Potentially Preventable Negative Outcomes
NY-ADR
2/1/12 N.Y. St. Reg. HLT-44-11-00023-A
NEW YORK STATE REGISTER
VOLUME XXXIV, ISSUE 5
February 01, 2012
RULE MAKING ACTIVITIES
DEPARTMENT OF HEALTH
NOTICE OF ADOPTION
I.D No. HLT-44-11-00023-A
Filing No. 38
Filing Date. Jan. 17, 2012
Effective Date. Feb. 01, 2012
Potentially Preventable Negative Outcomes
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:
Action taken:
Addition of section 86-1.42 to Title 10 NYCRR.
Statutory authority:
Public Health Law, section 2807-c(35)
Subject:
Potentially Preventable Negative Outcomes.
Purpose:
Denies additional reimbursement for hospital acquired conditions.
Text of final rule:
Pursuant to the authority vested in the Commissioner of Health by section 2807-c(35) of the Public Health Law, Subpart 86-1 of Title 10 of the Official Compilation of Codes, Rules and Regulations of the State of New York, is amended, by adding a new section 86-1.42, to be effective upon publication of a Notice of Adoption in the New York State Register, to read as follows:
86-1.42 Potentially preventable negative outcomes.
(a) Effective for discharges occurring on or after July 1, 2011, payments pursuant to this Subpart shall be denied with regard to the following potentially preventable negative outcomes if they are acquired during a patient's inpatient stay at the hospital seeking such payments:
(1) A foreign object retained within a patient's body after surgery.
(2) The development of an air embolism within a patient's body.
(3) A patient blood transfusion with incompatible blood.
(4) A patient's development of stage III or stage IV pressure ulcers.
(5) Patient injuries resulting from accidental falls and other trauma, including, but not limited to:
i. Fractures
ii. Dislocations
iii. Intracranial injuries
iv. Crushing injuries
v. Burns
vi. Electric shock
(6) A patient's manifestations of poor glycemic control, including, but not limited to:
i. Diabetic ketoacidosis
ii. Nonketotic hyperosmolar coma
iii. Hypoglycemic coma
iv. Secondary diabetes with ketoacidosis
v. Secondary diabetes with hyperosmolarity
(7) A patient's development of a catheter-associated urinary tract infection.
(8) A patient's development of a vascular catheter-associated infection.
(9) A patient's development of a surgical site infection following:
i. a coronary artery bypass graft – mediastinitis;
ii. bariatric surgery, including, but not limited to, laparoscopic gastric bypass, gastroenterostomy, and laparoscopic gastric restrictive surgery; or
iii. orthopedic procedures, including, but not limited to, such procedures performed on the spine, neck, shoulder and elbow.
(10) A patient's development of deep vein thrombosis or a pulmonary embolism in connection with a total knee replacement or a hip replacement, excluding pediatric patients, defined as patients under eighteen years of age, and also excluding obstetric patients, defined as patients with at least one primary or secondary diagnosis code that includes an indication of pregnancy.
Final rule as compared with last published rule:
Nonsubstantive changes were made in section 86-1.42(a)(5)(vi).
Text of rule and any required statements and analyses may be obtained from:
Katherine Ceroalo, DOH, Bureau of House Counsel, Regulatory Affairs Unit, Room 2438, ESP, Tower Building, Albany, NY 12237, (518) 473-7488, email: [email protected]
Revised Regulatory Impact Statement, Regulatory Flexibility Analysis, Rural Area Flexibility Analysis and Job Impact Statement
Changes made to the last published rule do not necessitate revision to the previously published RIS, RFA, RAFA and JIS.
Assessment of Public Comment
The agency received no public comment.
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