(a) Unless otherwise authorized medically managed withdrawal and stabilization services, as defined in section 816.4(c) of this Part, shall only be provided in facilities certified by the office and certified by the Department of Health as a general hospital pursuant to article 28 of the Public Health Law.

1. (1) medical management of acute intoxication and withdrawal conditions;
2. (2) an observation period for up to 48 hours of admission. Patients found to be stable and able to step-down to a lower level of care shall be transferred within or without the facility, with specific discharge instructions, as soon as possible;

3. (3) medically supervised inpatient withdrawal services.

   (c) Staffing.

4. (1) The medical director of a medically managed withdrawal and stabilization service, whether full or part time, may also serve as director of another service provided by the same program sponsor.
5. (2) A physician must be on duty or on call at all times and available if needed.
6. (3) There must be a physician, nurse practitioner and/or physician assistant under the supervision of a physician, on-site sufficient hours to perform the initial medical examination of all patients and to prescribe any and all necessary medications necessary to ensure safe withdrawal.
7. (4) There shall be registered nursing personnel immediately available to all patients at all times. Nursing services shall be under the direction of a registered professional nurse who has at least one year of experience in the nursing care and treatment of substance use disorder and related illnesses.
8. (5) There shall be sufficient hours of qualified psychiatric time to meet the evaluation and treatment needs of those patients with other psychiatric disorders in addition to substance use disorder.
9. (6) There shall be sufficient clinical staff to both maintain a ratio of 1 counselor for each 10 beds and be scheduled so as to be available for 1½ shifts, 7 days per week.
10. (7) One of the full time equivalent qualified health professionals employed by the service shall be designated to provide discharge and recovery planning to persons suffering from chemical dependence as needed.

(b) Required services.

Medically managed services must provide, at a minimum, all of the following services: