WSR 14-09-101
[Filed April 22, 2014, 3:15 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 14-02-027.
Title of Rule and Other Identifying Information: Chapter 246-440 WAC, creating a new chapter for healthcare associated infections reporting.
Hearing Location(s): Department of Health, Town Center 2, Room 158, 101 Israel Road S.E., Tumwater, WA 98501, on May 27, 2014, at 9:00 a.m.
Date of Intended Adoption: June 27, 2014.
Submit Written Comments to: Jason Lempp, Healthcare Associated Infections Program, Department of Health, P.O. Box 47811, Olympia, WA 98504-7811, e-mail, fax (360) 236-4245, by May 27, 2014.
Assistance for Persons with Disabilities: Contact Jason Lempp by May 19, 2014, TTY (800) 833-6388 or 711.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed rule establishes a new healthcare associated infections reporting requirement for acute-care hospitals. Acute-care hospitals licensed by the state would be required to report healthcare-associated Clostridium difficile (C. difficile) infections via the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) LabID event method. This will align state and federal requirements.
Reasons Supporting Proposal: HB 1471 (chapter 319, Laws of 2013 PV) requires the department of health to determine if necessary to delete, add, or modify in rules reporting of healthcare associated infections to align state reporting with the reporting categories of the Centers for Medicare and Medicaid Services. C. difficile infections are widespread and a growing problem in hospitals across the nation. They are steadily increasing in Washington state.
Statutory Authority for Adoption: RCW 43.70.056.
Statute Being Implemented: RCW 43.70.056.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of health, governmental.
Name of Agency Personnel Responsible for Drafting: David Birnbaum, 101 Israel Road S.E., Tumwater, WA 98501, (360) 236-4153; Implementation and Enforcement: Marisa D'Angeli, 1610 N.E. 150th Street, Shoreline, WA 98155-7224, (206) 418-5595.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rule would not impose more than minor costs on businesses in an industry. A copy of the statement may be obtained by contacting Ala Mofidi, 101 Israel Road S.E., Tumwater, WA, phone (360) 236-4055, fax (360) 586-7424, e-mail
A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Jason Lempp, 101 Israel Road S.E., Tumwater, WA 98501, phone (360) 236-4249, fax (360) 236-4245, e-mail
April 22, 2014
Jessica Todorovich
Deputy Secretary
for John Wiesman, DrPH, MPH
Chapter  246-440  WAC
WAC 246-440-010 Definitions.
The definitions in this section apply throughout the chapter unless the context clearly requires otherwise.
(1) "Health care-associated infection" means a localized or systemic condition that results from adverse reaction to the presence of an infectious agent or its toxins and that was not present or incubating at the time of admission to the hospital.
(2) "Hospital" means a health care facility licensed under chapter 70.41 RCW.
WAC 246-440-100 Hospital reporting requirements for health care-associated infections.
The purpose of this section is to provide access to data on hospital-specific rates of certain types of health care-associated infection. This type of data provides evidence-based information measures to reduce hospital-acquired infections.
(1) A hospital shall collect data related to health care-associated infections in compliance with RCW 43.70.056. Data must be collected and reported in accordance with the Centers for Disease Control and Prevention National Healthcare Safety Network on:
(a) Central line-associated bloodstream infection in all hospital inpatient areas where patients normally reside at least twenty-four hours;
(b) Surgical site infection for:
(i) Deep sternal wound for cardiac surgery, including coronary artery bypass graft;
(ii) Total hip and knee replacement surgery; and
(iii) Colon and abdominal hysterectomy procedures.
(2) A hospital shall also collect and report data for Clostridium difficile (C. difficile) infections by the Centers for Disease Control and Prevention National Healthcare Safety Network LabID Event method.