Oregon nursing home responsiveness requirements

Facility administration must immediately notify ODHS, its local designee, or local law enforcement of any incident of abuse or suspected abuse (law enforcement first if a crime is suspected, or if ODHS offices are closed with no after-hours investigator), physical injury of unknown cause counts as suspected abuse unless an immediate facility investigation reasonably concludes otherwise, and a long list of mandatory reporters — physicians, licensed nurses, facility employees and contractors, clergy, social workers, therapists, peace officers, and family members — must report immediately.

The nursing facility administration must immediately notify the Department, local designee of the Department, or local law enforcement agency of any incident of abuse or suspected abuse.

Every nursing facility must arrange for one or more physicians who can be called in a medical emergency, and must post those physicians' names and phone numbers at each nurses' station.

Emergency Backup. Each facility shall provide for one or more physicians to be called in the event of a medical emergency. The names and telephone numbers of such physicians shall be posted at each nurses' station.

Oregon sets its own licensed nurse coverage floor on top of the federal rule: licensed nurse hours must include no less than one RN hour per resident per week, and the facility must have a licensed charge nurse on each shift 24 hours per day, with an RN serving as the licensed charge nurse for no less than eight consecutive hours between the start of day shift and the end of evening shift, seven days a week. The DNS may serve as charge nurse only when the facility has 60 or fewer residents, and the hours of a licensed nurse acting as administrator do not count toward required licensed nurse coverage in facilities with 41 or more beds. The 24-hour charge nurse requirement may be waived by the Department only on annual review and only if the facility certifies, among other things, that an RN or physician is available and obligated to immediately respond to telephone calls from the facility.

The facility must have a licensed charge nurse on each shift 24 hours per day.

Oregon requires a named licensed-nurse fallback who must be reachable by phone at all times. The Director of Nursing Services must designate in writing a specific Oregon-licensed registered nurse to be available immediately, in person or by telephone, to direct the nursing services department whenever the DNS is not available, and that designation must be posted at each nursing station.

The DNS shall designate, in writing, a specific registered nurse, licensed to practice in Oregon, to be available immediately in person or by telephone to direct the functions and activities of the nursing services department when the DNS is not available in person or by telephone.

Residents have the right to communicate privately with people of their choosing, to send and receive unopened mail, and to have regular access to the private use of a telephone.

Associate and communicate privately with persons of the resident's choice, to send and receive personal mail unopened, and to have regular access to the private use of a telephone.

The building itself must provide at least one telephone on each floor and dedicated resident telephones that allow privacy during conversation and are wheelchair accessible, with fire and police numbers affixed to every telephone.

The facility shall have telephones designated for use by residents which allow for privacy during conversation and are wheelchair accessible.

The facility must keep a written emergency preparedness plan analyzing named hazards, addressing access to medical records and pharmaceuticals during and after evacuation, stocking five days of shelter-in-place supplies, must notify the state of its status during an emergency requiring evacuation, drill twice a year, review annually, and file a plan summary with the state every July 1.

The nursing facility must prepare and maintain a written emergency preparedness plan in accordance with the Oregon Fire Code (OFC) in OAR chapter 837, division 040 and the 2009 National Fire Protection Association (NFPA) 101 Life Safety Code.

As a matter of required resident equipment (not just construction), each resident must be furnished an electrically operated call system registering at the nurses' station, with the cord secured so it stays within the resident's reach without becoming an injury hazard.

Each resident shall be provided a bed, mattress, pillow with water-proof protection, necessary bed coverings, bedside table and chair, reading light, and electrically operated call system which registers at the nurses’ station.

Each facility must maintain a Quality Assessment and Assurance Committee including the administrator, medical director, DNS, consulting pharmacist and at least one other staff member, meeting no less than quarterly, conducting a documented annual review of care practices that includes resident audits of at least 20 percent of residents or ten residents (whichever is greater), clinical records, nutrition, care plans, and corrective actions taken.

Each facility must have a Quality Assessment and Assurance Committee. The committee must include the administrator, medical director, Director of Nursing Services (DNS), consulting pharmacist and at least one other facility staff person.