OAR 333-520-0075: Respite Care

(1) A general hospital or low occupancy acute care hospital may provide respite services. (2) Application for permission to accept respite care guests shall be made to the Oregon Health Authority (Authority) on a form provided by the Authority. (3) The Authority may grant permission for a hospital to accept respite care guests if: (a) Admittance of a respite care patient will not interfere with the care to be provided to other patients. (b) The hospital has written policies that address respite care services that are evaluated annually, and are implemented and followed by hospital staff. These policies shall address: (A) Type(s) of guests who may be admitted; (B) Scope of services provided; (C) Length of stay (which shall not exceed 30 consecutive days); (D) Emergency care provisions; (E) Written criteria delineating situations which necessitate physician contact; (F) Written criteria delineating situations which necessitate family or personal representative contact; and (G) Written criteria for administration and storage of medications. (4) Sufficient physical space shall be provided for respite care guests for dining and activities. Space shall allow for mobility and exercise. Respite care areas shall provide for bathing and toileting facilities. Each respite care guest shall have an assigned licensed bed and storage area for personal belongings. Regular acute care licensed beds may be utilized for respite care guests; however, respite care guests shall not share a room with acute care patients. Activities which are suitable to the needs of respite care guests shall be provided. (5) Respite care guest records: (a) There shall be available for each respite care guest an admission summary form containing the guest's name, address, telephone number, and other demographic data including the name, address, and telephone number of attending qualified member of the medical staff and nearest relative or personal representative. (b) The guest record shall include admission evaluation, medication administration record, flow sheets, assessments, and progress notes as required by paragraph (7)(d)(C) of this rule. (6) Medical supervision: (a) The name and telephone number of the guest's physician or other qualified member of the medical staff shall be readily available to respite care staff members. (b) A qualified health care practitioner order shall not be required for admission to respite care. (c) An order from a qualified health care practitioner authorized by law shall be required for any new medications or treatments. (7) Registered nurse (RN) supervision: (a) Respite care services shall be supervised by an RN. (b) The RN shall review the guest's medications and usual diet and verify information within four hours of admission. Documented intake information shall include, but not be limited to, current medications, dietary needs, level of ability for assisted or self-care, and any other information germane to the guest's condition. The RN shall document an evaluation of the guest's need on admission. (c) If the respite care guest stays seven days or more, a nursing assessment shall be performed and documented by the RN on the eighth day and weekly thereafter. If the respite care guest is initially planning to stay for seven or more days, a nursing assessment shall be performed and documented by an RN on admission and weekly thereafter. (d) In addition to the documentation required in subsections (7)(b) and (c) of this rule, the hospital shall maintain: (A) Activities of daily living (ADL) sheet by shift; (B) Medication administration record; and (C) Weekly progress notes by caregivers. (8) Medication administration: (a) Respite care guests taking medication prescribed by their physicians or other qualified health care practitioners may bring such medications in the original containers to the facility. All prescription medications brought in by guests shall be verified by a pharmacist prior to administration. (b) All medications shall be clearly labeled with the name of the medication, strength/dose, directions for administration, expiration date, and guest's name. (c) No outdated medication shall be administered. (d) Any change or alteration in medication shall require an order from a health care practitioner authorized by law. (e) Medications may be independently self-administered, self-administered under supervision of an RN/LPN, or administered by an RN, LPN, or certified medication aide, depending on the guest's ability. The type of administration shall be determined by the RN. This determination shall be in writing. Medications administered and the type of administration shall be documented on medication administration records. (9) Quality assurance: (a) Respite care services shall be included in the hospital-wide quality assurance program. (b) A mechanism for quality assurance activities shall be defined and implemented. (c) There shall be documentation of ongoing quality assurance activities. (d) Quality assurance activities shall be reported to the hospital committee, council, or other reviewing body designated by the hospital as having responsibility for quality assurance. (10) Nothing in this rule shall be interpreted for creating any obligations for third party payors to reimburse hospital respite care.