[(17)] (30) "Licensed practical nurse (LPN)" means [a person] an individual who holds a license to practice licensed practical nursing in this State. [(17-1)] (31)—[(17-2)] (32) (text unchanged) [(18)] (33) "Mantoux tuberculin skin test" means a test to diagnose tuberculosis infection [utilizing 5TU (tuberculin units) of] using purified protein derivative (PPD) that is injected intradermally and read within 48—72 hours with results recorded in millimeters of induration. [(18-1)] (34) (text unchanged) [(19)] (35) "Medical director" means [any person] an individual licensed to practice medicine in this State who, pursuant to a written agreement, is responsible for the overall coordination of the medical care in the facility to ensure the adequacy and appropriateness of the medical services provided to [patients] residents and to maintain surveillance of the health status of employees. [(20)] (36) "Medicine aide" means [a person] an individual who has successfully completed the 60-hour Department of Health and Mental Hygiene approved community college course and has further satisfied, where applicable, the continuing education requirements. [(20-1) "Minimum Data Assessment" means the Resident Assessment Instrument for Long Term Care Facilities, Transmittal No. 272, April 1995, and Transmittal No. 22, December 2000, U.S. Department of Health and Human Services, Center for Medicare and Medicaid Services.] [(20-2)] (37) "Minimum[data set] Data Set" means a core set of screening, clinical and functional status elements, including common definitions and coding categories, that forms the foundation of the comprehensive assessment for all residents of [long term] long-term care facilities certified to participate in Medicare or Medicaid.
[(50) "Social work associate" means any person licensed to practice as a social work associate in this State. ] [(50-1)] (78) (text unchanged) [(51)] (79) "Speech pathologist" means [a person] an individual licensed by the State Board of Audiologists, Hearing Aid Dispensers, and Speech-Language Pathologists. [(52)] (80) "Supportive personnel" an aide, assigned to a particular service such as nursing, dietary, physical therapy, or occupational therapy, who has been approved by the chief of the services as having sufficient training and experience to perform [his] the assigned duties. [(52-1)] (81) (text unchanged) [(53)] (82) Tuberculosis in a Communicable Form. (a) (text unchanged) (b) "Tuberculosis in a communicable form" does not include: (i) When the individual [with presumed or confirmed active disease] who has presumed or confirmed active disease, has had three negative AFB smears[at least] , collected 8—24 hours apart, shows clinical improvement, and has received chemotherapy to which the strain is susceptible for at least 14 days; or (ii) The individual [with] who has inactive scars, calcification, or a normal chest X-ray. [(54) "Tuberculosis suspect" means an individual who has a cough lasting more than 3 weeks and at least one other symptom that is compatible with active tuberculosis including bloody sputum, night sweats, weight loss, or fever.] [(55)] (83) "Two-step tuberculin skin testing" means the administration of a second tuberculin skin test 1 to 3 weeks after the initial [PPD] skin test is negative, to distinguish a boosted reaction from a reaction that is due to new infection.
Q. (text unchanged) R. Charge Nurses' Daily Rounds. The charge nurse or nurses shall make daily rounds to all nursing units for which responsible, performing such functions as: (1) — (2) (text unchanged) (3) To the degree possible, accompanying physicians when visiting [patients] residents. S. Program of Restorative Nursing Care. shall be an active program of restorative nursing care aimed at assisting each [patient] resident to achieve and maintain [his] the individual’s highest level of independent function including activities of daily living. This program shall include: (1) (text unchanged) (2) Maintaining good body alignment and proper positioning of bedfast [patients] residents; (3) Encouraging and assisting [patients] residents to change positions at least every 2 hours to stimulate circulation and prevent [decubiti] decubitus ulcers and deformities; (4) Encouraging and assisting [patients] residents to keep active and out of bed for reasonable periods of time, within the limitations permitted by physicians' orders, and encouraging [patients] residents to engage in resident chosen community and independent activities and achieve independence [in activities]; and (5) Assisting [patients] residents to adjust to their disabilities, [to] ensuring availability and use of their prosthetic and assistive devices, and to redirect their interests, if necessary. T. Coordination of Nursing and Dietetic Services. Nursing and dietetic services shall establish an effective policy to assure that: (1) Nursing personnel are aware of the nutritional needs and food and fluid intake of [patients] residents and ensure that special [feedings] meals and nourishment are provided when required;
(1) The infection prevention and control program shall establish written policies and procedures to investigate, control, and prevent infections in the facility including policies and procedures to: (a) Identify [facility] health care-associated infections and communicable diseases in accordance with COMAR 10.06.01; (b) Report occurrences of certain [communicable] infectious diseases and outbreaks of [communicable] infectious diseases to the local health department in a timely manner in accordance with COMAR 10.06.01 and Health-General Article, §18-202, Annotated Code of Maryland; (c) Institute appropriate [infection control steps] control measures when an infection or outbreak of infections is suspected or identified in order to control infection and prevent spread to other residents; (d) Perform surveillance for health care-associated and community-associated infections of residents and employees [at appropriate intervals] definitions and methods approved by the infection prevention and control oversight committee to monitor and investigate causes of infection, [facility-associated and community acquired,] and the manner [in which it was] that the infection is spread; (e) employees about infection prevention and control, [and hygiene] including: (i) Standard precautions and [Hand] hand hygiene; (ii) Respiratory [protection] hygiene and etiquette; (iii) Soiled laundry and linen processing; [(iv) Needles, sharps, or both;] (iv) Safe handling of needles and sharps and injections safety; (v) Special medical waste handling and disposal; [and]
situation, the facility shall provide common area or areas of refuge for all [patients] residents as described below. (a) (text unchanged) (b) The 30 square feet (2.79 square meters) per bed include a minimum of 5 percent of the [patients] resident bedrooms. A minimum temperature of [70] 71 °F (22°C) and a maximum temperature of 81 °F (27 °C) shall be maintained in this area. (c) (text unchanged) (d) The facility shall provide to the Department for approval a written plan which defines the specified area or areas of refuge[,] and outlines paths of egress from the common areas of refuge, the provision for light, heat,[ cooling], food service, and the washing and toileting of [patients] residents. (5) Emergency Power Source. The emergency power source shall be a generating set and prime move located on the premises with automatic transfer. The following are required as part of the emergency power system: (a)— (b) (text unchanged) (c) The emergency generator shall have a capability of 48 hours of operation from fuel stored onsite. (d) (text unchanged) [(6) Applicability of Emergency Requirements.] [G.—H. (Repealed)] [I] E. Lighting [New Construction and Existing Facilities]. Each [patient’s] resident’s room be lighted by outside windows and [also] shall have artificial light adequate for reading and other uses as required. All entrances, hallways, stairways, inclines, ramps, basements, attics,
Adjacent Areas Supplied [To] to Room Hour Supplied [To] to Room [To] to Outdoors [Patient] Resident Room E 2 2 Optional Optional [Patient] Resident Area Corridor E 2 4 Optional Optional Examination and Treatment Room E 2 6 Optional Optional Physical Therapy N 2 6 Optional Optional Occupational Therapy N 2 6 Optional Optional Soiled Workroom or Soiled Holding N 2 10 Yes No Workroom or Clean Holding P 2 4 Optional Optional Toilet Room N Optional 10 Yes No Bathroom N Optional 10 Yes No Janitors' Closet(s) N Optional 10 Yes No Sterilizer Equipment Room N Optional 10 Yes No and Trash Chute Room N Optional 10 Yes No Food Preparation Center E 2 10 Yes No Warewashing Room N Optional 10 Yes No Dietary Day Storage E Optional 10 Yes No
safety to ensure that the use of the resident’s belongings would not create any safety or health issues. Personal furnishings that are allowed must be appropriate for the resident’s use. (5) Windows shall be provided with shades or draperies adequate to control glare and maintain privacy; (6) Each living room for [patients] residents’ use shall be provided with a sufficient number of reading lamps, tables, and comfortable chairs or sofas; (7) [In new construction each patient's room] All bedrooms shall be provided with a[ lavatory] hand washing sink with both hot and cold running water unless [private] toilet or bathroom facilities are connected to the bedroom; (8) There shall be at least one bathtub or shower, or bathing device (approved by the Department), in a separate room or compartment for every licensed beds exclusive of bathing devices within a private bedroom or isolation bathroom. The compartment shall be large enough to accommodate wheelchair, shower chair, shower bed, and [attendant] caregiver; (9) There shall be at least one toilet room on each floor large enough to accommodate wheelchair and [attendant] caregiver, to permit toilet assistance or training; If the toilet facilities described above are provided in attached to each private or semi-private residents, bedroom, a separate toilet room on every floor will not be required. An inter-connecting bathroom may not be considered a private bath. (10) For each eight beds there shall be at least one toilet enclosed in a separate room or stall; (11) There shall be one lavatory hand washing sink for every four licensed beds excluding licensed beds in private and isolation bedrooms with private lavatories [found within private bedrooms or isolation bedrooms];