Code of Massachusetts Regulations
243 CMR - BOARD OF REGISTRATION IN MEDICINE
Title 243 CMR 3.00 - The Establishment Of And Participation In Qualified Patient Care Assessment Programs, Pursuant To M.G.L. c. 112, Section 5, and M.G.L. c. 111, Section 203
Section 3.02 - Definitions

Board: The Board of Registration in Medicine, including, but not limited to, its Data Repository, Disciplinary Unit, Patient Care Assessment Unit, Legal Unit, Licensing Unit, and its agents and employees.

Disciplinary Action: Please see 243 CMR 1.01(2).

Governing Body: the trustees, governing board or other persons responsible for establishing policy, maintaining quality patient care and providing for institutional management and planning at a health care facility.

Health Care Facility: any entity licensed pursuant to M.G.L. c. 111, § 51; any nursing home, within the meaning of M.G.L. c. 111, § 203(d); any state, county or municipal hospital; any entity maintaining more than one primary or episodic walk-in center; and any health maintenance organization within the meaning of M.G.L. c. 176G, § 1. The application of 243 CMR 3.00 to nursing homes and health maintenance organizations is limited as per 243 CMR 3.13 and 3.14.

Health Care Provider: As defined under M.G.L. c. 111, § 1, any doctor of medicine, osteopathy, or dental science, or a registered nurse licensed under the provisions of M.G.L. c. 112, or an intern, resident, fellow, or medical officer licensed under M.G.L. c. 112, a medical student, or a hospital, clinic or nursing home licensed under the provisions of M.G.L. c. 111 or a health maintenance organization within the meaning of M.G.L. c. 176G, § 1, and its licensed health professionals with employment, practice, association or privileges.

Licensee: a person holding any type of license issued pursuant to M.G.L. c. 112, §§ 2 through 9B.

Medical Peer Review Committee: consistent with M.G.L. c. 111, § 1, a committee of a state or local professional society of health care providers or of a medical staff of a licensed hospital, nursing home, or other health care facility, provided the medical staff operates pursuant to written by-laws that have been approved by the governing board of the hospital, nursing home, or other health care facility, which committee has as its function the evaluation or improvement of the quality of health care rendered by providers of health care services, the determination whether health care services were performed in compliance with the applicable standards of care, determination whether the cost of health care services rendered was considered reasonable by the providers of health services in the area, the determination of whether a health care provider's actions call into question such health care provider's fitness to provide health care services, or the evaluation and assistance of health care providers impaired or allegedly impaired by reason of alcohol, drugs, physical disability, mental instability or otherwise.

Patient Care Assessment Committee: a medical peer review committee, as defined by 243 CMR 3.02, and consistent with M.G.L. c. 111, §§ 1 and 204, that is created by the bylaws at the governing body level of a health care facility and which includes among its members not less than one governing body member, and other senior personnel essential to the quality of patient care, for example, higher level nursing administrators.

Patient Care Assessment Coordinator: a qualified physician or non-physician designated by a health care facility to implement and coordinate the facility's Qualified Patient Care Assessment Program established pursuant to 243 CMR 3.00. To be qualified, the Patient Care Assessment Coordinator shall evidence by education, training or experience the ability to carry out the functions and activities of the Patient Care Assessment Program. In lieu of appointing a single Patient Care Assessment Coordinator, the governing body of a health care facility may designate a committee to carry out the Patient Care Assessment Coordinator's functions as enumerated in 243 CMR 3.00. Thus, upon election of the health care facility's governing body, all references to Patient Care Assessment Coordinator may include Patient Care Assessment Committee.

Qualified Patient Care Assessment Program: A health care facility's rules, standards and procedures, adopted pursuant to the facility's bylaws (unless otherwise required by statute), designed to establish effective programs in quality assurance, risk management, peer review, identification and prevention of substandard practice, and maximization of patient care assessment and thus minimization of loss, and which meet or exceed the rules, procedures and standards set forth in 243 CMR 3.00. A Qualified Patient Care Assessment Program is a "risk management program" established by the Board of Registration in Medicine pursuant to M.G.L. c. 111, § 203(d) and recognized as a "risk management program" within the meaning of M.G.L. c. 112, § 5.