justicedao/ipfs_state_laws huggingface dataset:
333-077-0045 Return of License and Closure of Birthing Center (1) If a birthing center's license is suspended or revoked, or if a birthing center decides to permanently close, the license certificate in the licensee's possession shall be returned to the Oregon Health Authority (Authority) immediately. (2) If a birthing center voluntarily closes, at least 30 days prior to closure, it shall notify the public by: (a) Issuing a press release to multiple media outlets; (b) Updating the birthing center website; and (c) Posting information through social media, such as Facebook, Instagram, and X (formerly known as Twitter), if such applications are used by the birthing center. (d) Information posted on the website, through social media, and released to media outlets shall include information about how a client or a client's legal representative may obtain their medical records. (3) A birthing center that decides to voluntarily permanently close shall notify the Authority at least 14 calendar days prior to the closure and submit plans for the orderly transfer of the clients and the storage and disposal of medical records. Medical records not claimed must be retained for the time period specified under OAR 333-077-0130, and then may be destroyed. (4) The Authority may deny a birthing center the ability to surrender their license in lieu of an investigation or to avoid an administrative action. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 23-2025, amend filed 11/03/2025, effective 11/03/2025 PH 121-2024, renumbered from 333-076-0550, filed 12/24/2024, effective 12/24/2024 PH 15-2006, f. & cert. ef. 6-27-06 HD 2-1990, f. 1-8-90, cert. ef. 1-15-90
333-077-0050 Waivers (1) While all birthing centers are required to maintain continuous compliance with the Oregon Health Authority's (Authority’s) rules, these requirements do not prohibit the use of alternative concepts, methods, procedures, techniques, equipment, facilities, personnel qualifications or the conduct of pilot projects or research. A request for a waiver from a rule must: (a) Be submitted to the Authority in writing; (b) Identify the specific rule for which a waiver is requested; (c) Identify the special circumstances relied upon to justify the waiver; (d) Explain why the birthing center is unable to be in compliance, what alternatives were considered if any, and why alternatives (including compliance) were not selected; (e) Demonstrate that the proposed waiver is desirable to maintain or improve the health and safety of the clients, to meet the individual and aggregate needs of clients, and shall not jeopardize client health and safety; and (f) Include the proposed duration of the waiver. (2) Upon finding that the birthing center has satisfied the conditions of this rule, the Authority may grant a waiver. (3) A birthing center may not implement a waiver until it has received written approval from the Authority. (4) During an emergency, the Authority may waive a rule that a birthing center is unable to meet for reasons beyond the birthing’s center control. If the Authority waives a rule under this section, it shall issue an order, in writing, specifying which rules are waived, which birthing centers are subject to the order, and how long the order shall remain in effect. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025
333-077-0055 Complaints (1) Any person may make a complaint verbally or in writing to the Oregon Health Authority (Authority) regarding an allegation against a birthing center of a violation of birthing center licensing laws or regulations. (2) The identity of a person making a complaint and any personally identifiable information, as that is defined in ORS 432.005, is confidential and not subject to disclosure under ORS 192.311 to 192.478. (3) An investigation will be carried out as soon as practicable after receipt of a complaint in accordance with OAR 333-077-0060. (4) A birthing center shall post a complaint notice in the birthing center that is clearly visible to the public and includes the Authority's complaint reporting phone number, electronic mail address and website address. (5) An employee or contract provider with knowledge of inappropriate care or any violation of birthing center licensing laws shall use the reporting procedures established by the birthing center before notifying the Authority or other state agency of the inappropriate care or violation, unless the employee or contract provider believes a patient’s health or safety is in immediate jeopardy. (6) If the complaint involves an allegation of criminal conduct or an allegation that is within the jurisdiction of another local, state, or federal agency, the Authority will refer the matter to that agency. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 & ORS 441.044 History: PH 23-2025, amend filed 11/03/2025, effective 11/03/2025 PH 121-2024, renumbered from 333-076-0610, filed 12/24/2024, effective 12/24/2024 PH 15-2006, f. & cert. ef. 6-27-06 HD 2-1990, f. 1-8-90, cert. ef. 1-15-90
333-077-0060 Investigations (1) As soon as practicable after receiving a complaint, taking into consideration the nature of the complaint, Oregon Health Authority (Authority) staff will begin an investigation. (2) A birthing center shall permit Authority staff access to the birthing center during an investigation and make all requested documents and records available to Authority staff for review and copying. (3) An investigation may include but is not limited to: (a) Interviews of the complainant, clients of the birthing center, client family members or legal representatives, witnesses, birthing center management and staff; (b) On-site observations of clients, staff performance and the physical environment of the birthing center; and (c) Review of documents and records. (4) Following the investigation, Authority staff may conduct an exit conference and prepare and provide the birthing center administrator or the administrator's designee written notice of the findings in accordance with OAR 333-077-0065. (5) Information obtained by the Authority during an investigation of a complaint or reported violation under this section is confidential and not subject to public disclosure under ORS 192.410 to 192.505. Upon the conclusion of the investigation, the Authority may publicly release a report of its findings but may not include information in the report that could be used to identify the complainant or any client at the birthing center. The Authority may use any information obtained during an investigation in an administrative or judicial proceeding concerning the licensing of a birthing center, and may report information obtained during an investigation to a health professional regulatory board as defined in ORS 676.160 as that information pertains to a licensee of the board. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 & ORS 441.044 History: PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025
333-077-0065 Surveys (1) The Oregon Health Authority (Authority) shall, in addition to any investigations conducted under OAR 333-077-0060, conduct at least one in-person licensing survey of each birthing center every three years to determine compliance with birthing center licensing laws and at such other times as the Authority deems necessary. (2) A birthing center shall permit Authority staff access to the birthing center during a survey. (3) A survey may include but is not limited to: (a) Interviews of clients, client family members or legal representatives, birthing center management and staff; (b) On-site observations of clients, staff performance, and the physical environment of the birthing center; (c) Review of documents and records; and (d) Client audits. (4) A birthing center shall make all requested documents and records available to the surveyor for review and copying. (5) Following a survey, Authority staff may conduct an exit conference with the birthing center administrator or the administrator's designee. If an exit conference is conducted, Authority staff shall: (a) Inform the birthing center representative of the preliminary findings of the inspection; and (b) Give the birthing center representative a reasonable opportunity to submit additional facts or other information to the surveyor in response to those findings. (6) Following the survey, Authority staff shall prepare and provide the birthing center administrator or the administrator's designee specific and timely written notice of the findings. (7) If the findings result in a referral to another regulatory agency, Authority staff shall submit the applicable information to that referral agency for its review and determination of appropriate action. (8) If no deficiencies are found during a survey, the Authority shall issue written findings to the birthing center administrator indicating that fact. (9) If deficiencies are found, the Authority shall take informal or formal enforcement action in accordance with OAR 333-077-0240 or 333-077-0250. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 & ORS 441.060 History: PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025
333-077-0070 Governing Body Responsibility (1) Each birthing center must have a governing body or person clearly identified as being legally responsible for the control and operation of the birthing center, the selection of the clinical staff, and the quality of care and services provided in the birthing center. (2) The governing body shall employ or contract with an administrator or chief executive officer who is responsible for the administrative operation of the birthing center and who ensures compliance with all policies and procedures, birthing center licensing laws and these rules. (3) The governing body shall establish in writing: (a) A formal organizational plan that clearly sets forth policies, procedures and by-laws, and the responsibilities, accountability, and relationships of clinical providers, clinical staff and other personnel including volunteers; (b) The scope of services provided by the birthing center; (c) Administrative policies and procedures including but not limited to the policies and procedures specified in OAR 333-077-0090; (d) Responsibilities for the operation of the birthing center; (e) Qualifications for an administrator or chief executive officer; (f) That client care and services of the birthing center is under the supervision of a manager who is a licensed direct entry midwife, certified nurse midwife, or physician. (g) That all clinical staff for whom state licenses are required are currently licensed, certified or registered; (h) That all clinical providers admitted to practice in the facility are granted privileges consistent with their individual training, experience, and other qualifications; (i) Criteria and procedures for granting, restricting, and terminating privileges of all clinical providers, and that such procedures are reviewed on a regular basis; (j) The provision of sufficient personnel, facilities, equipment, supplies and other services to meet the needs of clients; and (k) Adoption and implementation of a quality improvement program in accordance with OAR 333-077-0200 to ensure that performance improvement activities of clinical staff result in continuous improvement of client health outcomes. (4) The governing body shall ensure that all clinical providers admitted to practice in the birthing center shall effectively review the professional practices of the birthing center for purposes of reducing morbidity and mortality and for improving client care Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 & ORS 441.055 History: PH 23-2025, amend filed 11/03/2025, effective 11/03/2025 PH 121-2024, renumbered from 333-076-0630, filed 12/24/2024, effective 12/24/2024 PH 15-2006, f. & cert. ef. 6-27-06 HD 2-1990, f. 1-8-90, cert. ef. 1-15-90, Renumbered from 333-076-0410 HD 26-1985, f. & ef. 10-28-85
333-077-0080 Personnel (1) A birthing center shall, at a minimum: (a) Maintain a sufficient number of clinical staff on duty and on call to provide effective client care and all other related services, and to ensure that no client in active labor shall be left unattended; (b) Have one clinical staff person trained in the use of emergency equipment and certified in neonatal resuscitation endorsed by the American Academy of Pediatrics, on duty at all times a client is present; (c) Have one clinical provider present at each birth; (d) Have a second clinical staff person trained in the use of emergency equipment and certified in neonatal resuscitation endorsed by the American Academy of Pediatrics present during each birth; (e) Maintain for all clinical staff providing direct client care a completion document that certifies that the clinical staff person holds a current American Heart Association, Basic Life Support (BLS) Provider or equivalent cardiopulmonary resuscitation (CPR) course that includes a practical skills evaluation; (f) Have a job description for each position that delineates the qualifications, duties, authority and responsibilities essential in each position; (g) Conduct an annual work performance evaluation for each employee; and (h) Create an annual continuing education plan for its employees. (2) A birthing center shall maintain personnel records on all employees, contractors, and volunteers working at the facility that include documentation of required licensure, certification(s), qualifications, health screenings, training and development, and annual performance evaluations. (3) A birthing center shall restrict the work of employees, contractors and volunteers with restrictable diseases in accordance with OAR chapter 333, division 19. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025
333-077-0110 Admission and Discharge (1) A birthing center shall only admit a client for whom medical history, physical examination, laboratory screening, and risk assessments do not exclude them from receiving care and services including delivery in a birthing center in accordance with OAR 333-077-0125. (2) After an assessment, a client who meets any exclusion factor, or a client or newborn who meet risk factor criteria or a complication specified in OAR 333-077-0125, shall be referred to an appropriate health care provider or facility. (3) Generally, a client and newborn shall be discharged within 24 hours after birth in accordance with written policies and procedures. If the client or newborn are not in satisfactory condition, or the client or newborn meet any of the risk factor criteria specified in OAR 333-077-0125, arrangements shall be made to transfer to hospital-based care in accordance with OAR 333-077-0120. (4) A discharge plan shall be developed and communicated to the client and documented in the medical record. (a) The discharge plan shall include, at a minimum, provisions for newborn screenings and follow-up care for both the client and newborn. (b) The plan shall clarify that a newborn follow-up visit is necessary at two weeks and again between 6-8 weeks with a provider of the client's choice, such as a pediatrician or other health care provider that is authorized within their scope of practice to provide follow-up care to a newborn. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025
333-077-0120 Client or Newborn Transfer (1) A birthing center shall have a policy for essential life saving measures, stabilization, and immediate transfer to hospital-based care, of a client or newborn requiring medical care that exceeds the capabilities of the birthing center. (2) The policy for essential life saving measures must address at a minimum the following: (a) Circumstances warranting transfer, including but not limited to: (A) The risk factor criteria specified in OAR 333-077-0125; and (B) The person responsible for making the transfer decision. (b) Documentation and transfer of information required for proper care and treatment of the client being transferred; (c) Arrangement for immediate emergency transport of the client including communication with the receiving facility; and (d) Annual staff training requirements for emergency and non-emergency transfer of clients and newborns. (3) Imminent fetal delivery may delay or preclude actual transfer prior to birth. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025
333-077-0140 Surgical Services Surgical services may be performed but are limited to procedures pertaining directly to pregnancy, labor, and delivery care, and that are normally accomplished during uncomplicated childbirth such as episiotomy and repair. Procedures performed must be consistent with the individual clinical provider's license and scope of practice. Tubal ligation or abortion shall not be performed. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025
333-077-0145 Laboratory Services (1) A birthing center shall provide or shall make available laboratory services using a licensed clinical laboratory in the facility or through a written contract. (a) A list of available tests and procedures shall be maintained by the birthing center. (b) A written report of laboratory findings shall be recorded in the client's medical record in accordance with OAR 333-077-0130. (2) The licensed clinical laboratory shall meet the requirements under ORS chapter 438 and OAR chapter 333, division 24. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025
333-077-0180 Equipment and Supplies (1) A birthing center shall have and maintain appropriate equipment and all ancillary supplies necessary to provide care for a client and newborn and to initiate emergency procedures in life threatening events to client and newborn including, but not limited to: (a) A bed suitable for labor, birth, and recovery; (b) Suction equipment; (c) Fetal monitoring equipment; (d) Equipment or supplies for monitoring and maintaining optimum body temperature of a newborn; (e) Sterile suturing equipment and supplies; (f) Oxygen with flow meter and positive pressure mask; (g) Blood pressure equipment; (h) Resuscitation equipment; (i) Intravenous equipment and fluids; (j) Newborn scale; (k) Medications identified in protocols approved by the governing body to meet emergency needs of a client and newborn in the birthing center, and during transport to acute care setting; and (l) Equipment for performing standard screenings and laboratory tests. (2) A birthing center shall have a system to monitor all equipment and supplies that includes, but is not limited to: (a) Regular maintenance and testing; and (b) Sufficient inventory availability to meet the needs of clients. (3) A birthing center shall apply appropriate infection control procedures for cleaning, disinfection, and sterilization of equipment in accordance with OAR 333-077-0190. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025
333-077-0190 Infection Control (1) A birthing center shall establish and maintain an active facility-wide infection control program for the control and prevention of infection. The program shall be managed by a qualified individual and overseen by a multi-disciplinary committee which shall be responsible for investigating, controlling, and preventing infections in the facility. (2) A birthing center shall be responsible for developing written policies and for annual review of such policies, relating to at least the following: (a) Identification of existing or potential infections in clients, newborns, employees, clinical staff, and clinical providers with birthing center privileges; (b) Control of factors affecting the transmission of infections and communicable diseases; (c) Provisions for orienting and educating all volunteers, employees, clinical staff, and clinical providers with birthing center privileges on the cause, transmission, and prevention of infections on an annual basis; and (d) Collection, analysis, and use of data relating to infections in the birthing center. (3) A birthing center shall have a tuberculosis (TB) infection control plan that includes employee assessment and screening for protecting clients and staff from TB in accordance with OAR 333-019-0041. (4) A birthing center shall comply with OAR chapter 333, division 19 for the control of communicable diseases and division 56 relating to infectious waste management, including the safe management and transport of placentas. (5) A birthing center shall comply with the OR-OSHA bloodborne pathogens standards and infection control training requirements, OAR 437-002-0360(26). The birthing center shall ensure that all staff with potential occupational exposure to bloodborne pathogens participate in a training program at the time of initial assignment and annually thereafter. (6) A birthing center shall establish infection control procedures for cleaning, disinfection, and sterilization of client care equipment, unless only pre-packaged and pre-sterilized items are used, and cleaning and disinfecting the health care environment in accordance with the U.S. Centers for Disease Control and Prevention (CDC), "Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 – Update: May 2019" adopted by reference. NOTE: The CDC guideline referenced in section (6) of this rule is available upon request by contacting the Health Care Regulation and Quality Improvement section at mailbox.hclc@odhsoha.oregon.gov. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025
333-077-0200 Quality Assessment and Performance Improvement (1) The governing body of a birthing center must ensure that there is an effective, facility-wide quality assessment and performance improvement program that demonstrates measurable improvement in client health outcomes and improves client safety by using quality indicators or performance measures associated with improved health outcomes and by the identification and reduction of medical errors. (2) The birthing center must measure, analyze, and track quality indicators, adverse client and newborn events including deaths, infection control, and other aspects of performance that includes care and services furnished in a birthing center. Written documentation of quality assessment and performance improvement activities shall be recorded at least quarterly. (3) After an analysis of the causes for adverse events, the birthing center must develop and implement facility-wide preventive strategies and ensure that staff are trained in and familiar with these strategies. (4) The birthing center must set priorities for its performance improvement activities that: (a) Focus on high risk, high volume, and problem prone areas; (b) Consider incidence, prevalence, and severity of problems in those areas; and (c) Affect health outcomes, client safety and quality of care. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025