reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0114 - ASC Complaints

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Any
			 person may make a complaint verbally or in writing to the Authority regarding
			 an allegation against an ASC 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
			 333-076-0116.
(4) An ASC 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 ambulatory
			 surgical 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  & 441.057
Statutes/Other Implemented: ORS
				  441.025,
				  441.086  & 441.057
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0115 - Renumbered

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS 441.025
Stats. Implemented: ORS 441.025 &
				  441.055
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0116 - ASC Investigations

Current through Register Vol. 63, No. 7, July 1, 2024
(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 ASC 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 ASC, patient family members, witnesses, ASC management and
			 staff;
(b) On-site observations of
			 patients, staff performance, and the physical environment of the ASC;
			 and
(c) Review of documents and
			 records.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0117 - ASC Surveys

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 Authority shall, in addition to any investigations conducted under OAR
			 333-076-0116, conduct at least one on-site licensing survey of each ASC every
			 three years to determine compliance with health care facility licensing laws
			 and at such other times as the Authority deems necessary.
(2) In lieu of an onsite inspection required
			 under section (1) of this rule, the Authority may accept:
(a) CMS certification by a federal agency or
			 an approved accrediting organization; or
(b) A survey conducted within the previous
			 three years by an accrediting organization approved by the Authority, if:
(A) The certification or accreditation is
			 recognized by the Authority as addressing the standards and Condition for
			 Coverage requirements of the CMS and other standards set by the Authority;
(B) The ASC notifies the Authority
			 to participate in any exit interview conducted by the federal agency or
			 accrediting body; and
(C) The ASC
			 provides copies of all documentation concerning the certification or
			 accreditation requested by the Authority including:
(i) Written evidence of all corrective
			 actions underway, or completed, in response to approved accrediting
			 organizations recommendations;
(ii)
			 All progress reports; and
(iii) The
			 letter from CMS indicating its deemed status.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0118 - ASC Health Care Practitioner Credentialing

Current through Register Vol. 63, No. 7, July 1, 2024
Each ASC 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
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0119 - ASC Governing Body Responsibility

Current through Register Vol. 63, No. 7, July 1, 2024
The governing body of each ASC 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:
(1) Ensure that all health care personnel for
			 whom state licenses or registration are required are currently licensed or
			 registered;
(2) Ensure that
			 physicians and dentists admitted to practice in the facility are granted
			 privileges consistent with their individual training, experience and other
			 qualifications;
(3) Ensure that
			 procedures for granting, restricting and terminating privileges exist and that
			 such procedures are regularly reviewed to assure their conformity to applicable
			 law;
(4) 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
(5) 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 ASC.
Statutory/Other Authority: ORS
				  441.025
Statutes/Other Implemented: ORS
				  441.025  & 441.055
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0120 - ASC Medical Staff

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 physicians and dentists organized into a medical staff pursuant to OAR
			 333-076-0119  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 facility to organize into a medical
			 staff;
(b) Procedures for ensuring
			 that physicians and dentists admitted to practice in the facility 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 facility are currently licensed by the
			 Oregon Medical Board or the Oregon Board of Dentistry;
(e) Procedures for ensuring that the
			 facility'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.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0125 - ASC Personnel

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 facility shall maintain a sufficient number of qualified personnel to provide
			 effective patient care and all other related services.
(2) There shall be written personnel policies
			 and procedures which shall be made available to personnel.
(3) Provisions shall be made for
			 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 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.
Publications: Publications referenced are available from the
				  agency.
Statutory/Other Authority: ORS
				  441.025
Statutes/Other Implemented: ORS
				  441.025
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0135 - ASC Nursing Services

Current through Register Vol. 63, No. 7, July 1, 2024
(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
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0137 - ASC Surgery Services

Current through Register Vol. 63, No. 7, July 1, 2024
(1) For purposes
			 of this rule:
(a) "Circulating nurse" means a
			 registered nurse who is responsible for coordinating the nursing care and
			 safety needs of the patient in the operating room and who also meets the needs
			 of the operating room team members during surgery.
(b) "Rural or medically underserved
			 community" means a geographic area of Oregon that is 10 or more miles from the
			 geographic center of a population center of 40,000 or more
			 individuals.
(c) "Surgical
			 technology" means intraoperative surgical patient care that involves:
(A) Preparing an operating room for surgical
			 procedures by ensuring that surgical equipment is functioning properly and
			 safely;
(B) Preparing an operating
			 room and the sterile field for surgical procedures by preparing sterile
			 supplies, instruments and equipment using sterile techniques;
(C) Anticipating the needs of a surgical team
			 based on knowledge of human anatomy and pathophysiology and how those fields
			 relate to the surgical patient and the patient's surgical procedure;
			 and
(D) Performing tasks as
			 directed in an operating room, including:
(i)
			 Passing instruments, equipment or supplies;
(ii) Sponging or suctioning of an operative
			 site;
(iii) Preparing and cutting
			 suture material;
(iv) Transferring
			 fluids or drugs;
(v) Handling
			 specimens;
(vi) Holding retractors
			 and other equipment;
(vii) Applying
			 electrocautery to clamps on bleeders;
(viii) Connecting drains to suction
			 apparatus;
(ix) Applying dressings
			 to closed wounds; and
(x) Assisting
			 in counting supplies and instruments, including sponges and needles.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0140 - ASC Anesthesia Services (If Provided)

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Publications: Publications referenced are available from the
				  agency.
Statutory/Other Authority: ORS
				  441.025
Statutes/Other Implemented: ORS
				  441.025
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0145 - ASC Storage, Disposal and Dispensing of Drugs

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0150 - ASC Emergency Services

Current through Register Vol. 63, No. 7, July 1, 2024
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
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0155 - ASC Laboratory Services

Current through Register Vol. 63, No. 7, July 1, 2024
(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
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0160 - Care of ASC Patients

Current through Register Vol. 63, No. 7, July 1, 2024
(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
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0170 - ASC Quality Assessment and Performance Improvement

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0175 - ASC Infection Control

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0180 - In-Service Training for ASC Nurses

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0190 - ASC Emergency Preparedness

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Publications: Publications referenced are available from the
				  agency.
Statutory/Other Authority: ORS
				  441.025
Statutes/Other Implemented: ORS
				  441.025
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0246 - Waivers

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0250 - ASC Violations

Current through Register Vol. 63, No. 7, July 1, 2024
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
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0255 - ASC Informal Enforcement

Current through Register Vol. 63, No. 7, July 1, 2024
(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
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0260 - ASC Formal Enforcement

Current through Register Vol. 63, No. 7, July 1, 2024
(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
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0265 - Civil Penalties, Generally

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0270 - Approval of ASC Accrediting Organizations

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0450 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
(1) "Free Standing
			 Birth Center" ("Birthing Center" or "Center") means any health care facility
			 (HCF), licensed for the primary purpose of performing low risk deliveries that
			 is not a hospital, or in a hospital, and where births are planned to occur away
			 from the mother's usual residence following normal, uncomplicated
			 pregnancy.
(2) "Division" means the
			 Oregon Health Authority, Public Health Division.
(3) "Low Risk Pregnancy" means a normal,
			 uncomplicated prenatal course as determined by documentation of adequate
			 prenatal care, and anticipation of a normal uncomplicated labor and birth, as
			 defined by reasonable and generally accepted criteria of maternal and fetal
			 health.
(4) "Absolute risk factors"
			 are those conditions that, if present, prohibit care in a birthing
			 center.
(5) "Patient audit" means
			 review of the clinical record and/or physical inspection of a client.
(6) "Reasonable and generally accepted
			 criteria" means criteria or standards of care adopted by professional groups
			 for maternal, fetal and neonatal health care, and generally accepted and
			 followed by the care providers to whom they apply, and accepted by the Division
			 as reasonable.
Stat. Auth.: ORS 441.025 & 442.015
Stats. Implemented: ORS 441.086 &
				  442.015
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0470 - Licensing

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Application for
			 a license to operate a Birthing Center must be in writing on a form provided by
			 the Division, including demographic, ownership and administrative information.
			 The form must specify such information required by the Division.
(2) No health care facility licensed pursuant
			 to the provisions of ORS Chapter 441, may in any manner or by any means assert,
			 represent, offer, provide or imply that such facility is or may render care or
			 services other than that which is permitted by or that is within the scope of
			 the license issued to such facility by the Division nor may any service be
			 offered or provided that is not authorized within the scope of the license
			 issued to such facility or licensed practitioner providing services in the
			 facility.
(3) The Birthing Center
			 license must be conspicuously posted in the area where clients are
			 admitted.
(4) A license that has
			 been suspended or revoked may be reissued after the Division determines that
			 compliance with Health Care Facility laws has been achieved
			 satisfactorily.
Stat. Auth.: ORS 441.015 & 442.015
Stats. Implemented: ORS 441.015 &
				  442.015
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0490 - Submission of Plans

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Any party
			 proposing to make certain alterations or additions to an existing health care
			 facility or to construct new facilities must, before commencing such
			 alteration, addition or new construction, submit plans and specifications to
			 the Division for preliminary inspection and approval of recommendations with
			 respect to compliance with Division rules. Submissions shall be in accord with,
			 OAR
			 333-675-0000.
			 Plans should also be submitted to the local building division having authority
			 for review and approval in accordance with state building codes.
(2) Centers must keep the Division informed
			 of any changes in ownership, organizational structure, procedures performed and
			 privileges permitted and any information requested on the application form, in
			 writing within 30 days of the change. Failure to notify the Division may result
			 in revocation of license.
Stat. Auth.: ORS 441.060 & 442.015
Stats. Implemented: ORS 441.060 &
				  442.015
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0510 - Expiration and Renewal of License

Current through Register Vol. 63, No. 7, July 1, 2024
Each license to operate a Birthing Center will expire on
				December 31 following the date of issue, and if a renewal is desired, the
				licensee must make application at least 30 days prior to the expiration date
				upon a form prescribed by the Division as described in OAR
				333-076-0470.
Stat. Auth.: ORS 441.025 & 442.015
Stats. Implemented: ORS 441.025 &
				  442.015
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0530 - Denial or Revocation of a License

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A license for any Birthing Center may be
			 denied, suspended or revoked by the Division when the Division finds that there
			 has been a substantial failure to comply with the provisions of Health Care
			 Facility licensing law.
(2) A
			 person or persons in charge of a Birthing Center must not permit, aid or abet
			 any illegal act affecting the welfare of the license.
(3) A license will be denied, suspended or
			 revoked in any case where the State Fire Marshal certifies that there was
			 failure to comply with all applicable laws, lawful ordinances and rules
			 relating to safety from fire.
(4) A
			 license may be suspended or revoked for failure to comply with a Division order
			 arising from a Center's substantial lack of compliance with the rules or
			 statutes.
Stat. Auth.: ORS 441.030 & 442.015
Stats. Implemented: ORS 441.030 &
				  442.015
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0550 - Return of Facility License

Current through Register Vol. 63, No. 7, July 1, 2024
Each license certificate in the licensee's possession must be
				returned to the Division immediately on the suspension or revocation of the
				license, failure to renew the license by December 31, or if operation is
				discontinued by the voluntary action of the licensee.
Stat. Auth.: ORS 441.086 & 442.015
Stats. Implemented: ORS 441.086 &
				  442.015
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0560 - Classification

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Health care
			 facilities licensed by the Division may neither assume a descriptive title or
			 be held out under any descriptive title other than the classification title
			 established by the Division and under which the facility is licensed.
(2) No change in the licensed classification
			 of any health care facility, as set out in this rule, may be allowed by the
			 Division unless such facility files a new application, accompanied by the
			 required license fee, with the Division. If the Division finds that the
			 applicant and facility comply with Health Care Facility laws and the
			 regulations of the Division relating to the new classification for which
			 application for licensure is made, the Division may issue a license for such
			 classification.
Stat. Auth.: ORS 441.025 & 442.015
Stats. Implemented: ORS 441.025 &
				  442.015
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0570 - Hearings

Current through Register Vol. 63, No. 7, July 1, 2024
Upon written notification by the Division of revocation,
				suspension or denial to issue or renew a license; a written request by the
				Center for a hearing in accordance with ORS 183.310 to 183.500 may be granted
				by the Division.
Stat. Auth.: ORS 441.037 & 442.015
Stats. Implemented: ORS 441.037 &
				  442.015
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0590 - Adoption by Reference

Current through Register Vol. 63, No. 7, July 1, 2024
All rules, standards and publications referred to in this
				division are made a part thereof. Copies are available for inspection at the
				Division during office hours. Where publications are in conflict with the
				rules, the rules govern.
Stat. Auth.: ORS 441.025 & 442.015
Stats. Implemented: ORS 441.086 &
				  442.015
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0610 - Division Procedures

Current through Register Vol. 63, No. 7, July 1, 2024
Inspections and investigations:
(1) Complaints:
(a) Any person may make a complaint to the
			 Division regarding violation of health care facility laws or regulations. A
			 complaint investigation will be carried out as soon as practicable and may
			 include but not be limited to, as applicable to facts alleged:
(A) Interviews of the complainant, client(s),
			 witnesses, and Center management and staff;
(B) Observations of the client(s), staff
			 performance, client environment and physical environment; and
(C) Review of documents and
			 records.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0630 - Administration

Current through Register Vol. 63, No. 7, July 1, 2024
Each Center must have a governing body or person clearly
				identified as being legally responsible for setting of policies and procedures,
				and assuring that they are implemented.
Stat. Auth.: ORS 441.025 & 442.015
Stats. Implemented: ORS 441.086 &
				  442.015
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0650 - Service Restrictions

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Procedures permitted, including surgical procedures, must be limited to those
			 directly pertaining to pregnancy, labor and delivery care of women experiencing
			 low risk pregnancy. Procedures performed will be consistent with the individual
			 practitioner's licensure and/or scope of practice. Tubal ligation and abortion
			 must not be performed. Table I outlines absolute risk factors that, if present
			 on admission to the birthing center for labor and delivery, would prohibit
			 admission to the birthing center. Table II outlines absolute risk factors that,
			 if they develop during labor and delivery, require transfer of the client to a
			 higher level of care. Table III outlines absolute risk factors that, if they
			 develop during the postpartum period in the mother or infant, would require
			 transfer to a higher level of care.
(2) General, spinal, caudal, and/or epidural
			 anesthesia must not be administered in the Center.
(3) Labor shall not be induced, stimulated,
			 or augmented with chemical agents during the first or second stages of
			 labor.
(4) Chemical agents may be
			 administered within the individual practitioner's scope of practice to inhibit
			 labor, as a temporary measure, until referral/transfer of the client is
			 complete.
Stat. Auth.: ORS 441.025 & 442.015
Stats. Implemented: ORS 441.025 &
				  442.015
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0690 - Health and Medical Records

Current through Register Vol. 63, No. 7, July 1, 2024
Health and Clinical Records must be developed according to
				procedures outlined in the Policy and Procedures Manual as a legal record and
				an instrument for the continuity of care and must include:
(1) Contents -- The records of each client
			 must contain:
(a) Demographic data, initial
			 prenatal physical examination, laboratory tests and evaluation of risk
			 status;
(b) Continuous periodic
			 prenatal examination and evaluation of risk status;
(c) A signed informed consent (refer also to
			 OAR
			 333-076-0670(12));
(d) History, physical
			 examination and risk assessment on admission to the Center in labor (including
			 assessment of mother and fetus);
(e) Continuous assessment of the mother and
			 fetus during labor and delivery;
(f) Labor summary;
(g) The emergency transport plan for the
			 client;
(h) Physical assessment of
			 newborn, including Apgar scores and vital signs;
(i) Post partum evaluation of the
			 mother;
(j) Discharge summary for
			 mother and newborn;
(k)
			 Documentation of consultation, referral, and/or transfer;
(l) Signed documents as may be required by
			 law; and
(m) Records of newborn and
			 stillborn infants must include, in addition to the requirement for medical
			 records, the following information:
(A) Date
			 and hour of birth, birth weight and length of infant, period of gestation, sex,
			 and condition of infant on delivery;
(B) Mother's name;
(C) Record of ophthalmic prophylaxis and
			 Vitamin K administration or refusal of same; and
(D) Progress notes including:
(i) Temperature, weight and feeding
			 data;
(ii) Number, consistency and
			 color of stools;
(iii) Urinary
			 output;
(iv) Condition of eyes and
			 umbilical cord;
(v) Condition and
			 color of skin; and
(vi) Motor
			 behavior.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0710 - Physical Facility

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Design --
			 The Center may be an adaptation of a house. It must include birthing rooms of
			 adequate size to meet the needs to accomplish the procedures specified in the
			 Policies and Procedures and must meet applicable codes for ordinary
			 construction and for water supply and sewage disposal. The building and
			 equipment must be kept clean and in good repair. The Center must include:
(a) Toilet facilities for staff, mothers and
			 families;
(b) Bath
			 facilities;
(c) Hand washing
			 facilities and single use towel dispensers adjacent or closely available to all
			 examining or birth rooms;
(d)
			 Examination areas;
(e) Laundry
			 facilities (unless laundry is done elsewhere);
(f) Kitchen facilities;
(g) Adequate storage areas for emergency
			 equipment;
(h) Separate storage for
			 clean/sterile supplies and equipment;
(i) Storage areas for laboratory equipment
			 and sterilizing, if applicable;
(j)
			 Space for resuscitation of the newborn; and
(k) Reception and family
			 facilities.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0800 - Extended Stay Center (ESC) Applicability

Current through Register Vol. 63, No. 7, July 1, 2024
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
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0805 - Application for ESC License and Fees

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 76 - AMBULATORY SURGICAL CENTERS (ASC) AND EXTENDED STAY CENTERS (ESC) › Section 333-076-0810 - ESC Application Review

Current through Register Vol. 63, No. 7, July 1, 2024
(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.