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Section 483.40, the federal standard specifically pertaining to physician services, specifies that each resident must have an attending physician and a backup physician when that attending physician cannot be reached.
The attending physician must, in writing, recommend admission to the nursing home.
- In Illinois and West Virginia, the physical examination must be complete 72 hours after admission unless performed in the previous 5 days before admission.
In Louisiana, it must be done within 72 hours unless performed in the previous 30 days.
- In California, Idaho, Rhode Island, and South Dakota the initial medical examination and assessment must be done within 48 hours unless one was performed in the 5 days prior to admission.
In Pennsylvania, the initial assessment needs to be on hand at admission or also be conducted no later than 14 days after admission.
Because medical directors often serve as attending physicians for high proportions of the residents in facilities where they hold that appointment, discussion of medical director and physician services are intertwined.
Physicians are mentioned in many other sections of the federal regulations as well.
A few states have requirements about the time by which a discharge summary must be complete.
For example, in Texas, the attending physician must write, sign, and date a physician's discharge summary within 20 workdays of being notified by the facility of the discharge.