Nick-Maximillien/medgate-compiler-data huggingface dataset:
Guideline text:
Limit EKG interpretation to 1 units per session.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"event_type": "ekg", "max_count": 1}, "rule_type": "count_sanity", "scope_tags": ["clinical"]}
Guideline text:
Cardiovascular disease is the leading cause of death globally. [Ref: 897]

Structured rule (JSON):
{"intent_tags": [], "logic_config": {}, "rule_type": "unsupported", "scope_tags": [], "summary": "Non-executable narrative text"}
Guideline text:
Patient preferences should be considered in all decisions. [Ref: 443]

Structured rule (JSON):
{"intent_tags": [], "logic_config": {}, "rule_type": "unsupported", "scope_tags": [], "summary": "Non-executable narrative text"}
Guideline text:
The routine use of thrombus aspiration is not recommended.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"forbidden_treatment": "thrombus aspiration", "trigger_condition": "routine use"}, "rule_type": "contra", "scope_tags": ["clinical"]}
Guideline text:
Transport of patients with out-of-hospital cardiac arrest to a cardiac arrest centre according to local protocol should be considered.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "transport to a cardiac arrest centre", "trigger_assertion": "out-of-hospital cardiac arrest"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
An invasive strategy is recommended in cancer patients presenting with high-risk ACS with expected life survival ≥6 months.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "invasive strategy", "trigger_assertion": "cancer patients presenting with high-risk ACS with expected life survival \u22656 months"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

[§482.42(c)(3)  The leader(s) of the antibiotic stewardship program is responsible for:] (iv) Competency-based training and education of hospital personnel and staff, including medical staff, and, as applicable, personnel providing contracted services in the hospital, on the practical applications of antibiotic stewardship guidelines, policies, and procedures.

## Interpretive Guidelines §482.42(c)(3)(iv)

Guidance is pending and will be updated in future release.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "Competency-based training and education program for antibiotic stewardship"}, "rule_type": "existence", "scope_tags": ["clinical", "facility"]}
Guideline text:
Twelve-lead ECG recording and interpretation is recommended as soon as possible at the point of FMC, with a target of <10 min. 5 , 19

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"anchor": "FMC", "max_delay_minutes": 10, "operator": "<", "target": "Twelve-lead ECG recording and interpretation"}, "rule_type": "temporal", "scope_tags": ["clinical"]}
Guideline text:
In patients who are event-free after 3–6 months of DAPT and who are not high ischaemic risk, single antiplatelet therapy (preferably with a P2Y12 receptor inhibitor) should be considered. 264 , 268 – 271 , 273 , 274 , 276 , 313 , 320

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "documentation of consideration for single antiplatelet therapy (preferably with a P2Y12 receptor inhibitor)", "trigger_assertion": "patient is event-free after 3-6 months of DAPT and not high ischaemic risk"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
Enoxaparin should be considered as an alternative to UFH in patients with STEMI undergoing PPCI. 258 , 261 , 298

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "consideration of Enoxaparin as an alternative to UFH", "trigger_assertion": "patient has STEMI and is undergoing PPCI"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
Evaluation of neurological prognosis (no earlier than 72 h after admission) is recommended in all comatose survivors after cardiac arrest.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"anchor": "admission", "min_delay_hours": 72, "target": "Evaluation of neurological prognosis"}, "rule_type": "temporal", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

## §482.43(a)(8) Standard: Discharge Planning Process

(8) The hospital must assist patients, their families, or the patient's representative in selecting a post-acute care provider by using and sharing data that includes, but not limited to, HHA, SNF, IRF, or LTCH data on quality measures and data on resource use on measures. The hospital must ensure that the post-acute care data on quality measures and data on resource measures is relevant and applicable to the patient's goals and treatment preferences.

## Interpretive Guidelines §482.43(a)(8)

Guidance is pending and will be updated in future release.

Structured rule (JSON):
{"intent_tags": ["quality", "compliance"], "logic_config": {"required_artifact": "Hospital process for assisting patients in selecting post-acute care providers by using and sharing relevant quality and resource use data"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
Systolic BP must be above 85.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"min_value": 85, "target_vital": "Systolic BP"}, "rule_type": "threshold", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

§482.27(a) Standard: - Adequacy of Laboratory Services

The hospital must have laboratory services available, either directly or through a contractual agreement with a certified laboratory that meets requirements of Part 493 of this chapter.

## Interpretive Guidelines §482.27(a)

The CLIA certification may be accomplished by having one certificate for the entire hospital's laboratory services, by having one certificate for each laboratory, or by the hospital having a mixture.  Whatever the arrangement, all laboratory services must be provided in accordance with CLIA requirements and under a current CLIA certificate, even when those laboratory services take place outside of a lab.

## Survey Procedures §482.27(a)

- Determine which services are provided directly by the facility and which are provided through contractual agreements.
- Determine if the referral laboratory is CLIA certified for the appropriate test specialty.
- If the hospital provides laboratory services in multiple locations, verify that all laboratory services are operating under a current CLIA certificate.
- Examine records and determine if the services, including emergency services, are provided in accordance with the hospital's policies.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "CLIA certified laboratory services"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

§482.13 Condition of Participation:  Patient's Rights

## A hospital must protect and promote each patient's rights.

## Interpretive Guidelines §482.13

These requirements apply to all Medicare or Medicaid participating hospitals including short-term, acute care, surgical, specialty, psychiatric, rehabilitation, long-term, children's and cancer, whether or not they are accredited.  This rule does not apply to critical access hospitals.  (See Social Security Act (the Act) §1861(e).)

These requirements, as well as the other Conditions of Participation in 42 CFR 482, apply to all parts and locations (outpatient services, provider-based entities, inpatient services) of the Medicare participating hospital.

## Survey Procedures §482.13

Survey of the Patients' Rights Condition of Participation (CoP) should be coordinated by one surveyor.  However, each surveyor, as he/she conducts his/her survey assignments, should assess the hospital's compliance with the Patients' Rights CoP.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "protection and promotion of patient's rights"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
Limit massage therapy to 3 units per session.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"event_type": "massage", "max_count": 3}, "rule_type": "count_sanity", "scope_tags": ["clinical"]}
Guideline text:
When echocardiography is suboptimal/inconclusive, an alternative imaging method (CMR preferably) should be considered.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "alternative imaging method", "trigger_assertion": "echocardiography is suboptimal/inconclusive"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.61(b)(4) Note the onset of illness and the circumstances leading to admission;

## Interpretive Guidelines §482.61(b)(4)

In a hospitalized patient, the identified problem should be related to the patient's need for hospital admission. The psychiatric evaluation includes a history of present illness, including onset, precipitating factors and reason for the current admission, signs and symptoms, course, and the results of any treatment received.

## Survey Procedures §482.61(b)(4)

How long has the patient been ill? Was it a gradual or sudden onset? Is this a recurrence? What were the precipitating factors? What happened? What symptoms, signs, behaviors made this hospitalization necessary?

What treatment has the patient already received before coming to the hospital?

Is any medication he received listed?

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "documentation of illness onset, precipitating factors, and circumstances leading to admission"}, "rule_type": "existence", "scope_tags": ["clinical", "legal"]}
Guideline text:
Staged PCI of non-IRA should be considered.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "consideration of Staged PCI", "trigger_assertion": "patient has non-IRA"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

§482.45(a)(5) - (C ontinued)

[Ensure that the hospital works cooperatively with the designated OPO, tissue bank and eye bank in educating staff on…] reviewing death records to improve identification of potential donors, and

## Interpretive Guidelines §482.45(a)(5)

Hospitals must cooperate with the OPOs, tissue banks and eye banks in regularly or periodically reviewing death records.  This means that the hospital must develop policies and procedures which permit the OPO, tissue bank, and eye bank access to death record information that will allow the OPO, tissue bank and eye bank to assess the hospital's donor potential, assure that all deaths or imminent deaths are being referred to the OPO in a timely manner, and identify areas where the hospital, OPO, tissue bank and eye bank staff performance might be improved.  The policies must address how patient confidentiality will be maintained during the review process.

## Survey Procedures §482.45(a)(5)

- Verify by review of policies and records that the hospital works with the OPO, tissue bank, and eye bank in reviewing death records.
- Verify that the effectiveness of any protocols and policies is monitored as part of the hospital's quality improvement program.
- Validate how often the reviews are to occur.  Review the protocols that are in place to guide record reviews and analysis.
- Determine how confidentiality is ensured.

Structured rule (JSON):
{"intent_tags": ["quality", "compliance"], "logic_config": {"required_artifact": "policy and process for cooperative death record review with OPOs, tissue banks, and eye banks"}, "rule_type": "existence", "scope_tags": ["facility", "legal"]}
Guideline text:
(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.42(a)(3) The infection prevention and control program includes surveillance, prevention, and control of HAIs, including maintaining a clean and sanitary environment to avoid sources and transmission of infection, and addresses any infection control issues identified by public health authorities; and

## Interpretive Guidelines §482.42(a)(3)

Guidance is pending and will be updated in future release.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "infection prevention and control program"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
If the LDL-C goal is not achieved despite maximally tolerated statin therapy after 4–6 weeks, the addition of ezetimibe is recommended.

Structured rule (JSON):
{"intent_tags": ["quality", "safety"], "logic_config": {"required_artifact": "addition of ezetimibe", "trigger_assertion": "LDL-C goal is not achieved despite maximally tolerated statin therapy after 4\u20136 weeks"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
Staged PCI of non-IRA should be considered. c

Structured rule (JSON):
{"intent_tags": ["quality", "safety"], "logic_config": {"required_artifact": "consideration of Staged PCI", "trigger_assertion": "patient has non-IRA"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
## (Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

§482.56(a)(1) - The director of the services must have the necessary knowledge, experience, and capabilities to properly supervise and administer the services.

## Interpretive Guidelines §482.56(a)(1)

Each service must be accountable to an individual that directs the overall hospital-wide operation of that service.  An individual may serve as the director of a multi-service department or as director of single service departments.

The service director must demonstrate through education, experience, and/or specialized training that he/she has the necessary knowledge, experience and capabilities to properly supervise and administer the service(s).

The director may be part-time or full time.  In all situations the director retains professional and administrative responsibility for personnel providing the service.  If the director is part-time, the time spent directing the service should be appropriate to the scope of the services provided.

## Survey Procedures §482.56(a)(1)

- Verify that each service is accountable to an individual who directs the overall operation of that service.
- Review the service director's position description to verify that he/she has been granted the authority and responsibility for operation of the service, consistent with hospital policies, State law, and accepted standards of practice.
- If the director does not work full-time, determine that the number of hours (review timesheets) spent working is appropriate to the scope of services provided.
- Review the director's personnel file to determine that he/she has the necessary education, experience and specialized training to properly supervise and administer the service.  This includes maintaining current licensure and certifications as required by State law.
- Interview the director to determine if he/she has the necessary knowledge,

experience and capabilities to properly supervise and administer the service.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "qualified service director"}, "rule_type": "existence", "scope_tags": ["facility", "legal"]}
Guideline text:
Treatment of asymptomatic and haemodynamically irrelevant ventricular arrhythmias with anti-arrhythmic drugs is not recommended.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"forbidden_treatment": "anti-arrhythmic drugs", "trigger_condition": "asymptomatic and haemodynamically irrelevant ventricular arrhythmias"}, "rule_type": "contra", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

[The use of restraint or seclusion must be --]

§482.13(e)(4)(ii) - implemented in accordance with safe and appropriate restraint and seclusion techniques as determined by hospital policy in accordance with State law.

## Interpretive Guidelines §482.13(e)(4)(ii)

Restraint or seclusion must be implemented appropriately and safely, and reflect hospital policy in accordance with State law.

The use of restraint or seclusion must never act as a barrier to the provision of other interventions to meet the patient's needs.

## Survey Procedures §482.13(e)(4)(ii)

- Review the hospital's policies and procedures to determine if they reflect current standards of practice regarding safe and appropriate restraint and seclusion techniques.  Are there any references to State law statutes or any indication State laws were reviewed and incorporated?
- Review a sample of patient medical records that include patients who required the use of restraint or seclusion for the management of both violent, self-destructive behaviors, and non-violent, non-self-destructive behaviors.
- After restraints were applied, was an assessment immediately made to ensure that restraints were properly and safely applied?
- Were the hospital policies and procedures followed?
- Was the use of restraint or seclusion effective in achieving the purpose for which it was ordered?  If not, were timely changes made?
- Was there any evidence of injury to the patient?

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "implementation adheres to safe and appropriate techniques, hospital policy, and State law, and does not impede other patient care", "trigger_assertion": "restraint or seclusion is used"}, "rule_type": "conditional_existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
Systolic BP must be above 98.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"min_value": 98, "target_vital": "Systolic BP"}, "rule_type": "threshold", "scope_tags": ["clinical"]}
Guideline text:
The use of established risk scores (e.g. GRACE risk score) for prognosis estimation should be considered. 47 – 49

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "consideration/use of established risk scores (e.g. GRACE risk score)", "trigger_assertion": "prognosis estimation is being performed"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

§482.55(b)(1) - The emergency services must be supervised by a qualified member of the medical staff.

## Interpretive Guidelines §482.55(b)(1)

A qualified member of the medical staff must supervise the provision of emergency services.  Since §482.55(a)(1) requires that emergency services must be organized under the direction of a qualified member of the medical staff, the requirement for supervision at§482.55(b)(1) must be distinguished from the prior requirement.  In this context, 'supervision' implies a more immediate form of oversight by a qualified member of the medical staff during all times the hospital makes emergency services available.  A supervisor may be briefly absent from the emergency department, but is expected to be in the hospital and immediately available to provide direction and/or direct care during the operating hours of the emergency department.

The medical staff must establish criteria, in accordance with State law, regulations, and guidelines, delineating the qualifications a medical staff member must possess in order to be granted privileges for the supervision of the provision of emergency care services. Qualifications include necessary education, experience and specialized training, consistent with State law and acceptable standards of practice.

## Survey Procedures §482.55(b)(1)

Verify that a qualified member of the medical staff is designated to supervise emergency services.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "supervision of emergency services by a qualified medical staff member"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
This document replaces the 2019 standards of care. [Ref: 960]

Structured rule (JSON):
{"intent_tags": [], "logic_config": {}, "rule_type": "unsupported", "scope_tags": [], "summary": "Non-executable narrative text"}
Guideline text:
Evaluation of neurological prognosis Evaluation of neurological prognosis (no earlier than 72 h after admission) is recommended in all comatose survivors after cardiac arrest.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"anchor": "admission", "min_delay_hours": 72, "target": "Evaluation of neurological prognosis"}, "rule_type": "temporal", "scope_tags": ["clinical"]}
Guideline text:
IRA-only PCI during the index procedure is recommended. 404 , 505

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "IRA-only PCI during the index procedure"}, "rule_type": "existence", "scope_tags": ["clinical"]}
Guideline text:
Complete revascularization is recommended either during the index PCI procedure or within 45 days.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"anchor": "index PCI procedure", "max_delay_days": 45, "target": "complete revascularization"}, "rule_type": "temporal", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.61(b)(3) Contain a record of mental status;

## Interpretive Guidelines §482.61(b)(3)

The mental status must describe the appearance and behavior, emotional response, verbalization, thought content, and cognition of the patient as reported by the patient and observed by the examiner at the time of the examination. This description is appropriate to the patient's condition.

Explore the mental status for descriptions of the patient's presentation during the examination that are relevant to the diagnosis and treatment of the patient. An example of a portion of the patient interview: The patient periodically states the examiner's name correctly during this examination after hearing it once, accurately describes his past history in great detail, precisely characterizes his present situation, can list events in logical sequence that have led to his present illness, but believes that his pre-admission insomnia, anorexia, and 35 pound weight loss over the past four months are totally the result of his sexual promiscuity of ten years ago and have nothing to do with his concurrent use of 50 to 60 mg. of Amphetamine daily.' From this information one can conclude that the patient is oriented, his memory is intact, but that he has poor judgment and no insight. It is not acceptable just to write 'oriented, memory intact, judgment poor, and insight nil,' without any supportive information.

Structured rule (JSON):
{"intent_tags": ["quality", "compliance", "integrity"], "logic_config": {"required_artifact": "mental status record", "required_artifact_details": "must describe appearance, behavior, emotional response, verbalization, thought content, and cognition, supported by observations and not just conclusions."}, "rule_type": "existence", "scope_tags": ["clinical", "legal"]}