Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 110 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF SKILLED NURSING FACILITIES AND NURSING FACILITIES › Section 144-110-16 - Physician Services

Current through 2024-29, July 17, 2024
16.A.
Physician Services
Each resident must be under the care of a physician.
16.A.1. A physician must personally approve,
				in writing, the recommendation that an individual be admitted to a nursing
				facility.
16.A.2. A physical
				examination, a copy of which must be in the resident's clinical record, must
				have been performed five (5) days prior to or within seven (7) days of
				admission.
16.A.3. The admitting
				physician must participate in the initial and ongoing medical evaluation and
				care planning of the resident.
16.A.4. The admitting physician must ensure
				that another physician supervises the medical care of residents, when the
				attending physician is unavailable.
16.A.5. The physician must visit the resident
				and review the resident's total program of care including medications and
				treatments as needed, at least once every thirty (30) days for the first ninety
				(90) days and every sixty (60) days thereafter. A grace period of ten (10) days
				may be allowed for the resident whose condition during this period of time did
				not require medical attention.
16.A.6. Orders concerning medications and
				treatments shall be in writing, signed and dated by a physician and shall be in
				effect for the time specified by the physician, but in no case to exceed a
				period of sixty (60) days unless there is a written reorder. A grace period of
				ten (10) days may be allowed for the resident whose condition did not require a
				review and reorders during this period of time.
16.A.7. Orders for Schedule II controlled
				substances shall be in effect for no longer than one (1) week, unless there are
				specific written orders to the contrary. In no case shall the order be in
				effect for a period of more than thirty (30) days.
16.A.8. At the option of the physician,
				required visits, after the initial visit, may alternate between personal visits
				by the physician and visits by a physician's assistant, nurse practitioner or
				clinical nurse specialist who meets the applicable definition, acts within the
				scope of State law, and is under the supervision of the physician.
16.A.9. At each visit, the physician,
				physician's assistant, nurse practitioner or clinical nurse specialist must
				write, sign, and date progress notes.
16.A.10.
Availability of Physician for
				Emergency Care
The facility must provide or arrange for the provision of
				  physician services twenty-four (24) hours a day, in case of an
				  emergency.
16.A.11.
Medical Director
a. There shall
				be a medical director who is responsible for the medical direction and
				coordination of medical care in the facility.
b. The duties, responsibilities and
				availability of the medical director, and the terms of agreement, shall be
				delineated in writing. The agreement shall be signed by the physician serving
				as medical director and by an authorized representative of the
				facility.
c. The medical director
				is responsible for the:
1. Overall
				coordination of medical care;
2.
				Liaison with attending physicians;
3. Participation in the Quality Assurance
				Committee and the Professional Policy Committee.