Section 216-RICR-40-10-1.20 - Confidentiality - Variance and Appeal Procedure1.20.1ConfidentialityA. Disclosure of any health care information relating to individuals shall be subject to all the statutory and regulatory provisions pertaining to confidentiality including but not limited to the provisions of R.I. Gen. Laws Chapter 5-37.3.1.20.2Variance ProcedureA. The licensing agency may grant a variance from the provisions of a Rule or Regulation in a specific case if it finds that a literal enforcement of such provision will result in unnecessary hardship to the applicant and that such a variance will not be contrary to the public interest, public health and/or health and safety of residents.1. Variances shall not be granted for the provisions of this Part found in §§ 1.4, 1.11, 1.15, 1.15.5, 1.16.2, 1.16.6, 1.16.8, 1.17.3(K), 1.19.11, 1.19.12, 1.19.14, and 1.20.1 of this Part.B. A request for a variance shall be filed by a high managerial agent of the nursing facility in writing, and set forth in detail the basis upon which the request is made, including:1. Identification of the specific regulatory section(s) of the Regulations;2. Alternative actions, processes, or procedures that through the facility's implementation will facilitate compliance with the specific regulatory intent, and how the home will ensure staff awareness and training regarding the variance, when appropriate.3. A variance period shall not exceed the nursing facility's license period. A nursing facility must request renewal of the variance when it submits its license renewal application.4. Upon the filing of each request for variance with the licensing agency, and within a reasonable time thereafter, the licensing agency shall notify the applicant by certified mail of its approval or in the case of a denial, a hearing date, time and place may be scheduled if the nursing facility appeals the denial.C. At a hearing held in furtherance of an appeal from a denial for a variance in accordance with §1.20.2(B)(1) of this Part, the applicant shall present his case to the Director or his designee for quasi-judicial matters, and shall have the burden of persuading the Director or his designee as aforesaid, through the introduction of clear and convincing evidence, that a literal enforcement of the Rules will result in unnecessary hardship, and that a variance will not be contrary to the public interest, public health and/or health and safety of residents.D. Nursing facilities that provide care in accordance with alternative service delivery models that facilitate resident-directed care may be eligible for a variance in accordance with any of the requirements contained in this Part.1.20.3Deficiencies and Plans of CorrectionA. The procedures in §1.20.3 of this Part are exclusive of those required in accordance with §1.16.7(B) of this Part and of those procedures required to be performed as a result of inspections and investigations conducted in accordance with R.I. Gen. Laws Chapter 23-17.B. The licensing agency shall notify the governing body or other legal authority of a nursing facility of violations of individual standards through a statement of deficiencies which shall be forwarded to the nursing facility within fifteen (15) days of the inspection team formally exiting the nursing facility unless the Director determines that immediate action is necessary to protect the health, welfare, or safety of the public or any member thereof through the issuance of an immediate compliance order in accordance with R.I. Gen. Laws § 23-1-21.C. A nursing facility which received a statement of deficiencies (SOD) report must submit a plan of corrections, signed by a high managerial agent of the nursing facility, to the licensing agency within fifteen (15) days of the date of the notice of deficiencies. The plan of corrections shall include and detail any requests for variances as well as document the reasons therefore, in accordance with §1.20.2 of this Part.D. The licensing agency will be required to approve or reject the plan of corrections submitted by a nursing facility in accordance with §1.20.3(C) of this Part within fifteen (15) days of receipt of the plan of corrections. 1. To be deemed acceptable by the licensing agency, a plan of correction shall:a. Address how corrective action will be accomplished for those residents found to have been affected by the deficient practice(s);b. Address how the nursing facility will identify other residents having the potential to be affected by the same deficient practice(s);c. Address what measures will be put into place or systemic changes made to ensure that the deficient practice(s) will not recur;d. Indicate how the nursing facility plans to monitor its performance to ensure that solutions are sustained;e. Include dates when corrective action will be completed; andf. Include any additional components deemed necessary by the licensing agency.2. The nursing facility shall develop a plan for ensuring that correction is achieved and sustained. This plan shall be implemented and the corrective action(s) evaluated for effectiveness. The plan of correction shall be integrated into the quality assurance system.3. All deficiencies shall be fully and wholly corrected within thirty (30) days of the date of notice of the deficiencies, unless an extension is granted for good cause shown, but in no case shall an extension exceed fifteen (15) days.E. If the licensing agency rejects the plan of corrections, or if the nursing facility does not provide a plan of corrections within the fifteen (15) day period stipulated in §1.20.3(C) of this Part, or if a nursing facility whose plan of corrections has been approved by the licensing agency fails to execute its plan within a reasonable time, the licensing agency may invoke the sanctions enumerated in § 1.12 of this Part. If the nursing facility is aggrieved by the action of the licensing agency, the nursing facility may appeal the decision and request a hearing in accordance with R.I. Gen. Laws Chapter 42-35.F. The notice of the hearing to be given by the Department shall comply in all respects with the provisions of R.I. Gen. Laws § 42-35-10. The hearing shall in all respects comply with R.I. Gen. Laws §§ 42-35-9, 42-35-10, and 42-35-12.G. A nursing facility's SOD is a public record upon Departmental approval of the corresponding plan of correction.216 R.I. Code R. 216-RICR-40-10-1.20
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