ARC 8465C

ARC 8465C

Proposing rulemaking related to stroke care reporting
and providing an opportunity for public comment

A Regulatory Analysis for this rulemaking was published in the Iowa Administrative Bulletin on October 30, 2024. A public hearing was held on the following date(s):

●November 19, 2024

Any persons who intend to attend a public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Department and advise of specific needs.

ITEM 1.Rescind 641—Chapter 146 and adopt the following new chapter in lieu thereof:

CHAPTER 146

STROKE CARE REPORTING

641—146.1(135) Definitions.

“Comprehensive stroke center” means a hospital certified as a comprehensive stroke center by a nationally recognized certifying body with certification criteria consistent with the most current nationally recognized, evidence-based stroke guidelines related to reducing the occurrence of and disabilities and death associated with stroke.

“Primary stroke center” means a hospital certified as a primary stroke center by a nationally recognized certifying body with certification criteria consistent with the most current nationally recognized, evidence-based stroke guidelines related to reducing the occurrence of and disabilities and death associated with stroke.

“Stroke” means a clinical diagnosis of acute stroke or principal International Classification of Disease, 10th Revision, Clinical Modification (ICD-10-CM) discharge code of “stroke,” or “transient ischemic attack,” or “cerebral infarction,” or “cerebral hemorrhage.”

“Stroke care” means care provided to individuals with confirmed cases of stroke.

641—146.2(135) Stroke care reporting.

146.2(1) Iowa statewide stroke database. The department designates the Get with the Guidelines stroke module of the American Heart Association/American Stroke Association as the Iowa stroke database established in Iowa Code section 135.191.

146.2(2) Who is required to report. All nationally certified comprehensive stroke centers and all nationally certified primary stroke centers operating in the state of Iowa are required to report stroke data. Nationally certified acute stroke-ready hospitals and emergency medical services operating in the state of Iowa are encouraged to report stroke care data.

146.2(3) What is to be reported. Reportable data are those data identified by a clinical diagnosis of acute stroke or by the following ICD-10 coding:

641—146.3(135) Method and frequency of reporting.

146.3(1) Stroke centers shall report the required stroke care information for any reportable stroke case no later than 120 days after the patient was discharged, transferred to another hospital, or pronounced dead.

146.3(2) Reports shall meet the data quality, format, and timeliness standards prescribed by the Iowa statewide stroke database.

641—146.4(135) Confidentiality. The Iowa statewide stroke database will comply with federal and state law and other health information and data collection, storage, and sharing requirements of the department.

641—146.5(135) Penalties and enforcement. If a stroke center reporting under this chapter does not comply with the reporting requirements, the department may request a review of the certification of the comprehensive or primary stroke center by the certifying entity.

These rules are intended to implement Iowa Code section 135.191.