Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 2 › Subtitle 09 - MEDICAL CARE PROGRAMS › Chapter 10.09.53 - Early and Periodic Screening, Diagnosis, and Treatment: Nursing Services for Individuals Younger than 21 Years Old › Section 10.09.53.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this
				  chapter, the following terms have the meanings indicated.
B. Terms Defined.
(1) "Caregiver" means a willing and able
				  individual who is trained in providing care to the participant.
(2) "Certified medication technician (CMT)"
				  means an individual, regardless of title, who:
(a) Completes a 20-hour course in medication
				  administration approved by the Maryland Board of Nursing;
(b) Is certified by the Board under COMAR
				  10.39.04; and
(c) Performs
				  medication administration tasks delegated by a nurse in accordance with COMAR
				  10.27.11.
(3) "Certified
				  nursing assistant (CNA)" means an individual, regardless of title, who:
(a) Is certified by the Maryland Board of
				  Nursing under COMAR 10.39.05; and
(b) Routinely performs nursing tasks
				  delegated by a nurse in accordance with COMAR 10.27.11.
(4) "Delegated nursing services" has the
				  meaning stated in COMAR 10.27.11.
(5) Employment.
(a) "Employment" means the condition of
				  having paid work.
(b) "Employment"
				  includes job training or classes required to obtain government licensure or
				  certification to engage in an occupation or profession, and work to fulfill
				  requirements to obtain Temporary Cash Assistance or other public
				  benefits.
(6)
				  "Department" has the meaning stated in COMAR 10.09.36.01.
(7) "Early and Periodic Screening, Diagnosis,
				  and Treatment (EPSDT)" means the provision of preventive health care under
				  42 CFR §
												441.50 et seq., including medical and dental
				  services, in order to assess growth and development and to detect and treat
				  health problems in Medical Assistance recipients under 21 years old.
(8) "Electronic visit verification (EVV)" has
				  the meaning stated in COMAR
				  10.09.36.03-2.
(9) "Emergency medical condition" means a
				  health condition manifested by symptoms of sufficient severity that the absence
				  of immediate medical attention could reasonably be expected by a prudent lay
				  individual possessing an average knowledge of health and medicine to result in:
(a) Placing health in jeopardy;
(b) Serious impairment to bodily
				  functions;
(c) Serious dysfunction
				  of any bodily organ or part; or
(d)
				  Development or continuance of severe pain.
(10) "Emergency service" means a service or
				  care rendered to a recipient exhibiting an emergency medical condition as
				  defined in §B(3) of this regulation.
(11) "EPSDT screen" means the complete
				  package of various health screening procedures, required by the State
				  periodicity schedule, or a partial screen, that an EPSDT participant
				  receives.
(12) "Home" means the
				  place of residence, occupied by the recipient, other than a residence or
				  facility where private duty nursing services are included in the living
				  arrangement by regulation or statute, or otherwise provided for
				  payment.
(13) "Home health agency"
				  means an agency licensed by the Department in accordance with COMAR
				  10.07.10.
(14) "Home health aide
				  (HHA)" means an individual, regardless of title, who meets all the conditions
				  of participation specified in:
(a) 42 CFR
				  § 484.36 ; and
(b) Health
				  Occupations Article, Title 8, Annotated Code of Maryland.
(15) "Medical Assistance Program" has the
				  meaning stated in COMAR 10.09.36.01.
(16) "Medically necessary" has the meaning
				  stated in COMAR 10.09.36.01.
(17)
				  "Nurse" means a person who is licensed to practice as a registered nurse (RN)
				  or licensed practical nurse (LPN) in the jurisdiction in which services are
				  provided.
(18) "Nursing care plan"
				  means a plan developed by a registered nurse that identifies the patient's
				  diagnoses and needs, the goals to be achieved, and the interventions required
				  to meet the patient's medical condition.
(19) "Participant" means a recipient who is
				  eligible for and receiving services in accordance with the provisions of this
				  chapter.
(20) "Plan of care" means
				  an individualized care plan, written in collaboration with the participant or
				  family, including the plan developed under COMAR 10.09.27 and 10.09.69, which
				  outlines a plan of action to meet the goals or expected outcomes for the
				  participant.
(21)
				  "Preauthorization" means the approval required from the Department or its
				  designee before services may be rendered.
(22) "Primary medical provider (PMP)" means
				  the medical provider who functions as the principal medical provider to the
				  participant including a physician, certified nurse midwife, or nurse
				  practitioner.
(23) "Private duty
				  nursing services" means skilled nursing services for recipients who require
				  more individual and continuous care than is available under the home health
				  program, and which are provided by a registered nurse or a licensed practical
				  nurse, in a recipient's own home or another setting when normal life activities
				  take the recipient outside his or her home.
(24) "Program" has the meaning stated in
				  COMAR 10.09.36.01.
(25) "Progress
				  note" means a signed and dated written notation by the home care nurse which:
(a) Summarizes facts about the care given and
				  the participant's responses during a given period of time;
(b) Specifically addresses the established
				  goals of treatment;
(c) Is
				  consistent with the participant's plan of care; and
(d) Is written during the course of
				  care.
(26) "Provider" has
				  the meaning stated in COMAR 10.09.36.01.
(27) "Recipient" has the meaning stated in
				  COMAR 10.09.36.01.
(28)
				  "Residential service agency" means an agency licensed by the Department in
				  accordance with COMAR 10.07.05.
(29) "School" means courses or classes for
				  the acquisition of a General Education Diploma, high school diploma,
				  associate's degree, or a first-time bachelor's degree.
(30) "Supervision" means authoritative,
				  procedural guidance by a licensed registered nurse for the accomplishment of a
				  function or activity, as well as the process of critical watching, directing,
				  and evaluating another's performance.
(31) "Urgent service" means a service or care
				  for a medical condition that is manifested by symptoms of sufficient severity
				  that the absence of medical attention within 48 hours could reasonably be
				  expected, by a prudent lay individual who possesses an average knowledge of
				  health and medicine, to result in an emergency medical condition.
(32) "Witness" means the recipient or an
				  individual who, on behalf of the recipient, is able to personally verify that
				  the recipient received private duty nursing services.