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Thursday 10:06 CST, October 30, 2014

State Recognition Details

State Recognition Contact Directory

Report a Complaint
800-994-6610

Jennifer Hoppe
Associate Director
630-792-5261

Karen Eberspacher
Government Relations Specialist
630- 792-5269


The Joint Commission actively monitors state legislative and regulatory activities for the purpose of identifying additional opportunities for state reliance on Joint Commission accreditation/certification.

The Joint Commission’s various accreditation/certification programs are recognized and relied on by many states in the states’ quality oversight activities. Recognition and reliance refers to the acceptance of, requirement for, or other reference to the use of Joint Commission accreditation, in whole or in part, by one or more governmental agencies in exercising regulatory authority. Recognition and reliance may include use of accreditation for licensing, certification or contracting purposes by various state agencies. 
 

STATE: PROGRAM:


State: Oregon
Program: Hospitals
Agency: Department of Health
State Reference: OR ADC 333-501-0015
Setting/Service: Hospital
Type of Recognition: Licensure

333-501-0015 Surveys

(1) The Division may, in addition to any investigations conducted under OAR 333-501-0010, conduct at least one general survey of each hospital to determine compliance with health care facility licensing laws during each calendar year and at such other times as the Division deems necessary.

(2) The Division, at its discretion, may accept a certificate of accreditation and deemed status for Medicare certification from the Joint Commission or the Committee on Hospitals of the American Osteopathic Association as evidence of compliance with health care facility licensing laws and conditions of participation in lieu of a survey.


State: Oregon
Program: Behavioral Health Care
Agency: Department of Human Services
State Reference: OR ADC 309-034-0170
Setting/Service: Child/Adolescent Residential Psychiatric Treatment Services
Type of Recognition: Medicaid

A service provider must:

(5) Be accredited as a psychiatric residential treatment facility for children under age 21 by JCAHO, CARF, COA, or any other accrediting organization with comparable standards, that is recognized by the State; be licensed by CAF; holds a Certificate of Approval per OAR 309-012-0130 through 309-012-0220 from the Division and be in compliance with the treatment services standards described in OAR 309-032-1100 through 309-032-1230.

(6) Provide a program consistent with standards set by JCAHO, CARF, COA, or any other accrediting organization, with comparable standards, that is recognized by the State.


State: Oregon
Program: Behavioral Health Care
Agency: Department of Human Services
State Reference: OR ADC 415-220-0010
Setting/Service: Outpatient Synthetic Opiate Treatment Programs
Type of Recognition: Licensure

(2) Application: To receive a letter of approval the Opioid Treatment Program must meet the criteria under OAR 415-012-0000 to 415-012-0090; in addition, the Opioid Treatment Program must:

(a) Meet the standards set forth in these rules and any other administrative rules applicable to the program;

(b) Comply with the federal regulations contained in 42 CFR Part 2 and 42 CFR Part 8;

and

(c) Submit documentation of accreditation as an opioid treatment program by an accreditation body approved by SAMHSA under 42 CFR Part 8.

(d) Specify in the application the identity and financial interest of any person (if the person is a corporation, the name of any stockholder holding stock representing an interest of 5 percent or more) or other legal entity who has an interest of 5 percent or more or 5 percent of a lease agreement for the facility.


State: Oregon
Program: Behavioral Health Care
Agency: Department of Human Services
State Reference: OR ADC 333-615-0050
Setting/Service: Psychiatric Inpatient Beds (Unit or Facility)
Type of Recognition: Licensure

All proposed psychiatric beds must meet the licensure, certification and accreditation criteria of the Health Division, Medicare and the Joint Commission on Accreditation of Health-care Organizations, as appropriate. “Quality” for purposes of review of certificate of need proposals is a description of threshold factors to be considered, not a presumption of clinical judgment, nor a substitute for the licensing or accreditation functions.

State: Oregon
Program: Home Care
Agency: Department of Human Services
State Reference:  O.R.S. § 443.860
Setting/Service: Hospice
Type of Recognition: Licensure

(b) May accept certification by a federal agency or accreditation by an accrediting organization approved by the department as evidence of compliance with the requirements for licensure adopted under paragraph (a) of this subsection if:

(A) The certification or accreditation meets standards and conditions established for hospice programs by the Centers for Medicare and Medicaid Services;

(B) The hospice program invites the department to participate in any exit interview conducted by the agency or organization; and

(C) The hospice program provides the department with copies of all documentation requested by the department concerning the certification or accreditation.


State: Oregon
Program: Ambulatory Health Care
Agency: Department of Human Services, Public Health Division
State Reference: OR ADC 333-076-0114
Setting/Service: Ambulatory Surgical Centers
Type of Recognition: Licensure

(2) Inspections:

(a) The Division may, in addition to any inspections conducted pursuant to complaint investigations, conduct at least one general inspection of each HCF to determine compliance with HCF laws during each calendar year and at such other times as the Division deems necessary. The Division may accept certificates by the Joint Commission on Accreditation of Health Care Organizations (JCAHO) or the Committee on Hospitals of the American Osteopathic Association as evidence of compliance with acceptable standards in lieu of health care facility inspections;

(b) Facilities providing Joint Commission on Accreditation of Health Care Organizations (JCAHO) or Committee on Hospitals of the American Osteopathic Association (CHAOA) certificates as evidence of compliance shall also be required to provide to the Division (or to have previously provided) with each license application (and license renewal application):

(A) All JCAHO (or CHAOA, as appropriate) survey and inspection reports; and
(B) Written evidence of all corrective actions underway, or completed, in response to JCAHO (or CHAOA, as appropriate) recommendations; including all progress reports


State: Oregon
Program: Behavioral Health Care
Agency: Department of Mental Health and Developmental Disabilities
State Reference: O.R.S. § 430.010
Setting/Service: Mental Health Facilities
Type of Recognition: Licensure

(3) “Health facility” means a facility licensed as required by ORS 441.015 or a facility accredited by the Joint Commission on Accreditation of Hospitals, either of which provides full-day or part-day acute treatment for alcoholism, drug addiction or mental or emotional disturbance, and is licensed to admit persons requiring 24-hour nursing care.

State: Oregon
Program: Laboratory
Agency: Division of Health
State Reference: OR ADC 333-024-0040
Setting/Service: Laboratory
Type of Recognition: Licensure

(4) On-site inspections and testing may be conducted by representatives of the Division or Federal Government at reasonable times during the laboratory's normal business hours without advance notice. The representative shall inspect the facilities, personnel policies, procedures, materials, staff qualifications, equipment, and records: (a) Routine inspections of moderate and high complexity laboratories shall occur at a minimum of every two years. (b) Laboratories accredited by a Health Care Financing Administration approved accreditation organization are exempt from routine, on site inspection provided the laboratory submits a copy of their accreditation certificate and authorizes its accreditation organization to release inspection data to the Division. The accreditation organization shall make available, upon request, a copy of the laboratory's statement of deficiencies, plan of correction and proof of accreditation to the Division. (12) Inspection of accredited laboratories: (a) The Division and the Federal government may conduct random validation inspections of any accredited laboratory at any time during its hours of operation; (b) The Division and the Federal government may conduct complaint inspections of an accredited laboratory at any time during its hours of operation upon receiving a complaint about that laboratory; (c) The laboratory may be required to comply with OAR 333-024-0040(11)(c) - (f).

State: Oregon
Program: Office-Based Surgery
Agency: Oregon Board of Dentistry
State Reference: OR ADC 818-026-0000
Setting/Service: Dental Surgery Concerning Higher Levels of Anesthesia or Sedation
Type of Recognition: Licensure

(1) These rules apply to the administration of substances that produce general anesthesia, deep sedation, conscious sedation, or nitrous oxide sedation in patients being treated by licensees in facilities not accredited by the Joint Commission on Accreditation of Health Care Organizations. These regulations are not intended to prohibit training programs for licensees or to prevent persons from taking necessary action in case of an emergency.

(2) Nothing in this Division relieves a licensee from the standards imposed by ORS 679.140(1)(e) and 679.140(4).


State: Oregon
Program: Office-Based Surgery
Agency: Oregon Medical Board
State Reference: OR ADC 847-017-0010
Setting/Service: Office-Based Surgery or Procedures
Type of Recognition: Requirement for Performing Procedures

A licensee performing office-based surgery must ensure that the facility meets standards to ensure patient safety.

(1) Facilities where office-based surgeries are performed must comply with all federal and state laws and regulations that affect the practice.

(2) Facilities where Level II or Level III office-based surgeries are performed must be accredited by an appropriate, Board-recognized accreditation agency, including the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF), the Accreditation Association of Ambulatory Health Care (AAAHC), the Joint Commission, or the Institute for Medical Quality (IMQ). Facilities accredited by the Oregon Medical Association (OMA) prior to January 1, 2013, will continue to be recognized as accredited facilities until the accreditation period expires. Licensees of the Board performing office-based procedures in a new or existing facility, must ensure that facility is accredited within one year of the start date of the office-based procedures being performed or the date these rules are adopted, whichever is later. During the period of time the facility is in the accreditation process, the facility will make changes to come into compliance with the Administrative Rules in this Division.

State: Oregon
Program: Behavioral Health Care
Agency: The Department of Insurance
State Reference: O.R.S. § 743A.168
Setting/Service: Treatment of Chemical Dependency and for Mental or Nervous Conditions
Type of Recognition: Insurance

(5) A provider is eligible for reimbursement under this section if:

(a) The provider is approved by the Department of Human Services;

(b) The provider is accredited for the particular level of care for which reimbursement is being requested by the Joint Commission on Accreditation of Hospitals or the Commission on Accreditation of Rehabilitation Facilities

The Joint Commission maintains a listing of state agencies that recognize accreditation/certification. These lists have been compiled from a variety of sources and are intended to identify state regulatory agencies that recognize and/or rely on accreditation in lieu of specific state licensure or certification requirements. The Joint Commission makes no claims about the accuracy of this list and it should be considered a reference document. Joint Commission accredited organizations are strongly encouraged to inquire with their state regulatory agency for a full description of the recognition and any additional requirements the state agency may have.
 

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