justicedao/ipfs_state_laws huggingface dataset:
411-086-0150 Nursing Services: Restorative Care (1) Restorative Program. Nursing services staff shall provide a restorative program which re-establishes and maintains to the greatest extent practical the functional abilities of residents. Such functional abilities shall include but not be limited by the abilities identified in OAR 411-086-0110(1). The facility shall have written policies governing the provision and documentation of restorative services pursuant to OAR 411-085-0210. (2) Director. The Director of Nursing Services or his/her designee shall ensure the development and implementation of an effective restorative services program. (3) Staffing. Restorative services shall be provided by facility nursing staff in accordance with the resident’s care plan. (4) Restorative Plan. Each resident shall have a restorative plan based on an assessment of resident’s needs and delivered in accordance with the resident care plan: (a) Restorative services shall be provided to the resident in accordance with the preliminary resident care plan not later than 24 hours after admission; (b) The restorative services plan shall be reviewed and updated as frequently as the resident’s condition changes, but no less often than quarterly. (5) Documentation. All restorative services provided and results of those services shall be clearly documented in the resident’s clinical record. Progress notes relevant to the plan shall be documented in the resident’s clinical record as frequently as the resident’s condition or ability changes, but no less often than 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
411-086-0160 Nursing Services: Discharge Summary (1) Discharge Summary Required. A discharge summary shall be completed for each resident before discharge. (2) Contents. The discharge summary shall include: (a) A recapitulation of the resident’s stay; (b) A final summary of the resident’s status, including the most recent nursing assessment as defined in OAR 411-086-0060; and (c) A post-discharge plan of care developed in accordance with OAR 411-086-0060 which will assist the resident to adjust to his/her new living environment. A post-discharge plan is not required when the resident is discharged to acute care or to the morgue. Statutory/Other Authority: ORS 410.070, 410.090 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 8-1993, f. & cert. ef. 10-1-93 SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-086-0210 Dental Services (1) Consulting Dentist. The facility shall have an consulting dentist who shall: (a) Participate in the development of written policies and procedures for routine dental care, dental emergencies, and oral hygiene (OAR 411-085-0210); (b) Be available in case of a dental emergency or arrange for another dentist to be available; (c) Recommend procedures for oral health inservice training. This training shall be provided to appropriate staff at least annually; and (d) Instruct or arrange for a dental hygienist to instruct registered nurses on the facility staff in how to perform oral screenings. (2) Physician Participation. The dentist’s written treatment orders shall be followed upon documented verbal approval of the attending physician. (3) Dentures Marked. The facility shall cause the resident’s dentures to be marked for identification. (4) Documentation. Oral and dental care services shall be documented 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
411-086-0220 Rehabilitative Services (1) Rehabilitation Program. The facility shall provide rehabilitative services, when applicable, which re-establishes and maintains to the greatest extent practical the functional abilities of residents. The facility shall have written policies governing the provision and documentation of rehabilitative services pursuant to OAR 411-085-0210. (2) Director. The Director of Nursing Services or his/her designee shall ensure the development and implementation of an effective rehabilitation services program when applicable. (3) Staffing. When a resident requires rehabilitative services, the services shall be ordered by the attending physician and provided or supervised by personnel qualified under state law to provide that service. (4) Rehabilitation Plan. Each resident shall have a rehabilitation plan based on an assessment of resident’s needs and delivered in accordance with the resident care plan: (a) The rehabilitation plan shall be implemented within seven days of admission; (b) The rehabilitation plan shall be reviewed and updated as frequently as the resident’s condition changes, but no less often than quarterly. (5) Documentation. All rehabilitative services provided and results of those services shall be clearly documented in the resident’s clinical record. Progress notes relevant to the plan shall be documented in the resident’s clinical record as frequently as the resident’s condition or ability changes, but no less often than 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
411-086-0320 Emergency and Disaster Planning An emergency preparedness plan is a written procedure that identifies a facility's response to an emergency or disaster for the purpose of minimizing loss of life, mitigating trauma, and to the extent possible, maintaining services for residents, and preventing or reducing property loss. (1) The nursing facility must prepare and maintain a written emergency preparedness plan in accordance with the Oregon Fire Code (OFC) in OAR chapter 837, division 040 and the 2009 National Fire Protection Association (NFPA) 101 Life Safety Code. (2) The emergency preparedness plan must: (a) Include analysis and response to potential emergency hazards including but not limited to: (A) Evacuation of a facility; (B) Fire, smoke, bomb threat, or explosion; (C) Prolonged power failure, water, or sewer loss; (D) Structural damage; (E) Hurricane, tornado, tsunami, volcanic eruption, flood, and earthquake; (F) Chemical spill or leak; and (G) Pandemic. (b) Address the medical needs of the residents including: (A) Access to medical records necessary to provide care and treatment; and (B) Access to pharmaceuticals, medical supplies, and equipment during and after an evacuation. (c) Include provisions and supplies sufficient to shelter in place for a minimum of five days without electricity, running water, or replacement staff. (3) The facility must notify SPD, or the local AAA office or designee, of their status in the event of an emergency that requires evacuation and during any emergent situation when requested. (4) The facility must conduct a drill of the emergency preparedness plan at least twice a year in accordance with the OFC in OAR chapter 837, division 040 and other applicable state and local codes as required. One of the practice drills may consist of a walk-through of the duties or a discussion exercise with a hypothetical event, commonly known as a tabletop exercise. These simulated drills do not take the place of the required fire drills. (5) The facility must annually review or update the emergency preparedness plan as required by the OFC in OAR chapter 837, division 040 and the emergency preparedness plan must be available on-site for review upon request. (6) A summary of the facility's emergency preparedness plan must be submitted to SPD annually on July 1, and at a change of ownership, in a format provided by SPD. Statutory/Other Authority: ORS 410.070, 410.090 & 441.055 Statutes/Other Implemented: ORS 441.055, 441.615 & OL 2007 ch. 205 History: SPD 14-2009, f. 9-30-09, cert. ef. 10-1-09 SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-086-0340 Pets (1) Pets Allowed. Household pets (dogs, cats, birds, fish, hamsters, etc.) are permitted in the nursing facility under the following conditions: (a) Pets must be clean and disease-free; (b) Immediate environment of pets must be kept clean; (c) Small pets (e.g., birds, hamsters) must be kept in appropriate enclosures; (d) Pets not confined in enclosures must be hand held, under leash control, or under voice control; and (e) Pets that are kept at the facility (or are frequent visitors) shall have current vaccinations as recommended by a designated licensed veterinarian (including, but not limited to, rabies). (2) Areas Pets Prohibited. Pets are not permitted in food preparation or storage areas. Pets shall not be permitted in any area where their presence would create a significant risk or annoyance to residents. (3) Administrative Control. The administrator or his/her designee shall determine which pets may be brought into the facility. Family members may bring resident’s pets to visit provided they have approval from the administrator and offer reasonable assurance that the pets are clean, disease-free, and vaccinated as appropriate. (4) Overnight Stay. Facilities with pets that are kept overnight shall have written policies and procedures for the care, feeding, and housing of such pets and for the proper storage of pet food and supplies. (5) Birds. Facilities with birds shall have procedures which protect residents, staff, and visitors from psittacosis. Procedures should ensure minimum handling of droppings. Droppings shall be placed in a plastic bag for disposal. Persons caring for the bird(s) shall not have nursing care or food handling responsibilities. (6) Exotic Pets Prohibited. Exotic pets (i.e., iguanas, snakes, other reptiles, monkeys, ferrets) shall not be kept at the facility. If exotic pets are brought in for a visit, they must be attended at all times by their owners. Skunks, foxes, and raccoons are not permitted in nursing facilities. 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
411-086-0350 Smoking (1) A nursing facility must be in compliance with: (a) The Oregon Indoor Clean Air Act, ORS 433.835 to 433.875; (b) The rules in OAR chapter 333, division 015; and (c) Any other applicable state and local laws. (2) A facility must provide a place of employment that is free of tobacco smoke for all employees. (3) Smoking may only be allowed outside the facility as prescribed by OAR 333-015-0064. (4) The facility must take adequate precautions to protect all residents from injury where residents are allowed and choose to smoke. (5) The facility must develop and implement a smoking policy that includes resident assessment and care planning. (6) If the facility's smoking policy changes, the licensee must provide written notice to all residents 30 days' prior to such change. (7) Nothing in this rule shall prevent the licensee from designating any part of the facility or the entire facility as a non-smoking area. If the facility decides to designate the entire facility as a non-smoking area, all persons admitted thereafter must be so notified by the facility prior to or at the time of admission. Such facility must continue to provide an outdoor smoking area as prescribed by OAR 333-015-0064 for residents who smoke and were admitted prior to the facility decision. Statutory/Other Authority: ORS 410.070, 410.090 & 441.055 Statutes/Other Implemented: ORS 433.835 to 433.990, 441.055 & 441.615 History: SPD 14-2009, f. 9-30-09, cert. ef. 10-1-09 SSD 19-1990, f. 8-29-90, cert. ef. 10-1-90
411-086-0360 Resident Furnishings, Equipment (1) Resident Equipment: (a) Each resident shall be provided a bed, mattress, pillow with water-proof protection, necessary bed coverings, bedside table and chair, reading light, and electrically operated call system which registers at the nurses’ station. The call system cord shall be secured in a manner which makes it accessible to the resident and which prevents the resident from injuring himself/herself with it; (b) According to his/her needs, each resident shall be provided with individual equipment, such as bedpans, bedpan covers, urinals, washbasins, emesis basins, mouthwash cups, soap, washcloths, towels, and drinking glasses; (c) Equipment such as wheelchairs, walkers, geri-chairs and crutches shall be readily available for residents needing this equipment; (d) After the discharge of any resident, the bed, bed furnishings, bedside furniture, and all multiple-use resident equipment shall be thoroughly cleansed and disinfected prior to re-use. Mattresses shall be professionally renovated when necessary; (e) Single resident use items must be identified with resident name and disposed of upon resident discharge; (f) Hot water bags and electric heating pads or blankets may be used only on the written order of the physician; (g) In nursing facilities caring for pediatric residents, an emergency signaling system for use by attendants summoning assistance and a two-way voice intercommunication system between the nurses’ station and rooms or wards housing pediatric residents shall be provided. (2) Storage Space. Separate storage space for clothing, toilet articles, and other personal belongings of residents shall be provided. (3) Privacy. In multiple-bed rooms, opportunity for privacy shall be provided by flame retardant curtains or screens. Cubicle curtains or screens are not required for beds assigned to pediatric residents. (4) Linen Supply. The use of torn or unclean bed linen is prohibited. Facilities shall have a linen supply available for at least three times the usual bed occupancy. 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
411-087-0005 Definitions As used in OAR 411, division 87, the definitions in OAR 411, division 85 and following definitions apply: (1) “ASHRAE” means the American Society of Heating, Refrigerating, and Air-Conditioning Engineers, Inc. (2) “Calling Station” means an individual light, or other electrically operated visual signalling device, with or without audio signaling device, which is located at a nursing station and which effectively alerts nursing staff to a specific room or location from which a resident or other staff is requesting assistance. (3) “Clearly Marked Emergency Power Duplex Receptacle” means an outlet for standard household current (110 volts) connected to an emergency power supply in accordance with the National Electrical Code and NFPA 99 and clearly marked to easily distinguish the outlet from an outlet not on the emergency power supply. (4) “Continuously Licensed” means licensed as a nursing facility without interruption. (5) “Easily Cleanable” means surfaces are readily accessible and made of materials and finish and fabricated so residue may be effectively removed by normal cleaning methods. (6) “Locked Unit” means a nursing facility or a part of a nursing facility, including resident rooms, from which egress is restricted by secured doors. (7) “NFPA” means National Fire Protection Association, Inc. (8) “Nursing Station” means a location at which nursing staff perform charting and related activities throughout the day and at which a calling station exists. (9) “Resident Room” means a room in the facility licensed for one or more beds. [Publications: Publications referenced are available from the agency.] Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 22-1991, f. 12-31-91, cert. ef. 1-1-92
411-087-0020 Referenced Regulations In addition to meeting OAR 411, division 087, the following additional requirements must be met except where determined by the Division to not be applicable to nursing facilities. Licensure is contingent on approval of the agency having enforcement authority: (1) Building and Fire Safety Codes: (a) State Building Codes as adopted by the Oregon Building Codes Division; (b) Local building codes and requirements as adopted by local government agencies; (c) State and local fire codes, NFPA 101 and applicable referenced NFPA publications; and (d) All facilities and construction completed after January 1, 1992, shall comply with the American National Standards Institute’s “Providing Accessibility and Usability for Physically Handicapped People” effective February 5, 1986, and Title III of the American with Disabilities Act of 1990. (2) Food Sanitation Rules. Food Sanitation Rules as adopted by the Public Health Division. (3) Drinking Water. Oregon Drinking Water Quality Act and the rules adopted thereunder by the Public Health Division. Documentation of conformance to this law is required except when the facility is served by an approved community water system. (4) Sewage. On-site sewage disposal rules as enforced by the Oregon Department of Environmental Quality (DEQ). Documentation of conformance to this law is required except when the facility is served by an approved community sewer system. [Publications: Publications referenced are available from the agency.] Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 22-1991, f. 12-31-91, cert. ef. 1-1-92
411-087-0030 Waivers for Physical Environment Requirements (1) Request. Any request for a waiver of these building requirements (OAR 411, division 087) shall comply with OAR 411-085-0040 general waiver requirements, except as otherwise provided by this rule. (2) Duration. The Division may grant waivers for building requirements for a period not to exceed ten years; however, such waiver may be rescinded if the Division determines continuance of the waiver has a potential adverse impact on resident well-being, privacy or dignity. Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 22-1991, f. 12-31-91, cert. ef. 1-1-92
411-087-0100 Physical Environment Generally (1) Good Repair and Cleanliness: (a) All interior and exterior surfaces (e.g., floors, walls, roofs, ceilings, windows, and furniture) and equipment necessary for the health, safety, and comfort of the resident shall be kept clean and in good repair; (b) All interior surfaces shall be easily cleanable; (c) Measures shall be taken which prevent the entry of rodents, flies, mosquitoes, and other insects; (d) The facility grounds shall be kept orderly and free of litter and refuse. (2) Outside Walkways, Parking: (a) Walkways and curbs from the street, public transit or parking spaces to the building entrance shall be designed to facilitate travel by people using wheelchairs or crutches; (b) Disabled Parking Facilities. Parking spaces for disabled visitors and staff shall be provided. (3) Entrance, Waiting Area. At least one primary grade level entrance to the building shall be sheltered from weather and be fully accessible to disabled persons. The facility shall have a waiting area or lounge located inside the main entrance. (4) Drinking Fountains, Telephones. At least one drinking fountain and telephone shall be available on each floor for residents, staff, and visitors, including those physically disabled. Telephones and fountains shall be provided in accordance with the American National Standards Institute’s “Providing Accessibility and Usability for Physically Handicapped People” effective February 5, 1986. The number of the fire department and police department shall be affixed to every telephone. The facility shall have telephones designated for use by residents which allow for privacy during conversation and are wheelchair accessible. (5) Exceptions. Facilities continuously licensed since January 1, 1992 shall not be required to have drinking fountains on every floor, waiting area/lounge or a sheltered entrance as required by this rule unless otherwise provided by OAR 411-087-0010. [Publications: Publications referenced are available from the agency.] Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 22-1991, f. 12-31-91, cert. ef. 1-1-92
411-087-0110 Administrative Area (1) Office Space. General or individual office(s) shall be provided for business transactions, medical and financial records, and administrative and professional staff. (2) Interview Space. Interview space(s) shall be provided for private interviews relating to social service, credit, and admissions. (3) Storage. Storage for office equipment, supplies and clinical records shall be provided. (4) Lighting. Lighting intensity shall comply with Table 4. [ED. NOTE: Tables referenced are available from the agency.] Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 22-1991, f. 12-31-91, cert. ef. 1-1-92
411-087-0120 Signs (1) Resident Rooms. All resident rooms shall be clearly identified by room number. Room numbers shall be no less than one inch high and shall contrast with their background (light characters on dark background or dark characters on light background). Such signs shall be located in order to be easily readable to all residents, including those in wheelchairs. (2) Other Rooms. All other rooms used by residents shall be clearly identified by name (e.g., “Dining Room,” “Activity Room”) with letters as described in section (1) of this rule. Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 22-1991, f. 12-31-91, cert. ef. 1-1-92
411-087-0140 Locked Units (1) Dining, Activities, Living Space. Each locked unit shall have dining, activities and living space within the locked unit. The total area of such space shall be the same as if the locked unit was a separately licensed nursing facility. (2) Nurses’ Station. There shall be at least one nurses’ station within each locked unit. Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 22-1991, f. 12-31-91, cert. ef. 1-1-92
411-087-0150 Nurses’ Station Each floor with resident rooms shall have a nurses’ station with space for charting and storage for administrative supplies: (1) Handwash Sink. There shall be a handwash sink, exclusive of resident and soiled utility room handwash sinks, within 20 feet of the nurses’ station. (2) Exceptions. The handwash sink required in section (1) of this rule is not required in a facility which has been continuously licensed since January 1, 1992 unless otherwise provided by OAR 411-087-0010. Statutory/Other Authority: ORS 410.070 & 441.055 Statutes/Other Implemented: ORS 441.055 & 441.615 History: SSD 22-1991, f. 12-31-91, cert. ef. 1-1-92