Aligning with an in-house medical provider

Over the years it has become extremely popular to align your community with the convenience of a mobile physician, who visits and oversees the care of their patients from the comfort of their apartment. The benefit of having a physician who rounds in your community is undeniable as they can coordinate the care of your residents, provide educational opportunities, as well as address any immediate clinical needs of your members. Check out the following requirement for Medical Supervision provided by ADPH:

420-5-4-.06 Care of Residents

  • Medical Direction and Supervision.

The medical care of residents shall be under the direction and supervision of a physician.

(a) Designation of Attending Physician. Upon admission, each resident shall be asked to designate an attending physician of his or her choice. If the resident is unable to designate an attending physician or does not wish to designate an attending physician, the facility shall assist the resident in identifying an attending physician who will serve the resident. A resident shall be permitted to change the designation of his or her attending physician at any time. Whenever a resident requires medical attention, an attempt shall first be made to contact the resident’s attending physician, except in medical emergencies requiring activation of the local EMS system (911 or another emergency call).

(b) Back-up Physician Support. Each assisted living facility shall have an agreement with one or more duly licensed physicians to serve in those instances when a resident’s own attending physician cannot be reached and to provide temporary medical attention to any resident whose attending physician is temporarily not available. A nurse practitioner or physician’s assistant shall not serve as the back-up physician in an assisted living facility.

(c) All physician orders shall be written in accordance with community standards. If verbal orders are used, they are to be used infrequently. A physician verbal order shall only be accepted by an RN or LPN employed by the facility and authorized to do so by facility policy and procedures and state law. All verbal orders shall be reduced to writing on the physicians’ order sheet by a licensed facility nurse and shall be dated and signed by the nurse receiving the order. All orders, including verbal orders, shall be dated, timed, and authenticated promptly by the ordering practitioner, or another practitioner who is responsible for the care of the resident and authorized to write orders by facility policy. All verbal orders must be authenticated within such time period as provided by facility policy, but in no case shall exceed 30 days following entry of the order.