Code of Massachusetts Regulations
105 CMR - DEPARTMENT OF PUBLIC HEALTH
Title 105 CMR 143.000 - Standards Governing Cardiac Rehabilitation Treatment
Section 143.009 - Staff
Universal Citation: 105 MA Code of Regs 105.143
Current through Register 1531, September 27, 2024
(A) Staff Responsibilities and Qualifications.
(1)
Medical Director.
(a) Each program shall employ, or otherwise
retain through a written agreement for services, a physician to serve as
medical director. The medical director shall be responsible for establishing
all medical protocols, policies and procedures, ensuring the achievement and
maintenance of quality standards of medical care, for overallpatient care
including participation inpatient treatment planning meetings and for
consultation with program personnel and referring physicians.
(b) The medical director shall be a physician
who is a board certified cardiologist or is board certified ininternal medicine
or family practice and shall have recent clinical experience in caring for
cardiac patients and experience in exercise testing and cardiac
rehabilitation.
(c) The medical
director shall be currently certified in advanced cardiac life support by the
American Heart Association.
(2)
Registered
Nurse.
(a) Each program shall
employ a registered nurse who shall collaborate with the Medical Director and
Program Director in the operational and clinical aspects of the
program.
(b) Primary
responsibilities of the registered nurse shall include, but not be limited to:
functional assessment of patients, patient education, participation in
establishing and monitoring exercise therapy, EKG telemetry monitoring,
provision of emergency care and maintenance of, regular, ongoing communication
with the patient's referring physician.
(c) The registered nurse shall hold a
baccalaureate degree or higher in nursing. This nurse shall have experience in
cardiac intensive care or other intensive care and in cardiac risk factor
intervention and exercise prescription and exercise testing. He/she shall be
currently certified in advanced cardiac life support by the American Heart
Association. The requirement for the baccalaureate degree shall be waived for
any person functioning in a cardiac rehabilitation program on the effective
date of these standards.
(3)
Program
Director.
(a) Each program shall
designate a program director who shall be responsible for the clinical services
provided by the program, including the accurate implementation of medical
policies and procedures with emphasis on close adherence to exercise
prescription and maintenance of safety standards; who supervises the staff and
directs all facets of the program, coordinates patient care and who is
responsible for the administration aspects of the program.
(b) The program director shall either be a
physician meeting the qualifications of the Medical Director as prescribed
above or a registered nurse meeting the qualifications of the Registered Nurse
as prescribed above except that such nurse shall hold a baccalaureate or higher
degree in nursing, or an individual who hold a baccalaureate or higher degree
in an allied health field. The Medical Director or the Registered Nurse may
also serve as the Program Director if he/she canadequately carryout the duties
of both positions. The program director shall have recent previous experience
or education in the organization and administration of a cardiac rehabilitation
program.
(4)
Exercise Therapist.
(a) Each program shall employ, or retain
through a written agreement for services, an exercise therapist. The exercise
therapist shall be responsible for providing consultation to program staff and
advising and/or implementing the exercise component of the program and
participating in the patient/family education program services.
(b) The exercise therapist shall be a
registered physical therapist or an individual who holds a baccalaureate or
higher degree in an exercise science. Such individuals shall have experience in
cardiac rehabilitation, EKG monitoring, exercise prescription and exercise
testing.
(c) The exercise therapist
shall be currently certified in basic life support by the American Heart
Association or the American Red Cross.
(5)
Dietitian.
(a) Each program shall employ, or otherwise
retain through a written agreement for services, a dietitian who shall provide
or supervise nutritional counseling services to the patient/family and assist
program staff in monitoring patient progress towards nutritional
goals.
(b) A dietitian responsible
for nutritional counseling services shall be registered or eligible for
registration by the American Dietetic Association.
(6)
Counselors.
(a) The cardiac rehabilitation program shall
employ, or otherwise retain through a written agreement for services, at least
one psycho/social counselor. Counseling services shall assist patients in
adjusting to illness.
(b)
Counseling services shall be provided by qualified professional staff who have
experience working in a medical care setting and who are licensed and/or
registered in accordance with state law.
(7)
Occupational
Therapist.
(a) If occupational
therapy services are provided, the services shall be provided by and supervised
by a registered occupational therapist. Occupational therapy services not
directly provided by a registered occupational therapist shall be provided by
certified occupational therapy assistants.
(b) Responsibilities of the occupational
therapist may include but not be limited to: instruction in energy
conservation, activity guidelines, pacing and development of coping strategies
for stress management.
(8)
Pharmacist.
Each program shall have available at least on a consultant basis the services of a registered pharmacist to advise program staff on drug usage. dosage and effects.
(B) Health Care Staff.
Each program shall retain sufficient qualified professional health care staff to render adequately and appropriately to each patient's needs the services the program holds itself out as providing. Professional health care staff shall be registered or licensed as required by law. They shall comply with the regulations of their registration or licensing boards.
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