Ga. Comp. R. & Regs. R. 111-8-22-.09 - Medical Staff and Medical Services
(1) Medical Director. Any medical director
beginning such a function for the first time in Georgia at any facility on or
after July 1, 2002 shall be a licensed physician who is board-certified in
nephrology. However, a physician who has completed a fellowship in nephrology
after July 1, 2002 may direct a dialysis facility in a medically- underserved
area for a maximum of two years provided that the physician obtains board
certification as a nephrologist by the end of the two-year period. Any
physician functioning as a facility medical director at the implementation date
of these rules shall be board-eligible or board-certified in nephrology,
internal medicine, or pediatrics, and shall have at least one year experience
in the care of patients at an end stage renal disease facility.
(a) The medical director shall participate in
the development of all patient care policies at the facility.
(b) The facility shall have mechanisms in
place for communication of essential patient care issues and information to the
medical director.
(c) The medical
director shall be responsible for the daily clinical operations of the
facility, and for the execution of patient care policies and
procedures.
(d) The medical
director shall be permitted to provide direct patient care services at the
facility, in addition to the duties as the medical director.
(2) Medical Services. The medical
director shall ensure that each patient at the facility receives medical care
and supervision appropriate to the patient's dialysis needs.
(a) Each patient shall have an attending
physician who is responsible on a continuing basis for the patient's medical
care. Each patient's records shall clearly indicate the name and contact number
for the patient's physician.
1. The facility
shall require a history and physical examination of each patient following
admission, prior to the development of the patient's care plan, and at least
annually thereafter.
2. The
facility shall require each patient to have a medical plan of care, prescribed
by a physician, to include indicated dialysis or related treatments, dialysis
orders, medications, diet, criteria for discharge and any other special
services needed.
3. The facility
shall require that the patient's physician participates in the development of
the care plan for the patient, and shall assure that the plan for the patient's
medical care is based on the assessment of the patient's individual
needs.
4. The facility shall
require and the medical director shall ensure that the patient's medical
progress at the facility is monitored by a physician on-site at least monthly.
The facility shall require that each patient have a scheduled opportunity to
see a physician at least once per month. Medical patient monitoring and
physician visits shall be documented by progress note entries in the patient's
medical record.
5. The facility
shall require and the medical director shall ensure that any adverse medical
patient outcomes are communicated to the patient's physician, and that the
facility takes appropriate corrective action.
(b) The medical director shall ensure that
there is medical care available at all times for managing emergency situations,
for both in-center and home dialysis patients. There shall be posted at each
nursing/monitoring station a roster of physicians on-call for the provision of
emergency care. The roster shall specify when each physician is available and
how they can be reached.
(c) The
facility shall ensure that each patient, or each patient's responsible party,
is aware of how to access medical care in an emergency, as appropriate to the
patient's age and abilities.
Notes
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No prior version found.