Current through Bulletin 2024-06, March 15, 2024
(1) A licensed
physician shall provide the care for each resident in need of nursing services,
habilitative, or rehabilitative care.
(2) The licensee shall permit each resident
to choose their physician.
(3) The
licensee shall ensure that the following physician responsibilities are met:
(a) each resident has a medical history and
pertinent physical examination at least annually;
(b) each intermediate care resident is seen
at least once during the first 60 days of residency;
(c) the attending physician or medical
practitioner sees the resident when necessary but at least every 60 days,
unless the attending physician or practitioner documents in the resident's
record why the resident does not need to be seen this frequently;
(d) the physician or practitioner establishes
and follows a schedule alternating visits; and
(e) each visit and evaluation is documented
in the resident's record.
(4) The licensee shall develop policies and
procedures that outline:
(a) access to
physician services in case of medical emergency or when the attending physician
is not available;
(b) names and
telephone numbers of on-call physicians in the health services supervisor's
office; and
(c) requirement for
reevaluation of the resident and review of care and treatment orders when there
is a change of attending physician that is completed within 15 days of the
change.
(5) The following
practitioners may provide medical services according to state law:
(a) a nurse practitioner licensed to practice
in Utah; and
(b) a physician's
assistant working under the supervision of a licensed physician and performing
only those selected diagnostic and therapeutic tasks identified in Title 58,
Chapter 70a, The Utah Physician's Assistant Act.
(6) The licensee shall ensure that any of the
following physician orders and notes are signed and dated by a physician and
maintained as part of each treatment record:
(a) admission orders;
(b) medication, treatment, therapy,
laboratory, and diet orders;
(c)
history and physical examinations;
(d) physician's progress notes;
(e) the discharge summary;
(f) discharge orders;
(g) telephone orders are immediately recorded
in the treatment record by the recipient and include:
(i) date and time of order;
(ii) the recipient's signature and title;
and
(iii) the order is
countersigned and dated within 15 days by the physician who prescribed the
order; and
(h) the
attending physician shall complete the resident's medical record within 60 days
of the resident's discharge, transfer, or death.
(7) The licensee shall promptly notify the
attending physician and document the following:
(a) admission of the resident;
(b) a sudden or marked adverse change in the
resident's signs, symptoms, or behavior;
(c) any significant weight change in a 30-day
period unless the resident's physician stipulates another parameter in
writing;
(d) any adverse response
or reaction by a resident to a medication or treatment;
(e) any error in medication administration or
treatment;
(f) the discovery of a
decubitus ulcer, the beginning of treatment, and if treatment is not effective;
and
(g) any inability of the
licensee to obtain or administer drugs, equipment, supplies, or services
promptly as prescribed.
(8) If the attending physician or designee is
not readily available, the emergency care physician shall provide any emergency
medical care. The licensee shall post the telephone numbers of the emergency
care physician at the control station.
(9) Any attempt by a staff member to notify a
physician shall be noted by the staff member in the resident's record, to
include the time and method of communication and the name of any person
acknowledging contact.
