What are the regulations for when telephone orders must be signed?

Per AHIMA guideline for LTC: It is important for a healthcare facility to review and understand all applicable federal and state laws and accreditation standards when developing policies and procedures for acceptance and authentication of verbal and telephone orders. This practice briefly outlines the federal laws from the Code of Federal Regulations (CFR) and The Joint Commission (TJC) standards that apply to verbal and telephone orders, as well as the time frames for authentication, if applicable.

In general, the federal regulations and accreditation standards do not prescribe a specific time frame for authentication. This information is usually in state licensure regulations. Therefore, it is imperative to refer to individual state laws and regulations to ensure full compliance.

Excerpt from the New Hampshire statutes

Any change or discontinuation of medications taken at the nursing home shall be pursuant to a written order from a licensed practitioner or other professional with prescriptive powers. (k) The licensee shall require that all telephone orders for medications, treatments, and diets are immediately transcribed and signed by the individual receiving the order. (l) The transcribed order in (k) above shall be counter-signed by the authorized provider within 30 days of receipt. (m) The licensee shall obtain written approval from the resident’s licensed practitioner for all over the-counter medications.