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emergency care is on call and immediately available by telephone or radio contact and available on site within 30 minutes on a 24-hours-per-day basis in a critical access hospital or a long-term acute care hospital;

(3) place each patient under the care of a member of the medical staff;

(4) require that an order of a practitioner, including a telephonic or other oral order, be reduced to writing and, within three days after the order is given, be dated, timed, and either initialed or signed by that practitioner or by another practitioner responsible for the care of the patient, even if the order did not originate with the other practitioner;

(5) ensure that the use of an investigational drug is properly supervised by a member of the medical staff, that an informed consent form provided by the sponsoring company or agency is used, and that complete records on the drug, including protocol and side effects, are maintained;

(6) establish procedures for circumstances in which consultation is required;

(7) establish standards for care by residents, interns, and medical students in accordance with a residency training program approved by the Council on Medical Education of the American Medical Association, the American Dental Association, or an applicable specialty board;

(8) review at regular intervals clinical and scientific work, medical services, and maintenance of accurate medical records;

(9) establish guidelines for referral to a pathologist of anatomical parts, foreign objects, and tissues removed by surgery;

(10) establish procedures for selection and supervision of advanced practice registered nurses and physician assistants;

(11) ensure that the medical history and physical examination for each patient are completed no more than 30 days before, or 24 hours after, admission; if completed within 30 days before admission, the medical staff must ensure that within 24 hours after admission

(A) an updated history and examination are completed to determine any change in the patient’s condition; and

(B) the updated history and examination required under (A) of this paragraph are documented in the patient’s medical record, with any change noted. (d) The onsite medical staff of a critical access hospital may consist exclusively of mid-level practitioners if

(1) the hospital is a member of a rural health network as described in 42 C.F.R. 485.603, as amended through July 1, 1999 and adopted by reference;

(2) the mid-level practitioners are subject to the oversight of a physician who is also a