(2)[Resident]MDS Care AreaAssessment[Protocol Summary]process;and. (39)Minimum Data Set (MDS) means acore set of screening, clinical, and functional status elements, including common definitions and coding categories, which: (a) Forms the foundation of a comprehensive assessment for all nursing home and swing bed residents; and. [(7) The facility shall request that each employee receive immunization from influenza virus in accordance with Health-General Article, 18-404, Annotated Code of Maryland. Issue/renew license to Advanced Practice Registered Nurses meeting established requirements. Editors Note on Incorporation by Reference. License Status Options Active. (2)[The total areas]The nursing home shallset asideareasfor[patients]residentsdining and recreation[areas shall be no less than]that totalat least30 square feet perlicensedbed for the first 100 beds[and], plus27 square feet perlicensedbed for all beds in excess of 100. All hoods over cooking surfaces shall comply with the requirements as provided in COMAR 10.15.03. (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. COMAR regulations are Maryland State agency regulations, which are referenced by Title numbers (currently 1-36). (2) Ifcorrected, will result in an unreasonable,substantial financial burdenon the nursing home. 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 patients.]. New construction providing a conventional type food service program shall have the following minimal space requirements (excluding bulk food-storage areas, dining areas, and separate floor pantries). (23) Full time means 40 hours per week or the standard work week adopted by the nursing home. The new regulations explicitly define changes that must be reported to the Board within ten days of their occurrence and provide penalties for failing to do so. A mental health care provider licensed under the Health Occupations Article or any institution or facility that provides treatment or services to individuals who have mental disorders has a statutory duty to warn of known threats of imminent physical injury: b) In general.- A cause of action or disciplinary action may not arise against any mental health care provider or administrator for failing to predict, warn of, or take precautions to provide protection from a patient's violent behavior unless the mental health care provider or administrator knew of the patient's propensity for violence and the patient indicated to the mental health care provider or administrator, by speech, conduct, or writing, of the patient's intention to inflict imminent physical injury upon a specified victim or group of victims. (g) Receives prompt and appropriate responses to requests for assistance. (2)Locatedconvenient to[patients]the residentsbedrooms. In person purchases can be made at 16 Francis Street - Wineland Building, D. A licensee[aggrieved by]that disagrees withthe imposition of a sanction under A(1) or (5) of this regulation may appeal the Secretarys action by filing a request for a hearing in accordance with Regulation[.59].78of this chapter. A facility which holds full licensure as of the adoption of these regulations shall be considered as having an adequate size dietetic service department.]. (4)For reference purposes, copies of the[patient]residentcare policies shall be readily available to all personnel responsible for[patient]residentcare. .41 Physical Plant New and Existing Construction Requirements. (1)If no approved public sewerage system is available, a private sewage disposal may be accepted, if approved by the Department. (d) The plumbing fixture for the utility or service sink within a janitors closet must be provided with a back-flow prevention device. The current license shall immediately become void and shall be returned to the Secretary if the: (a) Nursing home is sold, leased, or discontinued; C. Request for Departmental Permission to Exceed Capacity. Equipment for Food Preparation and[Distribution. (b) Is paid by a nursing home to feed residents who are unable to perform the task themselves. (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. 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. For example: Type in Consumer Protection and you will see eleven (11) different Titles covering this topic. (2) Departments Office of Capital Planning, Budgeting and Engineering Services. [(e)](f)Excessive HeatAny temperature above[40C (104F)]104F or 40C. A nursing home shall develop written policies consistent with Regulation .11 of this chapter pertaining to: [(3)](2)[Patients]Residentsrights[. (7) Culture Change Nursing Home. 22, December 2000, U.S. Department of Health and Human Services, Center for Medicare and Medicaid Services, is incorporated by reference. An existingnursing homeshall meetall local codes and standards for safety and maintenance of institutional elevators. (b) Receive signals originating from residents bedrooms, bathrooms, bathing areas, and therapy areas. (e) If windows can be opened, but the nursing home has concern over the window being opened due to resident safety issues and elopement, the window sash may be restricted by hardware as approved by the Department. (c) The nursing home shall provide heated toilet rooms adjacent to the common areas of refuge. The call system shall enablepatientsin the rehabilitation area to summon rehabilitation staff. Reporting Decision Tool: When Do I Report to State Agency and Law Enforcement? (2) The janitors closet or service alcoveshall be[equipped]: (iii) Arack for hanging brooms and mops; and. C. When the attending physician and medical director agree that a particular[facility-developed]nursing home developedprotocol is required to ensure that quality medical care is delivered to the[facilitys]nursing homesresidents, that protocol shall be implemented unless the[facility]nursing homedocuments in the[facilitys patient]nursing homes residentcare committee minutes the reason or reasons why the protocol should not be implemented. (2) As of July 1, 2020, a nursing home shall install a functioning AED unit. The installation of a portable air-conditioning unit shall be approved by the: (d) If windows cannot be opened for ventilation, a central HVAC system shall be provided and maintained. (i) Each bed providedshall bein good repair, witha cleanandcomfortable standard sizemattress and foundation. (2) Bedside hours include the care provided by: (3) Only those hours which the director of nursing spends in bedside care may be counted in the 3-hour minimum requirement. The nature of the threat; 2. [(4)](3)The[facility]nursing homeshall continue to monitor residents for signs and symptoms of tuberculosis by performing a yearly symptom review. (4) 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (Centers for Disease Control and Prevention (CDC), Healthcare Infection Control Practices Advisory Committee (HIPAC), 2007). All rights reserved. Please enable scripts and reload this page. Updated printed copies of the Nurse Practice Act and Regulations can be purchased at the Division of State Documents in person, by internet, or by telephone. (b) Has completed a minimum of 15 contact hours of infection prevention and control training that is approved by the: (i) Departments Office of Infectious Disease Epidemiology and Outbreak Response; and. A. (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. New construction providing a conventional type food service program shall have the following minimal space requirements (excluding bulk food-storage areas, dining areas, and separate floor pantries). The lock on the door of a medication room shall be counted as one of the two locks. If a body holding room is not provided, a holding area shall be designated that approximates the above conditions. L. Burning. A physician, physician's assistant, dentist, chiropractor, nurse practitioner, nurse, podiatrist, any other licensed health care provider, a medical examiner, or an administrator of a hospital, clinic, dispensary, or nursing home who knows of a case of a reportable disease, condition, outbreak, or unusual manifestation shall report it to the health officer within the time limits specified in B of this regulation.. Any individual (other than those listed above) who has reason to suspect elder abuse/neglect may file a report. Maryland Board of Physicians | 4201 Patterson Avenue | Baltimore, MD 21215. (4)Spacefor Storage of Linen[New Construction and Existing Facilities]. (7) The audible signal may not be turned off at the nursing station. D. A record of the posting shall be retained for 1 year. The[goal]goalsshall be realistic, practical, and tailored to the residents needs. The mandatory reporting . Dayroom areas shall be provided[, adequate]that are: (1) Adequatefor the[patients capable of using them]residentslocated on each nursing care unit;and. ]; (4) Past employment[with]documentation[that]withreferences[have been considered by the facility. non-renewed or expired. Comprehensive care facilities and extended care facilities shall develop written policies, consistent with these regulations, to govern the nursing care and related medical or other services they provide covering the following: (1) Admission, transfer, and discharge policies including categories of patients accepted and not accepted by the facility, or those who are required to transfer to another level of care. (b)[Be]Make the requestfor a term not to exceed 30 days. (3) In facilities with 25 beds or fewer, responsibility may be assigned to the full-time cook. (11) A training program shall provide at least 16 hours of training prior to a trainees direct assignment to resident care. The search provides a list of Subtitle Chapters. [E.]D.The[facilitys]nursing homescommunication mechanism shall ensure that theadministrator, director of nursing, and the medical director receive and address reports of infectionprevention andcontrol findings and recommendations in a timely manner. (1)If a safe public water supply is not available, a private water supply may be used if it is approved by the Department. Information reported to the C. Secured units shall meet the established standards applicable to nursing home set forth in NFPA 99 Health Care Facilities Code and NFPA 101 Life Safety Code. . records, Medication Administration Records (MARs) and controlled substance (1)Nursing service personnel shall provide care appropriate to theresidentsneeds with the organizational plan, authority, functions, and duties clearlydefined. Complete the mandatory pre-license education hours (RN and LPN) or Maryland School of Health Professions equivalent coursework to be accepted by the Maryland Board of Nursing. In this chapter, the following terms have the meanings indicated. C. Administrative AreasExisting[Facilities]Nursing Homes. Otherwise, a dedicated enunciator connected to the wireless call system will be needed. Comments will be accepted through, (b) Is a graduate of a certified dietetic technician program approved by the, (47) Occupational therapist means an individual who is currentlylicensed by the, (48) Occupational therapy assistant means an individual who is currentlylicensedby the, (1) The Secretary may issue a license to a, (d) If new construction is completed to the point of being able to provide all necessary services to its residents but certain substantial items of equipment, (1) An applicant desiring to open a comprehensive care facility or an extended care facility. (2) In accordance with a nursing home-developed procedure, a licensed nurse shall prepare medications to be sent with a resident during a short-term leave of absence of 24 hours or less. (1) A system of water supply, plumbing, sewerage, electrical power, garbage or refuse disposal may not be installed or extended untilthe architect or professional engineer of record submits stamped and sealed final construction drawings for Department record and provisional approval in accordance with A of this regulation. The facility shall make information available to all employees concerning other conditions in which pneumococcal vaccine may be of benefit for certain other underlying medical conditions. The janitors closet shall be equipped for, (a) There shall be separate clean and soiled utility rooms in each nursing unit. Standard Precautions. (c) A room may not be used as aresidentbedroomif it can only be reached bypassing through a kitchen. (2) Upon request, the director or assistant director of nursing may accompany physicians visiting residents. The mandatory reporting law, however, also is applicable to nursing homes and to any of the alternative health systems defined in 1-401 of the Health Occupations Article. In COMAR 10.32.22.03C, there is a list of common occurrences that do not have to be reported. (3)In new construction,thenight light shall be switched at theresidentroom door. (5) The nursing home shall make its resident care policies available for review by residents and the residents representative. 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. Exemptions: Out of state patients; Exemption granted by AIDs Administration. Search on a word or phrase, or enter the codification number (search is word-specific unless you add an asterisk *). (3) The individual who prepares medications shall give and record them. The water heating equipment shall supply adequate amounts ofheatedwater according to the following temperature guidelines for: (1)Resident use, the water temperature shall be between 100F (38C) and 120F (49C): (2) Food preparation use,as referencedin COMAR 10.15.03; and. Under the Nurse Licensure Compact (NLC), qualified nurses can apply for a multistate license, which allows for practice in other compact states without having to obtain additional licenses. The final regulations are codified at COMAR 10.32.22 and became effective November 7, 2016. The Maryland Board of Nursing requires written, verified evidence of completion of the appropriate education requirements in accordance with Md. [.11].15Medical Director Qualifications. (3) At least one nourishment pantry convenient to the nursing station shall be provided on each floor in facilities using a centralized food service system. (a) Relocation means the movement of a resident from one room to another within: (i) The same Medicare-certified nursing home; (ii) A Medicaid-only certified nursing home; or. Human Service Worker. (iii) Adequate storage and work counter space for storage and assembly of supplies for nursing procedures; (ii) A separate wall-hung hand sink for handwashing, equipped with wrist blades and soap and towel dispensers; (7) Utility RoomsExistingFacility. (1) The Secretary may issue a license to a[comprehensive care facility]nursing homeor an extended care facility for less than a 24-month period under any of the following conditions: (d) If new construction is completed to the point of being able to provide all necessary services to its residents but certain substantial items of equipment[of]foroptional servicesare temporarily lacking, which in the opinion of the Department will have no immediate adverse effect on the safety or health of its residents[, are lacking temporarily]; or. 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.