Managing Healthcare Compliance in Rhode Island

Sarah Jones
Outline of Rhode Island over a healthcare photo

Healthcare compliance in Rhode Island consists of specific rules and regulations, some of which are shared with other states and some are unique to Rhode Island. Certificate of Need (CON) requirements and surgical smoke evacuation laws are just two examples of the state’s dynamic regulatory landscape. Healthcare providers and organizations must maneuver through these compliance requirements with accuracy and efficiency, all while side-stepping the costly consequences of non-compliance. 

For successful compliance management, healthcare entities in Rhode Island need to develop a strong framework for tracking and understanding evolving regulations, and quickly adapt to any required changes. This article serves as a primer, highlighting crucial information you need to know about healthcare compliance in Rhode Island.

Rhode Island Healthcare Compliance Resources

Let’s start with the important state government agencies you’ll need to work with:

  • The Rhode Island Department of Health (RIDOH) is the state’s primary agency dedicated to protecting and promoting the health and safety of Rhode Islanders through a range of public health services and regulatory oversight.
  • The Hospital Association of Rhode Island (HARI) is a nonprofit organization that represents and advocates for the interests of hospitals in Rhode Island, working to improve healthcare quality and accessibility.
  • The Rhode Island Executive Office of Health and Human Services (EOHHS) oversees the state’s integrated health and human services system, focusing on providing a range of services from healthcare to assistance for families and individuals in need.
  • The Physicians Licensing division within the RIDOH is responsible for the licensing and regulation of medical professionals in the state, ensuring they meet necessary standards for practice.
  • The Marriage, Family and Mental Health Therapy Licensing division within the RIDOH manages the licensing and regulatory standards for professionals in these specific therapy fields, ensuring quality mental health services for the community.

These agencies help maintain the integrity and quality of healthcare services in Rhode Island, protecting the public and promoting patient safety. The resources provided by these Rhode Island state agencies are essential for promoting public health, ensuring access to healthcare, supporting healthcare professionals, and enhancing overall health outcomes for the residents of Rhode Island.

Regulations Unique to Rhode Island

To meet the standards of healthcare compliance in Rhode Island, there are a few additional regulations. For example, the state’s surgical smoke evacuation law aims to protect healthcare professionals involved with surgery, including nurses, doctors, and technologists. The law must be adhered to by certain facilities in order to maintain compliance. 

Surgical Smoke Evacuation Law

A regulation shared by only a handful of states, including Rhode Island, is the surgical smoke evacuation requirement. With more than 500,000 healthcare workers exposed to surgical smoke across the United States every year, Rhode Island was the first state to pass legislation to address the issue. Regulations mandate all licensed hospitals and ambulatory surgery centers (ASCs) to establish smoke evacuation system policies for surgical procedures that generate plume. Understanding the requirements of this law are essential to compliance officers tasked with building policies in alignment with state requirements.

Certificate of Need Required

In Rhode Island, the Certificate of Need (CON) regulations, effective January 30, 2024, require substantial construction and expansion projects to undergo review by the Department of Health. This includes the establishment of new nursing facilities. Further, nursing facilities granted a CON must submit their construction plans for review by various divisions, including the Center for Health Facilities Regulation and the Division of Fire Safety, as outlined in R.I. General Laws Chapter 23-1.

Tips To Manage Healthcare Compliance in Rhode Island

Effectively managing healthcare compliance in Rhode Island is a critical responsibility for healthcare organizations, as it ensures the delivery of high-quality care while adhering to legal and regulatory requirements. Here are some key strategies to help healthcare organizations manage compliance effectively:

  • Conduct State-Specific Training: Provide ongoing training and education to staff that is customized to your state’s regulations as well as your facility. If using a learning management system, ensure the vendor offers Rhode Island-approved training.
  • Organize Policies By Requirement: Including “RI” in every document that is required by the state will make it much easier for you to find these documents in an online system when a surveyor is onsite. It is also best practice to include the standard you are meeting for additional clarity.
  • Establish a System for Monitoring Risk: Being able to identify compliance risks before they become incidents or violations can save the entire organization time and money. Identifying trends and consistently reviewing reports can signal issues, such as training not being completed or a large number of incidents in one location.
  • Use Compliance Management Software: Accreditation surveyors say organizations that use compliance software are more prepared for onsite visits and surveys. The software helps to keep documents and policies organized, ensures training content is up to date, and makes reporting easy.

By implementing these strategies and fostering a culture of compliance within your healthcare organization, you can effectively manage healthcare compliance, reduce risks, and provide the best possible care to your patients while staying within legal boundaries.

Credentialing Compliance in Rhode Island

Rhode Island’s medical credentialing process, detailed in its General Laws, includes unique provisions for healthcare providers. Healthcare entities or plans must decide on credentialing applications within 45 days of receiving a complete submission. Minor updates by already credentialed providers, like address changes, are processed within seven business days. Entities are required to clearly define for providers and credentialers, what a complete application entails and must provide regular updates to applicants. Notably, the state allows transitional or conditional approval for resident graduates, effective upon graduation, provided their application is complete, resulting in a smoother transition into professional practice.

Meet Rhode Island Compliance Requirements With MedTrainer 

While the path may be complex, healthcare providers who prioritize compliance will not only avoid legal troubles but also enhance the quality of care they provide to their patients in Rhode Island

MedTrainer’s all-in-one compliance platform can streamline management of Rhode Island healthcare compliance. MedTrainer seamlessly consolidates your organization’s policies, incident reports, safety plans, HR documents, contracts, and more. This centralized repository ensures all employees have easy access to essential information. The course library is curated to align with regulatory and accreditation requirements, and courses are regularly added and updated to ensure the most current information. Learn more about MedTrainer today!