(j) Availability of on-call physicians.

In accordance with the on-call list requirements specified in Sec. 489.20(r)(2), a hospital must have written policies and procedures in place--

(1) To respond to situations in which a particular specialty is not available or the on-call physician cannot respond because of circumstances beyond the physician’s control; and

(2) To provide that emergency services are available to meet the needs of patients with emergency medical conditions if a hospital elects to -

(i) Permit on-call physicians to schedule elective surgery during the time that they are on call;
(ii) Permit on-call physicians to have simultaneous on-call duties; and
(iii) Participate in a formal community call plan. Notwithstanding participation in a community call plan, hospitals are still required to perform medical screening examinations on individuals who present seeking treatment and to conduct appropriate transfers. The formal community plan must include the following elements:
(A) A clear delineation of on-call coverage responsibilities; that is, when each hospital participating in the plan is responsible for on-call coverage.
(B) A description of the specific geographic area to which the plan applies.
(C) A signature by an appropriate representative of each hospital participating in the plan.
(D) Assurances that any local and regional EMS system protocol formally includes information on community on-call arrangements.
(E) A statement specifying that even if an individual arrives at a hospital that is not designated as the on-call hospital, that hospital still has an obligation under Sec. 489.24 to provide a medical screening examination and stabilizing treatment within its capability, and that hospitals participating in the community call plan must abide by the regulations under Sec. 489.24 governing appropriate transfers.
(F) An annual assessment of the community call plan by the participating hospitals.