(1) Each nursing home facility licensee must retain, pursuant to a written agreement, a physician licensed under Chapters 458 or 459, F.S., to serve as Medical Director. In facilities with a licensed capacity of 60 beds or less, pursuant to written agreement, a physician licensed under Chapters 458 or 459, F.S., may serve as medical consultant in lieu of a Medical Director.
    (2) Each resident or legal representative, must be allowed to select his or her own private physician.
    (3) Verbal orders, including telephone orders, must be immediately recorded, dated, and signed by the person receiving the order. All verbal treatment orders must be countersigned by the physician or other health care professional on the next visit to the facility.
    (4) Physician orders may be transmitted by facsimile machine, email or electronic medical record as required Florida Statutes § 501.171 and 45 Code of Federal Regulation, Section 164, effective October 1, 2014, which is incorporated by reference and is available at http://www.gpo.gov/fdsys/pkg/CFR-2014-title45-vol1/xml/CFR-2014-title45-vol1-part164.xml and http://www.flrules.org/Gateway/reference.asp?No=Ref-06388 and http://www.flrules.org/Gateway/reference.asp?No=Ref-06389. It is not necessary for a physician to re-sign a facsimile order when he or she visits a facility.
    (5) All physician orders must be followed as prescribed, and if not followed, the reason must be recorded on the resident’s medical record during that shift.
    (6) Each resident must be seen by a physician or another licensed health professional acting within their scope of practice at least once every 30 days for the first 90 days after admission, and at least once every 60 days thereafter. A physician visit is considered timely if it occurs not later than 10 days after the date the visit was required. If a physician documents that a resident does not need to be seen on this schedule and there is no other requirement for physician’s services that must be met due to Title XVIII or XIX of the Social Security Act, the resident’s physician may document an alternate visitation schedule.
    (7) If the physician chooses to designate another health care professional to fulfill the physician’s component of resident care, they may do so after the required visit. All responsibilities of a physician, except for the position of medical director, may be carried out by other health care professionals acting within their scope of practice.
    (8) Each nursing home licensee must have a list of physicians designated to provide emergency services to residents when the resident’s attending physician, or designated alternate is not available.
Rulemaking Authority 400.23 FS. Law Implemented 400.141, 400.23 FS. History-New 4-1-82, Amended 4-1-84, Formerly 10D-29.107, Amended 10-5-92, 4-18-94, 1-10-95, 12-21-15.