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 10.07.01.01 - 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) "Accredited hospital" means a hospital
				  accredited by The Joint Commission or other accreditation organization approved
				  by the Department.
(2) "Accredited
				  special rehabilitation hospital" means a hospital that is accredited by the
				  Commission on Accreditation of Rehabilitation Facilities for providing
				  comprehensive physical rehabilitation services.
(2-1) "Accreditation organization" means a private entity
					 that conducts inspections and surveys of health care facilities based on
					 nationally recognized and developed standards.
(3) "Administrative day" means a day of care
				  rendered to a patient who no longer requires the level of care the hospital is
				  licensed to provide.
(4)
				  "Admission" means the formal acceptance by a hospital of a patient who is to be
				  provided with room, board, and medical services.
(4-1) Aftercare.
(a) "Aftercare" means any assistance provided
				  by a lay caregiver to a patient after discharge of the patient.
(b) 'Aftercare" includes tasks that are
				  limited to the patient's condition at the time of discharge that do not require
				  a licensed professional.
(5) "Agent" means the individual or
				  individuals, or organization that shall conduct utilization review activities
				  in fulfillment of a hospital's responsibilities under these regulations. The
				  agent may be a hospital employee or employees, or it may be an independent
				  group or organization.
(6)
				  "Appointment" means designation of a physician to have staff privileges at the
				  hospital.
(7) "Authorized decision
				  maker" means the health care agent, guardian of the person, or surrogate
				  decision maker who is making health care decisions on behalf of a patient in
				  accordance with the Health Care Decisions Act, Health-General Article,
				  §§5-601 -5-618, Annotated Code of Maryland.
(8) "Calculated licensed bed capacity" means
				  the total number of inpatient beds recalculated annually as 140 percent of a
				  general hospital's average daily census as determined by the Health Services
				  Cost Review Commission for the most recent 12-month period.
(9) "Claim" means a written demand for
				  damages as a result of alleged professional malpractice.
(10) "Commission on Accreditation of
				  Rehabilitation Facilities" means the private, nonprofit organization formed in
				  1966 which has established standards of quality for rehabilitation services and
				  accredits those who provide the services.
(11) "Comprehensive physical rehabilitation
				  services" has the same meaning as defined in Health-General Article,
				  §19-1201(b), Annotated Code of Maryland.
(12) "Credentialing process" means the
				  process by which a hospital:
(a) Verifies
				  qualifications of a physician;
(b)
				  Delineates clinical privileges of a physician; and
(c) Monitors performance of a
				  physician.
(13)
				  "Department" means the Department of Health and Mental Hygiene.
(14) "Elective", when applied to admission or
				  to a health care service, means an admission or service that can be delayed
				  without substantial risk to the health of the individual.
(15) "Healthcare-associated infection" means
				  an infection that:
(a) Develops in a patient
				  who is cared for in any setting where healthcare is delivered; and
(b) Was not incubating or present at the time
				  the healthcare was provided.
(16) "Hospital" means an institution that:
(a) Has a group of at least five physicians
				  who are organized as a medical staff for the institution;
(b) Maintains facilities to provide, under
				  the supervision of the medical staff, diagnostic and treatment services for two
				  or more unrelated individuals; and
(c) Admits or retains the individuals for
				  overnight care.
(17)
				  "Incident" means any circumstance or occurrence that may be injurious to a
				  patient or that may result in an adverse outcome to a patient.
(18) "The Joint Commission" means the
				  voluntary national healthcare accreditation service recognized for Medicare
				  certification purposes by Public Law 89-97 and for Maryland State licensure
				  purposes by Health-General Article, §19-2302, Annotated Code of
				  Maryland.
(18-1) "Lay caregiver"
				  means an individual who:
(a) Is an
				  adult;
(b) Is designated as a lay
				  caregiver by a patient or the legal guardian of a patient; and
(c) Performs aftercare for the patient at the
				  residence of the patient.
(19) "License" means a license issued by the
				  Secretary to operate a hospital in this State.
(20) "Long-term care" means, for the purpose
				  of this chapter, care provided in a hospital, but is designed to treat
				  conditions requiring treatment at a level below that of acute hospital
				  care.
(21) "Maryland Medical
				  Assistance Program" means the program administered by the State under Title XIX
				  of the Social Security Act which provides comprehensive medical and other
				  health-related care for eligible categorically and medically needy persons. For
				  the purpose of this chapter, this shall include those persons provided care
				  under the program administered and financed by the State for eligible needy
				  persons who do not meet the technical requirements of federally funded Medical
				  Assistance.
(22) "Medical Orders for
				  Life Sustaining Treatment (MOLST) form" means the form required to be developed
				  pursuant to Health-General Article, §5-608.1, Annotated Code of Maryland.
(23) "Medicare Program" means the
				  federal program of health insurance for the aged and disabled established
				  pursuant to 42 U.S.C. §
												1395 et seq.
(24) "Nonaccredited hospital" means a:
(a) Hospital not accredited by The Joint
				  Commission or other accreditation organization approved by the Department;
				  or
(b) Special rehabilitation
				  hospital not accredited by The Joint Commission.
(25) "Nonelective", when applied to admission
				  or to a health care service, means an admission or service that cannot be
				  delayed without substantial risk to the health of the individual.
(26) "Palliative care" means specialized
				  medical care for individuals with serious illnesses or conditions that:
(a) Is focused on providing patients with
				  relief from the symptoms, pain, and stress of a serious illness or condition,
				  whatever the diagnosis;
(b) Has the
				  goal of improving quality of life for the patient, the patient's family, and
				  other caregivers;
(c) Is provided
				  at any age and at any stage in a serious illness or condition; and
(d) Can be provided along with curative
				  treatment.
(27)
				  "Palliative care program" means an interdisciplinary team that provides
				  palliative care services.
(28)
				  "Physician" has the meaning stated under Health Occupations Article, §
											14-101(j),
				  Annotated Code of Maryland.
(29)
				  "Plan" means a thorough written specification of how the elements of review
				  required by these regulations shall be performed.
(30) "Privilege" means the authority granted
				  to a physician by a hospital to:
(a) Admit
				  patients to the hospital; or
(b)
				  Perform specific procedures or treatments on patients at the
				  hospital.
(30-1) 
				  Residence.
(a) "Residence " means a dwelling
				  that a patient considers to be home.
(b) "Residence " does not include:
(i) A rehabilitation facility;
(ii) A hospital;
(iii) A nursing home;
(iv) An assisted living; or
(v) A group home licensed by the State.
(31)
				  "Secretary" means the Secretary of Health and Mental Hygiene.
(32) "Specialized rehabilitation program" has
				  the meaning stated in Health-General Article, §19-1201(e), Annotated Code
				  of Maryland.
(33) Telemedicine.
(a) "Telemedicine" means the use of
				  interactive audio, video, or other telecommunications or electronic technology
				  by a physician in the practice of medicine outside the physical presence of the
				  patient.
(b) "Telemedicine" does
				  not include:
(i) An audio only telephone
				  conversation between the physician and patient;
(ii) An electronic mail message between a
				  physician and a patient; or
(iii) A
				  facsimile transmission between a physician and a patient.
(34) "Unexpected adverse
				  outcomes" means unanticipated negative outcomes related to a patient's medical
				  treatment and not related to the natural course of the patient's illness or
				  underlying disease condition.
(35)
				  "Uniform standard credentialing form" means:
(a) The form designated by the Department
				  through COMAR
				  10.07.01.24C(6)
				  for credentialing physicians who seek to be employed by or have staff
				  privileges at a hospital; or
(b)
				  The uniform credentialing form that the Insurance Commissioner designates under
				  Insurance Article, §15"112.1, Annotated Code of
				  Maryland.
(36)
				  "Utilization review" means a system for reviewing the appropriate and efficient
				  allocation of hospital resources and services given or proposed to be given to
				  a patient or group of patients.
(37) "Utilization review plan" means a
				  description of the standards governing utilization review activities performed
				  by a private review agent or hospital utilization review agent.