(a) All health care practitioners shall have the necessary and appropriate training and skills to deliver the services provided by the ambulatory surgical center (ASC).     
      (b) Health care practitioners shall practice in accordance with applicable state law and conform to the standards and ethics of their professions.     
      (c) Patient care responsibilities shall be delineated in accordance with recognized standards of practice.     
      (d) There shall be qualified medical personnel available for emergency treatment whenever there is a patient in the ASC who has received services.     
      (e) The provision of quality health care services shall be demonstrated by at least the following:      
        (1) accessible and available health services;       
        (2) appropriate and timely diagnostic procedures;       
        (3) treatment that is consistent with clinical impression or working diagnosis;       
        (4) appropriate and timely consultation;       
        (5) absence of clinically unnecessary diagnostic or therapeutic procedures;       
        (6) provision for services when the ASC is not open;       
        (7) appropriate, accurate, and complete medical record entries; and       
        (8) adequate transfer of information when patients are transferred to and from other health care providers.       
      (f) When clinically indicated, patients shall be contacted as quickly as possible for follow-up regarding significant problems and/or abnormal laboratory or radiologic findings that have been identified.     
      (g) When the need arises, patients shall be transferred from the care of one health care practitioner to another.      
        (1) Adequate specialty consultation services shall be made available by prior arrangement.       
        (2) Referral to another health care practitioner shall be clearly outlined to the patient and arranged with the accepting health care practitioner prior to transfer.       
      (h) Concern for the appropriateness of care shall be governed by the following:      
        (1) the relevance of health care services to the needs of the patients;       
        (2) the absence of duplicative diagnostic procedures;       
        (3) the appropriateness of treatment frequency; and       
        (4) the use of ancillary services that is consistent with patients' needs.       
      (i) Education activities shall relate, in part, to the findings as quality assurance activities and shall include cardiopulmonary resuscitation training.     
     Source Note:        The provisions of this §135.7 adopted to be effective June 18, 2009, 34 TexReg 3948