216 R.I. Code R. § 216-RICR-40-10-9.5 - Organization and Management
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.
B. The governing body or equivalent legal
authority shall provide appropriate personnel, physical resources, and
equipment for the delivery of safe and effective emergency medical
care.
C. The governing body or
equivalent legal authority shall designate;
1.
An administrator who shall be responsible for the management and operation of
the facility; and
2. A medical
director to ensure achievement and maintenance of quality standards of
professional practice.
D.
The governing body or equivalent legal authority shall adopt and maintain
by-laws defining responsibilities for the operation and performance of the
organization, identifying purposes and means of fulfilling each. In addition,
the governing body shall establish administrative policies pertaining to no
less than the following:
1. Qualifications
and responsibilities of the medical director and administrator;
2. The plan of the governing body for the
implementation of long- and short-range plans as prescribed by the Director in
accordance with R.I. Gen. Laws Chapter 23-17; and
3. Such other matters as may be relevant to
the organization and operation of the FECF.
E. The governing body or other legal
authority shall be responsible through the organization's by-laws, policies, or
other mechanism to determine the qualifications of physicians and other
professionals as required herein, considering such factors as education,
training, experience, board certification, eligibility to sit for examination
of specialty board, evidence of current professional practice and licensure as
may be required by law or regulation, the relevant qualifications required in
§9.5.4 of this Part and such other relevant factors as may be deemed
necessary.
9.5.2
Administrator
A. The governing
body or equivalent legal authority shall appoint an administrator (who may also
be the medical director), who shall be operationally responsible for:
1. The management and operation of the FECF;
2. The compliance with policies,
rules and regulations and statutory provisions pertaining to the health and
safety of patients;
3. Serving as
liaison between the governing body and the staff; and
4. The planning, organizing and directing of
such other activities as may be delegated by the governing body.
9.5.3
Medical
Director
A. The FECF shall have a
physician licensed in this state, who shall serve as Medical Director and be
responsible for no less than the following:
1. Coordination and supervision of emergency
medical care services;
2. The
achievement and maintenance of quality assurances of professional practice
through a mechanism of peer review; and
3. The establishment of policies and
procedures for emergency medical care services and other related emergency
health care services.
9.5.4
Personnel
A. Each FECF shall be staffed by a licensed
physician(s) who has certification, as defined in §9.5.4(B) of this Part,
and full licensure and who shall be present within the facility during the
hours of operation.
B. At least one
physician on duty during the hours of operation shall be:
1. Certified or Board Eligible by the
American Board of Emergency Medicine or the American Board of Osteopathic
Emergency Medicine; OR
2. Certified
or Board Eligible to sit for the examination of one of the following boards:
Internal Medicine, Family Practice, or Surgery; AND must hold a certificate
from the following approved programs: Advanced Coronary Life Support; Advanced
Trauma Life Support; Pediatric Advanced Life Support.
C. No less than one licensed registered nurse
who has training and experience in emergency care shall be on duty during the
hours of operation.
D. Every
freestanding emergency care facility shall have a person qualified by training
and experience on the premises during the hours of operation who shall
determine the nature, level and urgency of care required of all persons seeking
treatment and to categorize them accordingly, assuring that serious cases are
accorded priority treatment. If such person is a non-physician, he or she shall
serve under the supervision of the physician-in-charge and in accordance with
policies and procedures acceptable to the governing body or other legal
authority.
E. Each FECF shall
establish a protocol to govern the interpretation by a radiologist, of
diagnostic images produced by x-ray or other modalities, including a procedure
for the prompt communication of the radiologist's interpretation to the
facility.
F. A health care facility
shall require all persons, including students, who examine, observe, or treat a
patient or resident of such facility to wear a photo identification badge which
states, in a reasonably legible manner, the first name, licensure/registration
status, if any, and staff position of such person.
G. Health Screening
Upon hire and prior to delivering services, a pre-employment health screening shall be required for each individual who has or may have direct contact with a patient in the freestanding emergency care facility. Such health screening shall be conducted in accordance with the Rules and Regulations Pertaining to Immunization, Testing, and Health Screening for Health Care Workers promulgated by the Department of Health.
9.5.5
Rights of Patients
A. Each FECF
shall observe the standards of R.I. Gen. Laws §
23-17-19.1 with respect to each patient.
B.
Each facility shall display in a conspicuous place in the licensed FECF a copy
of the "Rights of Patients."
9.5.6
Disaster Preparedness
A. Each FECF shall develop and maintain a
written disaster preparedness plan which shall include specific provisions and
procedures for the emergency medical care of patients in the event of an
external disaster or internal functional failure of equipment.
1. Such plan shall be developed in
cooperation with appropriate state and local agencies.
2. A copy of the plan shall be submitted to
the licensing agency.
9.5.7
Administrative Records
A. Each FECF shall maintain such
administrative records as may be deemed necessary by the licensing agency.
These records shall include but not be limited to:
1. Monthly statistical summary of numbers of
patients seen appropriately classified as to the nature of the
conditions;
2. A copy of the long
and short range plans;
3. An
administrative record of log book containing pertinent data such as patient's
name, record number, age, sex, date and time of arrival and discharge, type of
care, diagnosis and disposition, and provider of service; and
4. A record of all transfers to other health
facilities.
9.5.8
Uniform Reporting System
A. Each FECF shall establish and maintain
records and data in such a manner as to make uniform the system of periodic
reporting. The manner in which the requirements of this regulation may be met
shall be prescribed from time to time in directives promulgated by the
Director.
B. Each FECF shall make
available for review upon request of the licensing agency detailed statistical
data pertaining to its operations, services, and facility. Such reports and
data shall be made at such intervals and by such dates as determined by the
Director.
C. The licensing agency
is authorized to make the reported data available to any state or federal
agency concerned with or exercising jurisdiction over the FECF.
D. The directives promulgated by the Director
pursuant to these regulations shall be sent to each FECF to which they apply.
Such directives shall prescribe the form and manner in which the statistical
data required shall be furnished to the licensing agency.
Notes
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