In the chart below, you'll find standards for all site visit review elements.

Exterior standards

Handicapped entrance (D) 1-A

An existing public facility, or facility used by the public, undergoing an alteration other than ordinary maintenance, after July 20, 1975, shall meet the barrier-free design requirements contained in the state construction code.

Parking adequate (D) 1-B

Adequate parking must be available to provide accessibility to the facility in a safe and convenient manner for all patients.

Handicapped parking space (D) 1-C

Part 4 of the Building Code rules from the Michigan Department of Labor, (1987) states that off street parking for 1-25 cars must include one (1) handicapped marked parking space.

Adequate lighting (D) 1-D

Proper lighting for safety in parking lots is necessary to ensure patient safety.

Adequate maintenance/cleaning (D) 1-E

Adequate maintenance/cleaning is necessary to ensure patient safety.

Interior/general premises

Adequate lighting (D) 2-A

Proper lighting can prevent accidental injury and is conducive to proper practice. For example, a medication room with low or no light could lead to improper dosing.

Handicapped restroom with rails (D) 2-B

It is recommended that at least one public restroom have handicapped accessibility, with handrails, to allow for barrier free accessibility in a safe and convenient manner for all patients. An existing public facility or facility used by the public undergoing an alteration other than ordinary maintenance after July 20, 1975, shall meet the barrier free design requirements contained in the state construction code.

Waiting room seating adequate (D) 2-C

Adequate waiting room seating must be provided for patients.

Hallways clear (D) 2-D
Exits clear (at least two) (D) 2-E

All exits must be free from obstruction AT ALL TIMES. The Fire Marshal requires that corridors, hallways and doorways are free from obstruction so that a stretcher can be moved down the hallway in case of an emergency. In case of fire, exits and hallways must be clear so that time is not lost in evacuating the building. NOTHING can be left in hallways that may obstruct the emergency exit path.

Proper dtorage of toxic/hazardous/combustible materials (D) 2-F

Cleaning agents are potentially hazardous and should not be stored in exam rooms. They may leak and contaminate other items stored nearby and also pose a threat to small children. Cleaning supplies may be stored under sinks only in work areas or utility rooms.

Combustible items must NEVER be stored on or near the furnace, water heater or any other source of heat.

All patient care supplies stored off the floor (D) 2-G

To prevent both contamination of patient supplies and injury due to accidents, patient care supplies are to be stored off the floor.

Medical records stored away from patient care areas (D, N) 2-H

Medical records must be stored away from patient care areas to ensure confidentiality.

Confidentiality

Use of authorization to release records/confidential information (COC form) 3-A

The release of patient records/confidential information is granted only with appropriate, documented authorization by the patient/legal guardian/power of attorney.

Procedure for locking and securing patient files 3-B

It is recommended that a written policy exist and be enforced to ensure patient files are locked and maintained in a secure environment.

Computer screen locations do not violate confidentiality 3-C

Computer screens displaying confidential information regarding patients shall not be accessible or visible to patients or other individuals not directly involved in the patient's care, clinically or administratively.

Separate files exist for each patient 3-D

Practitioners must maintain an individual medical record for each member according to accepted professional standards.

Written policies & procedures address confidentiality (N) 3-E

It is recommended that a written policy regarding confidentiality of patient information and records is maintained. Priority Health's policy on confidentiality is available upon request.

Biomedical waste

Medical waste plan present (D) 4-A

All offices must have a medical waste plan. The plan should also be available for staff review. The Department regulates the management of medical waste to ensure that the public health and the environment are adequately protected.

Employee access to medical waste plan (D) 4-B

The medical waste plan must be readily accessible.

Syringes disposed of in puncture-proof containers (D) 4-C

Syringes, once used, must be disposed of in their entirety in the proper manner. Do not bend, break or remove the needle to prevent accidental needle puncture with contaminated needles. Place the entire syringe in a container that complies with the Michigan Medical Waste Regulatory Act.

Pharmacy/medications

Medications stored away from patient care areas (except local anesthetics) (D) 5-A

All medications (except for injectable local anesthetic agents) must be stored away from patient care areas to ensure patient safety.

Sample medications dispensed intact (D) 5-B

Only physicians licensed by the State Board of Pharmacy may dispense and/or repackage medications. All sample medications must be dispensed intact.

All medications/emergency medications are current (D)
1. Expiration dates checked monthly
2. Monthly log maintained (PH)
5-C

Only physicians licensed by the State Board of Pharmacy may dispense and/or repackage medications. All sample medications must be dispensed intact.

Narcotics double-locked (D)
1. Sign-out sheet
2. Restricted access to keys
5-D

Double locking of narcotics (Class II - V medications) is a Federal regulation and must be adhered to by providers who maintain narcotics on site. Restricted access to keys is important to the doctor whose name is on the DEA license for (s)he is the one who may be audited. A log documenting narcotic administration is required and must include date, patient name, drug name, dosage, physician prescribing, and individual administering the narcotic. This helps to prevent potential abuse of narcotics and accounts for narcotics within the facility.

Prescription pads/syringes stored away from patient care areas (D) 5-E

Prescription pads and syringes need to be stored away from patient care areas to eliminate the potential for theft and illicit use.

Offices in residences or non-related business sites

Dedicated entrance (PH) 6-A

The entrance is separate from other areas (residential or other businesses) not used for business purposes in order to maintain confidentiality.

Dedicated Waiting Area and Office Space (PH) 6-B

The waiting area and office space are dedicated to a sole purpose and separate from other areas (residential or other businesses) not used for business purposes in order to maintain confidentiality.

Physical separation from other areas not used for business purposes (PH) 6-C

A designated office site cannot share common space with others (dissimilar business or residential) and must have a physical separation from other areas not used for business purposes in order to maintain confidentiality.

Occupancy business permit valid (PH) 6-D

Authorization must be granted in accordance with local zoning requirements for a designated office site to serve as a location in which business may be conducted. Therefore, all offices in a residential area must have a valid occupancy permit to operate a business and show proof of the permit. The permit should also be available for staff review.

Accessibility

Routine care (N)
Psychiatrist initial evaluation (N) 7-A
Psychiatrist medication check (N) 7-B
Therapist (N) 7-C

Within 10 business days

For each site, access for all four areas is determined by first availability of any therapist and first availability of any psychiatrist (or mid-level practitioner under the supervision of a psychiatrist), rather than by individual practitioner.

Availability

After-hours availability (N) 8-A
Random phone call (N) 8-B

Article II, section 2.1-A of the Practitioner's Agreements and Obligations states that as a practitioner you "will provide Medically Necessary Covered Services with reasonable promptness and will be accessible by telephone or otherwise to Members, either personally or through back-up coverage from other Participating Practitioners (or non-Participating Practitioners, if Medically Necessary), twenty-four (24) hours per day, seven (7) days per week, three hundred sixty five (365) days per year, in accordance with the Member's Plan. In the case of a Psychiatric Emergency, practitioner agrees to obtain, where feasible and consistent with the appropriate standard of care, from a 24-hour on-call service provided by Priority Health, prior approval for any services not pre-authorized by Priority Health."