NAC695C.400. Requirements; written description of action plan; staff; periodic review of program.

     1. Each organization shall establish a quality assurance program which consists of a method for analyzing the outcomes of health care, peer review, the collection of health care data and appropriate recommendations for remedial action.

     2. The program must be designed to direct, evaluate and monitor the effectiveness of the health care provided by the organization.

     3. The organization shall maintain a written description of its program which describes the specific actions that will be taken to ensure that the quality of health care provided to members is adequate and the personnel responsible for such actions. The actions may consist of a particular study or methodology for determining the quality of health care.

     4. The organization shall inform each provider of health care of the organization of the manner in which the quality assurance program operates.

     5. The organization shall provide the necessary staff to implement the program and evaluate the effectiveness of the program.

     6. The organization is responsible for all activities conducted pursuant to the quality assurance program regardless of whether the organization performs the activity or the activity is delegated to another entity.

     7. Not less than annually, the organization shall review the continuity and effectiveness of the program and any proposed findings of the quality assurance committee. The organization shall take such actions as necessary to improve the program.

     (Added to NAC by Bd. of Health, eff. 11-1-95)