justicedao/ipfs_state_laws huggingface dataset:
333-076-0135 ASC Nursing Services (1) An RN shall be responsible for the nursing care provided to the patients. (2) The number and types of nursing staff and surgical technologists shall be based on the needs of the patients and the types of services performed. (3) At least one RN and one other nursing staff or medical assistant shall be on duty at all times patients are present. (4) Nurses who supervise the recovery area shall have current training in resuscitation techniques and other emergency procedures. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 266-2018, minor correction filed 11/28/2018, effective 11/28/2018 PH 7-2016, f. & cert. ef. 2-24-16 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10 PH 25-2006, f. 10-31-06, cert. ef. 11-1-06 PH 4-2006(Temp), f. & cert. ef. 3-2-06 thru 8-1-06 HD 3-1990, f. 1-8-90, cert. ef. 1-15-90, Renumbered from 333-076-0100(4)(a) - (c) HD 23-1985, f. & cert. ef. 10-11-85, Renumbered from 333-023-0163(1) HD 25-1983(Temp), f. & cert. ef. 12-21-83 HD 11-1980, f. & cert. ef. 9-10-80
333-076-0140 ASC Anesthesia Services (If Provided) (1) General or regional anesthesia shall be administered only by a physician, dentist or a certified nurse anesthetist. Either the physician or the CRNA shall be present for the administration of general or regional anesthetics, during anesthesia, and the recovery of the patients when any general or regional anesthesia is used. (2) In all areas where flammable anesthetics are used, such rooms shall be equipped and maintained in compliance with provisions of the 2012 NFPA 99, Health Care Facilities Code, adopted by reference, unless the governing body's written policy forbids the use or storage of flammable anesthetics in the facility. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 1-2019, amend filed 01/07/2019, effective 01/07/2019 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10 HD 3-1990, f. 1-8-90, cert. ef. 1-15-90, Renumbered from 333-076-0100(5)(a) & (b) HD 23-1985, f. & cert. ef. 10-11-85, Renumbered from 333-023-0163(1) HD 25-1983(Temp), f. & cert. ef. 12-21-83 HD 11-1980, f. & cert. ef. 9-10-80
333-076-0145 ASC Storage, Disposal and Dispensing of Drugs (1) In an ASC 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 ASC 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. (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; and 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 ASC are subject to ORS chapter 689 and the rules thereunder. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 1-2019, amend filed 01/07/2019, effective 01/07/2019 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10 HD 3-1990, f. 1-8-90, cert. ef. 1-15-90, Renumbered from 333-076-0100(6) HD 23-1985, f. & cert. ef. 10-11-85, Renumbered from 333-023-0163(1) HD 25-1983(Temp), f. & cert. ef. 12-21-83 HD 11-1980, f. & cert. ef. 9-10-80
333-076-0150 ASC Emergency Services The facility shall provide services, equipment and staff necessary to implement emergency medical care protocols. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 267-2018, minor correction filed 11/28/2018, effective 11/28/2018 HD 3-1990, f. 1-8-90, cert. ef. 1-15-90, Renumbered from 333-076-0100 HD 23-1985, f. & cert. ef. 10-11-85, Renumbered from 333-023-0163(1) HD 25-1983(Temp), f. & cert. ef. 12-21-83 HD 11-1980, f. & cert. ef. 9-10-80
333-076-0155 ASC Laboratory Services (1) Laboratory services shall be available for every patient either through the use of a licensed clinical laboratory in the facility or a written contract with a licensed clinical laboratory. (2) Any tissue removed during surgery except those exempted under OAR 333-076-0165, shall be submitted for histological examination by a pathologist. A written report of findings shall be filed in the patient's record in accordance with 333-076-0165. (3) OAR 333-024-0005 through 333-024-0350 shall also apply. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 268-2018, minor correction filed 11/28/2018, effective 11/28/2018 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10 HD 3-1990, f. 1-8-90, cert. ef. 1-15-90, Renumbered from 333-076-0100(8)(a) & (b) HD 23-1985, f. & cert. ef. 10-11-85, Renumbered from 333-023-0163(1) HD 25-1983(Temp), f. & cert. ef. 12-21-83 HD 11-1980, f. & ef. 9-10-80
333-076-0160 Care of ASC Patients (1) Each patient shall be evaluated for all risk factors before a surgical procedure may be performed in accordance with 42 CFR 416.42 and 416.52. (2) Each patient shall be observed for post-operative complications under the direct supervision of a licensed registered nurse. Patients shall be observed for post-procedure complications until their conditions are stable. (3) No medications or treatments shall be given without the order of a physician or other individual authorized within the scope of their license. (4) At the time of discharge from the ASC, each patient must be evaluated by a physician, or by an anesthetist as defined by 45 CFR 410.69(b) for proper anesthesia recovery. (5) Written instruction shall be given to patients on discharge covering signs and symptoms of complications as well as any necessary follow-up instructions for routine or emergency care. (6) Each facility shall adopt and observe written patient care policies. (7) Patient care policies shall be evaluated annually and rewritten as needed. Documentation of the evaluation is required. (8) A patient who prefers to communicate in a language other than English shall be provided health care interpreter services in accordance with ORS 413.559 and OAR 950-050-0160. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025, 441.086, ORS 413.559 & 413.561 History: PH 22-2023, minor correction filed 04/18/2023, effective 04/18/2023 PH 197-2022, amend filed 09/07/2022, effective 09/21/2022 PH 1-2019, amend filed 01/07/2019, effective 01/07/2019 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10 HD 3-1990, f. 1-8-90, cert. ef. 1-15-90, Renumbered from 333-076-0100(9)(a) - (e) HD 23-1985, f. & cert. ef. 10-11-85, Renumbered from 333-023-0163(1) HD 25-1983(Temp), f. & cert. ef. 12-21-83 HD 11-1980, f. & cert. ef. 9-10-80
333-076-0170 ASC Quality Assessment and Performance Improvement (1) The governing body of an ASC must ensure that there is an effective, facility-wide quality assessment and performance improvement program that demonstrates measurable improvement in patient health outcomes, and improves patient safety by using quality indicators or performance measures associated with improved health outcomes and by the identification and reduction of medical errors. (2) The ASC must measure, analyze, and track quality indicators, adverse patient events, infection control and other aspects of performance that includes care and services furnished in the ASC. 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 ASC must develop and implement facility-wide preventive strategies and ensure that staff are trained in and familiar with these strategies. (4) The ASC 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, patient safety and quality of care. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 1-2019, amend filed 01/07/2019, effective 01/07/2019 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10 HD 3-1990, f. 1-8-90, cert. ef. 1-15-90
333-076-0175 ASC Infection Control (1) Each ASC 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) Each ASC 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 patients, employees, medical staff, and health care practitioners with ASC privileges; (b) Control of factors affecting the transmission of infections and communicable diseases; (c) Provisions for orienting and educating all employees, medical staff, health care practitioners with ASC privileges and volunteers on the cause, transmission, and prevention of infections; (d) Collection, analysis, and use of data relating to infections in the ASC. (3) Each ASC shall be responsible for the development, implementation and annual review of policies under section (2) of this rule. (4) An ASC shall comply with all rules of the Authority for the control of communicable diseases. (5) Written isolation procedures in accordance with the 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, incorporated by reference, shall be established and followed by all ASC personnel for control and prevention of cross-infection. Guidelines can be obtained from U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA 30333 (https://www.cdc.gov/infectioncontrol/guidelines/isolation/). Any guidelines published and distributed by the Authority shall also be taken into consideration. (6) There shall be an employee health screening program for the purpose of protecting patients and employees from communicable diseases, including but not limited to requiring tuberculosis testing for employees in accordance with section (8) of this rule. (7) An ASC shall restrict the work of employees with restrictable diseases in accordance with OAR 333-019-0010. (8) Each ASC shall have a tuberculosis infection control plan that includes provisions for employee assessment and screening for protecting patients and employees from tuberculosis in accordance with OAR 333-019-0041. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025, ORS 433.004 & 433.411 History: PH 14-2020, amend filed 03/24/2020, effective 03/24/2020 PH 1-2019, amend filed 01/07/2019, effective 01/07/2019 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10 HD 3-1990, f. 1-8-90, cert. ef. 1-15-90
333-076-0180 In-service Training for ASC Nurses (1) Each year the in-service training agenda for nurses shall include at least 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. (2) 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. (3) Documentation of such training shall include the date, content, duration and names of attendees. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 1-2019, amend filed 01/07/2019, effective 01/07/2019 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10 HD 3-1990, f. 1-8-90, cert. ef. 1-15-90
333-076-0190 ASC Emergency Preparedness (1) An ASC shall establish and maintain an emergency preparedness program that complies with 42 CFR 416.54 and in accordance with the Oregon Fire Code, Oregon Administrative Rules chapter 837, division 40. (2) If an ASC is affiliated with an ESC, the ASC shall ensure that its emergency preparedness program integrates the ESC into its planning. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 1-2019, amend filed 01/07/2019, effective 01/07/2019 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10 PH 13-2008, f. & cert. ef. 8-15-08
333-076-0246 Waivers (1) While all ASCs are required to maintain continuous compliance with the Authority's rules, these requirements do not prohibit the use of alternative concepts, methods, procedures, techniques, equipment, facilities, personnel qualifications or the conducting 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 ASC 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 patients, to meet the individual and aggregate needs of patients, and shall not jeopardize patient health and safety; and (f) Include the proposed duration of the waiver. (2) Upon finding that the ASC has satisfied the conditions of this rule, the Authority may grant a waiver. (3) An ASC 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 facility is unable to meet, for reasons beyond the facility’s control. If the Authority waives a rule under this section it shall issue an order, in writing, specifying which rules are waived, which facilities 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 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0250 ASC Violations In addition to non-compliance with any health care facility licensing law or conditions for coverage, it is a violation to: (1) Refuse to cooperate with an investigation or survey, including but not limited to failure to permit Authority staff access to the ASC, its documents or records; (2) Fail to implement an approved plan of correction; (3) Fail to comply with all applicable laws, lawful ordinances and rules relating to safety from fire; (4) Refuse or fail to comply with an order issued by the Authority; (5) Refuse or fail to pay a civil penalty; or (6) Fail to comply with rules governing the storage of medical records following the closure of an ASC. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.015, 441.025 & 441.030 History: PH 276-2018, minor correction filed 11/28/2018, effective 11/28/2018 PH 269-2018, minor correction filed 11/28/2018, effective 11/28/2018 PH 28-2016, f. & cert. ef. 10-6-13 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10
333-076-0255 ASC Informal Enforcement (1) If, during an investigation or survey Authority staff document violations of health care facility licensing laws or conditions for coverage, the Authority may issue a statement of deficiencies that cites the law alleged to have been violated and the facts supporting the allegation. (2) A signed plan of correction must be received by the Authority within 10 business days from the date the statement of deficiencies was mailed to the ASC. A signed plan of correction will not be used by the Authority as an admission of the violations alleged in the statement of deficiencies. (3) An ASC shall correct all deficiencies within 60 days from the date of the exit conference, unless an extension of time is requested from the Authority. A request for such an extension shall be submitted in writing and must accompany the plan of correction. (4) The Authority shall determine if a written plan of correction is acceptable. If the plan of correction is not acceptable to the Authority, the Authority shall notify the ASC administrator in writing and request that the plan of correction be modified and resubmitted no later than 10 working days from the date the letter of non-acceptance was mailed to the administrator. (5) If the ASC does not come into compliance by the date of correction reflected on the plan of correction or 60 days from date of the exit conference, whichever is sooner, the Authority may propose to deny, suspend, or revoke the ASC license, or impose civil penalties. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.015 & 441.025 History: PH 270-2018, minor correction filed 11/28/2018, effective 11/28/2018 PH 28-2016, f. & cert. ef. 10-6-13 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10
333-076-0260 ASC Formal Enforcement (1) If, during an investigation or survey Authority staff document substantial failure to comply with health care facility licensing laws, conditions for coverage or if an ASC fails to pay a civil penalty imposed under ORS 441.170, the Authority may issue a Notice of Proposed Suspension or Notice of Proposed Revocation in accordance with ORS 183.411 through 183.470. (2) The Authority may issue a Notice of Imposition of Civil Penalty for violations of health care facility licensing laws. (3) At any time the Authority may issue a Notice of Emergency License Suspension under ORS 183.430(2). (4) If the Authority revokes an ASC license, the order shall specify when, if ever, the ASC may reapply for a license. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.015, 441.025, 441.030 & 441.037 History: PH 271-2018, minor correction filed 11/28/2018, effective 11/28/2018 PH 28-2016, f. & cert. ef. 10-6-13 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10
333-076-0265 Civil Penalties, Generally (1) A licensee that violates a health care facility licensing law, including OAR 333-076-0250 (Violations), is subject to the imposition of a fine not to exceed $500 per day per violation. (2) In addition to the penalties under section (1) of this rule, civil penalties may be imposed for violations of ORS 441.015 to 441.063, 441.086, 676.870 to 676.890 or program rules. (3) In determining the amount of a civil penalty, the Authority shall consider whether: (a) The Authority made repeated attempts to obtain compliance; (b) The licensee has a history of noncompliance with health care facility licensing laws; (c) The violation poses a serious risk to the public's health; (d) The licensee gained financially from the noncompliance; and (e) There are mitigating factors, such as a licensee's cooperation with an investigation or actions to come into compliance. (4) The Authority shall document its consideration of the factors in section (3) of this rule. (5) Each day a violation continues is an additional violation. (6) A civil penalty imposed under this rule shall comply with ORS 183.745. Statutory/Other Authority: ORS 441.025 & 676.890 Statutes/Other Implemented: ORS 441.030, 441.990 & 676.890 History: PH 1-2019, amend filed 01/07/2019, effective 01/07/2019 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10
333-076-0270 Approval of ASC Accrediting Organizations (1) An accrediting organization must request approval by the Authority to ensure that ASCs meet state licensing standards. (2) An accrediting organization shall request approval in writing and shall provide, at a minimum: (a) Evidence that it is a nationally recognized Medicare accreditation program approved by CMS; or (b) If the accrediting organization is not approved by CMS, provide: (A) Documentation of program policies and procedures that its accreditation process meets state licensing standards; (B) Accreditation history; and (C) References from a minimum of two health care facilities currently receiving services from the organization. (3) If the Authority finds that an accrediting organization has the necessary qualifications to certify that state licensing standards have been met, the Authority will enter into an agreement with the accrediting organization permitting it to accredit ASCs in Oregon. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.062 History: PH 272-2018, minor correction filed 11/28/2018, effective 11/28/2018 PH 28-2016, f. & cert. ef. 10-6-13 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10
333-076-0800 Extended Stay Center (ESC) Applicability Effective January 7, 2019, an extended stay center (ESC) licensed in accordance with OAR 333-076-0820 may provide post-surgical and post-diagnostic medical and nursing services to a patient who is recovering from a surgical procedure performed in an affiliated ambulatory surgical center (ASC). Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50 Statutes/Other Implemented: ORS 441.015 & OL 2018 Chapter 50 History: PH 1-2019, adopt filed 01/07/2019, effective 01/07/2019
333-076-0805 Application for ESC License and Fees (1) An applicant wishing to apply for a new or renewal license to operate an ESC shall submit an application on a form prescribed by the Authority and pay the nonrefundable fee. (a) The fee for an initial application is $20,000. (b) The annual renewal fee is $4,100. (2) If an applicant is proposing a new ESC, the applicant shall also submit evidence of plans review approval as required by OAR chapter 333, division 675. (3) An ESC must inform the Authority in writing of any changes in ownership, organizational structure, or other information required on the application form within 30 days of the change. Failure to notify the Authority may result in denial or revocation of the license. 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