Ala. Admin. Code r. 420-5-17-.14

Current through Register Vol. 43, No. 1, October 31, 2024

Section 420-5-17-.14 - Physician Services

(1) Patients in need of health care which can be met by the hospice are admitted to the hospice only upon the recommendation of, and remain under the care of, a physician. Each patient or sponsor designates a physician.

(2) There is made available prior to or at the time of admission patient information which includes current medical findings, diagnoses, and orders from the physician for the immediate care of the patient. A summary of prior treatments are made available at the time of admission or within 48 hours thereafter. The following provisions are applicable:

(a) If orders are from a physician other than the attending physician, they shall be communicated to the attending physician and verification of such shall be entered into the medical record by the nurse who took the orders from the physician.

(b) Physician's verbal orders for drugs, treatments, diets, etc., (e.g., oral orders, telephone orders, recopied orders, standing orders) are reduced to writing on the physicians' order sheet by a licensed nurse, physician, or pharmacist. They are dated and signed by the person receiving or transcribing the order. Such orders are dated and signed by the attending physician at the time of the next visit, but in no case longer than 30 days after dating and recording the order. Dietary counseling means education and interventions provided to the patient and family regarding appropriate nutritional intake as the patient's condition progresses and is provided by qualified individuals, which may include a registered nurse, dietitian, or nutritionist, when identified in the patient's plan of care.

(c) The attending physician shall designate an alternate physician to attend the patient in his/her absence.

(d) The hospice has written procedures, available at the nurses' station, that provides for having a physician available to furnish necessary medical care in case of emergency.

(e) In each inpatient hospice the physician shall write/dictate, date, and sign a progress note at the time of each patient's visit or within 7 days.

(f) In each inpatient hospice any changes in the interdisciplinary treatment team care plan shall be dated and signed by the physician at the time of each visit or within 7 days.

(g) The physician is responsible for the development of a discharge summary within 30 days after discharge or death.

(h) Each inpatient hospice must have a list of names and telephone numbers of physicians to be called in the event of an emergency.

(3)Documentation of emergencies, accidents and injuries. All the hospices shall have policies and procedures established relative to documentation of emergencies, accidents, and injuries to patients and staff.

(a) Sufficient information shall be documented in the medical record and/or on the accident and incident record to reflect facts about the incident, injuries, actions taken, and physician contacted. Dated and signed entries in the medical record and/or the incident and accident record shall be made by the physician and other appropriate hospice staff.

(b) The manager and appropriate staff shall be provided written reports of accidents and injuries.

(c) These reports shall serve the medical director and other appropriate staff as a basis for a written recommendation for corrective action.

Ala. Admin. Code r. 420-5-17-.14

New Rule: Filed August 20, 1993; effective September 23, 1993. Repealed and New Rule: Filed June 14, 2000; effective July 19, 2000.

Amended by Alabama Administrative Monthly Volume XL, Issue No. 06, March 31, 2022, eff. 5/15/2022.

Authors: Jimmy D. Prince, Dana Billingsley

Statutory Authority:Code of Ala. 1975, §§ 22-21-20, et seq.