1. (1) The licensee shall:

   1. (a) Provide an initial physical and mental health assessment by a physician, advanced registered nurse practitioner, or physician assistant. The initial mental status exam may be conducted by a mental health professional;
   2. (b) Admit only those patients for whom the hospital is qualified by staff, services and equipment to give adequate care; and

   3. (c) Provide appropriate transfer and acceptance of a patient needing medical care services not provided by the hospital, by:

      1. (i) Transferring relevant data with the patient;
      2. (ii) Obtaining written or verbal approval by the receiving facility prior to transfer; and
      3. (iii) Immediately notifying the patient's family.

2. (2) The licensee shall provide medical supervision and treatment, transfer, and discharge planning for each patient admitted or retained, including but not limited to:

   1. (a) Admittance by a member of the medical staff as defined by the staff bylaws;
   2. (b) An initial treatment plan upon admission incorporating any advanced directives of the patient;
   3. (c) A physical examination and medical history completed and recorded by a physician, advanced registered nurse practitioner, or physician assistant within twenty-four hours following admission, unless the patient had a physical examination and medical history completed within fourteen days prior to admission, and the information is recorded in the clinical record;
   4. (d) A psychiatric evaluation, including provisional diagnosis, completed and documented within seventy-two hours following admission;

   5. (e) A comprehensive treatment plan developed within seventy-two hours following admission:

      1. (i) Developed by a multidisciplinary treatment team with input, when appropriate, by the patient, family, and other agencies;
      2. (ii) Reviewed and modified by a mental health professional as indicated by the patient's clinical condition;
      3. (iii) Interpreted to staff, patient, and, when possible and appropriate, to family; and
      4. (iv) Implemented by persons designated in the plan;
   6. (f) Physician orders for drug prescriptions, medical treatments and discharge;
   7. (g) Current written policies and orders signed by a physician to guide the action of staff when medical emergencies or threat to life arise and a physician is not present;
   8. (h) A discharge plan including a review of the patient's hospitalization, condition upon discharge, and recommendations for follow-up and continuing care;
   9. (i) Patient education pertaining to the patient's illness, prescribed medications, and health maintenance; and
   10. (j) Referrals to appropriate resources and community services during and after hospitalization.

3. (3) The licensee shall provide, or arrange for, diagnostic and therapeutic services prescribed by the attending professional staff, including:

   1. (a) Medical services, including:

      1. (i) A physician on call at all times; and
      2. (ii) Provisions for emergency medical services when needed;

   2. (b) Psychiatric services, including:

      1. (i) A staff psychiatrist available for consultation daily and visits as necessary to meet the needs of each patient; and
      2. (ii) A child psychiatrist for regular consultation when hospital policy permits the admission of children or adolescents;

   3. (c) Nursing services, including:

      1. (i) A psychiatric nurse, employed full time, responsible for directing nursing services twenty-four hours per day; and
      2. (ii) One or more registered nurses on duty within the hospital at all times to supervise nursing care;

   4. (d) Social work services coordinated and supervised by a social worker with experience working with psychiatric patients, responsible for:

      1. (i) Reviewing social work activities;
      2. (ii) Integrating social work services into the comprehensive treatment plan; and
      3. (iii) Coordinating discharge with community resources;
   5. (e) Psychological services coordinated and supervised by a psychologist with experience working with psychiatric patients;
   6. (f) Occupational therapy services coordinated and supervised by an occupational therapist with experience working with psychiatric patients, responsible for integrating occupational therapy functions into the patient's comprehensive treatment plan;
   7. (g) Recreational therapy services coordinated and supervised by a recreational or occupational therapist with experience working with psychiatric patients, responsible for integrating recreational therapy functions into the comprehensive treatment plan; and
   8. (h) Special services, within the hospital or contracted outside the hospital, as specified in the comprehensive treatment plan.

[Statutory Authority: Chapter 71.12 RCW and RCW 43.60.040. WSR 95-22-012, § 246-322-170, filed 10/20/95, effective 11/20/95.]