Or. Admin. Code § 411-054-0037
Current through Register Vol. 63, No. 10, October 1, 2024
Section 411-054-0037 - [Effective 12/27/2024] Acuity-Based Staffing Tool(1) CHOICE OF ACUITY-BASED STAFFING TOOL: Every facility shall adopt an acuity-based staffing tool (ABST) to determine appropriate staffing levels for the facility. Each facility may choose to adopt the Department's ABST or may choose to adopt a different ABST. Regardless of the ABST the facility selects, all requirements set forth in this rule, in OAR 411-054-0034 (Resident Evaluation), and in the ABST Provider Guide must be met.(2) START DATE: All facilities must select an ABST by February 1, 2022. By July 1, 2022 facilities must fully implement the ABST selected and complete an ABST assessment for each resident.(3) FREQUENCY OF UPDATES: No later than July 1, 2022, an ABST assessment must be completed for each resident. Following this deadline, facilities must review the ABST tool for each resident: (a) Before a resident moves in, with amendments as appropriate within the first 30 days to address a resident's needs.(b) Whenever there is a significant change of condition as defined in OAR 411-054-0005.(c) No less than quarterly, preferably at the same time the resident's service plan is updated, as required by OAR 411-054-0034.(4) MAINTAIN UPDATED STAFFING PLAN: Each facility should use the results of an acuity-based staffing tool to develop and routinely update the facility's staffing plan. The ABST must convert evaluated care needs of residents into staff hours to generate a facility staffing plan.(5) ABST ELEMENTS: Each ABST must address activities of daily living and other tasks related to care, as outlined in OAR 411-054-0030 and 411-054-0034. Each ABST must address all the following activities of daily living (ADLs) for each resident and the amount of staff time needed to provide care: (a) Personal hygiene such as shaving and mouth care, as described in OAR 411-054-0030(1)(e)(C) and OAR 411-054-0034(5)(g)(B).(b) Grooming, such as nail care and brushing hair, as described in OAR 411-054-0030(1)(e)(E) and OAR 411-054-0034(5)(g)(B).(c) Dressing and undressing, as described in OAR 411-054-0030(1)(e)(D) and OAR 411-054-0034(5)(g)(B).(d) Bowel and bladder management, as described in OAR 411-054-0030(1)(e)(G) and OAR 411-054-0034(5)(g)(A).(e) Bathing, as described in OAR 411-054-0030(1)(e)(B) and OAR 411-054-0034(5)(a)(A) and (g)(B).(f) Transferring in or out of bed or a chair, as described in OAR 411-054-0030(1)(e)(A) and OAR 411-054-0034(5)(g)(C).(g) Repositioning in bed or chair, as described in OAR 411-054-0030(1)(e)(A) and OAR 411-054-0034(5)(g)(G).(h) Ambulation, escorting to and from meals or activities, as described in OAR 411-054-0030(1)(e)(F) and (G), and OAR 411-057-0160(2)(a).(i) If multiple staff are required to assist with transferring and completing tasks in previous question, how much additional time is needed, as described in 411-054-0070(1)(a).(j) Supervising, cueing, or supporting while eating, as described in 411-054-0030(1)(e)(F) and 411-054-0034(5)(a)(g)(D).(k) Medication administration, passing out medications, as described in 411-054-0030(1)(f), OAR 411-054-0055(2), and OAR 411-054-0070(1).(l) Providing non-drug interventions for pain management, as described in 411-054-0034(5)(c)(C) and OAR 411-054-0055(6)(c).(m) Providing treatments (e.g., skin care, wound care, antibiotic treatment), as described in OAR 411-054-0034(5)(l) and OAR 411-054-0055(1).(n) Cueing or redirecting due to cognitive impairment or dementia, as described in OAR 411-054-0034(5)(d), OAR 411-057-0160(2)(a) and (e), and OAR 411-054-0030(1)(e)(H).(o) Ensuring non-drug interventions for behaviors, as described in OAR 411-054-0030(1)(e)(l) and OAR 411-054-0055(6)(c) and (d).(p) Assisting with leisure activities, as described in OAR 411-054-0005(27)(b), OAR 411-054-0030(1)(c), and OAR 411-054-0034(5)(a)(B).(q) Monitoring physical conditions or symptoms, as described in OAR 411-054-0040(1)(2)(a) and (b).(r) Monitoring behavioral conditions or symptoms, as described in OAR 411-054-0040(1)(2)(a) and (b).(s) Assisting with communication, assistive devices for hearing, vision, speech, as described in OAR 411-054-0034(5)(f).(t) Responding to call lights, as described in OAR 411-054-0070(1).(u) Safety checks, fall prevention, as described in OAR 411-054-0034(5)(n)(A).(v) Completing resident specific housekeeping or laundry services performed by care staff, as described in OAR 411-054-0005(96) and OAR 411-054-0070(1)(a).(w) Providing additional care service, such as smoking assistance or pet care, as described in OAR 411-054-0034(5)(n)(H) and OAR 411-054-0070(1).(6) DETERMINE TIME TO MEET STAFF LEVELS: The ABST must inform facilities as they develop a staffing plan to specify the total number of weekly minutes required to meet the 24-hour scheduled and unscheduled needs of residents.(7) REVIEW BY DEPARTMENT. (a) The Department is required to assess facility staffing levels each time the Department conducts a survey, license approval or renewal, or an investigation into a complaint regarding: (B) Injury to a resident;(b) Each time the Department assesses a facility's staffing levels, the facility is required to provide the Department with the current acuity-based staffing tool data.(8) REGULATORY ACTION REQUIRED. The Department will impose corrective action or sanctions as defined in OAR 411-054-0110 (Conditions) and according to Oregon Laws 2021, chapter 588, section 2, if the Department determines the facility is: (b) Not meeting the scheduled and unscheduled needs of all residents 24 hours a day, seven days a week.(c) Using an ABST but is not consistently staffing to the levels, intensity and qualifications indicated by the tool. (d) Not determining facility staffing requirements with an ABST as required by rule.Or. Admin. Code § 411-054-0037
APD 58-2021, temporary adopt filed 12/23/2021, effective 1/1/2022 through 6/29/2022; APD 27-2022, adopt filed 06/15/2022, effective 6/24/2022; APD 29-2024, temporary amend filed 06/21/2024, effective 7/1/2024 through 12/27/2024Statutory/Other Authority: ORS 410.070, 443.450 & 443.738
Statutes/Other Implemented: ORS 443.400 - 443.455, 443.738, 443.991 & 678.710