Nick-Maximillien/medgate-compiler-data huggingface dataset:
Guideline text:
An invasive strategy during hospital admission is recommended in NSTE-ACS patients with high-risk criteria or a high index of suspicion for unstable angina. 196 – 200

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "invasive strategy during hospital admission", "trigger_assertion": "NSTE-ACS patients with high-risk criteria or a high index of suspicion for unstable angina"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
IABP should be considered in patients with haemodynamic instability/cardiogenic shock due to ACS-related mechanical complications.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "consideration of IABP", "trigger_assertion": "patient has haemodynamic instability/cardiogenic shock due to ACS-related mechanical complications"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

§482.12(d)(7) The plan must be prepared--

- (i)   Under the direction of the governing body; and
- (ii)  By a committee consisting of representatives of the governing body, the administrative staff, and the medical staff of the institution.

## Survey Procedures §482.12(d)(7)

Verify that the governing body, administrative staff, and medical staff have participated in the development of the institutional plan and budget.

Structured rule (JSON):
{"intent_tags": ["quality", "compliance", "integrity"], "logic_config": {"required_artifact": "Institutional plan and budget developed by a committee with governing body, administrative, and medical staff representation, under governing body direction."}, "rule_type": "existence", "scope_tags": ["facility"]}
Guideline text:
(Rev. 87, Issued: 07-19-13, Effective: 07-19-13, Implementation: 07-19-13)

§482.43(c)(4) - The hospital must reassess the patient's discharge plan if there are factors that may affect continuing care needs or the appropriateness of the discharge plan.

## Interpretive Guidelines §482.43(c)(4)

Changes in a patient's condition may warrant adjustments to the discharge plan.  Hospitals must have in place either a routine reassessment of all plans or a process for triggering a reassessment of the patient's post-discharge needs, capabilities and discharge plan when significant changes in the patient's condition or available supports occur.

## Survey Procedures §482.43(c)(4)

- Review a sample of cases to determine if any significant changes in the patient's condition were noted in the medical record that changed post-discharge needs, and if the discharge plan was updated accordingly.
- In making this determination, ask staff responsible for discharge planning when and how they reassess a patient's discharge plan.   If none of the records being used for the tracers suggest a need to revise the discharge plan, ask staff to present one or more clinical records that document reassessment.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "reassessment of discharge plan", "trigger_assertion": "significant change in patient condition or care needs"}, "rule_type": "conditional_existence", "scope_tags": ["clinical", "legal"]}
Guideline text:
Conflict of interest disclosures are available online. [Ref: 424]

Structured rule (JSON):
{"intent_tags": [], "logic_config": {}, "rule_type": "unsupported", "scope_tags": [], "summary": "Non-executable narrative text"}
Guideline text:
Treatment of recurrent VT with haemodynamic relevance (despite repeated electrical cardioversion) with lidocaine may be considered if beta-blockers, amiodarone, and overdrive stimulation are not

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "Lidocaine treatment consideration", "trigger_assertion": "recurrent VT with haemodynamic relevance (despite repeated electrical cardioversion) AND beta-blockers, amiodarone, and overdrive stimulation are not effective/available"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
Limit physical therapy unit to 2 units per session.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"event_type": "physical", "max_count": 2}, "rule_type": "count_sanity", "scope_tags": ["clinical"]}
Guideline text:
It is recommended to assess glycaemic status at initial evaluation in all patients with ACS.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "glycaemic status assessment", "trigger_assertion": "initial evaluation in all patients with ACS"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

[The bylaws must:]

§482.22(c)(2) - Include a statement of the duties and privileges of each category of medical staff (e.g., active, courtesy, etc.)

## Interpretive Guidelines §482.22(c)(2)

The medical staff bylaws must state the duties and scope of medical staff privileges each category of practitioner may be granted.  Specific privileges for each category must clearly and completely list the specific privileges or limitations for that category of practitioner. The specific privileges must reflect activities that the majority of practitioners in that category can perform competently and that the hospital can support.

Although the medical staff bylaws must address the duties and scope for each category of practitioner, this does not mean that each individual practitioner within the category may automatically be granted the full range of privileges.  It cannot be assumed that every practitioner can perform every task/activity/privilege that is specified for the applicable category of practitioner.  The individual practitioner's ability to perform each task/activity/privilege must be individually assessed.

## Survey Procedures §482.22(c)(2)

Determine whether the bylaws specify the duties and scope of medical staff privileges for each category of practitioner eligible for medical staff membership or privileges.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "Medical staff bylaws detailing duties and scope of privileges for each practitioner category, along with evidence of individual practitioner assessment for specific privileges."}, "rule_type": "existence", "scope_tags": ["facility", "legal"]}
Guideline text:
In patients with pre-discharge LVEF ≤40%, repeat evaluation of the LVEF 6–12 weeks after an ACS (and after complete revascularization and the institution of optimal medical therapy) is recommended to assess the potential need for sudden cardiac death primary prevention ICD implantation.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "repeat evaluation of LVEF 6\u201312 weeks after ACS", "trigger_assertion": "patient has pre-discharge LVEF \u226440% after an ACS, complete revascularization, and optimal medical therapy"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

## §482.45 Condition of Participation:  Organ, Tissue and Eye Procurement

## Interpretive Guidelines §482.45:

The hospital must ensure the specific organ, tissue, and eye procurement requirements are met.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "organ, tissue, and eye procurement requirements met"}, "rule_type": "existence", "scope_tags": ["clinical", "facility"]}
Guideline text:
(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.42(a)(4) The infection prevention and control program reflects the scope and complexity of the hospital services provided.

## Interpretive Guidelines §482.42(a)(4)

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 reflecting the scope and complexity of hospital services"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
The level of evidence for this section is based on expert consensus. [Ref: 349]

Structured rule (JSON):
{"intent_tags": [], "logic_config": {}, "rule_type": "unsupported", "scope_tags": [], "summary": "Non-executable narrative text"}
Guideline text:
It is recommended to base the choice of long-term glucose-lowering treatment on the presence of comorbidities, including heart failure, chronic kidney disease, and obesity.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "long-term glucose-lowering treatment choice based on comorbidities", "trigger_assertion": "presence of comorbidities (heart failure, chronic kidney disease, obesity)"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
Assessment of mental well-being using a validated tool and onward psychological referral when appropriate should be considered. 903 , 904 , 912 , 913

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "assessment of mental well-being using a validated tool and documentation of consideration for psychological referral"}, "rule_type": "existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

[At a minimum:]

§482.13(a)(2)(i) The hospital must establish a clearly explained procedure for the submission of a patient's written or verbal grievance to the hospital.

Interpretive Guidelines §482.13(a)(2)(i)

The hospital's procedure for a patient or the patient's representative to submit written or verbal grievances must be clearly explained.  The patient or patient's representative should be able to clearly understand the procedure.

## Survey Procedures §482.13(a)(2)(i)

- Review the information provided to patients that explains the hospital's grievance procedures.  Does it clearly explain how the patient is to submit either a verbal or written grievance?
- Interview patients or patient representatives.  Does the patient, or (if he/she is

incapacitated) his/her representative, know about the grievance process and how to submit a grievance?

Structured rule (JSON):
{"intent_tags": ["quality", "compliance"], "logic_config": {"required_artifact": "clearly explained procedure for patient grievance submission"}, "rule_type": "existence", "scope_tags": ["facility", "legal"]}
Guideline text:
The routine use of an IABP in ACS patients with CS and without mechanical complications is not recommended. 399 , 405 – 407

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"forbidden_treatment": "routine use of IABP", "trigger_condition": "ACS patients with CS and without mechanical complications"}, "rule_type": "contra", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

§482.12(d)(5) The plan must be submitted for review to the planning agency designated in accordance with section 1122(b) of the Act, or if an agency is not designated, to the appropriate health planning agency in the State. (See Part 100 of this title.)

## Survey Procedures §482.12(d)(5)

Determine that the hospital's plan for capital expenditures has been submitted to the planning agency designated to review capital expenditures.  In certain cases facilities used by HMO and CMP patients are exempt from the review process.

Structured rule (JSON):
{"intent_tags": ["compliance"], "logic_config": {"required_artifact": "submission of capital expenditures plan to designated planning agency"}, "rule_type": "existence", "scope_tags": ["facility", "legal"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

§482.27(a)(1) - Emergency laboratory services must be available 24 hours a day.

## Interpretive Guidelines §482.27(a)(1)

The hospital must provide emergency laboratory services 24 hours a day, 7 days a week. These onsite emergency services may be provided directly by the hospital or through onsite contracted laboratory services.  Emergency lab services include collection, processing, and provision of results to meet a patient's emergency laboratory needs.

In a hospital with multiple hospital campuses, these emergency laboratory services must be available onsite 24/7 at each campus.

The medical staff must determine which laboratory services are to be immediately available to meet the emergency laboratory needs of patients who may be currently at the hospital or those patients who may arrive at the hospital in an emergency condition.  The emergency laboratory services (procedures, tests, personnel) available should reflect the scope and complexity of the hospital's operation and be provided in accordance with Federal and State law, regulations and guidelines and acceptable standards of practice.

At a hospital with off-campus locations the medical staff must determine which, if any, laboratory services must be immediately available to meet the emergency laboratory needs of the patients who are likely to seek care at each off-campus location.  The emergency laboratory services available must reflect the scope and complexity of the hospital's operations at the location and be provided in accordance with Federal and State law, regulations and guidelines and acceptable standards of practice.  The services must be available during the hours of operation of that location.

## Survey Procedures §482.27(a)(1)

Review the written description of the emergency laboratory services.  Review records (including accession records, worksheets, and test reports) to verify the 24-hour availability of emergency services and that those services are provided when required.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "emergency laboratory services available 24 hours a day, 7 days a week"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
Heart Rate must be above 96.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"min_value": 96, "target_vital": "Heart Rate"}, "rule_type": "threshold", "scope_tags": ["clinical"]}
Guideline text:
ICD therapy is recommended to reduce sudden cardiac death in patients with symptomatic HF (NYHA Class II–III) and LVEF ≤35% despite optimal medical therapy for >3 months and at least 6 weeks after MI who are expected to survive for at least 1 year with good functional status. 434 , 609 , 610

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "ICD therapy recommendation", "trigger_assertion": "patient has symptomatic HF (NYHA Class II\u2013III) AND LVEF \u226435% AND has received optimal medical therapy for >3 months AND is at least 6 weeks post-MI AND is expected to survive for at least 1 year with good functional status"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

## §482.23(b) Standard:  Staffing and Delivery of Care

The nursing service must have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed.  There must be supervisory and staff personnel for each department or nursing unit to ensure, when needed, the immediate availability of a registered nurse for care of any patient.

## Interpretive Guidelines §482.23(b)

The nursing service must ensure that patient needs are met by ongoing assessments of patients' needs and provides nursing staff to meet those needs.  There must be sufficient numbers, types and qualifications of supervisory and staff nursing personnel to respond to the appropriate nursing needs and care of the patient population of each department or nursing unit.

There must be a RN physically present on the premises and on duty at all times.  Every inpatient unit/department/location within the hospital-wide nursing service must have adequate numbers of RNs physically present at each location to ensure the immediate availability of a RN for the care of any patient.

A RN would not be considered immediately available if the RN were working on more than one unit, building, floor in a building, or provider (distinct part SNF, RHC, excluded unit, etc.) at the same time.

Staffing schedules must be reviewed and revised as necessary to meet the patient care needs and to make adjustments for nursing staff absenteeism.

## Survey Procedures §482.23(b)

- Determine that there are written staffing schedules which correlate to the number and acuity of patients.  Verify that there is supervision of personnel performance and nursing care for each department or nursing unit.  To determine if there are adequate numbers of nurses to provide nursing care to all patients as needed, take into consideration:
- o Physical layout and size of the hospital;
- o Number of patients;
- o Intensity of illness and nursing needs;
- o Availability of nurses' aides and orderlies and other resources for nurses, e.g., housekeeping services, ward clerks etc.;
- o Training and experience of personnel;
- Review medical records to determine if patient care that is to be provided by nurses is being provided as ordered.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "adequate numbers of physically present and immediately available Registered Nurses on each inpatient unit/department/location at all times"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}
Guideline text:
Transvenous catheter pacing termination and/or overdrive pacing should be considered if VT cannot be controlled by repeated electrical cardioversion.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "Transvenous catheter pacing termination and/or overdrive pacing should be considered", "trigger_assertion": "VT cannot be controlled by repeated electrical cardioversion"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
• temporary pacing is recommended in cases of failure to respond to atropine.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "temporary pacing", "trigger_assertion": "failure to respond to atropine"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
See Appendix A for a list of contributing authors. [Ref: 655]

Structured rule (JSON):
{"intent_tags": [], "logic_config": {}, "rule_type": "unsupported", "scope_tags": [], "summary": "Non-executable narrative text"}
Guideline text:
Intravenous beta-blockers are recommended when rate control is needed in the absence of acute HF or hypotension. 605

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "Intravenous beta-blockers administration", "trigger_assertion": "rate control is needed and acute HF is absent and hypotension is absent"}, "rule_type": "conditional_existence", "scope_tags": ["clinical"]}
Guideline text:
It is recommended to measure cardiac troponins with high-sensitivity assays immediately after presentation and to obtain the results within 60 min

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"anchor": "patient presentation", "max_delay_minutes": 60, "target": "cardiac troponin results"}, "rule_type": "temporal", "scope_tags": ["clinical"]}
Guideline text:
Radial access is recommended as the standard approach, unless there are over-riding procedural considerations.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "Radial access as the standard approach"}, "rule_type": "existence", "scope_tags": ["clinical"]}
Guideline text:
Implementation of these guidelines varies by facility. [Ref: 106]

Structured rule (JSON):
{"intent_tags": [], "logic_config": {}, "rule_type": "unsupported", "scope_tags": [], "summary": "Non-executable narrative text"}
Guideline text:
Heart Rate must be above 68.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"min_value": 68, "target_vital": "Heart Rate"}, "rule_type": "threshold", "scope_tags": ["clinical"]}
Guideline text:
Limit physical therapy unit to 7 units per session.

Structured rule (JSON):
{"intent_tags": ["safety"], "logic_config": {"event_type": "physical", "max_count": 7}, "rule_type": "count_sanity", "scope_tags": ["clinical"]}
Guideline text:
(Rev. 37, Issued:  10-17-08; Effective/Implementation Date:  10-17-08)

§482.57(a)(1) - There must be a director of respiratory care services who is a doctor of medicine or osteopathy with the knowledge, experience and capabilities to supervise and administer the service properly.  The director may serve on either a full-time or part-time basis.

## Interpretive Guidelines §482.57(a)(1)

The service director must be a doctor of medicine or osteopathy and must demonstrate through education, experience and specialized training that he/she has the qualifications necessary to supervise and administer the service properly, appropriate to the scope and complexity of services offered.

If the director serves on a part-time basis, the time spent directing the department should be appropriate to the scope and complexity of services provided.

## Survey Procedures §482.57(a)(1)

- Verify that a director has been appointed and that he/she has fixed lines of authority and delegated responsibility for operation of the service.
- Interview staff regarding the role and oversight activities conducted by the director.
- Review the service director's credentialing file to determine that he/she is a M.D. or D.O. and has the necessary education, experience and specialized training to supervise and administer the service properly.

Structured rule (JSON):
{"intent_tags": ["safety", "quality", "compliance"], "logic_config": {"required_artifact": "director of respiratory care services who is a doctor of medicine or osteopathy with appropriate knowledge, experience, and capabilities"}, "rule_type": "existence", "scope_tags": ["facility", "legal"]}
Guideline text:
It is recommended that all hospitals and EMS participating in the care of patients with suspected STEMI record and audit delay times and work

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"required_artifact": "records of delay times for STEMI care"}, "rule_type": "existence", "scope_tags": ["clinical", "facility"]}
Guideline text:
The level of evidence for this section is based on expert consensus. [Ref: 744]

Structured rule (JSON):
{"intent_tags": [], "logic_config": {}, "rule_type": "unsupported", "scope_tags": [], "summary": "Non-executable narrative text"}
Guideline text:
Temperature control (i.e. continuous monitoring of core temperature and active prevention of fever [i.e. >37.7°C]) is recommended after either out-of-hospital or in-hospital cardiac arrest for adults who remain unresponsive after return of spontaneous circulation.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"min_value": 37.7, "operator": ">", "target_vital": "core temperature"}, "rule_type": "threshold", "scope_tags": ["clinical"]}
Guideline text:
Routine PCI of an occluded IRA is not recommended in STEMI patients presenting >48 h after symptom onset and without persistent symptoms.

Structured rule (JSON):
{"intent_tags": ["safety", "quality"], "logic_config": {"forbidden_treatment": "Routine PCI of an occluded IRA", "trigger_condition": "STEMI patients presenting >48 h after symptom onset and without persistent symptoms"}, "rule_type": "contra", "scope_tags": ["clinical"]}