reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.25 - Hearings

Current through Register Vol. 51, No. 14, July 12, 2024
A. The licensee
				  shall file a request for a hearing with the Office of Administrative Hearings,
				  with a copy to the Office of Health Care Quality of the Department, not later
				  than 30 days after receipt of notice of the Secretary's action. The request
				  shall include a copy of the Secretary's action.
B. A hearing requested under this chapter
				  shall be conducted consistent with State Government Article, §
										10-201 et seq.,
				  Annotated Code of Maryland, and COMAR 28.02.01 and 10.01.03.
C. The burden of proof is as set forth in
				  COMAR 10.01.03.28P.
D. Unless otherwise stated in this
				  chapter, the Office of Administrative Hearings shall issue a proposed decision
				  within the time frames set forth in COMAR 28.02.01.
E. The aggrieved person may file exceptions
				  as set forth in COMAR
				  10.01.03.35P.
F. The Secretary shall issue a
				  final decision consistent with COMAR
				  10.01.03.35P.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
The provisions of this chapter apply to a health care
					 facility which is licensed as a comprehensive or extended care facility under
					 COMAR 10.07.02. These facilities are generally known as "nursing facilities".
					 Failure to comply with the regulations of this chapter is ground for licensure
					 enforcement actions.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.02 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) Abuse of a Resident.
(a) "Abuse of a resident" means:
(i) The nontherapeutic infliction upon a
				  resident of physical pain or injury, for example, striking a resident;
				  or
(ii) A persistent course of
				  conduct intended to produce, or resulting in, mental or emotional distress to a
				  resident, for example, verbal intimidation of a resident.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.03 - Resident's Representative

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  nursing facility or nursing facility's agent shall recognize the authority of:
(1) A guardian of the person under Estates
				  and Trusts Article, §
											13-705, Annotated
				  Code of Maryland;
(2) A guardian of
				  the property under the Estates and Trusts Article, §
											13-201, Annotated
				  Code of Maryland;
(3) An advance
				  directive established in compliance with Health-General Article, §5-602,
				  Annotated Code of Maryland;
(4) A
				  surrogate decision maker with authority under Health-General Article,
				  §5-605, Annotated Code of Maryland;
(5) A power of attorney established in
				  compliance with Estates and Trusts Article, §
											13-601, Annotated
				  Code of Maryland;
(6) An individual
				  exercising a resident's rights pursuant to Health-General Article,
				  §19-344(r), Annotated Code of Maryland, but not for purposes of medical
				  care or treatment;
(7) A
				  representative payee or other similar fiduciary;
(8) An agent as defined in Health-General
				  Article, §19-344(c), Annotated Code of Maryland; or
(9) A person if that person was designated by
				  a resident who was not disabled at the time the designation was made and if the
				  resident or representative has provided the nursing facility with documentation
				  of the designation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.04 - Admission Procedures and Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A. At the time of admission of a resident,
				  and whenever information changes during the resident's stay, the nursing
				  facility shall notify the resident and, when applicable, a representative or
				  interested family member, in writing and orally, in a language that is easily
				  understood of all terms of admission including, but not limited to the:
(1) Residents' Bill of Rights;
(2) Nursing facility's policies and
				  procedures that implement the Residents' Bill of Rights;
(3) Rules of resident
				  responsibility;
(4) Nursing
				  facility's complaint procedure;
(5)
				  Nursing facility's visitation rules;
(6) Procedures for obtaining a determination
				  from the Medical Assistance Program of the amount of the resident's funds
				  available to pay for the cost of the resident's care;
(7) Procedures for establishing eligibility
				  for Medicaid and for receiving refunds for previous private payments covered by
				  these benefits, including the right to request an assessment under
				  42 U.S.C. §
												1396r(5)(c) for the purpose
				  of determining the:
(a) Extent of a couple's
				  nonexempt resources at the time of institutionalization, and
(b) Amount of a couple's resources to be
				  attributed to the community spouse as the spouse's equitable share of resources
				  which are not considered available for payment toward the cost of the
				  institutionalized spouse's medical care or for determining Medicaid eligibility
				  for the institutionalized spouse; and
(8) Resident's rights under State law to
				  formulate advance directives.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.05 - Admission Prohibitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  acts in §B of this regulation are admission prohibitions.
B. A nursing facility may not:
(1) Require or solicit, as a condition of
				  admission into the nursing facility, the signature of an individual other than
				  the applicant on the application or contract for admission to the nursing
				  facility, unless the:
(a) Applicant is
				  adjudicated disabled in accordance with Estates and Trusts Article, §
												13-701, Annotated
				  Code of Maryland, or
(b)
				  Applicant's physician determines that the applicant is incapable of
				  understanding or exercising the applicant's rights and responsibilities and
				  records, in the applicant's nursing facility record, the specific reasons for
				  the determination;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.06 - Admission Contract Required

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Before or upon admission, a nursing facility and applicant or, when applicable,
				  the applicant's agent, shall execute an admission contract which has been
				  approved by the Department.
B. If
				  the Department has approved a model contract, a nursing facility shall include
				  within its contract, at a minimum, all of the provisions of the model
				  contract.
C. The nursing facility
				  shall carefully explain all clauses of the contract and answer all questions
				  that the applicant, the applicant's agent, and any interested family member may
				  have.
D. Except as required in
				  §B of this regulation, the applicant and, when applicable, an agent, have
				  the right to delete clauses or sections of the contract with which they do not
				  agree, or to add clauses or sections, subject to the nursing facility's
				  concurrence. Substantive changes require the Department's approval.
E. An admission contract shall include a
				  statement regarding the nursing facility's policies if private funds are
				  exhausted during the resident's stay, including, in clear and concise language,
				  any restrictions with respect to the acceptance of third-party
				  payments.
F. An admission contract
				  used by a certified Medicaid provider shall clearly state that if private funds
				  are exhausted during the resident's stay, and Medicaid payment is available,
				  the nursing facility shall accept Medicaid payments on behalf of the
				  resident.
G. An admission contract
				  used by a certified Medicaid provider shall inform the applicant, through a
				  form established by the Department, that medical eligibility is a requirement
				  for Medical Assistance, and that the applicant should learn if the applicant
				  meets the Medicaid eligibility requirement at the time of admission.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.07 - Third-Party Signature on Admission Contract

Current through Register Vol. 51, No. 14, July 12, 2024
A. If a facility requires an individual,
				  other than the applicant or resident, to sign the admission contract, the
				  conditions of Regulation .05B(1) of this chapter shall be met.
B. If an agent, as defined in Regulation
				  .02B(3) of this chapter, signs the contract, the agent accepts responsibility
				  to pay for the cost of the resident's care only to the extent of the resident's
				  available funds and assets.
C. If
				  an agent, as defined in Regulation .02B(3) of this chapter, signs the contract,
				  the agent is not, by signing the contract, accepting any responsibility for
				  making payments from the agent's own personal funds, unless the agent does so
				  voluntarily. The facility shall list separately in the contract any obligations
				  voluntarily entered into by the agent, and the agent shall initial these
				  obligations on the contract.
D. An
				  agent who has not paid a current obligation for the resident's care may apply
				  to the Medical Assistance Program for a determination of the funds available to
				  pay for the cost of the resident's care.
E. An agent shall distribute any funds,
				  including income or assets of the applicant or resident that the Medical
				  Assistance Program has determined to be available, to pay for the cost of the
				  resident's care in the facility.
F.
				  An agent shall seek, on behalf of the applicant or resident, all assistance
				  from the Medical Assistance Program that may be available to the applicant or
				  resident.
G. The Attorney General
				  may impose civil money penalties against an agent who wilfully or with gross
				  negligence violates the requirements of this regulation as follows:
(1) An agent who wilfully or with gross
				  negligence violates §E of this regulation is subject to a civil money
				  penalty not less than the amount of funds subject to the violation;
				  and
(2) An agent who wilfully or
				  with gross negligence violates §F of this regulation is subject to a civil
				  money penalty not exceeding $10,000.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.09 - Implementation of Residents' Bill of Rights

Current through Register Vol. 51, No. 14, July 12, 2024
A nursing facility shall:
A. Ensure that:
(1) The rights of residents as set forth in
				  the Residents' Bill of Rights are protected, including but not limited to
				  informing each resident of the resident's right to select a physician and
				  pharmacy of the resident's choice;
(2) Employees of the nursing facility are
				  trained to:
(a) Respect and enforce the
				  Residents' Bill of Rights and the nursing facility's policies and procedures
				  that implement the Residents' Bill of Rights, and
(b) Protect the rights of
				  residents;
(3) The
				  nursing facility's policies and procedures implement all rights of the
				  residents as set forth in:
(a) Health-General
				  Article, §§19-343 -19-347 and 19-349-19-352, Annotated Code of
				  Maryland,
(b) Title XIX of the
				  Social Security Act,
(c)
												42 CFR §
													483.10 et seq., and
(d) The regulations of this chapter;
				  and
(4) The nursing
				  facility's policies comply with the requirements of federal and State law
				  concerning advance directives, including but not limited to:
(a) If an applicant is incapacitated or is
				  incapable of informing the nursing facility whether the applicant has executed
				  an advance directive, the facility may provide advance directive information to
				  the resident's health care representative, and
(b) Once the resident is no longer
				  incapacitated, the facility shall provide the advance directive information to
				  the resident directly at the appropriate time;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.10 - Resident Transfers and Discharges

Current through Register Vol. 51, No. 14, July 12, 2024
A. A nursing facility may not involuntarily
				  transfer or discharge a resident from the nursing facility unless the:
(1) Transfer or discharge is necessary for
				  the resident's welfare and the resident's needs cannot be met in the nursing
				  facility;
(2) Transfer or discharge
				  is appropriate because the resident's health has improved sufficiently so that
				  the resident no longer needs the health care or services provided by the
				  nursing facility;
(3) Resident's
				  presence endangers the health or safety of other individuals in the nursing
				  facility;
(4) Resident has failed,
				  after reasonable and appropriate notice, to pay, or to have paid under
				  third-party payers, for a stay at the nursing facility; or
(5) Nursing facility ceases to operate or, in
				  the case of a resident who receives Medicare or Medicaid services, when the
				  nursing facility has been decertified or has withdrawn from the Medicare or
				  Medicaid Program.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.11 - Involuntary Discharge or Transfer of a Resident

Current through Register Vol. 51, No. 14, July 12, 2024
A. In addition to the provisions of
				  Regulation .10 of this chapter, a facility may not involuntarily discharge or
				  transfer a resident unless, within 48 hours before the discharge or transfer,
				  the facility has:
(1) Provided or obtained:
(a) A comprehensive medical assessment and
				  evaluation of the resident, including a physical examination, that is
				  documented in the resident's medical record,
(b) A post-discharge plan of care for the
				  resident that is developed, if possible, with the participation of the
				  resident's representative, and
(c)
				  Written documentation from the resident's attending physician indicating that
				  the transfer or discharge is in accordance with the post-discharge plan of care
				  and is not contraindicated by the resident's medical condition; and
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.12 - Resident Relocation and Bed Hold

Current through Register Vol. 51, No. 14, July 12, 2024
A. Notification of Resident Relocation Within
				  a Facility.
(1) Except in emergency situations
				  or when it is documented in the resident's record that a resident's physical,
				  clinical, or psychological well-being would be jeopardized, a nursing facility
				  shall notify a resident or, when applicable, the resident's representative or
				  interested family member, if available, in writing at least 30 days before the
				  resident is relocated within a facility or to a different part of a facility,
				  unless the resident or, if the resident is incapacitated, the resident's
				  legally authorized representative, agrees to the relocation and this is
				  documented in the resident's record.
(2) Under the limited conditions set forth in
				  §A(1) of this regulation where 30-days notice cannot be provided in
				  advance of a relocation, the facility shall document that it has provided
				  notice of the relocation as soon as practicable.
(3) When a resident is relocated, the
				  facility shall elicit and make reasonable efforts to comply with the resident's
				  request of location and, if applicable, assignment of roommate.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.13 - Hearings for Transfers and Discharges, and Establishment of an Escrow Account

Current through Register Vol. 51, No. 14, July 12, 2024
A. A resident
				  may request a hearing within 30 days of receiving a notice of an intended
				  involuntary transfer or discharge as provided in Regulation .10C of this
				  chapter,
B. Except in an emergency
				  or when the resident has resided in a facility for less than 30 days, after a
				  request for a hearing has been filed, a nursing facility may not discharge or
				  transfer the resident until:
(1) A final
				  decision is issued after the hearing and all requirements of Regulation .11 of
				  this chapter are met; or
(2) The
				  resident consents to the discharge or transfer and withdraws the request for a
				  hearing.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.14 - Physical and Chemical Restraints

Current through Register Vol. 51, No. 14, July 12, 2024
A. Physical restraints may be used only:
(1) As an integral part of an individual
				  medical treatment plan;
(2) If
				  absolutely necessary to protect the resident or others from injury;
(3) If prescribed by a physician or
				  administered by another health care professional practicing within the scope of
				  their license; and
(4) If less
				  restrictive alternatives were considered and appropriately ruled out by the
				  physician.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.15 - Abuse of Residents

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  nursing facility shall develop and implement policies and procedures
				  prohibiting abuse and neglect of residents.
B. A nursing facility may not knowingly
				  employ an individual who has been convicted of abusing or neglecting a resident
				  or who has had a finding entered into the State Nurse Aide Registry concerning
				  abuse or neglect of a resident or misappropriation of a resident's
				  property.
C. Reports of Abuse.
(1) A person who believes that a resident has
				  been abused shall promptly report the alleged abuse to the:
(a) Appropriate law enforcement
				  agency;
(b) Licensing and
				  Certification Administration within the Department; or
(c) The Office on Aging.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.16 - Complaint Procedure

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  resident, the resident's representative, or an interested individual has the
				  right to:
(1) Make a complaint about the
				  nursing facility;
(2) Recommend a
				  change in facility policy and procedure; and
(3) Be free from reprisal, restraint,
				  interference, coercion, or discrimination by the nursing facility or its
				  employees as a result of making a complaint or recommending a change in
				  policy.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.17 - Personal Property of Residents

Current through Register Vol. 51, No. 14, July 12, 2024
A. Personal Possessions.
(1) A resident has the right to retain and
				  use personal possessions, including furnishings and appropriate clothing as
				  space permits, unless to do so would be detrimental to the rights or health and
				  safety of other residents.
(2) A
				  facility shall take reasonable steps to ensure the safety and security of the
				  personal belongings of its residents.
(3) A facility shall provide a reasonable
				  amount of locked storage space for personal property upon the request of a
				  resident.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.18 - Protection of a Resident's Personal Funds

Current through Register Vol. 51, No. 14, July 12, 2024
A. A resident has the right to:
(1) Manage the resident's financial affairs;
				  or
(2) Choose any person who is
				  willing to handle the resident's financial affairs.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.19 - Records of Resident Personal Funds

Current through Register Vol. 51, No. 14, July 12, 2024
A. Records. For all resident funds entrusted
				  to a nursing facility, the facility shall:
(1) Maintain an individual record for the
				  funds of each resident, which includes the following information regarding each
				  fund transaction:
(a) The date of the
				  transaction,
(b) The type of
				  transaction, whether it is a deposit, withdrawal, or any other
				  transaction,
(c) When the
				  transaction is a withdrawal or deposit, reference to a numbered receipt,
				  and
(d) The balance of funds after
				  the completion of the transaction;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.09 - Residents' Bill of Rights: Comprehensive Care Facilities and Extended Care Facilities › Section 10.07.09.20 - Misuse of Resident's Funds

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  person may not misappropriate a resident's assets or income, including spending
				  the resident's assets or income against or without the resident or resident's
				  agent's consent, except as permitted by Regulation .19B(4) of this
				  chapter.
B. A person who believes
				  that there has been an abuse of a resident's funds may make a complaint to the:
(1) Local department of social
				  services;
(2) Director of the
				  Office on Aging if the resident is 65 years old or older; or
(3) Director of the Licensing and
				  Certification Administration, regardless of the resident's age.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.01 - Purpose

Current through Register Vol. 51, No. 14, July 12, 2024
The purpose of these regulations is:
A. To promote the interests and general
				  well-being of all patients of home health agencies providing service within the
				  State;
B. To protect those
				  interests by a public declaration of support for a patient's bill of rights;
				  and
C. To assure that the treatment
				  of patients is, at all times, fully consistent with the provisions of this
				  Act.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.02 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. All terms used
				  in these regulations shall have the same meaning as those used in the
				  Act.
B. Terms Defined.
(1) "Administrator" means an individual who
				  has had:
(a) Formal education in health
				  services or administration, as evidenced by being a:
(i) Physician,
(ii) Registered nurse, or
(iii) College graduate with a bachelor's or
				  higher degree in a health-related field; and
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.03 - Application for a License

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  applicant shall file an application for a license to operate a home health
				  agency on forms provided by the Department.
B. The application for licensure shall
				  contain the name and address of each officer and director of the home health
				  agency. Those corporations having more than 100 owners shall name those having
				  an interest of 2 percent or more. Persons related by marriage or blood to the
				  third degree of consanguinity shall each be named if the sum of their separate
				  holdings exceeds 2 percent.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.05 - Inspections

Current through Register Vol. 51, No. 14, July 12, 2024
A licensed home health agency or an entity proposing to
					 operate such a facility shall be open during normal business hours, or any
					 other times that the facility is serving residents, for inspection by the
					 Department or by any other agency designated by the Department to:
A. Survey home health agencies at least every
				  3 years;
B. Verify compliance with
				  licensing regulations; or
C.
				  Investigate complaints.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.06 - Administrative Enforcement

Current through Register Vol. 51, No. 14, July 12, 2024
A. When a
				  home health agency fails to comply with these regulations, the Department may:
(1) Deny any application for a
				  license;
(2) Suspend or revoke a
				  license; or
(3) Issue a provisional
				  license.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.07 - Notice to Patients

Current through Register Vol. 51, No. 14, July 12, 2024
The home health agency shall notify each patient or the
					 patient's authorized representative, the patient's attending physician, and any
					 third-party payers at least 30 days before the voluntary surrender of its
					 license, or as directed under an order of denial, revocation, or suspension of
					 license issued by the Department.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.08 - Posting of License

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  home health agency shall conspicuously post its license in its office and in
				  each of its branch offices. The license shall be posted as to be viewable by
				  the general public.
B. In branch
				  offices, the license shall be accompanied by a Departmental statement affirming
				  the authority of the branch office to conduct its activities under the
				  licensure authority of its parent agency.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.09 - Governing Authority

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  home health agency shall have a duly constituted governing body, or designated
				  persons so functioning, with full legal authority, responsibility, and
				  accountability for its operation.
B. Adoption of By-laws.
(1) The governing body shall adopt written
				  by-laws, in accordance with applicable legal requirements, for the conduct of
				  business by the home health agency.
(2) These by-laws shall include, at least the
				  following:
(a) A statement of objectives;
				  and
(b) An organizational structure
				  by which agency policies and procedures are implemented.
(3) These by-laws shall be reviewed annually
				  and revised as necessary.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.10 - Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
A. All professional
				  personnel employed by or conducting business with a home health agency shall be
				  licensed or duly authorized to conduct the business under the laws and
				  regulations of the State.
B. The
				  home health agency shall have written policies on qualifications,
				  responsibilities, and requirements for employment for each classification of
				  personnel, including licensure where required.
C. The policies of the home health agency
				  shall, at a minimum, provide for:
(1) Wage
				  and salary schedules;
(2)
				  Eligibility for vacation, sick leave, and other fringe benefits;
(3) In-service training and orientation of
				  all personnel in the objectives, policies, and functions of the agency,
				  including grievance procedures; and
(4) Job descriptions for each classification
				  of personnel.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.11 - Staff Supervision and Training

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Administrator shall appoint a
				  full-time employee as a "service director" to provide general supervision and
				  direction of the professional services offered by the home health agency. The
				  service director, who shall be a physician, registered nurse, or an alternate
				  professional, who is sufficiently qualified by advance training to supervise
				  this service, shall be available at all times during operating hours of the
				  home health agency and shall participate in all activities related to the
				  professional services provided, including the qualifications of personnel as
				  related to their assigned duties. In his absence, he shall appoint a similarly
				  qualified designee.
B. The nursing
				  services of the home health agencies shall be provided under the supervision
				  and direction of a registered nurse who is qualified by having 2 to 3 years
				  experience or education in community health nursing.
C. There shall be periodic, on-site
				  supervision of services provided by home health aides, with complete and
				  accurate documentation maintained.
D. Training Requirements for Home Health
				  Aides. Aides shall receive a periodic, structured program of training and
				  orientation which includes, at a minimum:
(1)
				  The role of the home health aide as a member of the professional health
				  services team;
(2) Instruction and
				  supervised practice in personal care services of the sick at home, with major
				  attention being given to personal hygiene and activities of daily
				  living;
(3) Instruction in how to
				  assist patients to achieve maximum self-reliance through re-learning and
				  modifying activities of daily living;
(4) Principles of good nutrition;
(5) Meal planning, food purchasing, and
				  preparation of meals, including special diets;
(6) General information on the processes of
				  growth, development, and aging;
(7)
				  Information on the emotional and physical problems accompanying
				  illness;
(8) Principles and
				  practices in maintaining a clean, health, and safe environment as well as a
				  pleasant one that encourages morale building and self-help;
(9) Items requiring referral to the nurse
				  supervisor in the home health agency, including changes in the patient's
				  condition or family situation;
(10)
				  Record-keeping, when applicable;
(11) Policies and objectives of the
				  agency;
(12) Information concerning
				  the duties and responsibilities of a home health aide; and
(13) Ethical behavior and confidentiality of
				  information.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.12 - Clinical Records

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  clinical record shall be maintained for each patient in accordance with
				  accepted professional standards, including, at a minimum:
(1) All pertinent diagnoses;
(2) Name, address, and telephone number of
				  physicians;
(3) Physician's orders,
				  including specific instructions for services to be rendered, activities and
				  limitations, and medically-necessary supplies and equipment;
(4) Drug information, including type, dosage,
				  route of administration, frequency, and history of sensitivities or allergic
				  reactions;
(5) Nutritional
				  requirements, including specific dietary plans;
(6) Prognosis, including rehabilitation
				  potential;
(7) Patient care plans,
				  which should include:
(a) Long and short-range
				  goals;
(b) Physical needs,
				  including safety measures to protect against injury;
(c) Psycho-social needs;
(d) Actions taken by individual disciplines;
				  and
(e) Evidence of periodic
				  reappraisal of the needs of the patient;
(8) Progress notes and modifications to the
				  treatment plan; and
(9) Discharge
				  summary.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.13 - Program Review and Evaluation

Current through Register Vol. 51, No. 14, July 12, 2024
A. The home health agency shall establish
				  policies and procedures for self-evaluation of its programs. These should
				  include, at a minimum:
(1) Evaluations of
				  staffing patterns to assure adequacy and appropriateness of service
				  delivered;
(2) An annual review of
				  programs to determine:
(a) Trends in service
				  needs and activities;
(b) Problems
				  and unmet needs of patients;
(c)
				  Anticipated changes in delivery of service;
(d) Linkages with related community
				  services.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.14 - Patient's Bill of Rights

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  home health agency shall provide each patient, client, or designated
				  representative with a written statement affirming the agency's representatives
				  support of a patient's bill of rights, including:
(1) Upon request, a written statement of
				  services offered, including frequency and unit charge;
(2) Fully itemized, billing statements,
				  including date of service and unit charge, to be made available on request of
				  the patient;
(3) Written disclosure
				  of its policy on uncompensated care;
(4) Upon request, information as to the
				  identity of other health care providers with which the agency has contractual
				  relationships, insofar as the patient's home health care is
				  concerned;
(5) The name of the
				  responsible person supervising the patient's home health care and the manner in
				  which that person may be contacted during regular working hours;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.10 - Home Health Agencies › Section 10.07.10.16 - Rehabilitation Services

Current through Register Vol. 51, No. 14, July 12, 2024
A home health agency that holds itself out to the public as
					 providing a complete array of physical rehabilitation services shall:
A. Provide a program of coordinated
				  interdisciplinary rehabilitative care that shall include:
(1) Physical and occupational
				  therapy,
(2) Speech and language
				  therapy,
(3) Audiology
				  therapy,
(4) Psychotherapy,
				  and
(5) Social work
				  services;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.11 - Health Maintenance Organizations › Section 10.07.11.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
The purpose of these regulations is to regulate various
					 phases of the operations of health maintenance organizations in accordance with
					 the mandates of Health-General Article, §§19-701 -19-734, Annotated
					 Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.11 - Health Maintenance Organizations › Section 10.07.11.01-1 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) "Board" means the Board of Physicians.
(1-1) "Certified nurse practitioner" has the meaning stated
					 in Health Occupations Article, Title 8, Annotated Code of Maryland.
(2) "Commissioner" means the
				  Insurance Commissioner of Maryland.
(3) "Department" means the Department of
				  Health and Mental Hygiene.
(4)
				  "Enrollee" means a person who has entered into a health care services contract
				  or on whose behalf a contractual arrangement has been entered into with a
				  health maintenance organization (HMO).
(5) "Governing authority" means the person or
				  persons designated in the bylaws with the responsibility for operating the
				  HMO.
(6) "Grievance" means any
				  complaint by an enrollee:
(a) That the
				  enrollee has not received any benefit or other right to which the enrollee is
				  contractually entitled or that the enrollee has been treated unprofessionally
				  or otherwise improperly by the HMO, or a provider engaged by the HMO;
(b) Which is not resolved formally to the
				  satisfaction of the enrollee.
(7) "Operating year" means the consecutive
				  12-month period, or part thereof, during which the HMO makes available health
				  services as delineated in its Certificate of Authority (as issued by the
				  Insurance Commissioner), and beginning on the issuance date of this
				  Certificate.
(8) "Out-of-area
				  coverage" means contractual benefits provided by the HMO to its enrollees with
				  respect to emergency health care services received by enrollees outside the
				  primary geographical area served by the HMO.
(9) "Physician" means an individual
				  authorized by law to practice medicine in the State.
(10) "Preventive services" means those
				  services designed to prevent the occurrence of disease or injury or to arrest
				  disease at an early stage before complications and serious disabilities
				  develop.
(11) "Quality of health
				  care" means that level of health care delivered which reflects the general
				  health care standards and practices in the geographical area served by the
				  HMO.
(12) "Secretary" means the
				  Secretary of Health and Mental Hygiene.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.11 - Health Maintenance Organizations › Section 10.07.11.02 - Service Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A. The HMO
				  shall provide the services required by the Maryland Health Maintenance
				  Organization Act of 1975, Health-General Article, §19-701(d), Annotated
				  Code of Maryland.
B. The HMO shall
				  make available and encourage appropriate history and baseline examinations for
				  each enrollee within a reasonable time of enrollment set by the HMO. Medical
				  problems that are a potential hazard to the person's health shall be identified
				  and a course of action to alleviate these problems outlined. Progress notes
				  indicating success or failure of the course of action shall be
				  recorded.
C. The HMO shall offer or
				  arrange for preventive services that include health education and counseling,
				  early disease detection, and immunization. The HMO shall develop or arrange for
				  periodic health education on subjects which impact on the health status of the
				  enrollee population and shall notify every enrollee in writing of the
				  availability of these and other preventive services.
D. Services to prevent a disease shall be
				  offered if all of the following conditions exist:
(1) The disease produces death or disability
				  and exists in the enrolled population;
(2) The etiology of the disease is known or
				  the disease can be detected at an early stage;
(3) Elimination of factors leading to the
				  disease or immunization has been proven to prevent its occurrence, or early
				  disease detection followed by behavior modification, environmental
				  modification, or medical intervention has been proven to prevent death or
				  disability.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.11 - Health Maintenance Organizations › Section 10.07.11.03 - Quality Assurance Requirements - Program Planning and Evaluation

Current through Register Vol. 51, No. 14, July 12, 2024
A. The HMO shall
				  have a written program plan that is updated and reviewed at least every 3
				  years.
B. The plan shall include
				  the following information:
(1) Statistics on
				  age, sex, and other general demographic data used to determine the health care
				  needs of its population;
(2)
				  Identification of the major health problems in the enrolled
				  population;
(3) Identification of
				  enrolled special groups that have unique health problems such as the poor, the
				  elderly, the mentally ill, and educationally disadvantaged;
(4) A description of community health
				  resources and how they will be used.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.11 - Health Maintenance Organizations › Section 10.07.11.04 - Peer Review

Current through Register Vol. 51, No. 14, July 12, 2024
A. Internal
				  Review. The HMO shall have an internal peer review system that will evaluate
				  the utilization of services and the quality of health care provided enrollees.
				  The review system shall:
(1) Provide for
				  review by appropriate health professionals of the process followed in the
				  provision of health services;
(2)
				  Use systematic data collection of performances and patient results;
(3) Provide interpretation of this data to
				  the practitioners;
(4) Review and
				  update continuing education programs for health professionals providing
				  services to enrollees;
(5) Identify
				  needed change and proposed modifications to implement;
(6) Maintain written records of the internal
				  peer review process;
(7) Conduct
				  focused studies directly related to major health problems and preventive health
				  needs identified in Regulation .03B and C of this chapter; and
(8) Assure that at least three focused
				  studies related to the HMO specific plan under Regulation .03 of this chapter
				  are conducted each year.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.11 - Health Maintenance Organizations › Section 10.07.11.05 - Medical Records

Current through Register Vol. 51, No. 14, July 12, 2024
A. All
				  information contained in the medical records and information received from
				  physicians, surgeons, certified nurse practitioners, or hospitals, incident to
				  the health care practitioner-patient or hospital-patient relationship, shall be
				  kept confidential, and, except for use incident to bona fide medical research
				  and education, or for the Department's review under these regulations, or as
				  reasonably necessary in connection with the administration of the member's
				  contract, may not be disclosed without the consent of the patient.
B. Contents and Procedures. The medical
				  record shall contain at least the following information and be maintained under
				  the following procedures:
(1) Identification
				  and summary sheets;
(2) Prior
				  medical findings and referral information;
(3) Information necessary to support the
				  diagnosis and justify the treatment given as shown in the individual written
				  plan of treatment;
(4) Progress
				  notes by a medical staff member, as appropriate; a physician shall review and
				  approve the progress notes within 24 hours of entry;
(5) Dated record of all treatments,
				  medications, laboratory tests, X-rays, operative reports, anesthesia records,
				  and measurements;
(6) Consultation
				  report, if appropriate;
(7) Record
				  of any emergency care treatment rendered to patient; and
(8) Discharge summary of inpatient
				  hospitalization to include condition at time of discharge and post operative
				  instructions given to the patient.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.11 - Health Maintenance Organizations › Section 10.07.11.06 - Statistics

Current through Register Vol. 51, No. 14, July 12, 2024
The HMO shall provide the Department with full access to
					 all operational and statistical data to enable the Department to verify the
					 HMO's compliance and to enable the Department to conduct specific statistical
					 studies with respect to current status of various segments of the enrolled
					 population.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.11 - Health Maintenance Organizations › Section 10.07.11.07 - Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
A. When applicable,
				  each staff member of the HMO shall be licensed as required by State and local
				  law, and meet acceptable professional qualifications or have qualified by means
				  of an occupational proficiency examination or through acceptable training.
				  Provider staff patterns shall be designed to meet enrollee needs.
B. The HMO shall provide orientation for all
				  new employees and require continuing education of all professional and
				  supportive personnel which reflects advances in medical knowledge and enrollee
				  health education.
C. The HMO shall
				  establish a formal written process for:
(1)
				  Appointment of a physician or certified nurse practitioner to the clinical
				  staff of the HMO;
(2) Employment of
				  a physician or certified nurse practitioner by the HMO; or
(3) Selection of a physician or certified
				  nurse practitioner to provide services to the enrollees under contract with the
				  HMO.