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 1546
A-Engrossed
House Bill 3617
Ordered by the House May 24
Including House Amendments dated May 24
Sponsored by Representative GARDNER; Representatives ACKERMAN,
BARNHART, BATES, HASS, KAFOURY, LEE, LEONARD, LOWE, MERKLEY,
MONNES ANDERSON, MORRISETTE, ROSENBAUM, TOMEI, V WALKER,
WESTLUND, WILLIAMS, WILSON, Senator CORCORAN (at the request of
Safe Hospital Coalition - Oregon AFL-CIO, Oregon AFSCME, OFN
HP/AFT, and UFCW)
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 Health Division to adopt staffing standards for
nursing and ancillary staff in health care facilities. Directs
health care facilities to establish staffing committees. Requires
division to design staffing system for health care facility if
facility staffing committee cannot reach agreement. - } { +
Requires health care facilities to provide nursing staff based
on nursing staff plan. Specifies required content of nursing
staff plan. Provides that health care facility may not require
nursing staff to work in excess of prescheduled and agreed-upon
shifts. Provides exception for emergencies. Authorizes Health
Division to suspend or revoke license of health care facility and
to impose civil penalties of up to $5,000 for violation of
requirements to prepare and implement nursing staff plan.
Requires division to conduct audits of 10 percent of health care
facilities annually to verify compliance with requirements to
prepare and implement nursing staff plan.
Takes effect on October 1, 2002. + }
A BILL FOR AN ACT
Relating to staffing of health 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) 'Health care facility' has the meaning given that term in
ORS 442.015, but does not include a long term care facility.
(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 health care facilities.
Therefore, it is the policy of this state to require adequate
numbers of nursing staff at health care facilities to ensure that
a patient's nursing care needs are met when the patient is
admitted to a health care facility. + }
SECTION 3. { + (1) A health care facility shall provide
nursing staff based on the nursing staff plan described in this
section.
(2) The chief nursing executive at a health 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) A health 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 health care facility. + }
SECTION 4. { + A health 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 a health 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 health 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 health 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
health 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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