Oregon Administrative Rules
Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES
Division 54 - RESIDENTIAL CARE AND ASSISTED LIVING FACILITIES
Section 411-054-0045 - Resident Health Services
Universal Citation: OR Admin Rules 411-054-0045
Current through Register Vol. 63, No. 3, March 1, 2024
(1) RESIDENT HEALTH SERVICES. The facility must provide health services and have systems in place to respond to the 24-hour care needs of residents. The system must:
(a) Include written policies and
procedures on medical emergency response for all shifts.
(b) Include an Oregon licensed nurse who is
regularly scheduled for onsite duties at the facility and who is available for
phone consultation.
(c) Assure an
adequate number of nursing hours relevant to the census and acuity of the
resident population. IICs must meet contract requirements concerning nursing
hours.
(d) Ensure that the facility
RN is notified of nursing needs as identified in OAR 411-054-0034 (Resident
Move-In and Evaluation) or OAR 411-054-0036 (Service Plan - General).
(e) Define the duties, responsibilities and
limitations of the facility nurse in policy and procedures, admission, and
disclosure material.
(f) Licensed
nurses must deliver the following nursing services:
(A) Registered nurse (RN) assessment in
accordance with facility policy and resident condition. At minimum, the RN must
assess all residents with a significant change of condition. The assessment may
be a full or problem focused assessment as determined by the RN. A chart review
or phone consultation may be performed as part of this assessment. The RN must
document findings, resident status, and interventions made as a result of this
assessment. The assessment must be timely, but is not required prior to
emergency response in acute situations.
(B) Delegation and Teaching. Delegation and
teaching must be provided and documented by a RN in accordance with the Oregon
Administrative Rules adopted by the Oregon State Board of Nursing in chapter
851, division 047.
(C) Monitoring
of Resident Condition. The facility must specify the role of the licensed nurse
in the facility's monitoring and reporting system.
(D) Participation on Service Planning Team.
If the resident experiences a significant change of condition and the service
plan is updated, the licensed nurse must participate on the Service Planning
Team, or must review the service plan with date and signature within 48
hours.
(E) Health Care Teaching and
Counseling. A licensed nurse must provide individual and group education
activities as required by individual service plans and facility
policies.
(F) Intermittent Direct
Nursing Services. If a resident requires nursing services that are not
available through hospice, home health, a third-party referral, or the task
cannot be delegated to facility staff, the facility must arrange to have such
services provided on an intermittent or temporary basis. Such services may be
of a temporary nature as defined in facility policy, admission agreements and
disclosure information.
(2) ON-SITE AND OFF-SITE HEALTH SERVICES. The facility must assist residents in accessing health care services and benefits to which they are entitled from outside providers. When benefits are no longer available, or if the resident is not eligible for benefits, the facility must provide or coordinate the required services, as defined in facility disclosure information, for residents whose health status is stable and predictable.
(a) On-site Health Services. The facility
must coordinate on-site health services with outside service providers such as
hospice, home health, or other privately paid supplemental health care
providers.
(A) The facility management or
licensed nurse must be notified of the services provided by the outside
provider to ensure that staff are informed of new interventions, and that the
service plan is adjusted if necessary, and reporting protocols are in
place.
(B) The facility nurse must
review the resident's health related service plan changes made as a result of
the provision of on-site health services noted in section (2)(a)(A) of this
rule.
(C) The facility must have
policies to ensure that outside service providers leave written information in
the facility that addresses the on-site services being provided to the resident
and any clinical information necessary for facility staff to provide
supplemental care.
(b)
Off-site Health Services. The facility must coordinate off-site health services
for residents who cannot or choose not to self-manage their health services.
(A) The facility must assist the resident by
coordinating appointments, with outside providers, that are necessary to
support the resident's health needs.
(B) Transportation for medical purposes must
be arranged or provided for by the facility.
(C) Following a resident's visit to an
outside medical provider, if information is obtained from said provider, it
must be included in the resident's record. Adjustments to the resident's
services and service plan must be made as applicable.
(D) The facility must provide relevant
information to the off-site provider and must have a protocol to facilitate the
receipt of information from the provider.
(c) The facility is exempt from the
coordination of outside health services for residents who are capable and
choose to independently arrange and manage their health care needs.
Statutory/Other Authority: ORS 410.070 & 443.450
Statutes/Other Implemented: ORS 443.400 - 443.455 & 443.991
Disclaimer: These regulations may not be the most recent version. Oregon may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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