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Polices and procedures for the organizational
structure of the RHC. Is the clinic under the medical direction of
a physician and has a health care staff met the requirements of
481.8? |
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Do the organization’s policies set forth in
writing the lines of authority and the responsibilities? |
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RHC staffing availability and schedules. |
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Emergency policies and procedures for medical
and non-medical emergency procedures. |
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Compliance with local building, fire and safety
codes. |
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Policies and procedures for preventive
maintenance program to ensure that all essential mechanical,
electrical and patient-care equipment is maintained in safe
operating condition. |
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Policies and procedures for preventive
maintenance program to ensure that drugs and biologicals are
appropriately stored. |
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Policies and procedures for preventive
maintenance program to ensure that the premises are clean and
orderly. |
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The clinic’s health care services are
furnished in accordance with appropriate written policies which
are consistent with applicable State Law J55 Pt. Care Policies. |
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The policies are developed with the advice of a
group of professional personnel that includes one or more
physicians and one or more physicians and one or more physician’s
assistant or nurse practitioner. At least one member of the group
is not a member of the clinic’s staff. |
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The policies include a description of the
services the clinic furnishes directly and those furnished through
agreement or arrangement. |
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Personnel and fiscal policies. |
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RHC hours of operation. M _____________ Tu_________
Weds_______________ Thur____________
Fri__________
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Description |
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The policies include guidelines for the medical
management of health problems which include the conditions
requiring medical consultation and/or patient referral, the
maintenance of health care records, and procedures for the
periodic review and evaluation of the services furnished by the
clinic. |
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The policies include NP or PA responsibilities
and protocols. |
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The policies include medical direction and
supervision. |
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The policies include the rules for the storage,
handling, and administration of drugs and biologicals. |
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Are these policies reviewed at least annually
by the group of professional personnel required in this section,
and reviewed as necessary by the clinic. |
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Do the policies and procedures include direct
services the clinic staff furnished as well as diagostic and
therapeutic services and supplies that are commonly furnished in a
physician’s office or at the entry point into the health care
delivery system. These include medical history, physical
examination, assessment of health status, and treatment for a
variety of medical conditions? |
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The policies and procedures include basic
laboratory services essential to the immediate diagnosis and
treatment of the patient, including
(1) chemical examinations of urine by stick or
tablet methods or both (including urine ketones).
(2) hemoglobin or hematocrit
(3) blood sugar
(4) examination of stool specimens for occult
blood
(5) primary culturijg for traqnsmittal to a
certified laboratory
(6) pregnancy tests |
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The clinic has policies and procedures for
medical procedures as a first response to common life threatening
injuries and acute illness, and has available the drugs and
biologicals commonly used in life saving procedures such as
analgesic, anesthetic (local), antibiotics, anticonvulsants,
antidotes and emetics, serums and toxoids. |
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Does the clinic have policies and procedures
that include the agreements with one or more providers or
suppliers participating under Medicare or Medicaid to furnish
other services to its patients, including
(1) inpatient hospital care, (2) physician(s)
services (3) additional and specialized diagnostic and laboratory
services that are not available at the clinic. |
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Description |
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If the agreements are not in writing, is there
evidence that patients referred by the clinic are being accepted
and treated? |
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Patient Health Care Records: Policies and
procedures for content of medical health records and policies and
procedures for maintenance of health records. |
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Responsibility is assigned for the medical
record system to a designated member of the clinic’s
professional staff. Medical records must be maintained for each
person recieving health care services. |
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All records should be kept at the clinic site
so that they are available when pateients may need unscheduled
medical care. |
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Protection of Record Information: Maintains
confidentiality of record information. |
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Safeguards against loss, destruction, or
unauthorized use of record information. |
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Patients’ written consent is necessary before
any information not authorized by law may be released. |
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Retention of Records: HCFA--at least 6 years
from date of last entry.
State: 10 years for adult and 13 years for
minors. |
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Program Evaluation: Policies and procedures for
the clinic’s total operation including the overall organization,
administration, policies and procedures covering personnel, fiscal
and patient care areas must be done at least annually. |
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The evaluation is done by the clinic, the group
of professional personnel required under 42 CFR 491.9 (b) (2) or
through arrangement with other appropriate professionals. |
