216-40-10 R.I. Code R. § 3.6

Current through June 12, 2024

Section 216-RICR-40-10-3.6 - Health Care Services

3.6.1Management of Services

A. Each OACF shall be organized to provide services with adequate professional and ancillary staff to ensure that all persons are treated and released within a reasonable and appropriate length of time. No patients shall be held overnight.

B. Policies and procedures pertaining to the provision of services and supported by appropriate manuals and reference material shall be established by the appropriate professional staff and approved by the administrator and the governing body. Such policies and procedures shall pertain to no less than the following:

1. The responsibility of the physician(s) or dentist, as appropriate, for the provision of health care services;

2. The designation of personnel authorized to deliver health care services in accordance with licensure and/or certification requirements and the provisions of §3.5.1(C)(5) of this Part;

3. Standards of practice for each health care service provided;

4. Procedures that may and may not be performed;

5. Procurement and storage of drugs and medications in accordance with R.I. Gen. Laws Chapters 21-28 and 21-31;

6. Designation of personnel authorized to prescribe, administer, or dispense drugs;

7. Disposal of hypodermic needles, syringes and instruments in accordance with the requirements of the rules and regulations for Hypodermic Needles, Syringes, and Other Such Instruments (Part 20-15-6 of this Title);

8. Delineation of clinical privileges of non-physician practitioners;

9. Disclosure of patient information in accordance with federal and state law; and

10. Such other conditions as may be deemed appropriate.

C. Financial Interest Disclosure

1. Any OACF licensed pursuant to R.I. Gen. Laws Chapter 23-17, which refers clients to another such licensed health care facility or to a residential care/assisted living facility licensed pursuant to R.I. Gen. Laws Chapter 23-17.4 or to a certified adult day care program in which the referring entity has a financial interest shall, at the time a referral is made, disclose in writing the following information to the client:

a. That the referring entity has a financial interest in the facility or provider to which the referral is being made; and

b. That the client has the option of seeking care from a different facility or provider which is also licensed and/or certified by the state to provide similar services to the client.

2. The referring entity shall also offer the client a written list prepared by the Department of all such alternative licensed and/or certified facilities or providers. Said written list may be obtained by contacting:

Rhode Island Department of Health,

Center for Health Facilities Regulation, 3 Capitol Hill, Room 306

Providence, RI 02908

401.222.2566

3. Non-compliance with §§3.6.1(C)(1) and (2) of this Part shall constitute grounds to revoke, suspend or otherwise discipline the licensee or to deny an application for licensure by the Director, or may result in imposition of an administrative penalty in accordance with R.I. Gen. Laws Chapter 23-17.10.

3.6.2Radiology and Laboratory Services

A. Any OACF providing diagnostic radiology services must meet the requirements of the regulations for Radiation (Subchapter 40-20 of this Title).

1. Mammography:

a. All aspects of mammography services shall be managed in accordance with the requirements of the Mammography Quality Standards Reauthorization Act of 1998, Public Law 105-248, and 21 C.F.R. Part 900.

b. Pursuant to R.I. Gen. Laws § 23-4.9-1, each mammographic imaging facility that takes a mammography x-ray of any individual within Rhode Island shall keep and maintain that mammography x-ray for the life of the individual. However, any mammography x-ray may be destroyed if the individual has had no contact with the mammographic imaging facility for a period exceeding fifteen (15) years.

B. Clinical laboratory services may be provided on the premises of the OACF subject to the provisions of R.I. Gen. Laws § 23-16.2-3 and Federal CLIA requirements (42 C.F.R. § 493).

3.6.3Infection Control

A. An OACF shall establish policies and procedures governing infection control and reporting techniques which address §§3.6.3(B) through (F) of this Part, as applicable.

B. The medical/dental director in cooperation with other disciplines shall establish a team which shall be responsible for no less than the following:

1. Establishing and maintaining a facility-wide infection surveillance program which shall include an infection surveillance officer to conduct all infection surveillance activities;

2. Developing and implementing written policies and procedures for the surveillance, prevention, and control of infections;

3. Developing, evaluating and revising on a continuing basis infection control policies, procedures and techniques for all appropriate phases of facility operation and services.

C. Infection control provisions shall be established for the mutual protection of patients, employees and the public.

D. A continuing education program on infection control shall be conducted at intervals not to exceed twelve (12) months for all staff.

E. Reporting of Communicable Diseases:

1. The OACF shall promptly report to the Department cases of communicable diseases designated as "reportable diseases" by the Director, when such cases are diagnosed in the OACF in accordance with the rules and regulations pertaining to the Reporting and Testing of Infectious, Environmental and Occupational Diseases (Part 30-05-1 of this Title).

2. When infectious diseases present a potential hazard to patients or personnel, these shall be reported to the Department, even if not designated as "reportable diseases."

F. Reporting by Laboratories:

1. Laboratories shall report communicable diseases and submit specimens in accordance with the Department's Clinical Specimen Submission Guidance(available on-line http://www.health.ri.gov/programs/laboratory/biological/about/specimensubmission/).

2. Facilities must, in addition, comply with all other laboratory reporting requirements for TB, HIV/AIDS, sexually transmitted diseases, childhood lead poisoning and occupational diseases as outlined in the rules and regulations pertaining to the Reporting and Testing of Infectious, Environmental and Occupational Diseases (Part 30-05-1 of this Title).

3.6.4Health Care Records

A. Each OACF shall maintain a health care record on every patient seeking health care services.

B. For each visit to the OACF the health care record shall contain documentation relating to the following:

1. Patient identification (name, address, age and sex);

2. Pertinent health history and physical findings;

3. Diagnostic and therapeutic orders;

4. Reports of procedures, tests and findings of each visit;

5. Diagnostic impressions; and

6. Such other pertinent data as may be necessary to insure continuity of patient care.

C. Each OACF shall make provisions for the appropriate release or transfer of patient care information in accordance with the legal requirements governing confidentiality of health care information.

D. All medical records, either originals or accurate reproductions, shall be preserved for a minimum of five (5) years, except that records of minors shall be kept for at least five (5) years after such minor shall have reached the age of eighteen (18) years.

3.6.5Medical and/or Dental Equipment

Medical and/or dental equipment and supplies for the reception, appraisal, examination, treatment and observation of patients shall be determined by the amount, type and extensiveness of services provided.

216 R.I. Code R. § 216-RICR-40-10-3.6