Staff

(A) Staff Responsibilities and Qualifications. (1) Medical Director. (a) Each program shall employ, or otherwise retain through a written agreement for services, a physician to serve as medical director. The medical director shall be responsible for establishing all medical protocols, policies and procedures, ensuring the achievement and maintenance of quality standards of medical care, foroverallpatient care including participation inpatient treatment planning meetings and for consultationwithprogrampersonneland referring physicians. (b) The medical director shall be a physician who is a board certified cardiologist or is board certified ininternalmedicineor family practice and shall have recent clinical experience in caring for cardiac patients and experience in exercise testing and cardiac rehabilitation. (c) The medical director shall be currently certified in advanced cardiac life support by the American Heart Association. (2) Registered Nurse. (a) Each program shall employ a registered nurse who shall collaborate with the Medical Director and Program Director in the operational and clinical aspects of the program. (b) Primary responsibilities of the registered nurse shall include, but not be limited to: functional assessment of patients, patient education, participationinestablishing and monitoring exercise therapy, EKG telemetry monitoring, provision of emergency care and maintenanceof, regular, ongoing communication with the patient's referring physician. (c) The registered nurse shall hold a baccalaureate degree or higher in nursing. This nurse shall have experience in cardiac intensive care or other intensive care and in cardiac risk factor interventionand exercise prescription and exercise testing. He/she shall be currentlycertified in advanced cardiac life support by the American Heart Association. The requirement for the baccalaureate degree shall be waived for any person functioning in a cardiac rehabilitation program on the effective date of these standards. (3) Program Director. (a) Eachprogramshalldesignate a programdirector who shall be responsible for the clinical services provided by the program, including the accurate implementation of medical policies and procedures with emphasis on close adherence to exercise prescription and maintenance of safety standards; who supervises the staff and directs all facets of the program, coordinates patient care and who is responsible for the administration aspects of the program. (b) The programdirector shall either be a physician meeting the qualifications of the Medical Director as prescribed above or a registered nurse meeting the qualifications of the Registered Nurse as prescribed above except that such nurse shall hold a baccalaureate or higher degree in nursing, or an individual who hold a baccalaureate or higher degree in an allied health field. The Medical Director or the Registered Nurse may also serve as the Program Director if he/she canadequatelycarryout the duties of both positions. The program director shallhave recent previous experience or education in the organization and administration of a cardiac rehabilitation program. (4) Exercise Therapist. (a) Each program shall employ, or retain through a written agreement for services, an exercise therapist. The exercise therapist shall be responsible forprovidingconsultationto program staff and advising and/or implementing the exercise component of the program and participating in the patient/family education program services. (b) The exercise therapist shall be a registered physical therapist or an individual who holds a baccalaureate or higher degree in anexercise science. Such individuals shall have experience in cardiac rehabilitation, EKG monitoring, exercise prescription and exercise testing. (c) The exercise therapist shall be currently certified in basic life support by the American Heart Association or the American Red Cross. (5) Dietitian. (a) Eachprogramshall employ, or otherwise retain through a written agreement for services, a dietitianwho shall provide or supervise nutritional counseling services to the patient/familyand assist program staff in monitoring patient progress towards nutritional goals. (b) A dietitian responsible for nutritional counseling services shallbe registered or eligible for registration by the American Dietetic Association. (6) Counselors. (a) The cardiac rehabilitation program shall employ, or otherwise retain through a written agreement for services, at least one psycho/social counselor. Counseling services shall assist patients in adjusting to illness. (b) Counseling services shall be provided by qualified professional staff who have experience working in a medical care setting and who are licensed and/or registered in accordance with state law. (7) Occupational Therapist. (a) If occupational therapy services are provided, the services shall be provided by and supervised by a registered occupational therapist. Occupational therapy services not directly provided by a registered occupational therapist shall be provided by certified occupational therapy assistants. (b) Responsibilities of the occupational therapist may include but not be limited to: instruction in energy conservation, activity guidelines, pacing and development of coping strategies for stress management. (8) Pharmacist. Each program shall have available at least on a consultant basis the services of a registered pharmacist to advise program staff on drug usage. dosage and effects. (B) Health Care Staff. Each program shall retain sufficient qualified professional health care staff to render adequately and appropriately to each patient's needs the services the program holds itself out as providing. Professional health care staff shall be registered or licensed as required by law. They shall comply with the regulations of their registration or licensing boards.