Section 390.1030 Physician Services

Section 390

Section 390.1030 Physician

Services

a)         General Requirements for Physician Services

1)         The services of a physician licensed to practice medicine in

Illinois shall be available to every resident in the facility. (A, B)

2)         Physician services are to include a complete physical

examination at least annually and formal arrangements to provide for medical

and behavior emergencies on a 24 hour seven day week basis. (B)

b)         The resident shall be permitted his choice of a physician. If

the resident is a minor or under guardianship, the appropriate person shall

have this privilege.

c)         The resident shall be seen by a physician as often as

necessary to assure adequate medical care. (Medicare/Medicaid requires

certification visits.) (A, B)

d)         Physicians shall participate, when appropriate, in the

continuing interdisciplinary evaluation of individual residents, for the

purposes of initiating, monitoring, and following-up of individualized

habilitation programs for treatment.

e)         Physician Signature Requirements

1)         All physician orders, plans of treatment, Medicare/Medicaid

Certification and recertification statements and similar documents must have

the original written signature of the physician.

2)         The use of a physician's rubber stamp signature with or without

initials is not acceptable.

f)         Each resident admitted shall have a complete physical

examination, including stool culture, within two weeks prior to admission.

There shall be another physical examination (which need not include a stool

culture) conducted by the physician who will be attending the resident in the

facility within 72 hours after admission to the facility unless the preadmission

examination has been conducted by the same physician. In any case, the facility

shall have the results of a stool culture before a resident is admitted

mission.

There shall be another physical examination (which need not include a stool

culture) conducted by the physician who will be attending the resident in the

facility within 72 hours after admission to the facility unless the preadmission

examination has been conducted by the same physician. In any case, the facility

shall have the results of a stool culture before a resident is admitted. This examination

shall include an evaluation of the resident's condition, including height and

weight, and recommendations for care of the resident including personal care needs

and permission for participation in the activity and developmental program. This

examination shall also include documentation of the presence or the absence of

tuberculosis infection by tuberculin skin test in accordance with Section

390.1035. The report shall also include documentation of the presence or

absence of incipient or manifest decubitus ulcers (commonly known as bed sores)

with grade, size and location specified, and orders for treatment if present.

(A photograph of incipient or manifest decubitus ulcers is recommended on admission.)

The report shall also include orders from the physician regarding weighing of

the resident, and the frequency of such weighing, if ordered. (See Section

390.1620(a)) (B)

g)         The admission information for a resident shall include summary

of present medical findings, medical history, mental and physical functioning

capacity, diagnosis and prognosis when available and; it shall also include

orders for medications, treatments, restorative (re)habilitation services,

diet, specific procedures recorded for the health and safety of the resident,

activities and plans for continuing care and discharge. If this information is

not received with the resident at the time of admission, it must be received

within 48 hours.

h)         All admissions to or continued care in the facility shall be

upon the recommendation of a physician

rative (re)habilitation services,

diet, specific procedures recorded for the health and safety of the resident,

activities and plans for continuing care and discharge. If this information is

not received with the resident at the time of admission, it must be received

within 48 hours.

h)         All admissions to or continued care in the facility shall be

upon the recommendation of a physician.

i)          The provisions of subsections (f), (g) and (h) of this

Section will not apply in the use of emergency admissions. In such a case, the

physician shall meet the criteria in these standards within 72 hours.

j)          Physician Notification

1)         The facility shall immediately notify the physician of any

significant accident, injury, or unusual change in a resident's condition that

threatens the health, safety or welfare of a resident, including, but not

limited to, the presence of incipient or manifest decubitus ulcers or a weight

loss or gain of five percent or more within a period of 30 days.  (B)

2)         The facility shall obtain and record the physician's plan of

care for the care or treatment of such accident, injury or change in condition

at the time of notification.

k)         At the time of an accident, immediate first aid treatment

shall be provided by personnel trained in medically approved first aid

procedures. (B)