Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-4 - MINIMUM STANDARDS FOR NURSING HOMES › Section 59A-4.107 - Physician Services

Current through Reg. 50, No. 138; July 16, 2024
(1) Each nursing
				home facility licensee must retain, pursuant to a written agreement, a
				physician licensed under Chapters 458 or 459, F.S., to serve as Medical
				Director. In facilities with a licensed capacity of 60 beds or less, pursuant
				to written agreement, a physician licensed under Chapters 458 or 459, F.S., may
				serve as medical consultant in lieu of a Medical Director.
(2) Each resident or legal representative,
				must be allowed to select his or her own private physician.
(3) Verbal orders, including telephone
				orders, must be immediately recorded, dated, and signed by the person receiving
				the order. All verbal treatment orders must be countersigned by the physician
				or other health care professional on the next visit to the facility.
(4) Physician orders may be transmitted by
				facsimile machine, email or electronic medical record as required Section
				501.171, F.S. and 45 Code of
				Federal Regulation, Section 164, effective October 1, 2014, which is
				incorporated by reference and is available at
http://www.gpo.gov/fdsys/pkg/CFR-2014-title45-vol1/xml/CFR-2014-title45-vol1-part164.xml
and
http://www.flrules.org/Gateway/reference.asp?No=Ref-06388
and
http://www.flrules.org/Gateway/reference.asp?No=Ref-06389
.
				It is not necessary for a physician to re-sign a facsimile order when he or she
				visits a facility.
(5) All
				physician orders must be followed as prescribed, and if not followed, the
				reason must be recorded on the resident's medical record during that
				shift.
(6) Each resident must be
				seen by a physician or another licensed health professional acting within their
				scope of practice at least once every 30 days for the first 90 days after
				admission, and at least once every 60 days thereafter. A physician visit is
				considered timely if it occurs not later than 10 days after the date the visit
				was required. If a physician documents that a resident does not need to be seen
				on this schedule and there is no other requirement for physician's services
				that must be met due to Title XVIII or XIX of the Social Security Act, the
				resident's physician may document an alternate visitation schedule.
(7) If the physician chooses to designate
				another health care professional to fulfill the physician's component of
				resident care, they may do so after the required visit. All responsibilities of
				a physician, except for the position of medical director, may be carried out by
				other health care professionals acting within their scope of
				practice.
(8) Each nursing home
				licensee must have a list of physicians designated to provide emergency
				services to residents when the resident's attending physician, or designated
				alternate is not available.
Rulemaking Authority 400.23 FS. Law Implemented 400.141,
					 400.23 FS.
New 4-1-82, Amended 4-1-84, Formerly 10D-29.107, Amended
					 10-5-92, 4-18-94, 1-10-95, 12-21-15.