reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 05 - EMERGENCY MEDICAL SERVICES REGIONS AND REGIONAL PROGRAMS › Chapter 30.05.01 - Regional EMS Advisory Councils › Section 30.05.01.06 - Assistance from MIEMSS

Current through Register Vol. 51, No. 14, July 12, 2024
MIEMSS shall provide regional EMS councils:
A. Administrative and programmatic support;
B. Assistance in implementing projects sponsored by MIEMSS and the regional councils;
C. Regular communications about State EMS activities;
D. Technical assistance in developing the following materials related to the delivery of emergency medical services:
(1) Guidelines;
(2) Models;
(3) Procedures;
(4) Manuals; and
(5) Summary reports on EMS activities in each region.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 05 - EMERGENCY MEDICAL SERVICES REGIONS AND REGIONAL PROGRAMS › Chapter 30.05.01 - Regional EMS Advisory Councils › Section 30.05.01.07 - Advice from Regional EMS Councils

Current through Register Vol. 51, No. 14, July 12, 2024
A. Each regional EMS council shall be MIEMSS' primary advisory body for its region.
B. MIEMSS is not required to accept or implement any regional EMS council recommendation.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 06 - PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM › Chapter 30.06.01 - Definitions › Section 30.06.01.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this subtitle, the following terms have the meanings indicated.
B. Terms Defined.
(1) "Automated external defibrillator (AED)" means a medical heart monitor and defibrillator device that:
(a) Is cleared for market by the federal Food and Drug Administration;
(b) Recognizes the presence or absence of ventricular fibrillation or rapid ventricular tachycardia;
(c) Determines, without intervention by the operator, whether defibrillation should be performed;
(d) On determining that defibrillation should be performed, automatically charges; and
(e) Either:
(i) Requires operator intervention to deliver the electrical impulse, or
(ii) Automatically continues with delivery of electrical impulse.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 06 - PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM › Chapter 30.06.02 - Approval of Facilities and Compliance › Section 30.06.02.01 - Criteria for Registration of Facilities

Current through Register Vol. 51, No. 14, July 12, 2024
To be eligible for registration, or renewal of registration, to operate an AED under this subtitle, a registered facility shall:
A. Designate an AED coordinator who shall:
(1) Have successfully completed CPR and AED Training, and subsequent refresher training, in accordance with their training course requirements that at a minimum includes content consistent with the recommendations for layperson CPR and AED training in the most current publication of the American Heart Association Guidelines for CPR and ECC;
(2) Be responsible for implementing and administering the AED program at the registered facility; and
(3) Ensure that monthly safety inspections of all supplemental and AED equipment, including assurance of adequate battery charge, per the manufacturer's guidelines are conducted and maintain written logs of the inspections.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 06 - PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM › Chapter 30.06.02 - Approval of Facilities and Compliance › Section 30.06.02.02 - Protocol

Current through Register Vol. 51, No. 14, July 12, 2024
All personnel who are expected to operate an AED at a registered facility shall utilize the AED in accordance with their training. When an individual's training conflicts with the auditory and visual prompts of the device, the individual shall follow the auditory and visual prompts.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 06 - PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM › Chapter 30.06.02 - Approval of Facilities and Compliance › Section 30.06.02.03 - Quality Assurance and Maintenance

Current through Register Vol. 51, No. 14, July 12, 2024
Each registered facility shall:
A. Comply the federal Safe Medical Devices Act of 1990 and the Medical Device Amendments of 1992;
B. Maintain:
(1) The certificate issued by MIEMSS in a place where it is readily available;
(2) Each AED and all related equipment and supplies in accordance with the standards established by the device manufacturer and the federal Food and Drug Administration;
(3) Supplemental equipment with the AED at all times as follows:
(a) Two sets of defibrillator chest pads;
(b) Disposable gloves; and
(c) Maryland Facility AED Report Forms for Cardiac Arrest;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 06 - PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM › Chapter 30.06.02 - Approval of Facilities and Compliance › Section 30.06.02.04 - Application and Registration Process

Current through Register Vol. 51, No. 14, July 12, 2024
A. A facility seeking registration or renewal of registration shall submit an application and all required documentation to MIEMSS on the form required by MIEMSS.
B. MIEMSS may make the inspection and require the verification necessary to ensure that an applicant meets the requirements of this chapter, including an inspection of the facility, any sites, equipment, and records.
C. MIEMSS shall issue a certificate of registration or renewal to a facility that meets the requirements of Regulation .01 of this chapter.
D. The certificate of registration or renewal is valid for a period of 3 years.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 06 - PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM › Chapter 30.06.02 - Approval of Facilities and Compliance › Section 30.06.02.05 - Denial of Registration

Current through Register Vol. 51, No. 14, July 12, 2024
A. MIEMSS may deny an application if it finds that the applicant fails to meet the requirements of this chapter.
B. Notice of Denial.
(1) MIEMSS shall issue a written notice of denial to an applicant that includes the reasons for denial.
(2) The notice shall conform to the requirements of State Government Article, §
										10-207, Annotated Code of Maryland.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 06 - PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM › Chapter 30.06.02 - Approval of Facilities and Compliance › Section 30.06.02.06 - Compliance

Current through Register Vol. 51, No. 14, July 12, 2024
A. MIEMSS may initiate a compliance review of a registered facility upon information that the registered facility has failed to comply with this subtitle.
B. MIEMSS shall give written notice of the compliance review to the registered facility.
C. In the course of its compliance review, MIEMSS may:
(1) Inspect all:
(a) Sites where the registered facility maintains an AED;
(b) Records relating to the AED maintained by the facility; and
(c) Equipment related to the AED; and
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 06 - PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM › Chapter 30.06.02 - Approval of Facilities and Compliance › Section 30.06.02.07 - Procedure for Appeals

Current through Register Vol. 51, No. 14, July 12, 2024
A. An applicant or registered facility may appeal a disputed decision by filing a notice of appeal to the EMS Board with the Executive Director of MIEMSS not later than 20 days after receipt of the decision.
B. The appeal shall state with specificity the reasons why the disputed decision should be modified.
C. An applicant or registered facility that files an appeal shall be granted a hearing before the:
(1) EMS Board; or
(2) Office of Administrative Hearings, if the Board so elects and notifies the applicant or registered facility.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 06 - PUBLIC ACCESS AUTOMATED EXTERNAL DEFIBRILLATOR PROGRAM › Chapter 30.06.02 - Approval of Facilities and Compliance › Section 30.06.02.08 - Confidentiality of Records

Current through Register Vol. 51, No. 14, July 12, 2024
MIEMSS shall maintain the confidentiality of records referred to in this subtitle in accordance with:
A. Health-General Article, Title 4, Subtitle 3, Annotated Code of Maryland;
B. Health Occupations Article, Title 1, Subtitle 4, Annotated Code of Maryland; and
C. General Provisions Article, Title 4, Subtitle 3, Annotated Code of Maryland.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 07 - EMERGENCY MEDICAL SERVICES COMMUNICATIONS SYSTEM › Chapter 30.07.01 - Helicopter Communications › Section 30.07.01.01 - Helicopter Communications to SYSCOM

Current through Register Vol. 51, No. 14, July 12, 2024
A. Definitions.
(1) "EMSCS" means the Emergency Medical Services Communications System.
(2) "Hospital" means an institution that is required to be licensed as a hospital by the Secretary of Health and Mental Hygiene pursuant to Health-General Article, §19-301, Annotated Code of Maryland, and COMAR 10.07.01.
(3) "MIEMSS" means the Maryland Institute for Emergency Medical Services Systems established pursuant to Education Article, §
										13-503, Annotated Code of Maryland.
(4) "MULTICOM" means a mobile radio service not open to public correspondence, used to provide communications essential to conduct the activities being performed by or directed from private aircraft.
(5) "Patient transport" means the helicopter transport of a patient from one hospital to another or to or from a specialty center.
(6) "Specialty center" means a hospital specified by MIEMSS to be a specialty referral center or trauma center participating in the Emergency Medical Services System.
(7) "SYSCOM" means the Systems Communication Center operated by MIEMSS for the Emergency Medical Services Communications System.
(8) "UNICOM" means an aeronautical advisory radio station used for advisory and civil defense communications primarily with private aircraft stations.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.01 - General Provisions › Section 30.08.01.01 - Purpose

Current through Register Vol. 51, No. 14, July 12, 2024
This subtitle establishes:
A. Procedures for designating a hospital as a trauma or specialty referral center;
B. Standards for a designated center to provide trauma or specialty care service;
C. Procedures for disciplinary action to be taken if a trauma or specialty referral center fails to comply with this subtitle; and
D. Procedures for the collection and use of trauma or specialty care data by MIEMSS to monitor and evaluate the trauma and specialty care systems.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.01 - General Provisions › Section 30.08.01.02 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this subtitle, the following terms have the meanings indicated.
B. Terms Defined.
(1) "Adult burn center" means:
(a) An in-State hospital designated by MIEMSS and approved by the EMS Board to provide comprehensive burn treatment services to burn patients 15 years old or older; or
(b) An out-of-State hospital that has entered into an agreement with MIEMSS and that has been approved by the EMS Board to provide comprehensive burn treatment services to burn patients 15 years old or older.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.01 - General Provisions › Section 30.08.01.03 - System Administration

Current through Register Vol. 51, No. 14, July 12, 2024
A. Under Education Article, §
									13-504, Annotated Code of Maryland, MIEMSS is the State administrative agency responsible for the coordination of all emergency medical services.
B. MIEMSS shall:
(1) With the approval of the EMS Board, designate and verify hospitals to be trauma or specialty referral centers;
(2) Establish standards for trauma and specialty care, triage, and transfer protocols for injured patients;
(3) Establish and manage the State trauma registry;
(4) Facilitate the establishment of Statewide, inclusive, trauma and specialty care systems by encouraging all hospitals to participate in:
(a) The Statewide data collection process, and
(b) Prevention programs;
(5) Develop a quality management and improvement program to:
(a) Monitor compliance with this subtitle by hospitals in the Statewide trauma and specialty care systems, and
(b) Identify areas for enhancement;
(6) With the consultation and advice of appropriate persons, develop and periodically review:
(a) Prehospital trauma and specialty referral center triage criteria guidelines,
(b) Interfacility transfer criteria for adult and pediatric patients,
(c) Trauma and specialty referral center standards, and
(d) Trauma registry and specialty referral center data;
(7) Annually evaluate the effectiveness of the Statewide trauma and specialty care systems and its component subsystems by using trauma registry and other appropriate data to identify and analyze system and patient care trends and outcomes;
(8) Periodically conduct special studies of the Statewide trauma and specialty care systems to evaluate:
(a) System access,
(b) Capacity,
(c) Quality,
(d) Patient care outcomes, and
(e) The financial condition of the system components;
(9) Consult with appropriate persons in determining the need for trauma or specialty care services;
(10) Facilitate and, where necessary, develop and maintain, public information, education, and prevention programs as an integral component of the trauma and specialty care systems;
(11) As necessary, recommend to the EMS Board additional regulations to ensure the quality of the Statewide trauma and specialty care systems;
(12) Provide technical assistance and support to hospitals and providers as necessary to implement the components of the EMS Plan; and
(13) As necessary, verify compliance with trauma and specialty care standards by:
(a) Reviewing, inspecting, evaluating, and auditing trauma and specialty care patient records, trauma and specialty care quality improvement committee minutes, and any other documents relevant to trauma and specialty care in any trauma or specialty referral center, and
(b) Inspecting a trauma or specialty center's physical plant.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.01 - General Provisions › Section 30.08.01.04 - Confidentiality of Records

Current through Register Vol. 51, No. 14, July 12, 2024
MIEMSS shall maintain the confidentiality of records referred to in this subtitle in accordance with:
A. Health Occupations Article, Title 1, Subtitle 4, and §14-506, Annotated Code of Maryland; and
B. General Provisions Article, Title 4, Subtitle 3, 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 30.08.02 - Designation of Trauma and Specialty Referral Centers › Section 30.08.02.01 - Trauma Care Levels and Specialty Referral Centers

Current through Register Vol. 51, No. 14, July 12, 2024
A. MIEMSS shall designate a hospital by level of care capability as set forth for:
(1) Trauma centers, in COMAR 30.08.05; or
(2) Specialty referral centers, in the appropriate specialty care standards within this subtitle.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.02 - Designation of Trauma and Specialty Referral Centers › Section 30.08.02.02 - Criteria for Designation

Current through Register Vol. 51, No. 14, July 12, 2024
A. The EMS Board shall:
(1) Establish criteria for the number and level of trauma and specialty referral centers to be designated; and
(2) For specialty referral centers that require a certificate of need from the Maryland Health Care Commission, establish the criteria for the number of specialty referral centers in coordination with the Maryland Health Care Commission.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.02 - Designation of Trauma and Specialty Referral Centers › Section 30.08.02.03 - Initial Application Process

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hospital that is currently functioning as a trauma or specialtyreferral center may continue to function as a trauma or specialty referral center until MIEMSS has completed the designation process under this subtitle with respect to that hospital, if the hospital makes application for designation. The application must be received complete within 6 months of the publication date of the initial solicitation in the Maryland Register in accordance with §B of this regulation.
B. MIEMSS shall solicit applications for trauma and specialty referral center designation from any interested hospital, including all current trauma and specialty referral centers, by publication of the solicitation in the Maryland Register.
C. MIEMSS may periodically solicit applications for trauma and specialty referral center designation, as needed, by publication of the solicitation in the Maryland Register.
D. MIEMSS shall provide the applicant with appropriate application materials in paper or electronic form for trauma or specialty referral center designation.
E. An applicant for trauma or specialty referral center designation shall submit an application to the Office of Hospital Programs in a form specified by MIEMSS, which shall include, but not be limited to, submitting evidence of the applicant's financial capability to provide this care.
F. MIEMSS shall review each application submitted for completeness.
G. MIEMSS shall notify an applicant if an application is incomplete, and the applicant shall be afforded the opportunity to complete the application within 30 business days of the date of the notification.
H. As necessary, MIEMSS shall provide technical assistance to a hospital throughout the designation process by answering questions about this subtitle and the designation process.
I. An applicant's designation application is the property of MIEMSS and is confidential information in accordance with:
(1) Health Occupations Article, Title 1, Subtitle 4, and §14-506, Annotated Code of Maryland; and
(2) General Provisions Article, Title 4, Subtitle 3, 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 30.08.02 - Designation of Trauma and Specialty Referral Centers › Section 30.08.02.04 - Denial of Application for Designation

Current through Register Vol. 51, No. 14, July 12, 2024
A. MIEMSS may deny an application for designation without conducting an on-site review if it finds that the hospital:
(1) Would add unnecessary duplication of services to a geographic service area where there is not a sufficient need for additional trauma or specialty services;
(2) Is unable to meet the requirements of this subtitle for the level of designation sought;
(3) Makes a false statement or omits a material fact in the hospital records, documentation, or materials required to be submitted that pertain to the designation process;
(4) Is less qualified than another applicant hospital in the same geographic service area;
(5) Is applying for designation as a specialty center that requires a certificate of need from the Maryland Health Care Commission but does not have the required certificate of need or a waiver of the certificate of need; or
(6) Should not be designated for any other relevant reason.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.02 - Designation of Trauma and Specialty Referral Centers › Section 30.08.02.06 - On-Site Review for Initial Specialty Referral Center Designation

Current through Register Vol. 51, No. 14, July 12, 2024
A. At MIEMSS' discretion, MIEMSS may accept verification of a specialty referral center by a nationally recognized medical specialty organization, without conducting an on-site review.
B. The on-site review process for initial designation of specialty referral centers shall be conducted in accordance with Regulation .05 of this chapter, with the following exceptions:
(1) The on-site review team shall consist of MIEMSS staff, as well as medical, administrative, and nursing professionals having expertise in the specialty being designated;
(2) The Executive Director may appoint additional staff from other State agencies to the on-site review team when those agencies have shared regulatory oversight in the specialty referral center;
(3) MIEMSS shall select a team, which, at a minimum, shall include MIEMSS staff and three representatives from the following categories:
(a) Specialty physician;
(b) Emergency physician;
(c) Specialty nurse;
(d) Administrator;
(4) The on-site review team members shall:
(a) Evaluate the appropriateness and capability of the applicant to provide specialty care services, according to the designation standards for that particular specialty, as described at COMAR 30.08.06-30.08.12;
(b) Verify the hospital's ability to meet the:
(i) Responsibilities of, and the resources, equipment, and performance standards for, the type of specialty referral center designation sought, and
(ii) Overall needs of that particular specialty system in that region;
(c) Familiarize themselves with the hospital's application and the designation standards;
(d) Inspect the hospital's physical plant;
(e) Interview team members and management personnel;
(f) Examine the hospital's specialty care-related documents, including patient care records;
(g) Review other materials considered appropriate by MIEMSS;
(h) Provide an exit interview of preliminary findings to the applicant upon the completion of the on-site review; and
(i) Provide a brief written summary of preliminary findings upon the completion of the on-site review.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.02 - Designation of Trauma and Specialty Referral Centers › Section 30.08.02.07 - Designation Decision by MIEMSS

Current through Register Vol. 51, No. 14, July 12, 2024
A. As soon as practicable, but not later than 45 business days after completion of the on-site review, MIEMSS shall provide written notice to a hospital of its designation status.
B. MIEMSS may:
(1) Designate the hospital as a trauma or specialty referral center as proposed by the applicant;
(2) Designate the hospital at a level of designation lower than the applicant proposed, if the on-site review determined that the hospital does not meet the standards for the level of designation proposed;
(3) Adjust the level of an applicant's designation based on system needs and the hospital's ability to meet those needs; or
(4) Deny designation as a trauma center at any level or as a specialty 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 30.08.02 - Designation of Trauma and Specialty Referral Centers › Section 30.08.02.08 - Appeal to the EMS Board

Current through Register Vol. 51, No. 14, July 12, 2024
A. Procedures for Appeal by Hospital.
(1) Not later than 20 business days from the date a hospital receives MIEMSS' decision, the hospital may appeal MIEMSS' decision by filing written exceptions with the Executive Director for consideration by the EMS Board.
(2) For the written exceptions to be considered timely, a hospital shall file the written exceptions with the Executive Director within 20 business days from the date the hospital receives MIEMSS' decision.
(3) The exceptions shall state with specificity the reasons why MIEMSS' decision should be overturned.
(4) The hospital shall mail a copy of the exceptions to MIEMSS by first class mail, postage prepaid.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.02 - Designation of Trauma and Specialty Referral Centers › Section 30.08.02.09 - Change in Designation Status of Trauma or Specialty Referral Center

Current through Register Vol. 51, No. 14, July 12, 2024
A. A designated trauma or specialty referral center:
(1) Has the right to relinquish its designation as a trauma or specialty referral center or to request a designation lower than its current level of designation; and
(2) Shall provide the Office of Hospital Programs with 90 calendar days advance written notice of its request to change its designation status.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.02 - Designation of Trauma and Specialty Referral Centers › Section 30.08.02.10 - Reverification of Trauma or Specialty Referral Center Designation

Current through Register Vol. 51, No. 14, July 12, 2024
A. A designated trauma or specialty referral center, other than a designated adult or pediatric burn center, shall repeat the designation process, as set forth in this chapter, every 5 years.
B. A designated adult or pediatric burn center shall:
(1) Complete the reverification process every 3 years; and
(2) If verified by the American Burn Association:
(a) Concurrently submit to MIEMSS the application submitted to the American Burn Association, along with such supplements as may be required by MIEMSS to demonstrate compliance with COMAR 30.08.06; and
(b) Notify MIEMSS immediately of any change in their verification status.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.03 - Requirements for Designated Trauma or Specialty Referral Centers › Section 30.08.03.01 - Requirements for Trauma or Specialty Referral Centers

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hospital designated as a trauma or specialty referral center shall:
(1) Comply with the applicable standards for trauma or specialty care as developed by MIEMSS and set forth in COMAR 30.08.05-30.08.12;
(2) Receive all trauma or specialty patients, regardless of race, color, religion, age, sex, marital status, national origin, ancestry, physical or mental disability, or ability to pay;
(3) Upon MIEMSS' request, provide data to MIEMSS related to trauma or specialty care programs;
(4) Allow MIEMSS to monitor compliance with applicable regulations and standards as set forth by MIEMSS, including providing MIEMSS with access to:
(a) Patient discharge summaries,
(b) Patient care logs,
(c) Patient care records,
(d) Hospital trauma or specialty care quality management program records, including minutes, and
(e) Other documents that MIEMSS determines to be relevant; and
(5) Require confidentiality of information relating to an individual patient, provider, and hospital care outcomes in accordance with:
(a) Health Occupations Article, Title 1, Subtitle 4, Annotated Code of Maryland, and
(b) General Provisions Article, Title 4, Subtitle 3, 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 30.08.03 - Requirements for Designated Trauma or Specialty Referral Centers › Section 30.08.03.02 - Prehospital Triage and Transport

Current through Register Vol. 51, No. 14, July 12, 2024
A. MIEMSS shall develop and distribute to health care providers prehospital triage and transport protocols for patients needing trauma or specialty referral services to ensure that patients who meet the triage criteria established by the protocols are transported directly to an appropriate facility.
B. In the absence of extenuating circumstances, a health care provider shall transport a patient to the closest appropriate trauma or specialty referral center, consistent with the triage protocols.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.03 - Requirements for Designated Trauma or Specialty Referral Centers › Section 30.08.03.03 - Prohibited Acts

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hospital may not represent itself to be a trauma or specialty referral center unless it is so designated by MIEMSS and approved by the EMS Board.
B. A designated trauma or specialty referral center may not advertise services or capabilities for the treatment of patients above the trauma care level or specialty for which it has been designated.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.04 - Data Collection and Quality Management › Section 30.08.04.01 - Responsibilities of MIEMSS

Current through Register Vol. 51, No. 14, July 12, 2024
MIEMSS shall:
A. Maintain the State trauma registry to collect and analyze data including, but not limited to, data concerning the incidence, severity, and causes of trauma and burns;
B. Establish criteria to identify patients to be included in the State trauma registry;
C. Collect data about patients to be included in the State trauma registry from:
(1) EMS providers;
(2) Hospitals, both designated and nondesignated including, but not limited to:
(a) The primary adult resource center;
(b) Level I trauma centers;
(c) Level II trauma centers;
(d) Level III trauma centers; and
(e) Maryland Trauma Specialty Referral Centers as defined in Health-General Article, §19-130(a)(3), Annotated Code of Maryland;
(3) Office of Medical Examiner reports; and
(4) Other sources outside of the trauma and specialty care systems including, but not limited to:
(a) Death certificates,
(b) Hospital inpatient discharge data,
(c) Health care provider and third-party payer billing data, and
(d) Law enforcement agency records;
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.04 - Data Collection and Quality Management › Section 30.08.04.02 - Trauma and Specialty Care Quality Management Plan

Current through Register Vol. 51, No. 14, July 12, 2024
A. MIEMSS shall design a trauma and specialty care quality management plan for continued monitoring and evaluation of the State trauma and specialty care systems.
B. The trauma and specialty care quality management plan shall include the establishment, publication, and periodic review of the data required to be submitted to provide information regarding injury, trauma and specialty care, and system operation in the following categories:
(1) Demography;
(2) Anatomy;
(3) Physiology;
(4) Severity;
(5) Epidemiology;
(6) Resource utilization;
(7) Quality improvement;
(8) Outcomes; and
(9) Finance.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.04 - Data Collection and Quality Management › Section 30.08.04.03 - Trauma and Specialty Care Quality Management Programs

Current through Register Vol. 51, No. 14, July 12, 2024
A. A designated trauma or specialty referral center shall have a hospital-wide quality management plan to reflect and demonstrate continuous quality improvement in the delivery of trauma and specialty care.
B. The quality management program includes, but is not limited to, the requirements for trauma and specialty referral centers in COMAR 30.08.03.
C. A designated trauma and specialty referral center shall have a system for continuous monitoring and trend analysis of trauma patient bypass status.
D. Designated trauma and specialty referral centers shall participate in State trauma and specialty care quality management activities sponsored by MIEMSS.
E. If appropriate for quality assurance purposes, designated trauma and specialty centers shall provide EMS providers licensed or certified by the EMS Board under Education Article §
									13-516, Annotated Code of Maryland, who have or have had a direct treatment relationship with a patient, follow-up data or information on that patient. Quality assurance information provided under this action is considered to be provided in accordance with COMAR 30.03.04.05B.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.04 - Data Collection and Quality Management › Section 30.08.04.04 - Use of State Trauma Registry and Specialty Care Data

Current through Register Vol. 51, No. 14, July 12, 2024
MIEMSS may use State trauma registry and specialty care data to:
A. Monitor and provide information necessary to evaluate major trauma or specialty patient care, outcome, and cost;
B. Assess compliance of EMS providers, designated trauma and specialty referral centers, and other hospitals with the trauma and specialty care standards, regulations, and protocols;
C. Provide information necessary for resource planning and management;
D. Provide data for injury surveillance, analysis, and prevention programs; and
E. Provide a data resource for research and education.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.04 - Data Collection and Quality Management › Section 30.08.04.05 - Responsibilities of Emergency Medical Services Providers

Current through Register Vol. 51, No. 14, July 12, 2024
A. Prehospital services shall provide prehospital patient care reports and EMS data in accordance with COMAR 30.03.04.04B that include trauma or specialty care patient data about:
(1) Trauma victims dead at the scene of the trauma;
(2) Patients meeting State trauma or specialty triage criteria who are transported to a hospital;
(3) Patients transported in accordance with interfacility transfer policies to receive a higher level of care or for special resources; and
(4) Patients transported to specialty referral centers.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.04 - Data Collection and Quality Management › Section 30.08.04.06 - Access to Trauma Registry and Specialty Care Information

Current through Register Vol. 51, No. 14, July 12, 2024
A. Data that identifies individual patients, providers, and hospital outcomes is confidential.
B. MIEMSS may only release confidential information:
(1) As required by the Health Services Cost Review Commission under Health-General Article, §19-130, Annotated Code of Maryland; or
(2) In accordance with:
(a) The provisions of Health Occupations Article, Title 1, Subtitle 4, and §14-506, Annotated Code of Maryland; and
(b) Other criteria as developed by MIEMSS pertaining to patient confidentiality and quality management records.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.01 - 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) "E" means the standard is essential.
(2) "D" means the standard is desirable.
(3) "NA" means the standard does not apply.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.02 - Types of Trauma Centers

Current through Register Vol. 51, No. 14, July 12, 2024
A. "PARC" is a Primary Adult Resource Center.
B. "I" is a Level I trauma center.
C. "II" is a Level II trauma center.
D. "III" is a Level III trauma center.
E. "ED" is an emergency department for which the indicated standards are recommended, not required.
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.04 - Medical Staff

Current through Register Vol. 51, No. 14, July 12, 2024
PARC
I
II
III
ED
A. Credentialing Process. Each physician and Advanced Practice Professional (APP) shall be credentialed by the hospital for the appropriate specialty, including trauma care.
E
E
E
E
E
B. Delineation or Reevaluation of Privileges:
E
E
E
E
NA
(1) The trauma physicians and APPs shall be limited to those with demonstrated skills, commitment, experiences, and interest in trauma care.
E
E
E
E
NA
(2) The trauma medical director shall serve on the medical staff as the trauma chief of service.
E
E
E
E
NA
(3) Appointment and reappointment to the trauma admitting or consulting staff shall be coordinated by the trauma medical director and based on the following criteria:
E
E
E
E
NA
(a) Maintenance of good standing in the primary specialty;
E
E
E
E
NA
(b) Evidence of the required continuing medical education in trauma, including:
(i) For general surgeons taking trauma calls evidence of 16 hours of trauma-related CME credits a year;
E
E
E
E
NA
(ii) Over a 2-year period, half of the CME hours shall be obtained outside the hospital and be recognized by a national accrediting body;
E
E
D
D
NA
(iii) ATLSTM which may be counted in required CME credits; and
E
E
E
E
NA
(iv) Physician CME credits shall be documented in accordance with hospital policy.
E
E
E
E
NA
(c) Documented attendance at Trauma QM meetings, as those meetings are institutionally defined, of no less than monthly averaged over 12 months;
E
NA
NA
NA
NA
(d) Documented attendance at Trauma multidisciplinary meetings, Morbidity and Mortality (M and M) rounds, or hospital peer-review conference that deal with the care of injured patients; and
NA
E
E
E
NA
(e) Satisfactory performance in managing trauma patients based on performance assessment and outcome analysis.
E
E
E
E
NA
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.05 - Trauma Service

Current through Register Vol. 51, No. 14, July 12, 2024
PARC
I
II
III
ED
Trauma Service requirements are as follows:
A. The Trauma Service shall be established by the medical staff and shall be responsible for the care of injured patients.
E
E
E
E
NA
B. Privileges for physicians on the trauma service shall be determined by the medical credentialing process.
E
E
E
E
NA
C. The trauma service attending surgeon shall retain responsibility for the patient and coordinate all therapeutic decisions while the patient is on the Trauma Service.
E
E
E
E
NA
D. Injured patients may be observed by or admitted to an individual surgeon, but the structure of the program shall allow the Trauma Medical Director to have oversight authority for the care of these patients.
E
E
E
E
NA
E. The Trauma Center shall have a clearly defined response requirement for the trauma surgical evaluation of injured patients.
E
E
E
E
NA
F. Patients with injuries having a high index of suspicion, such as a significant mechanism of injury, shall be evaluated by the trauma service in compliance with hospital protocol.
E
E
E
E
NA
G. The emergency physician may initially evaluate the trauma patient, but the Trauma Center shall have a clearly defined response requirement for the trauma surgical evaluation of those patients requiring observation or admission.
NA
E
E
E
E
H. Patients with multiple system or complex single system injuries shall be evaluated by the trauma surgery service.
E
E
E
E
NA
I. The surgeon responsible for a patient's care shall be identified.
E
E
E
E
NA
J. The hospital shall document:
(1) Current certification as ATLS® instructors for all attending general trauma surgeons;
E
NA
NA
NA
NA
(2) Successful completion and continued certification of an ATLS® course for all general trauma surgeons;
E
E
E
D
NA
(3) Successful completion and continued certification of an ATLS® course for the TMD and all APP's who provide initial evaluation of trauma patients, treatment and care; and
E
E
E
E
E
(4) Current APLS® certification for physicians providing pediatric trauma care;
D
D
D
D
D
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.06 - Trauma Medical Director

Current through Register Vol. 51, No. 14, July 12, 2024
PARC
I
II
III
ED
The Trauma Medical Director (TMD) shall:
A. Be an expert in and committed to the care of the injured with a special interest in trauma care;
E
E
E
E
NA
B. Be board certified in general surgery or other surgical specialties;
E
E
E
E
NA
C. Be able to devote the time needed to fulfill the TMD responsibilities as delineated in COMAR;
E
E
E
D
NA
D. Have the following educational preparation and clinical experience:
(1) Successful completion of advanced specialty training in trauma care or Trauma/Critical Care fellowship for at least 1 year;
E
E
E
D
NA
(2) Demonstrated experience at a designated Level I Trauma Center in trauma systems management, trauma research, and quality management functions; and
E
D
NA
NA
NA
(3) Documented interest in trauma center or trauma system issues as evidenced by education, publications, professional experience, and involvement in planning and prevention efforts;
E
D
D
D
NA
E. Maintain membership and active participation in local, regional, state or national trauma-related activities and trauma organizations;
E
E
E
E
NA
F. Participate in trauma educational activities such as:
(1) Trauma/Critical Care fellowship programs;
E
D
NA
NA
NA
(2) Undergraduate medical education;
E
E
NA
NA
NA
(3) Continuing education; and
E
E
E
E
NA
(4) ATLS® courses;
E
E
E
E
NA
G. Participate in trauma research and publication efforts; and
E
E
D
D
NA
H. Demonstrate active participation in the resuscitation of multi system trauma patients, or surgery of multi system trauma patients or both.
E
E
E
E
NA
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.08 - Non-Surgical Specialty

Current through Register Vol. 51, No. 14, July 12, 2024
PARC
I
II
III
ED
A. Anesthesia. Anesthesia requirements are as follows:
(1) Board-certified, fellowship trained Anesthesiology Attending in-house, dedicated 24 hours a day to trauma care should be at the bedside upon arrival, and documented at least 80 percent of the time;
E
NA
NA
NA
NA
(2) Board-certified or board-eligible, in-house attending 24 hours a day;
NA
E
E
E
NA
(3) Attending anesthesiologist or CRNA taking trauma call shall be at the bedside within 15 minutes of being called with institution-specific criteria defining conditions requiring an immediate response, and present for all operations; and
NA
E
E
E
NA
(4) A liaison to the trauma QM program with 50 percent attendance.
E
E
E
E
E
B. Emergency Medicine. Emergency Medicine (EM) requirements are as follows:
(1) Physician Director or designated Director of Trauma Services in Emergency Medicine who:
(a) Is Board certified or board eligible in EM with evidence of active participation in daily emergency care;
NA
E
E
E
D
(b) Has administrative duties in the Emergency Department (ED);
NA
E
E
E
D
(c) Demonstrates the successful completion of the ATLS® course, at least once; and
NA
E
E
E
E
(d) Maintains ATLS® certification;
NA
E
E
E
E
(2) Emergency physician in-house 24 hours a day who is:
(a) Board certified or board eligible in EM;
NA
E
E
E
E
(b) Board certified or board eligible in a non-EM specialty with at least 7,000 hours of emergency practice and current ATLS® certification;
NA
NA
NA
E
E
(c) If certified by boards other than EM and treating trauma patients in the ED, current ATLS® status; or
NA
E
E
E
E
(d) Has demonstrated special capabilities through commitment, continuing education, and experience;
NA
NA
NA
NA
E
(3) Advanced Practice Professionals (APP) providing care to the trauma patient who have current ATLS® certification; and
NA
E
E
E
E
(4) A liaison to the trauma QM program with 50 percent attendance.
NA
E
E
E
E
C. Critical Care. Critical care requirements are as follows:
(1) Intensive care with a designated surgical director who is fellowship trained and board certified in surgery or critical care;
E
E
D
NA
NA
(2) A board certified surgeon who serves as director or co-director of the ICU and is actively involved in, and responsible for, setting policies and administrative decisions related to trauma ICU patients;
NA
NA
E
D
NA
(3) A trauma surgeon who retains responsibility for the patient and coordinates all therapeutic decisions;
NA
E
E
E
NA
(4) If Telemedicine is used, physician/s who have privileges in critical care and be approved by the TMD; and
E
E
E
E
NA
(5) A liaison to the trauma QM program with 50 percent attendance.
E
E
E
E
NA
Code of Maryland Regulations › Title 30 - MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS) › Subtitle 08 - DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS › Chapter 30.08.05 - Trauma Center Designation and Verification Standards › Section 30.08.05.09 - Additional Surgical Specialties

Current through Register Vol. 51, No. 14, July 12, 2024
The following surgical specialties shall be on call and available with a 30-minute response time:
PARC
I
1 II
III
ED
A. Cardiac;
E
E
D
NA
NA
B. Hand;
E
E
D
D
NA
C. Microvascular replant or flaps;
E
E
D
D
NA
D. Obstetric and gynecologic;
E
E
E
E
NA
E. Ophthalmic;
E
E
E
D
NA
F. Oral or maxillofacial;
E
E
E
D
NA
G. Otorhinolaryngologic;
E
E
E
D
NA
H. Pediatric;
E
E
D
D
NA
I. Plastic;
E
E
E
D
NA
J. Thoracic;
E
E
E
E
NA
K. Urologic; and
E
E
E
E
NA
L. Vascular.
E
E
E
D
NA