WSR 14-02-027
[Filed December 20, 2013, 2:38 p.m.]
Subject of Possible Rule Making: Title 246 WAC, adding a new chapter for healthcare associated infections (HAI) reporting.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 43.70.056 (amended in 2013 by HB 1471).
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The department is considering establishing rules for HAI reporting and requiring reporting of Clostridium (C.) difficile. RCW 43.70.056 allows the department to adopt rules to require statewide reporting in alignment with reporting categories of the Centers for Medicare and Medicaid Services (CMS). CMS introduced reporting of C. difficile through the National Healthcare Safety Network (NHSN) starting January 2013. This disease is a widespread and growing problem in hospitals across the nation and in Washington state. The number of fatalities associated with this disease has been steadily increasing. Requiring reporting will provide the department information about frequency and severity trends.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: CMS includes C. difficile in its list of pay-for-reporting incentive program categories; the department monitors and influences that CMS list through participation in a Council of State and Territorial Epidemiologists subcommittee, and the Centers for Disease Control and Prevention (CDC) NHSN program. CDC administers the NHSN system and associated conditions of participation through which hospitals report. Since 2008, the department administers the Washington state hospital reporting group in NHSN and works directly with CDC. The rule will align with the CMS and CDC specifications for C. difficile.
Process for Developing New Rule: Collaborative.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication. The department intends to hold a C. difficile information meeting prior to a public hearing. Comments may be submitted by phone or e-mail as indicated on the HAI public information web site ( Contact Jason Lempp at (360) 236-4249 or e-mail
December 17, 2013
Jessica Todorovich
Deputy Secretary
for John Wiesman, DrPH, MPH