Nick-Maximillien/medgate-compiler-data huggingface dataset:
Guideline text:
In patients with a working diagnosis of STEMI and a time from symptom onset >12 h, a PPCI strategy is recommended in the presence of ongoing symptoms suggestive of ischaemia, haemodynamic instability, or life-threatening arrhythmias. 220

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "PPCI strategy recommendation", "trigger_assertion": "patient has a working diagnosis of STEMI AND time from symptom onset >12 h AND (ongoing symptoms suggestive of ischaemia OR haemodynamic instability OR life-threatening arrhythmias)"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
Limit massage therapy to 1 units per session.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"event_type": "massage", "max_count": 1}, "rule_type": "count_sanity", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.61(b)(1) Be completed within 60 hours of admission;

Interpretive Guidelines §482.61(b)(1)

Guidance is pending and will be updated in future release

A-1632

(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.61(b)(2) Include a medical history

Interpretive Guidelines §482.61(b)(2)

The psychiatric evaluation must include the non-psychiatric medical history including physical disabilities, intellectual disabilities and treatment.

## Survey Procedures §482.61(b)(2)

Does the evaluation include:

Relevant past surgery? Past medical conditions and disabilities especially those of a chronic nature?

Have these contributed to the patient's psychiatric condition? How?

Are any of these conditions still present to any significant degree? Are they likely to impact on the patient's recovery/remission? Should they be addressed immediately? Does the facility have the capability to intervene? If not, how is the need to be met?

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"anchor": "admission", "max_delay_minutes": 3600, "target": "psychiatric evaluation"}, "rule_type": "temporal", "scope_tags": ["clinical"]}
Guideline text:
The level of evidence for this section is based on expert consensus. [Ref: 651]

Structured rule (JSON):
{"intent_tags": [], "logic_config": {}, "rule_type": "unsupported", "scope_tags": [], "summary": "Non-executable narrative text"}
Guideline text:
## (Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

[§482.42(c)(2)  The infection preventionist(s)/infection control professional(s) is responsible for:]

(iii)  Communication and collaboration with the hospital's QAPI program on infection prevention and control issues.

## Interpretive Guidelines §482.42(c)(2)(iii)

Guidance is pending and will be updated in future release.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "Communication and collaboration between infection preventionist(s) and the hospital's QAPI program on infection prevention and control issues"}, "rule_type": "existence", "scope_tags": ["facility", "legal"]}
Guideline text:
It is recommended that the pre-hospital management of patients with a working diagnosis of STEMI is based on regional networks designed to deliver reperfusion therapy expeditiously and effectively, with efforts made to make PPCI available

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "regional networks designed for expeditious and effective STEMI reperfusion therapy with PPCI availability"}, "rule_type": "existence", "scope_tags": ["clinical", "facility"]}
Guideline text:
(Rev. 141, Issued: 07-10-15, Effective: 07-10-15, Implementation: 07-10-15)

## §482.53(d) Standard: Records

The hospital must maintain signed and dated reports of nuclear medicine interpretations, consultations, and procedures.

- (1)  The hospital must maintain copies of nuclear medicine reports for at least 5 years.
- (2)  The practitioner approved by the medical staff to interpret diagnostic procedures must sign and date the interpretation of these tests.

## Interpretive Guidelines §482.53(d)(1) &amp; (2)

Nuclear medicine patient records, including interpretations, consultations, and procedures are patient medical records and the hospital must comply with the Medical Records CoP (§482.24).

Nuclear medicine patient records, like all patient medical records, must be maintained for at least five years.  If State law requires a longer period, the hospital must comply, but surveyors do not assess compliance with State law requirements as part of the Federal survey.  Each report of an interpretation of a nuclear medicine diagnostic study must be signed and dated by the practitioner who made the interpretation, as authorized by the medical staff.  Deficient nuclear medicine medical records practices related to these two requirements must be cited under this regulation; depending on the specific facts, citation under the Medical Records CoP might also be appropriate.

## Survey Procedures §482.53(d)(1) &amp; (2)

- Verify that copies of nuclear medicine reports are maintained for at least 5 years.
- Verify that reports of nuclear medicine interpretations are signed and dated only by the practitioner who interpreted the study's results, as authorized by the medical staff to perform these interpretations

Structured rule (JSON):
{"intent_tags": ["quality", "compliance", "integrity", "safety"], "logic_config": {"required_artifact": "nuclear medicine interpretation reports signed and dated by an approved practitioner"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
Limit massage therapy to 4 units per session.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"event_type": "massage", "max_count": 4}, "rule_type": "count_sanity", "scope_tags": ["clinical"]}
Guideline text:
Limit physical therapy unit to 5 units per session.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"event_type": "physical", "max_count": 5}, "rule_type": "count_sanity", "scope_tags": ["clinical"]}
Guideline text:
Transport of patients with OHCA to a cardiac arrest centre according to local protocols should be considered. 391 , 393

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "transport of OHCA patients to cardiac arrest centre"}, "rule_type": "existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

[The bylaws must:]

## §482.22(c)(5) - Include a requirement that  --

(iv)  The medical staff develop and maintain a policy that identifies those patients for whom the assessment requirements of paragraph (c)(5)(iii) of this section would apply.  The provisions of paragraphs (c)(5)(iii), (iv), and (v) of this section do not apply to a medical staff that chooses to maintain a policy that adheres to the requirements of paragraphs of (c)(5)(i) and (ii) of this section for all patients.

## Interpretive Guidelines §482.22(c)(5)(iv)

Guidance is pending and will be updated in future release.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "policy identifying patients for assessment requirements of paragraph (c)(5)(iii)", "trigger_assertion": "medical staff does not maintain a policy adhering to requirements of paragraphs (c)(5)(i) and (ii) for all patients"}, "rule_type": "conditional_existence", "scope_tags": ["facility", "clinical", "legal"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

§482.25(a)(2) - The pharmaceutical service must have an adequate number of personnel to ensure quality pharmaceutical services, including emergency services.

## Interpretive Guidelines §482.25(a)(2)

There must be sufficient personnel to respond to the pharmaceutical needs of the patient population being served.

The pharmaceutical services staff must be sufficient in types, numbers, and training to provide quality services, including 24 hour, 7-day emergency coverage, or there is an arrangement for emergency services, as determined by the needs of the patients and as specified by the medical staff.

The number of pharmacists and/or the number of hours of services provided by pharmacists at the hospital, or at each location of the hospital that provides pharmaceutical services, must meet and be in accordance with the needs of its patients and accepted professional principles (as previously defined), and reflect the scope and complexity of the hospital's pharmaceutical services.

There must be sufficient numbers and types of personnel to provide accurate and timely medication delivery, ensure accurate and safe medication administration and to provide appropriate clinical services as well as the participation in continuous quality improvement programs that meet the needs of the patient population being served.

## Survey Procedures §482.25(a)(2)

- Determine that the pharmaceutical services staff is sufficient in number and training to provide quality services, including 24 hour, 7-day emergency coverage, or there is an arrangement for emergency services, as determined by the needs of the patients and as specified by the medical staff.
- Determine if there are sufficient personnel to provide accurate and timely medication delivery, ensure accurate and safe medication administration and to provide appropriate clinical services as well as the participation in continuous quality improvement programs that meet the needs of the patient population being served.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "pharmaceutical service personnel sufficient in number, type, and training to provide quality and 24/7 emergency services"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
It is recommended to apply the same diagnostic and therapeutic strategies in patients with CKD (dose adjustment may be necessary) as in patients with normal kidney function.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "application of diagnostic and therapeutic strategies consistent with those for patients with normal kidney function, including consideration for dose adjustment", "trigger_assertion": "patient has Chronic Kidney Disease (CKD)"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
Intravenous amiodarone is recommended to facilitate electrical cardioversion and/or decrease risk for early recurrence of AF after electrical cardioversion in unstable patients with recent-onset AF. 607 , 608

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "Intravenous amiodarone administration", "trigger_assertion": "unstable patient with recent-onset Atrial Fibrillation requiring electrical cardioversion"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

## §482.13(d) Standard:  Confidentiality of Patient Records

## Interpretive Guidelines §482.13(d)

The hospital must ensure the confidentiality of patient records requirements are met.

Structured rule (JSON):
{"intent_tags": ["quality"], "logic_config": {"required_artifact": "unknown_requirement"}, "rule_type": "existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.42(d)(1) Standard:  Unified and integrated infection prevention and control and antibiotic stewardship programs for multi-hospital systems.

(1)  The unified and integrated infection prevention and control and antibiotic stewardship program sare established in a manner that takes into account each member hospital's unique circumstances and any significant differences in patient populations and services offered in each hospital;

## Interpretive Guidelines §482.42(d)(1)

Guidance is pending and will be updated in future release.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "unified and integrated infection prevention and control and antibiotic stewardship programs"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
Anticoagulation is recommended in patients treated with fibrinolysis until revascularization (if performed) or for the duration of hospital stay (up to 8 days). 260 , 347 , 348 , 350 , 357 – 360

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"duration_condition": "until revascularization (if performed) or for the duration of hospital stay (up to 8 days)", "required_artifact": "Anticoagulation", "trigger_assertion": "patient treated with fibrinolysis"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
Heart Rate must be above 114.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"min_value": 114, "target_vital": "Heart Rate"}, "rule_type": "threshold", "scope_tags": ["clinical"]}
Guideline text:
Conflict of interest disclosures are available online. [Ref: 812]

Structured rule (JSON):
{"intent_tags": [], "logic_config": {}, "rule_type": "unsupported", "scope_tags": [], "summary": "Non-executable narrative text"}
Guideline text:
Routine pre-treatment with a P2Y12 receptor inhibitor in NSTE-ACS patients in whom coronary anatomy is not known and early invasive management (<24 h) is planned is not recommended.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"forbidden_treatment": "Routine pre-treatment with a P2Y12 receptor inhibitor", "trigger_condition": "NSTE-ACS patients in whom coronary anatomy is not known and early invasive management (<24 h) is planned"}, "rule_type": "contra", "scope_tags": ["clinical"]}
Guideline text:
Angiography and PCI of the IRA, if indicated, is recommended between 2 and 24 h after successful fibrinolysis. 186 , 212 , 213 , 217 , 224

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"anchor": "successful fibrinolysis", "max_delay_hours": 24, "min_delay_hours": 2, "target": "Angiography and PCI of the IRA"}, "rule_type": "temporal", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

§482.45(a)(4) - Encourage discretion and sensitivity with respect to the circumstances, views, and beliefs of the families of potential donors;

## Interpretive Guidelines §482.45(a)(4)

Using discretion does not mean a judgment can be made by the hospital that certain families should not be approached about donation.  Hospitals should approach the family with the belief that a donation is possible and should take steps to ensure the family is treated with respect and care. The hospital staff's perception that a family's grief, race, ethnicity, religion or socioeconomic background would prevent donation should never be used as a reason not to approach a family.

All potential donor families must be approached and informed of their donation rights.

## Survey Procedures §482.45(a)(4)

- Interview a hospital-designated requestor regarding approaches to donation requests.
- Review the designated requestor training program to verify that it addresses the use of discretion.
- Review the hospital's complaint file for any relevant complaints.

Structured rule (JSON):
{"intent_tags": ["quality", "compliance"], "logic_config": {"required_artifact": "approach and informing of donation rights for potential donor families"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
Additional testing after 3 h is recommended if the first two hs-cTn measurements of the 0 h/1 h algorithm are inconclusive and no alternative diagnoses explaining the condition have been made. 45 , 46

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "additional testing after 3 h", "trigger_assertion": "first two hs-cTn measurements of the 0 h/1 h algorithm are inconclusive and no alternative diagnoses explaining the condition have been made"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 105, Issued: 03-21-14, Effective: 03-21-14, Implementation: 03-21-14)

## Performance Improvement Projects

§482.21(d) Standard:  Performance Improvement Projects.

As part of its quality assessment and performance improvement program, the hospital must conduct performance improvement projects.

(1) The number and scope of distinct improvement projects conducted annually must be proportional to the scope and complexity of the hospital's services and operations.

(2) A hospital may, as one of its projects, develop and implement an information technology system explicitly designed to improve patient safety and quality of care. This project, in its initial stage of development, does not need to demonstrate measurable improvement in indicators related to health outcomes.

(3) The hospital must document what quality improvement projects are being conducted, the reasons for conducting these projects, and the measurable progress achieved on these projects.

(4) A hospital is not required to participate in a QIO cooperative project, but its own projects are required to be of comparable effort.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "Performance Improvement Projects and their associated documentation"}, "rule_type": "existence", "scope_tags": ["facility", "legal"]}
Guideline text:
It is recommended that PCI of the non-IRA is based on angiographic severity. 511 , 524

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "decision for PCI of non-IRA is based on angiographic severity", "trigger_assertion": "PCI of the non-IRA is performed or considered"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

§482.45(a)(3) - (C ontinued)

The individual designated by the hospital to initiate the request to the family must be an organ procurement representative or a designated requestor.  A designated requestor is an individual who has completed a course offered or approved by the OPO and designed in conjunction with the tissue and eye bank community in the methodology for approaching potential donor families and requesting organ or tissue donation;

## Interpretive Guidelines §482.45(a)(3)

The individual designated by the hospital to initiate the request to a family must be an organ procurement representative, an organizational representative of a tissue or eye bank , or a designated requestor.  Any individuals involved in a request for organ, tissue, and eye donation must be formally trained in the donation request process.

The individual designated by the hospital to initiate the request to the family must be an OPO, tissue bank, or eye bank representative or a designated requestor.  A ' designated requestor ' is defined as a hospital-designated individual who has completed a course offered or approved by the OPO and designed in conjunction with the tissue and eye bank community.

Ideally, the OPO and the hospital will decide together how and by whom the family will be approached.  If possible, the OPO representative and a designated requestor should approach the family together.

The hospital must ensure that any 'designated requestor' for organs, tissues or eyes has completed a training course either offered or approved by the OPO, which addresses methodology for approaching potential donor families.

## Survey Procedures §482.45(a)(3)

- Review training schedules and personnel files to verify that all designated requestors have completed the required training.
- How does the hospital ensure that only OPO, tissue bank, or eye bank staff or designated requestors are approaching families to ask them to donate?

Structured rule (JSON):
{"intent_tags": ["quality", "compliance"], "logic_config": {"required_artifact": "proof of OPO-approved training completion", "trigger_assertion": "individual is a designated requestor for organ/tissue donation"}, "rule_type": "conditional_existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
Cardiovascular disease is the leading cause of death globally. [Ref: 566]

Structured rule (JSON):
{"intent_tags": [], "logic_config": {}, "rule_type": "unsupported", "scope_tags": [], "summary": "Non-executable narrative text"}
Guideline text:
O2 Saturation must be above 100.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"min_value": 100, "target_vital": "O2 Saturation"}, "rule_type": "threshold", "scope_tags": ["clinical"]}
Guideline text:
O2 Saturation must be above 95.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"min_value": 95, "target_vital": "O2 Saturation"}, "rule_type": "threshold", "scope_tags": ["clinical"]}
Guideline text:
Systolic BP must be above 140.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"min_value": 140, "target_vital": "Systolic BP"}, "rule_type": "threshold", "scope_tags": ["clinical"]}
Guideline text:
Future research is needed to establish optimal thresholds. [Ref: 919]

Structured rule (JSON):
{"intent_tags": [], "logic_config": {}, "rule_type": "unsupported", "scope_tags": [], "summary": "Non-executable narrative text"}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

[The hospital must require appropriate staff to have education, training, and demonstrated knowledge based on the specific needs of the patient population in at least the following:]

§482.13(f)(2)(ii) - The use of nonphysical intervention skills.

Interpretive Guidelines §482.13(f)(2)(ii)

Although we recognize that there may be circumstances in which the use of restraint or seclusion may be necessary to prevent a patient situation from escalating, staff often skillfully intervene with alternative techniques to redirect a patient, engage the patient in constructive discussion or activity, or otherwise help the patient maintain self-control and avert escalation.

The use of nonphysical intervention skills does not mean attempting a complex series of interventions or a lengthy checklist of steps to initiate before restraining or secluding a patient.  Rather, a whole toolbox of possible interventions can be implemented during the course of a patient's treatment based upon the assessment of an individual patient's responses.

## Survey Procedures §482.13(f)(2)(ii)

- Does the hospital educational program address the use of nonphysical intervention skills?
- Does the hospital's training program comply with the regulatory requirements?
- Interview staff to assess their non-physical intervention skills.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "staff education, training, and demonstrated knowledge in nonphysical intervention skills"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}