justicedao/ipfs_state_laws huggingface dataset:
411-085-0210 Facility Policies (1) A Quality Assessment and Assurance Committee must develop and adopt facility policies. The policies must be followed by the facility staff and evaluated annually by the Quality Assessment and Assurance Committee and rewritten as needed. Policies must be adopted regarding: (a) Admission, fees, and services; (b) Transfer and discharge, including discharge planning; (c) Physician services; (d) Nursing services; (e) Dietary services; (f) Rehabilitative services and restorative services; (g) Pharmaceutical services, including self administration; (h) Care of residents in an emergency; (i) The referral of residents who may be victims of acute sexual assault to the nearest trained sexual assault examiner. The policy must include information regarding the collection of medical and forensic evidence that must be obtained within 86 hours of the incident; (j) Activities; (k) Social services; (l) Clinical records; (m) Infection control; (n) Diagnostic services; (o) Oral care and dental services; (p) Accident prevention and reporting of incidents; (q) Housekeeping services and preventive maintenance; (r) Employee orientation and in-service; (s) Laundry services; (t) Possession of firearms and ammunition; (u) Consultant services; (v) Resident grievances; (w) LGBTQIA2S+ Protections policy that includes adding the following statement in its written materials, and in all places and on all materials where that policy or other written materials are posted: “(Name of care facility) does not discriminate and does not permit discrimination, including but not limited to bullying, abuse or harassment, based on an individual’s actual or perceived sexual orientation, gender identity, gender expression or human immunodeficiency virus status, or based on an individual’s association with another individual on account of the other individual’s actual or perceived sexual orientation, gender identity, gender expression or human immunodeficiency virus status. If you believe you have experienced this kind of discrimination, you may file a complaint with the Oregon Department of Human Services at (provide current contact information).”; and (x) Facility closure. The policy must identify an administrator’s responsibility to assure compliance with OAR 411-085-0025, OAR 411-088-0020(1)(f), and OAR 411-088-0070(1)(g), (3)(d), and (4). (2) Each policy must be in writing and must specify the date the policy was last reviewed by the Quality Assessment and Assurance Committee. Statutory/Other Authority: ORS 410.070, 441.055, 441.122 & 441.615 Statutes/Other Implemented: ORS 441.055, 441.112 & 441.615 History: APD 57-2024, amend filed 09/23/2024, effective 09/25/2024 APD 16-2024, temporary amend filed 03/29/2024, effective 04/01/2024 through 09/27/2024 APD 5-2014, f. 3-31-14, cert. ef. 4-1-14 SPD 38-2013(Temp), f. 10-4-13, cert. ef. 10-7-13 thru 4-4-14 SPD 26-2004, f. 7-30-04, cert. ef. 8-1-04 SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-085-0220 Quality Assurance (1) QUALITY ASSESSMENT AND ASSURANCE COMMITTEE. Each facility must have a Quality Assessment and Assurance Committee. The committee must include the administrator, medical director, Director of Nursing Services (DNS), consulting pharmacist and at least one other facility staff person. The committee must: (a) Ensure a quality assurance program is conducted as required in this rule; (b) Adopt facility policies as identified in OAR 411-085-0210; (c) Ensure a pharmaceutical services review is completed as required by OAR 411-086-0260(2); (d) Ensure that an infection control program as identified in OAR 411-086-0330 is conducted; and (e) Meet no less often than quarterly. (2) QUALITY ASSURANCE. The Quality Assessment and Assurance Committee must conduct an annual review of care practices to ensure quality. The review must include: (a) Evaluation of resident audits (biannual physical examination of a representative sample of facility residents). The sample must include a minimum of 20 percent of the residents or ten residents, whichever is greater; (b) Clinical records, including medication administration and treatments; (c) Resident nutritional status, including weights, intake, and output; (d) Care plans to ensure that care needs have been identified and addressed; (e) The services and functions required by the policies listed in OAR 411-085-0210; and (f) Actions taken to resolve identified problems and to prevent their recurrence. (3) DOCUMENTATION. All meetings of the Quality Assessment and Assurance Committee must be documented. Documentation must include a listing of those in attendance, length of the meeting, issues discussed, findings, actions, recommendations made and assessment of previous actions and recommendations. Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SPD 26-2004, f. 7-30-04, cert. ef. 8-1-04 SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-085-0300 Civil Rights (1) The facility must not make any distinction, discrimination or restriction based on a resident's, potential resident's or visitor's sex, marital status, race, color, national origin or disability. (2) The facility must make reasonable accommodations in order to provide services needed by applicants who are disabled. Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SPD 26-2004, f. 7-30-04, cert. ef. 8-1-04 SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-085-0320 Residents’ Rights: Charges and Rates (1) ADMISSION. The facility must provide written and oral notice before or at the time of admission to each resident specifying: (a) The base daily rate, or Medicaid rate and, as soon as known, amount of resident liability, as applicable; services provided for that rate, and other charges that might reasonably be expected, including but not limited to medical supplies, pharmaceuticals, incontinence care, feeding, bedhold daily rate, and laundry; (b) Whether the facility accepts Medicaid reimbursement: (A) If the facility accepts Medicaid reimbursement, the notice must include a description of the Medicaid eligibility requirements and who to contact to apply for Medicaid assistance; (B) If the facility does not accept Medicaid, the notice must include the facility's policy regarding residents who exhaust their private resources and become eligible for Medicaid; (C) Nothing in this section will be construed to permit discrimination based on payment source; and (c) Alternative forms of transportation available to the resident for routine and emergency transportation, including information on possible cost and how to access such service(s). (2) RATE CHANGES. The facility must give 30 days' written notice to all residents of changes in base rates and any other charge. Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055, 441.605 & 441.615 History: SPD 26-2004, f. 7-30-04, cert. ef. 8-1-04 SSD 8-1993, f. & cert. ef. 10-1-93 SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-085-0330 Residents’ Rights: Visitor Access (1) DEFINITION. As used in this rule, "full and free access" means access to the fullest extent possible without undue adverse interference on the operation of the facility. (2) FULL ACCESS. The facility must permit individuals and groups full and free access to: (a) Visit, talk with and make personal, social and legal services available to all residents; (b) Inform residents of their rights and entitlements, and their corresponding obligations, under federal and state laws by means of distribution of educational materials and discussion in groups and with individual residents; (c) Assist, advise and represent residents in obtaining public assistance, medical assistance, social security benefits and in asserting resident rights. Assistance may be provided to residents individually or in groups. (3) RIGHT TO REFUSE. The resident has the right to refuse contact with any individual or group who otherwise has access to the facility under this rule. The refusal to communicate with any individual or group must be made directly by the resident unless the resident's medical record clearly documents the reasons for not doing so. (4) SOLICITATION. This rule is not intended to allow access to persons or organizations whose primary purpose is to solicit purchase of services or products, or solicit contributions, from the residents or staff. Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055, 441.605 & 441.615 History: SPD 26-2004, f. 7-30-04, cert. ef. 8-1-04 SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-085-0340 Residents’ Rights: Pharmaceutical Services, Charges for Drugs (1) CHOICE OF SUPPLIERS: (a) The resident must have a choice from among prescription/nonprescription drug delivery systems so long as the system selected: (A) Provides for timely delivery of drugs; (B) Provides adequate protection to prevent tampering with drugs; (C) Provides that drugs are delivered in a unit of use compatible with the established system of the facility for dispensing drugs, whether that system is provided by a facility pharmacy or by a contract with a pharmacy; and (D) Provides a 24-hour emergency service procedure either directly or by contract with another pharmacy. (b) The resident must have a choice from among suppliers of nonprescription medication, but no facility is required to accept any opened container of such medication; (c) If the established system of the facility, whether provided by facility pharmacy or a pharmacy under contract, provides resident profile information (diagnosis, medications and allergies), the pharmacy chosen by the resident under subsection (1)(a) of this rule must also provide that information for any resident it serves at the facility; (d) The resident must have a choice from among suppliers of nonprescriptive sickroom supplies so long as any items supplied can be maintained in a clean manner with equipment available at the facility; (e) For purposes of subsections (1)(b) and (c) of this rule, "supplier" includes an authorized representative of the resident who purchases nonprescriptive medication or nonprescriptive sickroom supplies at retail. (2) CHARGES FOR DRUGS: (a) If a facility charges residents for drugs, the following must be made available to the resident on request: (A) Name of the drug; (B) Amount paid by the facility for the drug; (C) Amount charged by the facility for the drug; and (D) Amount of repackaging costs, if any. (b) If a pharmacy charges any resident's insurance company or other party for a drug administered to a resident in a nursing facility, the pharmacy must provide on request a written bill listing the: (A) Name of the drug; and (B) Amount charged by the pharmacy for the drug. Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055, 441.083, 441.084 & 441.615 History: SPD 26-2004, f. 7-30-04, cert. ef. 8-1-04 SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-085-0370 Confidentiality This rule applies to facility licensees, employees, and agents, to Department staff, and the staff of all Area Agencies on Aging. (1) RESIDENTS. The names of residents and all documentation that may allow the identification of a resident must be kept confidential and are not accessible for public inspection. (2) COMPLAINANTS, WITNESSES. The names and identity of complainants and witnesses referred to in Department complaint investigations must be kept confidential and are not accessible for public inspection. Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.637 & 441.671 History: APD 13-2015, f. 6-24-15, cert. ef. 6-28-15 APD 51-2014(Temp), f. 12-31-14, cert. ef. 1-1-15 thru 6-29-15 SPD 26-2004, f. 7-30-04, cert. ef. 8-1-04 SSD 1-1995, f. 1-30-95, cert. ef. 2-1-95
411-086-0010 Administrator (1) Full-Time. Each licensed nursing facility shall be under the supervision of a full-time Oregon licensed nursing home administrator: (a) In facilities physically connected with an Oregon licensed general hospital, the nursing home administrator shall be considered “full-time” if the administrator works full-time based on time worked in both nursing facility and hospital, and if the administrator is available to the nursing facility staff on a full-time basis; (b) In facilities with 40 or fewer beds and which admit only residents requiring intermediate care, a person who meets the requirements for both administrator and director of nursing services (DNS) may function simultaneously in both capacities. (2) Responsibility: (a) The administrator shall ensure that the facility uses its resources effectively and efficiently to attain and maintain the highest practicable physical, mental and psychosocial well-being of each resident; (b) The administrator shall comply with the rules of the Board of Examiners of Nursing Home Administrators; (c) The administrator shall provide a comprehensive review of Division survey reports and inspections to the licensee. (3) Temporary Absence of Administrator: (a) The licensee shall designate, by written policy, an individual who is familiar with the operation of the facility to assume administration in the temporary absence of the administrator. If the designee is the DNS, another RN shall assume the DNS’ responsibilities for this period; (b) If the absence of the administrator is to exceed 30 days, the facility must notify the Division and obtain approval for the arrangements prior to the absence. The Division shall determine whether a licensed administrator shall serve in the administrator’s absence. (4) Change of Administrator: (a) Upon termination of the administrator, the licensee shall immediately replace the administrator with a full-time administrator; (b) The licensee shall notify the Division and the Board of Examiners of Nursing Home Administrators within seven days from the date the administrator leaves employment of the facility. Statutory/Other Authority: ORS 410.070, 410.090 & 441.055 Statutes/Other Implemented: ORS 678.720 History: SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-086-0030 RN Care Manager The RN care manager is a registered nurse who is responsible and accountable for managing the nursing care of his/her assigned residents. Each resident shall have an RN care manager responsible for his/her care: (1) Training: (a) Within nine months of hire each RN care manager shall have successfully completed three credit hours from an accredited school, or 30 continuing education hours, pertinent to gerontology, rehabilitation, or long-term care; (b) Within nine months of hire each RN care manager shall have successfully completed three credit hours from an accredited college or university, or 15 continuing education hours, pertinent to management or supervision. (2) Responsibility: (a) The RN care manager shall be responsible and accountable for managing the nursing care of his/her assigned residents. The RN care manager shall ensure maximum independence and self-direction for residents; (b) The RN care manager shall coordinate the nursing functions and tasks for those residents with physicians and other health care providers. The responsible RN care manager shall ensure the nursing plan and resident care plan are developed and documented, and that residents’ care needs are met; (c) Delegated authority: (A) The RN care manager shall delegate to other licensed personnel only those nursing functions and tasks that the licensee is competent and qualified to perform and that are permitted by ORS Chapter 678; (B) The RN care manager, or an RN or LPN with delegated authority from the RN care manager, shall ensure that the nursing assistant is assigned and performs only those tasks for which he/she is competent and qualified to perform and that are permitted by ORS Chapter 678. (3) Documentation. The name of the responsible RN care manager shall be documented in each resident’s clinical record. Statutory/Other Authority: ORS 410.070, 410.090 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-086-0050 Admission of Day Care Residents Day care residents may be admitted to the facility only if the facility has written approval from the Division to admit day care residents, the facility is in compliance with OAR 411, divisions 85–89, and provided admittance does not intefere with care needs of other residents. Day care residents are considered “residents” for the purpose of OAR 411, divisions 85–89, unless specifically stated otherwise: (1) Application. Application for permission to accept day care residents shall be made to the Division on a form provided by the Division. (2) Physical Environment: (a) The number of day care residents shall not exceed one for every 40 square feet of floor space available for use by day care residents; (b) Provision shall be made for dining, such as tray service or dining area. Day care residents shall be served meals at the same times as other residents; (c) Each day care resident shall have either an unassigned bed or a folding cot in an area where rest and privacy can be provided; (d) There shall be one toilet and one lavatory available to every 15 day care residents. Such facilities shall be in close proximity to the area used by day care residents; (e) All space required for day care residents shall be in addition to space required for other residents. (3) Physician. Day care residents shall be under the care of a licensed physician. The physician shall provide the facility with a statement on admission concerning the diagnosis and general condition of the resident and with orders for prescribed care. (4) Medications. Day care residents taking medication prescribed by their physicians may bring such medication in the original containers to the facility. (5) Activities. The day care resident shall be encouraged to participate in a program of activities which are suitable to the needs and interests of the day care resident, and which promote learning by and independence of the resident. (6) Care Plan. Each day care resident shall have a preliminary care plan which includes a nursing assessment and addresses dietary needs/restrictions and activities. (7) Documentation: (a) There shall be available for each day care resident an admission summary sheet including resident’s name, address, telephone number, sex, social security number; name, address, and telephone number of nearest relative or personal representative and attending physician; (b) There shall be available for each day resident a medication sheet including date, time, dosage, method of administration, and any reaction to a medication. Such medication sheet shall be signed by the nursing personnel administering the medication. Statutory/Other Authority: ORS 410.070, 410.090 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-086-0110 Nursing Services: Resident Care (1) Nursing Services Generally. Nursing services staff shall provide and document nursing services for each resident. Nursing staff shall provide services to attain and maintain the highest practicable physical, mental and psychosocial well-being, independence, self-direction, and self-care of each resident, including: (a) Good grooming and cleanliness of body, skin, nails, hair, eyes, ears, and face, including removal or shaving of hair in accordance with resident wishes, and prompt assistance with toileting needs and care for incontinence; (b) Good body alignment and adequate exercise or range-of-motion, including, when practicable, ambulation; (c) Adequate fluid and nutritional intake: (A) Assistance or supervision with eating and drinking shall be provided as required; (B) Fluids shall be offered at least three times a day (in addition to meal times) to residents who are unable to help themselves; and (C) Weigh each resident on admission and quarterly thereafter or more often if resident’s condition warrants it. (d) Adequate sleep and rest; (e) Oral hygiene; (f) Bowel and bladder evacuation and continence; (g) Optimal freedom from pain; and (h) Resident ability to: (A) Dress, bathe and groom; (B) Transfer and ambulate; (C) Appropriately interact with others; and (D) Effective October 1, 1990, or in the event of delay of the federal requirement, effective the actual federal implementation date, self-medicate based on nursing and physician assessment and provision of instruction to the resident if necessary. (2) Coordination of Services. The DNS and RN care manager shall coordinate the provision of nursing services for the resident with other disciplines and providers. The DNS and RN care manager shall ensure provision and documentation of resident care interventions prescribed by other health care professionals, including timely medications and treatments ordered by the resident’s physician. (3) Questionable Care. When any RN questions the efficacy, need or safety of medications or treatments, the RN shall report that question to the attending physician or nurse practitioner. The RN shall seek and document instructions received and all actions taken to ensure problem resolution. (4) Standards of Practice. Nursing care staff shall provide nursing services in accordance with the Oregon Nurse Practice Act (ORS Chapter 678). (5) Documentation. Licensed nursing staff shall evaluate and accurately document in the clinical record the effectiveness of services provided to the resident, including required preventive care, at least quarterly. Statutory/Other Authority: ORS 410.070, 410.090 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-086-0120 Nursing Services: Changes of Condition (1) Change of Condition (Generally). Nursing staff shall observe, assess, document, and report to the DNS and the resident’s physician any significant change in resident condition that warrants medical or nursing intervention, including any significant change in: (a) Vital signs; (b) Skin integrity (i.e., decubitus ulcer); (c) Hydration; (d) Ability to take or retain food or fluids; (e) Weight gain/loss; (f) Bowel or bladder function; (g) Behavior; (h) Level of comfort (i.e., pain, injury); or (i) Level of consciousness. (2) Acute Condition Change. The nursing staff shall ensure that any significant and acute condition change is promptly assessed and documented by a registered nurse and that appropriate measures are immediately instituted. (3) Documentation. Documentation shall include assessment, appropriate interventions, monitoring and outcome until point of resolution. Statutory/Other Authority: ORS 410.070, 410.090 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-086-0130 Nursing Services: Notification (1) Notification of Significant Other(s). The nursing care staff or other designated staff shall notify the resident’s significant others as soon as possible whenever: (a) The resident has had a change of physical, mental or psychosocial status, including death or accident resulting in injury, or change in type of care needed; (b) The resident has wandered from the facility. (2) Notification of Division. The nursing care staff shall notify the Division of any situation in which the health or safety of the resident(s) was/is endangered such as: (a) Suspected abuse; (b) Fire; (c) Lost resident; (d) Accidental or unusual death. (3) Notification of Physician. The nursing care staff shall notify the resident’s physician of possible changes in the type of care the resident needs and document such notification in the resident’s clinical record. Such notification shall be timely. The physician’s determination shall be documented in the resident’s clinical record. NOTE: See requirements for physician visits under OAR 411-086-0200. (4) Documentation. The nursing care staff, except as provided by section (3) of this rule, shall document all notification/consultation required by this rule in the resident’s clinical record. Statutory/Other Authority: ORS 410.070, 410.090 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90