Text: H08154 Text: H08156 Text: H08100 - H08199 Text: H Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Amend House File 2542 as follows:
1 2 #1. By striking everything after the enacting
1 3 clause and inserting the following:
1 4 "Section 1. NEW SECTION. 135M.1 TITLE.
1 5 This chapter shall be known and may be cited as the
1 6 "Resident Safety and Quality Assurance Act".
1 7 Sec. 2. NEW SECTION. 135M.2 DEFINITIONS.
1 8 As used in this chapter:
1 9 1. "Action plan" means a written plan prepared
1 10 after a root cause analysis that identifies strategies
1 11 that a resident care provider intends to implement to
1 12 reduce the risk and reoccurrence of actual and
1 13 potential risks to resident safety. The plan shall
1 14 address resident care provider responsibility for
1 15 implementation, oversight, pilot testing as
1 16 appropriate, time lines, and strategies for measuring
1 17 the effectiveness of the actions.
1 18 2. "Quality assessment and assurance activities"
1 19 means the procedure by which a quality assessment and
1 20 assurance committee monitors, evaluates, recommends,
1 21 and implements actions to improve and assure the
1 22 delivery and quality of services and resident safety
1 23 through identification, correction, and prevention of
1 24 sentinel events.
1 25 3. "Quality assessment and assurance committee"
1 26 means a committee of a resident care provider
1 27 consisting of individuals responsible for the
1 28 identification of sentinel events that may adversely
1 29 impact the health and safety of residents, and for the
1 30 development of root cause analyses, action plans, and
1 31 other plans to correct identified quality of care
1 32 issues. The quality assessment and assurance
1 33 committee shall include resident care provider
1 34 leaders, including, but not limited to, the resident
1 35 care provider administrator and the director of
1 36 nursing.
1 37 4. "Quality assessment and assurance committee
1 38 records" means complaint files, investigation files,
1 39 reports, and other investigative information relating
1 40 to licensee discipline or professional competence in
1 41 the possession of a quality assessment and assurance
1 42 committee or an employee of the committee.
1 43 5. "Resident care provider" means a nursing
1 44 facility or a residential care facility as defined in
1 45 section 135C.1, or an assisted living program
1 46 certified by the department of elder affairs or
1 47 recognized as voluntarily accredited pursuant to
1 48 chapter 231C.
1 49 6. "Resident care provider leaders" means a health
1 50 care provider, executive, physician as defined in
2 1 section 135C.1, registered or licensed practical nurse
2 2 or nurse practitioner, or health care provider
2 3 administrator.
2 4 7. "Risk of death or serious injury" means any
2 5 variation in a process related to quality of care or
2 6 resident safety which may result in a serious adverse
2 7 outcome.
2 8 8. "Root cause analysis" means the process for
2 9 identifying causal factors that relate to any
2 10 variation in the delivery and quality of services and
2 11 resident safety, including the occurrence or possible
2 12 occurrence of a sentinel event. A root cause analysis
2 13 focuses primarily on systems and processes, and not on
2 14 individual performances.
2 15 9. "Sentinel event" means an unexpected occurrence
2 16 resulting in the death or serious physical or
2 17 psychological injury of a resident of a resident care
2 18 provider, or a risk of death or serious physical or
2 19 psychological injury to a resident of a resident care
2 20 provider.
2 21 10. "Unanticipated outcome" means a result that
2 22 differs significantly from what was anticipated to be
2 23 the result of a treatment or procedure, including an
2 24 outcome caused by an error of an employee of a
2 25 resident care provider or an independent practitioner
2 26 who provides medical services at a resident care
2 27 provider's facility.
2 28 Sec. 3. NEW SECTION. 135M.3 ACCOUNTABILITY OF
2 29 RESIDENT CARE PROVIDER LEADERS.
2 30 The resident care provider leaders, including the
2 31 resident care provider administrator and director of
2 32 nursing, and the quality assessment and assurance
2 33 committee, are responsible for all of the following:
2 34 1. Assuring the implementation of an integrated
2 35 resident safety program throughout the resident care
2 36 provider facility. The resident safety program shall
2 37 include, at a minimum, all of the following:
2 38 a. A designation of one or more qualified
2 39 individuals or an interdisciplinary group to manage
2 40 the resident care provider safety program.
2 41 b. A definition of the scope of the program
2 42 activities, including the types of occurrences to be
2 43 addressed.
2 44 c. A procedure for immediate response to medical
2 45 or health care errors or resident abuse, including
2 46 care of an affected resident, containment of risk to
2 47 others, and the preservation of factual information
2 48 for subsequent analysis.
2 49 d. A system for internal and external reporting of
2 50 information relating to medical and health care errors
3 1 or resident abuse.
3 2 e. A defined mechanism for support of staff
3 3 involved in a sentinel event.
3 4 f. An annual report to the board of directors of
3 5 the resident care provider and the department of
3 6 inspections and appeals concerning medical or health
3 7 care errors and resident neglect or abuse, and actions
3 8 taken to improve resident safety, both proactively and
3 9 in response to actual occurrences.
3 10 2. Defining and implementing processes for
3 11 identifying and managing sentinel events, including
3 12 establishing processes for the identification,
3 13 reporting, analysis, and prevention of sentinel events
3 14 and assuring the consistent and effective
3 15 implementation of a mechanism to accomplish those
3 16 activities.
3 17 3. Establishing a continuous proactive program for
3 18 identifying risks to patient safety and reducing
3 19 medical and health care errors and resident neglect or
3 20 abuse.
3 21 4. Allocating adequate resources for measuring,
3 22 assessing, and improving patient safety.
3 23 5. Assigning personnel to participate in
3 24 activities to improve patient safety and providing
3 25 adequate time for personnel to participate in such
3 26 activities.
3 27 6. Providing staff training on the improvement of
3 28 patient safety.
3 29 7. Allocating physical and financial resources to
3 30 support safety improvement.
3 31 8. Analyzing undesirable patterns or trends in
3 32 staff performance and sentinel events.
3 33 9. Assuring the resident care provider identifies
3 34 changes for improved patient safety.
3 35 Sec. 4. NEW SECTION. 135M.4 RESIDENT RIGHTS AND
3 36 DUTY OF DISCLOSURE.
3 37 1. Residents and their immediate families have a
3 38 right to know about the quality of care outcomes
3 39 involved in resident care, including unanticipated
3 40 outcomes and sentinel events.
3 41 2. The resident care provider leaders shall fully
3 42 disclose all of the facts and circumstances relating
3 43 to a sentinel event or an unanticipated outcome.
3 44 Sec. 5. NEW SECTION. 135M.5 SENTINEL EVENT
3 45 REPORTING.
3 46 1. A resident care provider involved in a sentinel
3 47 event shall submit a root cause analysis and an action
3 48 plan that describes the resident care provider's risk
3 49 reduction strategy and a strategy for evaluating the
3 50 effectiveness of the risk reduction strategy to the
4 1 department of inspections and appeals.
4 2 2. A root cause analysis shall contain an analysis
4 3 focusing primarily on systems and processes involved
4 4 in quality of care and resident safety which includes
4 5 changes that may be made to such systems and
4 6 processes, and shall be thorough, credible, and
4 7 acceptable as defined by industry standards.
4 8 Sec. 6. NEW SECTION. 135M.6 CONFIDENTIALITY OF
4 9 RECORDS.
4 10 1. Quality assessment and assurance committee
4 11 records shall be confidential and privileged and shall
4 12 not be subject to discovery or subpoena.
4 13 2. Information or documents discoverable from
4 14 sources other than a quality assessment and assurance
4 15 committee, a resident care provider, or the department
4 16 of inspections and appeals do not become
4 17 nondiscoverable from the other sources because they
4 18 are subject to a claim of confidentiality under this
4 19 section."
4 20 #2. Title page, by striking lines 1 through 3 and
4 21 inserting the following: "An Act relating to resident
4 22 safety and quality assurance in a nursing facility,
4 23 residential care facility, and an assisted living
4 24 program."
4 25
4 26
4 27
4 28 DOTZLER of Black Hawk
4 29 HF 2542.706 79
4 30 rh/cls
Text: H08154 Text: H08156 Text: H08100 - H08199 Text: H Index Bills and Amendments: General Index Bill History: General Index
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