reglab/statecodes huggingface dataset:
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 5 - Licensing of Freestanding Ambulatory Surgical Centers (216-RICR-40-10-5) › Section 216-RICR-40-10-5.4 - Organization and Management

Current through June 14, 2024
5.4.1
Governing Body and Management
A.
				  Each facility shall have an organized governing body or other legal authority,
				  responsible for:
1. The management and
				  control of the operation;
2. The
				  assurance of the quality of care and services;
3. The conformity of the facility with all
				  federal, state and local laws and regulations relating to fire, safety,
				  sanitation, infection control; and
4. Other relevant health and safety
				  requirements and with all the rules and regulations of this Part.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 5 - Licensing of Freestanding Ambulatory Surgical Centers (216-RICR-40-10-5) › Section 216-RICR-40-10-5.5 - Patient Care Services

Current through June 14, 2024
5.5.1
Admission, Transfer and Discharge
A. Each FASC shall have written admission,
				  transfer and discharge policies and procedures pertaining to at least the
				  following:
1. Types of surgical procedures
				  and conditions acceptable for admission;
2. Emergency admission;
3. Requirements for pre-admission history in
				  accordance with §5.5.5(C) of this Part;
4. Transfer of patients for continuity of
				  care or emergency care;
5.
				  Discharge of patient with responsible adult, as indicated;
6. Constraints imposed by limitations of
				  services, physical facilities; and
7. Instruction of patients on self-care upon
				  discharge.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 5 - Licensing of Freestanding Ambulatory Surgical Centers (216-RICR-40-10-5) › Section 216-RICR-40-10-5.6 - Environmental Maintenance

Current through June 14, 2024
5.6.1
Environment
A. The FASC shall be
				  maintained and equipped to provide a functional sanitary, safe and comfort-
				  able environment, with all furnishings in good repair, and the premises shall
				  be kept free of hazards.
B. Written
				  policies and procedures shall be established pertaining to environmental
				  controls to assure comfortable, safe and sanitary environment with well-lighted
				  space for the services provided.
C.
				  Equipment and supplies shall be provided for cleaning of all surfaces. Such
				  equipment shall be maintained in a safe, sanitary condition.
D. Hazardous cleaning solutions, compounds
				  and substances shall be labeled, stored in a safe place and kept in an enclosed
				  section separate from other cleaning materials.
E. Cleaning shall be performed in a manner
				  which minimizes the spread of pathogenic organisms in the atmosphere.
F. Operating rooms shall be thoroughly
				  cleaned after each operation.
G.
				  Smoking shall be permitted only in restricted areas.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 5 - Licensing of Freestanding Ambulatory Surgical Centers (216-RICR-40-10-5) › Section 216-RICR-40-10-5.7 - Physical Plant and Equipment

Current through June 14, 2024
5.7.1
New
				  Construction
A. All new construction
				  shall be subject to the provisions of R.I. Gen. Laws Chapters 23-28-1, 23-27.3,
				  and The American National Standard - Specifications for Making Buildings and
				  Facilities Accessible to and Usable by, The Physically Handicapped," American
				  National Standards Institute, Inc., 1430 Broadway, New York, New York
				  10013.
B. In addition, any other
				  applicable state and local laws, codes and regulations shall apply. Where there
				  is a difference between codes, the code having the higher standard shall
				  apply.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 5 - Licensing of Freestanding Ambulatory Surgical Centers (216-RICR-40-10-5) › Section 216-RICR-40-10-5.8 - Exception

Current through June 14, 2024
5.8.1
Exception
Modification of any individual standards herein, for
					 experimental or demonstration purposes, or any other purpose, shall require
					 advance written approval from the licensing agency.
5.8.2
Rules Governing Practices and
				  Procedures
All hearings and reviews required under the provisions of
					 R.I. Gen. Laws Chapter 23-17, shall be held in accordance with the provisions
					 of the rules and regulations regarding "Rules and Regulations Pertaining to
					 Practices and Procedures Before the Rhode Island Department of Health [R 42-35
					 -PP]" and "Rules and Regulations Pertaining to Access to Public Records of the
					 Rhode Island Department of Health [R 38-2 -APRA]".
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 6 - Patient Safety Organizations (216-RICR-40-10-6) › Section 216-RICR-40-10-6.1 - Authority

Current through June 14, 2024
These rules and regulations are promulgated pursuant to
					 the authority conferred under R.I. Gen. Laws §
										23-17.21-5(c),
					 for the purpose of adopting standards for certification of patient safety
					 organizations and operational requirements for both a reporting entity and a
					 patient safety organization.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 6 - Patient Safety Organizations (216-RICR-40-10-6) › Section 216-RICR-40-10-6.2 - Incorporated Materials

Current through June 14, 2024
These regulations hereby adopt and incorporate 45 C.F.R.
					 Parts 160 through 164 (2017) by reference, not including any further editions
					 or amendments thereof and only to the extent that the provisions therein are
					 not inconsistent with these regulations.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 6 - Patient Safety Organizations (216-RICR-40-10-6) › Section 216-RICR-40-10-6.4 - General Provisions

Current through June 14, 2024
A. Ineligible
				  Entities
1. Entities that may not seek
				  certification as a PSO include:
a. Health
				  insurance issuers or components of health insurance
				  issuers.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 6 - Patient Safety Organizations (216-RICR-40-10-6) › Section 216-RICR-40-10-6.5 - Privilege and Confidentiality Protections

Current through June 14, 2024
6.5.1
Privilege
Privilege of patient safety work product and document log
					 is pursuant to R.I. Gen. Laws §
										23-17.21-8(a).
6.5.2
Confidentiality of Patient Safety
				  Work Product and Document Log
Confidentiality of patient safety work product and document
					 log is pursuant to R.I. Gen. Laws §
										23-17.21-8(b).
6.5.3
Exceptions
A. Exceptions from privilege and
				  confidentiality are pursuant to R.I. Gen. Laws §
											23-17.21-8(c)(1).
B. Exceptions from confidentiality are
				  pursuant to R.I. Gen. Laws §
											23-17.21-8(c)(2).
C. Continued protection of
				  information after disclosure is pursuant to R.I. Gen. Laws §§
											23-17.21-8(d)(1) 
				  through
				   23-17.21-8(d)(3).
1. Limitations on actions are pursuant to
				  R.I. Gen. Laws §23-17.21(8)(d)(4).
D. Reporter protection is pursuant to R.I.
				  Gen. Laws §
											23-17.21-8(e).
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 6 - Patient Safety Organizations (216-RICR-40-10-6) › Section 216-RICR-40-10-6.6 - Reporting Entity Requirements

Current through June 14, 2024
Reporting entity requirements are pursuant to R.I. Gen.
					 Laws §
										23-17.21-6.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 6 - Patient Safety Organizations (216-RICR-40-10-6) › Section 216-RICR-40-10-6.7 - Patient Safety Organization Requirements

Current through June 14, 2024
6.7.1
Maintenance of Reports
Maintenance of reports is pursuant to R.I. Gen. Laws §
										23-17.21-7(b).
6.7.2
Dissemination of
				  Information
Dissemination of information is pursuant to R.I. Gen. Laws
					 §
										23-17.21-7(c).
6.7.3
Safeguards and Security
				  Measures
A. General Requirements
1. A PSO shall have in place appropriate
				  physical, technical and procedural safeguards and security measures to ensure
				  the technical integrity, physical safety, and confidentiality of any patient
				  safety work product. These safeguards and security measures shall be in place
				  at all times and at any location at which the PSO, its workforce members, or
				  its contractors hold patient safety work product. Such safeguards and security
				  measures shall comply with state and federal confidentiality laws including,
				  without limitation, the Health Insurance Portability and Accountability Act of
				  1996 and its implementing regulations 45 C.F.R. Parts 160 through 164 (2017)
				  incorporated at §
												6.2   of this Part and R.I.
				  Gen. Laws Chapter 5-37.3 (Confidentiality of Health Care Communications and
				  Information Act).
2. Nothing in the
				  Act or this Part shall be construed to prohibit a PSO from choosing to disclose
				  patient safety work product, or portions of patient safety work product, solely
				  to a reporting entity, in conformity with the PSO's mission and within its
				  contractual obligations to the reporting entity who submitted the information.
				  No patient safety organization shall release protected health information or
				  patient identifying information without meeting the requirements of R.I. Gen.
				  Laws §5-37.3 (Confidentiality of Health Care Communications and
				  Information Act) and the federal Health Insurance Portability and
				  Accountability Act of 1996, and its implementing regulations 45 C.F.R. Parts
				  160 through 164 (2017) incorporated at §
												6.2   of this
				  Part.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 6 - Patient Safety Organizations (216-RICR-40-10-6) › Section 216-RICR-40-10-6.8 - Application For Certification

Current through June 14, 2024
6.8.1
General
				  Requirements
A. Certification Required.
				  A patient safety organization (PSO) shall be certified by the Director pursuant
				  to this Part before entering into a contract with a reporting entity.
B. Submission of Application. Any entity,
				  except as specified in §
											6.4(A)   of
				  this Part may request an initial or renewal certification as a PSO by
				  submitting a completed application form to the Director on forms provided by
				  the Department. An individual with authority to make commitments on behalf of
				  the entity seeking certification will be required to acknowledge each of the
				  certification requirements, attest that the entity meets each requirement,
				  provide contact information for the entity, and certify that the PSO will
				  promptly notify the Department during its period of certification if it can no
				  longer comply with any of the criteria in this Part.
C. Notification of Changes. Any PSO certified
				  pursuant to this section shall notify the Department in writing before making
				  any change which would render the information contained in their application
				  for certification no longer accurate.
D. Federal Certification Required. Any entity
				  requesting certification as a PSO pursuant to this Part shall also obtain and
				  maintain certification/listing as a PSO pursuant to the Patient Safety and
				  Quality Improvement Act,
				   42 U.S.C. §§
												299b-21 through  299b-26, and any
				  implementing regulations promulgated by the U.S. Agency for Healthcare Quality
				  and Research.
1. Any PSO certified pursuant
				  to this Part prior to the establishment of a federal PSO certification/listing
				  program shall be required to obtain such certification when it becomes
				  available. The PSO shall provide copies of all federal PSO
				  certification/listing documents to the Director pursuant to §6.8.1(C) of
				  this Part.
2. Any entity requesting
				  certification as a PSO pursuant to this Part after the establishment of a
				  federal PSO certification/listing program shall be required to provide copies
				  of all federal PSO certification/listing documents with their
				  application.
3. Renewal. A PSO
				  seeking renewal of certification after the establishment of a federal PSO
				  certification/listing program shall include documentation that the PSO
				  maintains current certification/listing pursuant to that federal PSO
				  program.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 6 - Patient Safety Organizations (216-RICR-40-10-6) › Section 216-RICR-40-10-6.9 - Complaints and Enforcement

Current through June 14, 2024
A. Complaints and
				  Routine Correspondence.
1. Complaints. Any
				  person who desires to register a complaint citing a violation of the Act or
				  this Part shall submit a written and signed letter of complaint to the
				  Director. All complaints shall be directed to:
Rhode Island Department of Health
3 Capitol Hill
Providence, RI 02908-5097
Phone: (401) 222-5200
2.
				  Routine Correspondence. Routine correspondence, including all required
				  notifications and reports, shall also be directed to the address specified
				  above.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 6 - Patient Safety Organizations (216-RICR-40-10-6) › Section 216-RICR-40-10-6.10 - Rules Governing Practices and Procedures

Current through June 14, 2024
Upon due notice in accordance with R.I. Gen. Laws
					 §42-35, all hearings and reviews required under the provisions of the Act
					 and this Part shall be held in accordance with requirements of the Rules and
					 Regulations of the Rhode Island Department of Health Regarding Practices and
					 Procedures Before the Department of Health and Access to Public Records of the
					 Department of Health.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 7 - Licensing Adult Day Care Programs › Section 216-RICR-40-10-7.1 - Authority

Current through June 14, 2024
These rules and regulations are promulgated pursuant to the
					 authority conferred under R.I. Gen. Laws §
										23-1-52(a),
					 and are established for the purpose of defining the prevailing standards for
					 licensed adult day care programs in Rhode Island.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 7 - Licensing Adult Day Care Programs › Section 216-RICR-40-10-7.2 - Incorporated Materials

Current through June 14, 2024
A. These
				  regulations hereby adopt and incorporate "The American National Standard -
				  Specifications for Making Buildings and Facilities Accessible to and Usable by,
				  the Physically Handicapped" (1980) by reference, not including any further
				  editions or amendments thereof and only to the extent that the provisions
				  therein are not inconsistent with these regulations.
B. These regulations hereby adopt and
				  incorporate "The Americans with Disabilities Act"42 U.S.C §
											12101 - 12213;
				   47 U.S.C §§
											152, 221, 225, 611;
				   29 U.S.C §
											706  (1991) by reference, not including any
				  further editions or amendments thereof and only to the extent that the
				  provisions therein are not inconsistent with these regulations.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 7 - Licensing Adult Day Care Programs › Section 216-RICR-40-10-7.4 - Licensure Requirements

Current through June 14, 2024
7.4.1
General
				  Requirements
A. These rules and
				  regulations shall apply to all adult day care programs that provide services to
				  the elderly who are in need of supportive care and supervision during the
				  daytime.
B. A license issued to a
				  new adult day care program, unless sooner suspended or revoked, shall expire by
				  limitation on March 31st of each odd-numbered year
				  and may be renewed upon application to the Department.
C. No person, acting alone or jointly with
				  any other person, shall establish, conduct or maintain an adult day care
				  program in this state without a license in accordance with the requirements of
				  R.I. Gen. Laws §
											23-1-52,
				  and in conformity with this Part.
D. No facility or program shall represent
				  itself as an adult day care program or use the term "adult day care program" or
				  any other similar term in its title, advertising, publication or other form of
				  communication, unless licensed as an adult day care program in accordance with
				  the provisions herein.
E. An
				  application for a license shall be made to the Department, upon forms provided
				  by the Department and shall contain such information as the Department
				  reasonably requires.
F. Upon
				  receipt of a completed application for a license, the Department may issue a
				  license if the applicant meets the requirements of R.I. Gen. Laws §
											23-1-52,
				  and this Part.
G. A license issued
				  hereunder shall be the property of the state and loaned to such
				  licensee.
H. The license shall be
				  posted in a conspicuous place on the premises.
I. Each license shall be issued only for the
				  premises and person(s) named in the application and shall not be transferable
				  or assignable except with the written approval of the Department.
J. Each program shall be responsible for
				  complying with all local, state, and federal laws, codes, rules and regulations
				  that apply to the program.
K. Each
				  program shall be responsible for maintaining a policy of nondiscrimination in
				  the provision of services to participants and in the employment of staff
				  without regard to race, color, creed, national origin, sex, sexual orientation,
				  age, handicapping condition or degree of handicap, in accordance with all
				  applicable state and federal statutes and regulations.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 7 - Licensing Adult Day Care Programs › Section 216-RICR-40-10-7.7 - Variance, Practices, and Procedures

Current through June 14, 2024
7.7.1
Variance Process
A. The
				  Department may grant a variance either upon its own motion or upon request of
				  the applicant from the provisions of any 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 or safety of the
				  participants.
B. A request for a
				  variance shall be submitted in writing by the applicant or licensee to the
				  Department for review.
C. Within a
				  reasonable time thereafter, the Department will review the application and
				  return a written decision to the applicant.
D. If the applicant is dissatisfied with the
				  decision of the Department, an appeal may be made through the process outlined
				  in §7.7.2 of this Part.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 8 - Birth Centers › Section 216-RICR-40-10-8.1 - Authority

Current through June 14, 2024
A. These regulations are promulgated pursuant
				  to the authority set forth in R.I. Gen. Laws §
										23-17-10,
				  and are established for the purpose of adopting minimum standards for Birth
				  Centers which are consistent with acceptable standards of practice and which
				  ensure that, while providing pregnant women with a maternity care alternative,
				  the Birth Centers will provide services in such a manner as to safeguard the
				  health, safety, and welfare of mothers and newborns.
B. A hospital birth center service,
				  maintained and operated by a hospital on its licensed premises shall be subject
				  to the standards for birth center services as set forth in the rules and
				  regulations for Licensing of Hospitals (Part 4 of this Subchapter) and shall
				  operate under the hospital license.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 8 - Birth Centers › Section 216-RICR-40-10-8.2 - Incorporated Materials

Current through June 14, 2024
A. These
				  regulations hereby adopt and incorporate the Facility Guidelines Institute's
				  "Guidelines for Design and Construction of Hospital and Outpatient Facilities"
				  (2014) by reference, not including any further editions or amendments thereof
				  and only to the extent that the provisions therein are not inconsistent with
				  these regulations.
B. These
				  regulations hereby adopt and incorporate the U.S. Department of Health
				  && Human Services, Office of Minority Health's "National Standards on
				  Culturally and Linguistically Appropriate Services (CLAS)" (2013) by reference,
				  not including any further editions or amendments thereof and only to the extent
				  that the provisions therein are not inconsistent with these
				  regulations.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 8 - Birth Centers › Section 216-RICR-40-10-8.4 - Licensing Procedures

Current through June 14, 2024
8.4.1 General
				  Requirements for Licensure
A. No person or
				  governmental unit acting severally or jointly with any other person or
				  governmental unit shall establish, conduct, maintain or operate or hold itself
				  out as a Birth Center in Rhode Island without a license in accordance with the
				  requirements of R.I. Gen. Laws §
											23-17-4 and this Part.
B. Each license
				  shall specify the licensed capacity of the Center.
C. The number of women in active labor,
				  admitted to birth rooms at any given point in time shall be no greater than the
				  number of birth rooms in the Center.
D. Centers shall be limited to those
				  practices normally accomplished in uncomplicated childbirth, including simple
				  episiotomies and repairs. Any other surgical procedures such as tubal ligation,
				  termination of pregnancy or such other would require the Center to be
				  specifically licensed as a Freestanding Ambulatory Surgical Center in
				  accordance with the rules and regulations for Licensing of Freestanding
				  Ambulatory Surgical Centers (Part 5 of this Subchapter).
E. Proposed changes in birth room capacity
				  shall be submitted in writing to the Department and shall be subject to the
				  approval of the Department.
F. Any
				  Birth Center that utilizes latex gloves shall do so in accordance with the
				  provisions of Use of Latex Gloves by Health Care Workers, in Licensed Health
				  Care Facilities, and by Other Persons, Firms, or Corporations Licensed or
				  Registered by the Department (Part
				  20-15-3
				  of this Title).
G. Each Birth
				  Center shall establish and maintain a health care facility specific electronic
				  mail address (i.e., e-mail address) to be provided to the Department for the
				  purposes of contacting the Birth Center with both routine communications and
				  emergency notices. The Birth Center shall be responsible for providing notice
				  to the Department at any time that the Birth Center's specific electronic mail
				  address is changed or updated.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 8 - Birth Centers › Section 216-RICR-40-10-8.5 - Organization and Management

Current through June 14, 2024
8.5.1 Governing
				  Body and Management
A. Each Center shall have
				  an organized governing body or equivalent legal authority ultimately
				  responsible for:
1. The management and
				  control of the operation;
2. The
				  assurance of quality care and services;
3. Compliance with all federal, state and
				  local laws and regulations; and
4.
				  Other relevant health and safety requirements, including the rules and
				  regulations of this Part.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 8 - Birth Centers › Section 216-RICR-40-10-8.6 - Management of Clinical Services

Current through June 14, 2024
8.6.1 Selection of
				  Clients
A. Each Center shall clearly
				  delineate in its policy and procedure manual the medical and social risk
				  factors which exclude women from the low-risk intrapartum group. At a minimum,
				  mothers with problems and conditions considered to be high-risk as listed in
				  §
											8.10   of
				  this Part, must be precluded from admission to the Center's services, except
				  mothers with problems and conditions identified with an asterisk in §
											8.10   of this Part shall
				  require in each particular case for the Director of Medical Affairs to make a
				  determination as to whether or not the mother may be admitted to the Center for
				  services in accordance with §8.5.2 of this Part.
B. Therefore, only those mothers who have no
				  abnormal findings or findings declared insignificant (see §8.6.1(A) of
				  this Part) and demonstrate the potential for an uncomplicated course of
				  pregnancy and labor, may be accepted for childbirth at the Center.
C. An initial assessment shall be made of
				  every woman seeking Birth Center services. Such assessment shall be made by a
				  professional staff member (obstetrician and/or midwife) to determine
				  eligibility of the women for admission to the Center in accordance with the
				  provisions of §8.6.1(A) of this Part. All findings of the assessment shall
				  be recorded into the clinical record, signed by the responsible person and
				  countersigned by the Director of Medical Affairs.
D. Women who fail to register with the Center
				  before the end of first trimester shall be excluded from admission unless a
				  written, signed exception is made by the Director of Medical Affairs on an
				  individual basis.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 8 - Birth Centers › Section 216-RICR-40-10-8.7 - Environmental Management

Current through June 14, 2024
8.7.1 Housekeeping
A. The Center shall be maintained and
				  equipped to provide functional, sanitary, safe and comfortable environment,
				  with all furnishings in good repair, and the premises shall be kept free of
				  hazards.
B. Written policies and
				  procedures shall be established pertaining to environmental controls to assure
				  comfortable, safe and sanitary environment with well-lighted space.
C. Equipment and supplies shall be provided
				  for cleaning of all surfaces. Such equipment shall be maintained in a safe and
				  sanitary condition.
D. Hazardous
				  cleaning solutions, compounds, and substances shall be labeled, stored in a
				  safe place and kept in an enclosed section separated from other cleaning
				  materials.
E. Cleaning shall be
				  performed in a manner which minimizes the spread of pathogenic organisms in the
				  atmosphere.
F. Birth rooms shall be
				  thoroughly cleaned after each delivery in accordance with the Center's
				  infection control policies.
G.
				  Smoking shall be permitted only in areas designated pursuant to R.I. Gen. Laws
				  Chapter 23-20.10.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 8 - Birth Centers › Section 216-RICR-40-10-8.8 - Physical Plant and Equipment

Current through June 14, 2024
8.8.1 Physical
				  Facility
A. All construction shall be subject
				  to the laws, rules, regulations and codes of R.I. Gen. Laws Chapters 23-17 and
				  23-28.1, and "Guidelines for Design and Construction of Hospital and Outpatient
				  Facilities" incorporated above at §
											8.2(A)   of
				  this Part, and all other appropriate state and local laws, codes, regulations
				  and ordinances. Where there is a difference between codes, the code having the
				  more stringent standard shall apply.
B. All plans for new construction or the
				  renovation, alteration, extension, modification or conversion of an existing
				  Birth Center that may affect compliance with "Guidelines for Design and
				  Construction of Hospital and Outpatient Facilities" incorporated above at
				  §
											8.2(A)   of
				  this Part shall be reviewed by a licensed architect, acceptable to the
				  Director. Said architect shall certify that the plans conform to the
				  construction requirements of "Guidelines for Design and Construction of
				  Hospital and Outpatient Facilities" incorporated above at §
											8.2(A)   of
				  this Part, prior to construction. The Birth Center shall maintain a copy of the
				  plans reviewed and the architect's signed certification, for review by the
				  Department upon request.
1. In the event of
				  non-conformance for which the Birth Center seeks a variance, the general
				  procedures outlined in §8.9.1 of this Part shall be followed. Variance
				  requests shall include a written description of the entire project, details of
				  the non-conformance for which the variance is sought and alternate provisions
				  made, as well as detailing the basis upon which the request is made. The
				  Department may request additional information while evaluating variance
				  requests.
2. If variances are
				  granted, a licensed architect shall certify that the plans conform to all
				  construction requirements of "Guidelines for Design and Construction of
				  Hospital and Outpatient Facilities" incorporated above at §
												8.2(A)   of
				  this Part, except those for which variances were granted, prior to
				  construction. The Birth Center shall maintain a copy of the plans reviewed, the
				  variance(s) granted and the architect's signed certification, for review by the
				  Department upon request.
C. Upon completion of construction, the Birth
				  Center shall provide written notification to the Department, describing the
				  project, and a copy of the architect's certification. The Birth Center shall
				  obtain authorization from the Department prior to occupying/re-occupying the
				  area. At the discretion of the Department, an on-site visit may be
				  required.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 8 - Birth Centers › Section 216-RICR-40-10-8.9 - Practices and Procedures, Confidentiality

Current through June 14, 2024
8.9.1 Variance
				  Procedure
A. The Department may grant a
				  variance either upon its own motion or upon request of the applicant from the
				  provisions of any 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 patients.
B. A request for a variance shall be filed by
				  any applicant in writing, setting forth in detail the basis upon which the
				  request is made.
1. Upon the filing of each
				  request for variance with the Department, and within thirty (30) days
				  thereafter, the Department 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 facility appeals the denial and in accordance with the
				  provisions of §8.9.2 of this Part.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 8 - Birth Centers › Section 216-RICR-40-10-8.10 - Prenatal High-Risk Factors

Current through June 14, 2024
8.10.1 Reproductive
				  History
A. * Signifies that the risk factor
				  could be clinically significant and, therefore, subject to the Director of
				  Medical Affairs' final determination.
B. Maternal Characteristics.
1. Age: <16 and >40 years
2. *Height: <60 inches
3. *Weight: <100 lbs. and >200
				  lbs.
4. Parity: Four (4) or
				  more
C. Past Obstetrical
				  History.
1. *Habitual Abortion: more than two
				  (2) consecutive spontaneous or two (2) or more induced abortions
2. Post Partum Hemorrhage or 3rd Stage
				  problem(s), e.g., severe lacerations, inverted uterus, retained placenta,
				  etc.
3. *Pre-Eclampsia
4. Hypertension - all hypertensive disorders
				  of pregnancy
5. *Previous Second
				  Stage Labor greater than two (2) hours
6. Previous Delivery:
a. Other than spontaneous or low forceps; and
b. Caesarian Section
7. Baby:
a. *Prematurity <37 weeks or <2500
				  grams or >4500 grams
b.
				  *Respiratory Distress c. *Congenital abnormality
d. *Known genetic disorders
e. *Any Neonatal death
f. *Fetal death
g. *Significant birth injury
D. Associated
				  Conditions.
1. Scarred uterus - vaginal
				  plastic surgery - * Urinary tract surgery
2. Adrenal disease
3. Cardiovascular disease except for mild
				  asymptomatic Class I without hemodynamic abnormality
4. Collagen disease
5. Renal disease (albuminuria, hematuria,
				  casts)
6. Chronic or acute liver
				  disease
7. Diabetes
				  Mellitus
8. Gestational diabetes -
				  (blood or plasma screening test or abnormal glucose tolerance test or
				  equivalent)
9. *Gastrointestinal
				  disorders, e.g., regional ileitis, ulcerative colitis, etc.
10. Genetic Disorder
11. Hematologic disease
12. Hypertension
13. *Pulmonary disease, (not requiring
				  treatment) e.g., asthma, chronic bronchitis, etc.
14. *Pulmonary disease, requiring
				  treatment
15.
				  *Psychiatric
16. Neurologic
				  disorder
17.
				  Hyperthyroidism
18. Venereal and
				  Related diseases
19.
				  *Thrombophlebitis
20. *Alcohol
				  abuse
21. *Drug abuse
22. *Smoking - (> 1 pkg. a day)
23. Such other medial/obstetrical/or surgical
				  problem or condition as determined to be significant risk to the mother or
				  fetus.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 8 - Birth Centers › Section 216-RICR-40-10-8.11 - High-Risk Factors Requiring Transfer of Mother from the Center

Current through June 14, 2024
8.11.1 Labor -
				  Delivery - Post Partum
A. Abnormal
				  Bleeding
B. Cord Prolapse
C. Dystocia Labor (at term)
D. Prolonged latent phase with ruptured
				  membranes
1. (20 hrs. nulliparous)
2. (14 hrs. multiparous)
E. Protraction or arrest in the active stage
F. Prolonged second stage greater
				  than two (2) hours
G. Secondary
				  arrest
H. Extensive perineal or
				  cervical laceration
I. Fever above
				  100.4 F on two (2) occasions four (4) hours apart
J. Fetal Distress -
1. Fetal heart rate < 100 or > 180 or
				  any audible decelerations of heart beat
K. Meconium (stain of the amniotic fluid)
L. Hypertension or Hypotension
				  Maternal Tachycardia
M. More than
				  24 hours in active labor unless delivery is imminent
N. Presentation (any other than
				  vertex)
O. Retained placenta
				  (greater than one hour)
P. Any
				  other condition requiring more than twelve (12) hours observation post
				  delivery
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 8 - Birth Centers › Section 216-RICR-40-10-8.12 - Criteria Requiring Transfer of Newborn

Current through June 14, 2024
A. * Signifies
				  that the risk factor could be clinically significant and, therefore, subject to
				  the Director of Medical Affairs' final determination.
B. Apgar score of:
1. Five (5) or less at one (1) min.;
				  or
2. Seven (7) or less at five (5)
				  min.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 9 - Licensing of Freestanding Emergency Care Facilities (216-RICR-40-10-9) › Section 216-RICR-40-10-9.1 - Authority

Current through June 14, 2024
These regulations are promulgated pursuant to the authority
					 conferred under R.I. Gen. Laws §
										23-17-10,
					 as amended, and are established for the purpose of adopting minimal standards
					 for the licensing of freestanding emergency care facilities in this
					 state.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 9 - Licensing of Freestanding Emergency Care Facilities (216-RICR-40-10-9) › Section 216-RICR-40-10-9.2 - Incorporated Materials

Current through June 14, 2024
A. These
				  regulations hereby adopt and incorporate the following by reference, not
				  including any further editions or amendments thereof and only to the extent
				  that the provisions therein are not inconsistent with these regulations:
1. NFPA 56A: Standard for Fire and Explosion
				  Prevention During Cleaning and Purging of Flammable Gas Piping Systems.
				  National Fire Protection Association, 1975.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 9 - Licensing of Freestanding Emergency Care Facilities (216-RICR-40-10-9) › Section 216-RICR-40-10-9.3 - Definitions

Current through June 14, 2024
A. "Freestanding Emergency Care Facility"
				  hereinafter referred to as FECF, means an establishment, place or facility
				  which may be a public or private organization, structurally distinct and
				  separate from a hospital, staffed, equipped and operated to provide prompt
				  emergency medical care as defined herein.
B. "Emergency Medical Care" means services
				  provided for a medical condition that is manifested by symptoms of sufficient
				  severity that, in the absence of immediate medical attention, could result in
				  placing health in jeopardy, serious impairment to bodily functions, serious
				  dysfunction of any bodily organ or part, or development or continuance of
				  severe pain.
C. "Director" means
				  the Director of the Rhode Island Department of Health.
D. "Licensing Agency" means the Rhode Island
				  Department of Health.
E. "Person"
				  means any individual, trust or state, partnership, corporation (including
				  associations, joint stock companies) state, or political subdivisions or
				  instrumentality of the state.
F.
				  "Physician" means an individual licensed under the provisions of R.I. Gen. Laws
				  Chapter 5-37, to practice medicine or osteopathy in this state.
G. "Change in owner" means:
1. In the case of an FECF which is a
				  partnership, the removal, addition or substitution of a partner which results
				  in a new partner acquiring a controlling interest in such
				  partnership;
2. In the case of an
				  FECF which is an unincorporated solo proprietorship, the transfer of the title
				  and property to another person;
3.
				  In the case of an FECF which is a corporation;
a. A sale, lease, exchange or other
				  disposition of all, or substantially all of the property and assets of the
				  corporation; or
b. A merger of the
				  corporation into another corporation; or
c. The consolidation of two or more
				  corporations, resulting in the creation of a new corporation; or
d. In the case of an FECF which is a business
				  corporation, any transfer of corporate stock which results in a new person
				  acquiring a controlling interest in such corporation; or
e. In the case of an FECF facility which is a
				  non-business corporation, any change in membership which results in a new
				  person acquiring a controlling vote in such corporation.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 9 - Licensing of Freestanding Emergency Care Facilities (216-RICR-40-10-9) › Section 216-RICR-40-10-9.4 - Licensing Procedures

Current through June 14, 2024
9.4.1
General
				  Requirements for Licensure
A. No
				  person acting severally or jointly with any other person, shall establish,
				  conduct or maintain a FECF in this state without a license in accordance with
				  the requirements of R.I. Gen. Laws §§
											23-17-4 and
				   23-15-4,
				  and shall meet the requirements of the rules and regulations herein.
B. No person or facility shall represent
				  itself as a Freestanding Emergency Care Facility or except in the case of
				  licensed hospitals, shall use the term "emergency" in its title, advertising,
				  publications or other form of communication, unless licensed as a freestanding
				  emergency care facility in accordance with the provisions herein.
C. A facility licensed as a Freestanding
				  Emergency Care Facility must include in a prominent manner in all its
				  advertising, publications, signs or other forms of communication the following:
1. The term "freestanding," to distinguish
				  the emergency care facility from that of a hospital emergency care service of
				  Rules and Regulations for Licensing of Hospitals; and
2. Days and hours of the facility's
				  operation.
D. Pursuant to
				  R.I. Gen. Laws §
											23-17-26, a
				  freestanding emergency care facility shall provide to every person prompt
				  lifesaving medical care treatment in an emergency without discrimination on
				  account of economic status or source of payment and without delaying treatment
				  for the purpose of prior discussion of source of payment unless such delay can
				  be imposed without material risk to the health of the
				  person.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 9 - Licensing of Freestanding Emergency Care Facilities (216-RICR-40-10-9) › Section 216-RICR-40-10-9.5 - Organization and Management

Current through June 14, 2024
9.5.1
Governing Body and Management
A.
				  Each facility shall have an organized governing body or equivalent legal
				  authority ultimately responsible for:
1. The
				  management and control of the operation;
2. The assurance of the quality of care and
				  services;
3. The compliance with
				  all federal, state and local laws and regulations; and
4. Other relevant health and safety
				  requirements including the rules and regulations herein.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 9 - Licensing of Freestanding Emergency Care Facilities (216-RICR-40-10-9) › Section 216-RICR-40-10-9.6 - Emergency Care Services

Current through June 14, 2024
9.6.1
Management Services
A. Each FECF
				  shall provide emergency care service with professional and ancillary staff to
				  ensure that all persons treated are released or transferred within a reasonable
				  and appropriate length of time. No patient shall be held overnight.
B. Policies and procedures pertaining to the
				  provision of emergency medical care services and supported by appropriate
				  manuals and reference material shall be established by the Medical Director and
				  approved by the governing body. Such policies and procedures shall pertain to
				  no less than the following:
1. The
				  responsibility of the medical staff for emergency patient care;
2. Medical circumstances under which
				  definitive care cannot be provided and procedures for referral;
3. Procedures that may and may not be
				  performed in the FECF;
4.
				  Procurement, storage and administration of drugs and medications in accordance
				  with R.I. Gen. Laws Chapters 21-28 and 21-31;
5. Disposal of hypodermic needles, syringes
				  and instruments in accordance with the requirements of the Rules and
				  Regulations for Governing Hypodermic Needles, Syringes and Other Such
				  Instruments;
6. Handling of persons
				  who are emotionally ill, under the influence of drugs or alcohol, dead on
				  arrival, or other categories of special care;
7. Procedures for early transfer of severely
				  ill or injured to hospital;
8.
				  Written instructions to be given to the patient to assure continuity of
				  care;
9. Notification of patient's
				  personal physician and transmission of relevant reports per written consent of
				  patient;
10. Disclosure of patient
				  information in accordance with federal and state law;
11. Location and storage of supplies and
				  special equipment; and
12. Pursuant
				  to R.I. Gen. Laws §
												23-17-26 the provision of prompt emergency medical care for every person in an emergency
				  without discrimination on account of economic status or source of payment and
				  without delaying treatment for the purpose of prior discussion of source of
				  payment unless such delay can be imposed without material risk to the health of
				  the person.
Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 9 - Licensing of Freestanding Emergency Care Facilities (216-RICR-40-10-9) › Section 216-RICR-40-10-9.7 - Physical Plant and Equipment

Current through June 14, 2024
9.7.1
New
				  Construction
A. All new construction
				  shall be subject to the provisions of NFPA 56A: Standard for Fire and Explosion
				  Prevention During Cleaning and Purging of Flammable Gas Piping Systems,
				  incorporated above at §
											9.2(A)(1),
				  and R.I. Gen. Laws Chapters 23-28.1 and 23-27.3.
B. In addition, any other applicable state
				  and local laws, codes and regulations shall apply. (Where there is a difference
				  between codes, the code having the more stringent standard shall
				  apply.)