Rule 15-16-1-41.84.14 - Staffing and TreatmentThe PFER must possess the staff and resources necessary to evaluate all individuals presenting to the emergency department. The PFER must follow all requirements of EMTALA in regard to assuring the medical evaluation, stabilization and transfer of a patient found to have an emergency condition. The PFER must follow all Board approved System of Care Plans. Because of the unscheduled and episodic nature of health emergencies and acute illness, the PFER must be staffed with experienced American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA) board certified or board eligible medical director, physicians, nursing, and ancillary personnel who must be available 24 hours a day. The PFER will also provide treatment for individuals whose health needs are not of an emergent nature, but for whom the PFER may be the only accessible or timely entry point into the broader health care system.
1. Staffing that must be available 24 hours a day on site include:A. At-least one physician on site Certified or Board Eligible by the American Board of Emergency Medicine or the American Board of Osteopathic Emergency Medicine; or Certified or Board Eligible to sit for the examination of one of the following boards: Internal Medicine, Family Medicine, or Surgery; and shall hold a certificate from the following approved programs: Advanced Coronary Life Support; Advanced Trauma Life Support; Advanced Pediatric Life Support; and shall have three years of full-time clinical experience in emergency medicine within the past five years.B. At-least one registered nurse on site with training in emergency care. Registered nurse shall hold a current certification in both Advanced Cardiac Life Support and Advanced Pediatric Life Support, or two registered nurses on site at all times, one having current certification in Advanced Cardiac Life Support and one with current certification in Advanced Pediatric Life Support. C. At-least one certified and registered radiology technologist shall be on site at the PFER at all times.D. At-least one person qualified to perform laboratory testing at the level of laboratory services provided on site by the PFER shall be on duty at all times.E. Each PFER shall have a full-time administrative director who directors the daily administrative operations of the PFER, ensures the employees and staff are adequately trained, and provides oversight of the maintenance of the PFER, coordination of patient safety and quality improvement programs and activities.F. Compliance with the above will be evidenced by:i. Published on-call list of practitioners to the Emergency Department; andii. Documentation of nursing staffing patterns to assure 24-hour coverage.2. Each PFER shall have patient transfer agreements with an EMS service and with an affiliated acute care or trauma hospital with the capability of handling such emergencies or has State Board of Health approved system of care plan to assure provisions for patient admissions, continued emergency, and diagnostic services beyond the capability of the PFER, and the safe emergency transport of the patient, when needed.3. Once the decision for transfer has been made, it is the responsibility of the referring physician to initiate resuscitation measures within the capabilities of the local hospital. The referring provider shall select a mode of transport according to the patient's needs so that the level of care is appropriate during transport.4. As stated by the American College of Emergency Physicians (ACEP): A. Emergency medical care shall be available to all members of the public 24 hours a day.B. Access to appropriate emergency medical and nursing care shall be unrestricted.C. A smooth continuum should exist among pre-hospital providers, emergency room (ER) providers, and providers of definitive follow- up care.D. Evaluation, management, and treatment of patient shall be appropriate and expedient.E. Resources should exist in the ER to accommodate each patient from the time of arrival through evaluation, medical decision making, treatment and disposition.F. PFERs should have policies and plans to provide effective administration, staffing, training, facility design, equipment, medication, and ancillary services.G. The emergency physician, emergency nurse, and additional medical teammembers should establish effective working relationships with other health care providers and entities with whom they must interact. These include emergency medical services (EMS) providers, ancillary hospital personnel, other physicians, and other health care and social services resources.15 Miss. Code. R. 16-1-41.84.14
Miss. Code Ann. § 41-75-13