The hospital shall have: Operating room neurosurgical services available 24 hours a day with appropriately trained support staff, and: Necessary equipment and tools to aid in the care of acute stroke patients including equipment necessary for continuous hemodynamic monitoring; and A written plan for neurosurgical procedures or evaluations to be performed within 2 hours of the determination they are clinically necessary which is approved by: The neurosurgeons providing coverage; and The stroke center medical director; or A written agreement with another hospital which: Meets the requirements of this chapter; Has operating room neurosurgical facilities that meet the requirements of this regulation; and Is available to provide the required neurosurgical services to the patient.