Current through Register Vol. 48, No. 9, September 27, 2024
A. Residential
Facilities. A Physical Examination shall be completed by a Physician or other
Authorized Healthcare Provider for Patients within thirty (30) calendar days
prior to admission or two (2) business days of admission for Patients .
Physical Examinations conducted by Physicians or other Authorized Healthcare
Providers licensed in other states are permitted for new admissions under the
condition that the Patient undergoes a second Physical Examination by a South
Carolina licensed Physician or other Authorized Healthcare Provider within
thirty (30) calendar days of admission to the Facility. The Physical
Examination shall address:
1. The
appropriateness of level of services;
2. Identification of special conditions
and/or care required;
3. A
tuberculin skin test, as described in Section 1702, unless there is a
previously documented positive reaction;
4. If a Patient or potential Patient has a
communicable disease, the Facility shall follow the recommendations made by a
Physician or other Authorized Healthcare Provider in order to:
a. Ensure that the Facility has the
capability of providing adequate care and preventing the spread of that
condition, and that Staff and Volunteers are adequately trained; or
b. Transfer the Patient to an appropriate
Facility, if necessary; and
5. A substance use test. Following the test,
the Physician or Authroized Healthcare Provider shall determine the frequency
of subsequent testing based on the Patient's clinical presentation.
B. In Facilities providing
services for parents with children, there shall be a report of an examination
for each child by a Physician or other Authorized Healthcare Provider attesting
to the health status and special care needs that may impact the child, his/ or
her parent, and/or others within the Facility. The examination shall be
conducted not earlier than thirty (30) calendar days prior to the parent's
admission or no later than forty-eight (48) hours after admission.
C. Opioid Treatment Program.
1. Physical Examination. A Physical
Examination conducted by the Opioid Treatment Program Physician or other
Authorized Healthcare Provider shall be completed within seventy-two (72) hours
prior to the first dose of Opioid Treatment Program Medication and shall
address the following at a minimum: (I)
a.
Evidence of communicable or Infectious disease;
b. Pulmonary, liver, renal, and cardiac
abnormalities;
c. Neurological
issues;
d. Vital signs;
e. Evidence of clinical signs of dependency;
and
f. Examination of head, ears,
eyes, nose, throat, thyroid, chest (including heart, lungs and breast),
abdomen, extremities, and skin.
2. Medical Laboratory Analysis. A medical
laboratory analysis shall be conducted within seven (7) calendar days of
admission and shall include:
a. Serological
test for Infectious disease;
b.
Initial substance use testing for Controlled Substance profile;
c. Liver profile; and
d. If indicated, an electrocardiogram, chest
x-ray, and/or a biological pregnancy test.
3. In the event the medical staff are unable
to obtain an adequate blood draw for the medical laboratory analysis on the
first attempt, the Facility shall reattempt within the seven (7) days of
admission. After three (3) documented attempts within the seven (7) days of
admission, the Opioid Treatment Program Physician or other Authorized
Healthcare Provider may waive the blood testing requirements. The Physician's
decision shall be documented in the Patient's medical record. The Facility
shall follow its policies and procedures related to infection control if the
Physician waives the blood testing requirement.
D. In the event that a Patient transfers from
one Residential Facility to another , an additional admission Physical
Examination and/or tuberculin skin test shall not be necessary, provided the
Physical was conducted not earlier than twelve (12) months prior to the
admission of the Patient, and the Physical meets all other requirements
specified in Section 1100.A.1, unless the receiving Facility has an indication
that the health status of the Patient has changed significantly. In such
instances of transfer, issues of appropriateness of level of treatment
placement shall be addressed in the Patient record.
