Current through Register No. 40, October 3, 2024
(a) The department
shall investigate a complaint against a licensed, non-CMS certified hospital
when there is sufficient specific information for the department to determine
that the allegation(s), if proven to be true, would constitute a violation of
any of the provisions of RSA 151 or He-P 802.
(b) The bureau of licensing and certification
shall refer for investigation to the department's health facilities
administration-certification unit or to the accrediting organization, as
appropriate, any complaint against a CMS certified hospital that meets the
following conditions:
(1) There is sufficient
specific information to determine that if the allegation(s) were proven to be
true, a violation would be determined to exist of the applicable requirements
at 42 CFR 482, 42 CFR 485, 42 CFR 489, or the CMS, "Life Safety Code &
Health Care Facilities Code Requirements" (2017 update)
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/LSC,
as available and noted in Appendix A; and
(2) Investigations shall be conducted in
accordance with CMS Publication #100-07, "State Operations Manual",
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/CMS1201984,
including Chapter 5-Complaint Procedures, and applicable appendices, as
available and noted in Appendix A.
(c) For complaints alleging violations of RSA
151 or He-P 802, the department shall:
(1)
Provide written notification of the results of the investigation to the
licensee along with an inspection report if deficiencies were found as a result
of the investigation;
(2) Notify
any other federal, state or local agencies of alleged violations of their
statutes or rules based on the results of the investigation, as
appropriate;
(3) Notify the
licensee in writing and take no further action if the department determines
that the complaint is unfounded or does not violate any statutes or rules; and
(4) Require the licensee to submit
a POC in accordance with
He-P 802.12(c)
if the inspection results in deficiencies
being cited.
(d)
Investigations shall include all techniques and methods for gathering
information which are appropriate to the circumstances of the complaint,
including:
(1) Requests for additional
information from the complainant;
(2) A physical inspection of the premises;
(3) Review of any records that
might be relevant and have probative value;
(4) Interviews with individuals who might
have information that is relevant to the investigation and might have probative
value; and
(5) Any other relevant
investigative techniques.
(e) For complaints regarding an unlicensed
individual or entity:
(1) The department
shall provide written notification to the owner or person responsible that
includes:
a. The date of inspection;
b. The reasons for the inspection;
and
c. Whether or not the
inspection resulted in a determination that the services being provided require
licensing under RSA 151;
(2) The owner or person responsible shall be
allowed 7 days from the date of receipt of the notice required by (1) above to
respond to a finding that they are operating without a license or submit a
completed application for a license in accordance with
RSA 151:7-a,
II;
(3) If the owner of an unlicensed hospital
does not comply with (2) above, or if the department does not agree with the
owner's response, the department shall:
a.
Issue a written warning to immediately comply with RSA 151 and He-P 802;
and
b. Provide notice stating that
the individual has the right to appeal the warning in accordance with
RSA 151:7-a,
III; and
(4) Any person or entity who fails to comply
after receiving a warning, as described in (3)
a. above, shall be subject to an action by
the department for injunctive relief under
RSA 151:17. Whether or
not the department takes action for injunctive relief under
RSA 151:17 shall not
preclude the department from taking other action under RSA 151, He-P 802, or
other applicable laws.
(f) Complaint investigation files shall:
(1) Be confidential in accordance with
RSA
151:13;
(2) Not be disclosed publicly; and
(3) Be released by the department on written
request only:
a. To the department of justice
when relevant to a specific investigation;
b. To law enforcement when relevant to a
specific criminal investigation;
c.
When a court of competent jurisdiction orders the department to release such
information; or
d. In connection
with any adjudicative proceedings relative to the licensee.
#2044, eff 6-3-82; ss by #3193, eff 1-28-86, EXPIRED:
1-28-92; ss by #5317, EMERGENCY, eff 1-29-92, EXPIRED 5-28-92
New. #5846, eff 6-22-94,
EXPIRED: 6-22-00
New. #9580, eff
10-24-09
