§ 23-17-12.7 - Adverse change in financial condition.
SECTION 23-17-12.7
§ 23-17-12.7 Adverse change in financialcondition. – (a) Whenever the department, or the department in consultation with thedepartment of human services, determines that a nursing facility's financialstatus is of concern and determines, through inspection of the facility orinvestigation of a complaint, that incident(s), event(s) or patterns of careexist that harm or have the potential to result in harm or danger to theresidents of a facility, the departments, acting jointly, shall convene ameeting, as soon as possible but in no event later than ten (10) days after thefinding(s) cited above, with the license holder to communicate the state'sconcerns with respect to the operation of the facility. The license holdershall be given the opportunity to respond to the state's concerns and to offerexplanation as to why the concerns are not valid or accurate.
(b) In the event that the explanation provided by the licenseholder is not found by the department to be adequate or otherwise satisfactory,the department shall direct the license holder to prepare and submit, withinten (10) days of the meeting cited above, or for good cause shown no later thantwenty (20) days after said meeting, a plan of correction and remediation forthe department's review and approval, including, but not limited to, thefollowing elements:
(1) Specific targeted improvements;
(2) Definite deadlines for accomplishing those targetedimprovements;
(3) Measurable standards that will be used to judge whetherthe targeted improvements have been accomplished;
(4) A spending plan that supports all costs associated withaccomplishment of the targeted improvements;
(5) Monthly reporting of cash availability, the status ofvendor payments and employee payrolls, and staffing levels, as metricsconcerning financial status and quality of care; and
(6) With regard to concerns regarding resident care, and ifdirected by the department, a proposal to engage an independent quality monitoror independent quality consultant, to work, in consultation with the facilityadministrator and medical director, the implementation of the plan ofcorrection and remediation, and to provide progress updates to the departmentof health.
(c) The department, in consultation with the department ofhuman services, shall adopt regulations to implement this section. Theregulations shall incorporate the criteria to measure financial statuspromulgated by the department of human services pursuant to § 40-8-19.1.
(d) Whenever a facility's financial status is determined tobe marginal, the department shall cause such a facility to be inspected inorder to determine if financial problems are causing the facility to be out ofcompliance with nursing facility regulatory standards.
(e) Whenever a facility is determined to be having severefinancial difficulties, the department shall cause the facility to have morefrequent inspections and the director may, at the facility's expense:
(1) Appoint an independent consultant to review thefacility's management and financial status and make recommendations to improvethe facility's financial status; or
(2) Require the hiring of a temporary manager of thefacility's operations.
(f) With the exception of the plan of correction andremediation, as allowed in subsection (g) below, the information obtained bythe department under this section is confidential and is not subject todisclosure under § 38-2-2, Access to Public Records. However, uponrequest, the department shall release the information to the following whoshall treat the information as confidential:
(1) The facility;
(2) A person other than the facility if the facility consentsin writing to the disclosure;
(3) The state Medicaid agency responsible for rate setting ofnursing facilities;
(4) The state long-term care ombudsman; or
(5) The department of attorney general.
(g) Within ten (10) days, or twenty (20) days for good causeshown, of the submission of the plan of correction and remediation by thefacility, the department shall either:
(i) Accept the plan, at which time it shall be considered tobe a public record, and the facility shall make it, and all reports that followand are related to it, available for public inspection, and shall provide awritten summary of the plan to each resident of the facility or his or herlegal representative, and each resident's family representative;
(ii) Conditionally accept the plan with modifications made bythe department, at which time the plan shall be considered to be a publicrecord and the facility shall make it, and all reports that follow and arerelated to it, available in accordance with subsection (i) above; or
(iii) Reject the plan, at which time all records acquired inaccordance with this section that do not violate resident confidentiality shallbe considered to be a public record, and a notice of said plan rejection shallbe sent, along with directions on obtaining the complete record to eachresident of the facility or his or her legal representative and each resident'sfamily representative.
(h) The provisions in subsection (e) herein relating to theconfidentiality of records do not apply:
(1) To a facility whose license has been revoked or suspended;
(2) To the use of the information in an administrativeproceeding initiated by the department, including implementing enforcementactions, and in judicial proceedings relating thereto.