Oregon Revised Statutes Chapter 441 § 441.766 — Exceptions to direct care registered nurse staffing ratios

Exceptions to direct care registered nurse staffing ratios. (1) Direct care registered nurse-to-patient staffing ratios under ORS 441.765 do not apply to the care of: (a) Patients in intensive care or critical units in circumstances prescribed by the hospital nurse staffing committee; (b) Emergency department patients who are in critical condition, until they are stable; (c) Patients in swing beds, as defined by the Centers for Medicare and Medicaid Services; (d) Patients, in inpatient units, who are ready for discharge but are facing a barrier to discharge, as indicated by a licensed independent practitioner in each patient’s medical record; (e) Patients, including patients in an emergency department, who are located in adjacent rooms or the same room in the hospital and who are ready for discharge but are facing a barrier to discharge, as indicated by a licensed independent practitioner in each patient’s medical record; (f) Patients in outpatient units that operate under a hospital’s license; or (g) Patients in psychiatric units. (2) For patients described in subsection (1) of this section, the hospital nurse staffing committee established under ORS 441.762 shall adopt a nurse staffing plan that is: (a) Consistent with nationally recognized nurse staffing standards or benchmarks; (b) Consistent with a tool that measures patient acuity and intensity and that has been calibrated to the applicable unit; or (c) Approved after the committee has considered: (A) The specialized qualifications and competencies of the staff in the unit; (B) Historic acuity and intensity of the patients in the unit; (C) Nationally recognized nurse staffing standards, if any; and (D) Ensuring patient access to care. (3)(a)(A) If the hospital nurse staffing committee does not adopt a nurse staffing plan under subsection (2) of this section, either cochair of the committee may invoke the commencement of a 60-day period during which the committee shall continue to develop the staffing plan. (B) If by the end of the 60-day period, the hospital nurse staffing committee does not adopt a nurse staffing plan, the members of the committee may extend deliberations for one additional 60-day period only by a majority vote of the members of the committee. (C) If a quorum of members present at a meeting comprises an unequal number of nursing staff and managers, only an equal number of staff and managers may vote. (b) If by the end of the initial 60-day period of deliberations or by the end of the second 60-day period of deliberations, if deliberations are extended under subsection (3)(a)(B) of this section, the hospital nurse staffing committee does not adopt a nurse staffing plan, the cochairs of the committee shall submit the disputed plan or parts of the plan, as applicable, to the Oregon Health Authority, and the authority shall initiate expedited binding arbitration. (c) The arbitrator shall be selected using alternating strikes by the cochairs or their designees from a list of seven drawn from the interest arbitrator panel maintained by the State Conciliation Service. (d) Arbitration must be scheduled by mutual agreement no later than 30 calendar days after the cochairs submit the disputed nurse staffing plan or the disputed parts of the plan to the authority except as, by mutual agreement, the time may be extended. (e) The arbitrator shall issue a decision on the nurse staffing plan or the disputed parts of the plan, as applicable, based on the written submissions of evidence and arguments and may not conduct an evidentiary hearing or allow discovery. The arbitrator’s decision must be based on and within the parameters of the versions of the plan or the disputed parts of the plan submitted by the cochairs and must be within the staffing parameters. (f) The arbitrator shall issue a decision no later than 60 days after the submission of evidence and written arguments. (g) The hospital shall pay for the cost of the arbitrator. [2023 c.507 §9] Note: See note under 441.761.