Health Care Quality Program (216-RICR-10-10-7)

A.These rules and regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws § 23-17.17-4, as amended, and are established for the purpose of the development and reporting of quality performance measures to guide quality improvement initiatives and promote quality in the state's healthcare system.

A.Wherever used in this Part, the following terms shall be construed as follows:

1.“Core-staffing plan,” as used herein, means as defined in R.I. Gen. Laws § 23-17.17-8(b)(1).

2."Customer satisfaction" means the degree to which the facility or provider meets or exceeds the patient’s/resident’s/client’s/family’s or member’s expectations as perceived by the patient/resident/client/family or member by focusing on those aspects of care that the patient/resident/client/family or member can judge.

3."Department" means the Rhode Island Department of Health.

4."Director" means the Director of the Department of Health or their designee.

5."Healthcare facility" shall have the same meaning as contained in R.I. Gen. Laws Chapter 23-17, as amended, and the regulations promulgated thereunder.

6."Home care provider" means any person that provides, arranges to provide, offers to provide, or in any other way provides for the delivery of any direct health care services in the home requiring supervision by a registered nurse (RN), but excludes the delivery of direct nursing care by a registered (RN) or licensed practical (LPN) nurse on an on-going basis; and includes services rendered by a licensed health care professional, including but not limited to: a speech pathologist/audiologist, physical, occupational, or respiratory therapist. Also as used herein, "home care provider" includes homemaker services as defined in Licensing of Home Nursing Care Providers and Home Care Providers, Part 40-10-17 of this Title.

7."Home nursing care provider" means any person that provides, arranges to provide, offers to provide, or in any other way provides for the delivery of direct nursing services in the home by a registered (RN) or licensed practical (LPN) nurse, and provided such services are rendered in accordance with Licensing of Home Nursing Care Providers and Home Care Providers, Part 40-10-17 of this Title.

8."Hospital" means a healthcare facility with a governing body, an organized medical staff and a nursing service, providing equipment and services primarily for inpatient care to persons who require definitive diagnosis and treatment for injury, illness or other disabilities or pregnancy. A hospital shall provide psychiatric and/or medical and/or surgical care and at least the following services: dietetic, infection control, medical records, laboratory, pharmaceutical and radiology, except that a psychiatric facility need not provide radiology services.

9."Nursing facility" means a place, however named, or an identifiable unit or distinct part thereof that provides twenty-four (24) hour in-resident nursing, therapeutic, restorative or preventive and supportive nursing care services for two (2) or more residents unrelated by blood or marriage whose condition requires continuous nursing care and supervision.

10.“Patient care unit” means as defined in R.I. Gen. Laws § 23-17.17-8(b)(3).

11."Performance measure" means as defined in R.I. Gen. Laws § 23-17.17-2(h).

12."Person" means as defined in R.I. Gen. Laws § 23-17-2(16).

13."Reporting program" means as defined in R.I. Gen. Laws § 23-17.17-2(j).

14."R.I. Gen. Laws" means the General Laws of Rhode Island, as amended.

7.3.1Healthcare Quality Reporting Program

A.The Healthcare Quality Reporting Program shall include quality performance measures and reporting for healthcare facilities licensed in Rhode Island.

B.The Healthcare Quality Reporting Program established under R.I. Gen. Laws Chapter 23-17.17 shall incorporate the requirements provided in R.I. Gen. Laws § 23-17.17-4(a).

C.The Department may deny, suspend, or revoke the license or curtail the activities of any healthcare facility that has failed to comply with this Part.

7.3.2Program Reporting Requirements for Healthcare Facilities

A.Pursuant to R.I. Gen. Laws § 23-17.17-10, each licensed healthcare facility shall establish and maintain records and data in such a manner as to make uniform a system of periodic reporting to the Healthcare Quality Reporting Program. The manner in which the requirements of this Part may be met shall be prescribed from time to time in directives promulgated by the Director.

7.3.3Reporting Requirements for Hospitals, Nursing Facilities, and Home Care Providers/Home Nursing Care Providers

A.Hospitals, nursing facilities, and home care providers/home nursing care providers licensed under the provisions of R.I. Gen. Laws Chapter 23-17, shall be required to implement a customer satisfaction survey at periodic intervals as prescribed by the Director.

B.Prior to implementation, such customer satisfaction survey instrument shall be approved by the Director after consultation with the Health Care Quality Steering Committee, pursuant to R.I. Gen. Laws § 23-17.17-6(a)(3). Said survey shall consist of a standardized format and data set that shall be reported to the Director in such a manner so as to facilitate public reporting.

C.Hospitals, nursing facilities, and home care providers/home nursing care providers shall provide the Director with patient specific information necessary for the Director to conduct the survey.

7.3.4Annual Hospital Staffing Report

A.In accordance with R.I. Gen. Laws § 23-17.17-8, annually in the month of January, every licensed hospital shall submit its core-staffing plan to the Department in a form and manner as prescribed by the Department.

B.Such plan shall specify for each patient care unit and each shift, the information required pursuant to R.I. Gen. Laws § 23-17.17-8(a).

7.4.1Healthcare Quality Steering Committee

A.The Director shall establish and serve as chairperson of a Healthcare Quality Steering Committee of no more than nineteen (19) members to advise in the matters required by R.I. Gen. Laws § 23-17.17-6.

B.The members of the Healthcare Quality Steering Committee shall include the individuals required by R.I. Gen. Laws § 23-17.17-6(b).

1.In addition to the provisions of R.I. Gen. Laws § 23-17.17-6(b), the Director shall appoint five (5) members of the Health Care Quality Performance Steering Committee for a one (1) year term, four (4) members of the Health Care Quality Performance Steering Committee for a two (2) year term, and four (4) members of the Health Care Quality Performance Steering Committee for a three (3) year term. Thereafter, all terms of appointments shall be for three (3) years.

C.In addition to the provisions of R.I. Gen. Laws § 23-17.17-6,the Director may remove any member of the Healthcare Quality Steering Committee appointed by them for cause, including but not limited to, failure to attend Committee meetings on a regular basis.

7.5.1Rules Governing Practices and Procedures

A.All hearings and reviews required under the provisions of R.I. Gen. Laws Chapter 23-17.17, shall be held in accordance with the provisions of Practices and Procedures Before the Rhode Island Department of Health, Subchapter 05 Part 4 of this Chapter, and Access to Public Records, Subchapter 05 Part 1 of this Chapter.

7.5.2Severability

A.If any provision of these rules and regulations or the circumstance shall be held invalid, such invalidity shall not affect the provisions or application of the rules and regulations which can be given effect, and to this end the provisions of the regulations are declared to be severable.