71st OREGON LEGISLATIVE ASSEMBLY--2001 Regular Session
NOTE: Matter within { + braces and plus signs + } in an
amended section is new. Matter within { - braces and minus
signs - } is existing law to be omitted. New sections are within
{ + braces and plus signs + } .
LC 1221
A-Engrossed
House Bill 2800
Ordered by the House April 26
Including House Amendments dated April 26
Sponsored by Representative SIMMONS; Representatives BACKLUND,
BARNHART, BATES, DEVLIN, DOYLE, GARDNER, GARRARD, HILL, JENSON,
KNOPP, KROPF, KRUMMEL, LEE, MARCH, MINNIS, MONNES ANDERSON,
MORGAN, ROSENBAUM, G SMITH, STARR, V WALKER, WILLIAMS, WINTERS,
ZAUNER, Senators BROWN, COURTNEY, DUNCAN, GEORGE, HANNON,
MINNIS, NELSON, STARR
SUMMARY
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure.
Requires that acute inpatient care facilities develop and
implement nursing staff plan and establish internal review
process. Imposes civil penalties or license suspension or
revocation for violations. { + Requires Health Division to adopt
schedule of penalties by rule. Provides that penalty may not
exceed $5,000 per violation per day.
Takes effect October 1, 2002. + }
A BILL FOR AN ACT
Relating to nursing staff at acute inpatient care facilities;
creating new provisions; amending ORS 441.030; and prescribing
an effective date.
Be It Enacted by the People of the State of Oregon:
SECTION 1. { + As used in sections 1 to 5 of this 2001 Act:
(1) 'Acute inpatient care facility' has the meaning given that
term in ORS 442.470.
(2) 'Nursing staff' means a registered nurse, a licensed
practical nurse, a nursing assistant and all other assistive
nursing personnel. + }
SECTION 2. { + There is a direct positive correlation between
nursing staff and patient outcomes in acute inpatient care
facilities. Therefore, it is the policy of this state to require
adequate numbers of nursing staff at acute inpatient care
facilities to ensure that a patient's nursing care needs are met
when the patient is admitted to an acute inpatient care
facility. + }
SECTION 3. { + (1) An acute inpatient care facility shall
provide nursing staff based on the nursing staff plan described
in this section.
(2) The chief nursing executive at an acute inpatient care
facility shall develop and implement a written, hospital-wide
nursing staff plan for nursing services. The facility shall have
a process that ensures the consideration of input from direct
care nursing staff in the development, implementation,
monitoring, evaluation and modification of the nursing staff
plan. The nursing staff plan shall include the number,
qualifications and categories of nursing staff needed for all
units. The nursing staff plan shall be evaluated and monitored
for effectiveness and revised as necessary as part of the
facility's quality assurance process. Written documentation of
these quality assurance activities shall be maintained.
(3) The nursing staff plan shall:
(a) Be based on the aggregate and individual nursing care needs
of patients, which are the primary considerations in determining
the number of categories of nursing staff needed;
(b) Be based on the specialized qualifications and competencies
of the nursing staff to ensure that the nursing care needs of a
patient are met and to ensure patient safety;
(c) Be consistent with the scopes of practice for nursing
staff; and
(d) Include provisions for limiting patient population if
sufficient nursing staff cannot be provided.
(4) The nursing staff plan shall take into account sickness,
vacations, vacancies, seasonal and expected variances in nursing
staff needs, time for education and conferences, meal or break
periods and other absences, and shall identify the source of
nursing staff replacements.
(5) The nursing staff plan shall establish a minimum number of
nursing staff on duty for specified shifts. The number of nursing
staff on duty must be sufficient to ensure that the nursing care
needs of each patient are met. At least one registered nurse and
one other nursing staff member must be on duty when a patient is
present.
(6) An acute inpatient care facility shall establish and
maintain a formal internal review process that:
(a) Ensures compliance with the nursing staff plan;
(b) Provides for review of incidents and concerns of nursing
staff;
(c) Tracks and analyzes nursing staff patterns in relation to
individual and aggregate patient needs; and
(d) Provides for evaluation of the correlation between nursing
staff and patient outcomes for each acute inpatient care
facility. + }
SECTION 4. { + An acute inpatient care facility may not
require nursing staff to work in excess of prescheduled and
agreed-upon shifts to maintain compliance with the requirements
of the nursing staff plan. An individual member of the nursing
staff shall determine that individual's own fitness and
capability to work in excess of prescheduled and agreed-upon
shifts. The provisions of this section do not apply to nursing
staff needs in the event of a national or state emergency or
circumstances requiring the implementation of a facility disaster
plan. + }
SECTION 5. { + (1) The Health Division may impose civil
penalties in the manner provided in ORS 183.090 or suspend or
revoke a license of an acute inpatient care facility for a
violation of any provision of sections 3 and 4 of this 2001 Act.
The Health Division shall adopt by rule a schedule establishing
the amount of civil penalty that may be imposed for any violation
of section 3 or 4 of this 2001 Act when there is a reasonable
belief that safe patient care has been or may be negatively
impacted. A civil penalty may not exceed $5,000. Each violation
of a nursing staff plan shall be considered a separate violation.
Each day a violation continues shall be considered a separate
violation. Any license that is suspended or revoked under this
section shall be suspended or revoked as provided in ORS 441.030.
(2) The Health Division shall maintain for public inspection
records of any civil penalties or license suspensions or
revocations imposed on acute inpatient care facilities penalized
under subsection (1) of this section.
(3) The Health Division shall conduct an annual random audit of
not less than 10 percent of all acute inpatient care facilities
in this state to verify compliance with the requirements of
sections 3 and 4 of this 2001 Act. Surveys made by private
accrediting organizations may not be used in lieu of the audit
under this subsection. The Health Division shall compile and
maintain for public inspection an annual report of the audit
conducted under this subsection.
(4) The costs of the audit required under subsection (3) of
this section may be paid out of funds from licensing fees paid by
acute inpatient care facilities under ORS 441.020. + }
SECTION 6. ORS 441.030 is amended to read:
441.030. (1) The Health Division or the Senior and Disabled
Services Division of the Department of Human Services, pursuant
to ORS 479.215, shall deny, suspend or revoke a license in any
case where the State Fire Marshal, or the representative of the
State Fire Marshal, certifies that there is a failure to comply
with all applicable laws, lawful ordinances and rules relating to
safety from fire.
(2) The appropriate division may deny, suspend or revoke a
license in any case where it finds that there has been a
substantial failure to comply with ORS 441.015 to 441.063,
441.085, 441.087, 441.990 (3) or the rules or minimum standards
adopted under those statutes.
(3) The appropriate division may suspend or revoke a license
issued under ORS 441.025 for failure to comply with a division
order arising from a health care facility's substantial lack of
compliance with the provisions of ORS 441.015 to 441.063, 441.084
to 441.087 and 441.990 (3) { + or sections 3 and 4 of this 2001
Act + }, or the rules adopted thereunder, or for failure to pay a
civil penalty imposed under ORS 441.710 { + or section 5 of this
2001 Act + }.
(4) The Senior and Disabled Services Division may order a long
term care facility licensed under ORS 441.025 to restrict the
admission of patients when the division finds an immediate threat
to patient health and safety arising from failure of the long
term care facility to be in compliance with ORS 441.015 to
441.063, 441.084 to 441.087 and the rules adopted pursuant
thereto.
(5) Any long term care facility which has been ordered to
restrict the admission of patients pursuant to subsection (4) of
this section shall post a notice of such restriction, provided by
the division, on all doors providing ingress to and egress from
the facility, for the duration of the restriction.
SECTION 7. This 2001 Act takes effect on October 1, 2002.
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