reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.38 - Reports and Action Required in Unusual Circumstances

Current through Register Vol. 51, No. 14, July 12, 2024
A. Serious Emotional Disturbances. A facility
				  may not accept or keep patients who destroy property or are dangerous to
				  themselves or others, or who have acute symptoms of mental illness.
B. Action to Be Taken if a Patient Becomes
				  Actively Disturbed. The following action shall be taken:
(1) If a patient becomes actively disturbed,
				  the personal physician shall be notified immediately.
(2) A restraint may be used only if all of
				  the following conditions are met:
(a) Failure
				  to use a restraint or restraints is likely to endanger the health or safety of
				  the patient or others;
(b) There is
				  a written physician's order for the use of the restraint or restraints, which
				  shall comply with the following requirements:
(i) The physician's written order for the
				  restraint or restraints shall be for a specified maximum period of time, not to
				  exceed 24 hours.
(ii) The necessity
				  for the use of the restraint or restraints shall be documented, and
(iii) The frequency of patient observations
				  by licensed personnel on not less than an hourly basis during the period of
				  time that the restraint or restraints or the effects of the restraint or
				  restraints are present shall be indicated;
(c) Appropriate documentation by licensed
				  personnel shall be recorded in the clinical record;
(d) The facility may not re-impose a
				  restraint or restraints except upon the written order of a physician who has
				  personally observed the patient since the previous restraint or restraints
				  order was imposed.
(3) A
				  restraint or restraints may not be ordered PRN.
(4) If a physician is not immediately
				  available, a registered nurse may authorize the use of a physical restraint or
				  restraints for a period not to exceed 4 hours in any 30-day period. Licensed
				  personnel shall observe the patient hourly. The patient shall be seen by a
				  physician if the restraint or restraints are to be applied for more than the
				  initial 4-hour period.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.39 - Transfer Agreement

Current through Register Vol. 51, No. 14, July 12, 2024
A. Written
				  Agreement. A written agreement with at least one acute hospital shall be
				  effected which shall provide for the following actions:
(1) Planning to ensure that all services
				  required for the continuity of resident care will be made available
				  promptly;
(2) Advance discussion
				  with the resident regarding the reason for the transfer and any available
				  alternatives;
(3) Notification to
				  the next of kin or responsible person regarding the anticipated
				  transfer;
(4) Interchange of
				  medical and other information necessary in the care and treatment of residents
				  transferred between facilities, including notification of the licensed
				  pharmacist of resident transfer;
(5) Safe and timely transportation and care
				  of the resident during transfer;
(6) Security and accountability for the
				  resident's personal effects;
(7)
				  Prompt readmission to the nursing home at the end of the hospital
				  stay;
(8) Annual review of transfer
				  arrangements by a utilization review committee or other designated group to
				  ensure that each party is fulfilling the needs of the residents, the providers,
				  the hospital, and the nursing home;
(9) If needs are not being met, the
				  administrator of the nursing home shall act on recommendations of the reviewing
				  group to effect compliance;
(10)
				  Before licensure, the comprehensive care facility or the extended care facility
				  shall submit to the Department a copy of the written agreement, signed by
				  persons authorized to execute the agreement on behalf of the
				  facilities;
(11) Each facility
				  shall maintain a signed copy of the agreement.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.40 - Emergency and Disaster Plan

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Emergency and Disaster Plan.
(1) The licensee
				  shall develop an emergency and disaster plan that includes procedures that
				  shall be followed before, during, and after an emergency or disaster,
				  including:
(a) Evacuation, transportation, or
				  shelter in place of residents;
(b)
				  Notification of families and staff regarding the action that will be taken
				  concerning the safety and well-being of the residents;
(c) Staff coverage, organization, and
				  assignment of responsibilities for ongoing shelter in place or evacuation,
				  including identification of staff members available to report to work or remain
				  for extended periods; and
(d) The
				  continuity of services, including:
(i)
				  Operations, planning, and financial and logistical arrangements;
(ii) Procuring essential goods, equipment,
				  and services to sustain operations for at least 72 hours;
(iii) Relocation to alternate facilities or
				  other locations; and
(iv)
				  Reasonable efforts to continue care.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.41 - Physical Plant - New and Existing Construction Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A. Construction of
				  a New Nursing Home.
(1) A new nursing home
				  shall be constructed, equipped, and maintained to protect the health and safety
				  of residents, personnel, and the public.
(2) A nursing home desiring to provide
				  services other than those for which it is already licensed shall obtain prior
				  approval from the Department.
(3)
				  The nursing home shall obtain prior approval from the Department for any part
				  of the premises to be used for tenant occupancy or for unrelated business
				  purposes.
(4) A nursing home shall
				  be constructed in accordance with the provisions of the NFPA 101 Life Safety
				  Code.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.42 - Physical Plant - General Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A. Unless otherwise indicated, all general
				  requirements apply to both new construction and an existing nursing
				  home.
B. A nursing home shall
				  comply with all applicable federal, State, and local governing laws,
				  regulations, standards, ordinances, and codes.
C. A nursing home shall be constructed to
				  comply with the provisions of the NFPA 101 Life Safety Code, as promulgated by
				  the State Fire Prevention Commission, that are applicable to nursing
				  homes.
D. Securely anchored
				  handrails:
(1) Shall be provided on each side
				  of all corridors in resident areas; and
(2) May not be more than 36 inches high as
				  measured from the floor to the top of the handrail.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.43 - Physical Plant - Plumbing

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Unless otherwise indicated, all general requirements apply to both new
				  construction and an existing nursing home.
B. Plumbing.
(1) Plumbing shall be installed in
				  conformance with all applicable federal, State, and local codes and
				  ordinances.
(2) Plumbing and water
				  supplies shall be protected against backflow within a nursing home.
(3) Prevention of backflow shall be ensured
				  by proper installation of:
(a) Plumbing
				  cross-connections;
(b) Submerged
				  inlets; and
(c) Back
				  siphonage.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.44 - Physical Plant - Heating and Cooling

Current through Register Vol. 51, No. 14, July 12, 2024
A. Unless otherwise indicated, all general
				  requirements apply to both new construction and an existing nursing
				  home.
B. Temperatures. A nursing
				  home shall maintain a minimum design temperature of 75°F or 24°C for
				  all occupied areas.
C. Heating
				  System. A nursing home shall be equipped with a properly maintained and
				  operational central heating system. The heating system shall be:
(1) Capable of maintaining 75°F or
				  24°C throughout the residents' section of the building with the outside
				  temperature as prescribed in the Guidelines for Design and Construction of
				  Residential Health, Care, and Support Facilities; and
(2) In compliance with NFPA 101 Life Safety
				  Code, NFPA 99 Health Care Facilities Code, and other applicable codes, and all
				  federal, State, and local codes.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.47 - Nursing Care Unit

Current through Register Vol. 51, No. 14, July 12, 2024
A. Size.
				  Nursing care units may not exceed 60 beds. The Department may specify the
				  numbers and types of personnel for each unit which exceeds 40 beds.
B. Common Space. The nursing home shall
				  provide a living room for residents' use with a sufficient number of reading
				  lamps, tables, and comfortable chairs or sofas.
C. Service Areas Required.
(1) Nurses' Work Area.
(a) The nurses' work area shall be located on
				  the unit and within easy view of corridors outside of residents'
				  rooms.
(b) The Department may
				  specify the location and size of a nurses' work area which serves a nursing
				  care unit exceeding 40 beds.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.48 - Call Systems

Current through Register Vol. 51, No. 14, July 12, 2024
A. Call System.
(1) A nurse call system shall be installed
				  and maintained in operating order in all nursing units.
(2) A call system shall be maintained in a
				  manner that will provide visible and audible signal communication between
				  nursing service personnel and residents.
(3) A call station shall provide readily
				  accessible and detachable extension cords to each resident's bed in the
				  residents' rooms at all times.
(4)
				  A call system shall have a visible signal above the door of each resident's
				  bedroom that shall be visible from all parts of the corridor.
(5) A call system shall provide visual lights
				  at corridor intersections, in multi-corridor nursing units.
(6) A call system shall be provided in each
				  resident's bathroom and bathing area in locations accessible to the
				  residents.
(7) The call system
				  shall enable residents in the rehabilitation area to summon rehabilitation
				  staff.
(8) The nurses' call system
				  shall require resetting at the station where the call originates.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.49 - Resident Bedroom in Nursing Home

Current through Register Vol. 51, No. 14, July 12, 2024
A. Unless otherwise indicated, all general
				  requirements apply to both new construction and an existing nursing home unless
				  a waiver has been granted by the Office of Health Care Quality in accordance
				  with Regulation .03G of this chapter.
B. Bedroom Accommodations.
(1) Bedroom.
(a) A resident's room shall have direct
				  access to an exit in accordance with the requirements applicable to nursing
				  homes specified in NFPA 101 Life Safety Code.
(b) A room that opens into the kitchen may
				  not be used as a resident bedroom.
(c) A room may not be used as a resident
				  bedroom if it can only be reached by passing through a kitchen.
(d) Residents may not occupy rooms extending
				  below the ground level.
(e) No more
				  than four individuals may occupy a multiple occupancy bedroom.
(f) Residents' beds may not be located near
				  radiators, registers, or sources of draft.
(g) Adequate storage space shall be provided
				  in each bedroom to allow each resident to keep necessary items of clothing,
				  including items that need to be hung.Adequate storage space shall be provided
				  for residents' personal possessions, including the storage of seasonal
				  clothing.
(h) All occupants of any
				  bedroom shall be of the same sex, except in the case of a two-bed room occupied
				  by:
(i) Siblings;
(ii) A parent and child;
(iii) A married couple; or
(iv) Consenting residents.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.50 - Body-Holding Room

Current through Register Vol. 51, No. 14, July 12, 2024
A. Body-Holding
				  Room - New Construction and Existing Nursing Home.
(1) A body-holding room shall be equipped
				  with ventilation by mechanical means at the same rate and specifications as
				  designed for soiled linen sorting and storage areas.
(2) A nursing home shall develop and
				  implement a method for body-holding that minimizes the psychological effects on
				  other residents.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.51 - Resident Bathroom Amenities

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Bathing.
(1) There shall be at least one
				  separate room or compartment with a bathtub, shower, or other bathing device,
				  as approved by the Department, for every 15 licensed beds.
(2) The compartment shall be large enough to
				  accommodate:
(a) The resident;
(b) A caregiver; and
(c) A wheelchair, shower chair, or shower
				  bed.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.52 - Equipment and Supplies for Bedside Care and Therapy

Current through Register Vol. 51, No. 14, July 12, 2024
A. Needs of Residents.
(1) There shall be sufficient equipment to
				  meet the needs of the residents admitted.
(2) The administrator shall obtain specific
				  items required for individual cases where requested by the attending physician
				  or medical director.
(3) The
				  Department may require that the nursing home have specific types of equipment
				  based on the needs of the residents.
(4) A nursing home shall establish and
				  enforce a written preventive maintenance program to ensure that all resident
				  care and therapy equipment is maintained in safe operating condition.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.53 - Rehabilitation Facilities - Space and Equipment

Current through Register Vol. 51, No. 14, July 12, 2024
A. Unless otherwise indicated, all general
				  requirements apply to both new construction and an existing nursing
				  home.
B. General Requirements.
(1) Space.
(a) A nursing home shall provide adequate
				  space to:
(i) Receive, examine, and treat
				  residents;
(ii) Store supplies and
				  equipment, including wheelchairs and stretchers; and
(iii) Provide office space for the employed
				  personnel to work.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.54 - Dayroom and Dining Area

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  General Requirements. Resident Dining, Occupational Therapy, and Activities
				  Program. The nursing home shall provide one or more attractively furnished
				  areas of adequate size for resident dining, occupational therapy, and social
				  activities. Activities space shall be of adequate size to meet the needs of the
				  residents and shall be located on each floor occupied by residents.
B. Dining Area.
(1) A nursing home shall provide dining areas
				  large enough to accommodate all residents who eat there at the same
				  time.
(2) There shall be an
				  allowance of at least 12 square feet per resident. This allowance shall be
				  substantially increased proportionate to the number of residents who use a
				  wheelchair.
(3) The height of
				  tables provided in dining areas shall accommodate each resident using a
				  wheelchair.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.55 - Dietetic Service Area

Current through Register Vol. 51, No. 14, July 12, 2024
A. General
				  Requirements. Unless otherwise indicated, all general requirements apply to
				  both new construction and an existing nursing home.
B. Food Service Department.
(1) The size and location of the food service
				  area shall comply with COMAR 10.15.03.
(2) A catered or satellite system shall be
				  covered by a contract approved by the Department.
(3) The vendor providing the food shall have
				  a valid food service permit.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.56 - Administrative Areas

Current through Register Vol. 51, No. 14, July 12, 2024
A. Unless
				  otherwise indicated, all general requirements apply to both new construction
				  and an existing nursing home.
B.
				  Administrative Areas - New Construction.
(1)
				  A nursing home shall provide a separate room or rooms for the administrator and
				  administrative support staff. Sufficient areas shall be provided to accommodate
				  all necessary office furniture, files, and other equipment and enable the safe
				  storage of residents' valuables.
(2) In new construction, separate locker
				  rooms and a toilet facility shall be provided for male and female employees in
				  each nursing home.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.58 - Resident Care Management System

Current through Register Vol. 51, No. 14, July 12, 2024
A. Each comprehensive care facility and
				  extended care facility shall establish and maintain a resident care management
				  system.
B. The resident care
				  management system shall consist of three related components:
(1) Resident status assessment and data
				  gathering;
(2) Care planning;
				  and
(3) Actions in response to care
				  plan approaches.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.59 - Resident Status Assessment

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  A nursing home shall use the following forms and procedures for resident
				  assessment as described in the CMS Manual System, Pub. 100-07 State Operations
				  Provider Certification and in the CMS Long-term Care Facility Resident
				  Assessment Instrument 3.0 User's Manual:
(1)
				  The Minimum Data Set (MDS) version as determined by the U.S. Department of
				  Health and Human Services, Centers for Medicare and Medicaid Services, in
				  Transmittal No. 22, referenced in §B of this regulation.
(2) MDS Care Area Assessment process;
				  and
(3) Care plans.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.60 - Care Planning

Current through Register Vol. 51, No. 14, July 12, 2024
A. An
				  interdisciplinary team shall complete or revise as necessary a
				  resident-specific care plan for each resident within 7 calendar days following
				  completion of assessments, including:
(1)
				  Admission assessment;
(2) Annual
				  assessment;
(3) Quarterly
				  assessment; and
(4) Significant
				  change in the resident's condition.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.61 - Skin Record

Current through Register Vol. 51, No. 14, July 12, 2024
A. The facility
				  shall establish a skin care record documenting skin, hair, and nail condition
				  on admission, if any abnormal conditions exist.
B. The staff shall document progress of the
				  condition or conditions weekly until the condition or conditions have
				  healed.
C. At any time that a skin
				  condition persists for more than 7 days, staff shall add the condition to the
				  skin record.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.62 - Geriatric Nursing Assistant Training Program

Current through Register Vol. 51, No. 14, July 12, 2024
A. Nursing Home Responsibilities.
(1) A nursing home shall conduct or arrange a
				  geriatric nursing assistant training program for unlicensed personnel assigned
				  to direct resident care duties. The Maryland Board of Nursing shall approve the
				  geriatric nursing assistant training program curriculum.
(2) A nursing home may not employ an
				  individual as a geriatric nursing assistant until the individual has
				  successfully completed a competency evaluation approved by the Maryland Board
				  of Nursing.
(3) A geriatric nursing
				  assistant is deemed to satisfy the requirements of this chapter if that
				  individual has successfully completed a training program approved by the State
				  before July 1, 1990, or has been grandfathered under previous
				  regulations.
(4) Other persons
				  hired as geriatric nursing assistants shall complete an approved geriatric
				  nursing assistant training program within 120 days of employment.
(5) The nursing home shall:
(a) Record the satisfactory completion of the
				  program in each employee's personnel record; and
(b) Give the employee a certificate signed by
				  the program's teacher or trainer as evidence of completion of the
				  program.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.63 - Paid Feeding Assistants

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  facility may use a paid feeding assistant who has successfully completed a
				  State-approved training course as described in §E of this
				  regulation.
B. Supervision.
(1) A paid feeding assistant shall work under
				  the supervision of a licensed nurse.
(2) In an emergency, when the resident is fed
				  in the resident's room, a paid feeding assistant shall use the resident call
				  system to call a supervisory nurse for help.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.64 - Quality Assurance Program

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  A nursing home shall establish an effective quality assurance program that
				  includes components described in this regulation and Regulation .65 of this
				  chapter.
B. The nursing home shall
				  appoint a qualified individual to manage quality assurance activities within
				  the nursing facility.
C. The
				  nursing home shall establish a quality assurance committee that includes at
				  least:
(1) The nursing home director of
				  nursing;
(2) The nursing home
				  administrator;
(3) A social
				  worker;
(4) The nursing home
				  medical director;
(5) A
				  dietitian-nutritionist; and
(6) A
				  geriatric nursing assistant at the nursing home.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.65 - Quality Assurance Plan

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  nursing home's quality assurance committee shall develop and implement a
				  quality assurance plan that includes procedures for:
(1) Concurrent review;
(2) Ongoing monitoring;
(3) Resident complaints;
(4) Accidents and incidents; and
(5) Abuse and neglect.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.66 - Relocation of Residents

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  facility shall develop and implement a written plan to provide for the smooth
				  and orderly transfer of residents if the facility closes.
B. The plan for relocation shall include:
(1) A description of how residents, families,
				  or guardians will be notified and by whom;
(2) Sample letters and other documents that
				  will be used during a closure;
(3)
				  Procedures for notifying Medicaid and other payment sources;
(4) Procedures for notifying the Office of
				  Health Care Quality; and
(5) A
				  mechanism to ensure the safe and orderly transfer of residents that takes into
				  account:
(a) Roommates, medical care,
				  religious affiliation, geographical location and payer source;
(b) Proper assessment and identification of
				  any special needs;
(c) Transfer of
				  medical information and records; and
(d) Transfer of personal property.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.67 - Posting of Staffing

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  nursing home shall post a notice on each floor or unit of the nursing home, for
				  each shift, a notice that gives the ratio of licensed and unlicensed staff to
				  residents.
B. The posting on each
				  floor shall include:
(1) Names of the staff
				  members on duty and the room numbers of the residents to whom each is
				  assigned;
(2) Name of the charge
				  nurse or person who is in charge of the unit;
(3) If the person in charge is not a
				  registered nurse, the name of the registered nurse responsible for the unit;
				  and
(4) Name of the medicine aide
				  or person responsible for medication administration.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.68 - Sanctions

Current through Register Vol. 51, No. 14, July 12, 2024
A. If a deficiency
				  exists, the Department, in addition to the sanctions set forth in this
				  regulation and Regulations .67-.74 of this chapter, may:
(1) Restrict the number of residents the
				  nursing facility may admit in accordance with Health-General Article, §
				  19-328, Annotated Code of Maryland;
(2) Require the establishment of an escrow
				  account in accordance with Health-General Article, § 19-362, Annotated
				  Code of Maryland;
(3) Direct the
				  licensee to correct the deficiencies in a specific manner or within a specific
				  time frame, or both, to protect the health and welfare of residents;
(4) Enter into an agreement with the licensee
				  establishing certain conditions for continued operation, including time limits
				  for compliance; and
(5) In
				  accordance with Health-General Article, § 19-1405, Annotated Code of
				  Maryland, appoint an independent State monitor who is qualified on the basis of
				  education and experience to oversee correction of the deficiencies.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.69 - Mandated Staffing Pattern

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  When the Department determines that a deficiency or deficiencies exist, the
				  Department shall notify the nursing facility of the deficiency or deficiencies
				  and may either:
(1) Mandate a staffing
				  pattern which specifies the number of personnel or personnel qualifications, or
				  both; or
(2) Permit the facility
				  the opportunity to correct the deficiencies by a specific date.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.70 - Civil Money Penalties - Imposition

Current through Register Vol. 51, No. 14, July 12, 2024
A. A civil money penalty may be imposed when:
(1) A deficiency exists; or
(2) An ongoing pattern of deficiencies exist
				  in a nursing facility.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.71 - Civil Money Penalties - Amount of Penalty

Current through Register Vol. 51, No. 14, July 12, 2024
A. A civil money penalty imposed under this
				  chapter for potential for more than minimal harm deficiencies may not exceed:
(1) $10,000 per instance; or
(2) $1,000 per day for an ongoing pattern of
				  deficiencies until correction of the deficiencies has been verified and
				  sustained compliance has been maintained.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.72 - Civil Money Penalties - Effective Date and Duration of Penalty

Current through Register Vol. 51, No. 14, July 12, 2024
A. Per Instance
				  Civil Money Penalty. The effective date may be as early as the date that the
				  deficiency or deficiencies upon which the civil money penalty is based first
				  occurred.
B. Per Day Civil Money
				  Penalty.
(1) The daily civil money penalty
				  starts to accrue as of the date of the visit that identifies the deficiency or
				  deficiencies upon which the civil money penalty is based.
(2) The accrual of the daily civil money
				  penalty ceases when correction of the deficiency or deficiencies upon which the
				  civil money penalty was based has been verified and the facility has maintained
				  sustained compliance.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.73 - Civil Money Penalties - Payment of Penalty/Establishment of Escrow Account

Current through Register Vol. 51, No. 14, July 12, 2024
A. A civil money
				  penalty payment is due 15 calendar days after:
(1) The time period for requesting a hearing
				  has expired and a request for hearing was not received; or
(2) Receipt of a written request from the
				  facility to waive its right to a hearing and reduce the amount of the civil
				  money penalty by 40 percent provided the written request is received by the
				  Department within 30 calendar days of the Department's order imposing the civil
				  money penalty.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.74 - Civil Money Penalties - Hearings

Current through Register Vol. 51, No. 14, July 12, 2024
A. A licensee aggrieved by the imposition of
				  a civil money penalty may appeal the action by filing a request for a hearing
				  in accordance with State Government Article, Title 10, Subtitle 2, Annotated
				  Code of Maryland.
B. The Secretary
				  has the burden of proof with respect to the imposition of civil money
				  penalties.
C. The Office of
				  Administrative Hearings shall render a decision within 10 working days of the
				  hearing.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.75 - Criminal Penalties

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  person maintaining or operating a nursing home without a license is guilty of a
				  misdemeanor, and, on conviction, is liable for a fine of not more than $1,000
				  for the first offense and not more than $10,000 for each subsequent conviction
				  in accordance with Health-General Article, § 19-358, Annotated Code of
				  Maryland.
B. Each day that the
				  nursing home continues to operate without a license after the first conviction
				  is a subsequent offense and may subject the operator to further criminal
				  prosecution.
C. A person
				  maintaining and operating a nursing home that is in violation of this chapter
				  is guilty of a misdemeanor, and, on conviction, shall be fined not more than
				  $1,000 under the authority of Health-General Article, § 19-359, Annotated
				  Code of Maryland.
D. Each day that
				  the nursing home operates after the first conviction, without correction of the
				  cited violation, is considered a subsequent offense and may subject the
				  operator to further prosecution.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.76 - Emergency Suspension

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Secretary may immediately suspend a license on finding that the public health,
				  safety, or welfare imperatively requires emergency action pursuant to State
				  Government Article, § 10-405(b), Annotated Code of Maryland.
B. The Department shall deliver a written
				  notice to the nursing facility:
(1) Informing
				  the nursing facility of the emergency suspension;
(2) Giving the reasons for the action and the
				  regulation or regulations with which the licensee has failed to comply that
				  forms the basis for the emergency suspension; and
(3) Notifying the nursing facility of its
				  right to request a hearing and to be represented by counsel.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.77 - Denial or Revocation of License

Current through Register Vol. 51, No. 14, July 12, 2024
A. Denial or Revocation of License. The
				  Secretary, for cause shown, may notify the nursing facility of the decision to
				  revoke or deny the nursing facility's license. The denial or revocation shall
				  be stayed if a hearing is requested.
B. The Department shall notify the nursing
				  facility in writing of the following:
(1) The
				  effective date of the denial or revocation;
(2) The reason for the denial or
				  revocation;
(3) The regulations
				  with which the licensee has failed to comply that form the basis for the denial
				  or revocation;
(4) That the nursing
				  facility is entitled to a hearing if requested, and to be represented by
				  counsel;
(5) That the nursing
				  facility shall stop providing services on the effective date of the denial or
				  revocation if the nursing facility does not request a hearing;
(6) That the denial or revocation shall be
				  stayed if a hearing is requested; and
(7) That the nursing facility is required to
				  surrender its license to the Department if the denial or revocation is
				  upheld.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.78 - 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 Office of Health Care Quality of the Department, not later than 30 days
				  after receipt of notice of the Secretary's action. This request shall include a
				  copy of the Secretary's action.
B.
				  A hearing requested under this chapter shall be conducted in accordance with:
(1) State Government Article, Title 10,
				  Subtitle 2, Annotated Code of Maryland;
(2) COMAR 28.02.01; and
(3) COMAR 10.01.03.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.79 - Health Care Quality Account

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Department shall establish a health care quality account in the
				  Department.
B. The health care
				  quality account shall be funded by civil money penalties paid by nursing
				  homes.
C. The Department shall use
				  funds from the health care quality account to improve the quality of care in
				  nursing facilities.
D. Expenditure
				  of funds may include, but are not limited to the following:
(1) Funding for the establishment and
				  operation of a demonstration project;
(2) A grant award;
(3) Relocation of residents in crisis
				  situations;
(4) Provision of
				  educational programs to nursing facilities, the Office of Health Care Quality,
				  other government, professional, or advocacy agencies, and consumers;
				  and
(5) Any other purpose that will
				  directly improve quality of care.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.80 - Financial Disclosure

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  licensee shall have financial resources in accordance with this regulation in
				  order to:
(1) Satisfy obligations;
				  and
(2) Ensure at all times the
				  delivery of essential care and services, such as nursing, dietary services, or
				  utilities.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.03 - Health Care Staff Agencies › Section 10.07.03.01 - Purpose

Current through Register Vol. 51, No. 14, July 12, 2024
A. The purpose of
				  this chapter is to set minimum standards for licensure of health care staff
				  agencies providing services in Maryland.
B. The regulations of this chapter do not
				  preclude a health care staff agency from operating with independent
				  contractors.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.03 - Health Care Staff Agencies › Section 10.07.03.02 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) Abuse.
(a) "Abuse" means:
(i) The nontherapeutic infliction upon a
				  resident of physical pain or injury; or
(ii) A persistent course of conduct intended
				  to produce, or resulting in, mental or emotional distress to a resident, for
				  example, verbal intimidation of a resident.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.03 - Health Care Staff Agencies › Section 10.07.03.03 - License Required

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  person, firm, corporation, partnership, or other business entity may not
				  maintain or operate a health care staff agency in this State without first
				  obtaining a license from the Secretary and complying with the regulations of
				  this chapter.
B. An agency shall
				  post its license conspicuously onsite so that it is clearly visible to the
				  general public.
C. An out-of-State
				  agency providing services in this State shall have a current Maryland license
				  conspicuously posted at the:
(1) Office in
				  this State where the agency conducts its day-to-day operations, if the agency
				  operates an in-State office; or
(2)
				  Agency's records repository that is located in this State, if the agency
				  utilizes a records repository.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.03 - Health Care Staff Agencies › Section 10.07.03.04 - Restrictions of License

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  person operating an agency may not use the term "health care staff agency" in
				  its advertising without first obtaining a license from the Secretary.
B. A license is valid only in the name of the
				  licensee to whom the license is issued and is not subject to sale, assignment,
				  or other transfer.
C. If the agency
				  ceases to operate for any reason, the license is void and the licensee shall
				  immediately return the license to the Department.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.03 - Health Care Staff Agencies › Section 10.07.03.05 - Licensing Procedure

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Application for Licensure.
(1) A person
				  desiring to refer a health care practitioner to a health care facility to
				  render temporary health care services in this State shall file an application
				  with the Secretary, on a written or electronic form provided by the
				  Secretary.
(2) The application for
				  licensure shall contain the agency's business name, address, telephone number,
				  and responsible party.
(3) Along
				  with the application, the applicant shall submit a copy of the agency's
				  policies and procedures as specified in Regulation .08 of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.03 - Health Care Staff Agencies › Section 10.07.03.06 - Changes to Licensure Information

Current through Register Vol. 51, No. 14, July 12, 2024
A. A licensee shall notify the Department of
				  any change in agency ownership, name, or address within 30 calendar days of the
				  change.
B. Any change in agency
				  ownership, name, or address requires the issuance of a new license. If the
				  sale, transfer, assignment, or lease of an agency causes a change in the person
				  or persons who control or operate the agency, the agency shall be considered a
				  "new agency" and the new owner shall comply with all regulations of this
				  chapter when applying for a new license.
C. If the licensee fails to notify the Office
				  of the changes in §A of this regulation, the Office may impose a fine of
				  $100.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.03 - Health Care Staff Agencies › Section 10.07.03.07 - Inspections by the Department

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  The Department or its designee may conduct announced or unannounced licensure
				  or complaint inspection visits to the agency's office or records repository, if
				  utilized by an out-of-State agency, to ensure compliance with the requirements
				  of this chapter.
B. The agency's
				  office or records repository, if utilized by an out-of-State agency, shall be
				  available during normal business hours for announced or unannounced inspections
				  by the Department or its designee.
C. An agency with offices out-of-State shall
				  comply with the regulations of this chapter and shall reimburse the Department
				  for reasonable travel expenses incurred in conducting out-of-State
				  inspections.
D. An agency shall
				  maintain records to support compliance with the regulations of this chapter.
				  The responsible party of the agency shall provide all records requested by the
				  Office not later than 24 hours after the request.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.03 - Health Care Staff Agencies › Section 10.07.03.08 - Administration

Current through Register Vol. 51, No. 14, July 12, 2024
A. The agency shall
				  develop, document, and implement policies and procedures.
B. Policies and procedures shall include, but
				  are not limited to:
(1) Selecting and
				  verifying the credentials of a health care practitioner referred by the
				  agency;
(2) Validating the
				  experience of a health care practitioner prior to referral by the
				  agency;
(3) Tracking and acting on
				  serious or life-threatening complaints received by a client, facility, or the
				  client facility's agent;
(4)
				  Reporting of an action or condition performed by a health care practitioner as
				  required under Regulation .09C of this chapter;
(5) Verifying the following:
(a) A health care practitioner referred by
				  the agency is of satisfactory health status and has received the necessary
				  testing and immunization as required or requested by the client
				  facility;
(b) Drug screening of a
				  health care practitioner is performed before referral by the agency, if the
				  client facility requires drug screening for facility employees;
(c) Drug testing of a health care
				  practitioner referred by the agency is performed, if there is probable cause to
				  perform a drug test or if a client facility requests a drug test;
(d) Criminal background checks of a health
				  care practitioner are performed before referral by the agency, if the client
				  facility requires criminal background checks for facility employees;
(e) The references of a health care
				  practitioner referred by the agency;
(f) A health care practitioner referred by
				  the agency has I-9 status that permits them to legally work in the United
				  States; and
(g) A health care
				  practitioner has active licensure or certification with the Board;
				  and
(6) Investigating a
				  complaint or grievance presented to an agency by the client facility, an
				  individual receiving services, a representative of the individual receiving
				  services, or any concerned individual that includes a:
(a) Description of how and to whom to file a
				  complaint within the agency;
(b)
				  Description of how and to whom to file a complaint with the Office;
(c) Commitment to conduct a thorough
				  investigation into any allegation against individuals referred by the agency;
				  and
(d) Mechanism for making
				  completed investigation reports available to the Department immediately upon
				  request during inspections.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.03 - Health Care Staff Agencies › Section 10.07.03.09 - Referral and Reporting Health Care Practitioners

Current through Register Vol. 51, No. 14, July 12, 2024
A. An agency may not knowingly provide or
				  refer a heath care practitioner to render temporary services who is not
				  authorized under Health Occupations Article, Annotated Code of Maryland, to
				  practice their profession in Maryland.
B. An agency and client facility shall ensure
				  that the scope of practice of the referred health care practitioner is
				  consistent with Health Occupations Article, Annotated Code of
				  Maryland.
C. If an agency is aware
				  of an action or inaction by a health care practitioner who is provided or
				  referred by the agency that may be grounds for action under Health Occupations
				  Article, Annotated Code of Maryland, the agency shall report the action or
				  condition to the appropriate Board and the Office immediately when the action
				  or condition is known by the agency.
D. An individual shall have immunity from
				  liability described in the Courts and Judicial Proceedings Article, §
										5-709,
				  Annotated Code of Maryland, for making a report as required under §C of
				  this regulation.
E. Personnel
				  Qualifications and Duties.
(1) The agency
				  shall maintain the following from client facilities:
(a) Job descriptions for referred
				  individuals; and
(b) A documented
				  procedure for the agency and client facility to determine that an individual's
				  qualifications are consistent with the assignments to which the individual is
				  being referred.