reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.12 - Prevention/Public Education

Current through Register Vol. 51, No. 14, July 12, 2024
A. Surviving acute stroke patients and their families shall receive instruction on:
(1) Signs and symptoms of acute stroke, including the importance of activating EMS;
(2) Effects and prognosis of acute stroke;
(3) Potential complications of acute stroke;
(4) Needs and rationales for treatment;
(5) Patient compliance instructions for risk reduction of individual risk factors and secondary prevention programs; and
(6) Post-stroke support services.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.13 - Policies, Protocols, Guidelines, and Agreements

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital shall develop and implement:
A. A written policy which demonstrates that the hospital has established the stroke center to:
(1) Monitor the care delivered to acute stroke patients;
(2) Improve the quality of care delivered to acute stroke patients;
(3) Move patients through the initial acute care phase of their hospital stay in a timely fashion; and
(4) Ensure that all stroke patients will receive medical care commensurate with the hospital's designation as a primary stroke center;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.11 - Designated Primary Stroke Center Standards › Section 30.08.11.14 - Quality Management

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall participate, in a manner approved by the EMS Board, in a stroke registry that includes the data elements tracked by the Centers for Medicare and Medicaid Services and the American Heart/American Stroke Get With the Guidelines®-Stroke Registry.
B. The hospital shall authorize the stroke registry to provide the hospital's data to MIEMSS for health oversight activities in a manner approved by the EMS Board.
C. Outcome Objectives.
(1) The hospital shall establish at least 2 outcome objectives that are:
(a) Time-specific;
(b) Measurable;
(c) Reflective of tracking and trending of performance measures and indicators; and
(d) Reviewed in annual comparison studies.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.01 - 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) "Capability" means having the necessary equipment and supplies as well as staff with the skill and experience in its use.
(2) "Current" means generally accepted, used, practiced, or prevalent at the moment.
(3) "Dedicated" means a resource is assigned to or for the exclusive use by a unit and not shared with any other unit
(4) "E" means the standard is essential.
(5) "O" means the standard is optional.
(6) "NA" means the standard does not apply.
(7) "Programmatic responsibility" means the writing, review, and maintenance of practice guidelines, policies, and procedures; development of the operating budget in collaboration with hospital administration and other program directors; evaluation and guiding of the purchase of equipment; planning, development, and coordinating of educational programs, both in-hospital and outreach; participation in the evaluation of perinatal care; and participation in perinatal quality improvement and patient safety activities.
(8) "Readily available" means a resource is available for use a short time after it is requested.
(9) "Telemedicine" means the use of interactive audio, video, or other telecommunications or electronic technology by a licensed health care provider to deliver a health care service within the scope of practice of the health care provider at a site other than the site at which the patient is located in compliance with COMAR 10.32.05. and including at least two forms of communication.
(10) "Thirty (30) minutes" means in-house within thirty (30) minutes under normal driving conditions which include, but are not limited to, weather, traffic, and other circumstances which may be beyond the individual's control.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.02 - Types of Perinatal Referral Centers

Current through Register Vol. 51, No. 14, July 12, 2024
A. "III" is a Level III perinatal referral center
B. "IV" is a Level a Level IV perinatal referral center.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.03 - Organization

Current through Register Vol. 51, No. 14, July 12, 2024
III
IV
A. The hospital's Board of Directors, administration, and medical and nursing staffs shall demonstrate commitment to its specific level of perinatal center designation and to the care of perinatal patients. This commitment shall be demonstrated by:
(1) A Board resolution that the hospital agrees to meet the current Maryland Perinatal System Standards for its specific level of designation and assures that all perinatal patients shall receive medical care commensurate with that designation;
E
E
(2) Submission of patient care data to the Maryland Department of Health (MDH) and the Maryland Institute for Emergency Medical Services Systems (MIEMSS), for system and quality management; and
E
E
(3) A Board resolution, bylaws, contracts, and budgets indicating the hospital's commitment to the financial, human, and physical resources and to the infrastructure that are necessary to support the hospital's level of perinatal center designation.
E
E
B. The hospital shall be licensed by the Maryland Department of Health and Mental Hygiene (DHMH) as an acute care hospital.
C. The hospital shall be accredited by The Joint Commission.
E
E
D. The hospital shall have an agreement with the Health Services Cost Review Commission that addresses how the cost of neonatal intensive care services will be incorporated into the hospital's population health budget, and the hospital shall have a certificate of need (CON) from the Maryland Health Care Commission (MHCC) in order to provide neonatal intensive care services, defined as a Level III or IV perinatal program, unless establishment of the hospital's neonatal intensive care services preceded this requirement. A hospital shall obtain a CON in order to establish Level III or IV perinatal program or to expand a Level III perinatal program to Level IV.
E
E
E. The hospital shall obtain and maintain current equipment and technology, as described in these standards, to support optimal perinatal care for the level of the hospital's perinatal center designation.
E
E
F. If maternal or neonatal air transports are accepted, then the hospital shall have a heliport, helipad, or access to a helicopter landing site near the hospital.
E
E
G. The hospital shall provide specialized maternal and neonatal transport capability and have extensive Statewide perinatal educational outreach programs in both specialties in collaboration with the Maryland Institute for Emergency Medical Services Systems (MIEMSS) and the Maryland Department of Health and Mental Hygiene (DHMH).
O
E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.04 - Obstetrical Unit Capabilities

Current through Register Vol. 51, No. 14, July 12, 2024
III
IV
A hospital shall:
A. Demonstrate its capability of providing obstetrical care through written standards, protocols, or guidelines, including those for the following:
(1) Management of uncomplicated pregnancy;
E
E
(2) Detection, stabilization, and initiation of management of unanticipated maternal-fetal problems;
E
E
(3) Fetal monitoring, including internal scalp electrode monitoring;
E
E
(4) Ability to begin emergency cesarean delivery within a time interval that best incorporates maternal and fetal risks and benefits with the provision of emergency care; and
E
E
(5) Selection and management of obstetrical patients at a maternal risk level appropriate to its capability.
E
E
B. Have an on-site intensive care unit that accepts obstetrical patients and has critical care providers on-site to actively collaborate with obstetricians or maternal-fetal medicine specialists at all times.
E
E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.05 - Neonatal Unit Capabilities

Current through Register Vol. 51, No. 14, July 12, 2024
III
IV
A hospital shall demonstrate its capability of providing neonatal care through written standards, protocols, or guidelines, including those for the following:
A. Resuscitation and stabilization of the neonate according to the current American Academy of Pediatrics/American Heart Association (AAP/AHA) Neonatal Resuscitation Program (NRP) guidelines at every delivery;
E
E
B. Detection, stabilization, and initiation of management of unanticipated neonatal problems;
E
E
C. Evaluation and care of stable term newborn infants.
E
E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.06 - Obstetric Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
III
IV
A hospital shall have:
A. A physician board-certified in obstetrics /gynecology shall be a member of the medical staff and have programmatic responsibility for obstetrical services;
E
NA
B. A physician board-certified in maternal-fetal medicine shall be a member of the medical staff and have programmatic responsibility for obstetrical services;
O
E
C. A physician board-certified in maternal-fetal medicine shall be a member of the medical staff and have programmatic responsibility for high-risk obstetrical services;
E
E
D. A physician board-certified in anesthesiology shall be a member of the medical staff and have programmatic responsibility for obstetrical anesthesia services;
E
E
E. A physician board-certified or an active candidate for board certification in maternal-fetal medicine on the medical staff, in active practice available at all times and, if needed, in-house within 30 minutes; and
E
E
F. A physician board-certified or an active candidate for board-certification in obstetrics/gynecology shall be present in-house 24 hours a day and immediately available to the delivery area when a patient is in active labor.
E
E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.07 - Pediatric Personnel

Current through Register Vol. 51, No. 14, July 12, 2024
III
IV
A hospital shall have:
A. A physician board-certified in pediatrics, neonatal-perinatal medicine, or family medicine shall be a member of the medical staff and have privileges for neonatal care and have programmatic responsibility for neonatal services in the newborn nursery and/or the mother-baby unit;
E
E
B. A physician board-certified in neonatal-perinatal medicine shall be a member of the medical staff and have programmatic responsibility for neonatal services in the special care nursery or NICU;
E
E
C. Neonatal Resuscitation Program (NRP) trained professional(s) with experience in acute care of the depressed newborn and skilled in neonatal endotracheal intubation and resuscitation shall be immediately available to the delivery and neonatal units;
E
E
D. A physician who has completed postgraduate pediatric training, a nurse practitioner, or a physician assistant with privileges for neonatal care appropriate to the level of the neonatal services shall be present in-house 24 hours a day assigned to the delivery area and neonatal units and not shared with other units in the hospital;
E
E
E. A physician board-certified or an active candidate for board certification in neonatal-perinatal medicine shall be on the medical staff, in active practice, available at all times, and, if needed, in-house within 30 minutes;
E
E
F. An ophthalmologist with experience in neonatal retinal examination and an organized program for the monitoring, treatment, and follow up of retinopathy of prematurity;
E
E
G. The following pediatric subspecialists on staff, in active practice, and, if needed, readily available in-house or via telemedicine: (1) Cardiology; (2) Neurology; and (3) General pediatric surgery;
E
NA
H. The following pediatric subspecialties on staff, in active practice, available at all times, and, if needed, in-house within 30 minutes: cardiology, endocrinology, gastroenterology, genetics, hematology, nephrology, neurology, and pulmonology; and
O
E
I. General Pediatric Surgery and the following pediatric surgical subspecialists on staff, in active practice, available at all times, and, if needed, in-house within 30 minutes: (1) Neurosurgery; (2) Cardiothoracic surgery; (3) Orthopedic surgery; (4) Plastic surgery; and (5) Ophthalmology.
O
E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.09 - Laboratory

Current through Register Vol. 51, No. 14, July 12, 2024
III
IV
A hospital shall:
A. The programmatic leaders of the perinatal service and the hospital laboratory shall establish laboratory processing and reporting times that are appropriate for samples drawn from obstetrical and neonatal patients with specific consideration for the acuity of the patient and the integrity of the samples.
E
E
B. Demonstrate the capability to immediately receive, process, and report urgent/emergent obstetric and neonatal laboratory requests.
E
E
C. Have a process in place to report critical results to the obstetric and neonatal services.
E
E
D. Make laboratory results from standard maternal antepartum testing available to the providers caring for the mother and the neonate prior to discharge. If test results are not available or if testing was not performed prior to admission, such testing shall be performed during the hospitalization of the mother and results available prior to discharge of the newborn.
E
E
E. Have the capacity to conduct rapid HIV testing 24 hours a day.
E
E
F. Have available the equipment and trained personnel to perform newborn hearing screening prior to discharge on all infants born at or transferred to the institution as required by COMAR 10.11.02.
E
E
G. Have available the equipment and trained personnel to perform critical congenital heart disease screening between 24 and 48 hours of age on all well infants born at or transferred to the institution and report screening results as required by COMAR 10.52.15.
E
E
H. Have a protocol to perform critical congenital heart disease screening on all infants in the special care nursery or neonatal intensive care unit born at or transferred to the institution and to report screening results as required by COMAR 10.52.15.
E
E
I. Have available the equipment and trained personnel to collect newborn blood-spot screening on all infants born at or transferred to the institution at the appropriate time/intervals and to transport blood-spot specimens to the Maryland State Newborn Screening Laboratory as required by COMAR 10.52.12 and 10.10.13.14.
E
E
J. Have blood bank technicians present in-house 24 hours a day.
E
E
K. Have molecular, cytogenetic, and biochemical genetic testing.
E
E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.10 - Diagnostic Imaging Capabilities

Current through Register Vol. 51, No. 14, July 12, 2024
III
IV
A hospital shall have:
A. The capability of providing emergency ultrasound imaging and interpretation for obstetrical patients 24 hours per day;
E
E
B. The capability of providing detailed ultrasonography and fetal assessment, including Doppler studies, with interpretation for obstetrical patients 24 hours a day;
E
E
C. The capability of providing maternal echocardiology with interpretation for obstetrical patients 24 hours a day;
E
E
D. The capability of providing portable x-ray imaging with interpretation for neonatal patients 24 hours a day;
E
E
E. The capability of providing portable head ultrasound with interpretation for neonatal patients;
E
E
F. The capability on campus of providing computerized tomography (CT) and magnetic resonance imaging (MRI) with interpretation;
O
E
G. Neonatal echocardiography equipment and an experienced technician shall be available on campus as needed with interpretation by a pediatric cardiologist;
E
E
H. A pediatric cardiac catheterization laboratory and appropriate staff; and
O
E
I. The capability of providing interventional radiology services for:
(1) Obstetrical patients; and
E
E
(2) Neonatal patients.
O
E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.11 - Equipment

Current through Register Vol. 51, No. 14, July 12, 2024
III
IV
A hospital shall have:
A. All of the following equipment and supplies immediately available for existing patients and for the next potential patient:
(1) O2 analyzer, stethoscope, intravenous infusion pumps;
(2) Radiant heated bed in delivery room and available in the neonatal units;
(3) Oxygen hood with humidity;
(4) Bag and masks and/or T-piece resuscitator capable of delivering a controlled concentration of oxygen to the infant;
(5) Orotracheal tubes;
(6) CO2 detector;
(7) Aspiration equipment;
(8) Laryngoscope;
(9) Bowel bags;
(10) Umbilical vessel catheters and insertion tray;
(11) Cardiac monitor;
(12) Pulse oximeter;
(13) Transilluminator;
(14) Phototherapy unit;
(15) Doppler blood pressure for neonates;
(16) Cardioversion/defibrillation capability for obstetrical patients and neonates;
(17) Resuscitation equipment for obstetrical patients;
(18) Resuscitation equipment for neonates including equipment outlined in the current NRP;
(19) Individual oxygen, air, and suction outlets for obstetrical patients and neonates; and
(20) Emergency call system.
E
E
B. Special equipment and facilities needed to accommodate the care and services needed for obese women.
E
E
C. A neonatal stabilization bed set up and equipment available at all times for an emergency admission;
E
E
D. Fetal diagnostic testing and monitoring equipment for:
(1) Fetal heart rate monitoring;
E
E
(2) Ultrasound examinations; and
E
E
(3) Amniocentesis;
E
E
E. The capability to monitor neonatal intra-arterial pressure;
E
E
F. The capability on campus of providing laser coagulation for retinopathy of prematurity;
E
E
G. The capability on campus of providing laser coagulation for retinopathy of prematurity;
E
E
H. Appropriate equipment, including back-up equipment, for neonatal respiratory care as well as protocols for the use and maintenance of the equipment as required by its level of neonatal care;
E
E
I. The capability of providing advanced ventilatory support, beyond conventional mechanical ventilation, for neonates of all birth weights; and
O
E
J. The capability of providing continuing therapeutic hypothermia.
O
E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.12 - Medications

Current through Register Vol. 51, No. 14, July 12, 2024
III
IV
A hospital shall have:
A. Emergency medications, as listed in the current Neonatal Resuscitation Program (NRP) guidelines, shall be immediately available in the delivery area and neonatal units;
E
E
B. The following medications shall be immediately available to the neonatal units:
(1) Antibiotics, anticonvulsants, and emergency cardiovascular drugs; and
(2) Surfactant, prostaglandin E1;
E
E
C. All emergency resuscitation medications to initiate and maintain resuscitation, in accordance with current Advanced Cardiac Life Support (ACLS) guidelines of the American Heart Association (AHA), shall be immediately available in the delivery area;
E
E
D. The following medications shall be immediately available for management of obstetrical hemorrhage in the delivery area and postpartum floor:
(1) Oxytocin (Pitocin);
(2) Methylergonovine (Methergine);
(3) Misoprostol (Cytotec);
(4) Carboprost tromethamine (Hemabate); and
(5) Tranezamic acid (TXA); and
E
E
E. The following medications shall be immediately available for management of hypertensive crisis in all obstetrical care areas:
(1) Hydralazine;
(2) Labetalol; and
(3) Nifedipine.
E
E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.13 - Education Programs

Current through Register Vol. 51, No. 14, July 12, 2024
III
IV
A hospital shall:
A. Identify minimum competencies for obstetrical and neonatal clinical staff, not otherwise credentialed, that are assessed prior to independent practice and on a regular basis thereafter;
E
E
B. Provide continuing education programs available to all obstetrical and neonatal clinical staff concerning the treatment and care of obstetrical and neonatal patients;
E
E
C. Conduct multidisciplinary clinical drills or simulations including post-drill debriefs to help prepare obstetrical and neonatal staff for high risk, high complexity, low frequency events;
E
E
D. Provide evidence-based education every two years to all staff caring for newborns (nurses, respiratory therapist, technicians, etc.) that includes at a minimum stabilization after immediate resuscitation to address glucose metabolism, thermoregulation, respiratory support hemodynamic monitoring and stability, risk and treatment of infection, and support for the family; and
E
E
E. Accept maternal or neonatal primary transports and provide the following to the referring hospital/providers:
(1) Guidance on indications for consultation and referral of patients at high risk;
(2) Information about the accepting hospital's response times and clinical capabilities;
(3) Information about alternative sources for specialized care not provided by the accepting hospital;
(4) Guidance on the pre-transport stabilization of patients; and
(5) Feedback on the pre-transport and post-transport care of patients.
E
E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.12 - Perinatal and Neonatal Referral Center Standards › Section 30.08.12.14 - Quality Improvement

Current through Register Vol. 51, No. 14, July 12, 2024
III
IV
A hospital shall:
A. Have a multi-disciplinary Perinatal Quality Improvement Program which meets at least quarterly to evaluate maternal and neonatal health outcomes and to identify process changes to improve patient safety and perinatal outcomes.
E
E
B. The Perinatal Quality Improvement Program shall conduct internal case reviews, collect and analyze perinatal program data, conduct trend analyses, set quality improvement goals annually, and use data to assess progress toward those goals.
E
E
C. The Perinatal Quality Improvement Program shall conduct reviews of all cases of the following as well as cases related to other patient safety and systems issues identified:
(1) Maternal, intrapartum fetal, and neonatal deaths;
(2) Transports to a higher or comparable level of care; and
(3) Elective delivery at less than 39 weeks gestation.
E
E
D. Participate with the Maryland Department of Health and local health department Fetal and Infant Mortality Review program.
E
E
E. Participate in the collaborative collection and assessment of data with the Maryland Department of Health and/or the Maryland Institute for Emergency Medical Services Systems, for the purpose of improving perinatal health outcomes.
E
E
F. Maintain membership in the Vermont Oxford Network.
E
E
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.13 - Disciplinary Action for Violation of Subtitle › Section 30.08.13.01 - Grounds for Disciplinary Action

Current through Register Vol. 51, No. 14, July 12, 2024
MIEMSS may take disciplinary action against a designated trauma or specialty referral center if the trauma or specialty referral center:
A. Is out of compliance with the requirements of this subtitle, and has been unable or has refused to comply as required by MIEMSS;
B. Fails to comply with, or otherwise violates the provisions of, State or federal law;
C. Fails to provide data to MIEMSS, as required by COMAR 30.08.03.01I;
D. Makes a false statement or omits a material fact in:
(1) Its application for designation,
(2) A record required by this subtitle, or
(3) A matter under investigation;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.13 - Disciplinary Action for Violation of Subtitle › Section 30.08.13.02 - Preliminary and Further Investigations

Current through Register Vol. 51, No. 14, July 12, 2024
A. Receipt of Information.
(1) MIEMSS shall initiate a preliminary investigation if it receives information that might form the basis for action against a trauma or specialty referral center.
(2) A person may file a signed, written complaint with the Office of Hospital Programs regarding an alleged violation of this subtitle.
(3) MIEMSS may begin an investigation without a signed written complaint if it determines that sufficient cause exists.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.13 - Disciplinary Action for Violation of Subtitle › Section 30.08.13.03 - Confidentiality of Records of Investigation

Current through Register Vol. 51, No. 14, July 12, 2024
A. MIEMSS shall take reasonable precautions to ensure that an investigation is conducted in a confidential manner.
B. MIEMSS shall maintain a record for each designated trauma and specialty referral center in Maryland.
C. If MIEMSS begins an investigation, it shall create a confidential record containing the investigatory material, which:
(1) Is exempt from disclosure under Health Occupations Article, §§
										1-401 and  14-506, Annotated Code of Maryland, and General Provisions Article, Title 4, Subtitle 3, Annotated Code of Maryland; and
(2) Shall be placed in the designated trauma or specialty referral center's official record.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.13 - Disciplinary Action for Violation of Subtitle › Section 30.08.13.04 - Finding of Violation

Current through Register Vol. 51, No. 14, July 12, 2024
If MIEMSS finds that a trauma or specialty referral center has violated this subtitle, MIEMSS may:
A. Require a trauma or specialty referral center to submit a plan of corrective action;
B. Place a designated trauma or specialty referral center on probation;
C. Lower a trauma center's level of designation;
D. Suspend a trauma or specialty referral center's designation; or
E. Revoke a trauma or specialty referral center's designation.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.13 - Disciplinary Action for Violation of Subtitle › Section 30.08.13.05 - Plan of Corrective Action

Current through Register Vol. 51, No. 14, July 12, 2024
A. If MIEMSS requires a trauma or specialty referral center to submit a plan of corrective action, the notice required by Regulation .02D of this chapter shall include a deadline for submission of the plan of corrective action by the trauma or specialty referral center.
B. The plan shall include:
(1) Steps that the trauma or specialty referral center intends to take to correct deficiencies; and
(2) The projected date of completion.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.13 - Disciplinary Action for Violation of Subtitle › Section 30.08.13.06 - Procedures for Disciplinary Actions

Current through Register Vol. 51, No. 14, July 12, 2024
A. MIEMSS shall initiate an action to place a trauma or specialty referral center on probation or to lower, suspend, or revoke a trauma or specialty referral center's designation if MIEMSS:
(1) Determines that the violation warrants probation, lowered level of designation, suspension, or revocation; or
(2) Has required a plan of corrective action, and:
(a) The trauma or specialty referral center fails to submit a plan within the time set by MIEMSS, or
(b) MIEMMS determines that the trauma or specialty referral center has not satisfactorily complied with the plan.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.14 - Hand and Upper Extremity Trauma Center Standards › Section 30.08.14.01 - 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) "Accreditation Council for Graduate Medical Education (ACGME)" means the private, nonprofit council that evaluates and accredits medical residency programs in the United States.
(2) "Commission on Accreditation of Rehabilitation Facilities (CARF)" means the international independent, nonprofit accreditor of human service providers in the areas of rehabilitation, employment, child, and family.
(3) "Hand and upper extremity physician trauma team" means the physician team required by Regulation .03 of this chapter.
(4) "Hand Therapy Certification Commission (HTCC)" means an independent, nonprofit accrediting body for the testing and credentialing of hand therapists.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.14 - Hand and Upper Extremity Trauma Center Standards › Section 30.08.14.02 - Organization

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hand and upper extremity trauma center shall:
(1) Be licensed as an acute care hospital by the hospital licensing authority in the jurisdiction in which it is located;
(2) Be accredited by the Joint Commission on Accreditation of Health Care Organizations with a designated hand surgery service;
(3) Have an emergency department which offers comprehensive emergency care 24 hours a day with:
(a) At least one physician experienced in emergency care on duty in the emergency care area; and
(b) In-hospital physician coverage by members of the medical staff or by senior-level residents who are postgraduate year 3 or higher for the following services:
(i) Medical;
(ii) Surgical;
(iii) Orthopedic; and
(iv) Anesthesia;
(4) Have a resolution adopted by the Board of Directors of the hospital committing the hospital to:
(a) Participate in State and regional emergency medical services; and
(b) Maintain the infrastructure necessary to support the hospital's provision of state-of-the-art hand and upper extremity trauma care including the following resources necessary to the provision of such service:
(i) Financial;
(ii) Human; and
(iii) Physical.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.14 - Hand and Upper Extremity Trauma Center Standards › Section 30.08.14.03 - Medical Staff

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall have a hand and upper extremity physician trauma team that shall include at least eight physicians who are Board-eligible or Board-certified in the following specialties:
(1) General surgery;
(2) Plastic surgery; or
(3) Orthopedic surgery.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.14 - Hand and Upper Extremity Trauma Center Standards › Section 30.08.14.04 - Nursing Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hospital shall staff the hand and upper extremity trauma center with registered nurses competent in the care of patients with hand and upper extremity disorders.
B. The hospital shall provide all nurses who care for patients in the hand and upper extremity trauma center with:
(1) Specific orientation to procedures and protocols for hand and upper extremity emergencies; and
(2) Education in hand and upper extremity emergencies and trauma care that meets the learning outcomes approved by MIEMSS.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.14 - Hand and Upper Extremity Trauma Center Standards › Section 30.08.14.05 - Facility and Unit Capabilities

Current through Register Vol. 51, No. 14, July 12, 2024
A. Hand and upper extremity trauma facilities shall be able to optimally and comprehensively care for every patient with an isolated upper extremity injury from the time the patient arrives at the hospital through acute treatment, rehabilitation, reconstruction, and re-entry into the work force.
B. Hand and upper extremity trauma area facilities shall have:
(1) A suite of rooms identified and specialized for examination and treatment of hand and upper extremity trauma emergencies in the hospital's emergency department with:
(a) A medical director or representative on the hospital's emergency services committee that shall oversee the management of the hand and upper extremity trauma center; and
(b) Appropriate nurse leaders who shall be responsible for all venues in which hand and upper extremity trauma care is rendered;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.14 - Hand and Upper Extremity Trauma Center Standards › Section 30.08.14.06 - Quality Management

Current through Register Vol. 51, No. 14, July 12, 2024
A. The hand and upper extremity trauma center shall have an ongoing quality management program integrated with the hospital's overall quality management system.
B. Quality management for the hand and upper extremity trauma center shall include:
(1) Maintaining the hand physician representative on the following hospital committees to discuss quality management issues during monthly meetings:
(a) The hospital operating room committee; and
(b) The hospital emergency room committee;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.14 - Hand and Upper Extremity Trauma Center Standards › Section 30.08.14.07 - Prevention and Public Education

Current through Register Vol. 51, No. 14, July 12, 2024
The hand and upper extremity trauma center shall provide leadership and coordination for the development and implementation of prevention and public education programs for hand and upper extremity injuries, by, among other activities:
A. Participation in MIEMSS outcome studies when requested;
B. Training and teaching emergency medical services personnel;
C. Serving as a public resource for the prevention and safety of hand and upper extremity injuries;
D. Participation in media public service announcements for seasonal hand and upper extremity injuries; and
E. Monitoring the progress of prevention programs in cooperation with State monitoring programs.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.14 - Hand and Upper Extremity Trauma Center Standards › Section 30.08.14.08 - Research

Current through Register Vol. 51, No. 14, July 12, 2024
The hand and upper extremity trauma center shall participate in an organized clinical research program which shall include:
A. A research committee; and
B. A research director who shall:
(1) Coordinate ongoing research projects;
(2) Meet monthly with hand and upper extremity trauma injury center staff to discuss the progress of research projects;
(3) Assist in the preparation of projects for presentation and publication; and
(4) Prepare documentation of ongoing research grants.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.14 - Hand and Upper Extremity Trauma Center Standards › Section 30.08.14.09 - Formal Medical Staff Education

Current through Register Vol. 51, No. 14, July 12, 2024
Education of the hand and upper extremity trauma center medical staff shall include:
A. Formal didactic lectures available weekly to all hand and upper extremity trauma center staff;
B. At least every other week, cadaver prosections and dissections at the Maryland State Anatomy Board performed on various areas of the upper extremity performed by:
(1) Residents;
(2) Fellows; and
(3) Attending physicians;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.14 - Hand and Upper Extremity Trauma Center Standards › Section 30.08.14.10 - Continuing Education Programs

Current through Register Vol. 51, No. 14, July 12, 2024
A. Internal Continuing Education.
(1) Medical staff internal continuing education shall consist of:
(a) Participation in weekly case management conferences;
(b) Participation in weekly lecture series;
(c) Attendance at monthly specialized conferences that include the following subject areas:
(i) Amputee;
(ii) Microsurgery;
(iii) Plastic surgery;
(iv) Congenital deformities; and
(v) Anatomy;
(d) Participation in monthly hand surgery journal club;
(e) Attendance at yearly visiting professor lecture and anatomy laboratory;
(f) Access to electronic educational materials in the specialty;
(g) Access to video library including:
(i) Hand surgery; and
(ii) Microsurgery topics; and
(h) Completion of microsurgery laboratory refresher course.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.14 - Hand and Upper Extremity Trauma Center Standards › Section 30.08.14.11 - Policies and Procedures

Current through Register Vol. 51, No. 14, July 12, 2024
A hand and upper extremity trauma center shall maintain written policies and protocols for:
A. Emergency triage and protocol for massive upper extremity injuries and replantation;
B. Preoperative and postoperative orders for replantations and free flaps;
C. Care and treatment of a upper extremity injuries;
D. The physician on-call schedule for the hand and upper extremity trauma center;
E. The interhospital transfer protocol;
F. House staff privileges for:
(1) Educational activities;
(2) Responsibilities; and
(3) Grievances;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.15 - Freestanding Emergency Medical Facilities › Section 30.08.15.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter, the following term has the meaning indicated.
B. Term Defined. "Freestanding emergency medical facility" means a facility licensed by the Department of Health and Mental Hygiene under Health-General Article, § 19-3 A-02, Annotated Code of Maryland.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.15 - Freestanding Emergency Medical Facilities › Section 30.08.15.02 - Freestanding Emergency Medical Facility

Current through Register Vol. 51, No. 14, July 12, 2024
A. Freestanding Emergency Medical Facility. A freestanding emergency medical facility:
(1) Shall be licensed under Health-General Article, § 19-3 A-02, Annotated Code of Maryland;
(2) Shall comply with COMAR 10.07.08;
(3) Shall abide by the protocols approved by the EMS Board for the transport by EMS of patients to freestanding emergency departments;
(4) Shall abide by the Maryland Emergency Medical Services Interfacility Transfer Guidelines published by MIEMSS;
(5) Shall participate in the County Hospital Alert Tracking System (CHATS) program;
(6) Shall have radios and the ability to communicate with EMS and base stations;
(7) Shall advise MIEMSS immediately of any change in status regarding the freestanding emergency department; and
(8) Shall participate in data collection and quality management as required in COMAR 30.08.04.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.15 - Freestanding Emergency Medical Facilities › Section 30.08.15.03 - Determination of Adequacy and Appropriateness of Emergency Care Delivery Associated with Conversion of a Hospital to a Freestanding Medical Facility

Current through Register Vol. 51, No. 14, July 12, 2024
A. The EMS Board shall consider the following factors in determining whether the conversion of a general hospital to a freestanding medical facility under COMAR 10.24.19.04C will maintain adequate and appropriate delivery of emergency care within the Statewide emergency medical services system:
(1) The EMS resources in the jurisdictions affected by the proposed hospital conversion, including staffing, equipment, and units;
(2) Any additional resources which will be provided by the hospital seeking to convert to augment the resources available in the affected jurisdiction.
(3) The EMS call volume of affected jurisdictions by priority;
(4) The projected number of patients who could require transport to a general acute hospital rather than the proposed freestanding medical facility for appropriate medical care;
(5) EMS transport times in the jurisdictions affected by the proposed hospital conversion and the potential for extended transport and out-of-service times resulting from the proposed conversion to a freestanding medical facility, relative to the current pattern of transport times;
(6) Commercial ambulance services availability and response times in the jurisdictions affected by the proposed hospital conversion;
(7) The number of general hospitals likely to be affected by the proposed hospital conversion and the distance to the closest general hospital ED for appropriate patients if the hospital converts to a freestanding medical facility relative to current patterns of hospital use;
(8) The expected additional ED visit volume and associated increases in admission and observation patient volumes for the general hospitals likely to be affected by the proposed hospital conversion;
(9) Recent diversion utilization at the converting hospital and other general hospitals likely to be affected by the proposed hospital conversion and the potential impact of the proposed conversion on diversion utilization;
(10) The size, scope, configuration, services, and staffing of the proposed project; and
(11) Reasonable changes in the EMS system that are planned or can be made to maintain adequate and appropriate delivery of emergency care within the Statewide emergency medical services system if the hospital converts to a freestanding medical facility.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.16 - Cardiac Interventional Center Standards › Section 30.08.16.01 - 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) "Cardiac Interventional Center" means:
(a) An in-State hospital that meets the requirements in Regulation .02 of this chapter and is designated by MIEMSS and approved by the EMS Board to receive patients transported by ambulance with acute ST-segment elevation myocardial infarction (STEMI) who need Primary Percutaneous Coronary Intervention; or
(b) An out-of-State hospital that has entered into an agreement with MIEMSS and has been approved by the EMS Board to receive patients with acute ST-segment elevation myocardial infarction who need Primary Percutaneous Coronary Intervention.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.16 - Cardiac Interventional Center Standards › Section 30.08.16.02 - Cardiac Interventional Center

Current through Register Vol. 51, No. 14, July 12, 2024
A. A Cardiac Interventional Center shall be licensed as an acute care hospital by the hospital licensing authority in the jurisdiction in which it is located.
B. If located in Maryland, a Cardiac Interventional Center shall:
(1) Have one of the following:
(a) A Certificate of Need (CON) issued by the Maryland Health Care Commission for a cardiac surgery and percutaneous coronary intervention (PCI) program; or
(b) A current waiver issued by the Maryland Health Care Commission to provide primary percutaneous coronary intervention (PCI) services to STEMI patients meeting certain criteria without on-site cardiac surgery; and