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182-550-2531  <<  182-550-2541 >>   182-550-2551

Quality of careAgency-approved acute PM&R hospital.

(1) To ensure quality of care, the medicaid agency may conduct reviews (e.g., post-pay, on-site) of any agency-approved acute PM&R hospital.
(2) A provider of acute PM&R services must act on any report of substandard care or violation of the hospital's medical staff bylaws and CARF standards. The provider must have and follow written procedures that:
(a) Provide a resolution to either a complaint or grievance or both; and
(b) Comply with applicable CARF standards for adults or pediatrics as appropriate.
(3) A complaint or grievance regarding substandard conditions or care may be investigated by any one or more of the following:
(a) The department of health (DOH);
(b) The joint commission on accreditation of health care organizations (JCAHO);
(c) CARF;
(d) The agency; or
(e) Other agencies with review authority for the medicaid agency's programs.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 15-18-065, § 182-550-2541, filed 8/27/15, effective 9/27/15. WSR 11-14-075, recodified as § 182-550-2541, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090 and 74.09.500. WSR 07-12-039, § 388-550-2541, filed 5/30/07, effective 8/1/07. Statutory Authority: RCW 74.08.090, 74.09.520 and 42 C.F.R. 482.56. WSR 03-06-047, § 388-550-2541, filed 2/28/03, effective 3/31/03. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 99-17-111, § 388-550-2541, filed 8/18/99, effective 9/18/99.]