OHCA 2018 Report

2018 Oregon Long Term Care State Report www.ohca.com 17 Compliance Oversight and Quality Oregon’s long term care system continues to adopt and implement new federal and state standards and practices that assure person centered, quality care. Oregon’s desire to stay at the forefront of innovative long term care services is evidenced by the passage of HB 3359 in 2017 and other quality initiative work. Recent accomplishments and initiatives focused on quality include education through Oregon Care Partners; quality improvement and performance practices via the LiveWell™ program; and the adoption of quality metrics for assisted living, residential care, and memory care included in ORS 411-054-0320 from HB 3359. Breadth of Oversight Licensed long term care providers are subject to thousands of pages of federal and state rules and regulations and are scrutinized by a wide range of oversight and advocacy agencies. Service providers are required to meet federal, state, and local compliance standards for resident care, safety, and quality of life. Oregon nursing facilities continue to implement the Centers for Medicare and Medicaid (CMS) new Rules of Participation, and community based settings are set to be in full compliance with the CMS Home and Community Based Service standards well before the March 2022 compliance deadline. HB 3359—Quality Metrics and Accountability The 2017 Oregon Legislative Assembly passed HB 3359, which contains policy recommendations from the Purple Ribbon Commission (a collaboration of the Alzheimer’s Association and OHCA), legislators, and state agencies. The new law has many components, many of which are still in the process of being implemented. Key Components of HB 3359 1. Increased Staff Training and Competency All direct caregivers must receive training in nationally recognized dementia care best practices before caring for residents and DHS will develop rules for how they must demonstrate competency of the material. In addition, all caregivers must complete six hours of continuing education each year. Implementation Timeline: Now through January 2019. 2. Quality Measures on Key Outcomes Residential care/assisted living providers must track and report key quality measures. Individual provider results will be posted online by DHS and compiled in an annual report available to the public, providers and policymakers, who can use the data to monitor trends and determine how Oregon’s long term care system is performing over time. Quality measures include: the incidence of falls with injury, staff retention, compliance with staff training requirements, the use of anti-psychotic medications for nonstandard purposes and resident satisfaction indicators. Implementation Timeline: January 2019 through January 2020. 3. Enhanced Oversight and Supervision Residential care and assisted living providers currently are subject to extensive regulatory oversight and most providers perform very well. For the small percentage of underperforming providers, HB 3359 provides for increased oversight and more frequent surveys by the state until a provider is in compliance. Implementation Timeline: Currently being implemented. 4. Safe Prescription Drug Packaging Ensures that prescription drugs are packaged in unit dose packaging, such as blister packs, to promote safe drug administration. Implementation Timeline: Now through October 1, 2018. 5. Progressive Enforcement, Conditions on Licensure, and Increased Penalties Establishes a progressive enforcement system that increases penalties and requires that conditions on licensure are designed to remediate problems. Includes scope and severity criteria for assessing higher penalties for rule violations and abuse. If there is an imminent threat to the safety of residents, streamlines the department’s authority to impose an immediate license suspension. Implementation Timeline: Currently being implemented.