Current through Register Vol. 46, No. 39, September 25, 2024
(a)
Definitions.
For purposes of this section, the following terms shall
have the following meanings:
(1)
Acuity means the nursing care requirements of patients or
residents.
(2)
Case
mix means the differences in patients or residents within a population
in terms of their physical and mental conditions, and the resources that are
used in their care.
(3)
Fall means:
(i) for general
hospitals, an unplanned descent to the floor with or without injury to the
patient including unassisted and assisted descents whether they result from
physiological or environmental reasons; and
(ii) for nursing homes, an unintentional
change in position coming to rest on the ground, floor or onto the next lower
surface with or without injury to the resident including intercepted
falls.
(4)
Fall
injury level means:
(i) for general
hospitals, the degree of injury resulting from a fall and designated as
moderate, major or fatal. For purposes of this subparagraph: moderate injuries
involve suturing, application of steri-strips/skin glue, splinting or
muscle/joint strain; major injuries involve surgery, casting or traction, or
require consultation to rule out neurological or internal injury or patients
with coagulopathy that receive blood products as a result of the fall; and
fatal falls involve injuries that cause the patient's death but do not include
falls caused by physiologic events; and
(ii) for nursing homes, the degree of injury
resulting from a fall designated as major involves bone fractures, joint
dislocations, closed head injuries with altered consciousness or subdural
hematoma.
(5)
Healthcare setting associated infection means any localized or
systemic patient condition that:
(i) resulted
from the presence of an infectious agent or its toxin(s) as determined by
clinical examination or by laboratory testing; and
(ii) was not found to be present or
incubating at the time of admission unless the infection was related to a
previous admission to the same setting.
(6)
Licensed practical nurse
means a person who is licensed and currently registered as a licensed practical
nurse pursuant to article 139 of the New York State Education Law.
(7) Patient includes a resident of a nursing
home.
(8)
Patient care
staff means unit-based registered nurses, licensed practical nurses
and unlicensed personnel providing direct patient care greater than 50 percent
of their shift.
(9)
Patient
day is the average number of patients a unit has per shift during a 24
hour period.
(10)
Pressure
ulcer means a localized injury to the skin and/or underlying tissue as
a result of pressure or pressure in combination with shear acquired after
admission to a healthcare facility.
(11)
Registered nurse means
a person who is licensed and currently registered as a registered professional
nurse pursuant to article 139 of the New York State Education Law.
(12)
Shift means a 24 hour
period of time as a whole or divided into parts as appropriate to the reporting
facility.
(13)
Unit means a distinct location providing patient care in a
general hospital or nursing home distinguished from other distinct locations by
name, number or other patient-specific factors.
(14)
Unlicensed personnel
means individuals trained to function in an assistive role to nurses in the
provision of patient care, as assigned by and under the supervision of the
registered nurse.
(b)
Nurse staffing indicators are:
(1) the total
number of productive hours of care provided by patient care staff per patient
day for each unit, and the number and percentage of productive hours of care
provided by registered nurses, licensed practical nurses and unlicensed
personnel each; and
(2) the average
registered nurse and licensed practical nurse to patient ratio for each unit
and on each shift.
(c)
Nurse-sensitive patient outcome indicators for general hospitals are:
(1) falls with injury rate as indicated by
the frequency in which falls result in a fall injury level of moderate, major
or fatal per applicable unit calculated no less often than quarterly;
(2) health care acquired pressure ulcers as
indicated by the percentage of patients with facility-acquired pressure
ulcer(s) of the skin that are determined to be stages II, III, IV, unstageable
and suspected deep tissue injury per applicable unit calculated no less often
than quarterly;
(3) healthcare
setting associated infection rates per applicable unit calculated no less often
than quarterly for the following:
(i) central
line associated blood stream infection;
(ii) catheter associated urinary tract
infection; and
(iii) ventilator
associated (pneumonia) event.
(d) Nurse-sensitive patient outcome
indicators for nursing homes are:
(1) percent
of long-stay residents who experienced one or more falls with major
injury;
(2) percentage of
short-stay residents who have medical conditions that predispose them to
developing a facility-acquired pressure ulcer with new or worsening pressure
ulcers Stage II-IV; and
(3)
percentage of long-stay residents with urinary tract health care setting
associated infections.
(e) Within 30 days of a written request,
general hospitals and nursing homes shall provide to the requester in hard copy
or an electronic copy such as a portable document format (pdf) file, the
following information for a three to twelve month period of time that is not
more than one year prior to the date of the request:
(1) nurse staffing indicators and
nurse-sensitive patient outcome indicators specified in this section;
(2) the procedures and processes used for
determining and adjusting staffing levels based on patient case mix and
acuity;
(3) the final conclusions
of any complaint investigations filed with any state or federal regulatory
agency or accrediting agency and any citations resulting from surveys;
and
(4) the sources and dates for
data disclosed.
(f)
Facilities shall have policies and procedures for documentation and management
of requests and responses to requests under this section. Documentation of
requests and responses to requests under this section shall be kept for a
period of no less than two years from the date the request for information was
received.
(g) General hospitals
shall submit information for complying with the reporting requirements of
Public Health Law 2805 t(17)(a)(i), (ii) and (iii), allowing patients and the
public to clearly understand and compare staffing patterns and actual levels of
staffing across facilities. Such information shall be filed with the department
by filling out the General Hospital Clinical Staffing Plan Template using an
electronic reporting system designated by the department
