(a) A hospital that does not have an open heart surgical program onsite may perform low-risk cardiac catheterizations if the hospital has protocols for distinguishing between low and high-risk cardiac catheterization patients and a formal written agreement with at least one hospital that does have an open heart surgical program onsite, which agreement includes the following:

1. (1) Protocols addressing indications, contraindications and other criteria for the emergency transfer of patients in a timely manner.
2. (2) Assurance of transfer of patients to an open heart surgery program and initiation of open heart surgery in a timely manner.
3. (3) Provision for semiannual data exchange on performance between the hospitals party to the agreement.
4. (4) Specification of mechanisms for continued substantive communication between the hospitals party to the agreement, and between their sending and receiving physicians.