Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part II - Nursing Facilities
Subpart 3 - Standards for Payment
Chapter 101 - Standards for Payment for Nursing Facilities
Subchapter D - Resident Care Services
Section II-10119 - Physician Services
Current through Register Vol. 50, No. 9, September 20, 2024
A. Medical Director. The nursing facility shall have a written agreement with a physician who shall serve as the medical director on a full-time or part-time basis. Whether the physician is employed full-time or part-time shall be based on the residents' needs.
B. Physician Supervision; Ongoing Care. All facilities shall develop policies and procedures to ensure that each resident's health care is under a Louisiana physician's continuing supervision. Each resident must remain under the care of a physician. The care of every skilled/NRTP resident shall be under the supervision of a licensed physiatrist, certified in physical medicine and rehabilitation.
C. A physician visit is considered timely if it occurs not later than ten days after the date the visit was required. At the option of the physician, required visits after the initial visit may be made by a physician assistant, nurse practitioner or clinical nurse specialist. Otherwise, all physician visits shall be made by the physician personally. This does not relieve the physician of his/her obligation to visit a resident when the resident's medical condition makes that visit necessary.
D. Physicians may delegate tasks to a physician's assistant, nurse practitioner, of clinical nurse specialist who:
E. A physician may not delegate a task when the regulations specify that the physician shall perform it personally or when the delegation is prohibited under state law or by the facility's own policies.
F. The facility shall provide or arrange for the provision of physician services 24 hours a day in case of emergency.
G. Alternate Physicians. When continuing care by the attending physician is interrupted by that physician's illness or vacation, the attending physician shall arrange for a designated attending physician to provide coverage.
H. Frequency of Visits. Physician visits shall conform to the following schedule.
I. Physician Responsibilities. The attending physician's services shall include but shall not be limited to the following:
J. Physician's Signature. Whenever a physician's signature is required, the actual signature shall be written. The physician may use initials only if an original legend sheet with a full signature and the initials which will be used is placed on the record. Use of signature stamps by physicians is allowed when the signature stamp is authorized by the individual whose signature the stamp represents. The administration office of the nursing facility should have on file a signed statement to the effect that he/she is the only one who has the stamp and uses it. There is no delegation to another individual.
AUTHORITY NOTE: Promulgated in accordance with R.S. 46:153.