Skip to Main Content
<< Back | Return to Main COMAR Search Page

82 records match your request.

FileAbstract
10.07.02.00.htm 10.07.02.00. Title 10 MARYLAND DEPARTMENT OF HEALTH Subtitle 07 HOSPITALS Chapter 02 Nursing Homes Authority: Health-General Article, §19-308, 19-308.1, 19-323, and 19-1401 et seq. Public Safety Article, §14-110.1; Annotated Code of Maryland
10.07.02.01.htm 10.07.02.01. 01 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) “Administrator” means the individual licensed by the Board of Examiners of Nursing Home Administrators who is responsible for the operation of the nursing home.2) “Attending physician” means an individual licensed to practice medicine in the State who:. a) Admits residents to the nursing home; and. b) Is responsible for the overall care of a resident..
10.07.02.02.htm 10.07.02.02. 02 Incorporation by Reference.. A. In this chapter, the following documents are incorporated by reference.. B. Documents Incorporated.. 1) CMS Long-term Care Facility Resident Assessment Instrument 3.0 User’s Manual, (Version 1.14, October 2016)2) CMS Manual System, Pub. 100-07 State Operations Provider Certification, (Transmittal 127, November 26, 2014, U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services)3) Guidelines for Design
10.07.02.03.htm 10.07.02.03. 03 License Required.. A. A person may not establish, operate, or continue the operation of an existing comprehensive care facility or extended care facility without first obtaining a license from the Secretary. A license is valid for 2 years from the date of issuance, unless revoked by the Secretary.B. Separate License Required. Separate licenses are required for facilities maintained on separate premises, even though they are operated under the same management. Separate
10.07.02.04.htm 10.07.02.04. 04 Licensing Procedure.. A. Application for License.. 1) An applicant desiring to open a comprehensive care facility or an extended care facility shall file an application with the Secretary, on a written or electronic form provided by the Secretary.2) An application for a license shall be filed with the Department at least 60 days before the anticipated issuance of the license.3) Applications on behalf of a legal entity shall be made by the senior officer or other senior offi
10.07.02.05.htm 10.07.02.05. 05 Licensed Bed Capacity.. A. A facility may exceed its licensed bed capacity only if the Department:. 1) Requests that the facility exceed its licensed bed capacity; or. 2) Approves a request from a facility to exceed its licensed bed capacity.. B. Departmental Request of Facility to Exceed Capacity. If the Department requests a facility to exceed its licensed bed capacity, the written request is to include the:1) Circumstances that prompted the Department to make the request;.
10.07.02.06.htm 10.07.02.06. 06 Rights of Applicant if License Denied or Revoked.. A. Denial of License ― Proposed Facility. The Secretary shall inform the applicant of the reasons for refusal to issue a license.B. Revocation of License.. 1) The Secretary may, for cause shown, revoke or refuse to reissue any license issued by the Secretary. The Secretary shall consider the following factors in deciding whether a facility's license should be revoked:a) The number, nature, and seriousness of the deficiencies;.
10.07.02.07.htm 10.07.02.07. 07 Inspection by Secretary.. A. Open at all Times for Inspection. Licensed nursing homes and any premises that an applicant for a license proposes to operate shall be open at all times to inspection by the Secretary and by any agency designated by the Secretary.B. Site Visits and Surveys.. 1) The Department shall make a site visit and conduct a full survey of each licensed nursing home at least once per calendar year.2) All surveys shall be unannounced.. C. Records and Reports. L
10.07.02.08.htm 10.07.02.08. 08 New Construction, Conversion, Alteration, or Addition.. A. Submission of Plans.. 1) The architect or professional engineer of record shall submit stamped and sealed final construction drawings to the Department.2) The architect or professional engineer of record shall submit a letter certifying that the project has been designed in accordance with all applicable federal, State, and local codes, laws, ordinances, and regulations for construction.1) A system of water supp
10.07.02.09.htm 10.07.02.09. 09 Administration and Resident Care.. A. Responsibility.. 1) The licensee shall be responsible for the overall conduct of the comprehensive care facility or extended care facility and for compliance with applicable laws and regulations.2) The administrator shall be responsible for the implementation and enforcement of all provisions of the Patient's Bill of Rights Regulations under COMAR 10.07.09.B. Delegation to Administrator.. 1) The licensee, if not acting as an administrator
10.07.02.10.htm 10.07.02.10. 10 Employee Training on Cognitive Impairment and Mental Illness.. A. The following employees shall receive a minimum of 8 hours of training on cognitive impairment and mental illness within the first 90 days of employment:1) Any employee who is licensed, certified, or registered under the Health Occupations Article, Annotated Code of Maryland; and2) Any employee whose job duties include assisting residents with activities of daily living.. B. The training on cognit
10.07.02.11.htm 10.07.02.11. 11 Admission and Discharge.. A. Written Policy. The nursing home shall develop written policies, consistent with this chapter and COMAR 10.07.09, to govern the nursing care, related medical, and other services that the nursing home provides regarding:1) Admissions, transfers, and discharges;. 2) Acceptable payment sources; and. 3) Medical Assistance program information.. B. The nursing home shall make its admission and discharge policies available for review by resident
10.07.02.12.htm 10.07.02.12. 12 Resident's Representative.. A. A nursing home shall recognize the authority of:. 1) A guardian of the person under Estates and Trusts Article, §13-705, Annotated Code of Maryland;. 2) A guardian of the property under Estates and Trusts Article, §13-201, Annotated Code of Maryland;. 3) An advance directive that meets the requirements of Health-General Article, §5-602, Annotated Code of Maryland;4) A surrogate decision maker with authority under Health-General Article,
10.07.02.13.htm 10.07.02.13. 13 Resident Care Policies.. A. A nursing home shall develop written policies consistent with Regulation .11 of this chapter pertaining to:1) Physician services;. 2) Residents’ rights;. 3) Nursing services;. 4) Dietetic services;. 5) Specialized rehabilitative services including occupational therapy, physical therapy, speech pathology and audiology services;6) Pharmaceutical services;. 7) Laboratory and radiologic services;. 8) Dental services;. 9) Social services;.
10.07.02.14.htm 10.07.02.14. 14 Physician Services.. A. Responsibility for the Resident's Care. The attending physician shall:. 1) Assess a new admission in a timely manner, based on a facility-developed protocol, depending on:. a) The individual's medical stability;. b) Recent and previous medical history;. c) Presence of significant or previously unidentified medical conditions; or. d) Problems that cannot be handled readily by phone;. 2) Seek, provide, and analyze needed information r
10.07.02.15.htm 10.07.02.15. 15 Medical Director ― Qualifications.. A. Medical Director Qualifications. The nursing home shall:. 1) Designate a medical director who has at least the following qualifications:. a) A current license as a physician in this State;. b) At least 2 years of experience or specialized training in the medical care of geriatric or chronically ill and impaired residents; andc) Successful completion of a curriculum in physician management or administration from:.
10.07.02.16.htm 10.07.02.16. 16 Medical Director ― Responsibilities.. A. General Responsibilities. The medical director is responsible for:. 1) Overall coordination, execution, and monitoring of physician services;. 2) Monitoring and evaluating the health care services and outcomes, including clinical and physician services provided to the nursing home’s residents; and3) Designating an alternate medical director with sufficient training and experience to perform the responsibilities of the m
10.07.02.17.htm 10.07.02.17. 17 Nursing Home’s Responsibilities in Relation to the Nursing Home’s Medical Director.. A. The nursing facility shall:. 1) Be responsible for working with the medical director to ensure adequate resident care and practitioner performance;2) Inform the physician of explicit requirements as a medical director and assist the medical director in gaining the necessary information and tools to properly execute those responsibilities; and3) Ensure that the medical director has the necess
10.07.02.18.htm 10.07.02.18. 18 Nursing Services.. A. Organization, Policies, and Procedures.. 1) Nursing service personnel shall provide care appropriate to the residents’ needs with the organizational plan, authority, functions, and duties clearly defined.2) Nurses and support personnel shall be chosen for their training, experience, and ability.. 3) Policies and procedures shall be adopted and made available to all nursing service personnel.. B. Signed Agreement.. 1) A signed copy of the a
10.07.02.19.htm 10.07.02.19. 19 Nursing Services ― Staffing.. A. Supervisory Personnel ― Nursing Homes.. 1) Nursing homes shall provide at least the following supervisory personnel:. Residents. Registered Nurses. a) 2―99. One―full-time. b) 100―199. Two―full-time. c) 200―299. Three―full-time. d) 300―399. Four―full-time. 2) The director of nursing’s time is included in §A(1) of this regulation.. B. Hours of Bedside Care ― Nursing Home.. 1) A nursing home shall employ supervisory personnel and a sufficient numbe
10.07.02.20.htm 10.07.02.20. 20 Nursing Services ― Director of Nursing.. A. Director of Nursing. The nursing home shall provide for an organized nursing service, under the direction of a full-time registered nurse.B. Termination of Services of Director of Nursing.. 1) If the nursing home terminates the services of the director of nursing, the nursing home immediately shall notify the Department of the termination.2) The name and license number of the replacement director of nursing shall
10.07.02.21.htm 10.07.02.21. 21 Dietetic Services.. A. Services Provided. Services may be provided directly by the facility or the facility may contract with a food management company, a caterer, or another facility. The facility and the food management company (or caterer or facility providing service) shall comply with these regulations. Food service personnel shall comply with COMAR 10.15.03 Food Service Facilities.B. Supervision.. 1) In a nursing home with more than 50 beds, overall supervisory responsibi
10.07.02.22.htm 10.07.02.22. 22 Specialized Rehabilitative Services ― Occupational Therapy Services, Physical Therapy Services, Speech Pathology and Audiology Services.A. Rehabilitative Services ― Admission Policies. In a nursing home which does not accept residents in need of specialized rehabilitative services, the minimal acceptable restorative service shall be the restorative nursing care plan designed to maintain function or improve the resident’s ability to carry out activities of d
10.07.02.23.htm 10.07.02.23. 23 Special Care Units ― General.. A. A nursing home which holds a current and valid operating license may establish special care units with the approval of the:1) Office of Health Care Quality; and. 2) Department’s Office of Capital Planning, Budgeting and Engineering Services.. B. A facility may notify the Department of its intention to establish a special care unit before developing and submitting the required documents for approval as described in §C of this regulation.
10.07.02.24.htm 10.07.02.24. 24 Special Care Units ― Respiratory Care Unit.. A. A respiratory care unit shall meet the:. 1) General requirements established for all special care units as outlined in Regulation .23 of this chapter; and2) Requirements of this regulation.. B. The nursing home shall submit to the Department and obtain approval of the following:. 1) All documents required in Regulation .23 of this chapter;. 2) Policies and procedures for all aspects of care as outlined in Regulatio
10.07.02.25.htm 10.07.02.25. 25 Special Care Units ― Dementia Care Unit.. A. A dementia care unit shall meet the:. 1) General requirements established for all special care units as outlined in Regulation .24 of this chapter; and2) Requirements of this regulation.. B. Dementia Unit Disclosure.. 1) The disclosure shall be made to the Department and to any person seeking placement or receiving care in a Dementia special care unit or program of a nursing home.2) The information disclosed shall explain the add
10.07.02.26.htm 10.07.02.26. 26 Pharmaceutical Services.. A. Definition. In this regulation, the term “committee” means the pharmaceutical services committee.. B. Duties of the Nursing Home.. 1) The nursing home shall provide appropriate methods and procedures for administering drugs and biologicals to the nursing home’s residents.2) The nursing home shall provide pharmaceutical services in accordance with accepted professional standards and related federal, State, and local laws.
10.07.02.27.htm 10.07.02.27. 27 Pharmaceutical Management.. A. Administration Procedures.. 1) Medications, legend and non-legend, administered to residents shall be ordered in writing by the resident’s physician.2) Medications shall be administered by:. a) Appropriately licensed personnel in accordance with laws and regulations governing these acts; or. b) Certified graduates of a State-approved medicine aide course.. 3) The individual who prepares medications shall give and record them..
10.07.02.28.htm 10.07.02.28. 28 Laboratory and Radiologic Services.. A. Approved Source. Laboratory services provided by the facility shall meet the applicable conditions established under COMAR 10.10.01 Medical Laboratories in Maryland.B. Provisions of Services. If the facility does not provide laboratory and radiologic services, arrangements shall be made for obtaining these services from a physician's office, a licensed laboratory in a hospital or nursing facility, a licensed independent laboratory, or a
10.07.02.29.htm 10.07.02.29. 29 Dental Services.. A. Provision for Dental Care. Residents shall be assisted to obtain routine and emergency dental care.B. Advisory Dentist. There shall be an advisory dentist who shall:. 1) Recommend oral hygiene policies and practices for the care of the residents and for arrangements for emergency treatment;2) Assist in the formulation of dental health policies;. 3) Provide direction for in-service training to give the nursing staff an understanding of residents
10.07.02.30.htm 10.07.02.30. 30 Social Work Services.. A. Services Provided. The nursing home shall provide or make arrangements for services to identify and meet the resident’s medically related physical, social, and behavioral health needs.B. Social Work Staff Responsibility.. 1) Social services responsibilities in the nursing home shall be assigned to a:. a) Licensed bachelor social worker;. b) Licensed graduate social worker;. c) Licensed certified social worker; or.
10.07.02.31.htm 10.07.02.31. 31 Resident Activities.. A. Activities Program. The nursing home shall provide:. 1) A program of structured and unstructured activities; and. 2) Activities designed and monitored appropriately to meet the day-to-day needs and interests of each resident and encourage:a) Self-care;. b) Engagement in resident-selected activities; and. c) Maintenance of an optimal level of psychosocial functioning.. B. Staffing. A staff member who is qualified by experience or training shal
10.07.02.32.htm 10.07.02.32. 32 Clinical Records.. A. Records for all Residents. Records for all residents shall be maintained in accordance with accepted professional standards and practices.B. Contents of Record. Contents of record shall include:. 1) Identification and summary sheet or sheets including:. a) Resident’s name;. b) Social Security number;. c) Armed forces status;. d) Citizenship;. e) Marital status;. f) Age;. g) Sex;. h) Home address; and. i) Religion;.
10.07.02.33.htm 10.07.02.33. 33 Infection Prevention and Control Program.. A. Infection Prevention and Control Program. The nursing home shall establish, implement, and maintain an effective infection prevention and control program that:1) Investigates, controls, and prevents infections in a timely manner through a system that enables the facility to:a) Analyze patterns of infected individuals;. b) Analyze changes in prevalent organisms;. c) Analyze increases in the rate of infection; and.
10.07.02.34.htm 10.07.02.34. 34 Employee Health Program.. A. The nursing home’s infection prevention and control program shall monitor the relevant health status of all employees, as it relates to infection prevention and control. The nursing home shall refer to the following guidelines in implementing its employee health program:1) Guideline for Infection Control in Health Care Personnel;. 2) Immunization of Health Care Personnel: Recommendations of the Advisory Committee on Immunization
10.07.02.35.htm 10.07.02.35. 35 Resident Health Program.. A. Immunization.. 1) The nursing home shall offer influenza and pneumococcal immunization to each resident.. 2) The nursing home shall obtain written consent to administer the immunization from:. a) The resident; or. b) The resident's representative.. 3) A resident is not required to receive the influenza and pneumococcal immunization if it is:. a) Medically contraindicated;. b) Against the resident’s religious beliefs; or. c) After being fully info
10.07.02.36.htm 10.07.02.36. 36 Volunteer Health Program.. A. The nursing home shall urge that volunteers, defined as individuals who spend an average of 8 hours per week or more in the resident care areas and who receive no pay or benefits, receive annual influenza vaccination and tuberculin skin testing as considered necessary by the nursing home.B. The nursing home shall give appropriate health care information to such volunteers to provide maximum protection to residents.C. The nursing home shall
10.07.02.37.htm 10.07.02.37. 37 Infection Control ― Standard Precautions.. A. Standard Precautions. All employees shall routinely use appropriate barrier precautions to prevent skin and mucous membrane exposure when contact with blood or the body fluids of any resident is anticipated as outlined in:1) 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings; and2) COMAR 09.12.31.. B. The infection prevention and control program shall include the handling
10.07.02.38.htm 10.07.02.38. 38 Reports and Action Required in Unusual Circumstances.. A. Serious Emotional Disturbances. A facility may not accept or keep patients who destroy property or are dangerous to themselves or others, or who have acute symptoms of mental illness.B. Action to Be Taken if a Patient Becomes Actively Disturbed. The following action shall be taken:. 1) If a patient becomes actively disturbed, the personal physician shall be notified immediately..
10.07.02.39.htm 10.07.02.39. 39 Transfer Agreement.. A. Written Agreement. A written agreement with at least one acute hospital shall be effected which shall provide for the following actions:1) Planning to ensure that all services required for the continuity of resident care will be made available promptly;2) Advance discussion with the resident regarding the reason for the transfer and any available alternatives;3) Notification to the next of kin or responsible person regarding the anticipated transfer;.
10.07.02.40.htm 10.07.02.40. 40 Emergency and Disaster Plan.. A. Emergency and Disaster Plan.. 1) The licensee shall develop an emergency and disaster plan that includes procedures that shall be followed before, during, and after an emergency or disaster, including:a) Evacuation, transportation, or shelter in place of residents;. b) Notification of families and staff regarding the action that will be taken concerning the safety and well-being of the residents;c) Staff coverage, organization, and assignment of
10.07.02.41.htm 10.07.02.41. 41 Physical Plant ― New and Existing Construction Requirements.. A. Construction of a New Nursing Home.. 1) A new nursing home shall be constructed, equipped, and maintained to protect the health and safety of residents, personnel, and the public.2) A nursing home desiring to provide services other than those for which it is already licensed shall obtain prior approval from the Department.3) The nursing home shall obtain prior approval from the Department for any
10.07.02.42.htm 10.07.02.42. 42 Physical Plant ― General Requirements.. A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.B. A nursing home shall comply with all applicable federal, State, and local governing laws, regulations, standards, ordinances, and codes.C. A nursing home shall be constructed to comply with the provisions of the NFPA 101 Life Safety Code, as promulgated by the State Fire Prevention Commission, that are applica
10.07.02.43.htm 10.07.02.43. 43 Physical Plant ― Plumbing.. A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.B. Plumbing.. 1) Plumbing shall be installed in conformance with all applicable federal, State, and local codes and ordinances.2) Plumbing and water supplies shall be protected against backflow within a nursing home.. 3) Prevention of backflow shall be ensured by proper installation of:. a) Plumbing cross-connections;.
10.07.02.44.htm 10.07.02.44. 44 Physical Plant ― Heating and Cooling.. A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.B. Temperatures. A nursing home shall maintain a minimum design temperature of 75°F or 24°C for all occupied areas.C. Heating System. A nursing home shall be equipped with a properly maintained and operational central heating system. The heating system shall be:1) Capable of maintaining 75°F or 24°C throughout
10.07.02.45.htm 10.07.02.45. 45 Physical Plant ― Ventilation.. A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.B. An existing nursing home shall provide for adequate ventilation through windows or mechanical means or a combination of both.C. A new nursing home shall adhere to the requirements of this chapter.. D. Ventilation System Details.. 1) All air-supply and air-exhaust systems shall be mechanically operated.. 2) The ventilation rates
10.07.02.46.htm 10.07.02.46. 46 Physical Plant ― Emergency Power.. A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.B. Emergency Electrical Power.. 1) The nursing home shall provide emergency electrical power.. 2) Emergency power for the purpose of egress lighting and protection shall be as required by NFPA 101 Life Safety Code.3) Other emergency lighting shall be as follows:. a) Nursing station;.
10.07.02.47.htm 10.07.02.47. 47 Nursing Care Unit.. A. Size. Nursing care units may not exceed 60 beds. The Department may specify the numbers and types of personnel for each unit which exceeds 40 beds.B. Common Space. The nursing home shall provide a living room for residents’ use with a sufficient number of reading lamps, tables, and comfortable chairs or sofas.C. Service Areas Required.. 1) Nurses’ Work Area.. a) The nurses’ work area shall be located on the unit and within easy view
10.07.02.48.htm 10.07.02.48. 48 Call Systems.. A. Call System.. 1) A nurse call system shall be installed and maintained in operating order in all nursing units.. 2) A call system shall be maintained in a manner that will provide visible and audible signal communication between nursing service personnel and residents.3) A call station shall provide readily accessible and detachable extension cords to each resident’s bed in the residents’ rooms at all times.4) A call system shall have a visible signal above
10.07.02.49.htm 10.07.02.49. 49 Resident Bedroom in Nursing Home.. A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home unless a waiver has been granted by the Office of Health Care Quality in accordance with Regulation .03G of this chapter.B. Bedroom Accommodations.. 1) Bedroom.. a) A resident’s room shall have direct access to an exit in accordance with the requirements applicable to nursing homes specified in NFPA 101 Life Safety Code.
10.07.02.50.htm 10.07.02.50. 50 Body-Holding Room.. A. Body-Holding Room ― New Construction and Existing Nursing Home.. 1) A body-holding room shall be equipped with ventilation by mechanical means at the same rate and specifications as designed for soiled linen sorting and storage areas.2) A nursing home shall develop and implement a method for body-holding that minimizes the psychological effects on other residents.B. Body-Holding Room ― New Construction. A body-holding room shall be locat
10.07.02.51.htm 10.07.02.51. 51 Resident Bathroom Amenities.. A. Bathing.. 1) There shall be at least one separate room or compartment with a bathtub, shower, or other bathing device, as approved by the Department, for every 15 licensed beds.2) The compartment shall be large enough to accommodate:. a) The resident;. b) A caregiver; and. c) A wheelchair, shower chair, or shower bed.. B. Toilets.. 1) For every eight beds, there shall be at least one toilet enclosed in a separate room or stall..
10.07.02.52.htm 10.07.02.52. 52 Equipment and Supplies for Bedside Care and Therapy.. A. Needs of Residents.. 1) There shall be sufficient equipment to meet the needs of the residents admitted.. 2) The administrator shall obtain specific items required for individual cases where requested by the attending physician or medical director.3) The Department may require that the nursing home have specific types of equipment based on the needs of the residents.4) A nursing home shall establish and enforce a wr
10.07.02.53.htm 10.07.02.53. 53 Rehabilitation Facilities ― Space and Equipment.. A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.B. General Requirements.. 1) Space.. a) A nursing home shall provide adequate space to:. i) Receive, examine, and treat residents;. ii) Store supplies and equipment, including wheelchairs and stretchers; and. iii) Provide office space for the employed personnel to work.. b) A nursing home shall a
10.07.02.54.htm 10.07.02.54. 54 Dayroom and Dining Area.. A. General Requirements. Resident Dining, Occupational Therapy, and Activities Program. The nursing home shall provide one or more attractively furnished areas of adequate size for resident dining, occupational therapy, and social activities. Activities space shall be of adequate size to meet the needs of the residents and shall be located on each floor occupied by residents.B. Dining Area.. 1) A nursing home shall provide dining areas large
10.07.02.55.htm 10.07.02.55. 55 Dietetic Service Area.. A. General Requirements. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.B. Food Service Department.. 1) The size and location of the food service area shall comply with COMAR 10.15.03.. 2) A catered or satellite system shall be covered by a contract approved by the Department.. 3) The vendor providing the food shall have a valid food service permit.. C. Outside Service Entran
10.07.02.56.htm 10.07.02.56. 56 Administrative Areas.. A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.B. Administrative Areas ― New Construction.. 1) A nursing home shall provide a separate room or rooms for the administrator and administrative support staff. Sufficient areas shall be provided to accommodate all necessary office furniture, files, and other equipment and enable the safe storage of residents’ valuables.2) In new construction, s
10.07.02.57.htm 10.07.02.57. 57 Housekeeping Services, Pest Control, and Laundry.. A. General Requirements. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.B. Staff. Sufficient housekeeping and maintenance personnel shall be employed to maintain the interior and exterior of the facility in a safe, clean, orderly, and attractive manner.C. Cleanliness and Maintenance.. 1) The building and all its parts and facilities shall be kept in good repa
10.07.02.58.htm 10.07.02.58. 58 Resident Care Management System.. A. Each comprehensive care facility and extended care facility shall establish and maintain a resident care management system.B. The resident care management system shall consist of three related components:. 1) Resident status assessment and data gathering;. 2) Care planning; and. 3) Actions in response to care plan approaches..
10.07.02.59.htm 10.07.02.59. 59 Resident Status Assessment.. A. A nursing home shall use the following forms and procedures for resident assessment as described in the CMS Manual System, Pub. 100-07 State Operations Provider Certification and in the CMS Long-term Care Facility Resident Assessment Instrument 3.0 User’s Manual:1) The Minimum Data Set (MDS) version as determined by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, in Transmittal No. 22, ref
10.07.02.60.htm 10.07.02.60. 60 Care Planning.. A. An interdisciplinary team shall complete or revise as necessary a resident-specific care plan for each resident within 7 calendar days following completion of assessments, including:1) Admission assessment;. 2) Annual assessment;. 3) Quarterly assessment; and. 4) Significant change in the resident’s condition.. B. Care Plan Meeting. The nursing home shall, with the resident’s consent:. 1) Give an interested and appropriate family member or resident’s represent
10.07.02.61.htm 10.07.02.61. 61 Skin Record.. A. The facility shall establish a skin care record documenting skin, hair, and nail condition on admission, if any abnormal conditions exist.B. The staff shall document progress of the condition or conditions weekly until the condition or conditions have healed.C. At any time that a skin condition persists for more than 7 days, staff shall add the condition to the skin record.
10.07.02.62.htm 10.07.02.62. 62 Geriatric Nursing Assistant Training Program.. A. Nursing Home Responsibilities.. 1) A nursing home shall conduct or arrange a geriatric nursing assistant training program for unlicensed personnel assigned to direct resident care duties. The Maryland Board of Nursing shall approve the geriatric nursing assistant training program curriculum.2) A nursing home may not employ an individual as a geriatric nursing assistant until the individual has successfully complet
10.07.02.63.htm 10.07.02.63. 63 Paid Feeding Assistants.. A. A facility may use a paid feeding assistant who has successfully completed a State-approved training course as described in §E of this regulation.B. Supervision.. 1) A paid feeding assistant shall work under the supervision of a licensed nurse.. 2) In an emergency, when the resident is fed in the resident's room, a paid feeding assistant shall use the resident call system to call a supervisory nurse for help.C. A nursing home that us
10.07.02.64.htm 10.07.02.64. 64 Quality Assurance Program.. A. A nursing home shall establish an effective quality assurance program that includes components described in this regulation and Regulation .65 of this chapter.B. The nursing home shall appoint a qualified individual to manage quality assurance activities within the nursing facility.C. The nursing home shall establish a quality assurance committee that includes at least:. 1) The nursing home director of nursing;. 2) The nursing home administrator;.
10.07.02.65.htm 10.07.02.65. 65 Quality Assurance Plan.. A. The nursing home’s quality assurance committee shall develop and implement a quality assurance plan that includes procedures for:1) Concurrent review;. 2) Ongoing monitoring;. 3) Resident complaints;. 4) Accidents and incidents; and. 5) Abuse and neglect.. B. Concurrent Review. The quality assurance plan shall include:. 1) The procedures for conducting concurrent review of each resident including:.
10.07.02.66.htm 10.07.02.66. 66 Relocation of Residents.. A. The facility shall develop and implement a written plan to provide for the smooth and orderly transfer of residents if the facility closes.B. The plan for relocation shall include:. 1) A description of how residents, families, or guardians will be notified and by whom;. 2) Sample letters and other documents that will be used during a closure;. 3) Procedures for notifying Medicaid and other payment sources;.
10.07.02.67.htm 10.07.02.67. 67 Posting of Staffing.. A. A nursing home shall post a notice on each floor or unit of the nursing home, for each shift, a notice that gives the ratio of licensed and unlicensed staff to residents.B. The posting on each floor shall include:. 1) Names of the staff members on duty and the room numbers of the residents to whom each is assigned;2) Name of the charge nurse or person who is in charge of the unit;. 3) If the person in charge is not a registered nur
10.07.02.68.htm 10.07.02.68. 68 Sanctions.. A. If a deficiency exists, the Department, in addition to the sanctions set forth in this regulation and Regulations .67—74 of this chapter, may:1) Restrict the number of residents the nursing facility may admit in accordance with Health-General Article, §19-328, Annotated Code of Maryland;2) Require the establishment of an escrow account in accordance with Health-General Article, §19-362, Annotated Code of Maryland;3) Direct the licensee to correct the deficiencies
10.07.02.69.htm 10.07.02.69. 69 Mandated Staffing Pattern.. A. When the Department determines that a deficiency or deficiencies exist, the Department shall notify the nursing facility of the deficiency or deficiencies and may either:1) Mandate a staffing pattern which specifies the number of personnel or personnel qualifications, or both; or2) Permit the facility the opportunity to correct the deficiencies by a specific date.. B. If the facility does not correct the deficiency or deficiencies, the Dep
10.07.02.70.htm 10.07.02.70. 70 Civil Money Penalties ― Imposition.. A. A civil money penalty may be imposed when:. 1) A deficiency exists; or. 2) An ongoing pattern of deficiencies exist in a nursing facility.. B. In determining whether a civil money penalty is to be imposed, the Department shall consider the following factors:1) The number, nature, and seriousness of the deficiencies;. 2) The extent to which the deficiency or deficiencies are part of an ongoing pattern during the preceding 24 months;
10.07.02.71.htm 10.07.02.71. 71 Civil Money Penalties ― Amount of Penalty.. A. A civil money penalty imposed under this chapter for potential for more than minimal harm deficiencies may not exceed:1) $10,000 per instance; or. 2) $1,000 per day for an ongoing pattern of deficiencies until correction of the deficiencies has been verified and sustained compliance has been maintained.B. A civil money penalty imposed under this chapter for actual harm deficiencies may not exceed:. 2) $5,000 per day for an
10.07.02.72.htm 10.07.02.72. 72 Civil Money Penalties ― Effective Date and Duration of Penalty.. A. Per Instance Civil Money Penalty. The effective date may be as early as the date that the deficiency or deficiencies upon which the civil money penalty is based first occurred.B. Per Day Civil Money Penalty.. 1) The daily civil money penalty starts to accrue as of the date of the visit that identifies the deficiency or deficiencies upon which the civil money penalty is based.2) The accrual of the dai
10.07.02.73.htm 10.07.02.73. 73 Civil Money Penalties ― Payment of Penalty/Establishment of Escrow Account.. A. A civil money penalty payment is due 15 calendar days after:. 1) The time period for requesting a hearing has expired and a request for hearing was not received; or2) Receipt of a written request from the facility to waive its right to a hearing and reduce the amount of the civil money penalty by 40 percent provided the written request is received by the Department within 30 calendar da
10.07.02.74.htm 10.07.02.74. 74 Civil Money Penalties ― Hearings.. A. A licensee aggrieved by the imposition of a civil money penalty may appeal the action by filing a request for a hearing in accordance with State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland.B. The Secretary has the burden of proof with respect to the imposition of civil money penalties.. C. The Office of Administrative Hearings shall render a decision within 10 working days of the hearing.
10.07.02.75.htm 10.07.02.75. 75 Criminal Penalties.. A. A person maintaining or operating a nursing home without 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 conviction in accordance with Health-General Article, §19-358, Annotated Code of Maryland.B. Each day that the nursing home continues to operate without a license after the first conviction is a subsequent offense a
10.07.02.76.htm 10.07.02.76. 76 Emergency Suspension.. A. The Secretary may immediately suspend a license on finding that the public health, safety, or welfare imperatively requires emergency action pursuant to State Government Article, §10-405(b) Annotated Code of Maryland.B. The Department shall deliver a written notice to the nursing facility:. 1) Informing the nursing facility of the emergency suspension;. 2) Giving the reasons for the action and the regulation or regulations with which the licensee has f
10.07.02.77.htm 10.07.02.77. 77 Denial or Revocation of License.. A. Denial or Revocation of License. The Secretary, for cause shown, may notify the nursing facility of the decision to revoke or deny the nursing facility's license. The denial or revocation shall be stayed if a hearing is requested.B. The Department shall notify the nursing facility in writing of the following:. 1) The effective date of the denial or revocation;. 2) The reason for the denial or revocation;. 3) The regulations with w
10.07.02.78.htm 10.07.02.78. 78 Hearings.. A. A request for a hearing shall be filed with the Office of Administrative Hearings, with a copy to the Office of Health Care Quality of the Department, not later than 30 days after receipt of notice of the Secretary's action. This request shall include a copy of the Secretary's action.B. A hearing requested under this chapter shall be conducted in accordance with:. 1) State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland;.
10.07.02.79.htm 10.07.02.79. 79 Health Care Quality Account.. A. The Department shall establish a health care quality account in the Department.. B. The health care quality account shall be funded by civil money penalties paid by nursing homes.. C. The Department shall use funds from the health care quality account to improve the quality of care in nursing facilities.D. Expenditure of funds may include, but are not limited to the following:.
10.07.02.80.htm 10.07.02.80. 80 Financial Disclosure.. A. A licensee shall have financial resources in accordance with this regulation in order to:. 1) Satisfy obligations; and. 2) Ensure at all times the delivery of essential care and services, such as nursing, dietary services, or utilities.B. A licensee shall notify the Secretary of significant adverse changes in financial condition which reasonably could be anticipated to adversely affect the delivery of essential care and services. Th
10.07.02.9999.htm 10.07.02.9999. Administrative History Effective date: June 30, 1978 (5:13 Md. R. 1053). This chapter is a compilation and revision of prior regulations contained in COMAR 10.07.02, Nursing Homes―Extended Care, and COMAR 10.07.05, Intermediate Care Facilities―Long-term Care (Type A) COMAR 10.07.02 was effective January 1, 1967; amended effective March 27, 1973 and April 16, 1975 (2:8 Md. R. 565) COMAR 10.07.05 was effective July 1, 1969 and amended effective MRegulation .01B amended e
<< Back | Return to Main COMAR Search Page