to known health hazards: (a) In accordance with OAR 437-002-0368 through 2226of the Oregon Occupational Safety and Health Code, program staff must employ universal precautions whereby all human blood and certain body fluids are treated as if known to be infectious for HIV, HBV, and other blood borne pathogens; (b) Bathroom facilities must be equipped with an adequate supply of toilet paper, soap, and towels. (12) If pets or other household animals exist at the home, sanitation practices must be implemented to prevent health hazards: (a) These animals must be vaccinated in accordance with the recommendations of a licensed veterinarian. Proof of such vaccinations must be maintained on the premises; (b) Animals not confined in enclosures must be under control and maintained in a manner that does not adversely impact residents or others. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHD 3-2005, f. & cert. ef. 4-1-05 309-040-0380 Individual Furnishings (1) Bedrooms and Units: (a) Bedrooms for all household occupants and units for residents must have been constructed as a bedroom when the home was built or remodeled under permit; be finished with walls or partitions of standard construction that go from floor to ceiling and a door that opens directly to a hallway or common use room without passage through another bedroom or unit or common bathroom; be adequately ventilated, heated and lighted with at least one operable window that meets the requirements of Section R310 of the Oregon Residential Specialty Code; have at least 70 square feet of usable floor space for each resident or 120 square feet for two residents and have no more than two residents per room; (b) Providers, resident managers, or their family members may not sleep in areas designated as living areas, or share bedrooms or units with residents; (c) There must be an individual bed for each resident consisting of a mattress in good condition and springs at least 36 inches wide. Cots, rollaway, bunks, trundles, couches, and folding beds may not be used for residents. Each bed must have clean bedding in good condition consisting of a bedspread, mattress pad, two sheets, a pillow, a pillowcase, and blankets adequate for the weather. Sheets and pillowcases must be laundered at least weekly, and more often if necessary. Waterproof mattress covers must be used for incontinent residents. Day care individuals may not use resident beds; (d) Each unit must have sufficient separate, private dresser and closet space for each resident’s clothing and personal effects, including hygiene and grooming supplies. Residents must be allowed to keep and use reasonable amounts of personal belongings and to have private, secure storage space. Drapes or shades for windows must be in good condition and provider privacy for residents; (e) Units must be on ground level for residents who are non-ambulatory or have impaired mobility; (f) Units must be in close enough proximity to the provider to alert the provider to night time needs or emergencies or be equipped with a call bell or intercom. (2) Each resident must be assisted in obtaining personal hygiene items in accordance with resident needs. Items must be stored in a clean and sanitary manner and may be purchased with the resident’s personal allowance. Personal hygiene items include, but are not limited to, a comb or hairbrush, a toothbrush, toothpaste, menstrual supplies (if needed), and washcloths. (3) Sufficient supplies of soap, shampoo, toilet paper, and towels for all residents must be provided. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHD 3-2005, f. & cert. ef. 4-1-05 309-040-0385 Food Services (1) Providers must prepare and serve three nutritionally balanced meals and provide at least two snacks to residents each day at times consistent with those in the community. (a) Meals must be prepared and served in the facility where the residents live. (A) Meals eaten away from the AFH for the convenience of the provider (e.g. restaurants, community meal sites) must be paid for by the provider. (B) Meals and snacks eaten as part of a resident’s own recreational outing must be paid for by the resident. (b) Each meal must include food from the basic food groups according to the United States Department of Agriculture (USDAs) My Plate, and regularly include fresh fruit and vegetables. (c) Meals and snacks must be planned and served with consideration for resident food preferences, allergies, and special or modified diets as well as cultural, religious and ethnic considerations. (d) Meals will be offered in family style, however, residents may choose to eat in their personal living space. (e) A menu for the meals for the coming week must be prepared and posted weekly. (2) Foods purchased under the resident’s room and board agreement for meals and snacks will include dietary standards such breads, condiments, dairy products, fruits and vegetables and other common foods as may be requested by a resident for their use. (3) Residents will have unrestricted access to food and drinks purchased for their use under the room and board agreement for meals or snacks and will have unrestricted access to common food preparation and storage appliances, equipment, cleaning supplies and preparation space needed for preparing food. (4) Food must not be used as an inducement to control the behavior of a resident. (5) An order from an LMP must be obtained for each resident who for health reasons is on a modified or special diet. These diets must be planned in consultation with the resident. (6) Records of menus as served must be filed and maintained in the AFH for two years. (7) The provider must maintain adequate supplies of staple foods for a minimum of one week and perishable foods for a minimum of two days at the setting. An emergency supply of potable water must be available such that the provider maintains seven gallons of water per resident. (8) Food must be stored, prepared, and served in accordance with the Authority's Food Sanitation Rules: (a) All working refrigerators and freezers must have a thermometer in working order; (b) Food storage areas and equipment must be such that food is protected from dirt and contamination and maintained at proper temperatures to prevent spoilage. (9) Food preparation areas must be clean, free of obnoxious odors, and in good repair. (10) Equipment must be maintained in a safe and sanitary manner. Utensils, dishes, and glassware must be maintained in a sufficient number to accommodate the licensed capacity of the AFHs. Utensils, dishes, and glassware must be washed in hot soapy water, rinsed, and stored to prevent contamination. A dishwasher with sanitation cycle is recommended. (11) The provider must support the resident’s right to access food at any time. The provider may only apply an individually-based limitation when there is a threat to the health and safety of a resident or others, and the provider complies with the requirements outlined in OAR 309-040-0393. (12) The provider cannot restrict a resident’s right to have meals or snacks in their private living area unless an individual limitation is documented in their care plan based on a documented health or safety risk. (13) If a resident misses a meal at a scheduled time, an alternative meal must be made available. (14) The provider may not schedule meals with more than a 14-hour span between the evening meal and the following morning’s meal (see, OAR 411-050-0645) Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHD 3-2005, f. & cert. ef. 4-1-05 309-040-0390 Standards and Practices for Care and Services (1) The provider, resident manager and substitute caregivers must understand administration of each resident’s medications, including the reason the medication was ordered, route, frequency, parameters (such as when to hold or call the prescriber), required monitoring, how the medication is intended to work, common side effects, and adverse reactions. (2) Medication resource material must be readily available in the AFH. Acceptable resource materials include prescription drug information sheets, drug fact labels for over-the-counter medications, supplement fact labels, nutritional fact labels, current drug manuals and drug references websites. Caregivers must be able to readily access the internet when drug reference websites are the chosen material. (3) Medications and Prescriber's Orders: (a) There must be a signed copy of all medications, dietary supplements, over-the-counter medications, treatments, or therapies ordered by a prescribing practitioner or requested by the resident in the resident’s file, except as otherwise permitted under OAR 309-040-0390(4)-(5) Visit summary documents that list current medications are not consider medical orders even if the prescribing practitioner signs the document. Written orders must include: (A) Dated order; (B) Name of the medication; (C) Strength of the medication; (D) Dose; (E) Frequency; (F) Administration route; (G) Reason medication is being taken; and (H) Prescriber’s signature or typed name. (b) A provider, resident manager, or substitute caregiver must dispense medications, dietary supplements, over-the-counter medications, treatments, and therapies as prescribed unless the resident or the resident’s legal representative refuses to consent. (c) The prescribing practitioner must be notified of refusal to consent to an order. (d) Changes to orders may not be made without a prescribing practitioner order. Changes made over the phone must be followed-up with a, written or electronic copy of the order within 72 hours of the change notice. (A) The provider, resident manager, or substitute caregiver must promptly notify the resident’s case manager of any request for a change in the resident’s orders for medications, treatments, or therapies; (B) Changes in the dosage or frequency of an existing medication require a new properly labeled and dispensed medication container. If a new properly labeled and dispensed medication container is not obtained, the change must be written on an auxiliary label attached to the medication container, not to deface the existing original pharmacy label, and the information must match the new medication order. (C) Changes for a medication packaged in a blister pack, must be made by the Pharmacist that filled the order. (e) All medications, including over-the-counter medications must be in the original container and be clearly labeled with the pharmacist's label or the manufacturer's original label. Over-the-counter medications must be marked with the resident’s name. (f) All medications, including over-the-counter medications, must be stored as directed by the manufacturer, and kept in a locked location except as otherwise permitted under OAR 309-040-0390(4)-(5), that is cool, clean, dry and not subject to direct sunlight or fluctuations in temperature. (A) The provider or provider's family medication must be stored in a separate locked location. (B) All medication for pets or other animals must be stored in a separate locked location. (C) Medication requiring refrigeration must also be locked and stored separately from medications of others. (4) The program must ensure at least one unexpired opioid overdose kit for emergency response to suspected overdose is available in the facility at all times. Opioid overdose kits do not require a prescription and are not specific to an individual (see ORS 689.800). (a) All opioid overdose kits must include an ultraviolet light-protected hard case and must contain, but not be limited to: (A) Two doses of an FDA-approved short-acting, non-injectable, opioid antagonist medication; (B) One pair non-latex gloves; (C) One face mask; (D) One face shield for rescue breathing that is maintained according to manufacturer’s recommendations; and (E) One short-acting, non-injectable, opioid antagonist medication administration instruction card. (b) Opioid overdose kits must be: (A) Installed in an easily accessible, highly visible, and unlocked location; (B) At a height of no more than 48 inches from the floor; (C) In a location without direct sunlight; (D) In an area where temperatures are maintained between 59 degrees Fahrenheit and 77 degrees Fahrenheit; and (E) Have a sign clearly indicating the location and content of the kit. (c) Short-acting, non-injectable, opioid antagonist medication not within installed opioid overdose kits must be stored in a locked cabinet with other resident medications. (d) Opioid overdose kits must be: (A) Checked daily to ensure the required components have not been removed or damaged, with documentation of daily checks maintained for three years; (B) Checked monthly to ensure the short-acting, non-injectable, opioid antagonist medication has not expired, with documentation of monthly checks maintained for three years; and (C) Restocked immediately after use. (e) Upon recognizing a person appears to be experiencing an overdose, program staff must immediate respond based on the medical emergency procedures of the facility. (f) A person who has reasonable cause to believe and in good faith administers short-acting, non-injectable, opioid antagonist medication to a person experiencing an overdose, is protected against civil liability or criminal prosecution unless the person, while rendering care, acts with gross negligence, willful misconduct, or intentional wrongdoing as described in Oregon Revised Statute (ORS) 689.800. (g) Administration of short-acting, non-injectable, opioid antagonist medication must be documented by the caregiver who administered the medication. Documentation must be submitted to the Authority within 48 hours of the incident and must include: (A) Name of the individual; (B) Description of the incident including date, time, and location; (C) Time 9-1-1 contacted; (D) Time of administration(s) of short-acting, non-injectable, opioid antagonist medication; (E) Individual’s response; (F) Transfer of care to EMS; and (G) Signature of caregiver. (h) Program staff must fully cooperate with emergency medical service (EMS) personnel. Program staff must not interfere with or impede the administration of emergency medical services. (5) Opioid overdose medication and kits which are the personal property of a resident, do not need to be kept in a locked location or maintained as described under OAR 309-040-0390(4). (6) Discontinued, outdated, or recalled medications may not be kept in the AFH and must be disposed in a manner advised by Department of Environmental Quality, (a) The provider must document disposal of all discontinued, outdated, and recalled medication on resident’s drug disposal forms. (b) Disposal must occur within 10 calendar days of expiration, discontinuation, or provider’s knowledge of recall. (c) Prescription medications for resident’s who have died, must be disposed of within 24 hours. Prescription medications are not transferable to anyone other than the resident identified on the prescription label. (7) Medications may only not be mixed together in another container prior to administration as directed by a physician order, or as packaged by the pharmacy. (8) A written medication administration record (MAR) or electronic MAR must be maintained for each resident. (a) The MAR must include: (A) The name of all medications, treatments and therapies administered by the program staff to that resident, including over-the-counter medications and prescribed or dietary supplements. (B) The name of all medications, treatments and therapies self-administered by the resident and indicate that they are self-administered. Resident do not have to document self-administrations on the MAR. (C) The name of medication, dosage and frequency of administration, route or method, dates and times given, and any parameters for each prescribed medication, over-the-counter medication, and supplements. (D) Scheduled medications must have a specific time assigned on the MAR when the medication will be administered. Medications administered “as needed” (also known as PRN medications) must be listed as “PRN” and not have a specific time. (E) PRN medications must include what dosages not to exceed in a 24-hour period and may not include any dosage ranges. (F) Documentation of any known allergy or adverse reactions to a food or medication. (b) The MAR must be immediately initialed by the caregiver dispensing using only blue or black indelible ink. (c) Treatments, therapies, and special diets must be immediately documented on the medication administration record including the specific time given, type of treatment or therapy, and initials of the caregiver giving it using only blue or black indelible ink. (d) The medication administration record must have a legible signature for each set of initials using only blue or black indelible ink; (e) The MAR must indicate when medications are provided to non-staff, alternate caregivers (e.g. family members) to administer when residents will be away from the home. (f) The MAR must include , documentation and an explanation of why a PRN medication was administered and the results of such administration; (g) Medication may not be used for the convenience of the caregiver and must never be used to discipline a resident. (h) Changed or discontinued orders must be immediately documented on the MAR showing the date of the change or discontinued order. A changed order must be written on a new line. (i) Missed or refused medication, treatment or therapy must be documented by circling the caregivers initials and completing a brief explanation in the results section of the MAR. (j) The prescribing practitioner must be notified when there are observed side effects or concerns regarding the resident’s response to medication. (9) Subcutaneous, intramuscular, and intravenous injections may be self-administered by the resident if the resident is fully independent in the task, administered by a relative of the resident, or administered by a current Oregon licensed registered nurse. A current Oregon licensed practical nurse may administer subcutaneous and intramuscular injections. Providers and caregivers who have been delegated and trained by a registered nurse in accordance with administrative rules of the Board of Nursing chapter 851, division 047 may administer subcutaneous injections. Intramuscular and intravenous injections may not be delegated except as allowed by (3)(S) of this rule. Documentation regarding the training or delegation must be maintained in the resident’s record; (a) Intramuscular injections used to administer medications for lifesaving emergencies as outlined in ORS 433.800 to 433.830 and Chapter 333 Division 55 must be taught by a registered nurse, a pharmacist, or the prescriber, and the AFH provider must be given written detailed step-by-step instructions; and (b) Precautions must be taken to prevent injuries caused by needles, scalpels, and other sharp instruments or devices during procedures. All sharps, including, but not limited to, needles and lancets, must be disposed of in approved sharps containers that: (A) Are puncture-resistant; (B) Are leak-proof; (C) Are labeled or color-coded red to warn the contents are hazardous; (D) Have a lid, flap, door, or other means of closing the container and inhibits the ability to remove sharps from the container; (E) Are not overfilled; (F) Are stored in an upright position in a secure location as close as practical to the use area. The container must be accessible to residents and not close to any food preparation or food storage area; and (G) Must be closed immediately once full and properly disposed of within 10 days, according to the home’s waste management company’s or pharmacy’s instructions. (10) Nursing tasks may be delegated by a registered nurse to providers and other caregivers only in accordance with administrative rules of the Board of Nursing chapter 851, division 47. This includes but is not limited to the following conditions: (a) The registered nurse has assessed the resident’s condition to determine there is not a significant risk to the resident if the provider or other caregiver performs the task; (b) The registered nurse has determined the provider or other caregiver is capable of performing the task; (c) The registered nurse has taught the provider or caregiver how to do the task; (d) The provider or caregiver has satisfactorily demonstrated to the registered nurse the ability to perform the task safely and accurately; (e) The registered nurse provides written instructions for the provider or caregiver to use as a reference; (f) The provider or caregiver has been instructed that the task is delegated for this specific person only and is not transferable to other residents or taught to other care providers; (g) The registered nurse has determined the frequency for monitoring the provider or caregiver's delivery of the delegated task; and (h) The registered nurse has documented a residential care plan for the resident including delegated procedures, frequency of registered nurse follow-up visits, and signature and license number of the registered nurse doing the delegating. (11) The initial residential care plan must be developed within 24 hours of admission to the AFH. (a) During the initial 30 calendar days following the resident’s admission to the AFH, the provider must continue to assess and document the resident’s preferences and care needs. The provider must complete and document the assessment in an RCP within 30 days after admission, unless the resident is admitted to the AFH for crisis-respite services; (b) An RCP is an individualized plan intended to implement and document the provider’s delivery of services and identifies the goals to be accomplished through those services. The RCP must describe the resident’s needs, preferences, and capabilities relating to their activities of daily living and instrumental activities of daily living needs identified in their person centered service plan, and what assistance the individual requires for various tasks; (c) The provider must develop the RCP based upon the findings of the resident assessment and the person-centered service plan with participation of the resident and through collaboration with the resident’s primary mental health treatment provider. With consent of the resident, family members, representatives from involved agencies, and others with an interest in the resident’s circumstances may be invited to participate in the development of the RCP. The provider must have proper, prior authorization from the resident or the resident’s representative prior to such contact; (d) The RCP must adequately consider and facilitate the implementation of the resident’s person-centered service plan by addressing the following: (A) The resident’s care needs including night care. (B) The resident’s continued ability to evacuate the AFH in less than 3 minutes, and describe any supports that are needed to do so if applicable (C) Any current self-administration for medications, treatments or therapies and describe the providers responsibilities to support the self-administration. (D) Any approved individually based limitation and describe how the provider monitors resident progress in the area of the limitation. (E) Address the implementation and provision of services by the provider consistent with the obligations imposed by the person-centered service plan; (F) Identify the resident’s service needs, desired outcomes, and service strategies to advance all areas identified in the person-centered service plan to include, the resident’s physical and medical needs, medication regimen, self-care, social-emotional adjustment, behavioral concerns, independent living capability and community navigation, as well as any other area of concern or the other goals set by the resident; (G) Document all behavior intervention program approvals; (H) How the provider supports each identified services and support need identified in the Individual Services Plan including a description of what service/support is provide, and the duration and frequency of the support. Support services must include how the provider supports the resident in accessing community resources and engaging in community activities; and (I) If the person-centered service plan is unavailable for use in developing the RCP, providers must still develop an RCP based on the information available. Upon receipt of the person-centered service plan , the providers must amend the RCP as necessary to comply with this rule (e) The provider must attach the person-centered service plan to the RCP. (f) The RCP must be signed by the resident, the provider, or the provider’s designee, and others, as appropriate, to indicate mutual agreement with the course of services outlined in the plan; (g) The provider must review and update each resident’s RCP every six months and when a resident’s condition changes. The review must be documented in the resident’s record at the time of the review and include the date of the review and the provider’s signature. If a RCP changes the provider must write a new care plan. (12) A person-centered service plan must be completed in the following circumstances: (a) A person-centered service plan coordinator under contract with the Division must complete a person-centered service plan with each resident pursuant to OAR 411-004-0030. The provider must make a good faith effort to implement and complete all elements the provider is responsible for implementing as identified in the person-centered service plan; (b) The person-centered service plan coordinator documents the person-centered service plan on behalf of the resident and provides the necessary information and supports to ensure the resident directs the person-centered service planning process to the maximum extent possible; (c) The person-centered service plan must be developed by the resident, and as applicable, the legal or designated representative of the resident, and the person-centered service plan coordinator. Others may be included only at the invitation of the resident and, as applicable, the resident’s representative; (d) To avoid conflict of interest, the person-centered service plan may not be developed by the provider for residents receiving Medicaid. The Division may grant exceptions when it determines that the provider is the only willing and qualified entity to provide case management and develop the person-centered service plan in a specific geographic area; (e) For private pay residents, a person-centered service plan may be developed by the resident, or as applicable, the legal or designated representative of the resident, and others chosen by the resident. Providers must assist private pay residents in developing person-centered service plans when no alternative resources are available. Private pay residents are not required to have a written person-centered service plan. (13) A person-centered service plan must be developed through a person-centered service planning process. The person-centered service planning process includes the following: (a) Is driven by the resident; (b) Includes people chosen by the resident; (c) Provides necessary information and supports to ensure the resident directs the process to the maximum extent possible and is enabled to make informed choices and decisions; (d) Is timely, responsive to changing needs, occurs at times and locations convenient to the resident, and is reviewed at least annually; (e) Reflects the cultural considerations of the resident; (f) Uses language, format, and presentation methods appropriate for effective communication according to the needs and abilities of the resident and, as applicable, the resident’s representative; (g) Includes strategies for resolving disagreement within the process, including clear conflict of interest guidelines for all planning participants, such as: (A) Discussing the concerns of the resident and determining acceptable solutions; (B) Supporting the resident in arranging and conducting a person-centered service planning meeting; (C) Utilizing any available greater community conflict resolution resources; (D) Referring concerns to the Office of the Long-Term Care Ombudsman; or (E) For Medicaid recipients, following existing, program-specific grievance processes. (h) Offers choices to the resident regarding the services and supports the resident receives and from whom, and records the alternative HCB settings that were considered by the resident; (i) Provides a method for the resident to request updates to the person-centered service plan for the resident; (j) Is conducted to reflect what is important to the resident to ensure delivery of services in a manner reflecting personal preferences and ensuring health and welfare; (k) Identifies the strengths and preferences, service and support needs, goals, and desired outcomes of the resident; (l) Includes any services that are self-directed, if applicable; (m) Includes but is not limited to individually identified goals and preferences related to relationships, greater community participation, employment, income and savings, healthcare and wellness, and education; (n) Includes risk factors and plans to minimize any identified risk factors; and (o) Results in a person-centered service plan documented by the person-centered services plan coordinator, signed by the resident, participants in the person-centered service planning process, and all individuals responsible for the implementation of the person-centered service plan, including the provider, as described in these rules. The person-centered service plan is distributed to the resident and other people involved in the person-centered service plan as described in these rules. (14) Required contents of the person-centered service plan: (a) When the provider is required to develop the person-centered service plan, the provider must ensure that the plan includes the following: (A) HCBS and setting options based on the needs and preferences of the resident and for residential settings, the available resources of the resident for room and board; (B) The HCBS and settings are chosen by the resident, or resident’s legal representative, and are integrated in and support full access to the greater community; (C) Opportunities to seek employment and work in competitive integrated employment settings for those residents who desire to work. If the resident wishes to pursue employment, a non-disability specific setting option must be presented and documented in the person-centered service plan; (D) Opportunities to engage in greater community life, control personal resources, and receive services in the greater community to the same degree of access as people not receiving HCBS; (E) The strengths and preferences of the resident; (F) The service and support needs of the resident; (G) The goals and desired outcomes of the individual; (H) The providers of services and supports, including unpaid supports provided voluntarily; (I) Risk factors and measures in place to minimize risk; (J) Individualized backup plans and strategies, when needed; (K) People who are important in supporting the resident; (L) The person responsible for monitoring the person-centered service plan; (M) Language, format, and presentation methods appropriate for effective communication according to the needs and abilities of the resident receiving services; (N) The written informed consent of the resident; (O) Signatures of the resident, participants in the person-centered service planning process, and all people and providers responsible for the implementation of the person-centered service plan as described below in subsection (c) of this section; (P) Self-directed supports; and (Q) Provisions to prevent unnecessary or inappropriate services and supports. (b) When the provider is not required to develop the person-centered service plan but provides services to the resident, the provider must provide relevant information and provide necessary support for the person-centered service plan coordinator or other persons developing the plan to fulfill the characteristics described in these rules; (c) The resident decides on the level of information in the person-centered service plan that is shared with providers. To effectively provide services, providers must have access to the portion of the person-centered service plan that the provider is responsible for implementing; (d) The person-centered service plan is distributed to the resident and other people involved in the person-centered service plan as described in these rules; (e) The person-centered service plan must justify and document any individually-based limitation to be applied as outlined in OAR 309-040-0393 when a resident’s rights under OAR 309-040-0410(2)(b) through (i) may not be met due to threats to the health and safety of the resident or others; (f) The person-centered service plan must be reviewed and revised: (A) At the request of the resident: (B) When the circumstances or needs of the resident change; or (C) Upon reassessment of functional needs as required by 410-173-0025. (15) For crisis respite service providers, the provider is not required to develop a person-centered service plan under these rules during the short period of residency, but the provider must, at a minimum, develop an initial care plan as required by section (7) of these rules to identify service needs, desired outcomes, and service strategies to resolve the crisis or address the resident’s other needs that caused the need for crisis-respite services. In addition, the provider must provide relevant information and provide necessary support for the person-centered service plan coordinator as described in section (11)(b) of this rule. (16) The provider must develop a written resident record for each resident. The provider must keep the resident record current and available on the premises for each resident admitted to the AFH. The provider must maintain an resident record consistent with the following requirements: (a) General Information, Retention, and Release: (A) An easily accessible summary sheet that includes, but is not limited to, the resident’s name and pronouns, previous address, date of admission to the program, gender identity, biological sex, date of birth, marital status, legal status, religious preference, health provider information, mental health diagnoses, medical health diagnosis, medication allergies, food allergies, information specifying whether advance mental health and health directives and burial plan have been executed, the name of residents to contact in case of emergency, (B) The names, addresses, and telephone numbers of the resident’s representative, legal guardian or conservator, parents, next of kin, or other significant persons including, but not limited to; physicians or other medical practitioners; dentist; case manager or therapist; day program, school, or employer; and any governmental or other agency representatives providing services to the resident; (C) Copies of legal documents such as guardianships, power of attorney, advance mental health and medical health directives, PSRB requirements, burial plans, if applicable; (D) Resident records must be immediately available to the Authority upon request as well as available to the resident or the resident’s representative; (E) Original resident records must be kept for a period of three years after discharge or from when an resident no longer resides in the AFH; (F) Resident records must include copies of release authorizations signed by the resident for the CMHP serving the resident, medication prescribers and any other release approved by the resident. Release authorizations must be dated, signed by the resident, and include initials authorizing the disclosure of protected information and indicate how long the authorization is to be in effect. (G) All resident records must be kept confidential in compliance with applicable law and must be stored in a secure location which prohibits access by residents, guests, or other visitors in the home. In all other matters pertaining to confidential records and release of information, providers must comply with ORS 179.505, ORS 192.566, and ORS 441.114. (b) Medical Information: (A) History of physical, emotional, and medical problems, accidents, illnesses or mental status that may be pertinent to current care; (B) Current orders for medications, treatments, therapies, use of restraints, special diets, dietary supplements, and any known food or medication allergies; (C) Completed medication administration records for the last 12 months or from the date of admission, whichever is less; (D) Name and claim number of medical insurance and any pertinent medical information such as hospitalizations, accidents, immunization records including previous TB tests, incidents or injuries affecting the health, safety, or emotional well-being of any resident. (E) Documentation of current prescriber order for self-administration of medication, if applicable. (F) Documentation the resident has been trained for self-administering of prescribed medication or treatment, who provided the training and when it was provided or documentation that the prescriber has determined that the training for the resident is unnecessary, if applicable; (G) A description of how the resident manages his or her own medication regimen, or how the provider supports the resident’s medication management, and how the medications will be stored in an area that is inaccessible to others and locked when not on the resident’s person; (H) Documentation of self-administration retraining when there is a change in dosage, medication, and time of delivery or documentation that the prescriber has determined that the training continues to be unnecessary; and (I) The Residential Care plan must include a list of medications that can be self-administered by the resident and what services and supports the provider is required to provide to support the self-administration. (c) Individual account record: (A) Resident’s income sources; (B) The resident or the resident’s representative must agree to specific costs for room and board and services within the pre-set limits of the state contract. A copy must be given to the individual, the individual's representative, and the original in the resident’s resident record; (C) Resident’s record of discretionary funds including detailed receipts of all deposits and expenditures. (d) If an individual maintains custody and control of his or her discretionary funds, then no accounting record is required; (e) If a designee of the AFH maintains custody and control of an resident ‘s discretionary fund, the provider and resident must have a written agreement describing where funds will be maintained and how funds will be distributed. The agreement will include the resident’s right nullify the agreement at any time. The provider will maintain a signed and dated account and balance sheet that will accurately document the current balance and distribution of funds with initials indicating what staff distributed the funds and a signature of the resident receiving the funds. (f) The provider must maintain a copy of the written house rules with documentation the provider discussed the house rules with the resident; (g) Written incident reports of any unusual incidents relating to the resident including but not limited to resident care needs, safety concerns, conflicts with staff, or significant changes in the AFH environment. The incident report must include how and when the incident occurred, who was involved, what action was taken by staff, and the outcome to the resident. In compliance with HIPAA rules, only the resident’s name may be used in the incident report. Separate reports must be written for each resident involved in an incident. A copy of the incident report must be submitted to the CMHP within five working days of the incident. The original must be placed in the resident’s record; (h) Any other information or correspondence pertaining to the resident; (i) The provider or staff must document all services performed for the resident in the resident’s record, including all services for which Medicaid payment is being requested. Documentation must be compliant with OAR 410-120-1360, 410-172-0620 and 410-173-0045, and must include the service performed, the frequency the service was provided, the length of time each service is performed, and be initialed by the caregiver providing the service. (j) General progress notes must be documented at least weekly and must be documented immediately as significant events or changes in behavior are identified. All entries must be signed and dated by the author. (k) The provider must explain and document in the resident’s file that a copy of the Residents’ Bill of Rights was given to each resident at admission. (17) The licensee must ensure qualified staff are available to provide direct services to residents to assure resident safety and resident’s attain or maintain the highest practical physical, mental and psychosocial well-being of each resident as determined by the resident assessments and person-centered service plans and considering the number, acuity and diagnoses of the resident population. (18) The provider, resident manager and all substitute caregivers must provide care, services, and supports necessary to ensure the health, safety, and quality of life for each resident including activities of daily living, instrumental activities of daily living, services, and skills training. (19) The provider must: (a) Prominently post the State license and Abuse and Complaint poster where it can be seen by residents; (b) Cooperate with Division personnel, Oregon Department of Human Services (ODHS), or their designee in complaint investigation procedures, abuse investigations, and protective services, planning for resident care, application procedures, and other necessary activities, and allow access of Division and ODHS personnel, or their designee to the AFH, its residents, and all records; (c) Document all resident complaints, written or verbal and maintain a record of the complaint in both facility records and the resident’s personal records. The provider must document the date and time of the complaint, how they responded, how the complaint was resolved and whether the complaint was filed with another agency. The Provider may not retaliate in any manner when a complaint is filed. (d) Provide care and services, as appropriate to the age and condition of the resident and as identified on the RCP. The provider must ensure that physicians' orders and those of other medical professionals are followed and that the resident’s physicians and other medical professionals are informed of changes in health status or if the resident refuses care. Additional staff may be required to safely evacuate the residents and all occupants from the AFH; (e) Make available at least six hours of activities each week which are of interest to the residents, not including television or movies. (f) Be directly involved with residents on a daily basis. (g) Document their efforts to assist each resident to engage in activities of social, religious and community groups. (h) Develop House Rules: (A) The provider must develop reasonable written house rules that will be included in or attached to the residency agreement. House rules will address guidelines for visitors;, the use of cannabis and tobacco, and, mealtimes; guidelines for sharing the community telephones and kitchen appliances. No house rules shall restrict resident consumption of alcohol; (B) The provider must discuss house rules with the resident and families at the time of arrival. and be posted in a conspicuous place in the facility. (C) The provider must maintain written documentation in the resident record that the provider discussed the house rules with the resident along with a copy of the house rules; (D) House rules are subject to review and approval by the Division and must not violate resident’s rights as stated in ORS 430.210 and ORS 443.739; and (E) House rules must not restrict or limit the resident rights under OAR 309-040-0410(2). (i) Ensure a qualified caregiver (the provider, a resident manager or a substitute caregiver) is present in the home at all times residents are present; (j) Notify the CMHP of the name of the substitute caregiver for the provider or resident manager for absences greater than 72 consecutive hours; (k) Allow and encourage residents to exercise all civil and human rights accorded to other citizens; (l) Not allow or tolerate physical, sexual, or emotional abuse or punishment, or exploitation, or neglect of residents; (m) Provide care and services as agreed to in the RCP; (n) Keep information related to residents confidential as required under ORS 179.050; (o) Ensure that the number of residents requiring nursing care does not exceed the provider's capability as determined by the Division or CMHP; (p) Not admit residents who are clients of Aging and People with Disabilities without the express permission of the Division or its designee; (q) Exercise reasonable precautions against any conditions that threatens the health, safety, or welfare of residents; (r) Immediately notify the appropriate RCP Team members (in particular the CMHP representative and family or guardian) if: (A) The resident has a significant change in medical status; (B) The resident has an unexplained or unanticipated absence from the AFH; (C) The provider becomes aware of alleged or actual abuse of the resident; (D) The resident has a major behavioral incident, accident, illness, hospitalization; (E) The resident contacts or is contacted by the police; or (F) The resident dies, and follow-up with an incident report. (20) The provider must write an incident report for any unusual incident and forward a copy of the incident report to the CMHP within five working days of the incident. Any incident that is the result of, or suspected of being abuse, must be reported to the Office of Training, Investigations, and Safety within 24 hours of occurrence. (21) The provider must send critical incident reports to the Division within 48 hours of the incident occurring. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 14-2024, amend filed 06/24/2024, effective 07/01/2024 BHS 2-2024, temporary amend filed 01/09/2024, effective 01/10/2024 through 07/07/2024 BHS 6-2018, amend filed 03/21/2018, effective 03/30/2018 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHD 3-2005, f. & cert. ef. 4-1-05, Renumbered from 309-040-0052 MHD 4-2002, f. 2-26-02, cert. ef. 2-27-02 MHD 7-2001(Temp), f. 8-30-01, cert. ef. 9-1-01 thru 2-27-02 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92, Renumbered from 309-040-0050(8)-(10) 309-040-0393 Individually-Based Limitations (1) When the provider cannot meet the HCBS qualities described below due to a threat to the health and safety of a resident or others, the provider may seek to apply an individually based limitation through the process described in this rule. A provider must not otherwise limit HCBS qualities : (a) The freedom and support to access food at any time; (b) Have visitors of the resident’s choosing at any time; (c) Have a unit entrance door that is lockable by the resident with only appropriate program staff having access; (d) Choose a roommate when sharing a unit; (e) Furnish and decorate the resident’s unit as agreed to in the Residency Agreement; (f) The freedom and support to control the resident’s schedule and activities; and (g) Privacy in the resident’s unit. (2) The provider must demonstrate and document the individually-based limitation meets the elements described below in the person-centered service plan and the Division-approved consent form. The provider must submit and sign the consent form with the following: (a) The specific and individualized assessed need justifying the individually-based limitation; (b) The positive interventions and supports used prior to consideration or imposition of any individually-based limitation; (c) Documentation the provider or other entities have considered or evaluated the effectiveness of other less intrusive methods; ; (d) A clear description of the limitation that is directly proportionate to the specific assessed need; (e) Regular collection and review of data to measure the ongoing effectiveness of the individually-based limitation; (f) Established time limits for periodic reviews of the individually-based limitation to determine if the limitation should be terminated or remains necessary. The limitation must be reviewed at least annually; (g) The informed consent of the resident or the resident’s legal representative, including any discrepancy between the wishes of the resident and the consent of the legal representative, and that the resident has been notified they may request a review of the limitation or withdraw consent at any time; and (h) An assurance the interventions and support do not cause harm to the resident. (3) The provider must: (a) Maintain a copy of the completed and signed form documenting the consent to the individually based limitation described in section (2) of this rule. The form must be signed by the resident or the resident’s legal representative if applicable. The form must be available to the resident or the resident’s legal representative to access at any time; and. (b) Request review of the individually based limitation by the person-centered service plan coordinator when a new individually based limitation is indicated, or change or removal of an individually-based limitation is needed. (4) The qualities and obligations described in sections (1)(b)(g) do not apply to an resident receiving crisis-respite services, and a provider is not required to seek an individually-based limitation for such an resident to comply with these rules. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 309-040-0394 Residency Agreement (1) The provider must enter into a written residency agreement with each resident or the resident’s representative consistent with the following: (a) The written residency agreement must be signed by the provider and the resident or the resident’s representative prior to or at the time of admission and anytime the agreement is updated; (b) The provider must provide a copy of the signed agreement to the resident or the resident’s representative and must retain the original signed agreement within the resident’s record; (c) The provider must give written notice to a resident and the resident’s representative at least 30 calendar days prior to any general rate increases, additions, or other modifications of the rates; and (d) The provider must update residency agreements at least annually and anytime social security rates change or a resident’s finances change such that the amount paid for room and board changes; and (e) The provider must not charge or ask for application fees or nonrefundable deposits and must not solicit, accept or receive money or property from a resident other than the amount agreed to for services, including for OHP clients as described in OAR 410-120-1280(1). (2) The residency agreement must include, but is not limited to, the following: (a) The room and board rate describing the estimated public and private pay portions of the rate: (A) Where a resident’s social security or other funding is not active at the time of admission to the program, the program must prepare the room and board agreement based upon the estimated benefit to be received by the resident; and (B) If, when funding is later activated, actual income of the resident varies from the estimated income noted on the residency agreement, the agreement must be updated and re-signed by all the applicable parties. (b) Services and supports to be provided and the rate to be changed. For residents receiving Medicaid, the Residency Agreement may state the rate will be “as authorized by the Division”; (c) Conditions under which the provider may change the rates; (d) The provider’s refund policy in instances of a resident’s hospitalization, temporary absence, death, transfer to another care setting or other care facility, and voluntary or involuntary move from the home; (e) If a resident dies or leaves an adult foster home for medical reasons and indicates in writing the intent to not return, the provider must not charge the resident for more than 15 days or the time specified in the provider contract, whichever is less, after the resident has left the adult foster home. (f) The provider has an affirmative duty to take reasonable actions to reduce the charges by accepting a new resident. (g) However, if a resident dies or leaves an adult foster home due to substantiated allegations of neglect or abuse by the provider or due to observable conditions of imminent danger to life, health or safety, the provider may not charge the resident beyond the resident’s last day in the home. (h) If a resident eligible for Medicaid services dies and has no surviving spouse, the provider must forward all personal incidental funds (PIF) to the Estate Administration Unit, P. O. Box 14021, Salem, Oregon 97309-5024, within 10 business days of the death of an individual. (See Limits on Estate Claims, OAR 461-135-0835) (i) The provider must refund any advance payments within 30 days after the resident dies or leaves the adult foster home. (j) A statement indicating that the resident is not liable for damages considered normal wear and tear; (k) The provider’s policies on voluntary moves and whether or not the provider requires written notification of a non-Medicaid resident’s intent to not return; (l) The provider’s policies for involuntary transfer or discharge of residency in compliance with OAR 309-040-0395(5) and resident’s rights regarding the eviction and appeal process as outlined in OAR 309-040-0410; (m) Any policies the provider may have on the use of , cannabis, and illegal drugs of abuse. No policy shall prohibit resident consumption of alcohol; (n) Smoking policies in compliance with the Tobacco Freedom Policy established by the Division; (o) Policy addressing pet and service animals. The provider may not restrict animals that provide assistance or perform tasks for the benefit of a resident with a disability. Such animals are often referred to as service animals, assistance animals, support animals, therapy animals, companion animals, or emotional support animals. (p) Policy and procedures for resident requests for specific foods for meal planning and snacks purchased under the room and board agreement for the resident. (q) Schedule of mealtimes. The provider may not schedule meals with more than a 14-hour span between the evening meal and the following morning’s meal ; (r) Policy regarding refunds for residents eligible for Medicaid services, including prorating partial months, and if the room and board is refundable; (s) Any house rules or social covenants required by the provider that may be included in the agreement or as an addendum.; The provider must not include any illegal or unenforceable provision in a contract with a resident and may not ask or require a resident to waive any of the Resident’s Rights; (t) Statement informing the resident of the freedoms authorized by 42 CFR 441.301(c)(2)(xiii) & 42 CFR 441.530(a)(1)(vi)(F), and OAR 309-040-0410(2), which may not be limited without the informed, written consent of the resident and include the right to: (A) Live under a legally enforceable residency agreement. (B) The freedom and support to access food at any time; (C) To have visitors of the resident’s choosing at any time; (D) Have a lockable door in the resident’s unit that may be locked by the resident; (E) Choose a roommate when sharing a unit; (F) Furnish and decorate the resident’s unit according to the Residency Agreement; (G) The freedom and support to control the resident’s schedule and activities; and (H) Have privacy in the resident’s unit. (u) Include a clear and precise statement of any limitation to the implementation of advance directives on the basis of conscience. This rule does not apply to medical professional or hospice orders for administration of medications. The statement must include: (i) Description of conscientious objections as they apply to all occupants of the adult foster home; (ii) The legal authority permitting such objections under Oregon Revised Statute 127.505 through 127.660; and (iii) Description of the range of medical conditions or procedures affected by the conscientious objection. (3) The provider must not propose or enter into a residency agreement that: (a) Charges or asks for application fees, refundable deposits, or non-refundable deposits, including for OHP clients as described in OAR 410-120-1280(1); (b) Includes any illegal or unenforceable provision or asks or requires the resident to waive any of the resident’s rights or the provider’s liability for negligence; or (c) Conflicts with resident rights or these rules. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 309-040-0395 Standards for Admission, Transfers, Respite, Discharges, and Closures (1) Each adult referred for placement in an AFH may select and choose from available service settings. (2) A provider may only admit a resident with a referral from, or prior written approval of the CMHP or the Division. At the time of the referral, a provider must obtain complete information about the case history of the resident as it relates to behavior, skill level, medical needs, or other relevant information. The provider may deny admission of any person if the provider believes the person cannot be managed effectively in the AFH, or for any other reason not specifically prohibited by this rule. AFHs may not be used as a site for foster care for children, adults from other agencies, or any type of shelter or day care without the written approval of the CMHP or the Division. (3) The provider must screen a prospective resident before admitting the resident. (a) The screening must include but is not limited to diagnoses, medications, personal care needs, individually based limitations, nursing care needs, night care needs, nutritional needs, activities and lifestyle preferences. (b) The screening process must include interviews with the resident and the resident’s representative, as applicable. (c) Verify the individual's resources including potential benefit eligibility and coverage as described in OAR 410-120-1280(2). (d) A copy of the screening must be given to the resident and the resident’s legal representative, as applicable. (4) The provider must provide a copy of the house policies and the provider’s residency agreement to the resident and the resident’s representative, as applicable, at the time of the screening. (5) Each provider’s discharge and transfer policy and procedure must be described in each resident’s Residential Agreement and include the right to at least a written 30 day-notice of discharge or transfer unless discharged under the circumstances described in 309-040-0395(14), right to remedy, and right to appeal. The provider is required to give the resident a written notice of discharge or transfer, that clearly documents the provider reviewed the reason for the discharge or transfer with the resident and the resident’s rights to request an informal conference and administrative hearing. If the resident’s location is unknown, the notice may be given to a legal representative of the resident. The provider must make efforts to prevent unnecessary discharges and transfers by making reasonable accommodations within the program setting. (6) The resident or the resident’s legal representative, as applicable, may end the residency in a facility upon providing at least 30-days’ written notice. Upon mutual agreement between the provider and the resident or legal representative, less than 30 days’ notice may be provided. (a) The provider must promptly notify the CMHP or Division if a resident gives notice or plans to leave the AFH or if a resident abruptly leaves; (b) The provider must immediately document plans to move and voluntary moves in the resident’s record; and (c) The provider remains responsible for the provision of personal care, services, and supports until the resident has moved from the home including the provision of one-to-one supervision if necessary to ensure the safety of all residents. (7) Residents may only be involuntarily moved from the AFH for the following reasons: (a) The resident is assessed by a Licensed Medical Professional (LMP) or other qualified health professional to require services such as continuous nursing care or extended hospitalization that are not available in the local community or cannot be provided in the current placement as determined by the LMP; (b) The resident has engaged in a pattern of behaviors or activities that: (A) Repeatedly and substantially interfere with the rights, health, or safety of the resident or other individuals residing in the AFH; and (B) Presents an imminent threat to the health or safety of the resident or other individuals; and (C) The pattern of behaviors have been documented in individual and facility records and demonstrate the interventions and supports that have been attempted or considered to address the behaviors, including treatment goals, safety plans and progress notes. (c) The resident cannot safely evacuate the setting in accordance with the program’s evacuation plan after efforts described in OAR 309-040-00370(5)(b) have been taken; (d) For private paying individuals, failure of the resident or resident’s representative to make payment for care or failure to make payment for room and board as described in the resident’s residential agreement. For Medicaid recipients, failure to make payment for room and board as described in the resident’s residential agreement; (e) The home was not notified before the individual’s admission or learns following the individual’s admission that the individual is on probation, parole or post-prison supervision after being convicted of a sex crime defined in ORS 163A.005; (f) The provider’s Medicaid Provider Enrollment Agreement is terminated; or (g) The facility license was revoked, not renewed, suspended, or voluntarily surrendered, or the home was voluntarily closed. (8) The provider must make reasonable and good faith efforts to prevent unnecessary transfers or discharges by making reasonable accommodation with the AFH. (9) Prior to initiating an involuntary transfer process, the AFH must consider the following: (a) The availability of alternatives to transfer; (b) The resident’s ties to family and community; (c) The relationships the resident has developed with other residents and facility staff; (d) The duration of the resident’s stay at the facility; (e) The mental health needs of the resident and the availability of mental health services; (f) The availability of a receiving facility that would accept the resident and provide service consistent with the resident’s needs; (g) The consistency of the receiving facility’s services with the activities and routine with which the resident is familiar, and the receiving facility’s ability to provide the resident with similar access to personal items significant to the resident and enjoyed by the resident at the transferring facility; (h) The probability that the transfer would result in improved or worsened mental, physical, or social functioning, or in reduced dependency of the resident; (i) The type and amount of preparation for the move, including but not limited to: (j)Solicitation of the resident’s friends and/or family in preparing the resident for the move; and (k) Visitation by the resident to (prior to actual transfer) or familiarity of the resident with the place to which the resident is to be transferred; and On-site consultation or new mental health assessment by an individual with specific expertise in mental health services if the basis for considering transfer is behavioral. (10) An individual must not be involuntarily transferred to another room in the AFH or moved out of the AFH without the approval of the Division and a minimum of 30 days advance written notice to the individual, the individual’s representative, as applicable, and the CMHP, unless discharged under the circumstances described in 309-040-0395(14). (11) The provider must submit a completed notice of involuntary transfer or discharge request form to the Division in writing using the Division approved form prior to issuing a notice of involuntary transfer or discharge to a resident or representative. (a) The provider must offer the resident the right to remedy when the reason for involuntary transfer or discharge is not due to the closure of the facility, long-term incarceration, or need to transfer as identified by the LMP. The right to remedy must: (A) Be developed in cooperation with the resident, their representative if applicable, the CMHP, and the Division; (B) Identify reasonable behavioral goals that measurable and consistent with standard behavioral treatment practices, and must ensure protection of the individual’s rights; (C) Establish a specific period for the resident to demonstrate compliance with the agreed upon remedy and cannot be used to support future notices of involuntary transfer or discharge; and (D) Document the provider’s reasonable efforts to prevent unnecessary transfer or discharge including, but not limited to, clinical consultations, amending the individual’s residential care plan, requesting updated assessments for changes in behaviors, and developing safety plans. (b) The provider must make reasonable efforts to establish a reasonable end of residency date in consideration of both the program’s needs, and the resident’s needs to find alternative living arrangements; (c) The Division must review the cause for notice, interventions and supports attempted to address the cause for notice, and provide a written response of approval or denial to the provider within two business days of receiving the completed form. (d) Upon receipt of written approval from the Division, the provider must consult with the resident or their representative and present a ’30-day’ or ‘less than 30-day’ notice of involuntary transfer or discharge and the ODHS/OHA form MSC 0443, Administrative Hearing Request (12) The provider must provide at least 30 days’ written notice to the resident and their representative, if applicable, specifying the cause(s) and include steps the individual can take to remedy the cause. (13) The provider may issue a ‘less than 30-day’ notice of involuntary transfer or discharge to the resident and their representative, if applicable, once approved by the Division, if a resident has intentionally injured another resident or staff, has caused intentional significant destruction of property, or is engaged in behaviors that immediately jeopardize the health and safety of others that cannot be mitigated with a safety plan. The provider will not give a ‘less then 30-day’ notice of involuntary transfer or discharge to a resident receiving treatment or services for the purpose of stabilization, in a hospital, at a respite location, or temporarily placed in police custody. (14) Notifications of involuntary transfer or discharge must: (a) Be delivered to the resident in person; (b) Be given to the resident’s legal representative (guardian) as applicable; and (c) Specify the individual’s right to an administrative hearing in accordance with ORS 443.738(11)(c). (15) The provider must hold a pre transfer or discharge meeting with the individual and their representative, if applicable, and with the individual's permission other individuals with an interest in the individual's circumstances. The purpose of the meeting is to: (a) Provide copies of the notice; (b) Explain the cause for the notice and the right to remedy; (c) Explain the resident’s right to request an administrative hearing regarding the notice; and (d) Plan any arrangements necessary to facilitate the transfer or move. (16) The provider must ensure the resident has supports, including interpreter or translation services, to understand the involuntary transfer or discharge notice and the resident’s rights to an administrative hearing regarding the notice. (17) Residents who object to the involuntary transfer or discharge must be given the opportunity for a hearing as provided in ORS 443.738(11)(b) and 441.605(4). Participants may include the resident, and at the resident's request, the provider, a family member, and a CMHP staff member. (18) Residents must not be involuntary transferred or discharged while in the process of an appeal or after the program has knowledge of any indication of a resident’s desire to appeal the notice of involuntary transfer or discharge. (19) The Division determines if the cause for involuntary transfer or discharge is sufficient according to the licensing rules and may take action on a license if the resident is wrongfully discharged. (20) Upon transfer or discharge from the facility, program staff must offer two doses of an FDA-approved short-acting, non-injectable, opioid antagonist medication to the individual. If the individual accepts, program staff must: (a) Provide the individual with an instruction card on the use of short-acting, non-injectable, opioid antagonist medication; and (b) Document distribution of the short-acting, non-injectable, opioid antagonist medication in the individual’s record. (21) At the time of involuntary transfer or discharge, the resident must be given a statement of account, any balance of funds held by the provider, and all property held in trust or custody by the provider. (a) The provider may withhold funds to cover pending charges. Within 30 days after the resident is transferred or discharged, or as soon as pending charges are confirmed, the provider must provide the resident with a final financial statement along with any funds due; (b) If a resident’s property has been left at the AFH for longer than seven days after transfer or discharge of the resident, the provider must make a reasonable attempt to contact the resident or their representative, if applicable. The provider must allow the resident or their representative, if applicable, a minimum of 15 days to make arrangements concerning the property; and (c) If the provider determines the resident has abandoned the property, the provider may then dispose of the property. If the property is sold, proceeds of the sale, minus the amount of any expenses incurred and any amounts owed the provider by or on behalf of the resident, must be forwarded to the resident or their representative, as applicable. (22) Providers must provide written notification to the Division within 10 calendar days after receipt of any notice of default, or any notice of potential default (commonly referred to as foreclosure), with respect to a real estate contract, trust deed, mortgage, or other security interest affecting any property occupied or used by the provider. (23) The provider must provide a copy of the notice of default or warning of potential default to the Division. (24) The provider must provide written updates to the Division at least every 30 days until the default or warning of potential default has been resolved and no additional defaults or potential defaults have been declared and no additional warnings have been issued. Written updates must include: (a) The current status on what action has been or is about to be taken by the provider with respect to the notice received; (b) The action demanded or threatened by the holder of the security interest; and (c) Any other information reasonably requested by the Division. (25) The provider must provide written notification within 24 hours to the Division upon final resolution of the matters leading up to or encompassed by the notice of default or the notice warning of potential default. (26) If the subject default property is licensed as an AFH, the provider must provide written notification of the following within 24 hours to the Division, and all the residents and the residents' representatives, if applicable, regarding: (a) The filing of any litigation regarding such security interest, including the filing of a bankruptcy petition by or against the provider or an entity owning any property occupied or used by the provider; (b) The entry of any judgment with respect to such litigation; (c) The passing of the date 40 days before any sale scheduled pursuant to the exercise of legal rights under a security interest, or a settlement or compromise related thereto, of the provider's property or property occupied or used by the provider; and (d) The sale, pursuant to the exercise of legal rights under a security interest, or a settlement or compromise related thereto, of the provider's property or property occupied or used by the provider. (27) Providers must notify the Division prior to the voluntary closure, proposed sale, or transfer of ownership of an AFH and give residents, families, and the CMHP 30 days’ written notice, except in circumstances where undue delay might jeopardize the health, safety, or well-being of a resident, provider, or caregiver. If a provider has more than one AFH, a resident cannot be shifted from one house to another house without the same period of notice unless prior approval is given and agreement obtained from residents or their guardians, and the CMHP. (28) Provider’s must surrender the physical license to operate their adult foster home to the Division at the time of closure. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 14-2024, amend filed 06/24/2024, effective 07/01/2024 BHS 2-2024, temporary amend filed 01/09/2024, effective 01/10/2024 through 07/07/2024 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHD 3-2005, f. & cert. ef. 4-1-05, Renumbered from 309-040-0055 MHD 4-2002, f. 2-26-02, cert. ef. 2-27-02 MHD 7-2001(Temp), f. 8-30-01, cert. ef. 9-1-01 thru 2-27-02 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92, Former sec. (3)(a)-(c), Renumbered to 309-040-0057 MHD 6-1986, f. & cert. ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0400 Inspections (1) The Division must conduct an inspection of an AFH: (a) Prior to issuance of a license; (b) Upon receipt of an oral or written complaint of violations that threaten the health, safety, or welfare of residents ; or (c) Anytime the Division has probable cause to believe that an AFH has violated a regulation or provision of these rules or is operating without a license. (2) The Division or CMHP may conduct inspections of an AFH: (a) Anytime such inspections are authorized by these rules and any other time the Division or CMHP considers it necessary to determine if an AFH is in compliance with these rules or with conditions placed upon the license; (b) To determine if cited deficiencies have been corrected; and (c) For the purpose of monitoring of the residents’ care. (3) State or local fire inspectors must be permitted access to enter and inspect the AFH regarding fire safety upon request of the Division or CMHP. (4) The Division, the CMHP, the Oregon Department of Human Services (ODHS), and the Centers for Medicare and Medicaid Services (CMS) have authority and must have full access to examine and copy AFH records and accounts, including resident records and accounts, and to inspect the physical premises, including the buildings, grounds, equipment, and any vehicles. (5) The Division, CMHP, ODHS, and CMS staff must be permitted to interview the provider, resident manager, caregiver, and residents . Interviews are confidential conducted in private and are confidential except as considered public record under ORS 430.763. (6) Providers must authorize resident managers and substitute caregivers to permit entrance by the Division, CMHP, ODHS, and CMS staff for the purpose of inspection and investigation. (7) The Division, CMHP, ODHS, and CMS staff may conduct inspections with or without advance notice to the provider, staff, or a resident of the AFH. Advanced notice of an inspection will not be provided if such notice might obstruct or seriously diminish the effectiveness of the inspection or enforcement of these rules. (8) If the Division, CMHP, ODHS, or CMS staff is not permitted access or inspection, a search warrant may be obtained. (9) The inspector must respect the private possessions and living area of residents , providers, and caregivers while conducting an inspection. (10) Completed reports on inspections, except for confidential information, must be available to the public upon written request to the Division or CMHP during business hours. (11) For residents receiving services authorized or funded by the Division, the Division, ODHS or their designee must investigate allegations of abuse as defined in ORS 430.735 to 430.765. (12) When abuse is alleged or death of a resident has occurred and a law enforcement agency or the Division, OTIS, ODHS or their designee has determined to initiate an investigation, the provider may not conduct an internal investigation without prior authorization from the Division. For the purposes of this section, an internal investigation is defined as conducting interviews of the alleged victim, witness, the alleged perpetrator, or any other persons who may have knowledge of the facts of the abuse allegation or related circumstances; reviewing evidence relevant to the abuse allegation, other than the initial report; or any other actions beyond the initial actions of determining: (a) If there is reasonable cause to believe that abuse has occurred; or (b) If the alleged victim is in danger or in need of immediate protective services; or (c) If there is reason to believe that a crime has been committed; or (d) What, if any, immediate personnel actions must be taken. (13) The Division, ODHS or their designee or must complete an abuse investigation and protective services report in accordance with OAR 943-045-0000. (14) When the provider has been notified of the completion of the abuse investigation, a provider may conduct an investigation without Division approval to determine if any other personnel actions are necessary. (15) Upon completion of the investigation report described in (13) of this rule, notification is provided to the designated provider. (a) The provider must implement the reports recommended actions within the deadlines listed to prevent further abuse as stated in the report and notify the Division of completion. (b) In accordance with ORS 443,87, upon being notified of substantiated abuse of a resident by staff, the AFH licensee or designated provider must provide written notice of the findings to: (A)The staff found to have committed abuse; (B) Residents of the AFH; (C) The residents’ case managers; and (D) The residents’ legal representative. (16) A provider may not retaliate against any person who reports in good faith suspected abuse or against the resident with respect to the report. (17) In accordance with ORS 430.755 any provider who retaliates against any person because of a report of suspected abuse or neglect may be liable in a private action to that person for actual damages and, in addition, a penalty in accordance with 443.775(10) not withstanding any other remedy provided by law. The authority of the director to impose civil penalties and the factors to be considered must be in accordance with 443.790. (18) In accordance with ORS 430.755, any adverse action creates a presumption of retaliation if taken within 90 days of a report of abuse. For purposes of this section, "adverse action" means any action taken by a facility, community program, or person involved in a report against the person making the report or against the adult with respect to whom the report was made because of the report and includes but is not limited to the following: (a) Discharge or transfer from the AFH except for clinical reasons; (b) Discharge from or termination of employment; (c) Demotion or reduction in remuneration for services; or (d) Restriction or prohibition of access to the facility or its residents. (19) Adverse action may also be evidence of retaliation after 90 days even though the presumption no longer applies. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0060, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0405 Procedures for Correction of Violations (1) At any time after receipt of a notice of violations or an inspection report, the provider or the Division may request a conference in writing. The conference must be scheduled within ten days of a request by either party. The purpose of the conference is to discuss the violations stated in the notice of violation and to provide information to the provider to assist the provider in complying with the requirements of the rules. The written request by a provider or the Division for a conference may not extend any previously established time limit for correction. (2) The provider must notify the Division of correction of violations in writing no later than the date specified in the notice of violation. (3) If, after inspection of the AFH, if the Division determines that the violations have not been corrected by the date specified in the notice of violation or if the Division has not received a report of compliance, the Division may institute one or more of the following actions: (a) Imposition of an administrative sanction that may include revocation, suspension, or refusal to renew a license as deemed appropriate by the Division; (b) Placement of conditions on the license as deemed appropriate by the Division; or (c) Filing of a criminal complaint. (4) If a resident is in serious and immediate danger, the Division may institute one or more of the following actions: (a) If there is reliable evidence of abuse, neglect or exploitation, the license may be immediately suspended or revoked and arrangements made to move the resident pursuant to OAR 309-040-0425. (b) The Division may order the removal of the resident pursuant to OAR 309-040-0425; or (c) Placement of conditions on the license as deemed appropriate by the Division. Statutory/Other Authority: ORS 413.042 & ORS 443.745 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 6-2018, amend filed 03/21/2018, effective 03/30/2018 MHS 12-2017, temporary amend filed 10/03/2017, effective 10/03/2017 through 03/30/2018 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0070, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0410 Residents’ Bill of Rights, Complaints, and Grievances (1) Residents' Bill of Rights: (a) The provider must guarantee Residents’ Bill of Rights as described in ORS 443.739 and help residents exercise them; (b) The provider must post the Residents’ Bill of Rights in a location that is prominent and accessible to residents, residents’ representatives, parents, guardians, and advocates. The posted rights must include the telephone numbers of the CMHP, Health Systems Division, and Disability Rights Oregon to call to report complaints; (c) The provider must give a copy of the Residents’ Bill of Rights to each resident, residents’ representatives, parents, guardians, and advocates along with a description of how to exercise these rights; (d) Upon admission to the AFH: (A) The provider must explain the Residents’ Bill of Rights to each resident and to residents’ representatives, parents, guardians, and advocates; and (B) The provider must document in the resident’s file that a copy of the Residents’ Bill of Rights is given to each resident and to the residents’ representatives, parents, guardians, and advocates. (e) The Residents’ Bill of Rights state that each resident has the right to: (A) Be treated as an adult with respect and dignity; (B) Be informed of all Resident Rights and all house policies; (C) Be encouraged and assisted to exercise constitutional and legal rights as a citizen including the right to vote; (D) Receive appropriate care and services and prompt medical care as needed. Be informed of the resident’s medical condition and the right to consent to or refuse treatment; (E) Adequate personal privacy and privacy to associate and communicate privately with any individual of choice, such as family members, friends, advocates, and legal, social service, and medical professionals; send and receive personal mail unopened; engage in telephone conversations; (F) Have medical and personal information kept confidential; (G) Complete privacy when receiving treatment or personal care; (H) Have access to and participate in activities of social, religious, and community groups; (I) Be able to keep and use a reasonable amount of personal clothing and belongings and to have a reasonable amount of private, secure storage space; (J) Be free of discrimination in regard to race, color, national origin, gender, religion, sexual orientation, or disability; (K) Have religious freedom; (L) Manage financial affairs unless legally restricted (M) Be free from financial exploitation. The provider may not charge or ask for application fees or nonrefundable deposits and may not solicit, accept, or receive money or property from a resident other than the amount agreed to for services; (N) A safe and secure environment; (O) A written agreement regarding services to be provided and agreed upon rates and receive 30 days’ written notice before any change in the rates; (P) Voice suggestions, complaints, or grievances without fear of retaliation; (Q) Freedom from training, treatment, chemical or physical restraints except as agreed to in writing in a resident’s RCP and be free from chemical or physical restraints except as ordered by a physician or other qualified practitioner; (R) Be allowed and encouraged to learn new skills, to act on their own behalf to their maximum ability, and to relate to residents in an age appropriate manner; (S) An opportunity to exercise choices including food selection, personal spending, friends, personal schedule, leisure activities, and place of residence; (T) Freedom from punishment.; (U) Freedom from abuse and neglect ; (V) The opportunity to contribute to the maintenance and normal activities of the household; (W) Access and opportunity to interact with persons with or without disabilities; (X) The right not to be transferred or moved out of the AFH without 30 days' advance written notice unless discharged under the circumstances described in 309-040-0395(14), and an opportunity for a hearing as described in ORS 443.738 and 441.605(4); (Y) Be free of discrimination in regard to the execution of an Advance Directive, Physician Order for Life-Sustaining Treatment (POLST) or Do Not Resuscitate (DNR) orders and ; (Z) Not be required to perform labor, except personal housekeeping duties, without reasonable and lawful compensation as outlined in ORS 430.210. (2) The following HCBS Rights and Freedoms are also afforded to Residents: (a) To live under a legally enforceable residency agreement in compliance with protections substantially equivalent to landlord-tenant laws; (b) To have visitors of the resident’s choosing at any time and the freedom to visit with guests within the common areas of the program and the resident’s sleeping room, unless the visitor is deemed a threat to the health and safety of the other occupants in the AFH. If a visitor is deemed a threat to the health and safety of the other occupants in the home, an alternative visitation plan (e.g. visitation away from the AFH premises) must be crafted and must be supported by incident report(s); (c) The freedom and support to control one’s own schedule and activities including but not limited to accessing the community without restriction; (d) Access to community resources including recreation, religious services, agency services, employment, and day programs, unless such access is legally restricted; (e) Have a lockable door in the resident’s bedroom that may be locked by the resident; (f) Choose a roommate when sharing a bedroom; (g) Furnish and decorate the resident’s bedroom according to the residency agreement; (h) Privacy in the resident’s bedroom; (3) The provider must actively work to support and ensure each resident’s rights described in this rule are not limited or infringed upon by the provider or an AFH caregiver, except where expressly allowed under these rules. (4) Any person who believes these rules have been violated may file a complaint with the Division or CMHP. The Division or CMHP may investigate any complaint or grievance regarding the AFH. (5) The Division or CMHP must furnish each AFH with a Complaint and Grievance Notice that the provider must post in a prominent place stating the telephone number of the Division and the CMHP and the procedure for making complaints or grievances. (6) A copy of all AFH complaints or grievances must be maintained by the Division. All complaints or grievances and any actions taken as a result, must : (a) Be indexed by the name of the provider; (b) Be placed into the public file at the Division. Information regarding the investigation of the complaint or grievance may not be filed in the public file until the investigation has been completed; (c) Protect the privacy of the complainant or grievant and the resident; and (d) Treat the names of the witnesses as confidential information. (7) The Division may suspend, revoke, and refuse to renew or impose conditions against the license of a provider who acquires substantiated complaints or grievances pertaining to the health, safety, or welfare of residents. (8) The AFH provider, resident manager, or caregiver must not retaliate in any way against any resident after a complaint or grievance has been filed with the Division. Retaliation may include but is not limited to: (a) Increasing or threatening to increase charges; (b) Decreasing or threatening to decrease services; (c) Withholding or threatening to withhold, rights or privileges; (d) Taking or threatening to take any action to coerce or compel the resident to leave the AFH; or (e) Abusing, harassing, or threatening to abuse or harass a resident in any manner. (9) A complainant, grievant, witness, or caregiver of an AFH must not be subject to retaliation by a provider or any employee of an AFH for making a report or being interviewed about a complaint or being a witness. Retaliation may include but is not limited to caregiver dismissal or harassment or restriction of access to either the AFH or a resident. (10) The complainant has immunity from any civil or criminal liability with respect to the making or content of a complaint or grievance made in good faith. (11) Any individual may inspect and receive a photocopy of the public complaint files, including protective services files as applicable, maintained by the Division upon written request subject to the Division's procedures, ORS 192.310 through 192.431, and photocopy charges for public record requests. Requests for complaint and protective services files may be made using the form and process online at https://www.oregon.gov/oha/ERD/Pages/Records.aspx. Statutory/Other Authority: ORS 443.735 Statutes/Other Implemented: ORS 127.700 - 127.737 & ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 6-2018, amend filed 03/21/2018, effective 03/30/2018 MHS 12-2017, temporary amend filed 10/03/2017, effective 10/03/2017 through 03/30/2018 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHS 1-2010, f. & cert. ef. 1-29-10 MHS 4-2009(Temp), f. & cert. ef. 8-6-09 thru 2-2-10 MHD 3-2005, f. & cert. ef. 4-1-05, Renumbered from 309-040-0065 MHD 1-1992, f. & cert. ef. 1-7-92 MHD 6-1986, f. & cert. ef. 7-2-86 MHD 19-1985(Temp), f. & cert. ef. 12-27-85 309-040-0415 Administrative Sanctions (1) An administrative sanction may be imposed for non-compliance with these rules. (2) An administrative sanction includes one or more of the following actions: (a) Civil penalties; (b) Attachment of conditions to a license; and (c) Denial, suspension, non-renewal, or revocation of a license. (3) If the Division imposes an administrative sanction, the Division must serve a notice of administrative sanction upon the provider personally or by certified mail. (4) The notice of administrative sanction must state the following: (a) Each sanction imposed; (b) A short and plain statement of each circumstance, act, or omission that constitutes non compliance with the applicable rules; (c) Each statute or rule allegedly violated; (d) A statement of the provider’s right to a contested case hearing; (e) A statement of the authority and jurisdiction under which the hearing is to be held; (f) A statement that the Division files on the subject of the contested case automatically become part of the contested case record upon default for the purpose of proving a prima facie case; and (g) A statement that the notice becomes a final order upon default if the provider fails to request a hearing within the specified time. (5) All hearings are conducted in accordance with ORS 183. (6) The provider must comply with any final order of the Division. Statutory/Other Authority: ORS 413.042 & ORS 443.745 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 6-2018, amend filed 03/21/2018, effective 03/30/2018 MHS 12-2017, temporary amend filed 10/03/2017, effective 10/03/2017 through 03/30/2018 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0075, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0420 Temporary rule language in effect until 12/01/2026. Denial, Suspension, Revocation, or Refusal to Renew (1) The Division must deny, revoke, or refuse to renew a license where it finds any of the following: (a) There has been substantial non-compliance with these rules; (b) There is substantial non-compliance with local codes and ordinances or any other state or federal law or rule applicable to the health and safety of residents in an AFH; or (c) A background check conducted by ODHS determined the applicant or provider is not approved; (d) The provider allows a caregiver or any other person, excluding residents, who has been convicted of potentially disqualifying crimes and has been denied, or refused to cooperate with the Division, to reside or work in the AFH; (e) The applicant or provider falsely represents they have not been convicted of a crime; or (f) The Division has received notice from the Department of Revenue in accordance with ORS 305.385. (g) The applicant or provider has had a certificate or license to operate a foster home, assisted living facility, or residential care facility denied, suspended, revoked, or refused to be renewed in this or any other state within three years preceding the present action if the denial, suspension, revocation, or refusal to renew was due in any part to: (A) Abuse, creating a threat to the health, safety, or well-being of residents; or (B) Failure of the applicant or provider to possess the physical health, mental health, or good judgement or character deemed necessary by the division; (h) The applicant or provider, including a board member or officer, has had a certificate or license to operate a foster home, assisted living facility or residential care facility denied, suspended, revoked, or refusal to be renewed in this or any other state more than three years from the present action, the applicant or provider is required to demonstrate to the Division by clear and convincing evidence, the applicant or provider: (A) Does not pose a threat to resident; and (B) Posses the ability and fitness to operate an AFH in substantial compliance. (i) The applicant or provider is associated with a person whose license for a foster home, assisted living facility, or residential care facility was denied, suspended, revoked, or refused to be renewed due to: (A) Abuse or neglect, creating a threat to the health, safety, or well-being of residents; or (B) Failure to possess physical health, mental health, or good judgement or character within three years preceding the present action, unless the applicant or provider can demonstrate to the Division by clear and convincing evidence that the person does not pose a threat to the residents; (j) For purposes of this subsection, an applicant or provider is "associated with" a person as described above, if the applicant or provider: (A) Resides with the person; (B) Employs the person in the AFH; (C) Receives financial backing from the person for the benefit of the AFH; (D) Receives managerial assistance from the person for the benefit of the AFH; or (E) Allows the person to have access to the AFH; or (F) Rents or leases the AFH from the person. (k) For purposes of this section only, "present action" means the date of the notice of denial, suspension, revocation, or refusal to renew. (2) The Division may deny, suspend, revoke, or refuse to renew an AFH license if the applicant, provider or owner: (a) Submits fraudulent or untrue information to the Division; (b) Has a history of or demonstrates financial insolvency, such as bankruptcy, foreclosure, eviction due to failure to pay rent, or termination of utility services due to failure to pay bills; (c) Has threatened the health, safety, or well-being of any resident; (d) Has abused a resident; (e) Has a medical or psychiatric problem, which interferes with the ability to provide care; (f) Refuses to allow access and inspection; (g) Fails to comply with a final order of the Division to correct a violation of the rules for which an administrative sanction has been imposed; (h) Fails to comply with a final order of the Division imposing an administrative sanction; (i) Fails to report knowledge of the illegal actions of or disclose the known criminal history of a provider, resident manager, substitute caregiver, or volunteer of the AFH. (j) Interferes with a person who has made a good faith disclosure of information concerning the abuse or neglect of a resident receiving care and services in a licensed or certified facility; (k) Has previously been cited for the operation of an unlicensed AFH (l) Has previously surrendered a license or certificate while under investigation or administrative sanction during the last three years; (m) Fails to operate the AFH or any other facility in substantial compliance; or (n) An owner has been confirmed to be in violation of any tax laws described in ORS 305.380. (3) The provider may request a hearing in writing within 21 calendar days after the date the notice was personally served or mailed. If the provider fails to request a hearing in writing, or the request is not timely, the notice will become a final order of the Division by default. (4) In addition to, or in-lieu of, a contested case hearing, a provider may request an informal conference with the Division to discuss the administrative action. The informal conference does not diminish the provider’s right to a hearing. A request for informal conference does not delay, extend, or otherwise affect the 21 days allowed to request a hearing. (5) A license subject to revocation or non-renewal remains valid during the administrative hearing process even if the hearing and final order are not issued after the expiration date of the license when a complete renewal application and fee has been submitted to the Division prior to the expiration of the current license. (6) The applicant may appeal the denial of an application by submitting a request for reconsideration in writing to the Division within 14 calendar days from receipt of the denial notice. The Division must decide on the appeal within 30 days of receipt of the appeal. (7) An applicant whose license has been revoked or voluntarily surrendered, following a receipt of Notice of Intent to Revoke or Notice of Intent to Not Renew from the Division, or whose application has been denied by the Division for reasons relating to, but not limited to, criminal convictions, civil proceedings against the applicant, or substantiated allegations of abuse by the applicant, may not be permitted to submit an application for one year from the date that the revocation, non-renewal, surrender, or denial is made final. A longer period may be specified in the order revoking or denying the license. Statutory/Other Authority: ORS 413.042 & ORS 443.745 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 11-2026, temporary amend filed 05/28/2026, effective 06/05/2026 through 12/01/2026 BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 6-2018, amend filed 03/21/2018, effective 03/30/2018 MHS 12-2017, temporary amend filed 10/03/2017, effective 10/03/2017 through 03/30/2018 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0090, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0430 Conditions (1) Conditions may be attached to a license upon a finding that: (a) Information on the application or initial inspection requires a condition to protect the health and safety of individuals; (b) There exists a threat to the health, safety, and welfare of an individual; (c) There is reliable evidence of abuse or neglect of an individual; (d) The AFH is substantially non-compliant with these rules; or (e) The provider is licensed to care for a specific individual only and further placements may not be made to the AFH. (2) The provider shall be notified in writing of any conditions imposed, the reason for the conditions, and be given an opportunity to request a contested case hearing under ORS chapter 183. (3) Conditions may be attached to a license upon a finding that: (a) Information on the application or initial inspection requires a condition to protect the health and safety of individuals, pending further action by the Division; (b) There exists a threat to the health, safety, and welfare of an individual, pending further action by the Division or Division designee; (c) There is reliable evidence of abuse or neglect of an adult, pending further action by the Division; (d) The AFH is substantially non-compliant with these rules, pending further action by the Division. (4) Conditions that may be imposed on a licensee include but are not limited to the following: (a) Restricting the maximum capacity of the AFH; (b) Restricting the number and impairment level of individuals allowed based upon the capacity of the caregivers to meet the health and safety needs of all residents; (c) Requiring an additional caregiver or caregiver qualifications; (d) Requiring additional training of caregivers; (e) Requiring additional documentation as deemed necessary by the Division; (f) Restricting a provider from opening an additional AFH; or (g) Suspending admissions to the AFH. (5) The provider shall be notified in writing of any conditions imposed, the reason for the conditions, and be given an opportunity to request a contested case hearing under ORS chapter 183. (6) In addition to or in lieu of a contested case hearing, a provider may request in writing a review by the Division administrator or designee of conditions imposed by the Division or CMHP. The review does not diminish the provider's right to a hearing or extend the time period to request a hearing. (7) Conditions may be imposed for the extent of the license period (one year), extended to the next license period, or limited to some other shorter period of time as deemed necessary by the Division. If the conditions correspond to the licensing period, the reasons for the conditions may be considered at the time of renewal to determine if the conditions are still appropriate. The effective date and expiration date of the conditions shall be indicated on the attachment to the license. (8) Conditions attached to a license shall be effective upon order of the director of the licensing agency. (9) Hearing rights are in accordance with ORS 183.411 to 183.550. Statutory/Other Authority: ORS 413.042 & ORS 443.745 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 6-2018, amend filed 03/21/2018, effective 03/30/2018 MHS 12-2017, temporary amend filed 10/03/2017, effective 10/03/2017 through 03/30/2018 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0093, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) 309-040-0435 Criminal Penalties (1) Operating an AFH without a license is punishable as a Class C misdemeanor. (2) Refusing to allow any of the following is punishable as a Class B misdemeanor: (a) Division access to the AFH for inspection or investigation; (b) Division access to residents in order to interview residents privately or to review records; or (c) State and local fire inspector access to the AFH regarding fire safety. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0095, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) MHD 6-1986, f. & ef. 7-2-86 MHD 19-1985(Temp), f. & ef. 12-27-85 309-040-0440 Civil Penalties (1) Except as otherwise provided in this rule, civil penalties of not less than $100 per violation, and not more than $250 per violation may be imposed for a general violation of these rules . (2) Civil penalties of not less than $100 and not more than $1,000 per occurrence may be imposed for each substantiated abuse finding. (3) The Division must impose a mandatory civil penalty: (a) Up to $500, unless otherwise required by law, for falsifying resident or facility records or causing another to do so; (b) Of $250 for failure to have the provider or qualified substitute caregiver on duty 24 hours per day in the AFH; (c) Of $500, unless otherwise required by law, for admitting a resident knowing the resident’s needs exceed the ability of the AFH and the admission places the resident or other residents in the AFH at risk of harm; (d) Of $250 for operating an unlicensed AFH; (e) Of $250 for dismantling or removing the battery from, or failing to install, any required smoke detector or carbon monoxide alarm; (f) Of $500 for interfering with or retaliating against an individual making a good faith disclosure of information concerning abuse of an individual receiving care and services in an AFH; (4) Violations requiring a mandatory civil penalty that occurred while the provider was operating the AFH will be imposed by the Division even if the provider subsequently closes the AFH or voluntarily surrenders the license. (5) The provider may request a hearing in writing within 21 calendar days after the date the notice was personally served or mailed. If the provider fails to request a hearing in writing, or the request is not timely, the notice will become a final order of the Division by default. (6) In addition to, or in-lieu of, a contested case hearing, a provider may request an informal conference with the Division to discuss the administrative sanction. The informal conference does not diminish the provider’s right to a hearing. A request for informal conference does not delay, extend, or otherwise affect the 21 days allowed to request a hearing. (7) Civil penalties imposed under this section become due and payable 10 calendar days after the notice imposing the civil penalty becomes final by operation of law or on appeal. Unless the penalty is paid within 10 calendar days after the order becomes final, the order constitutes a judgment and may be recorded by the county clerk, which becomes a lien upon the title to any interest in real property owned by that person. The Division may also initiate a notice of revocation for failure to comply with a final order. (8) Civil penalties are subject to judicial review under ORS 183.480, except that the court may, at its discretion, reduce the amount of the penalty. (9) All penalties recovered under ORS 443.790 to 443.815 are paid to the Long-Term Care Ombudsman Account established in ORS 441.419 Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0097, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) 309-040-0450 Adjustment, Suspension or Termination of Payment (1) The Division or CMHP may adjust, suspend, or terminate payment to a provider when any of the following conditions occur: (a) The provider's AFH license is revoked, suspended, or terminated; (b) Upon a finding that the provider is failing to deliver any service as agreed to in the RCP; or (c) When funding, laws, regulations, or the Division or CMHP priorities change such that funding is no longer available, redirected to other purposes, or reduced; (d) The individual's service needs change; (e) The individual is absent without providing notice to the provider for five or more consecutive days; (f) The individual is determined to be ineligible for services; (g) The individual moves, with or without notice, from the AFH; the provider shall be paid only through the last day of the individual's occupancy. (2) The Division or CMHP is under no obligation to maintain the AFH at its licensed capacity or to provide payments to potential providers. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 MHD 3-2005, f. & cert. ef. 4-1-05, Renumbered from 309-040-0057 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92, Renumbered from 309-040-0055(3)(a)-(c) MHD 6-1986, f. & cert. ef. 7-2-86 MHD 19-1985(Temp), f. & cert. ef. 12-27-85 309-040-0455 Enjoinment of AFH Operation The Division may commence an action to enjoin the operation of an AFH pursuant to ORS 443.775(5): (1) When an AFH is operated without a valid license; or (2) After notice of revocation, non-renewal, or suspension has been given, a reasonable time for placement of residents in other facilities has been allowed, and such placement has not been accomplished. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0099, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92) 309-040-0470 Suspension of License (1) The Division must immediately suspend a license if: (a) There exists a threat to the health, safety or welfare of any resident; (b) There is reliable evidence of abuse of any resident ; or (c) The licensee fails to operate the AFH in substantial compliance with ORS 443.705 to 443.825 or these rules. (2) The Division must suspend a license upon written notice from the Oregon Department of Revenue in accordance with ORS 305.385, and after notice to the provider and an administrative hearing if requested. (3) If a license is suspended, the Division may arrange for a resident to move for their protection. (4) The provider may request an administrative review of the decision to immediately suspend a license by submitting a request in writing, within 10 calendar days from the date the notice and order of suspension was mailed or served upon the provider. (a) Within 10 calendar days after receipt of the provider’s request for a review, the Division must review all material relating to the allegation of abuse, neglect, or exploitation and to the suspension, including any written documentation submitted by the provider within that time frame; and (b) The Division must determine, based on a review of the material, whether to sustain the decision. If the Division does not sustain the decision, the suspension must be rescinded immediately. The decision of the Department is subject to a contested case hearing under ORS 183 if requested within 90 calendar days. (4) The provider may request a contested case hearing in writing within 90 calendar days after the date the notice was personally served or mailed. If the provider fails to request a hearing in writing, or the request is not timely, the notice will become a final order of the Division by default. (5) In addition to, or in-lieu of, a contested case hearing, a licensee may request an informal conference with the Division to discuss the administrative action. The informal conference does not diminish the licensee’s right to a hearing. A request for informal conference does not delay, extend, or otherwise affect the 90 days allowed to request a hearing. Statutory/Other Authority: ORS 413.042 & 443.745 Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 5-2025, adopt filed 02/28/2025, effective 03/01/2025