This rule establishes a Patient Safety Surveillance and Improvement program (PSSIP) which extends the past Sentinel Event Reporting program and consists of two components. The first component includes a reportable events program intended to meet public accountability and transparency needs at a state-wide level. The second component uses the data obtained from the reportable events requirement as a foundation intended to develop state-wide patient safety related improvement solutions. The intent of the rule has shifted from reporting rare and egregious events to a system wide surveillance approach which includes the rare and egregious events but also acknowledges other rules that are in effect. It also introduces a harm scale, extends to other licensed facilities and defined both an accountability function, as well as an improvement function. The new rule also makes an annual report mandatory rather than at the discretion of the program.