CMS SOM App. A, Tag A-1160

Services must be delivered in accordance with medical staff directives.

Interpretive Guidelines §482.57(b)

There should be written policies for the delivery of respiratory care services that are

developed and approved by the medical staff. Appropriate to the scope of services

provided, the written policies should address at least the following:

• Equipment assembly, operation, and preventive maintenance;

• Safety practices, including infection control measures for equipment, sterile

supplies, biohazardous waste, posting of signs, and gas line identification;

• Handling, storage, and dispensing of therapeutic gases to both inpatients and

outpatients;

• Cardiopulmonary resuscitation;

• Procedures to follow in the advent of adverse reactions to treatments or

interventions;

• Pulmonary function testing;

• Therapeutic percussion and vibration;

• Bronchopulmonary drainage;

• Mechanical ventilatory and oxygenation support;

• Aerosol, humidification, and therapeutic gas administration;

• Storage, access, control, administration of medications and medication errors; and

• Procedures for obtaining and analyzing blood samples (e.g., arterial blood gases).