reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.04 - Application Procedure

Current through Register Vol. 51, No. 14, July 12, 2024
A. Before
				  a person may apply for a license to operate a general hospice care program, the
				  person shall obtain a certificate of need from the Maryland Health Resources
				  Planning Commission under Health-General Article, Title 19, Annotated Code of
				  Maryland.
B. The applicant shall
				  submit an application for an initial license or renewal of a license on a
				  written or electronic form provided by the Secretary.
C. The applicant shall provide the following
				  information with the application as applicable:
(1) If the applicant is an individual and is
				  sole owner of the hospice care program, the name and address of the
				  applicant;
(2) If the applicant
				  proposes to operate a facility providing inpatient hospice care services and
				  someone other than the applicant owns the building or real property, or both,
				  the name and address of the owner or owners;
(3) If the applicant is a partnership or
				  limited partnership:
(a) The legal name of the
				  partnership or limited partnership,
(b) Any trade name used by the partnership or
				  limited partnership, and
(c) The
				  name and address of each partner;
(4) If the applicant is a corporation:
(a) The name of the corporation,
(b) The date of incorporation,
(c) The state of incorporation,
(d) The name and address of each
				  director,
(e) If the corporation is
				  incorporated outside of the State, the name and address of the resident agent
				  of the corporation,
(f) The name
				  and address of each officer, and
(g) The name and address of any stockholder
				  owning more than 5 percent of the stock of a corporate applicant;
(5) A statement that the applicant
				  meets the requirements of Health-General Article, Title 19, Annotated Code of
				  Maryland, and this chapter;
(6) The
				  name of the individual who is to be the medical director of the hospice care
				  program;
(7) The location and
				  postal address of:
(a) The principal office of
				  the proposed hospice care program,
(b) Any other office of the proposed hospice
				  care program,
(c) Any facility
				  providing inpatient hospice services to be operated by the hospice care
				  program, and
(d) Any location where
				  home-based hospice services are being provided in a residence owned or operated
				  by the hospice; and
(8)
				  A copy of the certificate of need determination from the Maryland Health
				  Resources Planning Commission as required under §A of this
				  regulation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.05 - Inspection by the Department

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  A licensee, or a program seeking licensure under this chapter, shall be open at
				  all times to inspection by the Department, and any agency designated by the
				  Secretary, to conduct an inspection.
B. The Department may:
(1) Periodically inspect a hospice care
				  program for compliance with this chapter; and
(2) Conduct complaint investigations
				  involving alleged licensure violations.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.06 - Administration

Current through Register Vol. 51, No. 14, July 12, 2024
A. Responsibility
				  of Licensee. A licensee shall ensure that the operation of the hospice care
				  program complies with Health-General Article, Title 19, Subtitle 9, Annotated
				  Code of Maryland, and this chapter.
B. Governing Body.
(1) A licensee shall have a governing body
				  for the hospice care program. The governing body shall:
(a) Determine the hospice care program's
				  mission and purpose;
(b) Conduct a
				  periodic community needs assessment;
(c) Provide outreach programs appropriate to
				  the needs of the communities it serves, including making information about
				  hospice care services readily available and providing appropriate educational
				  activities to the communities it serves;
(d) Make efforts to secure access to hospice
				  care services for the underserved;
(e) Adopt administrative and clinical
				  policies and procedures, and review them annually;
(f) Monitor the hospice's program and
				  establish a process to evaluate the quality of services it is
				  providing;
(g) Have fiscal and
				  fiduciary responsibility for the hospice care program including the review and
				  approval of its budget;
(h) Ensure
				  compliance with all legal requirements;
(i) Adopt bylaws which:
(i) Specify the role and responsibility of
				  the governing body, and
(ii) Define
				  the hospice care program's relationship to any other governing body;
				  and
(j) Develop and
				  implement a written conflict of interest policy which includes guidelines for
				  the resolution of any existing or apparent conflict of interest.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.07 - Policies and Procedures

Current through Register Vol. 51, No. 14, July 12, 2024
The hospice care program shall adopt and implement written
					 policies and procedures for:
A. The
				  use of advance directives;
B.
				  Identifying, reviewing, and discussing ethical dilemmas which arise in the care
				  of patients and family;
C. The use
				  of specific treatment modalities in different hospice care settings, that is,
				  palliative chemotherapy or radiation;
D. The administration of medications,
				  including who is qualified to administer medications;
E. The management of treatment-related
				  complications;
F. The use of
				  investigational drugs and implementation of research protocols;
G. The initiation of resuscitation;
H. Attending to remains at the time of
				  death;
I. The disposal of
				  controlled drugs after death;
J.
				  The provision of inpatient hospice care including:
(1) Privacy needs, including space for
				  families to gather,
(2) 24-hour
				  visitation and overnight stays, and
(3) Religious and spiritual
				  worship;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.08 - Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospice care
				  program shall maintain sufficient health care professionals and volunteers to
				  meet patient care needs.
B. The
				  hospice care program shall identify an interdisciplinary care team with
				  responsibility for ensuring continuous assessment of the patient's and family's
				  needs and implementation of an integrated plan of care. The hospice care
				  program shall ensure that:
(1) A qualified
				  health care professional coordinates the activities of the interdisciplinary
				  care team;
(2) The number of
				  individuals who perform interdisciplinary team services is consistent with the
				  needs of patients and their families and the type of services provided by the
				  hospice care program; and
(3) Each
				  interdisciplinary care team consists of at least:
(a) The patient's attending
				  physician,
(b) A physician with
				  training in palliative care,
(c) A
				  registered nurse with demonstrated experience in pain and symptom management
				  and the performance of physical assessments,
(d) A master's degree-prepared social worker
				  with clinical experience in counseling and casework for the terminally
				  ill,
(e) A volunteer, or
				  volunteers, supervised by an individual with management experience in a hospice
				  care program, and
(f) A spiritual
				  care counselor or counselors with education and experience in pastoral
				  counseling.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.09 - Quality Assurance

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  governing body shall ensure that the hospice care program conducts ongoing
				  quality assurance and utilization review.
B. Quality Assurance Program. The governing
				  body shall assure that the hospice care program develops and implements a
				  quality assurance and improvement program to assess and improve the quality of
				  services being provided by the program.
C. The quality assurance and improvement
				  program shall:
(1) Focus on:
(a) The needs, expectations, and satisfaction
				  of patients and their families, and
(b) All services provided by the hospice care
				  program;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.10 - The Interdisciplinary Plan of Care

Current through Register Vol. 51, No. 14, July 12, 2024
A. The interdisciplinary team shall develop a
				  written plan of care for each patient and family. The plan of care shall
				  reflect current standards of practice. The hospice care program shall document
				  the attending physician's participation in the development, revision, and
				  overall approval of the plan of care.
B. The interdisciplinary plan of care shall
				  reflect continuing communication between the attending physician and other
				  members of the interdisciplinary care team. The interdisciplinary plan of care
				  shall be reviewed, and revised if necessary, at least:
(1) Every 14 days after admission for
				  home-based hospice services; and
(2) Every 7 days after admission for
				  inpatient hospice services.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.11 - Continuity of Care

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospice
				  care program shall coordinate care to ensure continuity of care for the patient
				  and family.
B. Any changes in
				  service delivery are to be based on an assessment of the patient's and family's
				  needs and desires for hospice services and a hospice care program's transfer
				  and discharge criteria.
C. The
				  hospice care program shall:
(1) Provide case
				  management for the patient and family;
(2) Maintain an accurate, complete, and
				  documented record of services and activities provided to the patient and
				  family;
(3) Collaborate with other
				  organizations and individuals providing care to the patient and family to
				  ensure coordination of services;
(4) Provide on-call medical and nursing
				  services in response to patient and family needs;
(5) Ensure the safety of staff and inform the
				  patient and family of any personnel, service, or access limitations;
				  and
(6) Have reporting mechanisms
				  to keep all staff informed and updated about patient care changes to ensure
				  continuity and coordination of care among interdisciplinary team
				  members.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.12 - Transfer or Discharge

Current through Register Vol. 51, No. 14, July 12, 2024
A. If the
				  hospice care program does not provide inpatient hospice services directly, the
				  hospice care program shall have a written transfer agreement with a hospice
				  care program which provides those services.
B. The hospice care program shall provide
				  adequate and appropriate information about the patient and family at the time
				  of transfer or discharge.
C. When a
				  patient and family transfers from one hospice care program to another or from
				  home-based service to inpatient service, or vice versa, the current care
				  provider shall provide a written summary of:
(1) The services being provided;
(2) The specific medical, psychosocial,
				  spiritual, or other problems that require intervention or follow-up;
				  and
(3) Any scheduled follow-up by
				  a current interdisciplinary care team member.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.13 - Physician Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. Medical
				  Director. The hospice care program shall have a medical director who shall be:
(1) A physician licensed to practice medicine
				  in this State; and
(2)
				  Knowledgeable about the psychosocial and medical aspects of hospice
				  care.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.14 - Nursing Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. Nursing
				  services shall be provided by licensed or certified personnel, trained or
				  experienced in hospice care and supervised by a registered nurse with training
				  or experience in hospice nursing. All nursing services shall be provided in
				  accordance with the requirements of Health Occupations Article, Title 8,
				  Annotated Code of Maryland.
B. The
				  hospice care program shall provide nurse staffing levels based on:
(1) An assessment of patient and family care
				  needs;
(2) The experience level of
				  the nursing staff available to provide services; and
(3) Available assistance from support service
				  staff.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.15 - Ancillary Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  hospice care program shall have a written plan for the provision of pharmacy,
				  laboratory, radiology, chemotherapy, and other ancillary services. When the
				  service is provided by an organization other than the hospice care program, the
				  hospice care program shall enter into a written agreement with the provider of
				  ancillary services which specifies the services being provided and the
				  procedures for accessing those services.
B. The hospice care program shall ensure that
				  ancillary services are provided in accordance with federal and State laws and
				  regulations.
C. Pharmacy Services.
(1) The hospice care program shall employ or
				  contract with a licensed pharmacist to:
(a)
				  Supervise all pharmacy services;
(b) Serve as a consultant to the
				  interdisciplinary care team; and
(c) Ensure that all drugs and biologicals are
				  prescribed, dispensed, administered, stored, and disposed of in accordance with
				  applicable laws and regulations.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.16 - Counseling Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Counseling Services. The hospice care program shall provide counseling services
				  which address the needs of patients and families. The hospice care program
				  shall provide counseling services as set forth in B-----E of this
				  regulation.
B. Social Work
				  Services. Social work services are to be based on an initial and continuing
				  assessment of patient and family psychosocial needs. Each assessment shall be
				  conducted by a social worker. Services shall be provided in accordance with
				  each patient's interdisciplinary plan of care with the goal of assisting the
				  patient and family in adjusting to the psychosocial aspects of terminal
				  illness.
C. Spiritual Services. The
				  hospice care program shall provide spiritual services that are based on an
				  initial, ongoing assessment of the spiritual needs of the patient and family.
				  Spiritual services are to be consistent with patient and family beliefs and
				  desires. These services shall be provided by a member of the interdisciplinary
				  care team or by local clergy or spiritual counselors.
D. Nutritional Counseling. The hospice care
				  program shall provide nutritional counseling to the patient and family. This
				  counseling shall be provided by either a registered nurse, registered
				  dietitian, or licensed nutritionist as specified in the interdisciplinary plan
				  of care.
E. Bereavement services
				  shall be provided as set forth in Regulation .10H of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.17 - Emergency Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  hospice care program shall ensure that emergency services are available 24
				  hours per day, 7 days a week.
B.
				  Emergency services are to include, at a minimum:
(1) Registered nurse and physician
				  services;
(2) Palliative
				  medications; and
(3) Other
				  services, equipment, and supplies necessary to meet the patient's immediate
				  needs as directed by the patient's plan of care.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.18 - Volunteer Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  hospice care program's volunteer services shall play a vital role in enhancing
				  the quality of care delivered to the patient and family by encouraging
				  community participation in the overall hospice care program.
B. Volunteers may assist with patient care
				  and administrative services consistent with the hospice care program's policies
				  and in accordance with the requirements of this regulation.
C. Volunteers shall document their activities
				  in the clinical record.
D.
				  Volunteers shall comply with personnel policies and procedures.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.19 - Medical Records

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospice
				  care program shall establish and maintain a clinical record for each patient in
				  accordance with accepted principles of practice for maintaining medical
				  records. The record is to be complete, accurately documented, readily
				  accessible, and systematically organized to facilitate retrieval of
				  information.
B. The hospice care
				  program shall:
(1) Document clinical and
				  progress notes in a patient's medical record within 14 days of a visit or
				  provision of services;
(2) Obtain
				  the attending physician's signature on an order within 30 days of receiving a
				  verbal order; and
(3) Close a
				  medical record within 30 days of a patient's discharge.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.20 - Patient's Representative

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  hospice care program 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 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 that meets the
				  requirements of Estates and Trusts Article, §
											13-601, Annotated
				  Code of Maryland;
(6) A
				  representative payee or other similar fiduciary; or
(7) Any other person, if that person was
				  designated by a patient who was competent at the time of designation, and the
				  patient or representative has provided the hospice care program with
				  documentation of the designation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.21 - Patient's Rights

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospice
				  care program shall provide the patient or representative with a written notice
				  of the patient's rights in advance of furnishing care. Documentation verifying
				  receipt of and understanding of this information shall be included as part of
				  the patient's record.
B. The
				  patient has the right to:
(1) Be treated with
				  consideration and respect for individual dignity;
(2) Confidentiality in all aspects of service
				  or treatment;
(3)
				  Privacy;
(4) Be free from physical
				  or mental abuse;
(5) Participate in
				  the planning of the patient's hospice care;
(6) Formulate advance directives as provided
				  under State law;
(7) Have all
				  personal property treated with respect;
(8) Refuse care and services, including
				  continued participation in the hospice care program;
(9) Be informed of short-term inpatient care
				  options available for pain control, management, and respite;
(10) Be informed of the hospice care
				  program's discharge policy;
(11)
				  Make complaints or grievances to the hospice care program, government agencies,
				  or other persons without threat or fear of retaliation; and
(12) Be informed orally and in writing,
				  before care is initiated, of the extent to which payment may be expected from
				  the patient, third-party payers, and any other source of funding known to the
				  hospice care program.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.22 - Complaint Procedure

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  hospice care program shall establish a procedure under which a patient or
				  family member may make a complaint to a representative of the hospice care
				  program.
B. The hospice care
				  program shall investigate and seek to resolve the complaint.
C. The hospice care program shall maintain
				  documentation which reflects findings of the investigation and efforts to
				  resolve the complaint.
D. The
				  hospice care program shall inform each patient and family of:
(1) Its complaint procedure; and
(2) The address and telephone number of the
				  Department's Licensing and Certification Administration.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.23 - Infection Control

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospice
				  care program shall have an infection control program in all care
				  settings.
B. There is to be a
				  written plan for identifying, preventing, and controlling the spread of
				  infection, which includes:
(1) Identifying an
				  individual responsible for implementing and monitoring the infection control
				  program;
(2) Establishing a system
				  for periodic review and update of infection control policies and procedures
				  governing at a minimum:
(a) Personal
				  hygiene,
(b) Aseptic and isolation
				  techniques,
(c) Supplies,
				  medication, and food storage, and
(d) Waste disposal;
(3) Reviewing patient and family caregiver
				  practices to identify potential exposure to infection; and
(4) Ensuring that the infection control
				  program is monitored, reviewed, and evaluated regularly at specified
				  intervals.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.24 - Safety and Emergency Preparedness

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospice care program shall have a
				  safety and emergency preparedness program that includes, at a minimum:
(1) A plan for reporting, monitoring, and
				  following up on all accidents, injuries, and safety hazards;
(2) Education for patient and family
				  caregivers, employees, and volunteers in the safe use of medical
				  equipment;
(3) Evidence that
				  equipment maintenance and safety requirements have been met; and
(4) A safe and sanitary system for
				  identifying, handling, and disposing of special medical wastes that meets the
				  requirements of COMAR 10.06.06.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.25 - Home-Based Hospice Care Provided in a Licensed Health Care Facility

Current through Register Vol. 51, No. 14, July 12, 2024
A. Professional
				  Management.
(1) When a hospice care program
				  delivers hospice care to a resident of a licensed health care facility, the
				  hospice care program shall assume full responsibility for professional
				  management of the patient's hospice care in accordance with the requirements of
				  this chapter.
(2) When a hospice
				  care program delivers hospice care to a resident of a licensed health care
				  facility, the hospice and the facility shall have a written agreement which
				  defines their respective roles and responsibilities in regard to the care of
				  the patient.
(3) The hospice care
				  program shall designate a qualified health care professional from the hospice
				  care program who shall coordinate the activities of the interdisciplinary care
				  team and the health care facility staff to assure continuous assessments of the
				  patient's and family's needs, and to ensure implementation of an integrated
				  plan of care.
(4) All core hospice
				  services, specifically, physician, nursing, social work, and counseling
				  services identified in the plan of care, shall be provided directly by hospice
				  care program employees or volunteers and may not be delegated to the health
				  care facility.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.26 - Inpatient Hospice Care

Current through Register Vol. 51, No. 14, July 12, 2024
A. In
				  addition to the other requirements of this chapter, when a hospice care program
				  delivers inpatient care, the hospice care program shall provide nursing
				  services 24 hours a day in a manner sufficient to meet the total nursing needs
				  identified in the patient's plan of care. A registered nurse shall be on duty
				  during each shift.
B. The hospice
				  care program shall design and equip all areas for the comfort and privacy of
				  patients and family members. Specifically, the hospice care program shall:
(1) Provide accommodation for family members
				  to remain with the patient throughout the night;
(2) Provide an adequate supply of hot water
				  at all times for patient use;
(3)
				  Have available at all times a quantity of linen sufficient for proper care and
				  comfort of patients;
(4) Make
				  provisions for isolating patients with infectious diseases; and
(5) Provide privacy for patient/family
				  visitation and accommodations for the family's privacy immediately after a
				  patient's death.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.27 - Penalties

Current through Register Vol. 51, No. 14, July 12, 2024
A. Administrative
				  Penalty.
(1) The Secretary may, for
				  noncompliance with any regulation under this chapter, impose an administrative
				  penalty of up to:
(a) $500 for a first
				  violation; and
(b) $1,000 for a
				  subsequent repeated violation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.21 - Hospice Care Programs › Section 10.07.21.28 - Hearings

Current through Register Vol. 51, No. 14, July 12, 2024
A. A request for a
				  hearing shall be filed with the Office of Administrative Hearings, with a copy
				  to the Licensing and Certification Administration 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 in accordance with State Government Article, §
										10-210 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 10.01.03.28H.
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
				  10.01.03.35H.
F. A final decision by the
				  Secretary shall be issued in accordance with COMAR
				  10.01.03.35H.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.01 - Scope and Purpose

Current through Register Vol. 51, No. 14, July 12, 2024
A. This chapter
				  is effective January 1, 2014.
B.
				  This chapter applies to all general hospice care programs that operate a
				  hospice house.
C. An operator of a
				  hospice house shall also comply with all the requirements contained in COMAR
				  10.07.21 that are applicable to general hospice care programs.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.02 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In addition to
				  the definition contained in §B of this regulation, definitions set forth
				  in COMAR 10.07.21.02 are applicable to this
				  chapter.
B. Terms Defined.
(1) "Hospice house" means a residence
				  operated by a Maryland licensed general hospice care program that provides
				  home-based hospice services to hospice patients in a home-like environment and
				  the care is not billed as general inpatient care.
(2) "Primary hospice nurse" means the
				  registered nurse who is assigned to oversee the nursing care of an individual
				  hospice patient from the time of admission until the time of
				  discharge.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.03 - Incorporation by Reference

Current through Register Vol. 51, No. 14, July 12, 2024
In this chapter, the following document is incorporated by
					 reference: NFPA 101, The Life Safety Code, as adopted by the State Fire
					 Prevention Commission in COMAR 29.06.01.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.04 - License Required

Current through Register Vol. 51, No. 14, July 12, 2024
A person may not operate a hospice house without first
					 obtaining a license to operate a general hospice care
					 program.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.05 - Staffing Plan

Current through Register Vol. 51, No. 14, July 12, 2024
A. Following an
				  analysis of the number of beds the hospice house intends to serve and the
				  individual needs of each resident, the general hospice care program shall
				  develop a staffing plan that identifies the type and number of staff needed to
				  provide the services required by this chapter.
B. The staffing plan shall include on-site
				  staff sufficient in number and qualifications to meet the 24-hour scheduled and
				  unscheduled needs of the residents.
C. Relief personnel shall be available at all
				  times in the event that the regularly scheduled staff members are
				  unavailable.
D. The staffing plan
				  shall be reviewed annually and as needed.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.06 - Management of the Hospice House

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  The administrator of the general hospice care program shall identify a manager
				  of the hospice house who has full responsibility for the day-to-day operations
				  of the hospice house.
B. The
				  administrator shall evaluate the manager's performance on an annual
				  basis.
C. In the absence of the
				  hospice house manager, the hospice house shall remain under the continuous
				  supervision of a designated individual with appropriate experience and
				  training.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.07 - Staff Qualifications

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  hospice house shall be staffed by sufficient numbers of personnel to ensure
				  that the hospice house is capable of meeting the requirements of this chapter,
				  and all applicable federal, State, and local laws and regulations.
B. In addition to meeting all of the other
				  qualifications and requirements for hospice employees, all hospice house staff
				  shall participate in an orientation program and annual training to ensure
				  competency in maintaining the hospice house and meeting the needs of residents
				  in accordance with the plan of care.
C. Staff who administer medications to
				  residents shall meet all requirements of the Maryland Board of Nursing or
				  Maryland Board of Physicians.
D.
				  Documentation of all required training shall be included in the employee's
				  personnel record.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.08 - Admission Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A hospice patient appropriate for care in their own home
					 who does not require general inpatient services may be eligible for care in a
					 hospice house, in accordance with the hospice house admission
					 policy.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.09 - Residential Agreement

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Patients admitted to the hospice house or their representatives shall sign,
				  before or at the time of admission, a patient agreement that:
(1) Is a clear and complete statement of
				  commitments agreed to by the parties and the services provided in the hospice
				  house;
(2) Is accurate, legible,
				  and communicated in a language understandable to patient and family;
				  and
(3) Conforms to all applicable
				  federal, State, and local laws and requirements.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.10 - Patient Record

Current through Register Vol. 51, No. 14, July 12, 2024
The hospice house shall:
A. Maintain the privacy and confidentiality
				  of a patient's medical records;
B.
				  Release medical records or medical information about a patient only with the
				  consent of the patient or patient's representative, or as permitted by
				  Health-General Article, Title 4, Subtitle 3, Annotated Code of Maryland;
				  and
C. Maintain and dispose of a
				  resident's medical records in accordance with Health-General Article, Title 4,
				  Subtitle 4, Annotated Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.11 - Food

Current through Register Vol. 51, No. 14, July 12, 2024
A. A patient's food
				  preferences shall be assessed at the time of admission. The assessment shall be
				  maintained in the patient record.
B. Patients shall be provided meals and
				  snacks as requested.
C. Patients
				  shall be offered 3 meals and additional snacks during each 24-hour period, 7
				  days a week in accordance with their individual daily nutritional needs and
				  preferences and consistent with their plan of care.
D. Food that is prepared at the hospice house
				  shall be prepared in accordance with all State and local sanitation and safe
				  food handling requirements.
E. Food
				  preparation areas are to be maintained in accordance with all State and local
				  sanitation and safe food handling requirements.
F. Hospice house staff shall prepare or
				  arrange for the provision of special diets consistent with the plan of
				  care.
G. Hospice house staff shall
				  obtain food from sources that comply with all local laws and regulations
				  relating to food, food processing, food handling, and food labeling.
H. Hospice house staff shall protect food
				  from contamination while being stored, prepared, displayed, served, or
				  transported.
I. Hospice house staff
				  shall promptly discard the following:
(1)
				  Spoiled food;
(2) Swelled, rusty,
				  or leaky canned food; and
(3) Foods
				  exposed to fire, smoke, or water damage.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.12 - Personal Care Services

Current through Register Vol. 51, No. 14, July 12, 2024
The hospice house staff shall provide all necessary
					 personal care services to the patient in accordance with the plan of care and
					 as desired by the patient.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.13 - Medication Management and Administration

Current through Register Vol. 51, No. 14, July 12, 2024
A. All medications shall be administered
				  consistent with applicable requirements of COMAR 10.27.11.
B. Medications and treatments shall be
				  administered consistent with current medical orders and using acceptable
				  professional standards of practice.
C. All medications shall be stored in a
				  secure location, at proper temperature.
D. Each patient's medications shall be stored
				  in the original dispensed container;
E. Each patient shall receive the medications
				  that have been specifically prescribed for that patient in the manner that has
				  been ordered.
F. The hospice house
				  staff shall document and report to the patient's primary hospice nurse or the
				  hospice nurse on call any symptoms or pain that are not relieved by the current
				  medications and other interventions.
G. The hospice house staff shall document and
				  report to the patient's primary hospice nurse or the hospice nurse on call any
				  undesired side effects, adverse drug reactions, or medication errors.
H. The medication administration
				  documentation required under this regulation shall be recorded by a staff
				  member at the time that the patient takes or receives medications on a
				  medication administration report. This documentation shall be maintained in the
				  patient record and include at minimum:
(1)
				  Name of the patient;
(2) Date of
				  birth;
(3) Diagnosis;
(4) Allergies;
(5) Significant adverse drug
				  reactions;
(6) Name of the
				  medication;
(7) Reason for the
				  medication;
(8) Dose;
(9) Authorized prescriber's name;
(10) Date of issuance, and
(11) Directions for use.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.14 - Incident Reports

Current through Register Vol. 51, No. 14, July 12, 2024
A. The staff of
				  the hospice house shall complete an incident report in accordance with hospice
				  policy within 24 hours of having knowledge that an incident has
				  occurred.
B. All incident reports
				  shall include:
(1) Time, date, place, and
				  individuals present;
(2) Complete
				  description of the incident;
(3)
				  Response of the staff at the time; and
(4) Follow up action, including notification
				  to the:
(a) Patient's primary hospice nurse or
				  hospice nurse on call;
(b)
				  Patient's representative or family;
(c) Patient's attending physician or nurse
				  practitioner;
(d) Hospice medical
				  director; and
(e) Licensing or law
				  enforcement authorities, when appropriate.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.15 - Relocation and Discharges

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Relocation within the Facility. The hospice house may not relocate a patient
				  within the facility except in accordance with the terms and conditions of the
				  residential agreement.
B.
				  Discharge.
(1) Discharge of a patient without
				  the consent of the patient or the patient's representative shall be in
				  accordance with the residential agreement.
(2) When the patient is discharged or
				  transferred to another facility, the hospice house shall provide to the
				  receiving facility all information that is required to ensure that continuity
				  of care and services is maintained.
(3) Within 30 days of the date of discharge,
				  the hospice house shall:
(a) Give the patient
				  or patient's representative a final statement of account and refunds due;
				  and
(b) Return any money, property,
				  or valuables held in trust or custody by the hospice house.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.16 - Patient's Rights

Current through Register Vol. 51, No. 14, July 12, 2024
A. In addition
				  to all other rights as a hospice patient, the patient residing in a hospice
				  house has the right to:
(1) Privacy, including
				  the right to have a staff member knock on the patient's door before
				  entering;
(2) Be free from mental
				  abuse, verbal abuse, sexual abuse, physical abuse, neglect, involuntary
				  seclusion, and exploitation;
(3) Be
				  free from physical and chemical restraints;
(4) Manage personal financial
				  affairs;
(5) Maintain legal
				  counsel;
(6) Attend or not attend
				  religious services as the patient chooses, and receive visits from members of
				  the clergy;
(7) Possess and use
				  personal clothing and other personal effects to a reasonable extent, and to
				  have reasonable security for those effects in accordance with the hospice
				  house's security policy;
(8) Retain
				  personal clothing and possessions as space permits with the understanding that
				  the hospice house may limit the number of personal possessions retained at the
				  facility for the health and safety of other patients;
(9) Meet or visit privately with any
				  individual the patient chooses in accordance with patient and facility safety;
				  and
(10) Have reasonable access to
				  the private use of a telephone within the facility.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.17 - Abuse, Neglect, and Exploitation

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospice house shall develop and
				  implement policies and procedures prohibiting abuse, neglect, and exploitation
				  of hospice house patients.
B.
				  Reports of Abuse, Neglect, or Exploitation. An employee of the hospice house
				  who believes that a patient has been subjected to abuse, neglect, or
				  exploitation shall report the alleged abuse, neglect, or exploitation within 24
				  hours to:
(1) The appropriate local Department
				  of Social Services, Adult Protective Services office, or Child Protective
				  Services; and
(2) One of the
				  following:
(a) A local law enforcement agency;
				  or
(b) The Office of Health Care
				  Quality.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.18 - Restraint or Seclusion

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  hospice house shall develop a policy and procedure related to restraint and
				  seclusion.
B. Relevant staff shall
				  be trained in accordance with the facility's policy and procedure related to
				  restraint and seclusion.
C.
				  Patients have the right to be free from restraint or seclusion of any form
				  which are imposed as a means of coercion, discipline, convenience, or
				  retaliation by staff.
D. Restraint
				  or seclusion may only be imposed to ensure the immediate physical safety of the
				  patient, a staff member, or others and shall be discontinued at the earliest
				  possible time.
E. The type or
				  technique of restraint or seclusion used shall be the least restrictive
				  intervention that will be effective to protect the patient, a staff member, or
				  others from harm.
F. The use of
				  restraint or seclusion shall be:
(1) In
				  accordance with a written modification to the patient's plan of care;
				  and
(2) Implemented in accordance
				  with safe and appropriate restraint and seclusion techniques as determined by
				  hospice policy in accordance with applicable laws.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.22 - Hospice Care Programs: Hospice House Requirements › Section 10.07.22.19 - General Physical Plant Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A. The facility, which includes buildings,
				  common areas, and exterior grounds, shall be kept:
(1) In good repair;
(2) Clean;
(3) Free of any object, material, or
				  condition that may create a:
(a) Health
				  hazard, accident, or fire; or
(b)
				  Public nuisance; and
(4)
				  Free of insect infestations and rodents.