reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.16 - Cardiac Interventional Center Standards › Section 30.08.16.03 - Catheterization Lab

Current through Register Vol. 51, No. 14, July 12, 2024
A Cardiac Interventional Center may receive STEMI patients transported by ambulance directly to the catheterization lab when approved by the base station physician if the catheterization lab has a physician, appropriately credentialed to evaluate and stabilize an acute cardiac patient, a registered nurse, and a technician, capable of activating the catheterization lab, immediately available in house when:
A. The 12 lead EKG in the field is interpreted by an advanced life support EMS provider as a high probability of a STEMI; or
B. The 12 lead EKG in the field has been reviewed by an ED physician, a cardiologist, or both, and determined to be a STEMI.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.16 - Cardiac Interventional Center Standards › Section 30.08.16.04 - Site Reviews

Current through Register Vol. 51, No. 14, July 12, 2024
A. Notwithstanding COMAR 30.08.02.06I, MIEMSS may designate any Cardiac Interventional Center without a site review.
B. Notwithstanding §A of this regulation, MIEMSS staff may conduct an onsite review to verify compliance with this chapter, including:
(1) Inspecting the hospital's physical plant;
(2) Interviewing team members and management personnel;
(3) Examining the hospital's Cardiac Interventional Center related documents, including patient care records; and
(4) Reviewing other materials considered appropriate by MIEMSS.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.01 - Designated Comprehensive Stroke Center

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to meeting the requirements of COMAR 30.08.11.01, a designated comprehensive stroke center hospital shall:
A. Be designated by MIEMSS as a primary stroke center at the time of application for designation as a comprehensive stroke center;
B. Continue to meet the primary stroke center requirements in COMAR 30.08.11 to the extent such requirements are consistent with designation as a comprehensive stroke center;
C. Act as a resource center for other facilities in its region or state;
D. Annually care for at least 20 Subarachnoid Hemorrhage by aneurysm patients per year;
E. Annually perform a combined total of 15 endovascular coiling and surgical clippings per year for aneurysm;
F. Annually administer fibrinolytics to 25 eligible patients per year or 50 eligible patients over 2 years:
(1) IV fibrinolytic ordered and monitored via telemedicine at another hospital is acceptable; and
(2) IV fibrinolytic administered at an outside hospital and transferred to CSC site is acceptable;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.02 - Organization

Current through Register Vol. 51, No. 14, July 12, 2024
The designated comprehensive stroke center shall meet the requirements of COMAR 30.08.11.02.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.03 - Emergency Department

Current through Register Vol. 51, No. 14, July 12, 2024
The designated comprehensive stroke center shall meet the requirements of COMAR 30.08.11.03.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.04 - Neuroscience Intensive Care Unit

Current through Register Vol. 51, No. 14, July 12, 2024
The designated comprehensive stroke center shall maintain a dedicated neuroscience intensive care unit that meets the requirements of this regulation and:
A. Has designated beds for the care of acute stroke patients;
B. Has 24/7 on-site practitioners with neurovascular training, including, for example, APNs, PAs, neuro-intensivists, fellows, or residents;
C. Provides care to acute stroke patients through qualified clinical staff who meet the requirements in Regulations .12-.15 of this chapter;
D. Follows standardized processes derived from evidence-based practice clinical practice guidelines to facilitate clinical care;
E. Incorporates individualized plans of care that are based on the patient's assessed needs and reflect coordination of care with other programs, as determined by patient comorbidities;
F. Has a process to assess the abilities and resources of family members to be involved in post-acute care; and
G. Maintains written documentation delineating the function of the neuroscience intensive care unit, including:
(1) Admission criteria;
(2) Discharge criteria;
(3) Acute stroke care protocols;
(4) Interdisciplinary rounding;
(5) Rehabilitation assessment and services in the hospital; and
(6) Outcome data.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.05 - Stroke Unit

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to meeting the requirements of COMAR 30.08.11.07, the designated comprehensive stroke center shall:
A. Have sufficient personnel available to respond to health care personnel at other hospitals to provide them with guidance and recommendations about the diagnosis and treatment of stroke and referral to an appropriate facility if transfer is required or requested;
B. Have written policies or procedures to direct the organized, safe, intra-hospital and inter-hospital transport of stroke patients;
C. Have priority bed availability for stroke patients with appropriately trained registered nurses in sufficient numbers based on patient acuity; and
D. Have a written plan for triaging patients from the neuroscience intensive care unit and/or the dedicated this unit to make beds available for other stroke patients when necessary or for provision of alternate critical care beds for stroke patients with appropriately trained registered nurse staff.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.06 - Stroke Team

Current through Register Vol. 51, No. 14, July 12, 2024
A. In addition to meeting the requirement of COMAR 30.08.11.05, the hospital shall:
(1) Establish one or more acute stroke teams which shall respond to the emergency department with coordinated services for the effective delivery of emergency and acute stroke treatment;
(2) Use the National Institutes of Health Stroke Scale (NIHSS) for the initial assessment of patients with acute stroke, with clinicians performing an NIHSS having documented training in the completion of the NIHSS; and
(3) Perform ongoing neurological assessment on patients with acute stroke.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.07 - Operating Room

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to meeting the requirements of COMAR 30.08.11.04, the hospital shall have:
A. An attending board certified/board eligible neurosurgeon on call with a 45-minute arrival time to the hospital;
B. Written procedures demonstrating the ability to care for two complex neurosurgical stroke patients at one time using appropriate clinical staff; and
C. Written documentation demonstrating on-call and back-up on-call schedules for physicians and staff for 24/7 coverage.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.08 - Endovascular Interventional Services

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall have:
A. Interventional services promptly available 24 hours a day with appropriately trained support staff and equipment, including:
(1) Intra-arterial reperfusion therapy;
(2) Endovascular treatment of vasospasm;
(3) Endovascular ablation of arterial venous malformations;
(4) Stenting/angioplasty of extracranial vessels; and
(5) Stenting/angioplasty of intracranial vessels;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.09 - Neuroimaging Services

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to meeting the requirements of COMAR 30.08.11.09, a designated comprehensive stroke center shall have the following diagnostic capability available when indicated:
A. Carotid duplex ultrasound;
B. Transcranial ultrasonography; and
C. Transesophageal or transthorasic echocardiogram.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.10 - Laboratory/Diagnostic Services

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall meet the requirements of COMAR 30.08.11.08.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.11 - Qualifications of Stroke Center Director and Clinicians

Current through Register Vol. 51, No. 14, July 12, 2024
A. Director.
(1) The stroke center medical director shall be a physician with competence in caring for the acute stroke patient and be Board-certified or Board-eligible in:
(a) Neurology;
(b) Neurosurgery; or
(c) Vascular neurology.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.12 - Qualifications of Nurses, Nurse Practitioners, and Physician Assistants in the Neuroscience Intensive Care Unit

Current through Register Vol. 51, No. 14, July 12, 2024
Physician Assistants in the Neuroscience Intensive Care Unit.
A. Clinical nurses, nurse practitioners, and physician assistants providing care to stroke patients in the neuroscience intensive care unit shall be trained in assessment of neurological function and management and treatment of all aspects of neurocritical care, including:
(1) Function of ventriculostomy and external ventricular drainage apparatus;
(2) Monitoring and treatment of increased intracranial pressure;
(3) Care of patients with intracranial hemorrhage and subarachnoid hemorrhage;
(4) Care of patients post fibrinolytic therapy;
(5) Care of patients post mechanical thrombectomy;
(6) Treatment of blood pressure abnormalities with parenteral vasoactive agents;
(7) Management of intubated/ventilated patients; and
(8) Detailed neurological assessments and scales (i.e., National Institute of Health Stroke Scale and the Glasgow Coma Scale).
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.13 - Qualifications of Nurses, Nurse Practitioners, and Physician Assistants in the Emergency Department

Current through Register Vol. 51, No. 14, July 12, 2024
A. Emergency department nurses, nurse practitioners, and physician assistants who triage patients in the emergency department or care for acute stroke patients shall be trained in:
(1) Assessment of acute stroke;
(2) Treatment of acute stroke;
(3) Use of clinically appropriate fibrinolytic in acute ischemic stroke and the indication for endovascular therapy in acute ischemic stroke;
(4) Mechanical thrombectomy protocols;
(5) Treatment of blood pressure abnormalities with parenteral vasoactive agents;
(6) Neurological assessments and scales (i.e., National Institute of Health Stroke Scale and the Glasgow Coma Scale);
(7) Management of intubated/ventilated patients; and
(8) Care of patients post fibrinolytic therapy.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.14 - Continuing Medical Education Requirements for Nurses, Nurse Practitioners, and Physician Assistants in the Stroke Unit

Current through Register Vol. 51, No. 14, July 12, 2024
Continuing education requirements for nurses, nurse practitioners and physician assistants who care for the acute stroke patients in the stroke unit shall include a minimum of 5 hours of strokespecific education annually.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.15 - Prevention/Public Education

Current through Register Vol. 51, No. 14, July 12, 2024
The designated comprehensive stroke center shall meet the requirements of COMAR 30.08.11.12.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.16 - Policies, Protocols, Guidelines, and Agreements

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to meeting the requirements of COMAR 30.08.11.13, the hospital shall:
A. Have written policies ensuring that:
(1) Transfer of patients from another facility is appropriate and patients are received in a timely manner; and
(2) All stroke patients receive care commensurate with the hospital's designation as a comprehensive stroke center;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.17 - Quality Management

Current through Register Vol. 51, No. 14, July 12, 2024
A. In addition to the requirements of COMAR 30.08.11.14, the hospital shall incorporate into the hospital's quality assurance process reports about:
(1) Specific acute stroke treatment benchmarks; and
(2) Stroke treatment quality improvement goals.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.17 - Comprehensive Stroke Center Standards › Section 30.08.17.18 - Acute Stroke Research

Current through Register Vol. 51, No. 14, July 12, 2024
A hospital shall:
A. Have an acute stroke research program and acute stroke research plan; and
B. Demonstrate participation in clinical research trials in acute stroke care.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.01 - Designated Acute Stroke Ready Center

Current through Register Vol. 51, No. 14, July 12, 2024
A designated acute stroke ready center shall:
A. Be licensed as a hospital or freestanding medical center by the licensing authority in the jurisdiction in which it is located;
B. If a hospital, be accredited by The Joint Commission;
C. If located in Maryland, be a base station approved under COMAR 30.03.06;
D. Provide assessment and management of the stroke patient consistent with the most current AHA/ASA consensus based clinical practice guidelines to meet the needs of the patient;
E. Have a stroke center medical director;
F. Have a stroke center nurse coordinator dedicated to the facility;
G. Have sufficient personnel and resources needed to facilitate healthcare data management and concurrent review of quality metrics and program objectives;
H. Meet the requirements of Regulations .02-.14 of this chapter;
I. Satisfy the MIEMSS requirements for designation as an Acute Stroke Ready Center; and
J. Meet the requirements for a site review in COMAR 30.08.02.06, which may be satisfied by completing either:
(1) An on-site review by MIEMSS; or
(2) A site survey as part of The Joint Commission Disease Specific Care Certification Program for certification as an acute stroke ready center if the facility:
(a) Authorizes The Joint Commission to provide MIEMSS with survey findings, certification reports, and other information related to The Joint Commission's certification of the hospital as an acute stroke ready center;
(b) Allows MIEMSS to participate in the accreditation site survey; and
(c) Provides MIEMSS any additional information required to determine it has satisfied the requirements for designation under this chapter.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.02 - Organization

Current through Register Vol. 51, No. 14, July 12, 2024
The facility's board of directors, administrators, and medical and nursing staff shall demonstrate commitment to the facility's designation as an acute stroke ready center by:
A. A board of directors' resolution stating that the facility agrees to meet the standards of this chapter for designation as an acute stroke ready center;
B. An organizational chart showing key stroke center personnel, including the stroke center medical director and the stroke center nurse coordinator and their relationship with the facility;
C. Establishing mechanisms to guide and assure cooperative relationships with community and professional groups committed to increasing public awareness and improving acute stroke care;
D. Maintaining documentation of stroke center leadership, including:
(1) An appointment letter for the stroke center medical director; and
(2) Curricula vitae of key stroke program personnel with training and expertise in cerebrovascular disease, including:
(a) Physicians;
(b) Stroke center nurse coordinator; and
(c) Other key health care personnel; and
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.03 - Emergency Department

Current through Register Vol. 51, No. 14, July 12, 2024
The facility shall maintain an emergency department which:
A. Has written documentation on the process used to notify the stroke team of a patient with an acute stroke; and
B. Has sufficient emergency department clinical staff to meet the requirements of COMAR 30.08.11.05.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.04 - Operating Room

Current through Register Vol. 51, No. 14, July 12, 2024
A. The facility shall have a written agreement with a hospital which has operating room neurosurgical services available 24 hours a day with appropriately trained support staff.
B. Neurosurgical coverage shall be documented in a written plan approved by the covering neurosurgeon or neurosurgeons, stroke program leaders, and any involved facilities.
C. Neurosurgical services shall be available to patients within 2 hours of it being deemed necessary.
D. There shall be a written protocol for transfer that includes communication and feedback from the receiving facility.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.05 - Stroke Team

Current through Register Vol. 51, No. 14, July 12, 2024
A. The facility shall establish one or more acute stroke teams which shall respond to the emergency department with coordinated services for the effective delivery of emergency and acute stroke treatment.
B. The facility shall have the following present at the patient's bedside:
(1) A member of the emergency department clinical staff shall evaluate each patient with stroke-like symptoms within 10 minutes of the patient's arrival at the emergency department; and
(2) At least one member of the acute stroke team to provide care and to treat an acute stroke patient within 15 minutes of notification.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.06 - Transfer of Acute Stroke Patient

Current through Register Vol. 51, No. 14, July 12, 2024
The facility shall:
A. Transfer the clinically appropriate acute stroke patient after initial treatment and stabilization to the appropriate MIEMSS designated primary stroke center, primary stroke center with endovascular capability, or comprehensive stroke center; and
B. Maintain an agreement or agreements with a commercial ambulance service to:
(1) Transfer stroke patients as clinically necessary;
(2) Ensure the appropriate delivery of care during transport; and
(3) Limit utilization of local emergency medical services (EMS) resources unless by pre-existing agreement.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.07 - Stroke Unit

Current through Register Vol. 51, No. 14, July 12, 2024
The facility shall:
A. If an acute care hospital, maintain a stroke unit that meets the requirements of this regulation which:
(1) Has designated beds for the care of patients not eligible for fibrinolytic therapy or endovascular therapy through qualified clinical staff who meet the requirements in Regulation .10 of this chapter;
(2) Develops a standardized process originating in clinical practice guidelines or evidence-based practice to deliver or facilitate the delivery of clinical care;
(3) Develops an individualized plan of care that is based on the patient's assessed needs and reflects coordination of care with other programs, as determined by patient comorbidities; and
(4) Maintains written documentation delineating the function of the stroke unit including:
(a) Admission criteria;
(b) Discharge criteria;
(c) Stroke care protocols;
(d) Patient census;
(e) Rehabilitation in the hospital;
(f) Rehabilitation after discharge; and
(g) Outcomes data; or
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.08 - Laboratory/Diagnostic Services

Current through Register Vol. 51, No. 14, July 12, 2024
The facility shall have the ability 24 hours a day to perform laboratory and diagnostic services within 45 minutes of written order, including but not limited to:
A. Complete blood count;
B. Blood chemistries;
C. Coagulation studies;
D. Troponin;
E. Electrocardiograms; and
F. Chest radiographs.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.09 - Neuroimaging Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The facility shall have the ability 24 hours a day within 20 minutes of the patient's arrival to complete:
(1) All of the following:
(a) Brain computed tomography;
(b) CT Angiography; and
(c) CT Perfusion; or
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.10 - Qualifications of Stroke Center Director and Clinicians

Current through Register Vol. 51, No. 14, July 12, 2024
A. The stroke center medical director shall be a physician with special competence in caring for the acute stroke patient who is clinically active at the facility and is Board certified or Board eligible in:
(1) Neurology;
(2) Internal medicine; or
(3) Emergency medicine.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.11 - Qualifications of Emergency Department Clinical Staff

Current through Register Vol. 51, No. 14, July 12, 2024
A. Emergency department clinical staff shall participate in cerebrovascular disease educational activities at least two times a year if they:
(1) Triage patients in the emergency department; or
(2) Care for acute stroke patients.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.12 - Prevention/Public Education

Current through Register Vol. 51, No. 14, July 12, 2024
A. Surviving stroke patients and their families shall receive instruction on:
(1) Signs and symptoms of acute stroke, including the importance of activating EMS;
(2) Effects and prognosis of acute stroke;
(3) Potential complications of acute stroke;
(4) Needs and rationales for treatment;
(5) Patient compliance instructions for risk reduction of individual risk factors and secondary prevention programs; and
(6) Post-stroke support services.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.13 - Policies, Protocols, Guidelines, and Agreements

Current through Register Vol. 51, No. 14, July 12, 2024
The facility shall develop and implement:
A. A written policy which demonstrates that the facility has established the acute stroke ready center to:
(1) Monitor the care delivered to acute stroke patients;
(2) Improve the quality of care delivered to acute stroke patients;
(3) Move patients through the initial acute care phase of their hospital stay in a timely fashion; and
(4) Ensure that all stroke patients will receive medical care commensurate with the hospital designation as an acute stroke ready center;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.18 - Designated Acute Stroke Ready Center › Section 30.08.18.14 - Quality Management

Current through Register Vol. 51, No. 14, July 12, 2024
The facility shall:
A. Participate, in a manner approved by the EMS Board, in a stroke registry that includes the data elements tracked by the Centers for Medicare and Medicaid Services and the American Heart/American Stroke Get With the Guidelines®-Stroke Registry;
B. Have participated in the stroke registry and maintained a stroke log for a minimum of 6 months prior to time of requesting an application;
C. Demonstrate ongoing participation in the stroke registry;
D. Authorize the stroke registry to provide the hospital data to MIEMSS for health oversight activities in a manner approved by the EMS Board;
E. Establish at least two outcome objectives that:
(1) Are time-specific;
(2) Are measurable;
(3) Reflect tracking and trending of performance measures and indicators; and
(4) Are reviewed in annual comparison studies;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.01 - Designated Thrombectomy-Capable Primary Stroke Center

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to meeting the requirements of COMAR 30.08.11, a designated thrombectomy-capable primary stroke center hospital shall:
A. Be designated by MIEMSS as a primary stroke center at the time of application for designation as a thrombectomy-capable primary stroke center;
B. Continue to meet the primary stroke center requirements in COMAR 30.08.11 to the extent such requirements are consistent with designation as a thrombectomy-capable primary stroke center;
C. Require each physician who performs mechanical thrombectomy to have performed 15 mechanical thrombectomies over the past 12 months or 30 over the past 24 months, which may include procedures performed at other facilities;
D. Perform mechanical thrombectomy and have provided postprocedure care for a minimum of 15 patients in the past 12 months or at least 30 patients over the past 24 months;
E. Meet the requirements of Regulations .01-.15 of this chapter;
F. Satisfy the MIEMSS requirements for designation as a thrombectomy-capable primary stroke center by MIEMSS; and
G. Meet the requirements for a site review in COMAR 30.08.02.06, which may be satisfied by completing either:
(1) An on-site review by MIEMSS; or
(2) A site survey as part of The Joint Commission Disease Specific Care Certification Program for certification as a thrombectomy-capable primary stroke center if the hospital:
(a) Authorizes The Joint Commission to provide MIEMSS with survey findings, certification reports, and other information related to The Joint Commission's certification of the hospital as a thrombectomy-capable primary stroke center;
(b) Allows MIEMSS to participate in the accreditation site survey; and
(c) Provides MIEMSS any additional information required to determine that the hospital has satisfied the requirements for designation under this chapter.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.02 - Organization

Current through Register Vol. 51, No. 14, July 12, 2024
A hospital designated as a thrombectomy-capable primary stroke center shall meet the requirements of COMAR 30.08.11.02.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.03 - Emergency Department

Current through Register Vol. 51, No. 14, July 12, 2024
The emergency department of a hospital designated as a thrombectomy-capable primary stroke center shall meet the requirements of COMAR 30.08.11.03
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.04 - Operating Room

Current through Register Vol. 51, No. 14, July 12, 2024
The operating room of a hospital designated as a thrombectomy-capable primary stroke center shall meet the requirements of COMAR 30.08.11.04
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.05 - Stroke Team

Current through Register Vol. 51, No. 14, July 12, 2024
A. In addition to meeting the requirements of COMAR 30.08.11.05, the acute stroke team shall include at a minimum:
(1) A physician, with special competence in caring for an acute stroke patient, who is Board-certified or Board-eligible in:
(a) Neurology;
(b) Critical care medicine;
(c) Emergency medicine; or
(d) Internal medicine; and
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.06 - Intensive Care Unit

Current through Register Vol. 51, No. 14, July 12, 2024
A hospital designated as a thrombectomy-capable primary stroke center shall maintain an intensive care unit that:
A. Has designated beds for the care of the acute stroke patient;
B. Has 24/7 on-site practitioners with critical care privileges, including, for example, APNs, PAs, fellows, or residents;
C. Provides care to acute stroke patients through qualified clinical staff who meet the requirements in Regulation .11 of this chapter;
D. Follows standardized processes derived from evidence-based clinical practice guidelines to facilitate clinical care;
E. Incorporates individualized plans of care that are based on the patient's assessed needs and reflect coordination of care with other programs, as determined by patient comorbidities;
F. Has a process to assess the abilities and resources of family members to be involved in post-acute care; and
G. Maintains written documentation delineating the function of the intensive care unit, including:
(1) Admission criteria;
(2) Discharge criteria;
(3) Acute stroke care protocols;
(4) Interdisciplinary rounding;
(5) Rehabilitation assessment and services in the hospital; and
(6) Outcome data.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.07 - Stroke Unit

Current through Register Vol. 51, No. 14, July 12, 2024
The stroke unit of a hospital designated as a thrombectomy-capable primary stroke center shall meet the requirements of COMAR 30.08.11.07.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.08 - Laboratory/Diagnostic Services

Current through Register Vol. 51, No. 14, July 12, 2024
A hospital designated as a thrombectomy-capable primary stroke center shall meet the requirements of COMAR 30.08.11.08.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.09 - Neuroimaging Services

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to meeting the requirements of COMAR 30.08.11.09, a hospital designated as a thrombectomy-capable primary stroke center shall have the following diagnostic capability available when indicated:
A. Carotid duplex ultrasound;
B. Transcranial ultrasonography; and
C. Transesophageal/transthoracic echocardiogram.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.10 - Endovascular Interventional Services

Current through Register Vol. 51, No. 14, July 12, 2024
A hospital designated as a thrombectomy-capable primary stroke center shall have:
A. Interventional services promptly available 24 hours a day with appropriately trained support staff and necessary equipment;
B. Interventional services that include:
(1) Intra-arterial reperfusion therapy; and
(2) Stenting/angioplasty of intracranial vessels;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.11 - Qualifications of Stroke Center Director and Clinicians

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to meeting the requirements of COMAR 30.08.11.10, a neurointerventionalist shall have:
A. 4 or more hours of category 1 or 2 CME credits per year related to stroke care; and
B. Performed 15 mechanical thrombectomies over the past 12 months or 30 over the past 24 months.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.12 - Qualifications of Emergency Department Clinical Staff

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to meeting the requirements of COMAR 30.08.11.11, the emergency department clinical staff who triage or care for acute stroke patients shall be educated, by the hospital, on mechanical thrombectomy protocols.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.13 - Prevention/Public Education

Current through Register Vol. 51, No. 14, July 12, 2024
A hospital designated as a thrombectomy-capable primary stroke center shall meet the requirements of COMAR 30.08.11.12.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.14 - Policies, Protocols, Guidelines, and Agreements

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to meeting the requirements of COMAR 30.08.11.13, a hospital designated as a thrombectomy-capable primary stroke center shall:
A. Have written policies ensuring that:
(1) Transfer of patients from another facility is appropriate and patients are received in a timely manner; and
(2) All stroke patients will receive medical care commensurate with the hospital's designation as a thrombectomy-capable primary stroke center;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.19 - Designated Thrombectomy-Capable Primary Stroke Center Standards › Section 30.08.19.15 - Quality Management

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to meeting the requirements of COMAR 30.08.14, a hospital designated as a thrombectomy-capable primary stroke center shall:
A. Monitor and demonstrate 24-hour post-procedure stroke and death rates of less than or equal to 1 percent for diagnostic neuroangiography;
B. Monitor documentation of the reasons potentially eligible ischemic stroke patients did not receive mechanical thrombectomy;
C. Monitor and demonstrate tracking and trending of modified Rankin Scores (mRS) at 90 days post-discharge on patients with acute ischemic stroke who received mechanical endovascular reperfusion therapy;
D. In cases where mechanical endovascular reperfusion therapy is appropriate, achieve door-to-device times, arrival to first pass of thrombectomy device, in 50 percent or more of eligible acute ischemic stroke patients within 120 minutes for direct arriving patients and within 60 minutes for inter-facility transfer patients treated with endovascular therapy; and
E. Demonstrate progress towards reducing door-to-device times, arrival to first pass of thrombectomy device in 50 percent or more of eligible acute ischemic stroke patients within 90 minutes for direct arriving patients.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 09 - COMMERCIAL AMBULANCE SERVICES › Chapter 30.09.01 - Definitions › Section 30.09.01.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
This chapter defines terms used throughout this subtitle.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 09 - COMMERCIAL AMBULANCE SERVICES › Chapter 30.09.02 - Patient Rights › Section 30.09.02.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
This chapter describes the rights of patients transported or treated by commercial ambulance services.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 09 - COMMERCIAL AMBULANCE SERVICES › Chapter 30.09.02 - Patient Rights › Section 30.09.02.02 - Patient Rights

Current through Register Vol. 51, No. 14, July 12, 2024
A commercial ambulance service shall provide each patient:
A. Considerate and respectful care;
B. Information from the commercial ambulance service necessary in order to give informed consent for transport or treatment, or both;
C. The opportunity to refuse transport or treatment when the patient is apparently competent to do so;
D. Reasonable privacy concerning a patient's transportation and care;
E. Confidentiality of all communications and records relating to patient transportation and care except to the extent otherwise required by law;
F. Reasonable response to a request for services once the commercial ambulance service is engaged to provide service;
G. Service that is within reasonable limits of the scheduled pickup and delivery times;
H. Reasonable continuity of care once the commercial ambulance service is engaged to provide service;
I. An opportunity to examine and receive an explanation of the patient's bill;
J. An environment in the commercial ambulance free from recognized hazards and unreasonable annoyances including but not limited to:
(1) Smoking,
(2) Loud radio, and
(3) Loud conversation by the crew; and
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 09 - COMMERCIAL AMBULANCE SERVICES › Chapter 30.09.03 - Licensing Program-In General › Section 30.09.03.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
This chapter governs the requirement for licensing commercial ambulance services and commercial ambulances.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 09 - COMMERCIAL AMBULANCE SERVICES › Chapter 30.09.03 - Licensing Program-In General › Section 30.09.03.02 - State Office of Commercial Ambulance Licensing and Regulation

Current through Register Vol. 51, No. 14, July 12, 2024
A. There shall be a State Office of Commercial Ambulance Licensing and Regulation within MIEMSS which shall implement and enforce the provisions of this subtitle.
B. Unless otherwise specified, all communications to the Executive Director relating to this subtitle shall be addressed to Executive Director of MIEMSS, c/o State Office of Commercial Ambulance Licensing and Regulation, 653 West Pratt Street, Baltimore, Maryland 21201-1536.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 09 - COMMERCIAL AMBULANCE SERVICES › Chapter 30.09.03 - Licensing Program-In General › Section 30.09.03.03 - License Required

Current through Register Vol. 51, No. 14, July 12, 2024
A person may not operate a commercial ambulance service in Maryland unless:
A. Issued a license under Education Article, §
									13-515, Annotated Code of Maryland;
B. Exempt from this subtitle under Regulation .04 of this chapter; or
C. Issued a written waiver from SOCALR under Regulation .05 of this chapter.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 09 - COMMERCIAL AMBULANCE SERVICES › Chapter 30.09.03 - Licensing Program-In General › Section 30.09.03.04 - Exempt Vehicles

Current through Register Vol. 51, No. 14, July 12, 2024
A. The following vehicles are exempt from licensure under this subtitle:
(1) Vehicles, typically referred to as wheelchair vans, equipped with a hydraulic lift used exclusively for transporting, in wheelchairs, patients who do not require equipment or trained personnel available in an ambulance;
(2) Ambulances owned by, operated by, or under the jurisdiction of a unit of State or federal government, a political subdivision of the State, a volunteer fire company, a volunteer ambulance company, or a volunteer rescue squad; and
(3) Ambulances traveling through the State, regardless of frequency, exclusively for the purpose of interstate travel.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 09 - COMMERCIAL AMBULANCE SERVICES › Chapter 30.09.03 - Licensing Program-In General › Section 30.09.03.05 - Exempt Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The following services are exempt from licensure under this subtitle:
(1) Air ambulance services licensed and based outside Maryland which transport patients from or within Maryland less than 26 times per year; or
(2) Ambulance services licensed and based outside Maryland which transport patients:
(a) Into Maryland; or
(b) To and from Maryland for diagnostic or therapeutic services in the same calendar day.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 09 - COMMERCIAL AMBULANCE SERVICES › Chapter 30.09.03 - Licensing Program-In General › Section 30.09.03.06 - Preemption of Local Legislation

Current through Register Vol. 51, No. 14, July 12, 2024
A. The authority of a county or municipal corporation to regulate a commercial ambulance service with a base of operation located outside the county or municipal corporation that is licensed under this subtitle is preempted by Education Article, §
									13-515, Annotated Code of Maryland.
B. A county or municipal corporation is not preempted from regulating a commercial ambulance service with a base of operation located within its territorial boundaries, while the commercial ambulance service is operating within those territorial boundaries, so long as local legislation does not conflict with, frustrate, or diminish the intent of Education Article, §
									13-515, Annotated Code of Maryland, or this subtitle.