reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.02 - Freestanding Birthing Centers › Section 10.05.02.04 - Surveys

Current through Register Vol. 51, No. 14, July 12, 2024
A. A licensee
				  operating a freestanding birthing center shall undergo a routine annual survey.
B. A licensee shall allow an
				  on-site survey by the Department at any time during the center's normal hours
				  of operation to evaluate the center's compliance with the applicable
				  requirements and standards of this chapter.
C. Center employees shall make data and
				  records accessible within a reasonable time during the on-site
				  survey.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.02 - Freestanding Birthing Centers › Section 10.05.02.05 - Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
A. Administrator.
				  The licensee shall appoint an administrator of the freestanding birthing center
				  who is responsible for the:
(1) Daily
				  administration of the center; and
(2) Training and supervision of all
				  nonprofessional staff, unlicensed staff, and volunteers.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.02 - Freestanding Birthing Centers › Section 10.05.02.06 - Protocols

Current through Register Vol. 51, No. 14, July 12, 2024
A. The medical
				  director and director of nurse midwifery shall develop protocols for the
				  management of routine and emergency care of the patient and her fetus or
				  newborn during pregnancy, birth, and postpartum through discharge, whether
				  through completion of the pregnancy or referral or transfer to other levels of
				  care. The protocols shall include procedures for the :
(1) Transfer of patients or newborns for
				  appropriate hospital obstetric and newborn care; and
(2) Use of ultrasound imaging that is:
(a) Consistent with the current standards of
				  care; and
(b) Within the scope of
				  practice for a:
(i) Physician; or
(ii) Certified nurse midwife.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.02 - Freestanding Birthing Centers › Section 10.05.02.07 - Referral System

Current through Register Vol. 51, No. 14, July 12, 2024
A freestanding birthing center shall have a system for
					 consultation with and referral to a physician who is Board-certified in a
					 specialty that provides services for pregnant and postpartum patients, or a
					 physician who has appropriate experience in the care of pregnant and postpartum
					 patients.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.02 - Freestanding Birthing Centers › Section 10.05.02.08 - Quality Assurance Program

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  A freestanding birthing center shall develop and implement a quality assurance
				  program.
B. A freestanding birthing
				  center shall collect the following evaluative data in addition to that required
				  in COMAR 10.05.01.08 a:
(1) Number of births;
(2) Intrapartum transfer rates and
				  indications for transfer; and
(3)
				  Postpartum maternal and neonatal hospital admissions.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.02 - Freestanding Birthing Centers › Section 10.05.02.09 - Physical Plant

Current through Register Vol. 51, No. 14, July 12, 2024
A. Bedrooms. A
				  freestanding birthing center shall:
(1)
				  Locate bedrooms so as to provide unimpeded, rapid access to an exit of the
				  building where emergency transportation vehicles may be accommodated;
(2) Have bedrooms that can accommodate:
(a) A double bed or a bed large enough to
				  safely accommodate patient and baby,
(b) Birth attendants and support
				  persons,
(c) Space for supplies,
				  equipment, and family belongings, and
(d) Access to a sink with hot and cold
				  running water equipped with elbow-wrist controls such as are common in home
				  kitchens.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.02 - Freestanding Birthing Centers › Section 10.05.02.10 - Fire Safety and Emergency Preparedness

Current through Register Vol. 51, No. 14, July 12, 2024
A. Fire Safety Protection.
(1) Smoke Alarms. A freestanding birthing
				  center shall place smoke alarms on each floor and at points as recommended by
				  the State Fire Marshal or local fire authority. A freestanding birthing center
				  shall have alarms that are audible throughout the center.
(2) Fire Extinguishers. A freestanding
				  birthing center shall provide at least one approved fire extinguisher on each
				  floor, including below ground level.
(3) Lighting and Power. A freestanding
				  birthing center shall ensure that:
(a) Exits
				  are illuminated during time of occupancy; and
(b) Emergency lighting is located to provide
				  illumination in event of a power failure.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.02 - Freestanding Birthing Centers › Section 10.05.02.11 - Equipment

Current through Register Vol. 51, No. 14, July 12, 2024
A. Equipment and
				  furnishings shall be constructed of materials that are easily cleaned and
				  maintained and shall include, at a minimum:
(1) A heat source for infant examination or
				  resuscitation;
(2) A transfer
				  incubator or isolette or demonstrated capability of ready access to a transfer
				  incubator;
(3) A sterilizer or
				  demonstration of sterilizing capability;
(4) Blood pressure equipment, thermometers,
				  and fetoscope or doptone;
(5)
				  Intravenous equipment;
(6) Oxygen
				  equipment for patient and newborn that is stored in accordance with Standards
				  for Health Care Facilities, NFPA 99, which is incorporated by reference as part
				  of COMAR 29.06.01.06B(2);
				  and
(7) Instruments for delivery,
				  episiotomy, and repair.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.02 - Freestanding Birthing Centers › Section 10.05.02.12 - Health Record

Current through Register Vol. 51, No. 14, July 12, 2024
A. In addition
				  to meeting the requirements of this regulation, a freestanding birthing center
				  shall comply with the requirements of COMAR
				  10.05.01.09B.
B. The health record of each
				  patient shall contain documentation of all services provided while the patient
				  and her fetus or newborn are under the care of the freestanding birthing
				  center, including reports by outside providers who have examined or treated the
				  patient at the request of the center.
C. A freestanding birthing center shall:
(1) Send a copy of the health record with the
				  patient or newborn, or both, on referral to another health care provider or on
				  transfer to a hospital; and
(2)
				  Maintain birth and death certificates on file, as required by Health-General
				  Article, Title 4, Subtitle 2, Annotated Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.03 - Freestanding Major Medical Equipment Facilities › Section 10.05.03.01 - 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) Freestanding Facility Operating Major
				  Medical Equipment.
(a) "Freestanding facility
				  operating major medical equipment" means a facility using major medical
				  equipment.
(b) "Freestanding
				  facility operating major medical equipment" does not include any freestanding
				  ambulatory care facilities or service owned or operated by a hospital and
				  regulated under COMAR 10.07.01.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.03 - Freestanding Major Medical Equipment Facilities › Section 10.05.03.02 - License Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  facility operating major medical equipment shall meet all general licensing
				  requirements for a facility as provided in COMAR 10.05.01 and all requirements
				  of this chapter.
B. An owner of
				  mobile major medical equipment shall obtain a license under this
				  chapter.
C. A facility operating
				  major medical equipment that is engaged exclusively in biomedical research is
				  not required to be licensed under this chapter if:
(1) Charges for any health care service
				  provided with the equipment will not be paid by any patient or third-party
				  payor; and
(2) The capital costs
				  associated with the equipment and any related construction or renovation are
				  not included in patient charges.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.03 - Freestanding Major Medical Equipment Facilities › Section 10.05.03.03 - Licensing Procedure

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  person desiring to establish or operate a facility that operates major medical
				  equipment shall submit an application for licensure.
B. The following information for each piece
				  of equipment shall accompany the application:
(1) Manufacturer and model of the
				  equipment;
(2) Address where the
				  equipment is to be located; and
(3)
				  Qualifications of the licensed physician who will be supervising the use of the
				  equipment.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.03 - Freestanding Major Medical Equipment Facilities › Section 10.05.03.04 - Inspections by the Secretary

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  The Secretary may verify compliance with licensing requirements through on-site
				  random sample record reviews.
B.
				  For the purpose of verifying compliance, the Secretary shall have access to:
(1) The facility or office where the
				  equipment is located;
(2) Patients'
				  medical records, including image or scan records;
(3) Quality assurance records, including peer
				  review documentation;
(4) Records
				  documenting in-service training on use of the equipment;
(5) Records verifying personnel
				  training;
(6) Equipment quality
				  control and inspection records;
(7)
				  Radiation safety reports;
(8)
				  Records of referrals and evidence of appropriate use of equipment;
(9) Policies and procedures that ensure safe
				  operation of equipment; and
(10)
				  Qualifications of personnel:
(a) Permitted to
				  supervise use of the major medical equipment,
(b) Permitted to operate the major medical
				  equipment, and
(c) Responsible for
				  maintenance of the major medical equipment.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.03 - Freestanding Major Medical Equipment Facilities › Section 10.05.03.05 - Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
A. Operators of
				  Magnetic Resonance Imager (MRI) Equipment. Operators of MRI equipment shall
				  demonstrate competency to successfully and safely complete magnetic resonance
				  procedures.
B. Operators of
				  Radiation-Producing Equipment. The licensee shall ensure that operators of
				  radiation-producing equipment are qualified in accordance with Health
				  Occupations Article, 14-306 and 14-606, Annotated Code of Maryland.
C. Students and Graduate Technologists. This
				  regulation does not prohibit students or graduate technologists from operating
				  equipment, if the students or technologists are directly monitored by a
				  supervisor.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.03 - Freestanding Major Medical Equipment Facilities › Section 10.05.03.06 - Quality Assurance Program

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  A facility operating major medical equipment shall develop and implement:
(1) A quality assurance program in compliance
				  with the guidelines outlined in COMAR
				  10.05.01.08B;
				  and
(2) Additional quality
				  assurance requirements of this regulation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.03 - Freestanding Major Medical Equipment Facilities › Section 10.05.03.07 - Operating Standards for Safety

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  A person may not operate major medical equipment unless the operator uses
				  safety measures to protect the patient and the operator in accordance with the
				  requirements of this chapter.
B.
				  The administrator shall ensure that all equipment:
(1) Is manufactured according to the
				  requirements of 21 CFR 800 ----- 1299, which is incorporated by
				  reference;
(2) Is appropriately
				  labeled and includes an operating manual;
(3) Is considered safe and effective and
				  approved for marketing by receipt of an FDA classification or a letter of
				  approval according to 21 CFR 800 ----- 1050.10, which is incorporated by
				  reference; and
(4) Meets all
				  applicable standards for equipment adopted by the Division of Radiation Control
				  of the Department of the Environment.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.03 - Freestanding Major Medical Equipment Facilities › Section 10.05.03.08 - Medical Records

Current through Register Vol. 51, No. 14, July 12, 2024
A. A facility
				  operating major medical equipment shall comply with all requirements of COMAR
				  10.05.01.09B and
				  the requirements of this regulation.
B. A facility operating major medical
				  equipment shall maintain a medical record for each patient on whom a test is
				  performed and make the information available to the Secretary on
				  request.
C. Each patient's medical
				  record shall include the following information:
(1) Symptoms exhibited by the
				  patient;
(2) Suspected diagnosis
				  before the test or procedure; and
(3) Nature of findings.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.01 - 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) "Center administrator" means an
				  individual appointed by the governing body who is responsible for the center's
				  daily operation and the duties set forth in Regulation .04 of this
				  chapter.
(2) "Certified nursing
				  assistant-dialysis technician (CNA-DT)" means an individual certified by the
				  Maryland Board of Nursing as a certified nursing assistant-dialysis technician
				  (CNA-DT).
(3) "Chief executive
				  officer" means an individual who meets the requirements set forth in
				  42 CFR §
												405.2102, as amended, which is incorporated
				  by reference.
(3-1) "In-center daytime hemodialysis" means a hemodialysis
					 treatment that:
(a) Usually lasts 3 to
				  5 hours;
(b) Is performed on a
				  routine basis, usually three times a week, to treat a chronic condition;
				  and
(c) Is provided in a kidney
				  dialysis center during daytime hours.
(3-2) "In-center nocturnal hemodialysis" means a
					 hemodialysis treatment that:
(a) Lasts
				  6 to 9 hours;
(b) Is performed on a
				  routine basis, usually three times a week, to treat a chronic condition;
				  and
(c) Is provided in a kidney
				  dialysis center.
(3-3) "Interdisciplinary team (IDT)" means a
					 multidisciplinary team:
(a) Consisting
				  of, at a minimum:
(i) The patient or the
				  patient's designee, if the patient chooses;
(ii) A registered nurse;
(iii) A physician;
(iv) A nurse practitioner or physician
				  assistant treating the patient for ESRD;
(v) A social worker; and
(vi) A dietitian; and
(b) Whose professional members have dialysis
				  experience.
(4) Kidney Dialysis Center.
(a) "Kidney dialysis center" means a facility
				  that provides hemodialysis or chronic peritoneal dialysis.
(b) "Kidney dialysis center" does not include
				  a center or service owned or operated by a hospital and regulated under
				  Health-General Article, Title 19, Subtitle 2, Annotated Code of
				  Maryland.
(5) "Patient
				  comprehensive assessment" means an individualized comprehensive assessment that
				  reflects the patient's psychological, social, medical, dietary, and
				  rehabilitation needs and identifies the care required to meet those needs as
				  well as individualized modifications in the approaches required to meet the
				  patient's goals.
(6) "Patient plan
				  of care" means a written plan that includes all of the care, services, and
				  treatment interventions the interdisciplinary team decides to implement to meet
				  the specific needs of the patient.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.02 - License Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  kidney dialysis center shall meet all general licensing requirements for a
				  facility as provided in COMAR 10.05.01 and all requirements of this
				  chapter.
B. An applicant shall
				  obtain Medicare certification as a condition of licensure for a kidney dialysis
				  center.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.03 - Licensing Procedure

Current through Register Vol. 51, No. 14, July 12, 2024
A kidney dialysis center shall submit a nonrefundable fee
					 of $700 with an application for initial licensure or $700 with an application
					 for license renewal.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.04 - Administration

Current through Register Vol. 51, No. 14, July 12, 2024
A. Governing Body.
				  The governing body shall:
(1) Identify the
				  center administrator who has been given the authority and responsibility for
				  the overall policy and fiscal management of the facility; and
(2) Develop a written organizational
				  plan.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.05 - Quality Assurance Program

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  The Administrator shall ensure that the kidney dialysis center has a quality
				  assurance program as required under COMAR
				  10.05.01.08D.
B. The quality assurance team
				  shall document information regarding the quality assurance activities in
				  accordance with COMAR
				  10.05.01.08FF and
				  provide a report to the administrator.
C. The administrator shall:
(1) Review the report specified in §B of
				  this regulation;
(2) Implement any
				  necessary corrective actions; and
(3) Notify the quality assurance team when
				  corrective actions have been implemented.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.06 - Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
A. Medical
				  Director.
(1) The medical director shall:
(a) Be a nephrologist or other physician with
				  at least 12 months experience in the treatment of patients requiring chronic
				  hemodialysis;
(b) Be responsible
				  for the development of patient care policies; and
(c) Provide medical guidance in the provision
				  of patient care.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.07 - Affiliations

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to the requirements in 42 CFR §
					 405.2136(e), as amended, which is incorporated by reference, for affiliations,
					 the facility shall provide, make referrals, or have access to a certified home
					 dialysis training program.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.08 - Patient Long-Term Program

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  The facility's interdisciplinary team shall develop and maintain an
				  individualized interdisciplinary comprehensive assessment for each patient to
				  ensure that each patient receives the appropriate treatment modality, whether
				  dialysis or transplantation.
B.
				  Patient Comprehensive Assessment. The patient's comprehensive assessment shall
				  be developed by a multidisciplinary team.
C. The health care team described in §B
				  of this regulation shall review, document, and make appropriate revisions to
				  each patient's comprehensive assessment at least every 12 months or more often
				  as indicated by the patient's response to treatment.
D. When a patient is transferred to another
				  kidney dialysis center, the facility shall ensure that a copy of the patient's
				  comprehensive assessment accompanies the patient, or is sent to the new kidney
				  dialysis center within 1 working day after transfer.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.09 - Patient Care Plan

Current through Register Vol. 51, No. 14, July 12, 2024
A. Patient
				  Care Plan. A health care team, consisting of at least the physician, nurse
				  practitioner, or physician assistant responsible for the patient's end-stage
				  renal disease care, a nurse responsible for nursing services, a social worker,
				  and a dietitian, shall develop an individualized care plan for each
				  patient.
B. The patient or health
				  care decision maker shall be involved in developing the care plan.
C. The health care team shall review the
				  patient care plan:
(1) At least monthly for a
				  patient whose condition has not stabilized, as determined by a physician's
				  assessment of the patient's laboratory values and physical condition;
				  or
(2) Annually for a patient whose
				  condition has stabilized.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.10 - Dialyzer Reuse

Current through Register Vol. 51, No. 14, July 12, 2024
A. Patient
				  Information.
(1) The kidney dialysis center
				  shall:
(a) Provide information to the patient
				  or, if appropriate, the patient's health care decision maker concerning the
				  center's reuse of dialysis supplies, including hemodialyzers and tubing and
				  their suitability for home dialysis; and
(b) Obtain the patient's or, if appropriate,
				  the patient's health care decision maker's informed consent regarding the reuse
				  of dialysis supplies.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.11 - Physical Plant

Current through Register Vol. 51, No. 14, July 12, 2024
A. Floor Space.
(1) The kidney dialysis center shall have
				  usable floor space of at least 80 square feet per patient station.
(2) Floor space may include bed or chair
				  space, nursing space, and work area, but excludes storage space.
(3) At least 20 square feet of the patient
				  station floor space shall be available on the side of the patient to be
				  occupied by the dialysis assembly.
(4) Arrangement of space shall be
				  sufficiently flexible to provide access to any of the patient's four
				  extremities.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.12 - Water Standards

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  kidney dialysis center shall:
(1) Comply with
				  42 CFR § 405.2140(a)(5), as amended, which is incorporated by reference;
				  and
(2) Assure that the quality of
				  water provided by a municipal water supply meets the federal Environmental
				  Protection Agency standards for dissolved solutes.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.13 - In-Center Nocturnal Hemodialysis

Current through Register Vol. 51, No. 14, July 12, 2024
Before performing in-center nocturnal hemodialysis, the
					 facility's interdisciplinary team shall:
A. Determine the patient's appropriateness
				  for in-center nocturnal hemodialysis by considering the patient's:
(1) Overall medical condition;
(2) Expectations for care;
(3) Response to in-center day-time
				  hemodialysis; and
(4) Availability
				  of transportation;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.04 - Freestanding Kidney Dialysis Centers › Section 10.05.04.14 - Emergency Management

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  kidney dialysis center shall have an emergency plan.
B. An emergency plan shall include policies
				  and procedures that will be followed before, during, and after an emergency to
				  address:
(1) The safe management of
				  individuals who are receiving services at the kidney dialysis center when an
				  emergency occurs;
(2) Notification
				  of patients, families, staff, and licensing authorities regarding actions that
				  will be taken concerning the provision of dialysis services to the individuals
				  served by the kidney dialysis center;
(3) Staff coverage, organization, and
				  assignment of responsibilities; and
(4) The continuity of operations, including
				  procedures to secure access to essential goods, equipment, and dialysis
				  services.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.02 - License Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  freestanding ambulatory surgical facility shall meet all general licensing
				  requirements for a facility as provided in COMAR 10.05.01 and all requirements
				  of this chapter.
B. An applicant
				  shall obtain Medicare certification as a condition of licensure for a
				  freestanding ambulatory surgical facility.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.03 - Licensing Procedure

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to meeting all of the requirements of COMAR
					 10.05.01.03A-C,
					 the applicant shall submit a nonrefundable fee of $1,000 for a 3 year period,
					 with an application for initial licensure, or submit a nonrefundable fee of
					 $1,000 with an application for license renewal for a 3 year period.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.04 - Administration

Current through Register Vol. 51, No. 14, July 12, 2024
The medical director shall develop protocols for the
					 management of surgical patients and emergency situations. These protocols shall
					 be available on site at all times for reference. The medical director shall
					 review these protocols annually and make revisions as
					 necessary.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.05 - Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
A. Credentialing of
				  Physicians, Dentists, Podiatrists.
(1) As part
				  of the formal written appointment process, the administrator, in consultation
				  with the medical director, shall collect, review, and document the following
				  information concerning a physician, dentist, or podiatrist licensed under the
				  Health Occupations Article, Annotated Code of Maryland:
(a) The physician's, dentist's, or
				  podiatrist's education;
(b) The
				  professional experience of the physician, dentist, or podiatrist, including:
(i) Any board certification or specialty
				  training of the physician, dentist, or podiatrist, and
(ii) Any post-graduate training;
(c) Any license or registration to
				  practice a health occupation ever held by the physician, dentist, or
				  podiatrist, including DEA registration;
(d) Whether any license or registration to
				  practice a health occupation ever held by the physician, dentist, or podiatrist
				  has been:
(i) Suspended, or
(ii) Revoked;
(e) Any hospital where the physician,
				  dentist, or podiatrist was appointed or employed during the last 10 years,
				  including:
(i) The name of the
				  hospital,
(ii) The term of
				  appointment or employment, and
(iii) Privileges held and any disciplinary
				  action taken, including suspension, revocation, limitation, or voluntary
				  surrender;
(f) The
				  physician's, dentist's, or podiatrist's professional liability insurance for
				  the last 5 years, including:
(i) The
				  physician's, dentist's, or podiatrist's present carrier,
(ii) The physician's, dentist's, or
				  podiatrist's current limits of coverage,
(iii) The physician's, dentist's, or
				  podiatrist's current types of coverage, and
(iv) Restrictions on the physician's,
				  dentist's, or podiatrist's coverage;
(g) Any claim that has been made against the
				  physician, dentist, or podiatrist in the practice of a health occupation in the
				  last 5 years, and the status of the claim;
(h) Any physical or mental condition that
				  currently impairs the physician's, dentist's, or podiatrist's ability to
				  exercise privileges;
(i) Any
				  complaint or report, permitted to be disclosed by law, which has been filed
				  with any state licensing or disciplinary body, or comparable body of the armed
				  forces; and
(j) Data provided by
				  the National Practitioner Data Bank.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.06 - Surgical Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Surgical procedures shall be performed in a safe manner by qualified
				  physicians, dentists, or podiatrists who have been granted clinical privileges
				  by the administrator.
B. The
				  administrator, in consultation with the medical director, shall develop and
				  implement policies, procedures, and protocols for the provision of surgical
				  services including but not limited to:
(1)
				  Personnel;
(2) Pre-operative
				  testing and examinations;
(3)
				  Surgical procedures;
(4)
				  Post-anesthesia care and observation;
(5) Discharge planning;
(6) Emergency services;
(7) Informed consent; and
(8) Safety.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.07 - Anesthesia Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Anesthetics shall be administered by health practitioners who are licensed,
				  certified, or otherwise authorized to do so under the Health Occupations
				  Article, Annotated Code of Maryland.
B. Anesthetics shall be administered only by
				  a:
(1) Qualified anesthesiologist;
(2) Physician or dentist qualified to
				  administer anesthesia;
(3)
				  Certified registered nurse anesthetist in accordance with Health Occupations
				  Article, §
											8-205, Annotated
				  Code of Maryland, and COMAR 10.27.06; or
(4) Podiatrist in accordance with Health
				  Occupations Article, §
											16-101, Annotated
				  Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.08 - Emergency Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. Basic
				  Life Support. Licensed personnel employed by the freestanding ambulatory
				  surgical facility shall have certification in basic life support. A licensed
				  staff individual trained in basic life support shall be on duty whenever there
				  is a patient in the facility.
B.
				  The licensee shall have:
(1) A registered
				  nurse available on site for emergency treatment whenever there is a patient in
				  the freestanding ambulatory surgical facility;
(2) At least one physician available by phone
				  24 hours a day to respond to emergency situations; and
(3) Formal arrangements to obtain radiology
				  and laboratory services at all times in case of emergencies.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.09 - Hospitalization

Current through Register Vol. 51, No. 14, July 12, 2024
A. The freestanding
				  ambulatory surgical facility shall have an effective procedure for the transfer
				  of patients to a hospital when care beyond the capabilities of the facility is
				  required.
B. Procedures for
				  emergency transfer to a hospital shall include, at a minimum:
(1) Having a written transfer agreement with
				  a local Medicare participating hospital or requiring all physicians, dentists,
				  or podiatrists performing surgery in the freestanding ambulatory surgical
				  facility to have admitting privileges at such a hospital;
(2) Having a mechanism for notifying the
				  hospital of a pending emergency case;
(3) Having a mechanism for arranging
				  appropriate transportation to the hospital; and
(4) The manner in which a facility sends a
				  copy of the patient's medical record to the hospital.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.10 - Pharmaceutical Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  freestanding ambulatory surgical facility shall:
(1) Provide drugs and biologicals under the
				  direction of an authorized prescriber; and
(2) Develop and implement policies and
				  procedures for pharmacy services in accordance with accepted professional
				  practice.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.11 - Laboratory and Radiologic Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The administrator shall develop and
				  implement policies and procedures for obtaining routine and emergency
				  laboratory and radiologic services to meet the needs of patients. Policies and
				  procedures shall include:
(1) Turn-around
				  time;
(2) Review of laboratory
				  reports; and
(3) Documentation of
				  laboratory results.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.12 - Medical Records

Current through Register Vol. 51, No. 14, July 12, 2024
A. The facility
				  shall comply with COMAR
				  10.05.01.09A and
				  the requirements of this regulation.
B. Each medical record shall include, at a
				  minimum:
(1) Preoperative diagnostic studies,
				  entered before surgery, if performed;
(2) Findings and techniques of the operation,
				  including a pathologist's report on all tissues removed during surgery, except
				  those tissues exempted by the medical director;
(3) Any allergies and abnormal drug
				  reactions; and
(4) Entries related
				  to anesthesia administration.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.13 - Physical Environment

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  administrator shall ensure that the facility has a safe, functional, and
				  sanitary environment for the provision of surgical services.
B. Each operating room shall be designed and
				  equipped to ensure that surgical procedures conducted can be performed in a
				  manner that ensures the safety of all individuals in the area.
C. The facility shall have a separate
				  recovery room and waiting area.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.01 - Communicable Diseases and Related Conditions of Public Health Importance › Section 10.06.01.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
A. This chapter
				  does not apply to human immunodeficiency virus (HIV) infection or acquired
				  immunodeficiency syndrome (AIDS) surveillance, reporting, record maintenance,
				  or confidentiality, which are covered by COMAR 10.18.02 and 10.18.03.
B. This chapter applies to human
				  immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome
				  (AIDS) control.
C. This chapter
				  provides regulations for coordinated control efforts for communicable diseases
				  and related conditions by the Department, local health officers, medical
				  laboratory directors, physicians, veterinarians, and other Maryland
				  governmental agencies, as guided by policy statements such as:
(1) Recommendations of the Centers for
				  Disease Control and Prevention, such as those of the Advisory Committee on
				  Immunization Practices and the Advisory Council for the Elimination of
				  Tuberculosis;
(2) Recommendations
				  of the National Association of State Public Health Veterinarians, including:
(a) The Compendium of Animal Rabies
				  Prevention and Control, 2016;
(b)
				  The Compendium of Measures to Control Chlamydia psittaci Infection Among Humans
				  (Psittacosis) and Pet Birds (Avian Chlamydiosis), 2017; and
(c) The Compendium of Measures to Prevent
				  Disease Associated with Animals in Public Settings,
				  2017.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.01 - Communicable Diseases and Related Conditions of Public Health Importance › Section 10.06.01.01-1 - Incorporation by Reference

Current through Register Vol. 51, No. 14, July 12, 2024
In this chapter, the following documents are incorporated
					 by reference:
A. "Control of
				  Communicable Diseases Manual (American Public Health Association, Twentieth
				  Edition, 2015);
B. Compendium of
				  Measures to Control Chlamydia psittaci Infection Among Humans (Psittacosis) and
				  Pet Birds (Avian Chlamydiosis), 2017 (The Association of Avian Veterinarians,
				  2017);
C. Compendium of Measures to
				  Prevent Disease Associated with Animals in Public Settings, 2017 (The National
				  Association of State Public Health Veterinarians, 2017); and
D. Compendium of Animal Rabies Prevention and
				  Control, 2016 (The National Association of State Public Health Veterinarians,
				  2016).
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.01 - Communicable Diseases and Related Conditions of Public Health Importance › Section 10.06.01.02 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. The definitions
				  of terms used in the Control of Communicable Diseases Manual are accepted as
				  official and applicable to the control of diseases within this State under this
				  chapter.
B. Terms Defined.
(1) Body Fluid.
(a) "Body fluid" means an excretion or fluid
				  from a human body that contains visible blood and all other tissues, excretions
				  or fluids including:
(i) Visible blood or any
				  body fluid that is visibly contaminated with blood;
(ii) Semen or vaginal secretions;
(iii) Amniotic, cerebrospinal, pericardial,
				  peritoneal, pleural, or synovial fluids;
(iv) Saliva in dental procedures;
				  and
(v) All body fluids in
				  situations where it is difficult or impossible to differentiate between body
				  fluids.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.01 - Communicable Diseases and Related Conditions of Public Health Importance › Section 10.06.01.03 - Reportable Diseases, Conditions, Outbreaks, and Unusual Manifestations; Submitting Clinical Materials

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  A person, as set forth in Regulation .04 of this chapter, shall report the
				  diseases or conditions listed in §C of this regulation, or any other
				  condition as requested by the Secretary.
B. Upon a positive laboratory finding for a
				  disease or condition listed in §C of this regulation, or upon request of
				  the Secretary, the director of a medical laboratory or a laboratory that
				  possesses a biological agent as defined in COMAR
				  10.10.11.03B(8)
				  shall:
(1) Submit clinical material to the
				  Department's public health laboratory; and
(2) Include information about the clinical
				  material on a form provided by the Secretary.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.01 - Communicable Diseases and Related Conditions of Public Health Importance › Section 10.06.01.05 - Record Maintenance and Confidentiality

Current through Register Vol. 51, No. 14, July 12, 2024
A. The custodian of a report identifying an
				  individual that was filed by a reporting source (Regulation .04A) in compliance
				  with the provisions of Health-General Article, §§18-201, 18-202, and
				  18-205, Annotated Code of Maryland:
(1) Shall
				  keep the report and record confidential;
(2) May not open a report or record to public
				  inspection;
(3) Shall release a
				  report or record or respond to a subpoena for a report or record in criminal or
				  civil proceeding only pursuant to court order sealing the record; and
(4) Shall make a record or report available
				  to a governmental agency performing its lawful duties as authorized by an act
				  of the Maryland General Assembly or the United States Congress when the
				  Secretary determines that the release of information is necessary to protect
				  the public health or to prevent the spread of an infectious or contagious
				  disease.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.01 - Communicable Diseases and Related Conditions of Public Health Importance › Section 10.06.01.06 - General Control Measures

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Necessary Action. The Secretary or a health officer shall:
(1) Take any action or measure necessary to
				  prevent the spread of communicable disease or to control a reportable disease
				  and condition; and
(2) Issue, when
				  necessary, special instructions for control of a disease or
				  condition.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.01 - Communicable Diseases and Related Conditions of Public Health Importance › Section 10.06.01.07 - Minimum Control Measures for Specific Diseases or Conditions

Current through Register Vol. 51, No. 14, July 12, 2024
A. The definitions
				  of terms used in the text and the recommendations for control included in the
				  Control of Communicable Diseases Manual are accepted as official and applicable
				  to the control of disease within this State under the regulations of the
				  Secretary, except in those instances in which the recommendations may be in
				  conflict with Regulation .06A or Regulations .08-.21 of this chapter, in which
				  case the regulations of the Secretary or special instructions of the Secretary
				  or a health officer shall take precedence.
B. The diseases and conditions described in
				  Regulations .08-.21 of this chapter are subject to specific requirements and
				  control procedures as specified.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.01 - Communicable Diseases and Related Conditions of Public Health Importance › Section 10.06.01.08 - Amebiasis

Current through Register Vol. 51, No. 14, July 12, 2024
A. Control of a
				  Case. A case may not participate in an occupation involving patient care, care
				  of young children or the elderly, and food handling until chemotherapy is
				  completed and 24 hours after diarrhea has ceased.
B. Control of Contacts.
(1) A health officer shall investigate
				  household and close contacts whose occupations involve food handling, patient
				  care, and care of young children or the elderly.
(2) A contact who has diarrhea shall submit
				  three fecal specimens for examination. If a specimen is positive for Entamoeba
				  histolytica, the contact becomes a case, and the control measures specified in
				  §A of this regulation apply.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.01 - Communicable Diseases and Related Conditions of Public Health Importance › Section 10.06.01.08-1 - Campylobacteriosis

Current through Register Vol. 51, No. 14, July 12, 2024
A. Control of a
				  Case.
(1) For a case with diarrhea due to or
				  presumed due to campylobacteriosis, a health officer shall restrict or exclude
				  a case from:
(a) Attending a child care
				  facility; or
(b) Participating in
				  an occupation involving:
(i) Food
				  handling;
(ii) Patient care; or
(iii) Care of young children or
				  the elderly.