OAR 411-054-0045
Resident Health Services

(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) (Resident Move-In and Evaluation) or OAR 411-054-0036 (Service Plan — General) (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.

Source: Rule 411-054-0045 — Resident Health Services, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=411-054-0045.

411‑054‑0000
Purpose 411‑054‑0005
Definitions 411‑054‑0010
Licensing Standard 411‑054‑0012
Requirements for New Construction or Initial Licensure 411‑054‑0013
Application for Initial Licensure and License Renewal 411‑054‑0016
New Applicant Qualifications 411‑054‑0019
Change of Ownership or Management 411‑054‑0025
Facility Administration 411‑054‑0026
Notice to Potential Residents 411‑054‑0027
Resident Rights and Protections 411‑054‑0028
Abuse Reporting and Investigation 411‑054‑0030
Resident Services 411‑054‑0034
Resident Move-In and Evaluation 411‑054‑0036
Service Plan — General 411‑054‑0038
Individually-Based Limitations 411‑054‑0040
Change of Condition and Monitoring 411‑054‑0045
Resident Health Services 411‑054‑0050
Infection Prevention and Control 411‑054‑0055
Medications and Treatments 411‑054‑0060
Restraints and Supportive Devices 411‑054‑0065
Administrator Qualifications and Requirements 411‑054‑0070
Staffing Requirements and Training 411‑054‑0080
Involuntary Move-out Criteria 411‑054‑0085
Refunds and Financial Management 411‑054‑0090
Fire and Life Safety 411‑054‑0093
Emergency and Disaster Planning 411‑054‑0100
Exceptions and Waivers 411‑054‑0105
Inspections and Investigations 411‑054‑0106
Regulatory Framework 411‑054‑0110
Conditions 411‑054‑0120
Civil Penalties 411‑054‑0130
Non-Renewal, Denial, Suspension or Revocation of License 411‑054‑0133
Temporary Manager 411‑054‑0135
Criminal Penalties 411‑054‑0140
Additional Authority 411‑054‑0200
Residential Care Facility Building Requirements 411‑054‑0300
Assisted Living Facility Building Requirements 411‑054‑0320
Quality Measurement Program and Council
Last Updated

Jun. 8, 2021

Rule 411-054-0045’s source at or​.us