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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