reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.05 - Residential Service Agencies › Section 10.07.05.20 - Sanctions

Current through Register Vol. 51, No. 14, July 12, 2024
A. If the Secretary
				  determines that an agency has violated this chapter, the Secretary, in addition
				  to the sanctions set forth in Regulations .21.27 of this chapter may:
(1) Restrict the number of clients the agency
				  may serve;
(2) Limit the types of
				  clients an agency may serve;
(3)
				  Require the licensee, and any of its staff, to receive remedial instruction in
				  a specific area;
(4) Require the
				  agency to use the services of a management firm that is approved by the
				  Department;
(5) Mandate staffing
				  patterns that specify the number of personnel or personnel qualifications, or
				  both;
(6) Direct the licensee to
				  correct the violations in a specific manner or within a specified
				  timeframe;
(7) Notify, or require
				  the agency to notify, the client, the client representative, or the family of
				  any client who is affected by the noncompliance;
(8) Increase the frequency of monitoring
				  visits during a specified period of time; or
(9) Establish certain conditions for
				  continued operation, including time limits for continued operation and for
				  compliance.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.05 - Residential Service Agencies › Section 10.07.05.21 - Civil Money Penalties

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Secretary may impose a civil money penalty on an agency if a deficiency or
				  continuing pattern of deficiencies exists in the residential service
				  agency.
B. In determining whether a
				  civil money penalty will be imposed, the Secretary shall consider the following
				  factors:
(1) Nature, number, and seriousness
				  of the deficiencies;
(2) The extent
				  to which the deficiency or deficiencies are part of a continuing pattern during
				  the preceding 24 months;
(3) The
				  degree of risk to the health, life, or safety of the clients of the agency that
				  is caused by the deficiency or deficiencies;
(4) The efforts made by, and the ability of,
				  the agency to correct the deficiency or deficiencies; and
(5) An agency's prior history of
				  compliance.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.05 - Residential Service Agencies › Section 10.07.05.22 - Amount of Civil Money Penalties

Current through Register Vol. 51, No. 14, July 12, 2024
A. A civil money penalty imposed on a person
				  under this chapter may not exceed $10,000 per instance or, as provided in
				  Regulation .21 of this chapter, $1,000 per day.
B. In setting the amount of the civil money
				  penalty under this chapter, the Secretary shall consider the following factors:
(1) Nature, number, and seriousness of the
				  deficiencies;
(2) The degree of
				  risk to the health, life, or safety of the clients of the agency that is caused
				  by the deficiency or deficiencies;
(3) The efforts made by, and ability of, the
				  agency to correct the deficiency or deficiencies;
(4) Whether the amount of the civil money
				  penalty will jeopardize the financial ability of the agency to continue
				  operation as an agency;
(5) Prior
				  history of compliance by the agency; and
(6) Other factors as justice may
				  require.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.05 - Residential Service Agencies › Section 10.07.05.23 - Civil Money Penalties - Hearings

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hearing on the appeal shall be held
				  consistent with State Government Article, Title 10, Subtitle 2, Annotated Code
				  of Maryland.
B. The Secretary shall
				  have the burden of proof with respect to the imposition of the civil money
				  penalties under this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.05 - Residential Service Agencies › Section 10.07.05.24 - 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
B. The Department shall deliver a written
				  notice to the licensee:
(1) Informing the
				  licensee 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 licensee 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 10.07.05 - Residential Service Agencies › Section 10.07.05.25 - Denial or Revocation of a License

Current through Register Vol. 51, No. 14, July 12, 2024
The Secretary, for cause shown, may deny, revoke, or refuse
					 to reissue any license issued for inability or failure to comply with the
					 regulations of this chapter. This action is subject to the provisions of the
					 Administrative Procedure Act, State Government Article, §
										10-201 et seq.,
					 Annotated Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.05 - Residential Service Agencies › Section 10.07.05.26 - Notice to Clients

Current through Register Vol. 51, No. 14, July 12, 2024
Unless otherwise ordered by the Secretary, the agency shall
					 notify each competent client and each client representative within at least 30
					 days of:
A. Any significant change of
				  licensure status;
B. A voluntary
				  surrender of its agency license; or
C. Denial, revocation, or suspension of the
				  license.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.05 - Residential Service Agencies › Section 10.07.05.27 - Penalty for Unlicensed Operation

Current through Register Vol. 51, No. 14, July 12, 2024
A person that operates a residential service agency without
					 a license may be assessed a civil money penalty by the Department not to exceed
					 $10,000 per violation and, additionally, is guilty of a misdemeanor and, on
					 conviction, is subject to a criminal fine not exceeding $1,000 for the first
					 offense and $10,000 for each subsequent offense. Each day that a violation is
					 continued after the first conviction is a separate offense.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.05 - Residential Service Agencies › Section 10.07.05.28 - Hearings

Current through Register Vol. 51, No. 14, July 12, 2024
A. An agency shall
				  file a request for a hearing with the Office of Administrative Hearings, with a
				  copy to the Office of Health Care Quality, not later than 30 days after receipt
				  of notice of the Secretary's action. The request shall include a copy of the
				  Secretary's action.
B. A hearing
				  requested under this chapter shall be conducted in accordance with State
				  Government Article, Title 10, Subtitle 2, Annotated Code of Maryland, and COMAR
				  10.01.03 and 28.02.01.
C. The
				  burden of proof is as provided in COMAR
				  10.01.03.28P.
D. Unless otherwise stated in this
				  chapter, the Office of Administrative Hearings shall issue a proposed decision
				  within the time frames set forth in State Government Article, §
										10-205, Annotated
				  Code of Maryland.
E. An aggrieved
				  party may file exceptions as provided in COMAR
				  10.01.03.35P.
F. A final decision by the
				  Secretary shall be issued in accordance with COMAR
				  10.01.03.35P.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.01 - Purpose

Current through Register Vol. 51, No. 14, July 12, 2024
The purpose of this chapter is to provide a safe
					 environment for patients by requiring hospitals to:
A. Identify adverse events;
B. Encourage reporting of
				  near-misses;
C. Assess and
				  prioritize near-misses and adverse events based on level of disability or
				  potential disability to patients;
D. Determine the appropriate hospital
				  response based on level of disability or potential disability;
E. Conduct a root cause analysis of:
(1) All level 1 events;
(2) All level 2 events; and
(3) If warranted, any near-miss or other
				  adverse event;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.02 - 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) "Action plan" means a written document
				  that includes:
(a) Specific measures to
				  correct problems or areas of concerns;
(b) Specific measures to address areas of
				  system improvement;
(c) Time frames
				  for implementation of any specific measures; and
(d) Title of responsible individual to
				  monitor implementation and effectiveness.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.03 - Patient Safety Program

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  General. On or before March 15, 2004, a hospital shall have in effect a patient
				  safety program that meets the requirements of this chapter.
B. Duties of the Hospital.
(1) The hospital shall identify an individual
				  as patient safety coordinator who shall:
(a)
				  Coordinate patient safety activities;
(b) Facilitate assessment and determination
				  of the appropriate response to reported near-misses and adverse events related
				  to patient care;
(c) Monitor root
				  cause analyses and any actions resulting from a root cause analysis;
				  and
(d) Provide for flow of
				  information among quality assurance, credentialing, peer review, and any
				  patient safety committee.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.04 - Near-Miss and Adverse Event Reporting and Determination of Appropriate Response

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  hospital shall develop and encourage a supportive environment that permits
				  spontaneous identification, open discussion, and timely and accurate reporting
				  of near-misses and adverse events.
B. The hospital shall establish a clear and
				  well-defined near-miss and adverse event identification and reporting process
				  that shall:
(1) Encourage reporting of
				  near-misses and require reporting of adverse events;
(2) List and describe examples of adverse
				  events that shall be reported;
(3)
				  Designate a hospital representative to whom a near-miss is encouraged to be
				  reported or to whom an adverse event shall be reported;
(4) Provide a time frame within which the
				  near-miss is encouraged to be reported or within which an adverse event shall
				  be reported;
(5) Require that an
				  individual employed by the hospital or appointed to the medical staff and who
				  is aware of an adverse event shall report the adverse event in accordance with
				  this chapter;
(6) Develop a
				  procedure to coordinate receipt of all adverse events and near-misses and to
				  prioritize adverse events and near-misses based on level of disability or
				  potential disability; and
(7)
				  Develop a procedure to assign an appropriate response to level 1 and level 2
				  adverse events, other adverse events, and near-misses.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.05 - Procedures for Level 1 and 2 Adverse Events and Certain Near-Misses

Current through Register Vol. 51, No. 14, July 12, 2024
A. When a level 1
				  or 2 adverse event, or a near-miss that warrants a root cause analysis occurs,
				  the hospital shall:
(1) Provide immediate
				  care to the patient;
(2) Identify
				  any immediate corrective action to prevent reoccurrence;
(3) Identify and report the event in
				  accordance with the hospital's reporting process;
(4) Complete a root cause analysis within 60
				  days of the time that the hospital has knowledge of the occurrence;
(5) Develop and implement an action plan to
				  correct any systems problems;
(6)
				  Share any pertinent information with quality assurance or other medical review
				  committees; and
(7) Aggregate data
				  to determine patterns or trends.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.06 - Root Cause Analysis

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  hospital shall appoint an interdisciplinary root cause analysis team that shall
				  include:
(1) Individuals who have knowledge
				  of the event or near-miss;
(2)
				  Representatives of hospital leadership; and
(3) Individuals with expertise in the subject
				  matter of the event.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.07 - Procedures for Level 3 Adverse Events and Certain Near-Misses

Current through Register Vol. 51, No. 14, July 12, 2024
A. If the event is
				  not a level 1 or 2 event or a near-miss that warrants a root cause analysis,
				  the hospital shall conduct an evaluation of the event to determine any problem
				  area and corrective action.
B. All
				  events shall be aggregated by type and level to determine any patterns or
				  trends.
C. The hospital is
				  encouraged to evaluate and trend all near-misses to determine any system
				  problems.
D. The hospital shall
				  monitor the results and effectiveness of all action plans.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.08 - Information Sharing

Current through Register Vol. 51, No. 14, July 12, 2024
The patient safety program shall require that the quality
					 assurance and other medical review committees share information and take any
					 appropriate action concerning near-misses and adverse events.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.09 - Reports to the Department

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  hospital shall report any level 1 adverse event to the Department within 5 days
				  of the hospital's knowledge that the event occurred.
B. A hospital shall submit the root cause
				  analysis and action plan for the level 1 adverse event to the Department within
				  60 days of the hospital's knowledge of the occurrence.
C. Any root cause analysis and any other
				  medical review committee information submitted to the Department and the
				  identity of individuals appointed to the interdisciplinary root cause analysis
				  team are confidential under Health Occupations Article, §
										1-401, Annotated
				  Code of Maryland and are not discoverable, disclosable, or admissible as
				  evidence in any civil action or available under the Maryland Public Information
				  Act.
D. If the Department receives
				  a complaint alleging a level 1 adverse event, the Department may accept the
				  root cause analysis as a hospital's internal investigation under Health-General
				  Article, §19-309(b), Annotated Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.10 - Documentation

Current through Register Vol. 51, No. 14, July 12, 2024
Actions taken by the quality assurance and medical staff
					 credentialing and peer review committees shall be documented in committee
					 minutes.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.11 - Patient Complaint Program

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  In accordance with this regulation, the patient safety program shall include a
				  formal written program for addressing patient complaints.
B. The hospital shall provide patients with
				  information regarding the hospital's patient complaint program including:
(1) The name of the hospital's representative
				  that the patient may contact if the patient wishes to make a complaint;
				  and
(2) The hospital
				  representative's phone number or address.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.12 - Interhospital Notification Of Level 1 or Level 2 Adverse Events

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hospital that
				  admits a patient with a condition resulting from a level 1 or level 2 adverse
				  event that the hospital perceives may be related to care that was provided at
				  another Maryland hospital and that appears to be unknown to the other hospital
				  at the time of discharge shall notify and provide any necessary information to
				  the appropriate medical review committee at the hospital where the adverse
				  event allegedly occurred.
B. The
				  hospital where the event allegedly occurred shall conduct a root cause analysis
				  and provide notice to the Department in accordance with this chapter.
C. The hospital where the event allegedly
				  occurred shall notify the patient or the patient's family in accordance with
				  this chapter.
D. All communication
				  that occurs in accordance with §§A-B of this regulation is
				  confidential under Health Occupations Article, §
										1-401, Annotated
				  Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.14 - Documentation

Current through Register Vol. 51, No. 14, July 12, 2024
A. On or before
				  March 15, 2004, the hospital shall send to the Secretary a written description
				  of its patient safety program that includes:
(1) The name of the patient safety
				  coordinator;
(2) The board policy
				  statement relevant to patient safety activities including the process to review
				  the hospital's patient safety program and to determine the effectiveness of the
				  hospital's patient safety program;
(3) A description of the near-miss and
				  adverse event identification and reporting process;
(4) A list of examples of adverse events that
				  shall be reported;
(5) A
				  description of the process for determining which near-misses warrant a root
				  cause analysis to be conducted;
(6)
				  A description of the near-miss and adverse event review, prioritization,
				  evaluation, and root cause analysis process;
(7) A description of the process used to
				  provide notification to a patient, and, if appropriate, to a patient's family
				  whenever an outcome of care differs from an anticipated outcome; and
(8) A description of the formal written
				  patient complaint process.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.15 - Plan of Correction

Current through Register Vol. 51, No. 14, July 12, 2024
A. If the
				  Department notifies a hospital that the patient safety program of the hospital
				  does not meet the requirements of this chapter, the hospital shall submit a
				  plan indicating the steps the hospital shall take to meet the requirements of
				  this chapter.
B. The plan shall be
				  sent to the Secretary within 10 days after the Department notifies the hospital
				  that the hospital does not meet the requirements of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.16 - Penalties

Current through Register Vol. 51, No. 14, July 12, 2024
If a hospital fails to have in effect a patient safety
					 program in accordance with this chapter, then the Secretary may impose on the
					 hospital the following penalties:
A.
				  Revocation of the hospital's license; or
B. A fine of $500 for each day that the
				  hospital is in violation of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.06 - Hospital Patient Safety Program › Section 10.07.06.17 - Departmental Obligations

Current through Register Vol. 51, No. 14, July 12, 2024
The Department shall:
A. Provide feedback to hospitals regarding
				  submitted root cause analyses within 60 days of receipt; and
B. Release an annual public report containing
				  a compilation of de-identified data regarding the type and outcomes of reported
				  adverse events.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.07 - Nursing Referral Service Agencies › Section 10.07.07.01 - Purpose

Current through Register Vol. 51, No. 14, July 12, 2024
The purpose of this chapter is to set minimum standards for
					 licensure of nursing referral service agencies in Maryland. This chapter does
					 not preclude a nursing referral service agency from operating with independent
					 contractors.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.07 - Nursing Referral Service Agencies › Section 10.07.07.02 - 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) "Activities of daily living" means normal
				  daily activities including:
(a) Bathing,
				  toileting, and personal hygiene;
(b) Dressing;
(c) Meal preparation and eating;
(d) Companionship; and
(e) Assistance with physical transfer and
				  ambulation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.07 - Nursing Referral Service Agencies › Section 10.07.07.03 - License Required

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  person, partnership, corporation, association, or other business entity may not
				  conduct, operate, or maintain a nursing referral service agency in this State
				  before being licensed by the Secretary.
B. This chapter does not limit the right of
				  any person who holds a license issued under Health-General Article or Health
				  Occupations Article, Annotated Code of Maryland, to act as authorized by that
				  license.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.07 - Nursing Referral Service Agencies › Section 10.07.07.04 - Licensing Procedures

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Application for License.
(1) A person
				  desiring to conduct, operate, or maintain a nursing referral service agency in
				  this State shall file an application with the Secretary, on the written or
				  electronic form provided by the Secretary.
(2) The application for licensure shall
				  contain the name and address of each officer and the director of the nursing
				  referral service agency.
(3) Along
				  with the application, the applicant shall submit a:
(a) Nonrefundable 3-year license fee of
				  $1,000 payable to the Department; and
(b) Copy of the agency's policies and
				  procedures as specified in Regulation .08B(1) of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.07 - Nursing Referral Service Agencies › Section 10.07.07.05 - Posting Of License

Current through Register Vol. 51, No. 14, July 12, 2024
A nursing referral service agency shall post its license
					 conspicuously onsite so that it is clearly visible to the general
					 public.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.07 - Nursing Referral Service Agencies › Section 10.07.07.06 - Restrictions on a License

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  licensee may not, under any circumstances, transfer or reassign its nursing
				  referral service agency license to another person.
B. 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 10.07.07 - Nursing Referral Service Agencies › Section 10.07.07.07 - Inspections by the Secretary of Health and Mental Hygiene

Current through Register Vol. 51, No. 14, July 12, 2024
A. An applicant or a licensee shall maintain
				  records to support compliance with this chapter and ensure that all records are
				  open to inspection by the Department.
B. An applicant or a licensee shall assist
				  the Department in conducting an inspection if the Department determines that
				  the assistance is necessary to enable the Department to conduct the
				  inspection.
C. If the Department
				  issues deficiencies after an inspection, an agency shall submit a written plan
				  of correction to the Department within 10 business days of receiving the
				  Department's notice of deficiencies.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.07 - Nursing Referral Service Agencies › Section 10.07.07.08 - Administration

Current through Register Vol. 51, No. 14, July 12, 2024
A. Contractual
				  Arrangements. The regulations of this chapter do not preclude a nursing
				  referral service agency from operating with independent contractors.
B. Agency Referrals. An agency shall:
(1) Develop and implement policies and
				  procedures to screen licensed or certified health professionals and care
				  providers that include the following:
(a) A
				  State criminal history records check or a private agency background check in
				  accordance with Health-General Article, § 19-4 B-03(c), Annotated Code of
				  Maryland;
(b) Verification of
				  current professional licensure or certification under the Health Occupations
				  Article, Annotated Code of Maryland;
(c) A basic health screening including
				  tuberculosis screening;
(d)
				  Verification of references;
(e)
				  Verification of employment history;
(f) Completion of I-9 forms; and
(g) An in-person interview of a licensed or
				  certified health professional and care provider before any referral of the
				  individual is made to a client; and
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.07 - Nursing Referral Service Agencies › Section 10.07.07.09 - Sanctions

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Secretary
				  may deny, suspend, revoke, or refuse to reissue any license for inability or
				  failure to comply with this chapter. Any action taken to deny, suspend, or
				  refuse to issue a license is subject to provisions of the Administrative
				  Procedure Act, State Government Article, §
										10-201 et seq.,
				  Annotated Code of Maryland.
B. The
				  Secretary, in addition to or instead of the sanctions set forth in §A of
				  this regulation may direct the licensee to establish certain conditions for
				  continued operation, including time limits for compliance.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.07 - Nursing Referral Service Agencies › Section 10.07.07.10 - Penalty for Unlicensed Operation

Current through Register Vol. 51, No. 14, July 12, 2024
A person that operates a nursing referral services agency
					 without a license is guilty of a misdemeanor, and on conviction is subject to a
					 fine not exceeding $1,000 for the first offense and $10,000 for each subsequent
					 offense. Each day that a violation is continued after the first conviction is a
					 separate offense.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.02 - 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) Interhospital Transfer Guidelines Manual;
				  Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland
				  (January 2002).
(2) ACEP Policy
				  Statement: Emergency Department Planning and Resources Guidelines (June 2004),
				  American College of Emergency Physicians, PO Box 619911, Dallas, Texas
				  75261-9911.
(3) Guidelines for
				  Design and Construction of Hospital and Healthcare Facilities, 2001 Edition,
				  American Institute of Architects, 1735 New York Avenue, N.W., Washington D.C.
				  20006, which is incorporated in COMAR
				  10.07.01.03P.
(4) Hospital Accreditation
				  Standards, 2006 Edition, Joint Commission on Accreditation of Healthcare
				  Organizations, One Renaissance Blvd, Oakbrook Terrace, Illinois 60181, which is
				  incorporated in COMAR
				  10.07.01.09P.
(5) U.S. Centers for Disease
				  Control and Prevention Guidelines for Standard Precautions and the federal
				  Occupational Safety and Health Administration/Maryland Occupational Safety and
				  Health, Bloodborne Pathogen Standard
				  29 CFR §
												1910.1030 which is incorporated by reference
				  in COMAR 09.12.31.
(6) The Maryland
				  State Fire Prevention Code, which is incorporated by reference in COMAR
				  29.06.01.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.03 - Restrictions

Current through Register Vol. 51, No. 14, July 12, 2024
A freestanding medical facility may not use the name
					 "emergency room", "emergency department", or "hospital" in its title or
					 advertisements or on any signage.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.04 - Licensing Application Procedure

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hospital may not establish, operate, or
				  continue to operate an existing freestanding medical facility without first
				  obtaining a license from the Secretary.
B. A hospital desiring to establish a
				  freestanding medical facility shall apply to the Department for initial
				  licensure on a written or electronic form provided by the Secretary.
C. The application shall state the name of
				  the affiliated accredited hospital.
D. The application shall be accompanied by a
				  nonrefundable 3-year license fee of $3,000.
E. The Secretary shall issue a license to a
				  freestanding medical facility for a term of 3 years if the facility complies
				  with all licensing requirements.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.05 - Renewal of License

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  licensee shall file an application for license renewal with the Secretary on a
				  written or electronic form provided by the Secretary.
B. A licensed freestanding medical facility
				  shall apply for licensure within 60 days of the expiration date of its current
				  license.
C. The application fee for
				  license renewal shall be accompanied by a nonrefundable 3-year license renewal
				  fee of $2,000.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.06 - Inspections

Current through Register Vol. 51, No. 14, July 12, 2024
A. A freestanding
				  medical facility shall be open to inspection at all times by the Department for
				  annual licensure surveys, revisit surveys, and complaint
				  investigations.
B. Licensure
				  Standards. When conducting a licensure or complaint survey, the Department
				  shall use this chapter as well as the:
(1)
				  Joint Commission on Accreditation of Healthcare Organization, 2006 Hospital
				  Accreditation Standards;
(2) COMAR
				  10.07.06;
(3) COMAR
				  10.07.01.24P, .26
				  and .33; and
(4) ACEP Policy
				  Statement: Emergency Department Planning and Resources Guidelines.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.07 - Waiver

Current through Register Vol. 51, No. 14, July 12, 2024
A. Facilities that
				  are providing services on or before February 12, 2007, but do not meet all
				  requirements of this chapter, may request a waiver of specific requirements
				  from the Department.
B. All other
				  freestanding medical facilities seeking a waiver from this chapter shall submit
				  a request to the Department including the rationale for the waiver and
				  alternatives to the requirement based on clinical and technical
				  advances.
C. In its request, the
				  facility shall demonstrate that a waiver of the requirement would:
(1) Not pose a threat to patients or the
				  provision of services; and
(2) Be a
				  financial hardship for the facility to comply with that requirement.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.08 - Affiliated Hospitals

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  freestanding medical facility shall be reviewed under the affiliated hospital's
				  accreditation by the Joint Commission on Accreditation of Healthcare
				  Organizations.
B. The governing
				  body of the affiliated hospital shall provide administrative and clinical
				  oversight for the care and services provided by the freestanding medical
				  facility. Services of the facility shall be reviewed and monitored consistent
				  with the hospital's bylaws, including but not limited to:
(1) Patient safety;
(2) Peer review;
(3) Medical staff;
(4) Risk management; and
(5) Quality improvement.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.09 - Treatment of Patients

Current through Register Vol. 51, No. 14, July 12, 2024
Regardless of a patient's medical condition, insurance
					 status, or ability to pay, the freestanding medical facility shall provide
					 stabilizing treatment to a patient presenting with an emergency medical
					 condition.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.10 - Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
A. Administrative
				  Director. The freestanding medical facility shall have a full-time
				  administrative director who:
(1) Acts as a
				  liaison with the affiliated hospital;
(2) Directs the daily operation of the
				  facility; and
(3) Ensures that
				  employees are capable of providing:
(a)
				  Resuscitation;
(b)
				  Stabilization;
(c) Timely triage;
				  and
(d) Appropriate transfer of all
				  patients; and
(4)
				  Ensures that there is an organized and structured patient safety and quality
				  improvement program to monitor and improve patient care.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.11 - Quality Assurance

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  freestanding medical facility shall develop and implement a quality assurance
				  program.
B. The quality assurance
				  program shall have a quality management process that:
(1) Is multidisciplinary;
(2) Is integrated into the hospital's overall
				  quality management program that is reported to the hospital's governing
				  body;
(3) Has a structure to ensure
				  that defined program outcomes and performance measures are developed and
				  monitored regularly;
(4) Maintains
				  sufficient documentation to:
(a) Verify
				  problems;
(b) Identify
				  opportunities for improvement; and
(c) Show corrective actions taken and
				  resolution of problems;
(5) Includes review of morbidity and
				  mortality; and
(6) Evaluates
				  medical care, nursing care, utilization review, tissue review, and pre-hospital
				  care.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.12 - Laboratory Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  freestanding medical facility shall have on-site laboratory services that are
				  available during the facility's hours of operation.
B. Laboratory Licensure Standards. The
				  facility's laboratory services shall be licensed consistent with:
(1) COMAR 10.10.01;
(2) COMAR 10.10.02;
(3) COMAR 10.10.03;
(4) COMAR 10.10.04;
(5) COMAR 10.10.05;
(6) COMAR 10.10.06;
(7) COMAR 10.10.07; and
(8) COMAR 10.10.08.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.13 - Radiology Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  freestanding medical facility's radiology services shall comply with all State
				  and federal requirements for licensure.
B. Radiology services shall be available on
				  site at all times that the facility is open for business consistent with
				  "Radiological, Imaging, and Other Diagnostic Services", ACEP Policy Statement:
				  Emergency Department Planning and Resources Guidelines, Page 12, except for the
				  sections related to Nuclear Medicine, Radiographic Services, and Vascular/flow
				  Studies including impedance plethysmography.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.14 - Pharmacy Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Pharmacy services for freestanding medical facility patients may be provided
				  by:
(1) The facility's affiliated hospital;
				  or
(2) A contracted
				  pharmacy.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.15 - Access to Emergency Medical Services

Current through Register Vol. 51, No. 14, July 12, 2024
An emergency medical facility shall meet the requirements
					 of the Maryland Institute for Emergency Medical Services Systems to be eligible
					 to accept patients through the Emergency Medical System.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.16 - Transfer of Patients

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  freestanding medical facility shall have pre-arranged transfer agreements with
				  facilities that are capable of providing definitive care appropriate for the
				  nature and severity of the patient's illness or injury.
B. Patient transfers shall be consistent with
				  the Interhospital Transfer Guidelines published by the Maryland Institute for
				  Emergency Medical Services System.
C. When transfer by ambulance is medically
				  necessary the facility shall transfer the patient via:
(1) A hospital owned and operated ambulance
				  service;
(2) A contracted ambulance
				  service; or
(3) An ambulance
				  service through an agreement with the local emergency medical system (EMS)
				  jurisdictional program.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.17 - Medical Records

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  freestanding medical facility shall ensure that staff members develop a legible
				  and appropriate medical record for each patient who visits the facility for
				  treatment.
B. Security and
				  Disclosure of Medical Information. The freestanding medical facility shall:
(1) Maintain records in a secure manner that
				  protects the confidentiality of patient information at all times;
(2) Develop and implement policies and
				  procedures for disclosure of patient medical records and patient access to
				  their medical records, including the costs for retrieving and copying records
				  as defined in Health-General Article, §§4-301 - 4-309, Annotated Code
				  of Maryland; and
(3) Make medical
				  records available to emergency medical services agencies for outcome data as
				  directed by the Maryland Institute for Emergency Medical Services
				  System.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.18 - Nourishing Snacks

Current through Register Vol. 51, No. 14, July 12, 2024
A freestanding medical facility shall maintain a supply of
					 nourishing snacks for patients who may require them. The facility shall provide
					 appropriate storage facilities, including refrigeration for the nourishing
					 snacks.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.19 - Infection Control

Current through Register Vol. 51, No. 14, July 12, 2024
The freestanding medical facility shall comply with the
					 U.S. Centers for Disease Control and Prevention guidelines for standard
					 precautions and the federal Occupational Safety and Health
					 Administration/Maryland Occupational Safety and Health, Bloodborne Pathogen
					 Standard, except in a life-threatening emergency in which compliance is not
					 feasible or practicable.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.20 - Equipment and Supplies

Current through Register Vol. 51, No. 14, July 12, 2024
The freestanding medical facility shall have equipment and
					 supplies available consistent with the "Suggested Equipment and Supplies for
					 Emergency Departments," ACEP Policy Statement: Emergency Department Planning
					 and Resources Guidelines, pages 7-10.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.21 - Physical Environment

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Construction and Zoning. The freestanding medical facility shall comply with
				  the following construction and zoning requirements:
(1) All federal, State, and local building,
				  construction and zoning laws; and
(2) "Guidelines for Design and Construction
				  of Hospital and Healthcare Facilities, (2001 Edition)," Section 9.6
				  Freestanding Emergency Facility and other applicable sections.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.22 - Emergency Preparedness

Current through Register Vol. 51, No. 14, July 12, 2024
The freestanding medical facility shall develop an
					 emergency preparedness plan to address internal and external emergencies. The
					 emergency plan shall identify the manner by which the facility will interface
					 with local emergency services and the affiliated hospital in the event of a
					 major disaster.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.23 - 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.
B. Notice of Emergency Suspension. The
				  Department shall deliver a written notice to the licensee:
(1) Informing the licensee 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 licensee 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 10.07.08 - Freestanding Medical Facilities › Section 10.07.08.24 - Sanctions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In addition to
				  other penalties available under State law, the Department may impose sanctions
				  against a freestanding medical facility that fails to comply with
				  Health-General Article, Subtitle 3A, Annotated Code of Maryland, or the
				  regulations of this chapter. The sanctions include:
(1) A civil penalty not to exceed
				  $10,000;
(2) Restrictions on the
				  operation of the freestanding medical facility;
(3) A directed plan of correction;
				  and
(4) Suspension or revocation of
				  the freestanding medical facility's license.