What emergency services are CAHs required to provide?
CAHs must provide 24-hour emergency services, with medical staff on-site; or on-call and available on-site within 30 minutes, 60 minutes if certain frontier area criteria are met. The staff on-site or on call must meet state licensure requirements, but Medicare Conditions of Participation specify the coverage could be a doctor of medicine or osteopathy, a physician assistant, a nurse practitioner, or a clinical nurse specialist, with training or experience in emergency care. In certain very limited circumstances, the coverage could be provided temporarily by a registered nurse. As of October 1, 2007, CMS requires that any hospital, including a CAH, that does not have a physician on site 24 hours per day, 7 days per week, provide a notice to all patients upon admission. The notice must address how emergency services are provided when a physician is not on site. For more information, please see page 47413 of the August 22, 2007 Federal Register notice, Medicare Program; Changes to the Ho
