Critical Access Hospital.
1. Every patient may be under the care of a
physician or under the care of a practitioner supervised by a
2. Whenever a patient is
admitted to the facility by a practitioner, the supervising physician shall be
notified of that fact, by phone or otherwise, and within 24 hours the
supervising physician shall examine the patient or before discharge if
discharged within 24-hours, and a plan of care be placed in the patient's
chart, unless the patient is transferred to a higher level of care within
3. A physician, a
practitioner or a registered nurse shall be on duty and physically available in
the facility when there are inpatients.
A physician on staff shall:
(i) Provide medical direction to the
facility's health care activities and consultation for non-physician health
(ii) In conjunction
with the practitioner staff members, participate in developing, executing, and
periodically reviewing the facility's written policies and the services
provided to patients.
and sign the records of each patient admitted and treated by a practitioner no
later than fifteen (15) days after the patient's discharge from the
(iv) Provide health care
services to the patients in the facility, whenever needed and/or
(v) Prepare guidelines
for the medical management of health problems, including conditions requiring
medical consultation and/or patient referral.
(vi) At intervals no more than two (2) weeks
apart, be physically present in the facility for a sufficient time to provide
medical direction, medical care services, and staff consultation as
(vii) When not physically
present in the facility, either be available through direct telecommunication
for consultation and assistance with medical emergencies and patient referral,
or ensure that another physician is available for this purpose.
(viii) The physical site visit for a given
two week period is not required if, during that period, no inpatients have been
treated in the facility.
A practitioner on staff shall:
(i) Participate in the development,
execution, and periodic review of the guidelines and written policies governing
treatment in the facility.
Participate with a physician in a review of each patient's health
(iii) Provide health care
services to patients according to the facility's policies.
(iv) Arrange for or refer patients to needed
services that are not provided at the facility.
(v) Assure that adequate patient health
records are maintained and transferred as necessary when a patient is