reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.01 - Surgical Abortion Facilities › Section 10.12.01.20 - Hearings

Current through Register Vol. 51, No. 14, July 12, 2024
A. A request for a
				  hearing shall be filed with the Office of Administrative Hearings, with a copy
				  to the Office of Health Care Quality of the Department, not later than 30 days
				  after receipt of notice of the Secretary's action. The request shall include a
				  copy of the Secretary's action.
B.
				  A hearing requested under this chapter shall be conducted in accordance with:
(1) State Government Article, §§
											10-201 -10-227,
				  Annotated Code of Maryland;
(2)
				  COMAR 28.02.01; and
(3) COMAR
				  10.01.03.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.02 - Rape and Sexual Offenses-Physician and Hospital Charges › Section 10.12.02.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
These regulations outline the requirements for the
					 collection of evidence in cases of alleged rape, sexual offense, and child
					 sexual abuse and for reimbursement to hospitals, laboratories, and physicians
					 for the physical examination of, the collection of evidence from, and the
					 emergency treatment of individuals for physical injuries directly resulting
					 from the alleged rape or sexual assault and for an initial assessment, and
					 information and evidence collection, of a victim of alleged child sexual
					 abuse.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.02 - Rape and Sexual Offenses-Physician and Hospital Charges › Section 10.12.02.03 - Alleged Rape or Sexual Offense Victim Care

Current through Register Vol. 51, No. 14, July 12, 2024
A. The victim shall be considered an
				  emergency patient with special needs. The victim shall be taken immediately to
				  a quiet private area where tests and examinations will be performed on the
				  victim. The following measures are indicated under certain circumstances:
(1) Prophylactic medication shall be
				  discussed and offered to the victim who is at risk for pregnancy as a result of
				  the alleged rape or sexual assault;
(2) Prophylactic medication shall be
				  discussed and offered to the victim who is at risk for sexually transmitted
				  infections and recommended initial tests and follow-up tests shall be
				  performed, if indicated;
(3) After
				  the victim has been properly informed as to the significance of testing for the
				  presence of the human immunodeficiency virus (HIV), the victim shall be
				  referred to the appropriate anonymous or confidential, and free HIV counseling
				  and test sites for potential baseline and follow-up testing and support
				  services;
(4) Injuries suffered by
				  the victim shall be treated with appropriate consultation, as necessary;
				  and
(5) Tetanus prophylaxis may be
				  administered, if indicated.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.02 - Rape and Sexual Offenses-Physician and Hospital Charges › Section 10.12.02.04 - Alleged Child Sexual Abuse Victim Care

Current through Register Vol. 51, No. 14, July 12, 2024
A. The professional involved in the care of
				  the victim of alleged child sexual abuse shall make every effort to minimize
				  additional physical or emotional trauma to the child.
B. The following protocol is recommended for
				  the initial assessment:
(1) A history of the
				  child shall be obtained from the parent, guardian, or custodian separately from
				  the child, if possible, and shall:
(a)
				  Minimize repetitive questioning of the child;
(b) Recognize that the child is often
				  threatened and afraid to tell; and
(c) Include a review of behavior relevant to
				  sexual abuse;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.02 - Rape and Sexual Offenses-Physician and Hospital Charges › Section 10.12.02.05 - Reimbursements

Current through Register Vol. 51, No. 14, July 12, 2024
A. Restrictions. A
				  provider:
(1) May not charge the victim or
				  the victim's family of an alleged rape, sexual offense, or child sexual abuse
				  for a physical examination or an initial assessment for the purpose of
				  establishing and gathering information and evidence as to the alleged crime or
				  for emergency hospital treatment and follow-up medical testing performed up to
				  90 days after the initial physical examination;
(2) May not bill a victim of an alleged rape,
				  sexual offense, or child sexual abuse, or the victim's family or private
				  insurance, for any difference between charges and Department reimbursement;
				  and
(3) Shall accept the
				  Department's reimbursement as payment in full.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.03 - Cosmetic Surgical Facilities › Section 10.12.03.01 - 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) Cosmetic Surgical Facility.
(a) "Cosmetic surgical facility" means an
				  office or a facility in which a cosmetic surgical procedure is performed.
(b) "Cosmetic surgical facility"
				  does not include:
(i) An ambulatory surgical
				  facility;
(ii) A hospital; or
(iii) An office owned or operated
				  by one or more dentists providing services within the scope of practice of
				  dentistry.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.03 - Cosmetic Surgical Facilities › Section 10.12.03.02 - License Required

Current through Register Vol. 51, No. 14, July 12, 2024
A. A person
				  may not establish or operate a cosmetic surgical facility without obtaining a
				  license from the Secretary.
B.
				  License Period and Fee.
(1) A license is
				  valid for 3 years from the date of issuance, unless suspended or revoked by the
				  Secretary.
(2) The applicant shall
				  submit a nonrefundable fee of $3,000 for a 3-year period, with an application
				  for initial licensure, or submit a nonrefundable fee of $3,000 with an
				  application for license renewal for a 3-year period.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.03 - Cosmetic Surgical Facilities › Section 10.12.03.03 - Licensing Procedures

Current through Register Vol. 51, No. 14, July 12, 2024
A. A person
				  desiring to operate a facility shall:
(1) Be
				  in compliance with all applicable federal, State, and local laws and
				  regulations and be accredited as a cosmetic surgical facility by:
(a) The American Association for
				  Accreditation of Ambulatory Surgical Facilities;
(b) The Accreditation Association for
				  Ambulatory Health Care;
(c) The
				  Joint Commission; or
(d) An
				  accreditation organization approved by the Secretary; or
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.03 - Cosmetic Surgical Facilities › Section 10.12.03.04 - Service Standards

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  licensee is responsible for compliance with all laws and regulations applicable
				  to the operation of a cosmetic surgical facility including a physician's
				  compliance with Health Occupations Article, §
										14-404(a)(41),
				  Annotated Code of Maryland.
B.
				  Accreditation Standards.
(1) The licensee
				  shall meet the standards for the operation of a cosmetic surgical center issued
				  by the licensee's accreditation organization.
(2) If a licensee loses its accreditation,
				  the licensee shall immediately:
(a) Cease
				  operations;
(b) Notify the
				  Department; and
(c) Return the
				  license certificate to the Department.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.03 - Cosmetic Surgical Facilities › Section 10.12.03.05 - Investigation by the Secretary

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  The Secretary may investigate complaints concerning the conformance of a
				  cosmetic surgical facility to the requirements of this chapter and for
				  compliance with the standards for the operation of a cosmetic surgical center
				  issued by its accreditation organization.
B. A facility shall be open during normal
				  business hours, or any other times that the facility is serving patients, for
				  inspection by the Department and by any other agency designated by the
				  Secretary to investigate complaints.
C. The Department shall refer complaints
				  concerning a health care practitioner's performance or a health care
				  practitioner's conformance to the standards of medical practice to the
				  appropriate health occupations board that licenses, certifies, or otherwise
				  regulates the health care practitioner under the Health Occupations Article,
				  Annotated Code of Maryland.
D.
				  Noncompliance.
(1) If the Secretary
				  determines that a licensee fails to meet any provision of this chapter or fails
				  to comply with the standards for the operation of a cosmetic surgical center
				  issued by its accreditation organization, the Secretary shall:
(a) Advise the licensee of the exact nature
				  of the violation; and
(b) Require
				  that the facility specify what corrective action it is taking and monitor the
				  facility to ensure that it takes corrective action.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.03 - Cosmetic Surgical Facilities › Section 10.12.03.06 - Medical Records

Current through Register Vol. 51, No. 14, July 12, 2024
A. The facility
				  shall maintain a complete, comprehensive, and accurate medical record for a
				  patient.
B. A patient's medical
				  record shall include at least the following:
(1) Patient identifier;
(2) Significant medical history and results
				  of a physical examination;
(3)
				  Documentation of care or services provided;
(4) Evidence of consent; and
(5) Discharge diagnosis.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.03 - Cosmetic Surgical Facilities › Section 10.12.03.07 - Patients' Rights

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  administrator shall ensure that the facility develops and implements written
				  policies and procedures concerning patients' rights and responsibilities.
B. The facility shall make the
				  policies and procedures available to patients, guardians, and other health care
				  decision makers, as defined by Health-General Article, Title 5, Subtitle 6,
				  Annotated Code of Maryland, and the public.
C. The policies and procedures shall require
				  that:
(1) The facility informs patients of
				  services that are available and the charges for services not covered by
				  third-party payors;
(2) A
				  physician, dentist, podiatrist, or other qualified health care practitioner
				  informs patients of their medical conditions unless medically contraindicated
				  as documented in their medical records;
(3) All patients are afforded an opportunity
				  to participate in planning their medical treatments and to refuse to
				  participate in experimental research; and
(4) All patients are ensured confidential
				  treatment of their medical records, and may approve or refuse release of
				  records to any individual outside the facility, except as provided by federal
				  or State law.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.03 - Cosmetic Surgical Facilities › Section 10.12.03.08 - Physical Environment

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  facility shall meet all federal, State, and local laws, ordinances, and
				  regulations for construction.
B.
				  The facility shall meet all safety requirements of the National Fire Protection
				  Association, NFPA 101 "Life Safety Code", which is incorporated by reference at
				  COMAR 29.06.01.06.
C. The facility
				  shall meet the requirements for the handling, treatment, and disposal of
				  special medical wastes as provided in COMAR 10.06.06.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.03 - Cosmetic Surgical Facilities › Section 10.12.03.09 - Emergency Suspension

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Secretary may immediately suspend a license on a finding that the public
				  health, safety, or welfare 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 the licensee's
				  right to request a hearing and to be represented by counsel.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.03 - Cosmetic Surgical Facilities › Section 10.12.03.10 - Revocation of License

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Secretary, for good cause shown, shall notify the licensee of the Secretary's
				  decision to revoke the facility's license. The revocation shall be stayed if a
				  hearing is requested.
B. The
				  Secretary may revoke a license if the licensee:
(1) Has been convicted of a:
(a) Felony that relates to Medicaid or
				  Medicare; or
(b) Crime involving
				  moral turpitude;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.03 - Cosmetic Surgical Facilities › Section 10.12.03.11 - Penalties

Current through Register Vol. 51, No. 14, July 12, 2024
A. Administrative
				  Penalty. The Secretary may impose an administrative penalty of up to $1,000 for
				  a violation of any provision of this chapter.
B. When considering whether to impose an
				  administrative penalty and the amount of the penalty, the Secretary shall
				  consider the following factors:
(1) The
				  number, nature, and seriousness of the violations;
(2) The extent to which the violation or
				  violations are part of an ongoing pattern during the preceding 24 months;
(3) The degree of risk, caused by
				  the violation or violations, to the health, life, or safety of the patients of
				  the facility;
(4) The efforts made
				  by, and the ability of, the licensee to correct the violation or violations in
				  a timely manner; and
(5) Such
				  other factors as justice may require.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.03 - Cosmetic Surgical Facilities › Section 10.12.03.12 - Hearings

Current through Register Vol. 51, No. 14, July 12, 2024
A. A request for a
				  hearing shall be filed with the Office of Administrative Hearings, with a copy
				  to the Office of Health Care Quality of the Department, not later than 30 days
				  after receipt of notice of the Secretary's action. The request shall include a
				  copy of the Secretary's action.
B.
				  A hearing requested under this chapter shall be conducted in accordance with:
(1) State Government Article, §
											10-201 et seq.,
				  Annotated Code of Maryland;
(2)
				  COMAR 28.02.01; and
(3) COMAR
				  10.01.03.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
A. This chapter
				  applies to day care centers for the elderly and adults with a medical
				  disability as defined in Health-General Article, Title 14, Subtitles 2 and 3,
				  Annotated Code of Maryland.
B. This
				  chapter does not:
(1) Affect a relative,
				  domestic partner, neighbor, or friend who cares for an individual with a
				  medical disability by mutual agreement; or
(2) Apply to nutrition sites, senior centers
				  under the auspices of the Department of Aging, or social model programs that
				  individuals may attend to participate in meals or diversion
				  activities.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.02 - 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) Eating or
				  being fed;
(b) Grooming, bathing,
				  and oral hygiene;
(c) Mobility,
				  transfer, ambulation, and use of environmental aids to assist the individual to
				  achieve greater independence;
(d)
				  Toileting; and
(e)
				  Dressing.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.03 - License Required

Current through Register Vol. 51, No. 14, July 12, 2024
A. A person
				  may not establish, operate, or continue the operation of a center without first
				  obtaining a license from the Secretary.
B. Separate License Required Separate
				  licenses are required for centers that are maintained on separate premises,
				  even though the centers are operated under the same management
C. Posting of License. A center shall post
				  its license in a conspicuous place on the premises to which it
				  applies.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.04 - Licensing Procedure

Current through Register Vol. 51, No. 14, July 12, 2024
A. Letter
				  of Interest
(1) A person desiring to obtain
				  initial licensure for an adult day care center shall submit a letter of
				  interest to the Office of Health Care Quality that contains the following:
(a) Policies and procedures that address
				  medical record completion and retention, the administration and storage of
				  medications, nutrition services, social work support, employee criminal
				  background checks, transportation of participants and participant
				  activities;
(b) identification of
				  the individual or individuals or business entity that will own and operate the
				  adult medical day care program;
(c)
				  The job description and qualifications for each position;
(d) The projected hours of operation, daily
				  census, and the staffing plan that addresses both licensed and non-licensed
				  staff coverage; and
(e)
				  Verification that the structural design plans for the proposed adult medical
				  day care program have been forwarded to the Department's Plans Review and
				  Approval Unit
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.05 - Changes in a Program that Affect the Operating License

Current through Register Vol. 51, No. 14, July 12, 2024
A. Increase in Capacity or Name Change.
(1) During the license period, a licensee may
				  not increase capacity, change its name, or change the name under which the
				  program is doing business without the Department's approval. When there is a
				  change of program ownership or a change of location, the licensee shall submit
				  a new application and written request for a new license with an application
				  fee, as established in Regulation .04A(2) of this chapter to the
				  Department.
(2) Sale, Transfer, or
				  Lease of a Center.
(a) If a sale, lease or
				  any other transaction causes a change in the individual or individuals who
				  control or operate the center, the center shall be considered a new program and
				  the new owner-operator shall apply for a new license and conform to all
				  regulations applicable at the time of transfer of operations.
(b) The transfer of any stock which results
				  in a change of the individual or individuals who control the program or the
				  transfer of any stock in excess of 25 percent of the outstanding stock
				  constitutes a sale.
(c) For the
				  purpose of Life Safety Code enforcement, the program is considered an existing
				  center if it has been in continuous use as an adult medical day
				  program.
(3) The
				  Department shall issue a new license on approval of:
(a) A change in licensure capacity;
(b) A change in the name of the licensee;
				  or
(c) A change in the name under
				  which the program is doing business.
(4) The licensee shall return its original
				  license to the Department by certified mail.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.06 - Waiver of Provisions

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Secretary may waive any provision of this chapter if center:
(1) Experiences practical difficulties or
				  unnecessary hardship in complying with the provisions of this chapter:
				  and
(2) Can demonstrate that
				  granting a waiver will not adversely affect the health and safety of its
				  participants.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.07 - Inspection by the Department

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Center Open for Inspection.
(1) A licensed
				  center and any premises proposed to be operated as a center shall be open at
				  all reasonable times to announced or unannounced inspections by the Department
				  and by any agency designated by the Department.
(2) Any part of the center, and any
				  surrounding accessory buildings, are considered part of the center and are
				  subject to inspection.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.08 - Compliance Monitoring

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Department shall monitor or inspect a center at least once every 2 years to
				  ensure compliance with the requirements of this chapter.
B. The Department may conduct unannounced or
				  announced licensure or complaint investigation visits as frequently as
				  necessary to ensure compliance with this chapter or for the purpose of
				  investigating a complaint.
C. In
				  accordance with a written agreement, the Department may delegate certain
				  aspects of its monitoring or inspection responsibilities to a local health
				  department.
D. Notice of
				  Violations. If a complaint investigation or survey inspection identifies a
				  regulatory violation, the Department shall issue a notice:
(1) Citing the violation;
(2) Requiring the center to submit an
				  acceptable plan of correction within 10 calendar days of receipt of the notice
				  of violation or deficiency;
(3)
				  Notifying the center of sanctions or that failure to correct the violation may
				  result in sanctions; and
(4)
				  Offering the center the opportunity for informal dispute resolution
				  (IDR).
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.09 - Administration

Current through Register Vol. 51, No. 14, July 12, 2024
A. Governing Body.
				  The governing body shall establish and maintain sound operating procedures,
				  including:
(1) Maintenance of an identifiable
				  administrative unit, headed by a director who is responsible for the overall
				  conduct of all center activities;
(2) Adoption of an annual budget;
				  and
(3) Provision of staff capable
				  of performing the center's program.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.10 - Days and Hours of Operation

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  The center shall be open to participants for at least 6 hours per day 5 days a
				  week, exclusive of holidays and other planned closings.
B. The center's hours of operation shall be
				  posted in a prominent place accessible to and easily seen by
				  participants.
C. The public and
				  participants shall be notified of planned closings.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.11 - Preadmission Assessment

Current through Register Vol. 51, No. 14, July 12, 2024
A. Before
				  admission, the center shall obtain a written assessment from the prospective
				  participant's health care provider, who shall certify that the information
				  provided reflects the individual's health status within 45 days of the
				  individual's admission. Upon request and for good cause shown, the Department
				  may grant an exception to all or part of the preadmission assessment.
B. Written Assessment. The health care
				  provider's assessment shall include:
(1)
				  Recent medical history, including any acute medical condition or
				  hospitalization;
(2) Significant
				  medical conditions affecting function, including the individual's ability for
				  self-care, cognition, physical conditions, and behavioral and psychosocial
				  status;
(3) Other active and
				  significant chronic or acute medical diagnoses;
(4) Known allergies to medications,
				  environment, and food;
(5) Medical
				  confirmation that the individual is free from communicable disease and other
				  active reportable airborne diseases;
(6) Current and other needed medications and
				  treatments and the ability of the individual to self-medicate or
				  self-treat;
(7) Information on
				  status of advanced directives for health care;
(8) Current nutritional status including
				  height, weight, risk factors, and deficits;
(9) Diets ordered by the health care
				  provider;
(10) Medically necessary
				  limitations or precautions; and
(11) Monitoring or performance of tests after
				  admission.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.12 - Admission Criteria

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  center shall develop written criteria for admission. These criteria shall be
				  specific so that the center does not accept individuals whose needs cannot be
				  met by the center.
B. Admission
				  Criteria. The admission criteria shall include at least the following:
(1) The center may not discriminate against
				  the intended participant because of race, color, or national origin according
				  to Title VI of the Civil Rights Act of 1964, 42 U. S. C. § 2000 or as
				  otherwise provided by law;
(2) The
				  center may not deny admission to or involuntarily discharge an individual
				  solely because the individual has a communicable disease.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.13 - Participant Rights

Current through Register Vol. 51, No. 14, July 12, 2024
A. The adult
				  day care center shall provide care for participants in
(1) A manner and in an environment that
				  maintains or enhances each participant's dignity and respect; and
(2) Full recognition of the participant's
				  individuality.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.14 - Staff

Current through Register Vol. 51, No. 14, July 12, 2024
A. Staffing
				  Pattern.
(1) Staffing Ratio.
(a) The staff to participant ratio at each
				  center shall be minimum of one staff to seven participants (1:7) for a period
				  of years after the final adoption of COMAR 10.12.04.14A(1)(a).
(b) Two years after the final adoption of
				  COMA 10.12.04.14A(1)(a), the staffing ratio at each center shall be determined
				  by the needs of each program participant as determine in the ADCAPS.
(c) Staffing shall at all times be sufficient
				  to meet the need of the participants.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.15 - Program Components-Required Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. Health Services.
(1) Nursing Services. The center shall
				  provide nursing services under the direction of a registered nurse. The
				  licensee shall fully disclose the services that will be provided outside the
				  adult medical day care center's hours of operation, in the service contract
				  agreement. The registered nurse may delegate nursing services as appropriate,
				  to other staff in accordance with COMAR 10.27.09, 10.27.10, and
				  10.27.11.05H(1)-(3).
(2) Consultation with the Health Care
				  Provider. The RN or LPN nurse shall communicate with the participant's health
				  care provider to report observed changes in the participant's health status,
				  including reaction to medicine, and to obtain current medical orders regarding
				  such items as diet, medications, and treatments. The center shall assist
				  participants in locating a regular source of health care if a participant does
				  not have a health care provider.
(3) Mental Health Services. For participants
				  with mental health needs, the program shall provide, when needed, linkage,
				  collaboration, and coordination with the participant's treating psychiatrist or
				  other mental health professional.
(4) Observation. The registered nurse or the
				  licensed practical nurse shall observe the health, functional status, and
				  adherence to a prescribed medical regimen, and document his or her observations
				  in the participant's medical record at least monthly.
(5) The center shall provide meals and snacks
				  to participants in accordance with Regulation .20 of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.16 - Program Components

Current through Register Vol. 51, No. 14, July 12, 2024
A. Special
				  Services.
(1) The center shall provide or
				  make arrangements for the services listed in §A(2)-(8) of this regulation
				  when the center admits participants that require these services.
(2) Diet Modifications. The center shall
				  provide special diets and other diet modifications as ordered by the
				  participant's health care provider.
(3) Rehabilitative Services. Rehabilitative
				  services may include:
(a) Physical
				  therapy;
(b) Occupational therapy;
				  and
(c) Speech pathology provided
				  directly, or indirectly, through arrangements with qualified
				  personnel.
(4) Social
				  Services. A licensed social worker shall provide social work services to
				  participants. If social and emotional needs are identified during the
				  assessment that is required in Regulation .10 of this chapter, a licensed
				  social worker shall be consulted before the establishment of goals to meet
				  those needs.
(5) Mental Health
				  Services. When mental health needs are identified, the program shall seek
				  consultation from a mental health professional authorized under the Health
				  Occupations Article, Annotated Code of Maryland.
(6) Services for the Developmentally
				  Disabled. For individuals provided residential services through the
				  Developmental Disabilities Administration, the center shall incorporate the
				  individual plan (IP) in the development of the individual's plan of care and
				  the activities plan.
(7) Medical
				  Consultation. The center may use specialists on a part-time or consultant basis
				  in:
(a) Psychiatry;
(b) Physiatrics;
(c) Orthopedics; or
(d) Other specialties according to the needs
				  of the participants.
(8)
				  Other Special Services. The center may provide the following services as
				  needed:
(a) Alcoholism counseling;
(b) Podiatry;
(c) Dentistry;
(d) Nutrition counseling;
(e) Health education; and
(f) Other services depending upon
				  need.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.17 - Medication Services and Policies

Current through Register Vol. 51, No. 14, July 12, 2024
A. Written policies for the center shall
				  specify that the RN, LPN, or CMT is authorized to procure, receive, control,
				  and manage the administration of medications at the center.
B. Medications.
(1) Medicine or drugs shall be restricted to
				  those prescribed for the participant by the authorized prescriber.
(2) All medications shall be accurately and
				  plainly labeled and kept in the original container issued by the prescriber or
				  pharmacist except as provided in §F(3) of this regulation.
(3) Containers shall be labeled with the:
(a) Participant's full name;
(b) Authorized prescriber;
(c) Prescription number;
(d) Name of the medication and
				  dosage;
(e) Date of
				  issuance;
(f) Expiration
				  date;
(g) Refill limits;
(h) Directions for use; and
(i) Name, address, and telephone number of
				  the pharmacy issuing the drug.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.18 - Orders

Current through Register Vol. 51, No. 14, July 12, 2024
A. Orders
				  concerning medication, treatment, and diet shall be in effect for the specified
				  number of days indicated by the health care provider. If not specified, the
				  period may not exceed 6 months.
B.
				  Verbal Orders.
(1) A licensed nurse shall
				  take verbal medication orders from a health care provider.
(2) The nurse shall immediately write orders
				  into the participant's record, and sign and date the note.
(3) The original or faxed medication order
				  shall be included in the medical record within 10 calendar days after the date
				  of the telephone order.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.19 - First-Aid and Cardiopulmonary Resuscitation

Current through Register Vol. 51, No. 14, July 12, 2024
A. At least one staff member who is trained
				  in first aid and in cardiopulmonary resuscitation (CPR) shall be on-site at the
				  center when participants are in attendance, during outings, medical
				  appointments or during transportation of participants.
B. At least one staff member who is trained
				  in CPR and first aid shall accompany participants taken outside of the center
				  for outings and other activities.
C. First aid administered by staff shall be
				  limited to that necessary to preserve life or to prevent further immediate
				  danger.
D. Staff shall receive
				  first aid and CPR training from a certified provider approved by the
				  Department. Recertification shall be obtained according to the guidelines of
				  the certified provider.
E. The
				  center shall have adequate first aid supplies available for treating shock,
				  burns, and small, medium, and large wounds.
F. On a 90-day basis, staff shall inspect
				  first aid supplies in the center and in the vehicle or vehicles used for
				  transporting participants. Expiration dates of supplies and the maintenance of
				  supplies at the required levels shall be included in the inspection. The
				  findings of the inspection shall be documented at least quarterly.
G. Supplies with an expired date shall be
				  replaced immediately.
H. The center
				  shall conspicuously post a chart clearly describing first aid and emergency
				  medical treatment techniques and the names and phone numbers of health care
				  providers, ambulances, and medical facilities.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.20 - Nutrition

Current through Register Vol. 51, No. 14, July 12, 2024
A. The center shall
				  ensure that each participant who is present for 4 or more hours is provided
				  with a meal that meets 1/3 of the recommended dietary allowance of the Food and
				  Nutrition Board of the National Research Council.
B. The center shall provide snacks consisting
				  of a nourishing food or beverage, or both, to participants.
C. The minimum number of meals and snacks
				  shall be provided as follows:
Hours at Center
Minimum Meals and Snacks
Proportion of RDA
4-6 hours
1 meal and 1 snack
1/3 plus
7-8 hours
2 meals and 1 snack or 1 meal and 2 snacks
1/2
More than 8 hours
2 meals and 2 snacks
2/3
D.
				  A center may prepare food on-site if the center meets the requirements of COMAR
				  10.15.03.
E. The center shall
				  ensure that food prepared off-site from the center is prepared in a center
				  which meets the requirements of COMAR 10.15.03.
F. Therapeutic diets approved by a registered
				  and licensed dietitian shall be served only as ordered.
G. Staff shall assist participants who may be
				  unable to feed themselves, in accordance with the ADCAPS.
H. A Registered Dietitian shall perform a
				  nutritional assessment for all participants with a potential, or an actual,
				  nutritional deficit.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.21 - Comprehensive Assessments

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  participant shall receive a comprehensive assessment (ADCAPS) that is designed
				  to evaluate the participant's strengths and needs. A registered nurse shall
				  complete the initial assessment within 30 days of a participant's admission and
				  every 120 days thereafter as long as there is no change in the participant's
				  condition. The assessment shall include:
(1)
				  Health status;
(2) Functional
				  status;
(3) Participation in
				  activities;
(4) Nutritional
				  status;
(5) Psychosocial status;
				  and
(6) Home management
				  skills.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.22 - Care Planning

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Individualized Plan of Care.
(1) There shall
				  be an individualized plan of care completed for each participant within 30 days
				  following admission.
(2) The
				  participant shall participate in the development of the plan of care, along
				  with the multidisciplinary team, unless the center documents the reasons why
				  the participant is unable or unwilling to participate.
(3) The plan of care shall be consistent with
				  the comprehensive assessment and shall include a problem list.
(4) A registered nurse shall update the plan
				  of care within 7 calendar days of a participant's change in status, but not
				  less than semiannually.
(5) The
				  participant's plan of care shall be based on the comprehensive assessment that
				  is completed by registered nurse as described in Regulation .21 of this
				  chapter.
(6) The plan of care shall
				  include:
(a) Orders by a Health care
				  provider;
(b) All pertinent
				  diagnoses;
(c) Frequency and types
				  of services required;
(d) Treatment
				  goals for each type of service ordered;
(e) Rehabilitation, services, and
				  prognosis;
(f) Functional and
				  cognitive limitations;
(g) Level of
				  activity permitted;
(h)
				  Diet;
(i) Medication and treatment
				  or treatments;
(j) Measurable goals
				  for each problem or need that is identified;
(k) Goals that are realistic, practical, and
				  tailored to the desired outcome for the participant; and
(l) Approaches to accomplishing each
				  goal.
(7) The
				  multidisciplinary team shall document all components of the participant's care
				  plan in the participant's medical record;
(8) The center shall give family members, and
				  others designated by the individual with proper consent or responsible parties,
				  an opportunity to participate in the care plan meeting.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.23 - Use of Restraints

Current through Register Vol. 51, No. 14, July 12, 2024
A. Policy
				  and Procedures. The center shall have a policy and procedure on the use of any
				  device or medication for the specific purpose of restricting the participant's
				  freedom of motion or movement within the center.
B. A participant has the right to be free of
				  restraints used in violation of this chapter
C. Improper Use of Chemicals or Drugs.
				  Chemicals or drugs may not be used for participants in the following ways:
(1) In excessive dose, including duplicate
				  drug therapy;
(2) For excessive
				  duration, without adequate monitoring;
(3) Without adequate indications for its use;
				  or
(4) In the presence of adverse
				  consequences which indicate the dose should be reduced or
				  discontinued.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.24 - Discharge

Current through Register Vol. 51, No. 14, July 12, 2024
A. Before a center
				  discharges a participant, the center shall:
(1) Formulate a discharge plan, including at
				  least a 30-day written advance notice to the participant or the participant's
				  responsible party; and
(2) Assist
				  the participant in obtaining the resources needed to implement the
				  plan.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.25 - Reports and Actions Required in Unusual Occurrences

Current through Register Vol. 51, No. 14, July 12, 2024
A. The center shall immediately report an
				  occurrence such as a communicable disease or food-borne outbreak, poisoning,
				  death, fire, use of restraints or other unusual incident that threatens the
				  health or safety of any participant or staff member to:
(1) The Office of Health Care
				  Quality;
(2) The local health
				  officer, as required by law;
(3)
				  Participant; and
(4) Family and, if
				  applicable, guardian.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.26 - Records

Current through Register Vol. 51, No. 14, July 12, 2024
A. Records. The
				  center shall maintain records that are needed to operate the center, as
				  required by the Department, and to document the progress of the
				  participants.
B. Retention. The
				  center shall maintain participants' records for at least 5 years from the date
				  of discharge, except as provided in Health-General Article, §4-403,
				  Annotated Code of Maryland.
C.
				  Confidentiality. The center shall maintain records so that they are accessible
				  only to the director, the staff, emergency personnel, and to funding and
				  monitoring agencies. The center may not discuss or reveal the contents of the
				  records with any persons other than those listed above without the
				  participant's written permission.
D. Required Records.
(1) Participant Records. The center shall
				  maintain at least the following information for each participant:
(a) Name, age, sex, address, and telephone
				  number;
(b) Name and telephone
				  number of the individual to be notified in case of emergency;
(c) Next of kin;
(d) Medicare, Medicaid, or private insurance
				  member enrollment numbers related to health care benefits;
(e) Name and address of primary care
				  provider, with changes noted and dated when change occurs;
(f) Functional assessment with original and
				  revised versions noting participant progress;
(g) Assessment of the home environment at the
				  time of intake and as needed, or at change of home address;
(h) Individual plan of care;
(i) Admission physical and subsequent
				  additional information;
(j)
				  Medications and adverse drug reactions; and
(k) Accidents.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 12 - ADULT HEALTH › Chapter 10.12.04 - Day Care for the Elderly and Adults with a Medical Disability › Section 10.12.04.27 - Transportation

Current through Register Vol. 51, No. 14, July 12, 2024
A. The center shall
				  provide or arrange transportation to enable participants to attend the center
				  and to participate in activity outings, medical appointments, or other
				  participant required services.
B.
				  The center and its staff shall operate vehicles in accordance with all
				  applicable federal, State, and local requirements.
C. A participant may not be in transit for
				  more than 1 hour without an opportunity for a rest stop:
(1) For a period of 2 years after the final
				  adoption of Regulation .14A(1)(a) of this chapter; and
(2) Two years after the final adoption of
				  Regulation .14A (1)(a) of this chapter, the center shall utilize the ADCAPS to
				  determine the length of time a participant may be in transit without a rest
				  stop.