1. (1) The licensee shall:

   1. (a) Provide an initial physical and dependency assessment by a physician, advanced registered nurse practitioner, or physician assistant;
   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 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 chemical dependency counselor as indicated by the patient's clinical condition;
      3. (iii) Interpreted to personnel, staff, patient, and, when possible and appropriate, to family; and
      4. (iv) Implemented by persons designated in the plan;
   5. (e) Physician orders for drug prescriptions, medical treatments and discharge;
   6. (f) Current written policies and orders signed by a physician to guide the action of personnel when medical emergencies or threat to life arise and a physician is not present;
   7. (g) A discharge plan including a review of the patient's hospitalization, condition upon discharge, and recommendations for follow-up and continuing care;
   8. (h) Patient education pertaining to the patient's dependency, prescribed medications, and health maintenance; and
   9. (i) 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;
      2. (ii) Provisions for emergency medical services when needed; and
      3. (iii) Participation of a multidisciplinary treatment team;

   2. (b) Nursing services, including:

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

   3. (c) Chemical dependency counseling services, directed and supervised by a chemical dependency counselor, responsible for:

      1. (i) A twenty-four-hour per day chemical dependency program; and
      2. (ii) Patient education on chemical dependency; and
   4. (d) 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 95-22-013, § 246-324-170, filed 10/20/95, effective 11/20/95.]