[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR482.62]



[Page 503-504]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 482_CONDITIONS OF PARTICIPATION FOR HOSPITALS--Table of Contents

 

             Subpart E_Requirements for Specialty Hospitals

 

Sec. 482.62  Condition of participation: Special staff requirements for 

psychiatric hospitals.



    The hospital must have adequate numbers of qualified professional 

and supportive staff to evaluate patients, formulate written, 

individualized comprehensive treatment plans, provide active treatment 

measures, and engage in discharge planning.

    (a) Standard: Personnel. The hospital must employ or undertake to 

provide adequate numbers of qualified professional, technical, and 

consultative personnel to:

    (1) Evaluate patients;

    (2) Formulate written individualized, comprehensive treatment plans;

    (3) Provide active treatment measures; and

    (4) Engage in discharge planning.

    (b) Standard: Director of inpatient psychiatric services; medical 

staff. Inpatient psychiatric services must be under the supervision of a 

clinical director, service chief, or equivalent who is qualified to 

provide the leadership required for an intensive treatment program. The 

number and qualifications of doctors of medicine and osteopathy must be 

adequate to provide essential psychiatric services.

    (1) The clinical director, service chief, or equivalent must meet 

the training and experience requirements for examination by the American 

Board of Psychiatry and Neurology or the American Osteopathic Board of 

Neurology and Psychiatry.

    (2) The director must monitor and evaluate the quality and 

appropriateness of services and treatment provided by the medical staff.

    (c) Standard: Availability of medical personnel. Doctors of medicine 

or osteopathy and other appropriate professional personnel must be 

available to provide necessary medical and surgical diagnostic and 

treatment services. If medical and surgical diagnostic and treatment 

services are not available within the institution, the institution must 

have an agreement with an outside source of these services to ensure 

that they are immediately available or a satisfactory agreement must be 

established for transferring patients to a general hospital that 

participates in the Medicare program.

    (d) Standard: Nursing services. The hospital must have a qualified 

director of psychiatric nursing services. In addition to the director of 

nursing, there must be adequate numbers of registered nurses, licensed 

practical nurses, and mental health workers to provide nursing care 

necessary under each patient's active treatment program and to maintain 

progress notes on each patient.

    (1) The director of psychiatric nursing services must be a 

registered nurse who has a master's degree in psychiatric or mental 

health nursing, or its equivalent from a school of nursing accredited by 

the National League for Nursing, or be qualified by education



[[Page 504]]



and experience in the care of the mentally ill. The director must 

demonstrate competence to participate in interdisciplinary formulation 

of individual treatment plans; to give skilled nursing care and therapy; 

and to direct, monitor, and evaluate the nursing care furnished.

    (2) The staffing pattern must insure the availability of a 

registered professional nurse 24 hours each day. There must be adequate 

numbers of registered nurses, licensed practical nurses, and mental 

health workers to provide the nursing care necessary under each 

patient's active treatment program.

    (e) Standard: Psychological services. The hospital must provide or 

have available psychological services to meet the needs of the patients.

    (f) Standard: Social services. There must be a director of social 

services who monitors and evaluates the quality and appropriateness of 

social services furnished. The services must be furnished in accordance 

with accepted standards of practice and established policies and 

procedures.

    (1) The director of the social work department or service must have 

a master's degree from an accredited school of social work or must be 

qualified by education and experience in the social services needs of 

the mentally ill. If the director does not hold a masters degree in 

social work, at least one staff member must have this qualification.

    (2) Social service staff responsibilities must include, but are not 

limited to, participating in discharge planning, arranging for follow-up 

care, and developing mechanisms for exchange of appropriate, information 

with sources outside the hospital.

    (g) Standard: Therapeutic activities. The hospital must provide a 

therapeutic activities program.

    (1) The program must be appropriate to the needs and interests of 

patients and be directed toward restoring and maintaining optimal levels 

of physical and psychosocial functioning.

    (2) The number of qualified therapists, support personnel, and 

consultants must be adequate to provide comprehensive therapeutic 

activities consistent with each patient's active treatment program.



[51 FR 22042, June 17, 1986; 51 FR 27848, Aug. 4, 1986]