(1) A true statement of demand, including an itemized statement of services provided and setting forth the amount due and owing to the long term care facility as of the date of the notice, after deducting all credits and offsets;

(2) The name of the individual who received care;

(3) The name, address and telephone number of the long term care facility;

(4) A statement that the amount claimed is a true and bona fide existing debt as of the date of filing the notice of lien;

(5) A statement that the lien may cover contracted services provided by the long term care facility subsequent to the services itemized under subsection (1) of this section and that interested persons may obtain information on the current amount due under the lien by contacting the long term care facility;

(6) A statement that the long term care facility has given the individual or an authorized representative a written summary of the requirements and procedures for establishing eligibility for Medicaid, including the right to an assessment that determines the extent of spouses’ nonexempt resources at the time of institutionalization and attributes to the community spouse an equitable share of the resources that can not be considered available for payment of costs for the medical care of the institutionalized spouse in the process of spending down to Medicaid eligibility levels. The written statement shall be given no fewer than 30 days and no more than 60 days before the notice of lien is filed. The long term care facility may meet the requirement of this subsection by providing written materials relating to Medicaid eligibility for long term care services for persons with disabilities and elderly persons used by the Department of Human Services; and

(7) A description of the real property to be charged with the lien that complies with ORS 93.600. [1995 c.749 §4; 1997 c.744 §6; 2001 c.900 §12; 2007 c.70 §17]

Note: See note under 87.501.