216 R.I. Code R. 216-RICR-40-10-1.12

Current through November 7, 2024

Section 216-RICR-40-10-1.12 - Sanctions

A. The licensing agency may take appropriate action from within the following array for dealing with violations of R.I. Gen. Laws Chapters 23-17, 23-15, or herein.

1. As a result of denial, the rights and privileges attendant upon licensure will not accrue to a nursing facility.

2. As a result of an order to curtail any or all activities of a nursing facility, a licensee may be ordered to admit no additional persons to said nursing facility, and/or transfer to other suitable accommodations all or some of the residents residing in said nursing facility, and/or take any other corrective action necessary to secure compliance with the requirements established by R.I. Gen. Laws Chapter 23-17 and this Part.

3. As a result of suspension, a nursing facility shall be restrained from admitting any residents during the period of suspension and shall be required to transfer all residents to another nursing facility during the period of suspension. The difference between suspension and revocation of license is essentially a temporal one, such that the sanctions imposed as a result of suspension are so imposed until such time as the deficiency is corrected or until such other time as the licensing agency determines, whereas the sanctions imposed as a result of revocation are considered to be permanent and re-application for license would be necessary.

4. As a result of license revocation, a nursing facility loses all rights and privileges related to licensure and will be required to transfer all residents, will be restrained from admitting any residents and will be subject to prosecution for operation without a license if the foregoing actions are not accomplished.

B. In accordance with the requirements of R.I. Gen. Laws § 23-17-12.3, every person including a controlling person, or corporation who shall willfully and continually violate the provisions of R.I. Gen. Laws §§ 23-17-12 through 23-17-12.2, will be subject to a fine up to three hundred dollars ($300.00) for each violation of these sections.

1.12.1Adverse Change in Financial Condition

A. Whenever the licensing agency, or the licensing agency in consultation with the Rhode Island Executive Office of Health and Human Services, determines that a nursing facility's financial status is of concern and determines, through inspection of the nursing facility or investigation of a complaint, that incident(s), event(s) or patterns of care exist that harm or have the potential to result in harm or danger to the residents of a nursing facility, the Departments, acting jointly, shall convene a meeting, as soon as possible but in no event later than ten (10) days after the finding(s) cited above, with the license holder to communicate the State's concerns with respect to the operation of the nursing facility. The license holder shall be given the opportunity to respond to the State's concerns and to offer explanation as to why the concerns are not valid or accurate.

B. In the event that the explanation provided by the license holder is not found by the licensing agency to be adequate or otherwise satisfactory, the licensing agency shall direct the license holder to prepare and submit, within ten (10) days of the meeting cited above, or for good cause shown no later than twenty (20) days after said meeting, a plan of correction and remediation for the licensing agency review and approval, including, but not limited to, the following elements:

1. Specific targeted improvements;

2. Definite deadlines for accomplishing those targeted improvements;

3. Measurable standards that will be used to judge whether the targeted improvements have been accomplished;

4. A spending plan that supports all costs associated with accomplishment of the targeted improvements;

5. Monthly reporting of cash availability, the status of vendor payments and employee payrolls, and staffing levels, as metrics concerning financial status and quality of care; and

6. With regard to concerns regarding resident care, and if directed by the licensing agency, a proposal to engage an independent quality monitor or independent quality consultant, to work, in consultation with the nursing facility administrator and medical director, the implementation of the plan of correction and remediation, and to provide progress updates to the licensing agency.

C. Whenever a nursing facility's financial status is determined to be marginal, the licensing agency shall cause such a nursing facility to be inspected in order to determine if financial problems are causing the nursing facility to be out of compliance with nursing facility regulatory standards.

D. Whenever a nursing facility is determined to be having severe financial difficulties, the licensing agency shall cause the nursing facility to have more frequent inspections and the Director may, at the nursing facility's expense:

1. Appoint an independent consultant to review the nursing facility's management and financial status and make recommendations to improve the nursing facility's financial status; or

2. Require the hiring of a temporary manager of the nursing facility's operations.

E. With the exception of the plan of correction and remediation, the information obtained by the licensing agency under § 1.11 of this Part is confidential and is not subject to disclosure under R.I. Gen. Laws Chapter 38-2 ("Access to Public Records"). However, upon request, the licensing agency shall release the information to the following who shall treat the information as confidential:

1. The nursing facility;

2. A person other than the nursing facility if the nursing facility consents in writing to the disclosure;

3. The State Medicaid agency responsible for rate setting of nursing facilities;

4. The State long-term care ombudsman; and/or

5. The Department of Attorney General.

F. The provisions in §1.12.1(D) of this Part relating to the confidentiality of records do not apply:

1. To a nursing facility whose license has been revoked or suspended;

2. To the use of the information in an administrative proceeding initiated by the licensing agency, including implementing enforcement actions, and in judicial proceedings relating thereto.

216 R.I. Code R. 216-RICR-40-10-1.12

Amended effective 7/3/2022
Amended effective 8/25/2022
Amended effective 10/2/2023, exp. 1/30/2024(Emergency)
Amended effective 3/7/2024