reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.20 - Penalties

Current through Register Vol. 51, No. 14, July 12, 2024
If a hospital fails to submit a utilization review plan or
					 fails, after adequate discussion with the Department, to develop an approvable
					 plan, or fails to operate a plan which has been approved, then the Secretary
					 may impose upon the hospital the following penalties:
A. Delicensure of the hospital; or
B. A fine of $500 for each day that the
				  hospital is in violation of these regulations.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.22 - Practitioner Performance Evaluation

Current through Register Vol. 51, No. 14, July 12, 2024
A. Consistent with the standards of the Joint
				  Commission for focused and ongoing professional performance evaluations, the
				  hospital shall establish a practitioner performance evaluation process that
				  objectively evaluates the performance of each member of the medical
				  staff.
B. The hospital's
				  practitioner performance evaluation process shall include a review of care
				  which shall:
(1) Be undertaken for cases:
(a) Chosen at random; and
(b) With unexpected adverse
				  outcomes;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.23 - Guidelines Governing the Transfer of Patients Between Hospitals

Current through Register Vol. 51, No. 14, July 12, 2024
A. If a hospital is
				  able to provide adequate care to a patient, the hospital may not transfer the
				  patient to another hospital unless:
(1) One or
				  more of the following circumstances is present:
(a) The patient does not have a physician
				  with privileges at the hospital and the patient refuses treatment by any
				  physician with privileges at the hospital;
(b) The patient or a legally authorized
				  representative of the patient requests the transfer;
(c) The transfer is in compliance with
				  relevant sections of Health-General Article, Title 10, Subtitle 8, Annotated
				  Code of Maryland;
(d) The transfer
				  is in compliance with the Interstate Compact on Mental Health as adopted in
				  Health-General Article, Title 11, Annotated Code of Maryland; or
(e) The transfer is in compliance with any
				  agreement entered into between the Mental Hygiene Administration and a hospital
				  for the provision of acute inpatient psychiatric care in State hospital
				  conversion beds;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.25 - Medical Professional Liability Closed Claim Form

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hospital shall complete and submit to
				  the Department the approved Medical Professional Liability Closed Claim form,
				  DHMH form #4668, for each medical liability claim filed regarding the care or
				  services received by a patient under the care of that hospital.
B. Regardless of the result of a closed
				  claim, the hospital shall submit the Medical Professional Liability Closed
				  Claim form to the Department within 90 days after the end of the quarter during
				  which the final judgment, settlement, or final disposition of the claim was
				  made.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.26 - Anatomical Donations

Current through Register Vol. 51, No. 14, July 12, 2024
A. This
				  regulation does not:
(1) Limit the right of an
				  individual to make a gift under the Anatomical Gift Act, Estates and Trusts
				  Article, Title 4, Subtitle 5, Annotated Code of Maryland; or
(2) Interfere with the duties of the office
				  of the Chief Medical Examiner.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.27 - Discharge Planning Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A. Discharge Options. A hospital may
				  discharge a patient:
(1) Entirely;
(2) To another level of care, treatment, or
				  services;
(3) To different health
				  care professionals; or
(4) To
				  settings for continued services.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.28 - Emergency and Disaster Plan

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  A licensed acute general hospital or special hospital shall comply with the
				  Emergency Management standards outlined in the Hospital Accreditation Standards
				  (2009 Edition), pages 47-68 with the exception of standard EM.02.02.13, pages
				  61-65.
B. A licensee shall prepare
				  an executive summary of the hospital's evacuation procedures to provide to a
				  patient, family member, or legal representative upon request. The summary
				  shall:
(1) Describe the hospital's Emergency
				  Operation Plan (EOP), which is discussed throughout the Emergency Management
				  standards cited in §A(1) of this regulation; and
(2) Describe the role and responsibilities of
				  a patient, family member, or legal representative in the event of an emergency
				  situation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.29 - Notice to Patients of Outpatient on Observation Status

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hospital shall provide both an oral and
				  written notice to a patient of:
(1) The
				  patient's outpatient on observation status;
(2) The billing implications of the
				  outpatient on observation status; and
(3) The impact of the outpatient on
				  observation status on the patient's eligibility for Medicare rehabilitation
				  services if:
(a) The patient received on-site
				  services from the hospital for more than 23 consecutive hours;
(b) The on-site services received by the
				  patient include a hospital bed and meals that have been provided in an area of
				  the hospital other than the Emergency Department; and
(c) The patient is classified as an
				  outpatient at the hospital for observation rather than as an admitted
				  inpatient.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.30 - Physical Environment

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  facility shall be in compliance with:
(1)
				  Guidelines for the Design and Construction of Hospitals and Outpatient
				  Facilities (2014); and
(2) All
				  applicable State and local governing laws, regulations, standards, ordinances,
				  and codes for fire safety, building, and zoning
				  requirements.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.31 - Hospital Palliative Care Programs

Current through Register Vol. 51, No. 14, July 12, 2024
A. Acute general hospitals and special
				  hospitals-chronic care with 50 or more beds shall establish an active hospital
				  wide palliative care program that provides consultation services to patients
				  suffering from pain and symptoms due to serious illnesses or
				  conditions.
B. The hospital shall.
(1) Promote the palliative care
				  program;
(2) Provide information
				  and referrals to patients and families when appropriate regarding the
				  availability of palliative care services; and
(3) Inform patients of the patient's right to
				  request a palliative care consultation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.32 - Penalties - General

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Secretary shall deny a license to a person who has been convicted of a felony
				  that relates to Medicaid or to a nursing home.
B. The Secretary shall revoke the license of
				  any licensee convicted of a felony that relates to Medicaid or to a nursing
				  home.
C. The Secretary may deny or
				  revoke a license if the hospital does not meet the requirements of:
(1) Health-General Article, Title 19,
				  Subtitle 3, Annotated Code of Maryland;
(2) Any regulation adopted under
				  Health-General Article, Title 19, Subtitle 3, Annotated Code of Maryland,
				  including this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.32-1 - Civil Money Penalties - Imposition

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Department may impose a civil money
				  penalty not to exceed $10,000 for each failure of a hospital to comply with the
				  requirements of Regulation .27 of this chapter.
B. In determining whether to impose a civil
				  money penalty, the Department may consider the following factors:
(1) The number of failures to
				  comply;
(2) The nature and
				  seriousness of the failure to comply;
(3) The degree of risk to the health, life,
				  or safety of the patient being discharged that is caused by the failure to
				  comply;
(4) A hospital's prior
				  history to comply with discharge requirements; and
(5) Such other factors as justice may
				  require.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.32-2 - Civil Money Penalties - Payment of Penalty

Current through Register Vol. 51, No. 14, July 12, 2024
A. If a hospital owes a civil money penalty
				  to the Department, the hospital shall adhere to the procedures of this
				  regulation.
B. A civil money
				  penalty payment is due to the Department 15 calendar days after:
(1) The time period for requesting a hearing
				  has expired if a request for hearing is not received; or
(2) Receipt of a written request from the
				  hospital to waive its right to a hearing and reduce the amount of the civil
				  penalty by 40 percent, if 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 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.32-3 - Civil Money Penalties - Hearings

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hospital 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.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.33 - Uniform Emergency Codes

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Each hospital shall adopt and implement the following set of uniform codes for
				  the identified emergency situations as part of its emergency or disaster plans:
(1) Fire-Code Red;
(2) Infant or Child Abduction-Code
				  Pink;
(3) Cardiac Respiratory
				  Arrest-Code Blue-Adult;
(4) Cardiac
				  Respiratory Arrest-Code Blue-Child;
(5) Cardiac Respiratory Arrest-Code
				  Blue-Infant;
(6) Combative
				  Person-Code Green;
(7) Bomb
				  Threat-Code Gold;
(8) Hazardous
				  Material Spill or Release-Code Orange;
(9) Elopement-Code Gray;
(10) Security Only Response-Code
				  Purple;
(11) Emergency or
				  Disaster-Code Yellow; and
(12)
				  Active Shooter - Code Silver.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.34 - Infection Prevention and Control Program

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall have an active
				  hospital-wide program for the prevention, control, and investigation of
				  communicable diseases and infections.
B. Staffing.
(1) The hospital shall designate qualified
				  staff with training in infection prevention and control to be responsible for
				  the implementation of the infection prevention and control program.
(2) Additional clinical and support staff
				  shall be provided for the infection prevention and control program based on the
				  size and complexity of the hospital's services.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.35 - Designation of Lay Caregivers

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  A hospital shall provide a patient or legal guardian of a patient with an
				  opportunity to designate one lay caregiver before the discharge of the patient
				  to their residence.
B. The
				  hospital's discharge planning shall include the designation of the lay
				  caregiver as soon as practicable in the discharge planning process.
C. If a patient or legal guardian of a
				  patient declines to designate a lay caregiver, the hospital shall:
(1) Document the decision in the patient's
				  medical record; and
(2) Be deemed
				  to be in compliance with this regulation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.36 - Patient Rights

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hospital
				  shall develop a listing of the rights of patients that is consistent with the
				  requirements of:
(1) The Joint
				  Commission;
(2) Health-General
				  Article, §19-342, Annotated Code of Maryland; and
(3)
											42 CFR §
												482.13.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.37 - Maryland Health Care Decisions Act

Current through Register Vol. 51, No. 14, July 12, 2024
A hospital shall comply with the requirements of
					 Health-General Article, Title 5, Subtitle 6, Annotated Code of
					 Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.02 - Incorporation by Reference

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this
				  chapter, the following documents are incorporated by reference.
B. Documents Incorporated.
(1) CMS Long-term Care Facility Resident
				  Assessment Instrument 3.0 User's Manual, (Version 1.14, October
				  2016).
(2) CMS Manual System, Pub.
				  100-07 State Operations Provider Certification, (Transmittal 127, November 26,
				  2014, U.S. Department of Health and Human Services Centers for Medicare and
				  Medicaid Services).
(3) Guidelines
				  for Design and Construction of Residential Health, Care, and Support
				  Facilities. (2014) Facility Guidelines Institute, which is incorporated in
				  COMAR 10.07.01.02.
(4) 2007
				  Guideline for Isolation Precautions: Preventing Transmission of Infectious
				  Agents in Healthcare Settings (Centers for Disease Control and Prevention
				  (CDC), Healthcare Infection Control Practices Advisory Committee (HIPAC),
				  2007).
(5) Guidelines for
				  Preventing the Transmission of Mycobacterium tuberculosis in Health-Care
				  Settings, 2005 (MMWR2005; 54, No. RR-17, Centers for Disease Control and
				  Prevention (CDC), Atlanta, GA).
(6)
				  Immunization of Health-Care Personnel: Recommendations of the Advisory
				  Committee on Immunization Practices (ACIP), (MMWR2011; 60 No. SS-07, Centers
				  for Disease Control and Prevention (CDC), Atlanta, GA).
(7) National Fire Protection Association,
				  NFPA 99 Health Care Facilities Code (2015 Edition).
(8) National Fire Protection Association,
				  NFPA 101 Life Safety Code, which is incorporated by reference at COMAR
				  29.06.01.06.
(9) Recommended
				  Dietary Allowances, (10th Edition, Food and Nutritional Board, Commission on
				  Life Sciences, and National Research Council, 1989).
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.03 - License Required

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  person may not establish, operate, or continue the operation of an existing
				  comprehensive care facility or extended care facility without first obtaining a
				  license from the Secretary. A license is valid for 2 years from the date of
				  issuance, unless revoked by the Secretary.
B. Separate License Required. Separate
				  licenses are required for facilities maintained on separate premises, even
				  though they are operated under the same management. Separate licenses may be
				  required for separate buildings on the same grounds.
C. Other License Required. A facility having
				  a dual function, including care of the sick requiring hospital facilities in
				  addition to rendering other care services, is required to be licensed for each
				  level of health care rendered.
D.
				  Posting of License Application and Instructions for Written Comment.
(1) At least 50 days before the anticipated
				  date of the new license or relicensure, a facility shall conspicuously post:
(a) Its application for initial license or
				  license renewal; or
(b) A notice
				  describing where in the facility the application for licensure or relicensure
				  may be found.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.05 - Licensed Bed Capacity

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  facility may exceed its licensed bed capacity only if the Department:
(1) Requests that the facility exceed its
				  licensed bed capacity; or
(2)
				  Approves a request from a facility to exceed its licensed bed
				  capacity.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.06 - Rights of Applicant if License Denied or Revoked

Current through Register Vol. 51, No. 14, July 12, 2024
A. Denial of License - Proposed Facility. The
				  Secretary shall inform the applicant of the reasons for refusal to issue a
				  license.
B. Revocation of License.
(1) The Secretary may, for cause shown,
				  revoke or refuse to reissue any license issued by the Secretary. The Secretary
				  shall consider the following factors in deciding whether a facility's license
				  should be revoked:
(a) The number, nature,
				  and seriousness of the deficiencies;
(b) The degree of risk to the residents posed
				  by the deficiencies;
(c) The
				  compliance history of the facility; and
(d) Background of the owner and management,
				  including the owner's and management's experience in operating facilities and
				  other businesses.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.07 - Inspection by Secretary

Current through Register Vol. 51, No. 14, July 12, 2024
A. Open at
				  all Times for Inspection. Licensed nursing homes and any premises that an
				  applicant for a license proposes to operate shall be open at all times to
				  inspection by the Secretary and by any agency designated by the
				  Secretary.
B. Site Visits and
				  Surveys.
(1) The Department shall make a site
				  visit and conduct a full survey of each licensed nursing home at least once per
				  calendar year.
(2) All surveys
				  shall be unannounced.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.08 - New Construction, Conversion, Alteration, or Addition

Current through Register Vol. 51, No. 14, July 12, 2024
A. Submission of
				  Plans.
(1) The architect or professional
				  engineer of record shall submit stamped and sealed final construction drawings
				  to the Department.
(2) The
				  architect or professional engineer of record shall submit a letter certifying
				  that the project has been designed in accordance with all applicable federal,
				  State, and local codes, laws, ordinances, and regulations for
				  construction.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.09 - Administration and Resident Care

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Responsibility.
(1) The licensee shall be
				  responsible for the overall conduct of the comprehensive care facility or
				  extended care facility and for compliance with applicable laws and
				  regulations.
(2) The administrator
				  shall be responsible for the implementation and enforcement of all provisions
				  of the Patient's Bill of Rights Regulations under COMAR 10.07.09.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.10 - Employee Training on Cognitive Impairment and Mental Illness

Current through Register Vol. 51, No. 14, July 12, 2024
A. The following
				  employees shall receive a minimum of 8 hours of training on cognitive
				  impairment and mental illness within the first 90 days of employment:
(1) Any employee who is licensed, certified,
				  or registered under the Health Occupations Article, Annotated Code of Maryland;
				  and
(2) Any employee whose job
				  duties include assisting residents with activities of daily living.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.11 - Admission and Discharge

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Written Policy. The nursing home shall develop written policies, consistent
				  with this chapter and COMAR 10.07.09, to govern the nursing care, related
				  medical, and other services that the nursing home provides regarding:
(1) Admissions, transfers, and
				  discharges;
(2) Acceptable payment
				  sources; and
(3) Medical Assistance
				  program information.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.12 - Resident's Representative

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  nursing home shall recognize the authority of:
(1) A guardian of the person under Estates
				  and Trusts Article, §
											13-705, Annotated
				  Code of Maryland;
(2) A guardian of
				  the property under Estates and Trusts Article, §
											13-201, Annotated
				  Code of Maryland;
(3) An advance
				  directive that meets the requirements of Health-General Article, § 5-602,
				  Annotated Code of Maryland;
(4) A
				  surrogate decision maker with authority under Health-General Article, §
				  5-605, Annotated Code of Maryland;
(5) A power of attorney that meets the
				  requirements of Estates and Trusts Article, §
											13-601, Annotated
				  Code of Maryland;
(6) A
				  representative payee or other similar fiduciary; or
(7) To the extent permitted by Maryland law,
				  any other individual, if that individual was designated by a resident who was
				  competent at the time of designation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.13 - Resident Care Policies

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  nursing home shall develop written policies consistent with Regulation .11 of
				  this chapter pertaining to:
(1) Physician
				  services;
(2) Residents'
				  rights;
(3) Nursing
				  services;
(4) Dietetic
				  services;
(5) Specialized
				  rehabilitative services including occupational therapy, physical therapy,
				  speech pathology and audiology services;
(6) Pharmaceutical services;
(7) Laboratory and radiologic
				  services;
(8) Dental
				  services;
(9) Social
				  services;
(10) Resident
				  activities;
(11) Clinical
				  records;
(12) Reports and action
				  required in unusual circumstances;
(13) Utilization review;
(14) Infection control;
(15) Tuberculosis surveillance;
(16) Disaster plan;
(17) Housekeeping services, pest control, and
				  laundry; and
(18) Resident care
				  management.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.14 - Physician Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Responsibility for the Resident's Care. The attending physician shall:
(1) Assess a new admission in a timely
				  manner, based on a facility-developed protocol, depending on:
(a) The individual's medical
				  stability;
(b) Recent and previous
				  medical history;
(c) Presence of
				  significant or previously unidentified medical conditions; or
(d) Problems that cannot be handled readily
				  by phone;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.15 - Medical Director - Qualifications

Current through Register Vol. 51, No. 14, July 12, 2024
A. Medical Director Qualifications. The
				  nursing home shall:
(1) Designate a medical
				  director who has at least the following qualifications:
(a) A current license as a physician in this
				  State;
(b) At least 2 years of
				  experience or specialized training in the medical care of geriatric or
				  chronically ill and impaired residents; and
(c) Successful completion of a curriculum in
				  physician management or administration from:
(i) AMDA: The Society for Post-Acute and
				  Long-Term Care Medicine; or
(ii) A
				  curriculum approved by the Department or its designee;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.16 - Medical Director - Responsibilities

Current through Register Vol. 51, No. 14, July 12, 2024
A. General Responsibilities. The medical
				  director is responsible for:
(1) Overall
				  coordination, execution, and monitoring of physician services;
(2) Monitoring and evaluating the health care
				  services and outcomes, including clinical and physician services provided to
				  the nursing home's residents; and
(3) Designating an alternate medical director
				  with sufficient training and experience to perform the responsibilities of the
				  medical director as described in the regulations of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.17 - Nursing Home's Responsibilities in Relation to the Nursing Home's Medical Director

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  nursing facility shall:
(1) Be responsible
				  for working with the medical director to ensure adequate resident care and
				  practitioner performance;
(2)
				  Inform the physician of explicit requirements as a medical director and assist
				  the medical director in gaining the necessary information and tools to properly
				  execute those responsibilities; and
(3) Ensure that the medical director has the
				  necessary support and authority to perform medical director duties effectively
				  and to hold practitioners accountable.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.18 - Nursing Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Organization, Policies, and Procedures.
(1)
				  Nursing service personnel shall provide care appropriate to the residents'
				  needs with the organizational plan, authority, functions, and duties clearly
				  defined.
(2) Nurses and support
				  personnel shall be chosen for their training, experience, and
				  ability.
(3) Policies and
				  procedures shall be adopted and made available to all nursing service
				  personnel.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.19 - Nursing Services - Staffing

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Supervisory Personnel - Nursing Homes.
(1)
				  Nursing homes shall provide at least the following supervisory personnel:
Residents
Registered Nurses
(a) 2-99
One-full-time
(b) 100-199
Two-full-time
(c) 200-299
Three-full-time
(d) 300-399
Four-full-time
(2) The director of nursing's time is
				  included in §A(1) of this regulation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.20 - Nursing Services - Director of Nursing

Current through Register Vol. 51, No. 14, July 12, 2024
A. Director of Nursing. The nursing home
				  shall provide for an organized nursing service, under the direction of a
				  full-time registered nurse.
B.
				  Termination of Services of Director of Nursing.
(1) If the nursing home terminates the
				  services of the director of nursing, the nursing home immediately shall notify
				  the Department of the termination.
(2) The name and license number of the
				  replacement director of nursing shall be supplied to the Department as soon as
				  employment begins.
(3) A copy of
				  the agreement between the nursing home and the replacement shall be sent to the
				  Department.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.21 - Dietetic Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Services Provided. Services may be provided directly by the facility or the
				  facility may contract with a food management company, a caterer, or another
				  facility. The facility and the food management company (or caterer or facility
				  providing service) shall comply with these regulations. Food service personnel
				  shall comply with COMAR 10.15.03 Food Service Facilities.
B. Supervision.
(1) In a nursing home with more than 50 beds,
				  overall supervisory responsibilities for the food service department and food
				  production shall be assigned to a full-time qualified dietetic service
				  supervisor. It shall be the responsibility of the supervisor to delegate relief
				  duties to an individual qualified to serve as relief as stated in Regulation
				  .09I of this chapter.
(2) In a
				  nursing home with 50 or fewer beds, exceptions may be made by the Department to
				  allow the supervisor to share cooking responsibilities with the full-time
				  cook.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.22 - Specialized Rehabilitative Services - Occupational Therapy Services, Physical Therapy Services, Speech Pathology and Audiology Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. Rehabilitative
				  Services - Admission Policies. In a nursing home which does not accept
				  residents in need of specialized rehabilitative services, the minimal
				  acceptable restorative service shall be the restorative nursing care plan
				  designed to maintain function or improve the resident's ability to carry out
				  activities of daily living as set forth in Regulation .18G, of this
				  chapter.
B. Arrangements for
				  Services.
(1) If a nursing home's admission
				  policies include the admission of residents requiring rehabilitative services,
				  the nursing home shall provide, or arrange for under written agreement,
				  specialized rehabilitative services by qualified personnel, such as a physical
				  therapist, speech-language pathologist and audiologist, and occupational
				  therapist.
(2) Initiation of
				  services to meet the rehabilitative needs of the resident shall occur within 48
				  hours, excluding Saturday, Sunday, and State and federal holidays, of the
				  physician's order for the specialized service.
(3) The resident may not be accepted for
				  admission if at least one service to meet the rehabilitative needs of the
				  resident cannot be initiated within the 48-hour period, excluding Saturday,
				  Sunday, and State and federal holidays.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.23 - Special Care Units - General

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  A nursing home which holds a current and valid operating license may establish
				  special care units with the approval of the:
(1) Office of Health Care Quality;
				  and
(2) Department's Office of
				  Capital Planning, Budgeting and Engineering Services.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.24 - Special Care Units - Respiratory Care Unit

Current through Register Vol. 51, No. 14, July 12, 2024
A. A respiratory care unit shall meet the:
(1) General requirements established for all
				  special care units as outlined in Regulation .23 of this chapter; and
(2) Requirements of this
				  regulation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.25 - Special Care Units - Dementia Care Unit

Current through Register Vol. 51, No. 14, July 12, 2024
A. A dementia care unit shall meet the:
(1) General requirements established for all
				  special care units as outlined in Regulation .24 of this chapter; and
(2) Requirements of this
				  regulation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.26 - Pharmaceutical Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Definition. In this regulation, the term committee means the pharmaceutical
				  services committee.
B. Duties of
				  the Nursing Home.
(1) The nursing home shall
				  provide appropriate methods and procedures for administering drugs and
				  biologicals to the nursing home's residents.
(2) The nursing home shall provide
				  pharmaceutical services in accordance with accepted professional standards and
				  related federal, State, and local laws.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.27 - Pharmaceutical Management

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Administration Procedures.
(1) Medications,
				  legend and non-legend, administered to residents shall be ordered in writing by
				  the resident's physician.
(2)
				  Medications shall be administered by:
(a)
				  Appropriately licensed personnel in accordance with laws and regulations
				  governing these acts; or
(b)
				  Certified graduates of a State-approved medicine aide course.
(3) The individual who prepares
				  medications shall give and record them.
(4) Medicine may not be returned to the
				  container. If the resident refuses the drug or if a mistake occurs:
(a) The drug shall be discarded;
				  and
(b) The occurrence shall be
				  documented in the resident's chart.
(5) Before invoking stop order policies, the
				  resident's attending physician shall be contacted for instructions so that
				  continuity of the resident's therapeutic regimen is not interrupted. If the
				  attending physician cannot be reached, the medical director shall be contacted
				  for instructions.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.28 - Laboratory and Radiologic Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. Approved Source. Laboratory services
				  provided by the facility shall meet the applicable conditions established under
				  COMAR 10.10.01 Medical Laboratories in Maryland.
B. Provisions of Services. If the facility
				  does not provide laboratory and radiologic services, arrangements shall be made
				  for obtaining these services from a physician's office, a licensed laboratory
				  in a hospital or nursing facility, a licensed independent laboratory, or a
				  State-approved portable X-ray supplier.
C. Physician's Order Required. All services
				  shall be provided only on the orders of the attending physician.
D. Reports of Findings. The nursing home
				  shall notify the attending physician promptly of the findings. The nursing home
				  shall file signed and dated reports of diagnostic services in the resident's
				  medical record.
E. Transportation.
				  The nursing home shall assist the resident, if necessary, in arranging
				  transportation to and from the source of service.
F. Blood and Blood Products - Blood Handling
				  and Storage. Blood handling and storage facilities shall be safe, adequate, and
				  properly supervised.
G. Storage and
				  Transfusion. If the facility provides for maintaining and transfusing blood and
				  blood products, it shall meet the standards in COMAR 10.10.02 Blood
				  Banks.
H. Transfusion Services. If
				  the nursing home only provides transfusion services, it shall meet at least the
				  requirements established under COMAR 10.10.02.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.29 - Dental Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Provision for Dental Care. Residents shall be assisted to obtain routine and
				  emergency dental care.
B. Advisory
				  Dentist. There shall be an advisory dentist who shall:
(1) Recommend oral hygiene policies and
				  practices for the care of the residents and for arrangements for emergency
				  treatment;
(2) Assist in the
				  formulation of dental health policies;
(3) Provide direction for in-service training
				  to give the nursing staff an understanding of residents' dental
				  problems.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.30 - Social Work Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Services Provided. The nursing home shall provide or make arrangements for
				  services to identify and meet the resident's medically related physical,
				  social, and behavioral health needs.
B. Social Work Staff Responsibility.
(1) Social services responsibilities in the
				  nursing home shall be assigned to a:
(a)
				  Licensed bachelor social worker;
(b) Licensed graduate social
				  worker;
(c) Licensed certified
				  social worker; or
(d) Licensed
				  certified social worker-clinical.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.31 - Resident Activities

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Activities Program. The nursing home shall provide:
(1) A program of structured and unstructured
				  activities; and
(2) Activities
				  designed and monitored appropriately to meet the day-to-day needs and interests
				  of each resident and encourage:
(a)
				  Self-care;
(b) Engagement in
				  resident-selected activities; and
(c) Maintenance of an optimal level of
				  psychosocial functioning.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.32 - Clinical Records

Current through Register Vol. 51, No. 14, July 12, 2024
A. Records for
				  all Residents. Records for all residents shall be maintained in accordance with
				  accepted professional standards and practices.
B. Contents of Record. Contents of record
				  shall include:
(1) Identification and summary
				  sheet or sheets including:
(a) Resident's
				  name;
(b) Social Security
				  number;
(c) Armed forces
				  status;
(d) Citizenship;
(e) Marital status;
(f) Age;
(g) Sex;
(h) Home address; and
(i) Religion;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.33 - Infection Prevention and Control Program

Current through Register Vol. 51, No. 14, July 12, 2024
A. Infection Prevention and Control Program.
				  The nursing home shall establish, implement, and maintain an effective
				  infection prevention and control program that:
(1) Investigates, controls, and prevents
				  infections in a timely manner through a system that enables the facility to:
(a) Analyze patterns of infected
				  individuals;
(b) Analyze changes in
				  prevalent organisms;
(c) Analyze
				  increases in the rate of infection; and
(d) Obtain surveillance data for the
				  prevention and control of additional cases;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.34 - Employee Health Program

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  nursing home's infection prevention and control program shall monitor the
				  relevant health status of all employees, as it relates to infection prevention
				  and control. The nursing home shall refer to the following guidelines in
				  implementing its employee health program:
(1)
				  Guideline for Infection Control in Health Care Personnel;
(2) Immunization of Health Care Personnel:
				  Recommendations of the Advisory Committee on Immunization Practices (ACIP) and
				  the Hospital Infection Control Practices Advisory Committee (HICPAC);
				  and
(3) COMAR 09.12.31.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.35 - Resident Health Program

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Immunization.
(1) The nursing home shall
				  offer influenza and pneumococcal immunization to each resident.
(2) The nursing home shall obtain written
				  consent to administer the immunization from:
(a) The resident; or
(b) The resident's representative.
(3) A resident is not required to
				  receive the influenza and pneumococcal immunization if it is:
(a) Medically contraindicated;
(b) Against the resident's religious beliefs;
				  or
(c) After being fully informed
				  of the health risks associated with not receiving a vaccine, the resident
				  refuses the immunization.
(4) If the resident refuses to be immunized,
				  the nursing home shall document the refusal and the reason for the
				  refusal.
(5) The nursing home shall
				  notify each prospective resident of the immunization requirements and request
				  that the resident agree to be immunized.
(6) The nursing home shall make available to
				  residents educational and informational materials relating to immunization
				  against influenza virus and immunization against pneumococcal
				  disease.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.36 - Volunteer Health Program

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  nursing home shall urge that volunteers, defined as individuals who spend an
				  average of 8 hours per week or more in the resident care areas and who receive
				  no pay or benefits, receive annual influenza vaccination and tuberculin skin
				  testing as considered necessary by the nursing home.
B. The nursing home shall give appropriate
				  health care information to such volunteers to provide maximum protection to
				  residents.
C. The nursing home
				  shall maintain documentation of the discussion between the nursing home and the
				  volunteer concerning influenza vaccine and tuberculin skin testing.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.02 - Nursing Homes › Section 10.07.02.37 - Infection Control - Standard Precautions

Current through Register Vol. 51, No. 14, July 12, 2024
A. Standard Precautions. All employees shall
				  routinely use appropriate barrier precautions to prevent skin and mucous
				  membrane exposure when contact with blood or the body fluids of any resident is
				  anticipated as outlined in:
(1) 2007
				  Guideline for Isolation Precautions: Preventing Transmission of Infectious
				  Agents in Healthcare Settings; and
(2) COMAR 09.12.31.