This letter from CMS outlines the requirements for healthcare facilities, such as nursing homes, in providing and obtaining radiology and other diagnostic services. Facilities must provide or obtain these services only when ordered by a physician, physician assistant, nurse practitioner, or clinical nurse specialist in accordance with state law and scope of practice laws, and must promptly notify the ordering individual of results that fall outside of clinical reference ranges. Facility policies and procedures should be developed in consultation with the medical director, and should define categories where follow-up is required, the urgency of reporting specific concerns, and a process for monitoring the effectiveness of communication. If results are not acted upon in a timely manner, surveyors will investigate for possible deficient practices under Medical Director, Nursing Services, Quality of Care, or Quality of Life requirements. Nursing homes and other healthcare facilities must take action to ensure they are meeting the outlined requirements, including developing policies and procedures in consultation with the medical director, and ensuring results are acted upon in a timely manner.

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