Rule 111-8-22-.09 - Medical Staff and Medical Services(1) Medical Director. Any medical director beginning such a function for the first time in Georgia at any facility on or after July 1, 2002 shall be a licensed physician who is board-certified in nephrology. However, a physician who has completed a fellowship in nephrology after July 1, 2002 may direct a dialysis facility in a medically- underserved area for a maximum of two years provided that the physician obtains board certification as a nephrologist by the end of the two-year period. Any physician functioning as a facility medical director at the implementation date of these rules shall be board-eligible or board-certified in nephrology, internal medicine, or pediatrics, and shall have at least one year experience in the care of patients at an end stage renal disease facility. (a) The medical director shall participate in the development of all patient care policies at the facility.(b) The facility shall have mechanisms in place for communication of essential patient care issues and information to the medical director.(c) The medical director shall be responsible for the daily clinical operations of the facility, and for the execution of patient care policies and procedures.(d) The medical director shall be permitted to provide direct patient care services at the facility, in addition to the duties as the medical director.(2) Medical Services. The medical director shall ensure that each patient at the facility receives medical care and supervision appropriate to the patient's dialysis needs. (a) Each patient shall have an attending physician who is responsible on a continuing basis for the patient's medical care. Each patient's records shall clearly indicate the name and contact number for the patient's physician.1. The facility shall require a history and physical examination of each patient following admission, prior to the development of the patient's care plan, and at least annually thereafter.2. The facility shall require each patient to have a medical plan of care, prescribed by a physician, to include indicated dialysis or related treatments, dialysis orders, medications, diet, criteria for discharge and any other special services needed.3. The facility shall require that the patient's physician participates in the development of the care plan for the patient, and shall assure that the plan for the patient's medical care is based on the assessment of the patient's individual needs.4. The facility shall require and the medical director shall ensure that the patient's medical progress at the facility is monitored by a physician on-site at least monthly. The facility shall require that each patient have a scheduled opportunity to see a physician at least once per month. Medical patient monitoring and physician visits shall be documented by progress note entries in the patient's medical record.5. The facility shall require and the medical director shall ensure that any adverse medical patient outcomes are communicated to the patient's physician, and that the facility takes appropriate corrective action.(b) The medical director shall ensure that there is medical care available at all times for managing emergency situations, for both in-center and home dialysis patients. There shall be posted at each nursing/monitoring station a roster of physicians on-call for the provision of emergency care. The roster shall specify when each physician is available and how they can be reached.(c) The facility shall ensure that each patient, or each patient's responsible party, is aware of how to access medical care in an emergency, as appropriate to the patient's age and abilities.Ga. Comp. R. & Regs. R. 111-8-22-.09
O.C.G.A. § 31-44-3.
Original Rule entitled "Medical Staff and Medical Services" adopted. F. Feb. 20, 2013; eff. Mar. 12, 2013.Amended: F. May 9, 2017; eff. May 29, 2017.