There is some confusion as to what facilities must report adverse events to the Kansas DHE Bureau of Facilities. According to K.S.A. 65-4922, participation is mandatory for “each medical care facility.” As defined in K.S.A.65-4921(e), participating institutions include "medical care facilities," which
"means: (1) A medical care facility licensed under K.S.A. 65-425 et. seq. and amendments thereto; (2) a private psychiatric hospital licensed under K.S.A. 75-3307b* and amendments thereto; and (3) state psychiatric hospitals and state institutions for the mentally retarded, as follows: Larned state hospital, Osawatomie state hospital, Rainbow mental health facility, Kansas neurological institute and Parsons state hospital and training center."
According to K.S.A. 65-425(h), "medical care facility"
"means a hospital, ambulatory surgical center or recuperation center, but shall not include a hospice which is certified to participate in the medicare program under 42 code of federal regulations, chapter IV, section 418.1 et seq. and amendments thereto and which provides services only to hospice patients."
Therefore, these laws suggest that participating facilities include:
- ◊ hospitals,
- ◊ ambulatory surgical centers (ASCs),
- ◊ recuperation centers
- ◊ private psychiatric hospitals
- ◊ state psychiatric hospitals (Larned state hospital, Osawatomie state hospital, Rainbow mental health facility, Kansas neurological institute, and Parsons state hospital and training center)
* "all psychiatric hospitals, community mental health centers or facilities for the mentally retarded and facilities serving other handicapped persons receiving assistance through the department of social and rehabilitation services."
Regulations requiring risk managment have been established only for hospitals [K.A.R. 28-52-1 through K.A.R. 28-52-4] and Ambulatory Surgical Centers (K.A.R. 28-34-50 through K.A.R. 28-34-62 – [PDF]). In the ASC regulations, separate detail regarding ‘reportable incidents’ is not provided, but there is reference to the ‘Medical Care Facilities’ regulations [K.A.R. 28-52-1 through 28-52-4].
Contradicting these regulation-directed reporting requirements is a report from the KDHE appearing in Kansas Health Statistics Volume 1, No. 1, August 2000 [PDF, p6], which appears to reference KDHE information appearing in a NASHP report as its source:
"In To Err is Human, the Institute of Medicine reported on the high number of medical errors and adverse events that occur in the U.S. health care system each year. As a follow up, the National Academy for State Health Policy surveyed states on how they were addressing the issue. The academy details its findings in a copyrighted report, State Reporting of Medical Errors and Adverse Events: Results of a 50-State Survey."1
. . .
"Kansas is one of the 15 states with a mandatory reporting law. Hospitals are the only entities required to report, with no reporting requirement for labs, home health agencies, pharmacies, individual health professionals and outpatient mental health centers. Long term care facilities must report adverse events under nursing home licensing requirements."
On first glance, this statement from the KDHE is contrary to language in its own regulations that require reporting from ASCs, psychiatric centers, etc., but it may reflect the reality of Kansas reporting in 2000.
The Risk Management Quarterly Report Form [PDF] suggests, however, that the NASHP article is in error and that the form should be completed by all medical facilities. This quarterly form provide facilities with an opportunity to report all medical error and patient safety activity including a summary of all the incident reports that were filed and the number of corrective actions taken against providers, listed by reporting agency, which include hospitals, psychiatric hospitals, ambulatory care centers, and "Other" facilities.
1 "Rosenthal J, Riley T, Booth M, "Medical Errors and Adverse Events: A Report of a 50-State Survey ," National Academy for State Health Policy, GNL31; April 2000. [PDF]