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544 (07/2026) Chapter 2:Eligibility • Section 10: Long-Term Care (LTC) services To establish SPL eligibility, an individual must be evaluated using ODHS|OHA’s standardized assessment tool as meeting at least the requirements for assist or full assist in activities of daily living as defined in Priority of Paid Services Eligibility Levels (Stat. Auth.: ORS 410.070 Stats. Implemented: ORS 410.070). If the individual is SPL eligible, the case manager will complete and approve the service plan in Oregon ACCESS to create a service eligibility (SELG) record. Other resources LTC Service Request Task *includes screenshots: Describes the Long-Term Care (LTC) services request task, including how it is triggered, its queue, and steps to process and manually close the task. Level of care (LOC) For information on Level of Care for DD services, see DD services. Medical assignment For those with long-term care insurance who are receiving or applying for services, there are additional steps needed to meet the medical assignment requirements: For those applying for nursing facility (NF) services, a legally responsible individual must do one of the following: • Complete paperwork with the LTC insurance company to start receiving payments and have the NF as payee for the LTC insurance benefits, or • If the LTC insurance company will not pay the NF directly, the individual must submit paperwork to receive payments and then promptly turn them over to the NF. For those applying for home and community-based care, a legally responsible individual must do one of the following: • Complete paperwork with the LTC insurance company to start receiving payments and have ODHS|OHA as payee for the LTC insurance benefits, or • If the LTC insurance company will not pay ODHS|OHA directly, the individual must submit paperwork to receive payments and then promptly turn them over to ODHS|OHA. Note: The automatic medical assignment provisions trump any inaction on the part of the service recipient in this situation, meaning state statue allows ODHS|OHA to seek payment directly from a LTC insurer (see ORS 659.830 and ORS 743B.470). For additional information regarding LTC insurance refer to OSIPM worker guides. Acute care (ACS) or nursing facility (NF) settings Oregonians who require a continuous period of care in an acute care setting such as hospital, nursing facility or hospice, and who are otherwise over-income for OSIPM are evaluated for ACS. An individual in an acute care hospital or nursing facility is evaluated for OSIPM under the acute care setting rule as follows: