reglab/statecodes huggingface dataset:
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 111 - DIETETIC SERVICES › DIETETIC FACILITIES › Section 111.11 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
The dietetic service shall have adequate space, equipment
						and supplies to perform the efficient, safe and sanitary operation of all
						functions assigned to it.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 111 - DIETETIC SERVICES › DIETETIC FACILITIES › Section 111.12 - Equipment

Current through Register Vol. 54, No. 28, July 13, 2024
The type, size and layout of equipment shall provide for
						ease of cleaning, optimal workflow and efficient food production to meet the
						scope and complexity of the regular and therapeutic diet requirements of the
						patients. Equipment and work areas shall be clean and orderly. Effective
						procedures for cleaning all equipment and work areas shall be followed
						consistently to safeguard the health of the patient.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 111 - DIETETIC SERVICES › DIETETIC FACILITIES › Section 111.13 - Handwashing facilities

Current through Register Vol. 54, No. 28, July 13, 2024
Handwashing facilities, with hot and cold running water,
						liquid soap or individual soap leaves and towels shall be available for use by
						food handlers.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 111 - DIETETIC SERVICES › DIETETIC FACILITIES › Section 111.14 - Dry storage

Current through Register Vol. 54, No. 28, July 13, 2024
Dry or staple food items shall be stored in accordance
						with standard dry food storage techniques:
(1) Shelves shall be at a height above the
					 floor as to facilitate cleaning, or the shelves shall be of solid construction
					 and flush to the floor so as to eliminate the need for cleaning under
					 them.
(2) The room provided for
					 storage of dry or staple food items shall be ventilated and may not be subject
					 to sewage or waste water back-flow.
(3) The food products shall be protected from
					 contamination by condensation, leakage, mopping, insects, rodents or
					 vermin.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 111 - DIETETIC SERVICES › DIETETIC FACILITIES › Section 111.15 - Storage of perishable food

Current through Register Vol. 54, No. 28, July 13, 2024
Perishable foods shall be refrigerated at the appropriate
						temperature and in an orderly and sanitary manner as provided in regulations of
						the Department of Environmental Resources, set forth in 7 Pa. Code §§
											78.21-78.24,
						78.31 and
						78.32(Reserved).
						Foods being displayed or transported shall be protected from contamination and
						held at proper temperatures in clean containers, cabinets or serving
						carts.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 111 - DIETETIC SERVICES › DIETETIC FACILITIES › Section 111.16 - Refuse

Current through Register Vol. 54, No. 28, July 13, 2024
Leakproof, nonabsorbent containers with close-fitting
						covers shall be used for the disposal of garbage and kitchen refuse. Garbage
						and kitchen refuse shall be removed from the dietetic department in a manner
						which does not permit transmission of disease or create a nuisance or a
						breeding place for flies, insects or rodents. Garbage containers shall be
						thoroughly cleaned inside and out, each time emptied. Places in which refuse is
						stored shall be tightly sealed and leak-proof.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 111 - DIETETIC SERVICES › POLICIES AND PROCEDURES › Section 111.21 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
There shall be written policies and procedures to govern
						all dietetic service activities. These policies should be developed by the
						dietetic service in cooperation with personnel from other departments or
						services which are involved with dietetic service, and they shall be reviewed
						at least once every 2 years, revised as necessary, and dated to indicate the
						time of last review.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 111 - DIETETIC SERVICES › POLICIES AND PROCEDURES › Section 111.23 - Job descriptions

Current through Register Vol. 54, No. 28, July 13, 2024
Job descriptions shall be written for all classifications
						of dietetic services personnel. They shall be made available to dietetic
						services personnel.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 111 - DIETETIC SERVICES › POLICIES AND PROCEDURES › Section 111.24 - Education programs

Current through Register Vol. 54, No. 28, July 13, 2024
Education programs, including orientation, on-the-job
						training, in-service education, and continuing education programs shall be
						offered to dietetic services personnel. The programs shall include instruction
						in personal hygiene; in the proper inspection, handling, preparation, and
						serving of food; and in the proper cleaning and the safe operation of
						equipment. Current reference materials should be conveniently located,
						accessible, and available.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 111 - DIETETIC SERVICES › POLICIES AND PROCEDURES › Section 111.25 - Infection control

Current through Register Vol. 54, No. 28, July 13, 2024
There shall be procedures to control employes with
						infections and open lesions. Routine health examinations and infection control
						procedures shall meet at least the standards set forth in 7 Pa. Code
						§§
											78.41-78.43(Reserved).
						A dietician, dietetic technician, or dietetic assistant shall serve on any
						appropriate hospital infection control committees. These committees may be
						combined, and dietetic services infection control activities may be included
						among the responsibilities of the committee established pursuant to §
											147.21 (relating to infection
						control).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 111 - DIETETIC SERVICES › POLICIES AND PROCEDURES › Section 111.26 - Dishwashing

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Dishwashing
					 procedures and techniques shall be well developed, understood, and carried out.
					 Dishwashing procedures shall be at least those set forth in 7 Pa. Code
					 §§ 78.61-78.65 (Reserved).
(b) There shall be periodic checks at
					 established intervals of:
(1) washing,
					 rinsing, and sanitizing temperatures and cleanliness of machines and jets;
					 and
(2) Thermostatic
					 controls.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 111 - DIETETIC SERVICES › POLICIES AND PROCEDURES › Section 111.27 - Nutritional aspects of patient care

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The administration of the nutritional
					 aspects of patient care shall be under the direction of a qualified
					 dietitian.
(b) Therapeutic diets,
					 when appropriate, shall be prescribed in written orders on the medical record
					 by the physician and shall be instructive, accurate and as complete as
					 possible.
(c) The dietitian shall
					 have available an up-to-date manual of regimens for therapeutic diets, approved
					 jointly by the dietetic and medical staff, which shall be available to dietetic
					 supervisory personnel. There shall be a standardized recipe file.
(d) Patients' nutrition needs shall be met in
					 accordance with the current Recommended Dietary Allowance of the Food and
					 Nutrition Board, National Research Council, or shall be in accordance with
					 physician's orders.
(e) The
					 dietitian shall be responsible for the development of a nutritional care plan
					 in compliance with physician's orders to meet the needs of the patient for the
					 maintenance of health, prevention of disease, and treatment through diet
					 modification and normal nutritional counseling. The nutritional care plan shall
					 be integrated into the total care plan of the patient and shall be included on
					 his discharge plan and in transfer orders to any nursing facility or home
					 health agency to the extent necessary for continuity of care.
(f) The director of dietetic services should
					 attend and participate in meetings of heads of departments and function as an
					 integral member of the hospital staff.
(g) The director of dietetic services should
					 have regularly scheduled conferences with the chief executive officer or his
					 designee, to keep him informed, to seek his counsel, and to present program
					 plans for mutual consideration and solution.
(h) Conferences should be held regularly
					 within the dietary services department at all levels of responsibility, to
					 disseminate information, interpret policy, solve problems, and develop
					 procedures and program plans.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › GENERAL › Section 113.1 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
The hospital shall provide for pharmaceutical services
						  which are administered in accordance with accepted ethical and professional
						  practices.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › GENERAL › Section 113.2 - Organization and staffing

Current through Register Vol. 54, No. 28, July 13, 2024
The pharmaceutical service shall be directed by a
						  licensed pharmacist. When there is a pharmacy, it shall be staffed by a
						  sufficient number of competent personnel, in keeping with the size and scope of
						  services of the hospital.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › GENERAL › Section 113.3 - Pharmacist

Current through Register Vol. 54, No. 28, July 13, 2024
(a) When there is a
						pharmacy, it shall be directed by a licensed pharmacist. If a hospital does not
						have a pharmacy or full-time staff pharmacist, a consulting or part-time
						pharmacist shall have responsibility for control and dispensing of drugs and
						shall have responsibility for the pharmaceutical functions of nursing
						stations.
(b) The pharmacist shall
						be trained in the specialized functions of hospital pharmacy.
(c) The pharmacist shall be responsible to
						the chief executive officer or his designee for developing, supervising, and
						coordinating all the activities of the pharmacy.
(d) In the absence of a pharmacist, the
						dispensing of drugs shall be limited to emergencies and shall be performed only
						under the direct supervision of a practitioner licensed under State law to
						prescribe and dispense drugs.
The provisions of this § 113.3 issued under
							 67 Pa.C.S. §§
															6101-6104; and Reorganization Plan No. 2 of
							 1973 (71 P.S. §
															755-2).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › GENERAL › Section 113.4 - Staff

Current through Register Vol. 54, No. 28, July 13, 2024
The pharmacist shall be assisted by an adequate number
						  of additional pharmacists and such other personnel as the activities of the
						  pharmacy may require to ensure adequate pharmaceutical
						  services.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › GENERAL › Section 113.5 - Pharmacy and therapeutics committee

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A pharmacy and therapeutics committee or
						its equivalent, to include physicians, nurses, and pharmacists, shall be
						established.
(b) The committee
						shall meet at least quarterly, record its proceedings and report to the medical
						staff. It shall assist in the formulation of broad professional policies
						regarding the evaluation, appraisal, selection, procurement, storage,
						distribution, use and safety procedures, and all other matters relating to
						drugs in the hospital. This should include some mechanism to review and
						evaluate adverse drug reactions and make appropriate recommendations if
						necessary. The committee shall:
(1) serve as
						an advisory group to the hospital medical staff and the pharmacist on matters
						pertaining to the choice of drugs;
(2) develop and review periodically a
						formulary or drug list for use in the hospital;
(3) recommend standards regarding the use and
						control of investigational drugs and concerning research in the use of
						recognized drugs;
(4) evaluate
						clinical data concerning new drugs or preparations requested for use in the
						hospital;
(5) make recommendations
						concerning drugs to be stocked on the nursing unit floors and by other
						services;
(6) establish procedures
						which will prevent unnecessary duplication in stocking drugs and drugs in
						combination having identical amounts of the same therapeutic
						ingredients;
(7) make
						recommendations concerning drugs for which automatic stop drug orders are
						necessary; and
(8) make
						recommendations regarding proper procedures and policies on the administration
						of drugs.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › PHARMACY FACILITIES › Section 113.11 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
When there is a pharmacy, the hospital shall provide
						  equipment and supplies for the pharmaceutical service to carry out its
						  professional and administrative functions and to ensure patient safety through
						  the proper storage and dispensing of drugs. Facilities shall be provided for
						  the storage, safeguarding, preparation and dispensing of
						  drugs.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › PHARMACY FACILITIES › Section 113.12 - Supplies

Current through Register Vol. 54, No. 28, July 13, 2024
The pharmacy shall maintain a supply of drugs and
						  devices adequate to meet the needs of the patients and the medical staff.
						  Pharmacy supplies shall conform to the provisions of 49 Pa. Code §
												27.14 (relating to
						  supplies).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › PHARMACY FACILITIES › Section 113.13 - Cabinets

Current through Register Vol. 54, No. 28, July 13, 2024
Any area in the hospital where drugs are stored shall
						  be periodically checked by the pharmacist as specified by the pharmacy and
						  therapeutic committee. All floor stocks shall be controlled by the
						  pharmacist.
The provisions of this §
														113.13 issued under section
							 2102(g) of The Administrative Code of 1929 (71 P. S. §
															532(g)); and section 803 of
							 the Health Care Facilities Act (35 P. S. §
															448.803).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › PHARMACY FACILITIES › Section 113.14 - Space

Current through Register Vol. 54, No. 28, July 13, 2024
There shall be adequate space provided for all pharmacy
						  operations, and the storage of drugs at a satisfactory location provided with
						  proper lighting, ventilation, and temperature controls shall be in accordance
						  with 49 Pa. Code §§
												27.15-27.16 (relating to sanitary
						  standards and construction requirements).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › PHARMACY FACILITIES › Section 113.15 - Locked storage

Current through Register Vol. 54, No. 28, July 13, 2024
Special locked storage space shall be provided to meet
						  the requirements for storage of controlled substances, alcohol, and other
						  prescribed drugs as set forth in Chapter 25 (relating to controlled substances,
						  drugs, devices and cosmetics) and 49 Pa. Code §§
												27.16(4) and
						  27.17 (relating to construction
						  requirements and security for Schedule II controlled
						  substances).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › POLICIES AND PROCEDURES › Section 113.21 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
The scope of the pharmaceutical service shall be
						  consistent with the medication needs of the patients. Hospital pharmaceutical
						  policies shall include a program for the control and accountability of drug
						  products throughout the hospital.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › POLICIES AND PROCEDURES › Section 113.23 - Records

Current through Register Vol. 54, No. 28, July 13, 2024
(a) All drug
						transactions of the pharmacy shall be recorded, and those records shall be
						correlated with other hospital records. Such special records as are required by
						the provisions of Chapter 25 (relating to controlled substances, drugs, devices
						and cosmetics) shall also be kept.
(b) The pharmacy shall establish and maintain
						a system of records and bookkeeping in accordance with the policies of the
						hospital in order to maintain adequate control over the requisitioning and
						dispensing of all drugs and pharmaceutical supplies and over patient billing
						for all drugs and pharmaceutical supplies.
(c) Records for drugs dispensed from the
						pharmacy shall be maintained in the pharmacy, and records of drugs administered
						to patients shall be maintained in the medical record of the patient.
(d) Oral orders for drugs for immediate
						administration shall be subject to the medical staff policies on oral orders,
						set forth in §
												107.62 (relating to oral
						orders).
(e) Copies of records of
						all adverse drug reactions and drug sensitivities shall be maintained in
						accordance with the provisions of §
												109.65 (relating to recording of
						drugs administered). Copies of records of all adverse drug reactions and drug
						sensitivities shall be maintained in the pharmacy for two years.
The provisions of this § 113.23 issued under
							 67 Pa.C.S. §§
															6101-6104; and Reorganization Plan No. 2 of
							 1973 (71 P. S. §
															755-2).
This section cited in 28 Pa. Code §
														109.65 (relating to recording of
							 drugs administered).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › POLICIES AND PROCEDURES › Section 113.24 - Medications dispensed

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The hospital
						shall dispense only drugs which are listed in one or more of the references
						listed in subsection (b) or as provided in subsection (c). Any drug unfavorably
						evaluated in any of these references shall be used only in accordance with
						standards established by the hospital's pharmacy and therapeutics
						committee.
(b) References
						containing lists of drugs which may be dispensed by hospitals shall be as
						follows:
(1)
United States
						Pharmacopoeia.
(2)
National Drug Formulary.
(3)
AMA Drug Evaluation.
(4)
Accepted Dental
						Remedies.
(5)
Pennsylvania Generic Drug Formulary.
(6)
The Physician's Desk
						Reference.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › POLICIES AND PROCEDURES › Section 113.25 - Drug distribution systems

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
						The pharmacy and therapeutics committee or its equivalent shall develop written
						policies and procedures pertaining to the intra-hospital drug distribution
						system. In developing such policies, the committee shall utilize, as necessary,
						representatives of other disciplines within the hospital.
(b) The label of each patient's individual
						medication container shall bear all information required by section 8 of the
						Controlled Substance, Drug, Device and Cosmetic Act (35 P. S. §
													780.108), 49 Pa. Code §
												27.18(d)
						(relating to standards of practice) and §
												25.18 (relating to packaging and
						labeling).
(c) The pharmacist, with
						the advice and guidance of the pharmacy and therapeutics committee, or its
						equivalent, shall be responsible for specifications as to quality, quantity,
						and source of supplies of all drugs.
(d) There shall be a formulary or list of
						drugs accepted for use in the hospital which shall be developed and amended at
						regular intervals by the pharmacist and the appropriate committee. Drugs
						included in the Pennsylvania Generic Drug Formulary shall be considered for
						inclusion in the hospital's formulary.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › POLICIES AND PROCEDURES › Section 113.26 - Administration of drugs

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The pharmacy
						and therapeutics committee, or its equivalent, in cooperation with
						representatives of such other disciplines as necessary, shall develop written
						policies and procedures governing the safe administration of drugs. Such
						policies and procedures shall be approved by the governing body or its
						designee.
(b) The policies and
						procedures developed in accordance with subsection (a) shall establish controls
						governing the administration of dangerous drugs, as provided in this section.
(1) Dangerous drugs shall include controlled
						substances, sedatives, anticoagulants, antibiotics, oxytoxics, and
						corticosteroids.
(2) Policies shall
						be established regarding appropriate dosage and duration of order of dangerous
						drugs.
(3) Automatic stop
						procedures shall be established for dangerous drugs not specifically prescribed
						as to time or number of doses. The execution of automatic stop drug orders is
						subject to §
													107.65 (relating to automatic stop
						drug orders).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › POLICIES AND PROCEDURES › Section 113.27 - Emergency pharmaceutical services

Current through Register Vol. 54, No. 28, July 13, 2024
Provision shall be made for emergency pharmaceutical
						  services. A secure emergency medication kit, stocked and approved by the
						  pharmacist, shall be kept readily available and under the control of either the
						  pharmacy, a practitioner licensed by law to prescribe or dispense drugs, or,
						  during emergency periods, a staff member designated by the chief executive
						  officer, or his designee.
This section cited in 28 Pa. Code §
														109.68 (relating to emergency drug
							 cart or kit).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › POLICIES AND PROCEDURES › Section 113.28 - Distressed drugs, devices and cosmetics

Current through Register Vol. 54, No. 28, July 13, 2024
Drugs, devices, and cosmetics under the control of the
						  pharmacist which are outdated, visibly deteriorated, unlabeled or inadequately
						  labeled, recalled, discontinued, or obsolete shall be identified by the
						  pharmacist and shall be disposed of in compliance with applicable State and
						  Federal laws and regulations.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › POLICIES AND PROCEDURES › Section 113.29 - Commercial pharmaceutical service

Current through Register Vol. 54, No. 28, July 13, 2024
A hospital using an outside pharmacist or
						  pharmaceutical service must have a contract with that pharmacist or service. As
						  part of the contract, the pharmacist or service shall be required to maintain
						  at least the standards for operation of the pharmaceutical services outlined in
						  this chapter.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 113 - PHARMACY SERVICES › Subchapter A - GENERAL PROVISIONS › POLICIES AND PROCEDURES › Section 113.30 - Mishandling of drugs

Current through Register Vol. 54, No. 28, July 13, 2024
If there is reason to suspect mishandling of scheduled
						  or controlled drugs, the administration shall contact the Bureau of Drug
						  Control of the Office of Attorney General.
The provisions of this §
														113.30 issued under section
							 2102(g) of The Administrative Code of 1929 (71 P. S. §
															532(g)); and section 803 of
							 the Health Care Facilities Act (35 P. S. §
															448.803).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › GENERAL PROVISIONS › Section 115.1 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
The hospital shall maintain facilities and services
						adequate to provide medical records which are accurately documented and readily
						accessible to authorized persons requiring such access and which can be readily
						used for retrieving and compiling information.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › GENERAL PROVISIONS › Section 115.2 - Organization and staffing

Current through Register Vol. 54, No. 28, July 13, 2024
A hospital shall have a medical record service. It shall
						be directed, staffed and equipped to ensure the accurate processing, indexing
						and filing of all medical records.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › GENERAL PROVISIONS › Section 115.3 - Director

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The medical
					 records service shall be under the direction and supervision of a certified
					 medical records practitioner. If no certified person is available on a
					 full-time basis, a certified person shall be employed on a part-time or
					 consulting basis.
(b) The director
					 of the medical record service should advise, administer, supervise, and perform
					 work involved in the development, analysis, maintenance and use of medical
					 records and reports.
(c) When the
					 director is employed on a part-time or consulting basis, he shall organize the
					 department, train the regular personnel, and make periodic visits to the
					 hospital to evaluate the records and the operation of the service. A written
					 contract specifying his duties and responsibilities shall be kept on file and
					 made available for inspection by the Department's surveyor.
The provisions of this §
													115.3 issued under section 2102(g)
						  of The Administrative Code of 1929 (71 P.S. §
														532(g)); and section 803 of
						  the Health Care Facilities Act (35 P.S. §
														448.803).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › GENERAL PROVISIONS › Section 115.4 - Medical record personnel

Current through Register Vol. 54, No. 28, July 13, 2024
At least one full-time or part-time employe shall provide
						regular medical service. Other personnel shall be employed as needed to
						effectively perform the functions assigned to the medical record
						department.
The provisions of this § 115.4 issued under
						  67 Pa.C.S. §§
														6101-6104 (Repealed); and Reorganization Plan
						  No. 2 of 1973 (71 P.S. §
														755-2)
						  (Renumbered).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › GENERAL PROVISIONS › Section 115.5 - Education programs

Current through Register Vol. 54, No. 28, July 13, 2024
The hospital shall provide orientation, on-the-job
						training, and regular in-service, either hospital-based or outside the
						hospital, education programs for medical records personnel. Employes should be
						encouraged to participate in job-related workshops, institutes or
						correspondence education courses available outside the
						hospital.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › FACILITIES › Section 115.11 - Principle

Current through Register Vol. 54, No. 28, July 13, 2024
The medical record service shall be properly equipped to
						enable its personnel to function in an effective manner and to maintain medical
						records so that they are readily accessible and secure from unauthorized
						use.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR MEDICAL RECORDS SERVICE › Section 115.21 - Identification and filing of medical records

Current through Register Vol. 54, No. 28, July 13, 2024
The medical record service shall maintain a system of
						identification and filing to facilitate the prompt location of the medical
						record of a patient.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR MEDICAL RECORDS SERVICE › Section 115.22 - Storage of medical records

Current through Register Vol. 54, No. 28, July 13, 2024
Medical records shall be stored in such a manner as to
						provide protection from loss, damage and unauthorized access.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR MEDICAL RECORDS SERVICE › Section 115.23 - Preservation of medical records

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Medical records, whether original, reproductions or microfilm, shall be kept on
					 file for a minimum of 7 years following the discharge of a patient.
(b) If the patient is a minor, records shall
					 be kept on file until his majority, and then for 7 years or as long as the
					 records of adult patients are maintained.
(c) If a hospital discontinues operation, it
					 shall make known to the Department where its records are stored. Records are to
					 be stored in a facility offering retrieval services for at least 5 years after
					 the closure date. Prior to destruction, public notice shall be made to permit
					 former patients or their representatives to claim their own records. Public
					 notice shall be in at least two forms, legal notice and display advertisement
					 in a newspaper of general circulation.
The provisions of this § 115.23 issued under
						  67 Pa.C.S. §§
														6101-6104; and Reorganization Plan No. 2 of
						  1973 (71 P. S. §
														755-2).
This section cited in 28 Pa. Code §
													139.28 (relating to patient
						  medical records).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR MEDICAL RECORDS SERVICE › Section 115.24 - Microfilming medical records

Current through Register Vol. 54, No. 28, July 13, 2024
Medical records may be microfilmed immediately after
						completion. Microfilming may be done on or off the premises. If done off the
						premises, the hospital shall take precautions to assure the confidentiality and
						safekeeping of the records. The original of microfilmed medical records shall
						not be destroyed until the medical records department has had an opportunity to
						review the processed film for content.
The provisions of this §
													115.24 issued under section
						  2102(g) of The Administrative Code of 1929 (71 P. S. §
														532(g)); and section 803 of
						  the Health Care Facilities Act (35 P. S. §
														448.803).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR MEDICAL RECORDS SERVICE › Section 115.25 - Infant footprints

Current through Register Vol. 54, No. 28, July 13, 2024
The imprint of infant footprints shall be retained.
						Microfilm records are acceptable to meet this requirement.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR MEDICAL RECORDS SERVICE › Section 115.26 - Automation of medical records

Current through Register Vol. 54, No. 28, July 13, 2024
Nothing in this subpart shall be construed to prohibit
						the use of automation in the medical records service, provided that all
						provisions in this chapter are met and the information is readily available for
						use in patient care. Innovations in medical record formats, compilation and
						data retrieval are specifically encouraged.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR MEDICAL RECORDS SERVICE › Section 115.27 - Confidentiality of medical records

Current through Register Vol. 54, No. 28, July 13, 2024
All records shall be treated as confidential. Only
						authorized personnel shall have access to the records. The written
						authorization of the patient shall be presented and then maintained in the
						original record as authority for release of medical information outside the
						hospital.
This section cited in 28 Pa. Code §
													115.28 (relating to
						  ownership).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR MEDICAL RECORDS SERVICE › Section 115.28 - Ownership

Current through Register Vol. 54, No. 28, July 13, 2024
Medical records are the property of the hospital, and
						they shall not be removed from the hospital premises, except for court
						purposes. Copies may be made available for authorized appropriate purposes such
						as insurance claims, and physician review, consistent with §
											115.27 (relating to
						confidentiality of medical records).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR MEDICAL RECORDS SERVICE › Section 115.29 - Patient access

Current through Register Vol. 54, No. 28, July 13, 2024
Patients or patient designees shall be given access to or
						a copy of their medical records, or both, in accordance with §
											103.22(b)(15)
						(relating to implementation). Upon the death of a patient, the hospital shall
						provide, upon request, to the executor of the decedent's estate or, in the
						absence of an executor, the next of kin responsible for the disposition of the
						remains, access to all medical records of the deceased patient. The patient or
						the patient's next of kin may be charged for the cost of reproducing the
						copies; however, the charges shall be reasonably related to the cost of making
						the copy.
The provisions of this §
													115.29 issued under section
						  2102(g) of The Administrative Code of 1929 (71 P. S. §
														532(g)); and section 803 of
						  the Health Care Facilities Act (35 P. S. §
														448.803).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR PATIENT MEDICAL RECORDS › Section 115.31 - Patient medical records

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An adequate
					 medical record shall be maintained for every inpatient, outpatient and patient
					 treated or examined in the emergency unit. This record shall contain data from
					 all episodes of care and treatment of the patient whether services were
					 performed on an inpatient basis, on an outpatient basis, or in the emergency
					 unit. The unit record system should be used whenever feasible. When it is not
					 feasible or appropriate to combine all inpatient, outpatient and emergency
					 records of an individual patient into a unitary record, a system shall be
					 established to:
(1) Assemble, when necessary,
					 all divergently located record components when an inpatient is admitted to the
					 hospital or appears for a prescheduled outpatient appointment.
(2) Require placing copies of pertinent
					 portions of an inpatient's medical record, such as the discharge resume, the
					 operative note and the pathology report, in the outpatient or combined
					 outpatient/emergency unit record file.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR PATIENT MEDICAL RECORDS › Section 115.32 - Contents

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The medical
					 record shall contain sufficient information to identify the patient clearly, to
					 justify the diagnosis and treatment, and to document the results
					 accurately.
(b) If a member of the
					 hospital's medical staff has performed a physical examination consistent with
					 the medical staff bylaws within 30 days prior to a patient's admission to the
					 hospital, a reasonably durable, legible copy of the record of this examination
					 may be used in lieu of an admission history and report of physical examination.
					 An interval admission note shall, however, be recorded, including any additions
					 to the history and any subsequent changes in the physical findings.
(c) If the patient was admitted to another
					 hospital within 30 days prior to his admission, the medical staff or attending
					 physician shall determine whether to record its own complete history and
					 physical examination. The hospital shall, with the written authorization of the
					 patient, request the records of the previous admission from the other hospital
					 as soon as possible.
(d) A medical
					 record shall include notes by authorized house staff members and individuals
					 who have been granted clinical privileges, consultation reports, nurses' notes
					 and entries by specified professional personnel.
(e) A medical record shall include the
					 findings and results of any pathological or clinical laboratory examinations,
					 radiology examinations, medical and surgical treatment, and other diagnostic or
					 therapeutic procedures.
(f) A
					 medical record shall include a provisional diagnoses; primary and secondary
					 final diagnoses, the latter if necessary; a clinical resume; and, where
					 appropriate, necropsy reports.
The provisions of this § 115.32 issued under
						  67 Pa.C.S. §§
														6101-6104; and Reorganization Plan No. 2 of
						  1973 (71 P. S. §
														755-2).
This section cited in 28 Pa. Code §
													119.24 (relating to patient
						  medical records); 28 Pa. Code §
													135.13 (relating to patient's
						  medical record; preoperative procedures); 28 Pa. Code §
													710.23 (relating to patient
						  records); 28 Pa. Code §
													711.43 (relating to client
						  records); 28 Pa. Code §
													711.53 (relating to client
						  records); 28 Pa. Code §
													711.62 (relating to client
						  records); 28 Pa. Code §
													711.72 (relating to client
						  records); 28 Pa. Code §
													711.83 (relating to client
						  records); 28 Pa. Code §
													711.93 (relating to client
						  records); and 49 Pa. Code §
													16.95 (relating to medical
						  records).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR PATIENT MEDICAL RECORDS › Section 115.33 - Entries

Current through Register Vol. 54, No. 28, July 13, 2024
(a) All significant
					 clinical information pertaining to a patient shall be incorporated in the
					 patient's medical record.
(b)
					 Entries in the record shall be dated and authenticated by the person making the
					 entry.
(c) Symbols and
					 abbreviations may be used only when they have been approved by the medical
					 staff and when there exists a legend to explain them.
(d) Oral orders shall include the date and
					 signature of the person recording them. They shall be given and authenticated
					 in accordance with the provisions of §
											107.62 (relating to oral orders).
					 All other orders shall be recorded in accordance with the provisions in
					 §§
											107.61 and 107.62-107.65 (relating
					 to medical orders).
(e) A single
					 signature on the face sheet of a record shall not suffice to authenticate the
					 entire record. Each entry shall be individually authenticated.
(f) Notation of unusual incidents shall be
					 entered in accordance with the provisions of §
											109.37 (relating to unusual
					 incidents) and Chapter 151 (relating to fire, safety and disaster
					 services).
(g) Records of patients
					 discharged shall be completed within 30 days following discharge.
The provisions of this § 115.33 issued under
						  67 Pa.C.S. §§
														6101-6104; and Reorganization Plan No. 2 of
						  1973 (71 P. S. §
														755-2).
This section cited in 28 Pa. Code §
													119.24 (relating to patient
						  medical records); 28 Pa. Code §
													135.13 (relating to patient's
						  medical record; preoperative procedures); and 49 Pa. Code §
													16.95 (relating to medical
						  records).
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 115 - MEDICAL RECORD SERVICES › POLICIES AND PROCEDURES FOR PATIENT MEDICAL RECORDS › Section 115.34 - Medical records review

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Medical
					 records shall be reviewed periodically in accordance with medical staff bylaws,
					 rules and regulations by the medical records committee, or its equivalent,
					 established under §
											107.26(b)(4)
					 (relating to additional committees).
(b) The medical records committee:
(1) Shall review records for completeness and
					 shall establish requirements regarding completion of medical records, including
					 a system for disciplinary actions for those who do not complete records in a
					 timely manner.
(2) Shall make
					 recommendations to the medical staff, regarding any changes in the format of
					 the records.
(3) Should review the
					 medical records to ensure that the recorded clinical information is sufficient
					 for the purpose of medical care evaluation.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 117 - EMERGENCY SERVICES › GENERAL PROVISIONS › Section 117.1 - Provision of services

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Regardless
					 of the scope of services offered, every hospital shall institute essential
					 life-saving measures and provide emergency procedures that will minimize
					 aggravation of the condition of the patient during transportation when referral
					 is indicated. In accordance with the principle that an individual confronting
					 an emergency should not bear the responsibility of choosing the proper
					 emergency service, every hospital shall provide and maintain equipment
					 necessary to institute essential life-saving measures.
(b) Where there is an emergency service, it
					 shall provide prompt examination or treatment, or both, to all persons who come
					 or are brought into the hospital in need of treatment, irrespective of ability
					 to pay. The treatment shall be of the highest type consistent with the
					 facilities available and with the standards established in the medical
					 community of which the hospital is a part.
(c) Where emergency services are provided
					 indirectly, through a contract between the hospital and other organizations or
					 individuals or through alternative, innovative, organizational approaches,
					 these services should meet the principles and standards set forth in this
					 chapter.
(d) Where emergency
					 services are provided indirectly, as set forth in subsection (c), the name of
					 the organization and individuals responsible for the operation of the emergency
					 services shall be posted conspicuously to so inform patients.
Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart B - General and Special Hospitals › Chapter 117 - EMERGENCY SERVICES › EMERGENCY SERVICES PLANNING › Section 117.11 - Emergency services plan

Current through Register Vol. 54, No. 28, July 13, 2024
A comprehensive written plan for emergency care, based on
						community need and on the capability of the hospital, shall exist within every
						hospital.
This section cited in 28 Pa. Code §
													141.25 (relating to emergency
						  dental services); and 28 Pa. Code §
													1021.104 (relating to
						  responsibilities of regional EMS
						  councils).