3 CCR 713-30.6 - RULES GOVERNING THE DELEGATING PHYSICIAN'S REQUIREMENTS FOR SUPERVISION OF DELEGATEES

A. The delegating physician must:

1. Provide ongoing inspection, evaluation, advice and control;

2. Make decisions as to the necessity, type, effectiveness and method of treatment;

3. Provide sufficient on-the-spot inspection to determine that the physician's directions are regularly being followed;

4. Monitor the quality of the services provided by the delegatee; and,

5. Provide personal and responsible direction and supervision that is consistent with generally accepted standards of medical practice.

B. The physician's direction and supervision of the delegatee shall be sufficient to limit the need for a delegatee to exercise the judgment required of a physician.

C. Delegated services must be provided in the context of an appropriate physician/patient relationship.

D. Ongoing care of a particular patient without direct physician involvement is inappropriate and demonstrates insufficient personal and responsible direction and supervision of a delegatee.

1. Factors establishing the presence of an appropriate physician/patient relationship include, but are not limited to, some or all of the following: physician performance of an initial consultation with the patient, direct observation by the physician of delegated services rendered by the delegatee, physician review of care rendered to the patient by the delegatee, physician review of outcomes following the performance of delegated services, and other active physician involvement in the provision, review and documentation of services provided by the delegatee.

E. Except as otherwise provided in these Rules, a physician must be on the premises and readily available to provide adequate personal and responsible direction and supervision.

F. Where a delegatee is acting pursuant to specific and detailed written protocols and where adequate written emergency protocols are in place, the presence of the delegating physician on the premises may not be necessary. However, a delegating physician must be physically present in the State and available to promptly, personally attend to the patient. At any time when a delegating physician is not physically present within the State, the delegating physician must identify and provide the contact information to delegatees of a covering physician who is physically present in the State and available to promptly, personally attend to the patient.

G. At least every two weeks, the delegating physician must monitor the quality of the services provided by the delegatee through such means as direct observation, review of care, review of outcomes, review of equipment, review of protocols and procedures and review of charts. The monitoring must occur at the site where the delegated services are performed.

H. On at least an annual basis, the delegating physician must personally reassess the qualifications and competence of the delegatee to perform the medical services. This reassessment must include, but must not be limited to, over-the-shoulder monitoring of the delegatee's performance of each delegated medical service.

I. The delegating physician must document the initial assessment and follow-up reassessments of the delegatee's performance of the delegated medical services. Upon request, the delegating physician must provide such documentation to the Board.

1. In a hospital or medical practice, a delegating physician may rely on a credentialing committee, human resources, or other documented institutional process/es for verification of this Section 30.6(F),(G),(H) and(I).

Notes

3 CCR 713-30.6

40 CR 10, May 25, 2017, effective 6/14/2017