NAC449.552. Physicians.

     1. Each patient of a facility must be under the care of a physician who is a member of the medical staff of the facility.

     2. If a patient of the facility receives pediatric dialysis at the facility, the treatment provided to the patient must be supervised by a pediatric nephrologist or a pediatrician. If a pediatric nephrologist is not available to serve as the primary physician for the patient, an adult nephrologist may serve as the primary physician for the patient if a direct patient evaluation is prepared by a pediatric nephrologist or a pediatrician at the initiation of care for the patient and annually until the patient reaches 6 years of age.

     3. Each patient who receives treatment at the facility must be evaluated at least once each month by a physician who is a member of the medical staff of the facility. If a patient of the facility performs dialysis for himself or herself at the patient’s residence, the patient must be examined by such a physician at least once every 3 months. The record of any examination conducted pursuant to the provisions of this subsection must include evidence of:

     (a) A monthly assessment concerning any new or recurrent problems; and

     (b) A review of the adequacy of the treatment provided to the patient.

     4. Each facility shall ensure that at least one physician who is a member of the medical staff of the facility is available, in person or by telecommunication, 24 hours each day to patients and members of the staff of the facility.

     5. Any order concerning the treatment of a patient of a facility must be prepared in writing and signed by the physician preparing the order. If a physician prepares a routine order for treatment, the order must:

     (a) Be revised at least annually; and

     (b) Include a statement indicating the:

          (1) Duration of treatment;

          (2) Dialyzer to be used for that treatment;

          (3) Rate of the flow of blood for the patient during that treatment;

          (4) Target weight of the patient; and

          (5) Medications required for the patient, including heparin.

     (Added to NAC by Bd. of Health by R130-99, eff. 8-1-2001)