Oregon Administrative Rules
Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES
Division 48 - LONG TERM CARE COMMUNITY NURSING
Section 411-048-0180 - Long Term Care Community Nursing Services
Current through Register Vol. 63, No. 3, March 1, 2024
When authorized by an individual's case manager, the following long term care community nursing services must be provided by an RN in accordance with these rules and the scope of practice as stated in the OSBN rules in OAR chapter 851.
(1) REVIEW OF REFERRAL. An RN must screen a referral and notify the individual's case manager of their decision to accept or refuse the referral within two business days of receiving the referral on the Department approved form. The RN may refuse any referral.
(2) INITIAL ASSESSMENT. The RN must perform a face-to-face nursing assessment within 10 business days following the acceptance of a referral. The assessment is defined in OAR chapter 851, division 006 and regulated by OAR chapter 851, division 045.
(3) REASSESSMENT. For the purpose of this rule, the RN must perform a face-to-face reassessment and update the individual's Nursing Service Plan at a minimum annually. Based on the RN's assessment of the individual, the RN may determine that an assessment needs to occur more frequently. Reasons for increased frequency may include, but are not limited to, a change of condition or change of environment.
(4) NURSING SERVICE PLAN. Based on the initial assessment or reassessment, the RN develops or updates the individual's Nursing Service Plan and must:
(5) DELEGATION. The RN must follow the standards and documentation requirements for delegation of nursing tasks as required by OAR chapter 851, divisions 006, 045, and 047.
(6) TEACHING. The RN must follow the standards and documentation requirements for teaching health promotion as described in OAR 851-045-0060.
(7) MONITORING. The RN must provide monitoring visits at the individual's home, sufficient in frequency and duration to implement and keep current an individual's Nursing Service Plan.
(8) MEDICATION REVIEW. The RN must provide a medication review during each monitoring visit and as part of an initial assessment or reassessment. The scope of a medication review shall be based on the needs of the individual or the individual's caregiver. Information collected and evaluated as part of a medication review may result in changes to an RN's nursing plan of care, subsequent Teaching Plan or care coordination activity.
(9) CARE COORDINATION. The RN provides care coordination in order to advocate for health care services that an individual needs and to gather the information that is needed to complete the assessment, nursing service plan or reassessment process, and medication review. The RN uses care coordination to provide updated information to people involved in an individual's health care via phone calls, faxes, electronic mediums, or meetings. Care coordination is provided, but not limited, to case managers, other nurses, healthcare providers, and non-caregiving family members or legal representatives.
(10) Time spent completing the services described in sections (3) through (9) of this rule may be included in the claim for the respective service but must meet documentation standards specified in OAR 410-120-1360(2)(a)(b) and the Department's Long Term Care Community Nursing Procedure Codes and Payment Authorization Guidelines.
(11) PRIOR AUTHORIZATION. All long term care community nursing services in sections (2) through (9) of this rule must be prior authorized by an individual's case manager.
(12) Prior authorization for the initial assessment and delegation of services described in sections (2) and (5) of this rule is granted once the Department approved form for referral is signed by the RN and the individual's case manager. The payment received by an RN for initial assessment shall include compensation for all long term care community nursing services excluding delegation, provided by the RN to the individual and the individual's caregiver. Payment is not provided until prior authorization as described in section (11) of this rule has been provided to the RN by the individual's case manager.
(13) The RN must use the Department approved Service Summary form as the communication tool for case managers and caregivers to document the monitoring, care coordination, teaching, delegation, or other services as noted in these rules provided to each individual.
(14) A local office manager may grant an exception to the timeframes required in this rule on a case specific basis.
Statutory/Other Authority: ORS 409.050 & 410.070
Statutes/Other Implemented: ORS 409.010 & 410.070