Section 225.1020  Medical Care Policies

a)         A medical director shall be responsible for advising the provost on the overall medical management of the residents and the staff of the facility.

b)         Every resident shall be under the care of a physician.

c)         All residents, or their guardians, shall be permitted their choice of a physician.

d)         The facility shall notify the resident's physician of any accident, injury, or significant change in a resident's condition that threatens the health, safety or welfare of a resident, including, but not limited to, the presence of incipient or manifest decubitus ulcers or a weight loss or gain of five percent or more within a period of 30 days.  The facility shall obtain and record the physician's plan of care for the care or treatment of the accident, injury or change in condition at the time of notification.

e)         Review of medication orders:  The staff pharmacist or consultant pharmacist shall review the medical record, including physician orders and laboratory test results, at least monthly and, based on his/her clinical experience and judgment, determine if there are irregularities that would cause potential adverse reactions, allergies, contraindications, or ineffectiveness.  This review shall be done at the facility.  Documentation of this review must be entered in the clinical record.  Any irregularities noted shall be reported to the attending physician, the medical director, and the provost.