Quality Measurement and Reporting

Rhode Island has implemented the following quality measurement and reporting provisions:

• The director of health may assign, or require a nursing facility to obtain, an independent quality monitor.1
• The department of health must create “a data modeling or other capacity to use quality data already collected from nursing facilities to detect patterns of high performance and/or potential deficiency(ies) affecting resident care.”2
• Licensed nursing facilities must create a quality improvement program, quality improvement committee, and a quality improvement plan.3
• Licensed hospitals and their insurance carriers must create an “internal risk management program” that, among other functions, monitors the quality or care.4
• Licensed health care facilities must meet “state-approved quality assurance standards” when performing mammograms.5
• The director of health may establish quality standards for volume related tertiary services.6
• All assisted living residences must create a “documented, ongoing quality assurance program.”7
• The director of health must “develop a state health care quality performance and reporting program” for the purpose of measuring and reporting on the quality of Rhode Island health care facilities.8 The quality performance measurement and reporting program must include the periodic reporting of (1) standardized and risk-adjusted clinical performance measures; and (2) “statistically valid patient satisfaction measures.”9 The director will use the reported data publish a public report that compares facility performance.10
• The director of the department of health must create a “unified health care quality and value database” that will help, among other functions, identify health care needs and evaluate the impact of interventions on patient outcomes.11
• HMOs must establish a quality assurance program to assess the quality of health care services provided to subscribers.12
• Nursing home patients “shall be encouraged and assisted to voice their grievances through a document grievance mechanism established by the facility….”13