The agreement shall provide for sufficient hours of consultation to assure that the staffs services meet the medically related social and emotional needs of the residents. (1)At least three meals or their equivalent shall be[served]offereddaily, at regular times,with not more than 14-hour intervals between the substantial evening meal and breakfast. ], [Agency Note: It is recommended that the comprehensive care facility arrange for a similar transfer agreement with an extended care facility.]. Amber Havensamber.havens@maryland.gov, Compliance Coordinator: Before or at admission, a contract shall be executed by the administrator and[patient]resident,guardian, or responsible agency which is consistent with the requirements of Health-General Article, 19-344, Annotated Code of Maryland, Rights of Individuals. Exemptions: Out of state patients; Exemption granted by AIDs Administration. Please refer to Renewal Fee Waiver for Active Duty Military Personnel for additional details. JavaScript is required to use content on this page. (1)Specialized rehabilitative services shall be provided only[upon]onwritten orders of the attending physician. This map shows you which states are currently in the NLC. [(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. Please enable JavaScript in your browser. The[facility]nursing homeshall give appropriate health care information to such volunteers to provide maximum protection to residents. (3) Qualifications of social worker. As you may recall . [A.] There shall be provision for the laundering of patients clothing. (3)Policies and procedures shall be adopted and made available to all nursingservicepersonnel. E. The Department shall make a site visit and conduct a full survey of each licensed nursing home at least once per calendar year. from civil liability.-Except as provided in subsection (b) of this section, the A. (ii) A small sink equipped with soap and individual paper towels in a dispenser; (iv) Equipment[, approved by the Department,]to clean and sanitize bedpans, urinals, and basins;and. Nursing service personnel shall help the resident perform daily routine dental hygiene. In this chapter, the following terms have the meanings indicated. Once the complaint is received at the Board office, an (13) Supervision of certified medicine aides to ensure that the aides act within the limitations and restrictions placed on them. (b) On request, provide the resident with copies of the residents medical records at a reasonable cost and in the residents preferred format. Body Holding RoomNew Constructionand Existing Nursing Home. (1) A nursing home shall providea separate room or rooms[shall be provided]for the administrator andadministrative supportstaff. Please enable JavaScript in your browser. (b) 42 CFR 494.130494.180, as amended. The Office of Health Care Quality surveyed multiple facilities and determined that 25 percent of nursing homes employed or contracted with a licensed social worker. This program shall include: (2) Maintaining good body alignment and proper positioning of bedfastresidents; (3) Encouraging and assistingresidentsto change positions at least every 2 hours to stimulate circulation and preventpressure ulcersand deformities; (4) Encouraging and assistingresidentsto keep active and out of bed for reasonable periods of time, within the limitations permitted by physicians orders; (5) Encouragingresidentstoengage in resident-chosen community and independent activities andachieve independence;and. The facility may use an outside program if it has been reviewed and approved by the Department.] An existingnursing homeshall meetall local codes and standards for safety and maintenance of institutional elevators. K. GarbageStorage Space. 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. (1)When the director of nursing is absent, the individual shall designate an experienced, qualified registered nurse to direct the nursing service. Please enable JavaScript in your browser. NOTE 2: COMAR 10.06.01 further requires the following: (1) Health Care Providers. a list of all states/jurisdictions where the institutions curriculum meets state educational requirements for professional licensure or certification, a list of all states/jurisdictions where the institutions curriculum does not meet state educational requirements for professional licensure or certification, and. There shall be sufficient[supportive]supportstaff to accomplish all medical[record]recordsfunctions. (1)[Problems]Residents problemsand needs shall be identified, based upon the interdisciplinary assessment. (b) Controlled medications to be stored within medication storage cabinets in a residents room shall be held within a separate compartment that is locked and inside of the larger medication storage cabinet in that room. Schedule II drugs shall be kept in separately locked, securely fixed boxes or drawers in a cabinet, under two locks, keyed differently; medicine storage and preparation area with illumination of 100 footcandles at the work counter; preparation area shall include a small sink set into the counter or with drain boards; biological refrigerator. hotline in the past has helped to eliminate As of July 1, 2020, the U.S. Department of Education implemented new regulations that professional nursing programs (PN, RN and APRN) must adhere to if they participate in Title IV HEA funding, and if the program is: designed to meet educational requirements for a specific professional . A nursing homeshall be served by water from a safe public water supply, if available, as determined by the Department. Complete the form below for state-specific nurse licensure . Organization, Policies, and Procedures. You may be trying to access this site from a secured browser on the server. The nursing home shall meet the requirements for handling, treatment, and disposal of special medical wastes as provided in COMAR 10.06.06. (2)The physician may document on the record that[his]thereevaluation may be less frequent but in no case may[his]thereevaluation exceed 60 days. [A facility shall give a]Care Plan Meeting. The facility shall document refusals and shall conduct surveillance of nonimmune employees during the recognized influenza season.]. Please enable JavaScript in your browser. (vii) A bedsidelamp, over-bed lamp,or other directional light source forresidentreadingandbedside care. Please fill out the form. with rehabilitation areas shall provide a, There shall be an allowance of at least 12 square feet per, C. Dayroom Area. customers, and stakeholders with The statutory language implies but does not specifically require a patient-provider relationship, so it is possible that the duty to warn might be found to extend to certain research settings involving investigators who are mental health providers. (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. (17) Discharge means the removal of a resident from a nursing home when the releasing nursing home is no longer responsible for the residents care. State Operations Manual for Provider Certification, Appendix RResident Assessment Instrument for Long-Term Care Facilities, Transmittal No. (5) Consent forms when required,[(]such as[consent for administering]: (a) Administration ofinvestigational drugs[, for burial]; (b) Burialarrangements made in advance[, for release]; (c) Releaseof medical record information[, for handling]; and. maryland board of nursing reporting requirements maryland board of nursing reporting requirements. (1) Adequate equipment for preparation, serving, and distribution of food shall be provided, (2) A dumbwaiter, elevator, or ramp shall be provided in a, (3) Equipment to protect food from dust or contamination and to maintain food at proper temperature shall be provided, (2) The storeroom shall be cool and well-ventilated. B. Search on a word or phrase, or enter the codification number (search is word-specific unless you add an asterisk *). (a) Comply with Health-General Article, 18-404, Annotated Code of Maryland, regarding immunizations of employees; (b) Inform all new and current employees of the health risks of not being immunized; (d) Require that any employee who is not vaccinated with the current influenza vaccine wear a mask when: (ii) During the influenza season as specified by the States Prevention and Health Promotion Administration, based on influenza activity in Maryland. The[facility]nursing homeshall provide or make arrangements for services to identify and meet the[patients]residentsmedically relatedphysical,social, and[emotional]behavioral healthneeds. Therapeutic diets shall be planned, prepared, and served as prescribed by the attending physician: (1) Therapeutic diets shall be planned by alicensedregistered dietitian[or other qualified person]; (2) Preparation and serving shall be supervised by a qualified dietetic supervisor;and. The ratio of nursing service personnel on duty providing bedside care toresidents may not at any time be less than one to 15. [(1)](a)[There]A nursing homeshall[be]provideadequate space[for the reception, examination, and treatment ofpatients;storage of]to: (i) Receive, examine, and treat residents; (ii) Storesupplies and equipment,including wheelchairs and stretchers; and[office]. (2) In[facilities]a nursing homewith[26 50]50or fewerbeds, exceptions may be made by the Department to allow the supervisor to share cooking responsibilities with the full-time cook. The regulations provide an objective test that does not depend on the terminology used by either the health care provider or the hospital. (4) A[patient]residentin a protective device or devices shall be observed periodically by personnel, to[insure]ensurethat the[patients]residentshealthand personal careneeds are met. input into the contents of the orientation program; the number of hours of orientation required for the various levels of. [(2)](4)The Department shall consider the following factors when[considering]decidingwhether to approve an administrator to serve on a less than full-time basis: (a)[Geographical]Geographiclocation of the facilities; (1)In the absence of the administrator, the[facility]nursing homeat all times shall be under the direct and personal supervision of an experienced, trained, competent employee. (a)If the sale, transfer, assignment, or lease of a[facility]nursing homecauses a change in the person or persons who control or operate the[facility]nursing home, the[facility]nursing homeshall be considered a new[facility]nursing home and the licensee shall conform to all regulations applicable at the time of transfer of operations. (iii) Provideofficespace for theemployedpersonnel[employed;]to work. C. Measles, Mumps, Rubella, and Chickenpox. (c) Administrative, Bulk Storage and Soiled. A physician in attendance must report positive syphilis tests for patients, pregnant women, and infants, and must notify the health officer if a patient who tests positive fails to return for medical observation. Copyright Maryland.gov. Exceptions may be made in part at the discretion of the Department for an individual facility only when the facility can demonstrate compliance with the intent of this section by showing an effective patient call system to provide quality patient care.]. 10.34.23 Pharmaceutical Services to Patients in Comprehensive Care Facilities, Effective September 16, 2013. Equipment for Food Preparation and[Distribution. (ii) The nursing home shall make its residents personal furnishing policies available for review by residents and the residents representative. 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. General Requirements. (1) A special care unit shall meet the general construction requirements of Regulations[.06,and .26].08, .42, and .41of this chapter, and the requirements in this regulation. (a) There shall be separate clean and soiled utility rooms in each nursing unit: (i)[, accessible]Accessibleto the[patient]residentarea[, no]; (iii) Nomore than 120 feet to the most remote[patient]residentbedroom[. the Maryland Board of Nursing respectfully submits . C. Administrative AreasExisting[Facilities]Nursing Homes. (d) Any other relevant parameters affecting or reflecting the residents physical and mental status. (3)The Department may requirethat the nursing home havespecific types of equipment based on the needs of the[patients]residents. (c) After being fully informed of the health risks associated with not receiving a vaccine, the employee refuses the immunization. F.Space Heaters. Effective in 2013. (66) Resident Assessment Instrument (RAI). (f) Except for trays that are assembled in the main kitchen and then distributed to the nursing care units, equipment to hold hot food if bulk foods are plated and served to the residents on the nursing care unit. 410-402-8015 Toll Free 877-402-8218 TTY 800-735-2258 . (1) A nursing home shall ensure that screened doors and windows are installed and maintained in accordance with applicable fire and safety codes and COMAR 10.15.03 Food Service Facilities. to provide constituents, businesses, [Comprehensive care facilities or extended care facilities]A nursing homelicensed under this regulation may not usethe word hospitalin[their]itstitle[the word Hospital]. Menus shall be written at least 1 week in advance. (1) A nursing homeshallhavesufficient lighting at night inthe followingareas: (c) Designated toiletsof the nursing home for the safety of theresidentwhogetsup during the night. (23) Full time means 40 hours per week or the standard work week adopted by the nursing home. (1)The food and nutritional needs of[patients]residentsshall be met in accordance with physicians orders. (1)A nursing home shall be equipped with a properly maintained air conditioning system. (1) The building and all its parts and facilities shall be kept in good repair, neat, (2) All walls, floors, ceilings, windows, and fixtures shall be kept clean. In person purchases can be made at 16 Francis Street - Wineland Building, Department of Health Professions Perimeter Center 9960 Mayland Drive, Suite 300 Henrico, Virginia 23233-1463. See Regulation .21G of this chapter for tuberculosis surveillance requirements.] (4) A call system shall have a visible signal above the door of each residents bedroom that shall be visible from all parts of the corridor. E. Space. 410.764.4777 | Toll Free 800.492.6836 (4) A nursing homeshallscreen with wire screen or its equivalent, not less than 16 meshes per linear inch for doors and windows that provide ventilation. (1) The nursing home shall inform a residents designated pharmacy about the nursing homes written policies concerning the provision of drugs. If the designee is not a qualified[patient]residentactivities coordinator as defined in Regulation[.01Y,].01ofthis chapter, the Department may approve the designee based on the persons education, performance, and experience. (2) Departments Office of Capital Planning, Budgeting and Engineering Services. (d) Theminimum horizontaldimensions of a bedroom areto be 10 feet to: (i) Facilitate the placement of beds as required inRegulation .44of thischapter;and. One of these is the Department of Electrical Engineering and Computer Science, which offers software engineering degree programs at the bachelors, masters, and Ph.D. levels. Laurie has 1 job listed on their profile. The[facility]nursing homeunit shall meet all applicable requirements in Regulation[.26F].46of this chapter for emergency electrical power, including the provision of: (a) To service the medical gas systems, a vendor or staff shall be trained and accredited in accordance with NFPA 99 Health Care Facilities Code. All comprehensive care facilities and extended care facilities shall have written policies and procedures, acceptable to the Department, for tuberculosis surveillance of all residents. Issue/renew Prescriptive Authority Recognition to Advanced Practice Registered Nurses meeting approved standards. (6) The sounding of the audible signal shall be continuous or intermittent until answered. Office Hours: Monday - Friday 8:15AM - 5:00PM (except Holidays) Agency Note: Recommended space: Storage10 percent of area designated for exercise and rehabilitation; Officeone therapist, 110 square feet; two or more, 85 square feet per therapist. (2) The charge nurse or nurses shall have the ability to recognize significant changes in the condition of residents and to take necessary action. (1)Adequate refrigerated storage, refrigerators,and frozen food storage cabinets[,]shall be provided[which are]andregulated to maintain temperatures prescribed in COMAR 10.15.03[Food Service Facilities]. (53) Physician means an individual licensed to practice medicine in this State. (33) Licensed or certified professional health care practitioner means a nurse practitioner, physician assistant, or other practitioner licensed or certified under the Health Occupations Article, Annotated Code of Maryland. The printed version is considered the official version. (1) The administrator of the nursing home shall immediately report to the local health department and the Department the occurrence of: (e) Any symptomatic condition of importance to public health that affects the nursing home; or. InfectionPrevention andControl Program. Board of Nursing Professional Licensure Requirements. (4)[All facilities]A nursing homeshall establish and enforce a written preventive maintenance program to ensure that all[essential mechanical, electrical, and patient care]resident care and therapyequipment is maintained in safe operating condition. The proposed action has no impact on individuals with disabilities. truthful and transparent services. (3)With the Departments approval,an administrator may[, with the Departments approval,]serve on a less than full-time basis for a maximum of two nursing facilities, one of which shall have a licensed capacity of 35 beds or less. A. [Patients]Residentsshall be assisted to obtain routine and emergency dental care. (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. All rights reserved. [.29].52Equipment and Supplies for Bedside Careand Therapy. B. 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. B. O. This program shall consist of: (a) An explanation of organizational structure, policies, and procedures; (b) Discussion of the philosophy of care; (c) Description of the resident population; and. (f) Any other serious occurrence that threatens the welfare, safety, or health of any resident. If the comprehensive care facility or the extended care facility is sold, leased, discontinued, the operation moved to a new location, the license revoked, or its renewal denied, the current license immediately shall become void and shall be returned to the Secretary. Results will be mailed to you within five days of exam date. C.Cleanliness and Maintenance. (1)[New Construction. (3) Demonstratea genuine interest in the well-being and welfare of[patients]residentsin the[facility]nursing home. [(f)](g)[Sufficient]A nursing care unit shall have sufficientspace and equipment for medical records[which enables]so thatpersonnel[to]canfunction[in an effective manner]effectivelyand[to]maintaineasily accessiblerecords on all[patientsso they are easily accessible]residents. Definition. If the comprehensive care facility or the extended care facility is sold, leased, discontinued, the operation moved to a new location, the license revoked, or its renewal denied, the current license immediately shall become void and shall be returned to the Secretary.]. (2) Renovations ofexistingkitchens shall be approved by the Department which will consider modification of the minimum space requirement based on space available, costs, and type of service. [Facilities]A nursing homeshall provide: (1) Space for social work personnel, accessible to[patients]residents, medical, and other staff;and. (a) Beresponsible for the control of the operation on a 24-hour basis;and[shall serve]. C. Director of Nursings Vacancy Exceeding 30 Days. (a) A nursing care unit, regardless of size, including special care units, shall be equipped as described in this regulation. ]; [(13)](12)Reports and action required in unusual circumstances[. (v) The medicine storage cabinet, medicine preparation area, and biological refrigerator shall be under the direct visual control of the nursing or pharmacy staff. All rights reserved. mbon.nursemonitoringdept@maryland.gov, Director of Discipline & ComplianceKaren E. B. Evanskarene.evans@maryland.gov, Administrative Officer - Discipline: National Human Trafficking Hotline - 24/7 Confidential. Reports shall be in writing or by telephone, and must be made as soon as possible.. (c) Within 24 hours of admission, notify and direct residents to the nursing homes emergency plans and maps, including evacuation procedures. resources. Arrangements shall be made, when necessary, for the[patient]residentto be transported to the dentists office. Currently, a license has not been required for an individual to operate in this role. [E.]F.JanitorsCloset or Service Area. Please enable scripts and reload this page. The search provides a list of Subtitle Chapters. Hospitals have to report only if they made a "change" and if that change was based in whole or in part of any of the 14 specific reasons listed in. D.Humidity. Nursing homes that employ an individual on or before January 1, 2021 shall be exempt from the license requirement. 22, December 2000, U.S. Department of Health and Human Services, Center for Medicare and Medicaid Services, is incorporated by reference. (1) Medications shall be accurately and plainly labeled. L. Burning. You may be trying to access this site from a secured browser on the server. (45) Nursing home means a comprehensive care facility or extended care facility which offers nonacute inpatient care to patients: (a) Suffering from a disease, chronic illness, condition, disability of advanced age, or terminal disease requiring maximal nursing care without continuous hospital services; and. Comments may be sent to Jake Whitaker, Acting Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to mdh.regs@maryland.gov, or fax to 410-767-6483. (ii) The individual who has inactive pulmonary scarring,calcification, or a normal chest X-ray. [E.]I. (1) The building and all its parts and facilities shall be kept in good repair, neat,and attractive. State resources. (c) A room may not be used as aresidentbedroomif it can only be reached bypassing through a kitchen. The facilitys infection control program shall include monitoring of the health status of all residents to determine if the residents are free from tuberculosis in a communicable form.]. G.Emergency Procedures. [In existing facilities,]. Advisory Dentist. (b) A nursing home shall register at least four representatives, including the administrator and the director of nursing. A. H. Transfusion Services. (5) A call system shall provide visual lights at corridor intersections, in multi-corridor nursing units. 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. (2) Private water systems shall comply with all federal, State, and local requirements. State resources. There shall be sufficient equipment to meet the needs of the. (3) The equipment provided in food service floor pantries shall comply with the requirements of the local health department. B. However, once a facility elects to use these procedures or systems and a modification is granted, the systems may not be changed without prior approval of the Department. However, once a facility elects to use these procedures or systems and a modification is granted, the systems may not be changed without prior approval of the Department. (73) Support personnel means an aide who: (a) Isassigned to a particular service such as: (b) Has been approved by the managerof the services as having sufficient training and experience to perform the assigned duties. (2) The course content shall adhere to the[Geriatric Nursing Assistant Program]geriatric nursing assistant training programcurriculumapproved by the Maryland Board of Nursing[in Regulation .40 of this chapter]. [In]Anexisting[facilities]nursing homeshall: (1) Havea sufficient number of lockers[capableof being]that can besecurely locked[shall be provided]for all employees working at any one time[,];and[provision shall be made].