US Laws, Codes, Statutes & Cases

Chapter 441 — Health Care Facilities

 

2007 EDITION

 

HEALTH CARE FACILITIES

 

PUBLIC HEALTH AND SAFETY

 

LICENSING AND SUPERVISION OF FACILITIES AND ORGANIZATIONS

 

441.015     Licensing of facilities and health maintenance organizations; compliance with rules and standards

 

441.017     Exclusions from licensing requirements for health care facilities

 

441.020     Application; fees

 

441.022     Factors to be considered in licensing

 

441.025     License issuance; rules; renewal; disclosure; transfer; posting

 

441.030     Denial, suspension or revocation of licenses; restrictions on admission

 

441.037     Hearings; procedures; judicial review

 

441.050     Additional remedies

 

441.055     Rules; evidence of compliance; health care facilities to ensure compliance; medical staff bylaws; peer review; procedure

 

441.057     Rules concerning complaints about care; reporting by employee

 

441.059     Access to previous X-rays and reports by patients of chiropractic physicians

 

441.060     Inspections; approval of plans and specifications; rules; fees

 

441.061     Delegation of health inspections to local governmental agencies; financial assistance

 

441.062     Coordination of inspections; rules

 

441.063     Use of facilities by licensed podiatric physicians and surgeons; regulation of admission and conduct

 

441.064     Use of facilities by licensed nurse practitioners; rules regarding admissions and privileges

 

441.065     Exemption of certain religious institutions

 

441.067     Inspection reports, complaint procedures and rules; posting

 

441.073     Rules regarding staff ratio in long term care facilities; variances; posting

 

441.077     Revocation of license and other penalties for imposing restrictions upon certain physicians; construction of section

 

441.079     Eye, organ and tissue transplants

 

441.082     Registration of organ procurement organization, tissue bank and eye bank; rules; penalties

 

441.083     Drug information to be provided patients of long term and intermediate care facilities

 

441.084     Choice of patient on suppliers of drugs and supplies

 

441.085     Rules establishing licensing classifications; use of descriptive titles limited

 

441.087     General inspection of long term care facility

 

441.089     Application of Health Care Quality Improvement Act of 1986

 

441.094     Denial of emergency medical services because of inability to pay prohibited

 

441.096     Identification badges

 

ADMISSION TO OR MOVE FROM LONG TERM CARE FACILITY OR RESIDENTIAL CARE FACILITY OF PERSON CONVICTED OF SEX CRIME

 

(Temporary provisions relating to admission to or move from long term care facility or residential care facility of person convicted of sex crime are compiled as notes following ORS 441.096)

 

LONG TERM CARE OMBUDSMAN

 

441.100     Definitions

 

441.103     Office of Long Term Care Ombudsman; terms; appointment; confirmation; qualifications

 

441.107     Funding of office

 

441.109     Duties of ombudsman; rules

 

441.113     Procedures to maintain confidentiality

 

441.117     Right of entry into facilities and access to records

 

441.121     Report after investigation; referral to other agencies

 

441.124     Notice of complaint procedures; posting

 

441.127     Immunity of employees

 

441.131     Appointment of designees; qualifications; duties

 

441.133     Effect of ORS 441.100 to 441.153 on right to visitors

 

441.137     Long Term Care Advisory Committee; appointment; confirmation; term; qualifications

 

441.142     Duties

 

441.146     Appeal to Long Term Care Advisory Committee

 

441.147     Officers; quorum; meetings; expenses

 

441.153     Long Term Care Ombudsman Account

 

HOSPITAL NURSING SERVICES

 

441.160     Definition for ORS 441.162 to 441.170

 

441.162     Written staffing plan for nursing services

 

441.164     Variances in staffing plan requirements

 

441.166     Need for replacement staff

 

441.168     Leaving a patient care assignment

 

441.170     Civil penalties; suspension or revocation of license; rules; records; compliance audits

 

441.172     Definitions for ORS 441.172 to 441.182

 

441.174     Retaliation prohibited

 

441.176     Remedies for retaliation

 

441.178     Unlawful employment practices; civil action for retaliation

 

441.180     Hospital posting of notice

 

441.182     Rights, privileges or remedies of nursing staff

 

441.192     Notice of employment outside of hospital

 

TRUSTEE TO ENSURE COMPLIANCE WITH CARE RULES

 

441.277     Definitions for ORS 441.277 to 441.323

 

441.281     Petition for appointment of trustee; hearing; order

 

441.286     Grounds for appointment of trustee

 

441.289     Powers and duties of trustee

 

441.293     Liability to trustee for goods and services after notice; effect of nonpayment

 

441.296     Liability for rent or contracts

 

441.301     Payment of expenses when income inadequate

 

441.303     Fees from facilities in addition to license fee; use of fees

 

441.306     Compensation of trustee

 

441.309     Trustee as public employee

 

441.312     License renewal of facility placed in trust

 

441.316     Termination of trust; extension; license revocation

 

441.318     Trustee accounting; lien

 

441.323     Effect of trust on prior obligations or civil or criminal liabilities

 

MOVES FROM LONG TERM CARE FACILITIES

 

441.357     Definitions for ORS 441.357 to 441.367

 

441.362     Notice by Department of Human Services prior to move or termination; hearing; consent to move; who may consent

 

441.367     Facility required to give notice of base rate and policy on nonpayment; rules; notice of changes; civil penalty

 

FINANCING OF HEALTH CARE FACILITIES CONSTRUCTION

 

441.525     Definitions for ORS 441.525 to 441.595

 

441.530     Policy

 

441.532     Municipalities authorized to create authority; issuance of obligations; conditions; purpose of authority

 

441.535     Procedure to create public authority

 

441.540     Board of directors; rules; conflict of interest; quorum; personnel

 

441.545     Authority may not levy taxes

 

441.550     General powers

 

441.555     Issuance of revenue obligations; nature of obligation; refunding

 

441.560     Borrowing; bond anticipation notes

 

441.565     Obligations of authority not obligations of municipality

 

441.570     Payment of principal and interest

 

441.575     Authorities may act jointly

 

441.580     Authority as public body; tax status of assets, income and bonds

 

441.585     Disposition of excess earnings; disposition of assets on dissolution

 

441.590     Authority granted by ORS 441.525 to 441.595

 

441.595     Construction of ORS 441.525 to 441.595

 

LONG TERM CARE FACILITIES

 

(Nursing Home Patients’ Bill of Rights)

 

441.600     Definitions for ORS 441.600 to 441.625

 

441.605     Legislative declaration of rights intended for residents

 

441.610     Nursing home patients’ bill of rights; rules

 

441.612     Additional rights; rules

 

441.615     Powers and responsibilities of department; rules

 

441.620     Disclosure of business information required

 

(Enforcement of Nursing Home Laws)

 

441.624     Purpose

 

441.625     Retaliation against resident exercising rights prohibited

 

(Resident Abuse)

 

441.630     Definitions for ORS 441.630 to 441.680 and 441.995

 

441.635     Legislative finding

 

441.637     Rules; submission of rules to advisory group

 

441.640     Report of suspected abuse of resident required

 

441.645     Oral report to area agency on aging, department or law enforcement agency

 

441.650     Investigation of abuse complaint; initial status report; content; distribution of report; duties of investigator; investigation report

 

441.655     Immunity provided reporter of abuse

 

441.660     Photographing resident; photograph as record

 

441.665     Record of reports; classification of investigation report

 

441.671     Confidentiality of reports; when available

 

441.675     Certain evidentiary privileges inapplicable

 

441.676     Investigation of licensing violations; powers of investigator

 

441.677     Letter of determination; determination rules; distribution of letter; notice to nursing assistant

 

441.678     Review of finding that nursing assistant responsible for abuse; name placed in registry

 

441.679     Preemployment inquiries; when employment prohibited

 

441.680     Spiritual healing alone not considered abuse of resident

 

441.685     Monitors; designation; duties; peer review of facilities

 

(Investigation of Complaints)

 

441.690     Complainant may accompany investigator

 

441.695     Conduct of investigation

 

(Drug Supplies for Unscheduled Leaves)

 

441.697     Prescribed drug supply for unscheduled therapeutic leave from long term care facility; dispensing of drugs by registered nurse

 

(Access)

 

441.700     Access to facilities by persons providing services

 

(Complaint File)

 

441.703     Complaint file; summary; availability on request

 

CIVIL PENALTIES

 

441.705     Definitions for ORS 441.705 to 441.745

 

441.710     Civil penalties; when imposed

 

441.712     Notice of civil penalty

 

441.715     Objective criteria for civil penalties; rules

 

441.720     Remittance or reduction of penalties

 

441.740     Judicial review

 

441.745     Penalties to General Fund

 

SUICIDE ATTEMPTS BY MINORS

 

441.750     Suicide attempts by minors; referral; report; disclosure of information; limitation of liability

 

441.755     Report form; contents

 

MISCELLANEOUS

 

441.815     Smoking of tobacco in certain hospital rooms prohibited

 

441.820     Procedure for termination of physician’s privilege to practice medicine at health care facility; immunity from damage action for good faith report

 

441.825     Authority of hospital to require medical staff to provide professional liability insurance

 

PENALTIES

 

441.990     Criminal penalties

 

441.995     Factors considered in determining penalties under ORS 441.630 to 441.680; civil penalty

 

      441.005 [Amended by 1971 c.730 §1; 1973 c.840 §1; repealed by 1977 c.751 §57]

 

      441.007 [1973 c.840 §2; repealed by 1977 c.751 §39]

 

      441.010 [Amended by 1971 c.730 §3; 1973 c.840 §3; 1977 c.751 §18; renumbered 442.300]

 

LICENSING AND SUPERVISION OF FACILITIES AND ORGANIZATIONS

 

      441.015 Licensing of facilities and health maintenance organizations; compliance with rules and standards. (1) No person or governmental unit, acting severally or jointly with any other person or governmental unit, shall establish, conduct, maintain, manage or operate a health care facility or health maintenance organization, as defined in ORS 442.015, in this state without a license.

      (2) Any health care facility or health maintenance organization which is in operation at the time of promulgation of any applicable rules or minimum standards under ORS 441.055 or 731.072 shall be given a reasonable length of time within which to comply with such rules or minimum standards. [Amended by 1971 c.730 §4; 1973 c.840 §4; 1977 c.751 §19; 2003 c.14 §249]

 

      441.017 Exclusions from licensing requirements for health care facilities. For purposes of licensing health care facilities, health care facility, as defined in ORS 442.015, does not include:

      (1) Facilities established by ORS 430.306 to 430.335 for treatment of alcoholism or drug abuse; and

      (2) Community mental health and development disabilities programs established under ORS 430.610 to 430.695. [1981 c.231 §2; 1987 c.753 §1]

 

      441.020 Application; fees. (1) Licenses for health care facilities including long term care facilities, as defined in ORS 442.015, shall be obtained from the Department of Human Services.

      (2) Applications shall be upon such forms and shall contain such information as the department may reasonably require, which may include affirmative evidence of ability to comply with such reasonable standards and rules as may lawfully be prescribed under ORS 441.055.

      (3) Each application shall be accompanied by the license fee. If the license is denied, the fee shall be refunded to the applicant. If the license is issued, the fee shall be paid into the State Treasury to the credit of the Department of Human Services Account for carrying out the functions under ORS 441.015 to 441.063 and 431.607 to 431.619.

      (4) Except as otherwise provided in subsection (5) of this section, for hospitals with:

      (a) Fewer than 26 beds, the annual license fee shall be $750.

      (b) Twenty-six beds or more but fewer than 50 beds, the annual license fee shall be $1,000.

      (c) Fifty or more beds but fewer than 100 beds, the annual license fee shall be $1,900.

      (d) One hundred beds or more but fewer than 200 beds, the annual license fee shall be $2,900.

      (e) Two hundred or more beds, the annual license fee shall be $3,400.

      (5) For long term care facilities with:

      (a) Fewer than 16 beds, the annual license fee shall be up to $120.

      (b) Sixteen beds or more but fewer than 50 beds, the annual license fee shall be up to $175.

      (c) Fifty beds or more but fewer than 100 beds, the annual license fee shall be up to $350.

      (d) One hundred beds or more but fewer than 200 beds, the annual license fee shall be up to $450.

      (e) Two hundred beds or more, the annual license fee shall be up to $580.

      (6) For special inpatient care facilities with:

      (a) Fewer than 26 beds, the annual license fee shall be $750.

      (b) Twenty-six beds or more but fewer than 50 beds, the annual license fee shall be $1,000.

      (c) Fifty beds or more but fewer than 100 beds, the annual license fee shall be $1,900.

      (d) One hundred beds or more but fewer than 200 beds, the annual license fee shall be $2,900.

      (e) Two hundred beds or more, the annual license fee shall be $3,400.

      (7) For ambulatory surgical centers, the annual license fee shall be $1,000.

      (8) For birthing centers, the annual license fee shall be $250.

      (9) For outpatient renal dialysis facilities, the annual license fee shall be $1,500.

      (10) During the time the licenses remain in force holders thereof are not required to pay inspection fees to any county, city or other municipality.

      (11) Any health care facility license may be indorsed to permit operation at more than one location. In such case the applicable license fee shall be the sum of the license fees which would be applicable if each location were separately licensed.

      (12) Licenses for health maintenance organizations shall be obtained from the Director of the Department of Consumer and Business Services pursuant to ORS 731.072. [Amended by 1957 c.697 §1; 1971 c.650 §19; 1971 c.730 §5; 1973 c.840 §5; 1977 c.284 §4; 1977 c.751 §20a; 1979 c.696 §15; 1987 c.428 §3; 1987 c.918 §7; 1995 c.449 §1; 1997 c.249 §139; 2001 c.100 §2; 2001 c.900 §161]

 

      441.022 Factors to be considered in licensing. In determining whether to license a health care facility pursuant to ORS 441.025, the Department of Human Services shall consider only factors relating to the health and safety of individuals to be cared for therein and shall not consider whether the health care facility is or will be a governmental, charitable or other nonprofit institution or whether it is or will be an institution for profit. [1967 c.584 §2; 1971 c.730 §6; 1973 c.840 §6; 1987 c.428 §4; 2001 c.900 §162]

 

      441.025 License issuance; rules; renewal; disclosure; transfer; posting. (1) Upon receipt of an application and the license fee, the Department of Human Services shall issue a license if it finds that the applicant and health care facility comply with ORS 441.015 to 441.063, 441.085 and 441.087 and the rules of the department provided that it does not receive within the time specified a certificate of noncompliance issued by the State Fire Marshal, deputy, or approved authority pursuant to ORS 479.215.

      (2) Each license, unless sooner suspended or revoked, shall be renewable annually for the calendar year upon payment of the fee, provided that a certificate of noncompliance has not been issued by the State Fire Marshal, deputy, or approved authority pursuant to ORS 479.215.

      (3) Each license shall be issued only for the premises and persons or governmental units named in the application and shall not be transferable or assignable.

      (4) Licenses shall be posted in a conspicuous place on the licensed premises as prescribed by rule of the department.

      (5) No license shall be issued or renewed for any health care facility or health maintenance organization that offers or proposes to develop a new health service unless a certificate of need has first been issued therefor pursuant to ORS 442.340 (1987 Replacement Part) or approval has been granted under ORS 442.315 or section 9, chapter 1034, Oregon Laws 1989.

      (6) No license shall be issued or renewed for any skilled nursing facility or intermediate care facility, as defined in ORS 442.015, unless the applicant has included in the application the name and such other information as may be necessary to establish the identity and financial interests of any person who has incidents of ownership in the facility representing an interest of 10 percent or more thereof. If the person having such interest is a corporation, the name of any stockholder holding stock representing an interest in the facility of 10 percent or more shall also be included in the application. If the person having such interest is any other entity, the name of any member thereof having incidents of ownership representing an interest of 10 percent or more in the facility shall also be included in the application.

      (7) A license may be denied to any applicant for a license or renewal thereof or any stockholder of any such applicant who has incidents of ownership in the facility representing an interest of 10 percent or more thereof, or an interest of 10 percent or more of a lease agreement for the facility, if during the five years prior to the application the applicant or any stockholder of the applicant had an interest of 10 percent or more in the facility or of a lease for the facility and has divested that interest after receiving written notice from the department of intention to suspend or revoke the license or to decertify the home from eligibility to receive payments for services provided under this section.

      (8) No license shall be issued or renewed for any long term care facility, as defined in ORS 442.015, unless the applicant has included in the application the identity of any person who has incident of ownership in the facility who also has a financial interest in any pharmacy, as defined in ORS 689.005. [Amended by 1957 c.697 §2; 1961 c.316 §6; 1967 c.89 §3; 1971 c.730 §7; 1973 c.38 §1; 1973 c.840 §7; 1977 c.261 §3; 1977 c.751 §21; 1979 c.336 §1; 1983 c.740 §156; 1985 c.747 §20; 1987 c.428 §5; 1989 c.1034 §4; 2001 c.900 §163]

 

      441.030 Denial, suspension or revocation of licenses; restrictions on admission. (1) 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 department 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 or 441.087 or the rules or minimum standards adopted under ORS 441.015 to 441.063, 441.085 or 441.087.

      (3) The department may suspend or revoke a license issued under ORS 441.025 for failure to comply with a department 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, 441.162 or 441.166 or the rules adopted under ORS 441.015 to 441.063, 441.084 to 441.087, 441.162 or 441.166, or for failure to pay a civil penalty imposed under ORS 441.170 or 441.710.

      (4) The department may order a long term care facility licensed under ORS 441.025 to restrict the admission of patients when the department 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 or 441.084 to 441.087 and the rules adopted under ORS 441.015 to 441.063 or 441.084 to 441.087.

      (5) Any long term care facility that has been ordered to restrict the admission of patients pursuant to subsection (4) of this section shall post a notice of the restriction, provided by the department, on all doors providing ingress to and egress from the facility, for the duration of the restriction. [Amended by 1959 c.222 §1; 1961 c.316 §7; 1971 c.730 §8; 1977 c.582 §46; 1987 c.428 §6; 1989 c.171 §55; 1991 c.734 §22; 2001 c.609 §8; 2001 c.900 §164; 2007 c.71 §125]

 

      441.035 [Amended by 1959 c.222 §2; 1959 c.466 §1; 1971 c.730 §9; repealed by 1971 c.734 §21]

 

      441.037 Hearings; procedures; judicial review. (1) When the Department of Human Services proposes to refuse to issue or renew a license, or proposes to revoke or suspend a license, opportunity for hearing shall be accorded as provided in ORS chapter 183.

      (2) Adoption of rules, conduct of hearings, issuance of orders and judicial review of rules and orders shall be in accordance with ORS chapter 183. [1971 c.734 §56; 1977 c.582 §47; 1987 c.428 §7; 2001 c.900 §165]

 

      441.040 [Amended by 1959 c.222 §3; 1971 c.730 §10; repealed by 1971 c.734 §21]

 

      441.045 [Amended by 1959 c.222 §4; 1959 c.466 §2; 1971 c.730 §11; repealed by 1971 c.734 §21]

 

      441.050 Additional remedies. Notwithstanding the existence and pursuit of any other remedy, the Department of Human Services may, in the manner provided by law, maintain an action in the name of the state for injunction or other process against any person or governmental unit to restrain or prevent the establishment, conduct, management or operation of a health care facility or health maintenance organization without a license. [Amended by 1971 c.730 §12; 1973 c.840 §8; 1977 c.751 §22; 1987 c.428 §8; 2001 c.900 §166]

 

      441.055 Rules; evidence of compliance; health care facilities to ensure compliance; medical staff bylaws; peer review; procedure. (1) The Department of Human Services shall adopt such rules with respect to the different types of health care facilities as may be designed to further the accomplishment of the purposes of ORS 441.015 to 441.087. No rules shall require any specific food so long as the necessary nutritional food elements are present.

      (2) Rules describing care given in health care facilities shall include, but not be limited to, standards of patient care or patient safety, adequate professional staff organizations, training of staff for whom no other state regulation exists, suitable delineation of professional privileges and adequate staff analyses of clinical records. The department may in its discretion accept certificates by the Joint Commission on Accreditation of Hospitals or the Committee on Hospitals of the American Osteopathic Association as evidence of compliance with acceptable standards.

      (3) The governing body of each health care facility shall be responsible for the operation of the facility, the selection of the medical staff and the quality of care rendered in the facility. The governing body shall:

      (a) Ensure that all health care personnel for whom state licenses, registrations or certificates are required are currently licensed, registered or certified;

      (b) Ensure that physicians admitted to practice in the facility are granted privileges consistent with their individual training, experience and other qualifications;

      (c) Ensure that procedures for granting, restricting and terminating privileges exist and that such procedures are regularly reviewed to assure their conformity to applicable law;

      (d) Ensure that physicians admitted to practice in the facility are organized into a medical staff in such a manner as to effectively review the professional practices of the facility for the purposes of reducing morbidity and mortality and for the improvement of patient care; and

      (e) Ensure that a physician is not denied medical staff membership or privileges at the facility solely on the basis that the physician holds medical staff membership or privileges at another health care facility.

      (4) The physicians organized into a medical staff pursuant to subsection (3) of this section shall propose medical staff bylaws to govern the medical staff. The bylaws shall include, but not be limited to the following:

      (a) Procedures for physicians admitted to practice in the facility to organize into a medical staff pursuant to subsection (3) of this section;

      (b) Procedures for ensuring that physicians admitted to practice in the facility are granted privileges consistent with their individual training, experience and other qualifications;

      (c) Provisions establishing a framework for the medical staff to nominate, elect, appoint or remove officers and other persons to carry out medical staff activities with accountability to the governing body;

      (d) Procedures for ensuring that physicians admitted to practice in the facility are currently licensed by the Oregon Medical Board;

      (e) Procedures for ensuring that the facility’s procedures for granting, restricting and terminating privileges are followed and that such procedures are regularly reviewed to assure their conformity to applicable law; and

      (f) Procedures for ensuring that physicians provide services within the scope of the privileges granted by the governing body.

      (5) Amendments to medical staff bylaws shall be accomplished through a cooperative process involving both the medical staff and the governing body. Medical staff bylaws shall be adopted, repealed or amended when approved by the medical staff and the governing body. Approval shall not be unreasonably withheld by either. Neither the medical staff nor the governing body shall withhold approval if such repeal, amendment or adoption is mandated by law, statute or regulation or is necessary to obtain or maintain accreditation or to comply with fiduciary responsibilities or if the failure to approve would subvert the stated moral or ethical purposes of the institution.

      (6) The Oregon Medical Board may appoint one or more physicians to conduct peer review for a health care facility upon request of such review by all of the following:

      (a) The physician whose practice is being reviewed.

      (b) The executive committee of the health care facility’s medical staff.

      (c) The governing body of the health care facility.

      (7) The physicians appointed pursuant to subsection (6) of this section shall be deemed agents of the Oregon Medical Board, subject to the provisions of ORS 30.310 to 30.400 and shall conduct peer review. Peer review shall be conducted pursuant to the bylaws of the requesting health care facility.

      (8) Any person serving on or communicating information to a peer review committee shall not be subject to an action for damages for action or communications or statements made in good faith.

      (9) All findings and conclusions,