Current through February 24, 2025
(a) A frontier extended stay clinic must have
the medical staff necessary to provide the care and services required in
7
AAC 12.453.
(b) The medical staff shall develop, for
approval by the governing body of the clinic, bylaws and rules that provide for
(1) eligibility for medical staff
membership;
(2) the biennial
recommendation by the medical staff regarding the credentialing and privileges
of each member of the medical staff, including establishing standards for
(A) assessing the training, experience, and
competence of medical staff;
(B) a
formal process that includes
(i) querying the
National Practitioner Data Bank; and
(ii) verifying that medical staff meet
professional licensing requirements;
(C) a delineation of privileges as authorized
by the governing body, including verification of education and training related
to the privileges requested and to the level of care that will be
provided;
(D) the inclusion of
quality assurance findings in ongoing credentialing of medical staff;
and
(E) the assurance of
participation in continuing professional education;
(3) quality assurance under
7
AAC 12.460;
(4) medical records retention and protection
under 7 AAC 12.483;
(6) pharmacy and therapeutics, including
(A) development and maintenance of a
formulary of drugs; and
(B)
development and implementation of procedures for the safe and effective
control, storage, dispensing, and administration of prescribed drugs,
chemicals, and biologicals; and
(c) The medical staff shall
(1) ensure that a physician or a mid-level
practitioner with training or experience in emergency care is, on a
24-hour-per-day basis,
(B) immediately available by telephone or
radio contact; and
(C) able to be
on site at the frontier extended stay clinic within 30 minutes after an
emergency contact;
(2)
ensure that a mid-level practitioner is available on site to provide patient
care services at least 60 percent of the time during the clinic's normal hours
of operation, or a minimum of 32 hours a week, whichever is less;
(3) require that an order by a practitioner,
including a telephonic or other verbal order, be reduced to writing and
authenticated within three days after the order was given; the authentication
must be signed and dated by the practitioner who gave the verbal
order;
(4) require that a physician
approve each standing order;
(5)
establish procedures for circumstances in which consultation, referral, or
transfer is required;
(6) ensure
that the review required under
7
AAC 12.460(c) (1) is conducted at
regular intervals, at least annually, and that the clinic maintains accurate
medical records;
(7) establish
procedures for selection and supervision of mid-level practitioners;
and
(8) establish procedures for
the annual review of policies and procedures, including clinical,
administrative, and fiscal policies and procedures, by a group consisting, at a
minimum, of a physician, a mid-level practitioner, and one person who is not an
employee of the clinic.
(d) A physician shall be on site for
sufficient periods of time, at least once in every three-month period, except
in extraordinary circumstances, to provide the medical direction, medical care
services, consultation, and supervision described in this section. Any
extraordinary circumstance must be documented in the clinic's records. A site
visit by a physician is not required if no patients have been treated since the
last time a physician made a site visit. The clinic must
(1) ensure that, in addition to the site
visits required by this subsection, a physician will be
(A) available 24 hours a day through direct
radio or telephone communication for consultation, assistance with medical
emergencies, or patient referral; and
(B) in contact with the clinic telephonically
or through telemedicine at least once in every two-week period;
(2) demonstrate sufficient
staffing during periods the physician is not onsite; and
(3) ensure that the physician adheres to the
plan submitted under
7
AAC 12.457(a) (6).
(e) A physician shall
(1) provide medical direction, consultation,
and medical supervision regarding the clinic's health care
activities;
(2) at regular
intervals, no less than once each year, participate with a mid-level
practitioner member of the clinic staff, either separately or together, in
(A) developing, executing, and reviewing the
clinic's written policies; and
(B)
the review of services provided to patients through the periodic program
evaluation under
7
AAC 12.460(c), unless that review is
conducted under contract;
(3) review at least quarterly the clinic's
patient records;
(4) provide
medical orders and medical care services to the clinic's patients;
and
(5) at least quarterly, sign
the records of patients cared for by a mid-level practitioner.
(f) The onsite medical staff of a
frontier extended stay clinic may consist exclusively of one or more mid-level
practitioners if
(1) the mid-level
practitioners are subject to the oversight of a physician who is also a member
of the clinic's medical staff, even though the physician might not be on site,
if
(A) that physician is
(i) notified by a mid-level practitioner when
a patient is admitted for extended stay; and
(ii) available 24 hours per day through
direct radio or telephone communication for consultation, assistance with
medical emergencies, or patient referral; and
(B) each contact with the physician is
documented;
(2) each
mid-level practitioner participates
(A) in the
development, execution, and periodic review of the written policies governing
the services provided by the clinic; and
(B) in the periodic review of the medical
records of patients with a physician as described in
7
AAC 12.460(c) (1), unless that review
is conducted under contract; and
(3) each mid-level practitioner performs the
following functions when the functions are not performed by a physician:
(A) provide services in accordance with the
clinic's policies;
(B) arrange for,
or refer patients to, needed services that cannot be furnished at the
clinic;
(C) assure that adequate
patient health records are maintained and transferred as required if patients
are referred or services are arranged under (B) of this paragraph.
(g) A physician or a
mid-level practitioner member of the staff may be an owner or employee of the
clinic, or may be under contract or agreement with the clinic to carry out the
responsibilities described in this section and in
7
AAC 12.470.
Information about the National Practitioner Data Bank
referred to in 7 AAC 12.465 may be obtained from National Practitioner Data
Bank, P.O. Box 10832, Chantilly, VA 20153-0832; telephone: 1-800-767-6732; or
at the following website:
www.npdb-hipdb.hrsa.gov.
Authority:AS
47.32.010
AS
47.32.030
