A N A C T
RELATING TO HEALTH AND SAFETY --
LICENSING OF HEALTH CARE FACILITIES
It is enacted by the General Assembly as follows:
SECTION 1. Sections 23-17-2, 23-17-19.1 and 23-17-38 of the General Laws in Chapter 23-17 entitled "Licensing of Health Care Facilities" are hereby amended to read as follows:
23-17-2. Definitions. -- As used in this chapter:
(1) "Alzheimer's dementia special care unit or program" means a distinct living environment within a nursing facility that has been physically adapted to accommodate the particular needs and behaviors of those with dementia. The unit provides increased staffing, therapeutic activities designed specifically for those with dementia, and trains its staff on an ongoing basis on the effective management of the physical and behavioral problems of those with dementia. The residents of the unit/program have had a standard medical diagnostic evaluation and have been determined to have a diagnosis of Alzheimer's dementia or another dementia.
(2) (i) "Change in operator" means a transfer by the governing body or operator of a health care facility to any other person (excluding delegations of authority to the medical or administrative staff of the facility) of the governing body's authority to:
(A) Hire or fire the chief executive officer of the health care facility;
(B) Maintain and control the books and records of the health care facility;
(C) Dispose of assets and incur liabilities on behalf of the health care facility; or
(D) Adopt and enforce policies regarding operation of the health care facility.
(ii) This definition is not applicable to circumstances wherein the governing body of a health care facility retains the immediate authority and jurisdiction over the activities enumerated in subdivisions (2)(i)(A) -- (2)(i)(D).
(3) "Change in owner" means:
(i) In the case of a health care facility which is a partnership, the removal, addition, or substitution of a partner which results in a new partner acquiring a controlling interest in the partnership;
(ii) In the case of a health care facility which is an unincorporated solo proprietorship, the transfer of the title and property to another person;
(iii) In the case of a health care facility 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 or two or more corporations, resulting in the creation of a new corporation; or
(D) In the case of a health care facility which is a business corporation, any transfer of corporate stock which results in a new person acquiring a controlling interest in the corporation; or
(E) In the case of a health care facility which is a nonbusiness corporation, any change in membership which results in a new person acquiring a controlling vote in the corporation.
(4) "Director" means the director of the Rhode Island state department of health.
(5) "Health care facility" means any institutional health service provider, facility or institution, place, building, agency, or portion thereof, whether a partnership or corporation, whether public or private, whether organized for profit or not, used, operated, or engaged in providing health care services, including but not limited to hospitals; nursing facilities; home nursing care provider (which shall include skilled nursing services and may also include activities allowed as a home care provider or as a nursing service agency); home care provider (which may include services such as personal care or homemaker services); rehabilitation centers; kidney disease treatment centers; health maintenance organizations; free-standing emergency care facilities, and facilities providing surgical treatment to patients not requiring hospitalization (surgi-centers); hospice care, and physician office settings providing surgical treatment. The term "health care facility" also includes organized ambulatory care facilities which are not part of a hospital but which are organized and operated to provide health care services to outpatients such as central services facilities serving more than one health care facility or health care provider, treatment centers, diagnostic centers, rehabilitation centers, outpatient clinics, infirmaries and health centers, school based health centers and neighborhood health centers; providing, however, that the term "health care facility" shall not apply to organized ambulatory care facilities owned and operated by professional service corporations as defined in chapter 5.1 of title 7, as amended (the "Professional Service Corporation Law"), or to a private practitioner's (physician, dentist, or other health care provider) office or group of the practitioners' offices (whether owned and/or operated by an individual practitioner, alone or as a member of a partnership, professional service corporation, organization, or association). Individual categories of health care facilities shall be defined in rules and regulations promulgated by the licensing agency with the advice of the health services council. Rules and regulations concerning hospice care shall be promulgated with regard to the "Standards of a Hospice Program of Care", promulgated by national hospice organization. Any provider of hospice care who provides such hospice care without charge shall be exempt from the licensing provisions of this chapter but shall meet the "Standards of a Hospice Program of Care." Facilities licensed by the department of mental health, retardation and hospitals, and the department of human services, and clinical laboratories licensed in accordance with chapter 16.2 of this title, as well as Christian Science institutions (also known as Christian Science Nursing Facilities) listed and certified by the Commission for Accreditation of Christian Science Nursing Organizations/Facilities, Inc. shall not be considered health care facilities for purposes of this chapter.
(6) "Homemaker", or however else called, means a trained non-professional worker who performs related housekeeping services in the home for the sick, disabled, dependent, or infirmed, and as further defined by regulation; the director shall establish criteria for training.
(7) "Licensing agency" means the Rhode Island state department of health.
(8) "Medical services" means such professional services and supplies rendered by or under the direction of persons duly licensed under the laws of this state to practice medicine, surgery, or podiatry as may be specified by any medical service plan. Medical service shall not be construed to include hospital services.
(9) "Person" means any individual, trust or estate, partnership, corporation, (including associations, joint stock companies, and insurance companies) state, or political subdivision or instrumentality of a state.
(10) "Physician office setting providing surgical treatment" means an office or portion of an office owned and/or operated by a physician controlled professional service corporation as defined in chapter 5.1 of title 7, as amended (the "Professional Service Corporation Law"), or a private physician's office or group of the physicians' offices (whether owned and/or operated by an individual practitioner, alone or as a member of a partnership, professional service corporation, organization, or association) which is utilized for the purpose of furnishing surgical services to the owner and/or operator's own patients on an ambulatory basis.
(11) "School based health center" means a facility located in an elementary or secondary school that delivers primary and preventive health care services to students on site.
23-17-19.1. Rights of patients. -- Every health care facility licensed hereunder shall observe the following standards and such other standards as may be prescribed in rules and regulations promulgated by the licensing agency with respect to each patient who utilizes the facility:
(1) The patient shall be afforded considerate and respectful care.
(2) Upon request, the patient shall be furnished with the name of the physician responsible for coordinating his or her care.
(3) Upon request, the patient shall be furnished with the name of the physician or other person responsible for conducting any specific test or other medical procedure performed by the health care facility in connection with the patient's treatment.
(4) The patient shall have the right to refuse any treatment by the health care facility to the extent permitted by law.
(5) The patient's right to privacy shall be respected to the extent consistent with providing adequate medical care to the patient and with the efficient administration of the health care facility. Nothing in this section shall be construed to preclude discreet discussion of a patient's case or examination of appropriate medical personnel.
(6) The patient's right to privacy and confidentiality shall extend to all records pertaining to the patient's treatment except as otherwise provided by law.
(7) The health care facility shall respond in a reasonable manner to the request of a patient's physician for medical services to the patient. The health care facility shall also respond in a reasonable manner to the patient's request for other services customarily rendered by the health care facility to the extent the services do not require the approval of the patient's physician or are not inconsistent with the patient's treatment.
(8) Before transferring a patient to another facility, the health care facility must first inform the patient of the need for and alternatives to such a transfer.
(9) Upon request, the patient shall be furnished with the identities of all other health care and educational institutions that the health care facility has authorized to participate in the patient's treatment and the nature of the relationship between the institutions and the health care facility.
(10) If the health care facility proposes to use the patient in any human experimentation project, it shall first thoroughly inform the patient of the proposal and offer the patient the right to refuse to participate in the project.
(11) Upon request, the patient shall be allowed to examine and shall be given an explanation of the bill rendered by the health care facility irrespective of the source of payment of the bill.
(12) Upon request, the patient shall be permitted to examine any pertinent health care facility rules and regulations that specifically govern the patient's treatment.
(13) The patient shall be offered treatment without discrimination as to race, color, religion, national origin, or source of payment.
(14) Patients shall be provided with a summarized medical bill within thirty (30) days of discharge from a health care facility. Upon request, the patient shall be furnished with an itemized copy of his or her bill. When patients are residents of state-operated institutions and facilities, the provisions of this subsection shall not apply.
(15) Upon request, the patient shall be allowed the use of a personal television set provided that the television complies with underwriters' laboratory standards and O.S.H.A. standards, and so long as the television set is classified as a portable television.
(16) No charge shall be made for furnishing a health record or part thereof to a patient, his or her attorney or authorized representative if the record or part thereof is necessary for the purpose of supporting an appeal under any provision of the Social Security Act, 42 U.S.C. section 301 et seq., and the request is accompanied by documentation of the appeal or a claim under the provisions of the Workers' Compensation Act, chapters 29 -- 38 of title 28. A provider shall furnish a health record requested pursuant to this section within thirty (30) days of the request. Further, for patients of school based health centers, the director is authorized to specify by regulation an alternative list of age appropriate rights commensurate with this section.
23-17-38. Establishment of fees. -- The director shall establish fees for licensure application, licensure renewal, inspection and administrative actions under this chapter. Annual inspection fees for hospitals and rehabilitation hospital centers shall be three thousand dollars ($3,000) per facility plus an additional fee of fifteen dollars ($15.00) per bed. Annual licensure fees for health maintenance organizations and for profit end stage renal dialysis facilities shall be three thousand dollars ($3,000) per facility. Annual licensure fees for home nursing care providers and home care providers shall be five hundred dollars ($500) per facility. Annual licensure fees for organized ambulatory care facilities shall be five hundred dollars ($500), provided that not-for-profit entities operating more than one such facility shall be subject to a single annual licensure fee for all such licenses; provided, further, that non-profit charitable community health centers and school based health centers shall be exempt from said fee. All such fees not otherwise designated shall be established in regulation and shall be collected and deposited as general revenues of the state.
SECTION 2. Chapter 23-17 of the General Laws entitled "Licensing of Health Care Facilities" is hereby amended by adding thereto the following section:
23-17-56. School based health centers-special requirements and exceptions. -- (1) In order to apply for and/or maintain a current license as a school based health center, a person must possess a current license as a health care facility pursuant to the provisions of this chapter.
(2) School based health centers shall be exempt from the provisions of sections 23-17-14.3 and 23-17-14.4.
SECTION 3. This act shall take effect upon passage.