| (a) If a limited services rural hospital (LSRH) provides
respiratory care as an outpatient service, the services shall meet
the needs of the patients in accordance with acceptable standards
of practice and shall comply with this section.
(b) The LSRH shall adopt, implement, and enforce policies
and procedures that describe respiratory care services provision in
the LSRH.
(c) The LSRH shall provide respiratory care services
only on, and in accordance with, a physician's orders.
(d) The LSRH shall organize respiratory care services
to ensure they are appropriate to the scope and complexity of the
services offered.
(e) The LSRH shall have a medical director or clinical
director of respiratory care services who is a physician with the
knowledge, experience, and capabilities to supervise and administer
the services properly. The medical director or clinical director may
serve on either a full-time or part-time basis.
(f) The LSRH shall ensure the LSRH has an adequate
number of respiratory therapists, respiratory therapy technicians,
and other personnel who meet the qualifications specified by the medical
staff, consistent with state law.
(g) The LSRH shall designate, in writing, personnel
qualified to perform specific procedures and the amount of supervision
required for personnel to carry out specific procedures.
(h) When respiratory care services staff perform blood
gases or other clinical laboratory tests, the respiratory care staff
shall comply with the Clinical Laboratory Improvement Amendments of
1988 (CLIA 1988) and the CLIA 1988 regulations at Code of Federal
Regulations Title 42 CFR Part 493 (relating to Laboratory Requirements).
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