States often provide detail on the timing and nature of ongoing medical orders.
These include specifications about telephone orders, such as who may receive them (typically a licensed nurse), how quickly signed orders must be in the chart, and what constitutes an acceptable signature. In several states faxed or electronic signatures are specifically prohibited (e.g., Illinois), whereas Texas specifically permits Faxed and stamped signatures under particular conditions.
In Maryland, the attending physicians must provide a pertinent medical discharge summary within 30 days of discharge or transfer of the resident.
Also under resident’s rights, the facility must inform the resident of the name, address, and way to reach his/her physician.
Because medical directors often serve as attending physicians for high proportions of the residents in facilities where they hold that appointment, discussion of medical director and physician services are intertwined.
Physicians are mentioned in many other sections of the federal regulations as well.
- In California, Idaho, Rhode Island, and South Dakota the initial medical examination and assessment must be done within 48 hours unless one was performed in the 5 days prior to admission.
- In Vermont the physical examination should be available at admission or within 48 hours after admission.