justicedao/ipfs_state_laws huggingface dataset:
333-076-0810 ESC Application Review (1) Upon receipt of an application and the license fee, the Authority shall: (a) Verify compliance with the applicable sections of ORS chapters 441, 442 and 476, these rules, and Oregon Administrative Rules chapter 333, division 675; and (b) Conduct an on-site licensing survey in accordance with OAR 333-076-0860 and in coordination with the State Fire Marshal's Office. (2) In determining whether to license an ESC, the Authority shall consider factors relating to the health and safety of individuals to be cared for at the ESC and the ability of the operator to safely operate the ESC. The Authority may not consider whether the ESC is or shall be a governmental, charitable or other nonprofit institution or whether it is or shall be an institution for profit. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.020, 441.022, 441.025 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0820 Approval of ESC License Application (1) For purposes of this rule, "operating room" means a room designated and equipped for performing invasive procedures and includes procedure rooms where surgical procedures that do not required a sterile environment are performed. (2) The Authority shall notify an applicant in writing if a license application is approved and shall include the license with the appropriate information. (3) A license shall be issued only for the premises and persons or governmental units named in the application and it is not transferrable or assignable. (4) The license shall be conspicuously posted in the area where patients are admitted. (5) No person or ESC licensed pursuant to the provisions of ORS chapter 441, shall in any manner or by any means assert, represent, offer, provide or imply that such person or facility is or may render care or services other than that which is permitted by or which is within the scope of the license issued to such person or facility by the Authority nor shall any service be offered or provided which is not authorized within the scope of the license issued to such person or facility. (6) An ESC must not be located within a rural area as defined by the Office of Rural Health. (7) In order to be licensed and to maintain a license, an ESC must be affiliated with an Oregon licensed ASC whose license is in good standing. The affiliated ASC: (a) May not be affiliated with any other ESC; (b) Must be physically contiguous with the ESC; (c) Must be certified by the CMS as participating in the ASC quality reporting program administered by CMS; (d) Must be accredited by an accrediting organization approved by CMS in accordance with 42 CFR 488.4; and (e) Must have demonstrated safe operating procedures in an outpatient surgery setting located in Oregon for no less than 24 consecutive months. Safe operating procedures are demonstrated by the absence of any condition level deficiency pursuant to the CMS, Conditions for Coverage for Ambulatory Surgery Centers that has not been corrected. (8) An ESC may be affiliated with only one ASC. (9) An ESC may have no more than two recovery beds for each operating room that is in its affiliated ASC and shall have no more than 10 recovery beds total. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.022, 441.025 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0830 Denial of ESC License Application If the Authority intends to deny a license application, it shall issue a Notice of Proposed Denial of License Application in accordance with ORS 183.411 through 183.470. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.025, 441.030 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0840 Expiration and Renewal of ESC License Each license to operate an ESC shall expire on December 31 following the date of issue, and if a renewal is desired, the licensee shall make application and pay the required renewal fee at least 30 days prior to the expiration date upon a form prescribed by the Authority as described in OAR 333-076-0805. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.020, 441.025 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0850 Return of ESC License and ESC Closure (1) If an ESC license is suspended, revoked, or if an ESC decides to permanently close, the license certificate in the licensee's possession shall be returned to the Authority immediately. (2) If an ESC decides to voluntarily permanently close, it shall issue a multimedia press release at least 24 hours prior to closure, notifying the public of the closure. The press release must include information about how an individual may obtain their medical records. (3) An ESC that decides to voluntarily permanently close shall notify the Authority at least 14 days prior to the closure and submit plans for the orderly transfer of the patients and the storage and disposal of medical records. Medical records not claimed that are more than seven years old from the last date of discharge may be destroyed. Medical records not claimed that are less than seven years old from the last date of discharge shall be stored until they are more than seven years old from the last date of discharge. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.025 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0860 ESC Surveys (1) The Authority shall, in addition to any investigations conducted under OAR 333-076-0880, conduct at least one on-site licensing survey of each ESC every three years to determine compliance with health care facility licensing laws and at such other times as the Authority deems necessary. (2) An ESC shall permit Authority staff access to the facility during a survey. (3) A survey may include but is not limited to: (a) Interviews of patients, patient family members, ESC management and staff; (b) On-site observations of patients, staff performance, and the physical environment of the facility; (c) Review of documents and records, including documents and records of the affiliated ASC if necessary; and (d) Patient audits. (4) An ESC 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 ESC administrator or the administrator's designee. During the exit conference Authority staff shall: (a) Inform the ESC representative of the preliminary findings of the inspection; and (b) Give the person 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 ESC 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 ESC administrator indicating that fact. (9) If deficiencies are found, the Authority shall take informal or formal enforcement action in compliance with OAR 333-076-1080 or OAR 333-076-1090. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.025, 441.060 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0870 ESC Complaints (1) Any person may make a complaint verbally or in writing to the Authority regarding an allegation against an ESC of a violation of health care facility 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 333-076-0880. (4) An ESC shall post a notice in the facility, in a prominent place and size that must include, but is not limited to the following: "If you have concerns about this extended stay center and the services provided here, contact the Oregon Health Authority, Health Care Regulation and Quality Improvement Program: 800 NE Oregon Street, Suite 465, Portland OR 97232; 971-673-0540." Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.025, 441.057 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0880 ESC Investigations (1) As soon as practicable after receiving a complaint, taking into consideration the nature of the complaint, Authority staff will begin an investigation. (2) An ESC shall permit Authority staff access to the facility during an investigation. (3) An investigation may include but is not limited to: (a) Interviews of the complainant, patients of the ESC, patient family members, witnesses, ESC management and staff; (b) On-site observations of patients, staff performance, and the physical environment of the hospital; and (c) Review of documents and records, including documents and records of the affiliated ASC. (4) Information obtained by the Authority during an investigation of a complaint or reported violation under this rule 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 patient at the ESC. The Authority may use any information obtained during an investigation in an administrative or judicial proceeding concerning the licensing of an ESC, 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 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.025, 441.057 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0890 ESC Health Care Practitioner Credentialing Each ESC shall comply with the health care practitioner credentialing requirements in accordance with OAR chapter 409, division 045. Statutory/Other Authority: ORS 441.223 & 441.233 Statutes/Other Implemented: ORS 441.226 & 441.228 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0900 ESC Governing Body (1) The governing body of each ESC shall be responsible for the operation of the facility, the selection of the medical staff and the quality of care rendered in the facility. The governing body shall: (a) Establish in writing the ESC's scope of services and qualifications for an administrator; (b) Designate an administrator, in writing, who is directly responsible for the daily operations of the ESC; (c) Ensure that all health care personnel for whom state licenses or registration are required are currently licensed or registered; (d) Ensure that physicians and dentists admitted to practice in the facility are granted privileges consistent with their individual training, experience and other qualifications; (e) Ensure that procedures for granting, restricting and terminating privileges exist and that such procedures are regularly reviewed to assure their conformity to applicable law; (f) Ensure that physicians and dentists admitted to practice in the facility are organized into a medical staff insofar as applicable in such a manner as to effectively review the professional practices of the facility for the purposes of reducing morbidity and mortality and for the improvement of patient care; and (g) Ensure that a physician or dentist is not denied medical staff membership or privileges at the facility solely on the basis that the physician or dentist holds medical staff membership or privileges at another ESC. (2) The governing body for an ESC may be the same governing body as the affiliated ASC. All actions of the ESC governing body must be separate and distinct from the ASC governing body. (3) The administrator for an ESC may be the same administrator as the affiliated ASC. An administrator responsible for the daily operations of both the ESC and the affiliated ASC may have clinical responsibilities in either the ASC or ESC but shall not have clinical responsibilities in both facilities at the same time. (4) An ESC must keep its own records that are separate and distinct from the affiliated ASC. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.025, 441.055 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0910 ESC Medical Staff (1) The physicians and dentists organized into a medical staff pursuant to OAR 333-076-0900 shall propose medical staff bylaws to govern the medical staff. The bylaws shall include, but not be limited to the following: (a) Procedures for physicians and dentists admitted to practice in the ESC to organize into a medical staff; (b) Procedures for ensuring that physicians and dentists admitted to practice in the ESC are granted privileges consistent with their individual training, experience and other qualifications; (c) Provisions establishing a framework for the medical staff to nominate, elect, appoint or remove officers and other persons to carry out medical staff activities with accountability to the governing body; (d) Procedures for ensuring that physicians and dentists admitted to practice in the ESC are currently licensed by the Oregon Medical Board or the Oregon Board of Dentistry; (e) Procedures for ensuring that the ESC’s procedures for granting, restricting and terminating privileges are followed and that such procedures are regularly reviewed to assure their conformity to applicable law; and (f) Procedures for ensuring that physicians and dentists provide services within the scope of the privileges granted by the governing body. (2) Amendments to medical staff bylaws shall be accomplished through a cooperative process involving both the medical staff and the governing body. Medical staff bylaws shall be adopted, repealed or amended when approved by the medical staff and the governing body. Approval shall not be unreasonably withheld by either. Neither the medical staff nor the governing body shall withhold approval if such repeal, amendment or adoption is mandated by law, statute or regulation or is necessary to obtain or maintain accreditation or to comply with fiduciary responsibilities or if the failure to approve would subvert the stated moral or ethical purposes of this institution. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.055 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0920 ESC Personnel (1) Each ESC shall maintain a sufficient number of qualified personnel to provide effective patient care and all other related services that are separate and distinct from the affiliated ASC. (2) There shall be written personnel policies and procedures which shall be made available to personnel. (3) Provisions shall be made for initial orientation. (4) Provisions shall be made for an annual continuing education plan. (5) There shall be a job description for each position which delineates the qualifications, duties, authority and responsibilities inherent in each position. (6) There shall be an annual work performance evaluation for each employee with appropriate records maintained. (7) The facility shall assure that each licensed or certified employee is knowledgeable of the laws and rules governing his or her performance and that employees function within those performance standards. (8) The actions taken under this rule and all results thereof shall be fully documented for each employee. Such documentation is subject to review by authorized representatives of the Authority. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.025 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0950 ESC Patient Transfer (1) An ESC shall have a policy for essential life saving measures and stabilization of a patient and immediate transfer, to a local hospital, of a patient requiring medical care that exceeds the capabilities of the ESC or when care extends beyond the 48-hour time frame from admission to the affiliated ASC. The policy must address the following: (a) Circumstances warranting transfer, including the person responsible for making the transfer decision; (b) Documentation that must accompany the patient being transferred including but not limited the requirements identified in OAR 333-076-0165(3)(b) and the name of the affiliated ASC; and (c) Arrangement for immediate emergency transport of the patient including communication with the local receiving hospital. (2) A written transfer agreement must be in place with at least one local hospital or the ESC must be affiliated with an ASC in which all of the physicians performing surgeries have admitting privileges at a local hospital that has the capability to treat patients requiring medical care that exceeds the capability of the ESC. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.025 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0960 ESC Nursing Services (1) In an ESC, a registered nurse with experience in post-operative care shall be responsible for the direction of nursing services and for the nursing care provided to patients. (2) The number and types of nursing staff necessary for an ESC shall be based on the number of patients and the health care needs of each patient. (a) At least one registered nurse and one of the following employees shall be on duty at all times patients are present in the ESC: (A) Nursing staff; (B) Health care professional licensed by a health care professional licensing board defined in ORS 676.160; or (C) Unlicensed assistive personnel. (b) A registered nurse shall be assigned to each patient in the ESC for the duration of the patient's stay. (c) A registered nurse shall be responsible for completing a nursing assessment of each patient which addresses patient care needs. (d) There shall be at least one registered nurse with specialized training or experience in emergency care on the premises and immediately interruptible to be able to respond rapidly to provide emergency treatment whenever there is a patient in the ESC. (3) Each year the nursing staff of an ESC shall receive in-service training on the following: (a) Infection control measures; (b) Emergency procedures including, but not limited to, procedures for fire and other disaster; (c) Procedures for life-threatening situations including, but not limited to, cardiopulmonary resuscitation and the life-saving techniques for choking victims; and (d) Other special needs of the patient population. (e) Documentation of such training shall include the date, content, duration and names of attendees. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.025 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0970 ESC Pharmacy Services (1) In an ESC that does not have a pharmacy on the premises, stock quantities of prescription drugs, including local anesthetics, shall be stored on the premises only when such drugs have been obtained for dispensation or administration to respective patients by a physician, dentist, podiatrist or other person authorized within the scope of his or her license to so dispense or administer such drugs. Prescribed drugs already prepared for patients in the ESC may also be stored on the premises. (2) Old medications, including special prescriptions for patients who have left the facility, shall be disposed of by incineration or other equally effective method, except narcotics and other drugs under the drug abuse law, which shall be handled in the manner prescribed by the Drug Enforcement Administration of the United States Department of Justice and the Oregon Board of Pharmacy. (3) Drugs shall not be administered to patients unless ordered by a physician, dentist, podiatrist or individual authorized within the scope of his or her professional license to prescribe drugs. Such order shall be in writing over the physician's or other authorized individual's signature or authentication. (4) Prescription drugs dispensed by a physician shall be personally dispensed by the physician. Dispensing functions may be delegated to staff assistants when the accuracy and completeness of the prescription is verified by the physician and where no independent judgement of the staff assistant is required. (5) The dispensing physician shall label prescription drugs with the following information: (a) Name of patient; (b) The name and address of the dispensing physician; (c) Date of dispensing; (d) The name of the drug. If the dispensed drug does not have a brand name, the prescription label shall indicate the generic name of the drug dispensed along with the name of the drug distributor or manufacturer, its quantity per unit and the directions for its use stated in the prescription. However, if the drug is a compound, the quantity per unit need not be stated; (e) Cautionary statements, if any, as required by law; and (f) When applicable, and as determined by the Oregon Board of Pharmacy, an expiration date after which the patient should not use the drug. (6) Prescription drugs shall be dispensed in containers complying with the federal Poison Prevention Packaging Act unless the patient requests a noncomplying container. (7) Pharmacist and pharmacy personnel providing services to the ESC are subject to ORS chapter 689 and the rules thereunder. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.025 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0980 ESC Laboratory Services (1) Laboratory services shall be available for every patient either through the use of a licensed clinical laboratory in the ESC or a written contract with a licensed clinical laboratory. (2) Notwithstanding section (1) of this rule, an affiliated ASC may provide laboratory services for the ESC if: (a) The ASC is able to provide the laboratory services and complies with OAR 333-076-0155; (b) There is a written agreement between the affiliated ASC and the ESC to provide laboratory services; and (c) All patient records for laboratory services are kept separate and distinct from the ASC. (3) OAR 333-024-0005 through 333-024-0350 shall also apply. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.025 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0990 ESC Radiologic Services (1) An ESC may provide radiologic services directly or under a contract with the affiliated ASC or other party. (2) All radiologic services must meet hospital radiologic service requirements at 42 CFR 482.26(b), (c)(2) and (d)(2), regardless of whether the service is provided directly or under contract. Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.025 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019