Alaska Administrative Code
Title 7 - Health and Social Services
Part 1 - Administration
Chapter 12 - Facilities and Local Units
Article 10 - Frontier Extended Stay Clinics
7 AAC 12.460 - Periodic program evaluation and quality assurance
Universal Citation: 7 AK Admin Code 12.460
Current through August 30, 2024
(a) At least once each year, a frontier extended stay clinic must evaluate, or arrange for evaluation of, its total program to determine whether
(1) the utilization of services was
appropriate;
(2) established
policies were followed; and
(3) any
changes are needed.
(b) The evaluation required under (a) of this section must include review of
(1) the utilization of clinic services,
including, at a minimum, the number of patients served, the services provided,
and the number of patients who received each service;
(2) all patient care services and other
services affecting patient health and safety; and
(3) the clinic's health care
policies.
(c) The clinic must have an effective quality assurance program to evaluate the quality and appropriateness of diagnoses and treatment provided at the clinic and of treatment outcomes. The quality assurance program must require that
(1) at regular intervals, no less than once
each year, a physician and a mid-level practitioner, either separately or
together, review the records for all patients admitted for an extended stay
during the review period, and the records selected under (2) of this
subsection; the review under this paragraph must include an evaluation of the
appropriateness of the diagnoses and treatment provided, treatment outcomes,
and the accuracy of the records; the physician shall document the review and
any recommendations; the clinic must provide documentation of the review to the
department upon request;
(2) for
the review described in (1) of this subsection, the clinic develop policies and
procedures for the random sampling of medical records for each type of service
provided during the review period in addition to extended stay services; this
sampling must include
(A) at least 25 of
every 1,000 encounters if the number of records for extended stay patients is
less than 2.5 percent of the total encounters during the review period;
or
(B) at least 10 of every 1,000
encounters if the number of records for extended stay patients is 2.5 percent
or more of the total encounters during the review period;
(3) the physician and the mid-level
practitioner conducting a review under this subsection be on the clinic's staff
or under contract with the clinic; and
(4) the clinic staff, after each evaluation
(A) consider the findings and any
recommendations of the medical staff and take corrective action if necessary;
and
(B) document the outcome of any
corrective action.
Authority:AS 47.32.010
AS 47.32.030
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