Rhode Island General Laws
Chapter 23-17 - Licensing of Healthcare Facilities
Section 23-17-12.7. - Adverse change in financial condition.

§ 23-17-12.7. Adverse change in financial condition.
(a) Whenever the department, or the department in consultation with the department of human services, determines that a nursing facility’s financial status is of concern and determines, through inspection of the facility or investigation of a complaint, that incident(s), event(s) or patterns of care exist that harm or have the potential to result in harm or danger to the residents of a facility, the departments, acting jointly, shall convene a meeting, as soon as possible but in no event later than ten (10) days after the finding(s) cited above, with the license holder to communicate the state’s concerns with respect to the operation of the facility. The license holder shall be given the opportunity to respond to the state’s concerns and to offer explanation as to why the concerns are not valid or accurate.
(b) In the event that the explanation provided by the license holder is not found by the department to be adequate or otherwise satisfactory, the department shall direct the license holder to prepare and submit, within ten (10) days of the meeting cited above, or for good cause shown no later than twenty (20) days after said meeting, a plan of correction and remediation for the department’s review and approval, including, but not limited to, the following elements:
(1) Specific targeted improvements;
(2) Definite deadlines for accomplishing those targeted improvements;
(3) Measurable standards that will be used to judge whether the targeted improvements have been accomplished;
(4) A spending plan that supports all costs associated with accomplishment of the targeted improvements;
(5) Monthly reporting of cash availability, the status of vendor payments and employee payrolls, and staffing levels, as metrics concerning financial status and quality of care; and
(6) With regard to concerns regarding resident care, and if directed by the department, a proposal to engage an independent quality monitor or independent quality consultant, to work, in consultation with the facility administrator and medical director, the implementation of the plan of correction and remediation, and to provide progress updates to the department of health.
(c) The department, in consultation with the department of human services, shall adopt regulations to implement this section. The regulations shall incorporate the criteria to measure financial status promulgated by the department of human services pursuant to § 40-8-19.1.
(d) Whenever a facility’s financial status is determined to be marginal, the department shall cause such a facility to be inspected in order to determine if financial problems are causing the facility to be out of compliance with nursing facility regulatory standards.
(e) Whenever a facility is determined to be having severe financial difficulties, the department shall cause the facility to have more frequent inspections and the director may, at the facility’s expense:
(1) Appoint an independent consultant to review the facility’s management and financial status and make recommendations to improve the facility’s financial status; or
(2) Require the hiring of a temporary manager of the facility’s operations.
(f) With the exception of the plan of correction and remediation, as allowed in subsection (g) below, the information obtained by the department under this section is confidential and is not subject to disclosure under § 38-2-2, Access to Public Records. However, upon request, the department shall release the information to the following who shall treat the information as confidential:
(1) The facility;
(2) A person other than the facility if the facility consents in writing to the disclosure;
(3) The state Medicaid agency responsible for rate setting of nursing 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 cause shown, of the submission of the plan of correction and remediation by the facility, the department shall either:
(i) Accept the plan, at which time it shall be considered to be a public record, and the facility shall make it, and all reports that follow and are related to it, available for public inspection, and shall provide a written summary of the plan to each resident of the facility or his or her legal representative, and each resident’s family representative;
(ii) Conditionally accept the plan with modifications made by the department, at which time the plan shall be considered to be a public record and the facility shall make it, and all reports that follow and are related to it, available in accordance with subsection (i) above; or
(iii) Reject the plan, at which time all records acquired in accordance with this section that do not violate resident confidentiality shall be considered to be a public record, and a notice of said plan rejection shall be sent, along with directions on obtaining the complete record to each resident of the facility or his or her legal representative and each resident’s family representative.
(h) The provisions in subsection (e) herein relating to the confidentiality 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 administrative proceeding initiated by the department, including implementing enforcement actions, and in judicial proceedings relating thereto.
History of Section.P.L. 2005, ch. 156, § 3; P.L. 2005, ch. 248, § 3.

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