Summary of Facility Participation in States's
Incident and Outcomes Reporting Programs

Hospitals compose the largest group of facilities/entities that are targeted to provide and report data. Among the 32 States with some form of reporting program, 30 States have some form of hospital reporting. Among these 32 States, only New Mexico and North Carolina have no hospital reporting options. Reporting Options by hospitals are detailed in the table below.

TYPES OF HOSPITAL REPORTING State Incident Reporting Non-cardiac Outcomes Cardiac Outcomes Other 1. CA X X X X 2. CO X X – – 3. CT X – – – 4. FL X – – – 5. GA X – – – 6. IL X X – – 7. IN X – – – 8. KS X – – – 9. ME X X – – 10. MD X – – – 11. MA X – X – 12. MN X – – – 13. NE X – – – 14. NV X – – – 15. NJ X – X – 16. NM – – – – 17. NY X X X – 18. NC – – – – 19. OH – X X – 20. OR X – X – 21. PA X X X – 22. RI X X X – 23. SC X – – – 24. SD X – – – 25. TN X – – – 26. TX X X – – 27. UT X – – – 28. VA – – X – 29. WA X – – – 30. WV X – – – 31. WI – – – X 32. WY X – – – TOTALS 27 25 9 9 2 X  = States (KS, NE) that report physicians only and that have been misclassified historically as incident reporting programs

• ◊  Mixed Classification of Hospitals

  A hospital in one state is not necessarily a hospital in another State.

  Most States require licensure and recertification based on inspection and maintenance of quality standards, whereas some States like Ohio in abandoning Certificate of Need (CON) have no licensure requirement, except for 6 categories of freestanding health facilities. Consequently, Ohio government has no authority to mandate hospital incident reporting programs, (although the legislature provided that selected hospital sub-specialty services are subject to quality review via outcomes reporting).

  More commonly the differences among States is simply related to how the States choose to classify health facilities. Dissimilar classifications across States are common. Some examples include:

  • √  MARYLAND – Maryland's statute MD Health-General Code §19.307 hospital classification includes four distinct types of hospitals: General hospitals, Special Hospitals (e.g., Orthopedic, Mental Health/Psychiatry, Children's hospitals, etc.), Special Rehabilitation Hospitals, and Limited services hospitals (e.g., Critical Access Hospitals).
  • √  FLORIDA – In defining licensed facilities that must report in its incident reporting program, a Florida hospital "regularly makes available at least clinical laboratory services, diagnostic X-ray services, and treatment facilities for surgery or obstetrical care, or other definitive medical treatment of similar extent.." By this definition, certain specialty hospitals and rehabilitation hospitals defined as hospitals in Maryland are not hospitals in Florida.
  • √  MINNESOTA – Minnesota law does not segregate hospitals nor provide definitions for subtypes of hospitals so that there is no designation in law for any specialized hospitals, including Psychiatric Hospitals.
  • √  PENNSYLVANIA – Pennsylvania law includes rehabilitiation facilities, but specifically excludes Psychiatric Hospitals from inclusion as "hospitals." Indiana similarly excludes any psychiatric hospital as a type of hospital.

  Therefore, States agree that general acute hospitals meet the definition of "hospitals," there is lack of agreement as to what specialty hospitals (if any) are included as hospitals.

• ◊  Incident Reporting Hospitals

  The 28 Incident Reporting program States, 27 of which have hospital participation, are discussed in greater detail in the national Overview, Part III. Of all States incident reporting programs, only New Mexico has no hospital incident reporting. The hospital participants in this group includes

  • √  21 States with a single mandatory program,
  • √  1 state with 2 mandatory programs (Massachusetts),
  • √  1 State with both voluntary and mandatory reporting programs (Georgia),
  • √  2 States with voluntary programs (Oregon, West Virginia), and
  • √  2 States that have been historically misclassified as incident reporting states (Nebraska, Kansas).¹

  Therefore, 25 States have HOSPITAL incident reporting programs.

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  ¹   Kansas and Nebraska are not true incident reporting programs, although both States have been referenced in literature as having adverse event reporting programs.² They are more properly termed "physician reporting" programs since only a physician must be reported. In Kansas, the "reportable incident" is "an act by a health care provider," while Nebraska administrative rules require reporting of "gross Incompetence or a pattern of negligent conduct," whether associated with an adverse event or not. Neither State provides lists or definitions of incidents that might qualify as reportable events in State laws or regulations.

  ²   Rosenthal J and Booth M, "Defining Reportable Adverse Events: A Guide for States Tracking Medical Errors," National Academy for State Health Policy, GNL50; March 2003. [PDF, p6]

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• ◊  Outcomes Reporting Hospitals

  Unlike most incident reporting programs, outcomes reporting is usually published by facility or provider, as designated by State laws or rules.

  The 13 Outcomes Reporting program States are discussed in greater detail in the national Overview, Part IV. With one exception (Virginia), these 13 States with some form of outcomes reporting also have mandatory or voluntary (Oregon) incident reporting programs. 5 States have more than one type of outcome reporting, as listed below, and California and Pennsylvania have more than one non-cardiac outcome reporting program.

  TYPES OF HOSPITAL OUTCOME REPORTING
  State		AHRQ IQIs	Non-cardiac Outcomes	Cardiac Outcomes Reporting
  				Facility Only	Facility & Physician
  1.	CA	–	X	–	X
  2.	CO	X	–	–	–
  3.	IL	–	X	–	–
  4.	ME	X	–	–	–
  5.	MA	–	–	X	–
  6.	NJ	–	–	–	X
  7.	NY	X	–	–	X
  8.	OH	–	X	X	–
  9.	OR	–	–	X	–
  10.	PA	–	X	–	X
  11.	RI	–	X	X	–
  12.	TX	X	–	–	–
  13.	VA	–	–	X	–
  TOTALS		4	5	5	4

• ◊  Hospitals with Other Reporting

  The 3 States with ‘Other’ reporting programs that are not incident reporting or outcomes reporting programs are discussed in greater detail in the national Overview, Part V. Two of these programs (California and Wisconsin) require reporting by hospitals. Wisconsin's voluntary and privately-supported CheckPoint program for reporting of hospital compliance with JCAHO National Patient Safety Goals is the sole reporting program in Wisconsin for hospitals. California's medication-error reporting is a mandatory reporting program that provides multiple options via which to achieve compliance.