Section 7.12.265. Physician services.

	(a)  Physicians shall review, recap, and sign orders for nursing facility residents at least once every 60 days.  
	(b)  A physician shall visit nursing facility residents and make a notation in each resident's medical record of the resident's status every 30 days for the first 90 days, and after that, every 60 days. If the condition of a resident warrants more frequent visits, a physician shall visit a resident as often as necessary.  
	(c)  A nursing facility shall ensure that a physician personally approves a recommendation in writing that an individual be admitted. Each resident shall remain under the care of a physician and shall be provided care that is consistent with the plan of care, comprehensive assessment, and needs of the resident.  
	(d)  A nursing facility shall ensure that   
		(1) the medical care of each resident is supervised by a physician who assumes the principal obligation and responsibility to manage the resident's medical condition and who agrees to visit the resident as often as necessary to address the resident's medical care needs;  
		(2) another physician will supervise the medical care of the resident when the resident's attending physician is unavailable; and  
		(3) the medical director is informed of the results of all department surveys related to medical service deficiencies and is involved in resolving such problems.  
	(e)  A nursing facility shall ensure that the responsible physician  
		(1) participates as a member of the interdisciplinary care team in the development and review of the resident's comprehensive care plan, with the understanding that the minimum level of physician participation in interdisciplinary development and review of the care plan must be a person-to-person conference with the registered nurse who has principal responsibility for development and implementation of the resident's care plan;  
		(2) reviews the resident's total program of care, including medications and treatments, at each regularly scheduled visit;  
		(3) prepares, authenticates, and dates progress notes at each visit;  
		(4) authenticates and dates all orders; and  
		(5) provides for scheduled visits after the initial visit; the responsible physician may alternate between in-person visits and visits by a physician assistant or advanced nurse practitioner in accordance with (f) of this section.  
	(f)  A nursing facility may permit a physician to delegate tasks to a physician assistant who is acting within the scope of practice set out under AS 08.64  and 12 AAC 40, or to an advanced nurse practitioner who is acting under the scope of practice set out under AS 08.68  and 12 AAC 44. The nursing facility may not permit a physician to delegate a task if state or federal statutes or regulations prohibit the delegation, or if the nursing facility's own policies prohibit the delegation.   

Authorities

47.32.010;47.32.030

Notes

Authority

AS 47.32.010 AS 47.32.030

History

Eff. 11/19/83, Register 88; am 5/28/92, Register 122; am 7/29/2011, Register 199