411-051-0125 Registered Nurse Consultation (1) RN CONSULTATION AND ASSESSMENT. A licensee or administrator must have an arrangement with at least one registered nurse, who has a current, active, unencumbered Oregon license to provide consultation, assessment, teaching, delegation, or review of medication administration processes, as needed to meet the care needs of non-Medicaid residents as required by these rules. (a) The licensee or administrator must check to confirm the RN has a current, active, unencumbered Oregon license on the OSBN website at: https://osbn.oregon.gov/OSBNVerification/Default.aspx. (b) Verification of the RN’s status with the OSBN must be documented and readily accessible in the facility’s records . (2) An RN consultation must be obtained when a nursing procedure has been ordered by a health care professional with prescribing authority for any medical treatment other than medications that are taken by mouth. (3) A licensee or administrator must also request a registered nurse consultation under the following conditions: (a) When a resident has a health concern or behavioral symptoms that is unfamiliar to caregivers. (b) To clarify a prescribing practitioner’s PRN order when it includes dose or frequency ranges, or when there is no information given about what the medication is treating, or signs and symptoms for when to give the PRN medication to the resident. (c) Before the use of physical restraints when not assessed, taught, and reassessed, according to section OAR 411-051-0130(14) of this rule, by a physician, nurse practitioner, physician assistant, Christian Science practitioner, mental health clinician, physical therapist, or occupational therapist. (d) When there are concerns about resident behaviors that do not respond to non-medication interventions, or the use of new psychotropic medications when not assessed, taught, and reassessed according to section OAR 411-051-0130(8), by a physician, nurse practitioner, physician assistant, or mental health practitioner. (e) When care procedures are ordered that are new for a resident, the licensee, or other caregivers. (4) RN DELEGATIONS. A registered nurse may determine a nursing care procedure must be delegated before the caregiver can perform the procedure. The delegation of a nursing procedure must be completed prior to any caregiver performing the procedure. (a) RN delegations are not transferable to other residents or caregivers. (Refer to OAR chapter 851, division 047). (b) A Long-Term Care Community Nurse (LTCCN) may be available to provide consultation, teaching, and delegation for Medicaid consumers only. (5) DOCUMENTATION OF RN VISITS. Documentation of nurse consultations, teaching, and step-by-step instructions on any delegated nursing procedure or other taught procedure, assessments, and reassessments must be maintained in the resident's record and made available to the Department upon request. Statutory/Other Authority: ORS 127.520, 409.050, 410.070, 413.085, 441.373, 443.001, 443.004 & 443.725, 443.730, 443.735, 443.738, 443.742, 443.760, 443.767, 443.775, 443.790 Statutes/Other Implemented: ORS 409.050, 410.070, 413.085, 441.373, 443.001 - 443.004, 443.705 - 443.825 & 443.875, 443.991 History: APD 27-2019, minor correction filed 07/01/2019, effective 07/01/2019 APD 19-2019, adopt filed 06/20/2019, effective 07/01/2019