Persons other than licensed health care providers may report suspected abuse or neglect of a vulnerable adult. The director of a medical laboratory defined at Health-Gen 17-201(b)(1) as any facility, entity, or site that offers or performs tests or examinations in connection with the diagnosis and control of human diseases or the assessment of human health, nutritional, or medical conditions . (2)Initiation of services to meet the rehabilitative needs of the[patient]residentshall occur within 48 hours[(],excluding Saturday[and],Sunday[)],andState and federal holidays,of the physicians order for the specialized service. (1) The size and location of the food service area shall comply with COMAR 10.15.03. (2014) Facility Guidelines Institute, which is incorporated in COMAR 10.07.01.02. (1) All policies and procedures for the mobile food cart shall be approved by the Department and the nursing homes local health department before implementation. All rights reserved. See COMAR 10.32.22.02B(18) for alterations in practice and COMAR 10.32.22.02B(20) for resignations. (1) New Construction. An occurrence of a communicable or suspected communicable disease shall be reported and acted upon in accordance with medical asepsis as described in COMAR 10.06.01 Communicable Diseases and COMAR 10.15.03 Food Service Facilities. It looks like your browser does not have JavaScript enabled. Please refer to Renewal Fee Waiver for Active Duty Military Personnel for additional details. (2) The air conditioning system shall be in compliance with NFPA 101 Life Safety Code, NFPA 99 Health Care Facilities Code, and all federal, State, and local codes. (iv)[Provision for storing and transporting clean linen in covered container.] (4) If a facility can demonstrate that because of the experience and training of its personnel and the physical layout and equipment, less supervisory personnel is required, the Department may modify the above requirements for supervision.]. C. Ongoing Monitoring. Yes. Any hiatus during which the health care provider does not exercise staff privileges or fulfill the duties of employment or a contract is a leave of absence. Closed or inactive records shall be filed and stored in a safe place[(],free from fire hazards[)],which provides for confidentiality and, when necessary, retrieval. (1)[In a decentralized]There shall be at least onefood service[,the area or areas for]floor[pantries shall be approved by the Department]pantry per nursing care unit. truthful and transparent services. The[facility]nursing homeshall give appropriate health care information to such volunteers to provide maximum protection to residents. (2)Existing Facilities. 22, referenced in B of this regulation. E. Quality Assurance. (2) Medications shall be administered by: (a) Appropriately licensed personnel in accordance with laws and regulations governing these acts; or. COMAR regulations are Maryland State agency regulations, which are referenced by Title numbers (currently 1-36). (iii) Describes provisions for light, heat, food service, washing, and toileting residents. C. A new nursing home shall adhere to the requirements of this chapter. hotline in the past has helped to eliminate (2) A dumbwaiter, elevator, or ramp shall be provided in a[facility]nursing homeof more than one story where more than eight[patients]residentsabove or below the kitchen level[,]receive bedside tray service[;]. (g) Advance directives, living will, or a copy of the residents Marylands Medical Orders for Life-Sustaining Treatment (MOLST) form. The director of nursing shall assume responsibility for maintaining professional competence of staff through their participation in education programs. (i) A nursing home shall develop policies and procedures to give residents the opportunity to use the residents own furnishings as detailed in this chapter. The Maryland General Assemblys Office C. The[facility]nursing homeshall obtain Departmental approval of the following pertaining to thespecial care unit: (2) An organization chartofthe special care unitandits[inter-relatedness]relationshipto the rest of the nursing[facility]home; (5) A quality assurance plan which includes: (b) Identification of the[most important]predominantaspects of care provided; (b) The administration of[medicines unique to the needs of]medicationsthat are relevant tothe special care residents; (9) An inventory of[the]anyspecialized equipment to be housed[in]onthe unit to provide services in the special care unit. A person maintaining or operating a nursing[facility]homewithout a license is guilty of a misdemeanor, and, on conviction, is liable for a fine of not more than $1,000 for the first offense and not more than $10,000 for each subsequent convictionin accordance with Health-General Article, 19-358, Annotated Code of Maryland. (8) National Fire Protection Association, NFPA 101 Life Safety Code, which is incorporated by reference at COMAR 29.06.01.06. ]; and. (1) The[facility]nursing homeshall assess residents for tuberculosis according to the[following guidelines: (a)]Guidelines for Preventing the Transmission of Mycobacterium[Tuberculosis]tuberculosisin Health Care[Facilities; and]Settings. (vi) The arc of anydoors that open into the room, excluding closet doors. Further, we believe that federal Certificates of Confidentiality do not shield a researcher from the obligation to report diseases, conditions, or circumstances when such reports are required by state law. (a) A facility shall file an application to renew its license every 2 years at least 60 days before expiration of the issued license. (5) Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005 (MMWR2005; 54, No. Standardized recipes adjusted to appropriate yield shall be followed. The[facility]nursing homeshall establish,implement, andmaintain[, and implement]aneffective infectionprevention andcontrol program that: (3) Maintains a record of infections in the[facility,]nursing homeand the corrective actions that were taken related to infections; and, (a) Effectiveness of the infectionprevention andcontrol program by surveying rates of infection, especially of[those residents who have an especially high risk of]infectionrates that are significantly higher than usual; and. fraud hotline to receive allegations of (2) The[facility]nursing homeshall ensure that floor space allocated to each bed meets minimum requirements listed in Regulation[.28C].49ofthis chapter, andis sufficient to accommodate the special equipment necessary to meet the needs of residents. Interior walls and floors shall be of a, maintained free of insects and rodents by operation of an active pest-control program, either by use of maintenance personnel or by contract with, Care shall be exercised in the usage and storage of toxic. B. The Mandated 10-Day Report Form is required. (e) Smoke dampers shall be controlled to close automatically to prevent flow of smoke-laden air in either direction. The activating device for those signals shall be located in each patients room and each and every bathing compartment and toilet room or compartment used by patients. (1) A pharmaceutical services committee, or its equivalent, shall develop written policies and procedures for safe and effective drug therapy, distribution, control, and use. Thereshall be sufficient space to accommodate all activities without[interference]interferingwith each other. (8) The nurses call system shall require resetting at the station where the call originates. (6) A call system shall be provided in each residents bathroom and bathing area in locations accessible to the residents. (56) Positive tuberculin skin testmeansa test provided as authorized by the Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings. (3) The[facility]nursing homeshall prohibit employees with[a communicable]an infectiousdisease or with infected skin lesions fromhavingdirect contact with residents or their food if direct contact could transmit the disease. This wording is sometimes difficult to interpret. Determine if a report should be madeif yes you MUST report immediately to the State Agency (see below). Residents shall be given the opportunity to participate in planning menus. The nursing home shall provide for an organized nursing service, under the direction of a full-time registerednurse. Registered Professional Nurse. (b) At least 2 years of experience or specialized training in the medical care of geriatric or chronically ill and impaired residents; (c) Successful completion of a curriculum in physician management or administration from. truthful and transparent services. If you have the exact number, subtitle, and chapter, type it in. [F.]J. fraud and/or abuse of State government A. (ii) Ahand washing sink equipped with[4 inch wrist blades,]goose-neck spout,[and]separate soap dispensers,anddisposable papertowel dispensers. (b)[Be]Make the requestfor a term not to exceed 30 days. (a) Stored in water-tight containers with tight-fitting covers; and. (a) The nursing home shall provide a common area or areas of refuge in an emergency situation if all resident rooms, day rooms, and toilet rooms are not tied into the emergency generator to provide heat and cooling. State resources. Summary of Economic Impact. Provide a detailed description of the incident:dates, The proposed action has no impact on individuals with disabilities. The Secretary of Health proposes to repeal the Preface and Regulations.01,.01-1,.06,.12,.15,.25,.26,.28,.40, and.42.44, adopt new Regulations.01,.02,.08,.18.20,.25.27,.41.46,.4851, amend and recodify existing Regulations.02,.03,.03-1,.05,.07,.07-1,.08,.08-1,.09.11,.11-1, .11-2,.13,.14,.14-1,.14-2,.16.21-4,.22.24,.27,.29.39,.41,.45,.46,.48,.49, and.56to be Regulations.03,.04,.05,.07,.09.17,.21.24,.28.40,.47,.52.68, and.75, and recodify existing Regulations.04,.47,.50.55, and.57.61to be Regulations.06,.66,.69.74, and.76.80underCOMAR 10.07.02 Nursing Homes. Agency Note: Supervision should be adequate to prevent patients from intruding into the rooms of other patients. In short, any member of the research team who is a licensed health care provider will be covered by the obligation to report child abuse or neglect, while any non-provider member is also obligated to report suspected abuse or neglect of a child. YouwillneedAdobe Acrobat Readeror equivalent software. (a) A nursing home shall provide laundry service, whether on-site or off-site. Each care unit shall have a nurses station provided with a medicine storage cabinet and preparation counter or table having adequate lighting overhead. It can be filled out with your computer and saved, orprinted out and filled in by hand. The Office of Health Care Quality (OHCQ) is the agency within the Maryland Department of Health charged with monitoring the quality of care in Maryland's health care facilities and community-based programs. (5) The pharmacy shall be responsible for delivering medications to the nursing home. (4)Authorized prescriber has the meaning stated in Health Occupations Article, 12-101, Annotated Code of Maryland. (1)If a[facilitys]nursing homesadmission policies include the admission of[patients]residentsrequiring rehabilitative services, the[facility]nursing homeshall provide, or arrange for under written agreement, specialized rehabilitative services by qualified personnel[(],such asaphysical therapist, speech-languagepathologist and audiologist, and occupational therapist[)]. If you are requesting licensure as an Advance Practice provider and hold an active compact/multistate license, you only need to apply at: Verify Nursing Education is approved by the Maryland Board of Nursing, Complete and take to any fingerprinting facility in Maryland, Request an Out-of-State fingerprinting card at Criminal Justice Information System (CJIS), Criminal Justice Information System (CJIS)-located in Reisterstown Road Plaza. (11) Table 2. There shall be provision for the laundering of patients clothing. In new construction, facilityshall provide a lobby area. (71) Special care unit means a nursing home unit that provides intensive specialized care, such as respiratory, rehabilitative, dementia, or dialysis care, continuously on a 24-hour basis. [There]The nursing homeshall[be provided]provideone or more attractively furnished areas of adequate size for resident dining, occupational therapy, and social activities. (3)The nursing home shall obtain prior approval from the Department for any part of the premises to be used for tenant occupancy or for unrelated business purposes. Citation numbers for the Annotated Code begin with a (section sign), for example 1-101. Please enable scripts and reload this page. or Advanced Practice Registered Nurse (APRN). hotline in the past has helped to eliminate This meal represents[no less than]at least20 percent of the days total nutritional requirements. (1) The Commission, through the Department, shall certify a facility or center to perform dialysis upon determination that the facility or center meets the standards adopted by the Commission, including: (a) 42 CFR 494.1494.110, as amended; and. (1) A new nursing home shall satisfy the review of the Maryland Health Care Commission for the: (a) Establishment of a new nursing home; and. (3) Analysis of additional burden or cost on the regulated person: The proposed requirement that social work services be performed by a licensed social worker becomes effective January 1, 2021. [(5)](4)The[facility]nursing homeshall assess and manage a resident with a history ofaprevious positive tuberculin skin test,a history of latent infection, or aprevious history of active tuberculosis,[or positive skin test conversion]in accordance with Guidelines for Preventing the Transmission of Mycobacterium[Tuberculosis]tuberculosisin Health-Care[Facilities]Settings. (c) Air ducts that pass through a required smoke barrier shall be provided with a smoke damper at the barrier. American Song Book Lincoln Center, New York, NY Saturday, Feb 6, 2016 8:30 PM A Room of My Own June Havoc Theatre, New York, NY Friday, Feb 13-March 13, 2016. . ; (vii) Blood borne pathogens, including hepatitis B and C and human immunodeficiency virus; (ix) Proper use and wearing of personal protective equipment, such as gloves, gowns, and eye protection; (f) Train and[monitor]perform compliance monitoring ofemployee application of infectionprevention andcontrol[and aseptic techniques; and]activities, such as hand hygiene and personal protective equipment used for isolation precautions; (g) Review the infectionprevention andcontrol programelementsat least annually and revise as necessary[. No. (f) Residents beds may not belocated near radiators, registers, or sources of draft. (ii) A bed that is certified for Medicaid to a distinct part of the nursing home that is a skilled nursing facility. The baccalaureate degree program in nursing, master's degree program in nursing, Doctor of Nursing Practice program and post-graduate APRN certificate programs at University of Maryland School of Nursing are accredited by the Commission on Collegiate Nursing Education. The sounding of the audible signal shall be continuous or intermittent until answered. (2)The[water]temperatures[in hot water bottles]in the building, hot packs, and therapeutic equipmentmay not exceed 120For 49C. Rollaway type beds, cots, or folding beds may not be used. (a) Medication storage cabinets with locks shall be permitted for the storage of resident medications that do not require refrigeration within a resident bedroom. [The location of thefood serviceareshall be approved by the Department. (2) All walls, floors, ceilings, windows, and fixtures shall be kept clean. Please see the Nurse Practice Act 8-505.Report of certain State Operations Manual for Provider Certification, Appendix RResident Assessment Instrument for Long-Term Care Facilities, Transmittal No. schedule, patient assignment, incident reports, termination notice, names and Because specific temperatures are often required for the safe storage of drugs, the. (22) Fire authorities means the official fire safety agency including the State Fire Marshal or local fire marshals or fire departments as appropriate. (2)Nurses andsupportpersonnel shall be chosen for their training, experience,and ability. Disciplines shall record all assessments on a form approved by the Department. Minimum equipment shall include the following: (b) Cabinets for dry storage and supplies; (d) Sink for purposes other than handwashing; dwashing sink with soap and towel dispenser or approved drying device.]. If the applicant simply withdrew of his or her own accord and without any suggestion or recommendation by anyone associated with the hospital, this need not be reported. (a) Resident Assessment Instrument (RAI) meansa standardized and reproducible resident assessment process based on completion of Minimum Data Set (MDS) screening items, and including the MDS Care Area Assessment process, and related process for care planning and evaluation. [B.] A nursing home shall have a documented preventative maintenance program. If you typed in the word submeters the Search feature would take you to the same Subtitle. If you are unable to find the exact regulation, contact the Division of State Documents at: To report Waste, Fraud or Abuse to the Office of Legislative Audits. (1) Planning to ensure that all services required for the continuity of, (4) Interchange of medical and other information necessary in the care and treatment of. (3) The facility shall monitor the purified protein derivative (PPD) status of employees at any time that symptoms suggestive of tuberculosis develop, and periodically, consistent with the tuberculosis control plan. address of all witnesses). B. (ii) The nursing home shall make its residents personal furnishing policies available for review by residents and the residents representative. Medical Director Qualifications. (23) Full time means 40 hours per week or the standard work week adopted by the nursing home. (3) Local Law or Ordinance, Where Applicable. Agency Note: The following equipment is recommended: dwashing sink with soap and towel dispenser or approved drying device. Policies shall provide for the coordination of rehabilitative services and the rehabilitative aspects of nursing. (1) A sufficient number of food service personnel shall be employed to[carry out]performefficiently the functions of the[dietetic]food and nutritionservice and meet the dietary needs of the[patient]residents. (1)When the director of nursing is absent, the individual shall designate an experienced, qualified registered nurse to direct the nursing service. Records for all[patients]residentsshall be maintained in accordance with accepted professional standards and practices. (13) Supervision of certified medicine aides to ensure that the aides act within the limitations and restrictions placed on them. The[facility]nursing homeshall ensure that: (1)The nurse manager or the director of nursing of vent units has a background in ventilator care or is qualified in ventilator management; [(1)](2)Respiratory care services are provided by a sufficient number of qualified personnel;and. As of July 1, 2021, OHCQ oversees 19,032 providers in 45 industries . Any member of the research team is covered by the requirement that any person report to the health officer any knowledge of an animal bite. (3) Pass standardized edits as defined by CMS and the State. Order forms can be downloaded from the Division of State Documents . If a deficiency exists, the Department, in addition to the sanctions set forth in this regulation and Regulations[.5058].69.77of this chapter, may: (1) The duties of the State monitor shall be specified in a written agreement between the Department and the State monitor and shall include but are not limited to: (c) Issuing written reports to the Department and the nursing[facility]nursing home,detailing the findings of the on-site inspections and the status of[recommended actions that]requirements andrecommendations forthe[facility shall complete]nursing hometo achieve compliance. (6) The sounding of the audible signal shall be continuous or intermittent until answered. Currently, a license has not been required for an individual to operate in this role. Access through Table of Contents Structure (will display table of contents by Title, Subtitle & Chapter). Existing facilities (those facilities licensed at the time this regulation becomes effective) shall provide some method/means of a patient summoning aid that shall include as minimum a combined visual and audible signal that is audible at the nurses station and simultaneously activates a light located in the hall, outside of and adjacent to the patients room. (5) The ventilation systems shall be designed and balanced to provide the pressure relationships as shown in Table 1 under D(10) of this regulation. mbon.nets@maryland.gov, National Human Trafficking Hotline - 24/7 Confidential. [(1) New Construction. (7) In cases where the cost of any medication obtained from the pharmacy selected by the resident exceeds the cost of the same or equivalent medication available through a pharmacy that the nursing home has contracted with to provide pharmaceutical services, the resident shall be responsible for the additional amount. of Legislative Audits operates a toll-free The[facility]nursing home, in consultation with the medical director and other physicians, if necessary, shall establish and maintain surveillance of the health status of employees, including: (1) Advising on the development and execution of an employee health program, which shall include provisions for determining that employees are free of communicable diseases according to current[acceptable]acceptedstandards of practice; and. A. The Code of Maryland Regulations, often referred to as COMAR, is the official compilation of all administrative regulations issued by agencies of the state of Maryland and authorized by the General Assembly. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home. friendly and courteous, timely and (1) Amend, repeal, recodify, and adopt new language in order to make this chapter more cohesive, comprehensive, and clear; (2) Enable the Department to accept electronic submissions of both initial applications and renewal applications and thereby improve efficiency and decrease the administrative burden on providers and the Department; (6) Incorporate by reference additional documents; (7) Require that new facilities shall satisfy the review of the Maryland Health Care Commission for the establishment of new facilities and the increase or decrease in capacity of existing facilities; (8) Require that an existing facility that wishes to convert, alter, modify, or add to the existing infrastructure shall notify the Office of Health Care Quality in writing; (9) Require that a nursing home shall employ supervisory personnel and a sufficient number of support personnel, to provide a minimum of 3 hours of bedside care per occupied bed per day, 7 days per week; (10) Require that the ratio of nursing service personnel on duty providing bedside care to resident may not at any time be less than one to 15; (11) Require that the nurse manager or the Director of Nursing of vent units shall possess a background in ventilator care or be qualified in ventilator management; (12) Require that after January 1, 2021 social services responsibilities in the facility will be assigned to a Licensed Bachelor Social Worker, Licensed Graduate Social Worker, Licensed Certified Social Worker, or Licensed Certified Social WorkerClinical; (13) Require that the facility shall assign at least one infection preventionist staffed at a ratio of1.0 Full Time Equivalentsfor every 200 beds; (14) Require that facilities shall possess a functioning automated external defibrillator (AED) as of July 1, 2020; (15) Allow Certified Dietary Managers to share cooking responsibilities with the full-time cook in facilities with fifty or fewer beds.
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