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href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/history.html">History of NHA</a></li> <li class="fdpc_even fdpc_page mission"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/mission.html">Mission and Vision</a></li> <li class="fdpc_odd fdpc_page staff"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/staff.html">Staff Contacts</a></li> <li class="fdpc_even fdpc_page board_members"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/board_members.html">Board Members</a></li> <li class="fdpc_odd fdpc_page districts"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/districts.html">Districts & District Chairs</a></li> <li class="fdpc_even fdpc_page member_hospitals"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/member_hospitals.html">Member Hospitals</a></li> <li class="fdpc_odd fdpc_section fdpc_here member_services"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/member_services/">Member Services</a> <ul class="fdpc_level_2 member_services"> <li class="fdpc_odd fdpc_page nha_member_services"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/member_services/">NHA Member Services</a></li> <li class="fdpc_even fdpc_section cah"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/member_services/cah/">Critical Access Hospitals</a> <ul class="fdpc_level_3 cah"> <li class="fdpc_odd fdpc_page cah"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/member_services/cah/">Critical Access Hospitals</a></li> <li class="fdpc_even fdpc_page cah_contacts"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/member_services/cah/cah_contacts.html">CAH Contacts List</a></li> <li class="fdpc_odd fdpc_page state_operations_manuals"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/member_services/cah/state_operations_manuals.html">State Operations Manuals</a></li> <li class="fdpc_even fdpc_page fdpc_last top10_deficiencies"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/member_services/cah/top10_deficiencies.html">CAH Top 10 Deficiencies</a></li> </ul> </li> <li class="fdpc_odd fdpc_section all_members"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/member_services/all_members/">All NHA Members</a> <ul class="fdpc_level_3 all_members"> <li class="fdpc_odd fdpc_page member_guide"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/member_services/all_members/">Member Guide</a></li> <li class="fdpc_even fdpc_page fdpc_last boardeffect_intro"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/member_services/all_members/boardeffect_intro.html">BoardEffect Introduction</a></li> </ul> </li> <li class="fdpc_even fdpc_page fdpc_here fdpc_last faq"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/member_services/faq.html">Frequently Asked Questions</a></li> </ul> </li> <li class="fdpc_even fdpc_page affiliate_members"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/affiliate_members.html">Affiliate Members</a></li> <li class="fdpc_odd fdpc_page subsidiaries"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/subsidiaries.html">Subsidiaries</a></li> <li class="fdpc_even fdpc_page fdpc_last sponsorship"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/about_us/sponsorship.html">Sponsorship</a></li> </ul> </li> <li class="fdpc_level_0 fdpc_even fdpc_section communications"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/" class="fdpc_level_0">Communications</a> <ul class="fdpc_level_1 communications"> <li class="fdpc_odd fdpc_section publications"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/publications/">Publications</a> <ul class="fdpc_level_2 publications"> <li class="fdpc_odd fdpc_section electronic"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/publications/electronic/">E-Publications</a> <ul class="fdpc_level_3 electronic"> <li class="fdpc_odd fdpc_page the_advocate"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/publications/electronic/">The Advocate</a></li> <li class="fdpc_even fdpc_page newslink"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/publications/electronic/newslink.html">Newslink</a></li> <li class="fdpc_odd fdpc_page ep_news"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/publications/electronic/ep_news.html">Emergency Preparedness News</a></li> <li class="fdpc_even fdpc_page fdpc_last e-bulletin"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/publications/electronic/e-bulletin.html">e-Bulletin</a></li> </ul> </li> <li class="fdpc_even fdpc_section fdpc_last print"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/publications/print/">Print Publications</a> <ul class="fdpc_level_3 print"> <li class="fdpc_odd fdpc_page health_neb"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/publications/print/">Healthier Nebraska</a></li> <li class="fdpc_even fdpc_page cbr"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/publications/print/cbr.html">Community Benefits Report</a></li> <li class="fdpc_odd fdpc_page fdpc_last mvr"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/publications/print/mvr.html">Member Value Report</a></li> </ul> </li> </ul> </li> <li class="fdpc_even fdpc_page nebraska-healthcare-marketers"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/nebraska-healthcare-marketers.html">Nebraska Healthcare Marketers</a></li> <li class="fdpc_odd fdpc_page social_media"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/social_media.html">Social Media</a></li> <li class="fdpc_even fdpc_section calendar"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/calendar/">Health Care Observances Calendar</a> <ul class="fdpc_level_2 calendar"> <li class="fdpc_odd fdpc_page fdpc_last observances-calendar-2014"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/calendar/">Health Care Observances Calendar</a></li> </ul> </li> <li class="fdpc_odd fdpc_section fdpc_last communications_resources"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/communications_resources/">Resources</a> <ul class="fdpc_level_2 communications_resources"> <li class="fdpc_odd fdpc_page electronic_archive"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/communications_resources/">E-Publications Archive</a></li> <li class="fdpc_even fdpc_page print_archive"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/communications_resources/print_archive.html">Print Publications Archive</a></li> <li class="fdpc_odd fdpc_page fdpc_last links"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/communications/communications_resources/links.html">Important Links</a></li> </ul> </li> </ul> </li> <li class="fdpc_level_0 fdpc_odd fdpc_section advocacy"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/" class="fdpc_level_0">Advocacy</a> <ul class="fdpc_level_1 advocacy"> <li class="fdpc_odd fdpc_page be_an_advocate"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/">Be an Advocate</a></li> <li class="fdpc_even fdpc_section state_issues"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/state_issues/">State Issues</a> <ul class="fdpc_level_2 state_issues"> <li class="fdpc_odd fdpc_section fdpc_last legislature_2013_14"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/state_issues/legislature_2013_14/">103rd Legislative Session 2013-14</a> <ul class="fdpc_level_3 legislature_2013_14"> <li class="fdpc_odd fdpc_page state_issues"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/state_issues/legislature_2013_14/">Issues</a></li> <li class="fdpc_even fdpc_page state_bills"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/state_issues/legislature_2013_14/state_bills.html">Bills of Interest</a></li> <li class="fdpc_odd fdpc_page state_testimonies"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/state_issues/legislature_2013_14/state_testimonies.html">Testimonies</a></li> <li class="fdpc_even fdpc_page regulatoryhearing_testimony"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/state_issues/legislature_2013_14/regulatoryhearing_testimony.html">Regulatory Hearing Testimonies</a></li> <li class="fdpc_odd fdpc_page 2014_legislative_wrapup"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/state_issues/legislature_2013_14/2014_legislative_wrapup.html">2014 Legislative Wrap-Up</a></li> <li class="fdpc_even fdpc_page fdpc_last 2013_legislative_wrapup"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/state_issues/legislature_2013_14/2013_legislative_wrapup.html">2013 Legislative Wrap-Up</a></li> </ul> </li> </ul> </li> <li class="fdpc_odd fdpc_section federal_issues"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/federal_issues/">Federal Issues</a> <ul class="fdpc_level_2 federal_issues"> <li class="fdpc_odd fdpc_page fdpc_last federal_tracker"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/federal_issues/federal_tracker.html">Tracking Federal Issues</a></li> </ul> </li> <li class="fdpc_even fdpc_section action_center"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/action_center/">Action Center</a> <ul class="fdpc_level_2 action_center"> <li class="fdpc_odd fdpc_page current_state_legislation"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/action_center/">Current state legislation</a></li> <li class="fdpc_even fdpc_page presentations"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/action_center/presentations.html">Presentations</a></li> <li class="fdpc_odd fdpc_page fdpc_last advocacy_alerts"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/action_center/advocacy_alerts.html">Advocacy alerts</a></li> </ul> </li> <li class="fdpc_odd fdpc_page nhapac"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/nhapac.html">NHA Political Action Committee</a></li> <li class="fdpc_even fdpc_page advocacyday2014"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/advocacyday2014.html">Advocacy Day </a></li> <li class="fdpc_odd fdpc_page fdpc_last advocacy_resources"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/advocacy/advocacy_resources.html">Resources</a></li> </ul> </li> <li class="fdpc_level_0 fdpc_even fdpc_section quality_and_safety"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/" class="fdpc_level_0">Quality & Safety</a> <ul class="fdpc_level_1 quality_and_safety"> <li class="fdpc_odd fdpc_section quality_initiatives"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/">Quality Initiatives</a> <ul class="fdpc_level_2 quality_initiatives"> <li class="fdpc_odd fdpc_section quest_for_excellence"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/quest_for_excellence/">Quest for Excellence</a> <ul class="fdpc_level_3 quest_for_excellence"> <li class="fdpc_odd fdpc_page quest_for_excellence"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/quest_for_excellence/">Quest for Excellence Award</a></li> <li class="fdpc_even fdpc_section fdpc_last questforexcellence_archive"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/quest_for_excellence/questforexcellence_archive/">Quest for Excellence Awards Archive</a> <ul class="fdpc_level_4 questforexcellence_archive"> <li class="fdpc_odd fdpc_page questforexcellence_archive_2012"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/quest_for_excellence/questforexcellence_archive/">2012 Quest for Excellence Awards</a></li> <li class="fdpc_even fdpc_page questforexcellence_archive_2011"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/quest_for_excellence/questforexcellence_archive/questforexcellence_archive_2011.html">2011 Quest for Excellence Awards</a></li> <li class="fdpc_odd fdpc_page questforexcellence_archive_2010"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/quest_for_excellence/questforexcellence_archive/questforexcellence_archive_2010.html">2010 Quest for Excellence Awards</a></li> <li class="fdpc_even fdpc_page questforexcellence_archive_2009"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/quest_for_excellence/questforexcellence_archive/questforexcellence_archive_2009.html">2009 Quest for Excellence Awards</a></li> <li class="fdpc_odd fdpc_page questforexcellence_archive_2008"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/quest_for_excellence/questforexcellence_archive/questforexcellence_archive_2008.html">2008 Quest for Excellence Awards</a></li> <li class="fdpc_even fdpc_page questforexcellence_archive_2007"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/quest_for_excellence/questforexcellence_archive/questforexcellence_archive_2007.html">2007 Quest for Excellence Awards</a></li> <li class="fdpc_odd fdpc_page fdpc_last questforexcellence_archive_2005"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/quest_for_excellence/questforexcellence_archive/questforexcellence_archive_2005.html">2005 Quest for Excellence Awards</a></li> </ul> </li> </ul> </li> <li class="fdpc_even fdpc_page med_reconciliation"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/med_reconciliation.html">Medication Reconciliation</a></li> <li class="fdpc_odd fdpc_page hen"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/hen.html">Hospital Engagement Network (HEN)</a></li> <li class="fdpc_even fdpc_page fdpc_last color_coded_wristbands"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_initiatives/color_coded_wristbands.html">Color Coded Wristbands for Safety</a></li> </ul> </li> <li class="fdpc_even fdpc_page leaders_in_quality"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/leaders_in_quality.html">Leaders in Quality Videos</a></li> <li class="fdpc_odd fdpc_page rural_qi"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/rural_qi.html">Rural QI Steering Committee</a></li> <li class="fdpc_even fdpc_section emergency_preparedness"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/emergency_preparedness/">Emergency Preparedness</a> <ul class="fdpc_level_2 emergency_preparedness"> <li class="fdpc_odd fdpc_page fdpc_last emergency_preparedness"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/emergency_preparedness/">Emergency Preparedness</a></li> </ul> </li> <li class="fdpc_odd fdpc_section fdpc_last quality_resources"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_resources/">Resources</a> <ul class="fdpc_level_2 quality_resources"> <li class="fdpc_odd fdpc_page patient_safety"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_resources/">Patient Safety Links</a></li> <li class="fdpc_even fdpc_page fdpc_last quality_improvement"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/quality_and_safety/quality_resources/quality_improvement.html">Quality Improvement Links</a></li> </ul> </li> </ul> </li> <li class="fdpc_level_0 fdpc_odd fdpc_section education"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/education/" class="fdpc_level_0">Education</a> <ul class="fdpc_level_1 education"> <li class="fdpc_odd fdpc_section events"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/education/events/">Events</a> <ul class="fdpc_level_2 events"> <li class="fdpc_odd fdpc_page upcoming"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/education/events/">Upcoming Events</a></li> <li class="fdpc_even fdpc_page webinars"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/education/events/webinars.html">Webinars</a></li> <li class="fdpc_odd fdpc_page 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href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/education/leadership_institute/">Leadership Institute</a> <ul class="fdpc_level_2 leadership_institute"> <li class="fdpc_odd fdpc_page li_overview"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/education/leadership_institute/">Overview</a></li> <li class="fdpc_even fdpc_page program_components"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/education/leadership_institute/program_components.html">Program Components</a></li> <li class="fdpc_odd fdpc_page current_participants"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/education/leadership_institute/current_participants.html">Current Participants</a></li> <li class="fdpc_even fdpc_page fdpc_last alumni_main"><a 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href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/education/one_book/">Overview</a></li> </ul> </li> <li class="fdpc_odd fdpc_page e_store"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/education/e_store.html">Education e-Store</a></li> <li class="fdpc_even fdpc_page fdpc_last education_resources"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/education/education_resources.html">Resources</a></li> </ul> </li> <li class="fdpc_level_0 fdpc_even fdpc_section health_data"> <a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/health_data/" class="fdpc_level_0">Health Data</a> <ul class="fdpc_level_1 health_data"> <li class="fdpc_odd fdpc_page nhis"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/health_data/nhis.html">Nebraska Hospital Information System</a></li> <li class="fdpc_even fdpc_page databank"><a 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<a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/resources/quality/">Quality & Safety</a> <ul class="fdpc_level_2 quality"> <li class="fdpc_odd fdpc_page res_qsres"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/resources/quality/">Partnering Agency Resources</a></li> <li class="fdpc_even fdpc_page fdpc_last res_qs_links"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/resources/quality/res_qs_links.html">Important Links</a></li> </ul> </li> <li class="fdpc_even fdpc_section education"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/resources/education/">Education</a></li> <li class="fdpc_odd fdpc_section health_data"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/resources/health_data/">Health Data</a></li> <li class="fdpc_even fdpc_section fdpc_last member_services"> <a 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href="#item4669199">MD/DO 24/7 On-Site Presence (Click here to download)</a> </li><li><a href="#item4692673">CMS Delays 2-Midnight Rule Implementation</a> </li><li><a href="#item4692677">OIG Strategic Plan Goals</a> </li></ul> <ul class="content_collection_items spacing_default list_style_none"> <li id="item4669199"> <div class="collection_item_label"> <a href="/web/20141026052131/http://www.nebraskahospitals.org/file_download/760b40fe-bd4e-4ca1-a13b-7f1f80b2e8a4" target="_blank" class="firespring_log_download">MD/DO 24/7 On-Site Presence (Click here to download)</a> </div> <div class="collection_item_description"> <p><br><p><font face="verdana" size="2">The MD/DO 24/7 On-Site Presence was issued on Dec. 12, 2013 and was implemented on June 7, 2013. The MD/DO 24/7 On-Site Presence was included in C-0151 of the State Operations Manual.</p> <p><font face="verdana" size="2">The regulation 42 CFR 489.20 (w) mandates that <i><span style="color:#003876">if there is no doctor of medicine or osteopathy present in the CAH 24 hours per day, seven days per week, the</span></i> CAH <i><span style="color:#003876">must</span></i> provide written notice to all <i><span style="color:#003876">in</span></i>patients at the beginning of a <i><span style="color:#003876">planned or unplanned</span></i>inpatient stay, <i><span style="color:#003876">and to outpatients for certain types</span></i> of outpatient visit<i><span style="color:#003876">s</span></i>. <i><span style="color:#003876">The purpose of the requirement is</span></i> to assist the patient in making an informed decision about his/her care. CAHs that have an MD/DO <i><span style="color:#003876">(including residents who are MDs or Dos)</span></i> on-site 24/7 do <i><span style="color:#003876">not</span></i> need to issue any disclosure notice <i><span style="color:#003876">about emergency services capability.</span></i></p> <p><font face="verdana" size="2"><i><span style="color:#003876">(The items in blue were added to the regulation)</span></i></p> <p><font face="verdana" size="2"><b>THE NOTICE:</b><ul> <li><p><font face="verdana" size="2">The notice must be provided to <u>all inpatients</u> and to those <u>outpatients who are under observation or who having surgery or any other procedure using anesthesia.</u><br/> (Each qualifying patient must be given a copy of the notice)</p></li> <li><p><font face="verdana" size="2">The notice must be <u>provided at the beginning of the planned or unplanned inpatient stay, or applicable outpatient visit.</u></p></li> <li><font face="verdana" size="2"><span style="color:#000000"><u>Individual notices are not required in the CAH’s dedicated emergency department (DED) (as that term defined), but the DED must post a notice conspicuously, in a place or places likely to be noticed by all individuals entering the dedicated emergency department. The posted notice must state that the CAH does not have a doctor of medicine or a doctor of osteopathy present in the hospital 24 hours per day, 7 days per week, and must indicate how the CAH will meet the medical need of any patient with an emergency medical condition, (the EMTALA definition), at a time when there is no doctor of medicine or doctor of osteopathy present in the CAH. If an emergency department patient is determined to require admission, then the individual notice provisions of 42 CFR 489.20 (w) would apply to that patient.</u><br/> (Notices are not required for a CAH dedicated emergency department) (A sign must be posted in all conspicuous places where an individual might be entering to receive services in the dedicated emergency department)</p></li></span></p> <li><p><font face="verdana" size="2"><u>Before admitting an inpatient or providing outpatient services requiring notice, the CAH must obtain a signed acknowledgement from the patient stating that he/she understands that a doctor of medicine or doctor of osteopathy may not be present during all hours services are furnished to him/her.</u> (This acknowledgement may be added to the admission packet and signed accordingly – NDHHS)<br/> (A signed acknowledgement from the qualifying patient must be received prior to initiating treatment or providing the service.)</p></li> <li><p><font face="verdana" size="2">In the event of an unplanned surgery or inpatient admission to treat an emergency medical condition, it may be necessary to provide treatment before the required notice can be given and acknowledgement can be obtained.</p></li> <li><p><font face="verdana" size="2">For a CAH participating in Medicare with multiple campuses providing inpatient services, a separate determination is made for each campus/location with inpatient services as to whether the disclosure notice is required.</p></li></ul> <p><font face="verdana" size="2">A detailed review of the MD/DO 24/7 On-Site Presence in attached for your review.</p> <hr width="90%" align="left" size="5" noshade> </div> </li> <li class="Alt" id="item4692673"> <div class="collection_item_label"> <a href="https://web.archive.org/web/20141026052131/http://www.htmsinc.com/wp-content/uploads/2014/02/CEO-Update-Feb-2014.pdf" target="_blank">CMS Delays 2-Midnight Rule Implementation</a> </div> <div class="collection_item_description"> <p><br><p><font face="verdana" size="2">Due to the opposition from hospitals and physicians, CMS has delayed enforcement of the two-midnight rule until October.</p> <p><font face="verdana" size="2">The rule is part of the 2014 Medicare Inpatient Prospective Payment Rule, and requires that inpatient admissions for at least two midnights qualify for Medicare hospital rates. CMS has issued a clarification that says that although nurses, medical residents, and physician assistants can write admitting orders, only physicians can sign off on inpatient admissions.</p> <hr width="90%" align="left" size="5" noshade> </div> </li> <li id="item4692677"> <div class="collection_item_label"> <a href="https://web.archive.org/web/20141026052131/http://www.htmsinc.com/wp-content/uploads/2014/02/CEO-Update-Jan-2014.pdf" target="_blank">OIG Strategic Plan Goals</a> </div> <div class="collection_item_description"> <p><br></p> <p><font face="verdana" size="2">The Office of the Inspector General (OIG) has released their strategic plan for 2014-2018.</p> </div> </li> </ul> </div> </div> <footer class="wrap"> <div class="footer_links"> </div>  <div class="locations"> <div class="locations_website_title"> Nebraska Hospital Association </div> <div class="location location1"> <div class="location_addresses"> <div class="location_address location_address1"> 3255 Salt Creek Circle, Suite 100 </div> <div class="location_address location_address2"> Lincoln, NE 68504-4778 </div> <div class="location_end"></div> </div> <div class="location_phones"> <div class="location_phone location_phone1"> <span class="location_phone_label">Phone</span> <span class="location_phone_number">(402) 742-8140</span> </div> <div class="location_phone location_phone2"> <span class="location_phone_label">Fax</span> <span class="location_phone_number">(402) 742-8191</span> </div> <div class="location_end"></div> </div> <div class="location_email"> <span class="location_email_label">E-mail</span> <span class="location_email_link"><a href="https://web.archive.org/web/20141026052131/http://www.nebraskahospitals.org/contact.html">info@NebraskaHospitals.org</a></span> </div> <div class="location_info"> <p>Monday-Friday, 8:30 a.m. - 5:00 p.m.</p> </div> <div class="location_social_media"> <div class="location_facebook"> <span class="location_facebook_label">Facebook</span> <span class="location_facebook_link"><a href="https://web.archive.org/web/20141026052131/http://facebook.com/NEhospitals" target="_blank">NEhospitals</a></span> </div> <div class="location_twitter"> <span class="location_twitter_label">NebHospitals</span> <span class="location_twitter_link"><a href="https://web.archive.org/web/20141026052131/https://twitter.com/#!/NebHospitals" target="_blank">NebHospitals</a></span> </div> <div class="location_end"></div> </div> <div class="location_end"></div> </div> </div> <p class="copyright">© Copyright 2014</p>   <div class="fdpc_design_footer"> </div>  </footer> </div> <script src="https://web.archive.org/web/20141026052131js_/http://cdn.firespring.com/designs/np_bulwark/js/anythingslider/jquery.anythingslider.js"></script> <script type="text/javascript" src="https://web.archive.org/web/20141026052131js_/http://cdn.firespring.com/designs/np_bulwark/js/scripts.js"></script> <script src="https://web.archive.org/web/20141026052131js_/http://cdn.firespring.com/cache/core.1414165487.js" type="text/javascript"></script> <script type="text/javascript"> var firespring = { log: function(){ return; }, goal: function(){ return; }}; var firespring_site_id = 66415578; (function() { var s = document.createElement('script'); s.type = 'text/javascript'; s.async = true; s.src = ( document.location.protocol == 'https:' ? 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