reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.04 - School Health Services and Required Immunizations Before Entry into School › Section 10.06.04.03 - Required Immunizations

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Except as provided in Regulations .04-.06 of this chapter, a preschool or
				  school principal or other person in charge of a preschool or school, public or
				  private, may not knowingly admit a student to or retain a student in a:
(1) Preschool program unless the student's
				  parent or guardian has furnished evidence of age-appropriate immunity against
				  Haemophilus influenzae, type b, and pneumococcal disease;
(2) Preschool program or kindergarten through
				  the second grade of school unless the student's parent or guardian has
				  furnished evidence of age-appropriate immunity against pertussis; and
(3) Preschool program or kindergarten through
				  the 12th grade unless the student's parent or guardian has furnished evidence
				  of age-appropriate immunity against:
(a)
				  Tetanus;
(b) Diphtheria;
(c) Poliomyelitis;
(d) Measles (rubeola);
(e) Mumps;
(f) Rubella;
(g) Hepatitis B;
(h) Varicella;
(i) Meningitis; and
(j) Tetanus-diphtheria-acellular pertussis
				  acquired through a Tetanus-diphtheria-acellular pertussis (Tdap)
				  vaccine.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.04 - School Health Services and Required Immunizations Before Entry into School › Section 10.06.04.04 - Medical Contraindications

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  The requirements of Regulation .03 of this chapter do not apply to a student
				  who presents a licensed physician's or health officer's written statement that
				  the student's immunization against a disease in Regulation .03 of this chapter
				  is medically contraindicated.
B.
				  The physician or health officer shall indicate in the statement presented under
				  §A of this regulation whether the contraindication is:
(1) Permanent; or
(2) Temporary.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.04 - School Health Services and Required Immunizations Before Entry into School › Section 10.06.04.05 - Religious Exemption

Current through Register Vol. 51, No. 14, July 12, 2024
A. Using
				  the form provided by the Department of Health and Mental Hygiene, a student
				  whose parent or guardian objects to immunization on the ground that the
				  immunization conflicts with the parent's or guardian's bona fide religious
				  beliefs and practices is exempt from the requirement to present a physician's
				  certificate of immunization in order that the student be admitted to
				  school.
B. The exemption allowed
				  under §A of this regulation does not apply when the Secretary declares an
				  emergency or epidemic of disease.
C. A preschool or school, public or private,
				  shall maintain a current list of all students enrolled who have an exemption to
				  immunizations on religious grounds.
D. Annually, by November 15th, a preschool or
				  school, public or private, shall report to the Secretary of Health and Mental
				  Hygiene the number of students with a religious exemption enrolled in all
				  grades.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.04 - School Health Services and Required Immunizations Before Entry into School › Section 10.06.04.06 - Temporary Admission or Retention

Current through Register Vol. 51, No. 14, July 12, 2024
A. Subject to the provisions of §B of
				  this regulation, a preschool or school, public or private, shall temporarily
				  admit a student to or retain a student in a preschool or school if:
(1) The student is homeless; or
(2) The student's parent or guardian is
				  unable to provide proof of immunization pursuant to the requirements of
				  Regulation .03 of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.04 - School Health Services and Required Immunizations Before Entry into School › Section 10.06.04.07 - Vaccine Provision

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  student may have an immunization administered by the student's personal
				  physician.
B. If a parent or
				  guardian cannot obtain the service of a private physician, the parent or
				  guardian of the student may take the student to the local health department for
				  the immunizations.
C. A local
				  health department shall provide the immunization referenced in §B of this
				  regulation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.04 - School Health Services and Required Immunizations Before Entry into School › Section 10.06.04.08 - Record Review

Current through Register Vol. 51, No. 14, July 12, 2024
A preschool or school, public or private, shall make
					 immunization records of students available for review by a health officer as
					 needed to assure compliance with regulations or to ascertain the immunization
					 status of students.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.04 - School Health Services and Required Immunizations Before Entry into School › Section 10.06.04.09 - Report on New Students

Current through Register Vol. 51, No. 14, July 12, 2024
Annually, by November 15, on a form provided by the
					 Department, a preschool or school, public or private, shall provide the health
					 officer of the jurisdiction where the school is located with an immunization
					 report of students in preschool through 12th grade who are new to the
					 school.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.04 - School Health Services and Required Immunizations Before Entry into School › Section 10.06.04.10 - Responsible Agencies

Current through Register Vol. 51, No. 14, July 12, 2024
The local superintendents of schools and the local health
					 officers shall be responsible for carrying out the provisions of this
					 chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.05 - Meningococcal Vaccination Requirements for Students in Institutions of Higher Education › Section 10.06.05.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
This chapter applies to meningococcal vaccination of
					 individuals enrolled in institutions of higher education who are living in
					 on-campus student housing.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.05 - Meningococcal Vaccination Requirements for Students in Institutions of Higher Education › Section 10.06.05.02 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) "Enrolled" means having registered for a
				  credit or noncredit course.
(2)
				  "Institution of higher education" means a school of post-secondary education
				  that generally limits enrollment to graduates of secondary schools and awards
				  degrees at the associate, baccalaureate, or graduate level.
(3) "Meningococcal vaccination" means receipt
				  of the vaccine protecting against at least the four serogroups of A, C, Y, and
				  W-135 of meningococcal disease within the preceding 5 years before the
				  individual moves into on-campus student housing.
(4) "On-campus student housing" means housing
				  provided to individuals, regardless of the fee, that is owned, rented, or
				  contracted for and operated by an institution of higher education, or through
				  written agreement, with an agent of the institution of higher
				  education.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.05 - Meningococcal Vaccination Requirements for Students in Institutions of Higher Education › Section 10.06.05.03 - Required Meningococcal Vaccination

Current through Register Vol. 51, No. 14, July 12, 2024
Except as provided in Regulation .05 of this chapter, an
					 individual enrolled in an institution of higher education living in on-campus
					 student housing shall:
A. Obtain a
				  meningococcal vaccination; and
B.
				  Submit written documentation to the institution of higher education from a
				  health care professional or clinic of receipt of a meningococcal
				  vaccination.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.05 - Meningococcal Vaccination Requirements for Students in Institutions of Higher Education › Section 10.06.05.04 - Notification of Required Meningococcal Vaccination

Current through Register Vol. 51, No. 14, July 12, 2024
An institution of higher education shall:
A. Inform an individual or the parent or
				  guardian of an individual younger than 18 years old of the requirement for
				  meningococcal vaccination at the time the individual:
(1) Is accepted for admission to an
				  institution of higher education; or
(2) Registers for classes, if the individual
				  is not required to apply for admission before registering for
				  courses;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.05 - Meningococcal Vaccination Requirements for Students in Institutions of Higher Education › Section 10.06.05.05 - Exemption from Meningococcal Vaccination Requirement

Current through Register Vol. 51, No. 14, July 12, 2024
A. An individual 18 years old or older is
				  exempt from the meningococcal vaccination requirement set forth at Regulation
				  .03 of this chapter if the individual presents to the institution of higher
				  education a signed written waiver as set forth in Regulation .06A of this
				  chapter stating that the individual has:
(1)
				  Received and reviewed the information specified in Regulation .04C of this
				  chapter; and
(2) Chosen not to
				  obtain the meningococcal vaccination.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.05 - Meningococcal Vaccination Requirements for Students in Institutions of Higher Education › Section 10.06.05.06 - Waiver Form

Current through Register Vol. 51, No. 14, July 12, 2024
A. A waiver
				  form for an individual 18 years old or older shall:
(1) State that the individual:
(a) Is 18 years old or older;
(b) Has received and reviewed the information
				  provided by the institution of higher education on the risk of meningococcal
				  disease and the availability and effectiveness of meningococcal vaccine;
				  and
(c) Chooses to waive the
				  receipt of meningococcal vaccine; and
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.05 - Meningococcal Vaccination Requirements for Students in Institutions of Higher Education › Section 10.06.05.07 - Payment for Meningococcal Vaccination

Current through Register Vol. 51, No. 14, July 12, 2024
Nothing in this chapter shall be construed to require an
					 institution of higher education or a local public health agency to provide or
					 pay for a meningococcal vaccination.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.06 - Communicable Disease Prevention-Handling, Treatment, and Disposal of Special Medical Waste › Section 10.06.06.01 - Scope and Purpose

Current through Register Vol. 51, No. 14, July 12, 2024
A. Scope.
(1) Regulations .01-.03 apply to a person who
				  generates and handles special medical waste or sharps.
(2) Regulations .01-.07 apply to a person who
				  treats and disposes of special medical waste.
(3) This chapter does not apply to:
(a) Waste generated from veterinary practices
				  that is governed by COMAR
				  15.14.03.02A;
(b) Radioactive medical waste that is
				  governed by COMAR
				  26.12.01.01A;
(c) Remains of a dead human; and
(d) Fetuses and placentas that are released
				  to a funeral director or a parent.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.06 - Communicable Disease Prevention-Handling, Treatment, and Disposal of Special Medical Waste › Section 10.06.06.03 - Handling of Special Medical Waste

Current through Register Vol. 51, No. 14, July 12, 2024
A person shall handle special medical waste in accordance
					 with the requirements of:
A.
										29 CFR §
											1910.1030(d)(4)(iii)(A) and
				  (B), which is incorporated by reference at
				  COMAR 09.12.31; and
B. COMAR
				  26.13.12.05A and
				  26.13.13.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.06 - Communicable Disease Prevention-Handling, Treatment, and Disposal of Special Medical Waste › Section 10.06.06.04 - Treatment of Special Medical Waste, Excluding Sharps, Before Disposal

Current through Register Vol. 51, No. 14, July 12, 2024
A. Except as
				  provided in §B of this regulation, a person shall:
(1) Treat special medical waste, excluding
				  sharps, before disposal; and
(2)
				  Use one of the following treatment methods:
(a) Autoclaving;
(b) Chemical disinfection;
(c) Cremation;
(d) Disinfection;
(e) Mechanical destruction after
				  decontamination;
(f) Incineration;
				  or
(g) An alternative method that
				  meets the criteria of Regulation .06 of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.06 - Communicable Disease Prevention-Handling, Treatment, and Disposal of Special Medical Waste › Section 10.06.06.05 - Treatment of Sharps Before Disposal

Current through Register Vol. 51, No. 14, July 12, 2024
A person shall treat sharps:
A. Before disposal; and
B. By one of the following methods:
(1) Encapsulation;
(2) Incineration;
(3) Mechanical destruction after
				  decontamination; or
(4) An
				  alternative method that meets the criteria of Regulation .06 of this
				  chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.06 - Communicable Disease Prevention-Handling, Treatment, and Disposal of Special Medical Waste › Section 10.06.06.06 - Alternative Treatment Systems

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Except as provided in §B of this regulation, a person may not use a method
				  for treatment of special medical waste other than those set forth at
				  Regulations .04A(2) and .05B of this chapter.
B. Criteria for Alternative Treatment System.
				  A person may use a method for treatment of special medical waste that complies
				  with the following standards for treatment and microbial test procedures:
(1) The method inactivates vegetative
				  bacteria, fungi, parasites, lipophilic or hydrophilic viruses, and mycobacteria
				  at a 6 log reduction or greater;
(2) The method inactivates bacterial spores
				  at a 4 log reduction or greater; and
(3) The tests have been performed on a
				  representative from each of the following microbial groups:
(a) Staphylococcus aureus (ATCC 6538) or
				  Pseudomonas aeruginosa (ATCC 15422);
(b) Candida albicans (ATCC 18804) or
				  Penicillium chrysogenum (ATCC 24791);
(c) Polio 2 or Polio 3 or MS-2 Bacteriophage,
				  (ATCC 15597-B1);
(d)
				  Cryptosporidium spp. oocysts or Giardia spp. cysts;
(e) Mycobacterium terrae, Mycobacterium
				  phlei, or Mycobacterium bovis (BCG) (ATCC 35743); and
(f) Bacillus stearothermophilus (ATCC 7953)
				  or Bacillus subtilis (ATCC 19659).
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.06 - Communicable Disease Prevention-Handling, Treatment, and Disposal of Special Medical Waste › Section 10.06.06.07 - Disposal of Special Medical Waste

Current through Register Vol. 51, No. 14, July 12, 2024
A. Subject to §§B and C of this
				  regulation, a person shall dispose of special medical waste after treatment by
				  one of the following methods:
(1)
				  Interment;
(2) Depositing in a
				  facility approved to accept the type of solid waste being disposed in
				  accordance with §C of this regulation; or
(3) Incineration.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.06 - Communicable Disease Prevention-Handling, Treatment, and Disposal of Special Medical Waste › Section 10.06.06.08 - Enforcement

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Secretary
				  may enter the property of any person who generates, handles, treats, or
				  disposes of special medical waste to investigate a complaint the Secretary
				  receives regarding the handling, treatment, or disposal of special medical
				  waste.
B. Criminal Penalties.
(1) A person who violates these regulations
				  is guilty of a misdemeanor, and on conviction is subject to a fine not
				  exceeding $500.
(2) Each day that a
				  violation exists shall constitute a separate offense.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.07 - Sexually Transmitted Infections - Expedited Partner Therapy for Chlamydia, Gonorrhea, and Trichomoniasis › Section 10.06.07.01 - Purpose and Scope

Current through Register Vol. 51, No. 14, July 12, 2024
A. The purpose
				  of expedited partner therapy in Maryland is to:
(1) Provide antibiotic therapy to any partner
				  of a patient diagnosed with chlamydia, gonorrhea, or trichomoniasis without a
				  personal physical assessment of the partner, and without having a previous
				  provider-patient relationship with the partner;
(2) Contain and stop the further spread of
				  chlamydia, gonorrhea, and trichomoniasis; and
(3) Reduce the likelihood of reinfection in
				  the diagnosed patient.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.07 - Sexually Transmitted Infections - Expedited Partner Therapy for Chlamydia, Gonorrhea, and Trichomoniasis › Section 10.06.07.02 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) "Antibiotic therapy" means the oral
				  antibiotic treatment regimens:
(a) Currently
				  recommended by the Centers for Disease Control and Prevention for the treatment
				  of chlamydia and gonorrhea through expedited partner therapy; and
(b) For the treatment of trichomoniasis
				  through expedited partner therapy:
(i) In
				  accordance with Regulation .05A of this chapter; and
(ii) As authorized by Health-General Article,
				  §18-214.1, Annotated Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.07 - Sexually Transmitted Infections - Expedited Partner Therapy for Chlamydia, Gonorrhea, and Trichomoniasis › Section 10.06.07.03 - Partners Eligible for EPT

Current through Register Vol. 51, No. 14, July 12, 2024
Partners eligible for EPT are:
A. Any partner within 60 calendar days of the
				  patient's diagnosis; or
B. The most
				  recent partner of a patient if the patient has not had sex in the 60 days
				  before diagnosis.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.07 - Sexually Transmitted Infections - Expedited Partner Therapy for Chlamydia, Gonorrhea, and Trichomoniasis › Section 10.06.07.04 - Health Care Providers Authorized to Prescribe and Dispense EPT

Current through Register Vol. 51, No. 14, July 12, 2024
Notwithstanding any other provision of law, and only in
					 accordance with their current scope of practice, EPT may be prescribed or
					 dispensed by the following health care providers:
A. A physician licensed under Health
				  Occupations Article, Title 14, Annotated Code of Maryland;
B. An authorized physician assistant licensed
				  under Health Occupations Article, Title 15, Annotated Code of Maryland, acting
				  in accordance with Health Occupations Article, §
										15-302.2,
				  Annotated Code of Maryland;
C. An
				  advanced practice registered nurse with prescriptive authority licensed under
				  Health Occupations Article, Title 8, Annotated Code of Maryland, acting in
				  accordance with Health Occupations Article, §
										8-508, Annotated
				  Code of Maryland; and
D. A
				  registered nurse employed by a local health department who complies with:
(1) The formulary developed and approved
				  under Health-General Article, §3-403(b), Annotated Code of Maryland;
				  and
(2) The requirements
				  established under Health Occupations Article, §
											8-512, Annotated
				  Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.07 - Sexually Transmitted Infections - Expedited Partner Therapy for Chlamydia, Gonorrhea, and Trichomoniasis › Section 10.06.07.04-1 - Pharmacists Authorized to Dispense EPT

Current through Register Vol. 51, No. 14, July 12, 2024
Notwithstanding any other provision of law, a pharmacist
					 licensed under Health Occupations Article, Title 12, Annotated Code of
					 Maryland, may dispense antibiotic therapy for EPT prescribed in accordance with
					 Regulation . 04 of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.07 - Sexually Transmitted Infections - Expedited Partner Therapy for Chlamydia, Gonorrhea, and Trichomoniasis › Section 10.06.07.05 - Prescribing and Dispensing EPT Medications

Current through Register Vol. 51, No. 14, July 12, 2024
A. Antibiotic therapy prescribed or dispensed
				  for EPT shall be in accordance with treatment recommendations from the Centers
				  for Disease Control and Prevention.
B. Prescribing.
(1) A separate
				  prescription shall be issued for each partner.
(2) The designation "EPT" or "Expedited
				  Partner Therapy" shall be included on the face of the prescription for each
				  prescription issued.
(3) If the
				  partner's name is known, the prescription shall be issued in the partner's
				  name.
(4) If the partner's name is
				  unknown, the written designation "EPT" or "expedited partner therapy" shall be
				  sufficient for the pharmacist to fill the prescription.
(5) An EPT prescription may not be refilled.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.07 - Sexually Transmitted Infections - Expedited Partner Therapy for Chlamydia, Gonorrhea, and Trichomoniasis › Section 10.06.07.06 - Counseling and Educational Information Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A. A health care provider prescribing or
				  dispensing EPT to a patient shall:
(1)
				  Counsel the patient to encourage each partner to seek a personal physical
				  assessment; and
(2) Provide the
				  patient with educational information for each partner, in accordance with
				  §C of this regulation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.07 - Sexually Transmitted Infections - Expedited Partner Therapy for Chlamydia, Gonorrhea, and Trichomoniasis › Section 10.06.07.07 - Documenting EPT in a Medical Chart

Current through Register Vol. 51, No. 14, July 12, 2024
A. A health care provider prescribing or
				  dispensing EPT shall document the provision of EPT in the patient's
				  chart.
B. Documentation shall
				  include the:
(1) Number of EPT prescriptions
				  or medications provided to the patient for each partner; and
(2) Medication and dosage being provided to
				  the patient for each partner.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 06 - DISEASES › Chapter 10.06.07 - Sexually Transmitted Infections - Expedited Partner Therapy for Chlamydia, Gonorrhea, and Trichomoniasis › Section 10.06.07.08 - Reporting of Chlamydia and Gonorrhea by a Health Care Provider or Institution

Current through Register Vol. 51, No. 14, July 12, 2024
A. This
				  chapter may not affect the obligation of a health care provider or institution
				  to report to a health officer cases of chlamydia and gonorrhea and the
				  treatment provided to those cases in accordance with COMAR 10.06.01.04.
B. When reporting a case of
				  chlamydia or gonorrhea for which EPT was prescribed or dispensed, a health care
				  provider or institution shall report the number of partners for whom:
(1) Prescriptions were provided;
				  and
(2) Medications were
				  dispensed.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.02 - Incorporation by Reference

Current through Register Vol. 51, No. 14, July 12, 2024
The Guidelines for the Design and Construction of Hospitals
					 and Outpatient Facilities, The Facilities Guidelines Institute (2014 Edition),
					 is incorporated by reference, with the following exceptions:
A. 2.3 Specific Requirements for Freestanding
				  Emergency Department, pp. 211-213;
B. 3.3 Specific Requirements for Freestanding
				  Outpatient Diagnostic and Treatment Facilities, pp. 295-296;
C. 3.4 Specific Requirements for Freestanding
				  Birthing Center, pp. 297-302;
D. 3.5
				  Specific Requirements for Freestanding Urgent Care Centers, pp. 303-306;
				  and
E. 3.6 Specific Requirements for
				  Freestanding Cancer Treatment Facilities, pp. 307-309.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.03 - Physical Environment

Current through Register Vol. 51, No. 14, July 12, 2024
A. General
				  Hospital. A hospital shall be classified as a general hospital if the hospital
				  at least has the facilities and provides the services that are necessary for
				  the general medical and surgical care of patients.
B. Special Hospital. A hospital shall be
				  classified as a special hospital if the hospital:
(1) Defines a program of specialized
				  services, such as obstetrics, mental health, tuberculosis, orthopedy, chronic
				  disease, or communicable disease;
(2) Admits only patients with medical or
				  surgical needs within the program; and
(3) Has the facilities for and provides those specialized
				  services.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.04 - Licensure Application Procedure

Current through Register Vol. 51, No. 14, July 12, 2024
A. A person desiring to open a hospital, to
				  continue the operation of an existing hospital, or to change the classification
				  of an existing hospital shall file an application with the Secretary, on a
				  written or electronic form provided by the Secretary. An application shall
				  state the classification of hospital for which a license is sought.
B. Applications on behalf of a corporation,
				  association, or governmental unit or agency shall be made by two officers of
				  the corporation, association, or governmental unit or agency and names of their
				  Board members shall be submitted. Ownership of property, real estate, and
				  equipment shall be disclosed if it is other than the licensee's. The names of
				  persons holding 2 percent or more of the stock or assets shall be
				  disclosed.
C. License Renewal. An
				  application for the renewal of the license on a written or electronic form
				  provided by the Secretary shall be made:
(1)
				  By a nonaccredited hospital at least 60 days before expiration of the issued
				  license; or
(2) By an accredited
				  hospital within 30 calendar days of the exit date of the triennial survey
				  conducted by an accreditation organization approved by the
				  Department.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.05 - Duration of License

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Secretary shall issue a license to an accredited hospital or special
				  rehabilitation hospital for the term of the facility's accreditation.
B. The Secretary shall issue a license to a
				  nonaccredited hospital for a term not to exceed 1 year.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.06 - Separate License Required

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Separate licenses are required for institutions maintained on separate
				  premises, even though both institutions are operated under the same
				  management.
B. Separate licenses
				  are not required for separate buildings on the same grounds.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.06-1 - Licensed Bed Capacity

Current through Register Vol. 51, No. 14, July 12, 2024
A. On or
				  before July 1, 2000, and each July 1 thereafter, the Secretary shall determine
				  the authorized licensed bed capacity for each hospital classified as a general
				  hospital.
B. Methodology for
				  Calculating Total Authorized Licensed Bed Capacity.
(1) The average daily census for each general
				  hospital shall be obtained from the most current Health Services Cost Review
				  Commission inpatient utilization data for a 12-month period.
(2) The calculation of average daily census
				  shall include the utilization of inpatient medical-surgical, gynecology,
				  obstetric, pediatric, and acute psychiatric service beds. Newborn services are
				  excluded from the calculation of average daily census.
(3) The total licensed bed capacity for each
				  general hospital shall equal 140 percent of the calculated average daily census
				  for all inpatient acute care hospital services.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.07 - Inspections

Current through Register Vol. 51, No. 14, July 12, 2024
A. New Hospitals. A
				  hospital that began initial operation on or after July 1, 1982, shall be
				  inspected for compliance with the safety and sanitation components of the
				  regulations promulgated by the Department until the hospital receives
				  accreditation by an accreditation organization approved by the Department. If
				  the hospital has not applied for accreditation by an accreditation organization
				  approved by the Department within 1 year after beginning operation or has had
				  its application for accreditation rejected, the Department shall inspect the
				  hospital for compliance with the standards adopted under this
				  subtitle.
B. Accredited Hospitals
				  and Accredited Special Rehabilitation Hospitals. An accredited hospital and an
				  accredited special rehabilitation hospital shall be subject to inspection under
				  this chapter by the Department to:
(1)
				  Determine compliance with a quality requirement;
(2) Follow up on any serious problem
				  identified by an accreditation organization approved by the
				  Department;
(3) Investigate a
				  complaint; or
(4) Validate the
				  findings of an accreditation organization approved by the Department.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.08 - Complaint Investigations

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Notwithstanding any other provisions of this subtitle, each hospital and
				  residential treatment center shall be open to inspections by the Department to
				  investigate and resolve any complaint concerning patient care, safety, medical
				  and nursing supervision, physical environment, sanitation, or dietary
				  matters.
B. Complaints.
(1) To resolve expeditiously a complaint that
				  alleges the existence of any non-life-threatening deficiency, the Department
				  shall refer the complaint directly to the hospital.
(2) If appropriate, issues relating to the
				  practice of medicine or the licensure or conduct of a health professional shall
				  be referred to the hospital and may be referred to the appropriate licensure
				  Board for resolution.
(3) If the
				  Department determines that the hospital has not satisfactorily addressed the
				  referred complaint or if the complaint alleges the existence of a
				  life-threatening deficiency, the Department shall conduct an independent
				  investigation. When conducting its independent investigation, the Department
				  shall use:
(a) For an accredited hospital, the
				  standards of review of The Joint Commission;
(b) For an accredited special rehabilitation
				  hospital, the standards of review of the Commission on Accreditation of
				  Rehabilitation Facilities; or
(c)
				  For a nonaccredited hospital, the standards adopted by the Secretary under this
				  subtitle.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.09 - Service Standards - Nonaccredited Hospitals

Current through Register Vol. 51, No. 14, July 12, 2024
A. Acute General Hospitals and Special
				  Hospitals.The 2013 Hospital Accreditation Standards (July Update, The Joint
				  Commission, One Renaissance Blvd., Oakbrook, Illinois 60181), is incorporated
				  by reference.
B. Waiver Authority.
				  The Secretary may, for good cause, waive compliance with the incorporated Joint
				  Commission standards. The hospital shall justify the need for the waiver in the
				  manner prescribed by the Department.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.10 - Service Standards - Special Rehabilitation Hospitals

Current through Register Vol. 51, No. 14, July 12, 2024
A. Before a special rehabilitation hospital
				  can provide or hold itself out as providing comprehensive physical
				  rehabilitation services, the special rehabilitation hospital shall:
(1) Except as otherwise provided in this
				  regulation, be accredited by the Commission on Accreditation of Rehabilitation
				  Facilities; and
(2) Meet the
				  standards of the Commission on Accreditation of Rehabilitation Facilities as
				  set forth in the Medical Rehabilitation Standards Manual, which is incorporated
				  by reference under COMAR
				  10.07.18.05C.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.11 - Special Rehabilitation Programs - Hospitals

Current through Register Vol. 51, No. 14, July 12, 2024
A. Except as otherwise provided in this
				  regulation, before a hospital can provide or hold itself out as providing any
				  specialized rehabilitation program, the hospital shall be accredited by the
				  Commission on Accreditation of Rehabilitation Facilities to provide the
				  program.
B. The requirement that a
				  hospital be accredited by the Commission on Accreditation of Rehabilitation
				  Facilities before the hospital can provide any specialized rehabilitation
				  program shall be waived if the hospital has applied for accreditation for the
				  program, for not more than 2 years from the later of:
(1) July 1, 1986; or
(2) The date on which the hospital begins
				  operation of the specialized rehabilitation program.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.12 - Records and Reports - Inspection

Current through Register Vol. 51, No. 14, July 12, 2024
Licensees shall keep such records and make reports in the
					 manner and form as the Secretary shall prescribe by regulation, and all these
					 records shall be open to inspection by the Secretary.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.13 - Utilization Review Plan

Current through Register Vol. 51, No. 14, July 12, 2024
A. Before
				  October 1, 1985, each hospital shall submit a proposed utilization review plan
				  to the Secretary.
B. Effective
				  October 1, 1985, each hospital shall have in effect a utilization review plan
				  approved by the Secretary pursuant to this chapter.
C. The purpose of the hospital's utilization
				  review program, as defined by the plan, shall be to determine for patients
				  included in the hospital's review responsibilities the:
(1) Reasonableness and medical necessity of
				  care given or proposed to be given at the hospital;
(2) Quality of care given at the hospital;
				  and
(3) Appropriateness of the
				  level of care proposed or given, including whether the care could be or could
				  have been provided appropriately and more economically on an outpatient basis
				  or in a facility that provides a lower level of care.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.14 - Utilization Review Agent

Current through Register Vol. 51, No. 14, July 12, 2024
A. Each
				  hospital shall appoint a utilization review agent to carry out the requirements
				  of the utilization review plan. When the agent is composed of hospital related
				  personnel the hospital's plan shall expressly designate the positions and the
				  organizational structure within the hospital that constitute the utilization
				  review agent for that institution.
B. Each utilization review plan shall set
				  forth the manner in which the agent:
(1)
				  Utilizes the services of doctors of medicine or osteopathy and other
				  practitioners capable of admitting patients, who are representative of
				  practicing physicians in the area in which the hospital is located.
(2) Has available the services of sufficient
				  numbers of physicians and dentists to assure the adequate review of medical
				  specialty and subspecialty cases.
(3) Utilizes the services of registered
				  nurses, medical records technicians, or similarly qualified persons supported
				  and supervised by physicians in carrying out its review activities.
(4) Uses only a doctor of medicine,
				  osteopathy, or dentistry to make a final determination that care rendered or to
				  be rendered was, is, or may be medically inappropriate.
(5) Makes direct comparisons with
				  professionally developed, objective criteria to determine the appropriateness
				  of admission and continued stay. The criteria should:
(a) Be nationally recognized and accepted,
				  unless a special exception is granted by the Secretary;
(b) Be capable of being utilized to define
				  the type and extent of services which are to be considered as within the range
				  of appropriate diagnosis and treatment for a given condition;
(c) Identify the level of care at which the
				  services can appropriately and economically be rendered; and
(d) Recognize that for many conditions more
				  than one mode or site of treatment or diagnosis may be medically
				  acceptable.
(6) Collects
				  information relevant to its function, maintains records, and reports to the
				  Department as required. The hospital's utilization review plan shall outline
				  the method by which patient confidentiality shall be maintained.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.15 - Performance Standards for Utilization Review

Current through Register Vol. 51, No. 14, July 12, 2024
The hospital's program shall apply to all patients with the
					 exceptions of those noted in Regulation .17, below. Except when noted for
					 certain types of review, the program may delineate certain types and kinds of
					 cases to be reviewed, so as to most efficiently carry out the purposes of these
					 regulations. As a minimum, the hospital utilization review program shall
					 satisfy the following performance standards:
A. Pre-admission Review.
(1) A review of those elective admissions
				  identified under the plan shall be performed by the agent in advance of the
				  proposed admission.
(2) The purpose
				  of this review shall be to determine the reasonableness and medical necessity
				  of the admission, and the appropriateness of the level of proposed
				  care.
(3) In conducting the review,
				  the agent may supplement the information provided by the hospital through
				  discussion with the patient's physician.
(4) The agent, using specific medical
				  criteria, shall render a decision as to whether the admission is medically
				  appropriate within 3 working days of the time it receives the case, except in
				  those circumstances when responding within this period would not permit
				  sufficient consultation or discussion to render a responsible
				  opinion.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.16 - Protection of Patients - Patient Liability

Current through Register Vol. 51, No. 14, July 12, 2024
A. Charges for any days disallowed as a
				  result of retrospective review by the agent or by a payer conducting
				  utilization review under these regulations shall be deducted from the gross
				  charges in the bill to the patient as a contractual allowance unless the
				  patient refuses or has refused to leave the hospital when it is medically
				  appropriate to do so, and the disallowed days occur:
(1) After the hospital has notified the
				  patient in writing of the potential disallowance; or
(2) As a direct result of the noncompliance
				  by the patient to treatment or hospital regulations.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.17 - Exemptions from Hospital Utilization Review

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hospital shall be exempt from carrying
				  out utilization review procedures for a given patient if the:
(1) Person, corporate entity, or insurance
				  plan paying for the patient's hospitalization has a utilization review program
				  that is determined by the Insurance Commissioner and the Secretary to
				  substantially meet the minimum standards described in these regulations,
				  including the reporting requirements detailed in Regulation .19 of this
				  chapter, those programs and amendments to them having been submitted to the
				  Commissioner for approval;
(2)
				  Patient is a subscriber or a member of a health maintenance organization as
				  defined in Health-General Article, §19-701, Annotated Code of Maryland;
				  or
(3) Patient is a Medicare or
				  Maryland Medical Assistance Program beneficiary, and the services rendered at
				  the hospital are within the scope of coverage provided by the relevant
				  program.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.18 - Record Maintenance by Utilization Review Agents

Current through Register Vol. 51, No. 14, July 12, 2024
A. The plan shall describe how, in addition
				  to maintaining documents which describe its utilization review procedures, the
				  agent shall maintain the following records for each individual patient for whom
				  any aspect of the utilization review procedure has been applied:
(1) The patient's name, hospital history
				  number, source of payment, and other demographic information capable of
				  identifying the patient.
(2) The
				  principal diagnosis or diagnoses (with corresponding codes listed in the
				  International Classification of Diseases, Ninth Revision, Clinical Modification
				  (ICD-9-CM) as defined in COMAR
				  10.09.06.01P),
				  and the particular category of patient chosen for review in accordance with the
				  hospital's utilization review plan.
(3) The date or dates on which review
				  activities were requested and the date or dates on which opinions were
				  rendered.
(4) The type of review
				  carried out, the nature of the criteria applied, and the results of the review.
				  In the case of disallowed services, the reasons for disallowance shall be
				  stated, as well as the name of the physician member of the agent's staff making
				  the final disallowance determination.
(5) In the case of objective second opinions,
				  documentation shall include the name of the physician rendering the second
				  opinion, the physician's specialty, and the nature of the opinion.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 07 - HOSPITALS › Chapter 10.07.01 - Acute General Hospitals and Special Hospitals › Section 10.07.01.19 - Reports to the Secretary

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Each hospital shall report annually to the Secretary the following summary
				  statistics on the activity of its utilization review program:
(1) The number of discharges and total
				  patient days reviewed under the program;
(2) For each of the procedures requiring
				  pre-authorization for inpatient treatment, the number of patients:
(a) Reviewed; and
(b) Approved for inpatient
				  treatment;
(3) For each
				  of the procedures requiring an objective second opinion, the number of
				  patients:
(a) Undergoing the procedure at the
				  hospital;
(b) Admitted
				  non-electively for the procedure;
(c) Admitted electively after the patient had
				  obtained a second opinion; and
(d)
				  Admitted electively but for whom the requirement of a second opinion was
				  waived, including a tabulation of the reasons for waivers;
(4) For admissions reviewed concurrently or
				  retrospectively, the number of all reviewed admissions disapproved, and reasons
				  for disapproval;
(5) The number of
				  all reviewed days of hospitalization disapproved, by reason for
				  disapproval;
(6) A summary of the
				  findings of re-admission review, including the frequency and proportion of
				  these cases, the diagnoses or treatments involved, and the reasons
				  found;
(7) A listing and
				  description of quality care problems found by the agent in the course of
				  reviewing patient records in furtherance of its duties under the utilization
				  review plan.