PRINTER'S NO.  2447

  

THE GENERAL ASSEMBLY OF PENNSYLVANIA

  

HOUSE BILL

 

No.

1880

Session of

2011

  

  

INTRODUCED BY ADOLPH, MUNDY, HENNESSEY, DENLINGER, DePASQUALE, SONNEY, BARBIN, BARRAR, BOBACK, CARROLL, COHEN, D. COSTA, DALEY, DAVIDSON, DeLUCA, DiGIROLAMO, DONATUCCI, DUNBAR, FABRIZIO, GALLOWAY, GEORGE, GIBBONS, GINGRICH, GODSHALL, GOODMAN, GROVE, HARHART, HARKINS, HARPER, HESS, HORNAMAN, JOSEPHS, F. KELLER, M. K. KELLER, W. KELLER, KILLION, KORTZ, KOTIK, MARSHALL, MICOZZIE, MILNE, MULLERY, MURPHY, MURT, M. O'BRIEN, PASHINSKI, PETRI, RAVENSTAHL, ROEBUCK, SAINATO, SANTONI, SIMMONS, STERN, THOMAS, WATSON AND YOUNGBLOOD, SEPTEMBER 29, 2011

  

  

REFERRED TO COMMITTEE ON HEALTH, SEPTEMBER 29, 2011  

  

  

  

AN ACT

  

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Amending the act of July 19, 1979 (P.L.130, No.48), entitled "An

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act relating to health care; prescribing the powers and

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duties of the Department of Health; establishing and

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providing the powers and duties of the State Health

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Coordinating Council, health systems agencies and Health Care

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Policy Board in the Department of Health, and State Health

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Facility Hearing Board in the Department of Justice;

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providing for certification of need of health care providers

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and prescribing penalties," providing for professional nurse

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staffing standards.

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The General Assembly of the Commonwealth of Pennsylvania

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hereby enacts as follows:

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Section 1.  The act of July 19, 1979 (P.L.130, No.48), known

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as the Health Care Facilities Act, is amended by adding a

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chapter to read:

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CHAPTER 8-A

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PROFESSIONAL NURSE STAFFING STANDARDS

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Section 801-A.  Scope of chapter.

 


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This chapter relates to professional nurse staffing standards

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in general or special hospitals that will address patient safety

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and the delivery of quality nursing care to patients.

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Section 802-A.  Definitions.

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The following words and phrases when used in this chapter

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shall have the meanings given to them in this section unless the

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context clearly indicates otherwise:

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"Direct patient care."  Care provided by a professional nurse

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with direct responsibility to carry out medical regimens or

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nursing care for one or more patients.

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"Hospital unit."  An area in a hospital where direct patient

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care is provided.

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"Professional nurse."  An individual who holds a license to

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practice professional nursing under the act of May 22, 1951

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(P.L.317, No.69), known as The Professional Nursing Law.

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"Quality measures."  Measures or indicators derived from

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various sources. The term includes, but is not limited to,

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claims and medical records that allow the organization to

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evaluate processes and outcomes of care and nursing sensitive

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indicators endorsed by the National Quality Forum or that are

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part of the National Database for Nursing Quality Indicators.

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"Staffing committee."  The professional nurse staffing

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committee or committees established under section 804-A.

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"Staffing plan."  The professional nurse staffing plan

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established under section 803-A.

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Section 803-A.  Organizational development of professional nurse

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staffing plan.

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A hospital shall develop, implement and monitor a

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professional nurse staffing plan for each hospital unit. The

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development of the plan shall occur internally by a professional

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nurse staffing committee or committees established under section

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804-A.

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Section 804-A.  Professional nurse staffing committees.

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(a)  Establishment.--A hospital shall establish at least one

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professional nurse staffing committee within 60 days of the

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effective date of this section. The committee shall meet at

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least three times each year.

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(b)  Membership.--The majority of the members of a

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professional nurse staffing committee shall be professional

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nurses currently providing direct patient care in the hospital.

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Professional nurses shall be selected by their peers to serve on

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the committee. Hospital and nursing administration and the

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elected chairperson of the professional nurse staffing committee

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may determine other staff to be represented on the committee.

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(c)  Oversight.--The hospital chief nursing officer shall

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ensure that the staffing committee develops a staffing plan for

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each unit and that the plans are evaluated.

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Section 805-A.  Duties and responsibilities of hospital.

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A hospital shall have the following duties and

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responsibilities:

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(1)  Establish the committee required to develop the

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staffing plan prescribed in section 804-A within 60 days of

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the effective date of this section.

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(2)  Provide the education and parameters necessary for

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staff to create a staffing plan given the available resources

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of the hospital so that staff can responsibly develop the

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staffing plan within 120 days of the effective date of this

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section.

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(3)  Adopt the staffing plan in a timeline that mirrors

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the hospital budgetary planning process.

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(4)  Make accessible to all nursing staff the final and

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approved staffing plan for the units in the hospital.

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(5)  Evaluate adherence to the adopted staffing plans no

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less than twice annually.

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(6)  Enlist the assistance of frontline nursing staff,

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appropriate managers and human resources, as necessary, to

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develop and implement a plan of action when there is evidence

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of noncompliance with the staffing plan and the noncompliance

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is negatively impacting patients and nurses.

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(7)  Establish a process by which immediate concerns

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about nurse staffing can be reported and addressed within

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nursing.

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(8)  Develop mechanisms by which nursing staff can raise

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concerns and make recommendations about the unit staffing

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plans either through the existing committee or nursing

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administration, or both.

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(9)  Ensure that the chief nursing officer receives

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periodic reports from the staffing committee in a format

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developed by the hospital to ensure that consistent

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information is captured.

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(10)  Receive reports from other hospital committees,

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including, but not limited to, the patient safety committee

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and quality committee, that may be related to nurse staffing.

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(11)  Provide an annual report to the chief executive

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officer and governing board relating to nurse staffing,

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including, but not limited to, compliance with the approved

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nurse staffing plans and any actions taken to address nurse

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staffing issues.

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(12)  Post notices and use other means to make the

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general public aware that staffing plans will be made

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available upon request. The information shall include how to

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make a request, including the appropriate person, office or

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department that may be contacted to review or obtain a copy

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of the plan.

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(13)  Make available a copy of the relevant staffing plan

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to any person who requests it for a fee not to exceed the

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actual copying costs incurred by the hospital.

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(14)  Prohibit any retaliatory action against a

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professional nurse for reporting a violation of this chapter

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in accordance with the act of December 12, 1986 (P.L.1559,

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No.169), known as the Whistleblower Law, and section 307(4)

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of the act of March 20, 2002 (P.L.154, No.13), known as the

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Medical Care Availability and Reduction of Error (Mcare) Act.

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Section 806-A.  Duties and responsibilities of committees.

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The committee shall have the following duties and

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responsibilities:

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(1)  Develop a plan prescribed in section 803-A within

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120 days following the effective date of this section.

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(2)  Establish a professional nurse staffing plan for

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each hospital unit.

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(3)  Elect a chairperson from within the committee who is

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a professional nurse that provides direct patient care.

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(4)  Develop a staffing plan that takes into

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consideration variables that can influence the staffing plan

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for that hospital unit. The variables include, but are not

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limited to, the following:

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(i)  The special skills and competencies required by

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the nursing staff in that hospital unit to provide care

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to the hospital unit's patient population to ensure the

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delivery of quality care and quality outcomes.

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(ii)  Staffing standards recommended by nationally

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recognized professional nursing organizations,

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particularly those that address professional standards of

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care for the selected patient population.

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(iii)  Staff skill mix, specialty certification and

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years of experience.

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(iv)  The numbers and types of other professional,

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paraprofessional or support staff that nurses must

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collaborate with or supervise to ensure the delivery of

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quality care and quality outcomes.

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(v)  Patient volume, patient acuity, nursing care

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intensity and patient turnover and throughput issues that

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can affect the numbers and types of staff required for

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the patient population in a hospital unit.

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(vi)  The time needed to complete various key nursing

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tasks, including, but not limited to, surveillance,

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patient assessment, patient education and discharge

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planning.

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(vii)  The physical environment in which care is

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provided, including, but not limited to, the physical

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architecture of each hospital unit, patient location and

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available technology of the health care facility.

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(5)  Ensure that the plan contains information informing

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professional nurses how to report concerns about

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noncompliance with the staffing requirement of the plan to a

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person designated by the committee. If, after investigation

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and consideration by the committee or other hospital and

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nursing administration, the issue is not resolved, the nurse

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who raised the concern may file a complaint with the

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department.

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Section 807-A.  Powers and duties of the department.

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For purposes of this chapter, the department may:

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(1)  Adopt and promulgate any regulations it deems

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necessary to carry out the purposes and provisions of this

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chapter.

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(2)  Review and investigate as it deems necessary any

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reported violations of this chapter.

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(3)  Impose an administrative penalty of $1,000 per day

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upon any hospital not in compliance.

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(4)  Ensure confidentiality of reports in accordance with

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the act of June 10, 2009 (P.L.1, No.1), known as the

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Preventable Serious Adverse Events Act.

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Section 2.  This act shall take effect in 60 days.

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