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

75 records match your request.

FileAbstract
10.07.02.00.htm 10.07.02.00. Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle 07 HOSPITALS Chapter 02 Comprehensive Care Facilities and Extended Care Facilities 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 PrefaceThe Secretary of Health and Mental Hygiene has legal responsibility for and is empowered to establish regulations and standards for the licensure of hospitals and related inst
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) "Actual harm deficiency" means a condition existing in a nursing facility or an action or inaction by the nursing facility staff that has caused physical or emotional injury or impairment to a resident.1-1) "Administrator" means the individual licensed by the Board of Examiners of Nursing Home Administrators and responsible for the operation of the h2) "Ambulatory patients"
10.07.02.01-1.htm 10.07.02.01-1. 01-1 Incorporation by Reference.. A. In this chapter, the following documents are incorporated by reference.. B. Documents Incorporated.. 1) Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Facilities, 1994 (MMWR 1994; 43 No. RR-13; U.S. Centers for Disease Control and Prevention (CDC) Atlanta, Georgia)2) Immunization of Health-Care Workers: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Ho
10.07.02.02.htm 10.07.02.02. 02 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
10.07.02.03.htm 10.07.02.03. 03 Licensing Procedure.. A. Application for License.. 1) An applicant desiring to open a comprehensive care facility or an extended care facility or to continue the operation of an existing facility as a comprehensive care facility or an extended care facility shall file an application with the Secretary, on a 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.
10.07.02.03-1.htm 10.07.02.03-1. 03-1 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 request1) Circumstances that prompted the Department to make the request;.
10.07.02.04.htm 10.07.02.04. 04 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;.
10.07.02.05.htm 10.07.02.05. 05 Inspection by Secretary of Health and Mental Hygiene.. A. Open at all Times for Inspection. Licensed comprehensive care facilities and extended care facilities and any premises proposed to be operated by an applicant for a license 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
10.07.02.06.htm 10.07.02.06. 06 New Construction, Conversion, Alteration, or Addition.. A. Submission of Plans. The plans review cycle normally will consist of a schematic phase, a design and development phase, and a final or construction phase. The applicant or his designated representative shall provide information as required in the plans review cycle.B. Service Facilities. A system of water supply, plumbing, sewerage, electrical power, garbage or refuse disposal may not be installed or extended unt
10.07.02.07.htm 10.07.02.07. 07 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
10.07.02.07-1.htm 10.07.02.07-1. 07-1 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
10.07.02.08.htm 10.07.02.08. 08 Admission and Discharge.. A. Discrimination Prohibited. A facility licensed under these regulations may not discriminate in admitting or providing care to an individual because of the race, color, national origin, or physical or mental handicap of the individual.B. Contract. Before or at admission, a contract shall be executed by the administrator and patient, guardian, or responsible agency which is consistent with the requirements of Health-General Article,
10.07.02.08-1.htm 10.07.02.08-1. 08-1 Resident's Representative.. A. A comprehensive or extended care facility 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 advanced directive that meets the requirements of Health-General Article, §5-602, Annotated Code of Maryland;4) A surrogate decision maker with authority under
10.07.02.09.htm 10.07.02.09. 09 Resident Care Policies.. A. Written Policies. 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. The facility'
10.07.02.10.htm 10.07.02.10. 10 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
10.07.02.11.htm 10.07.02.11. 11 Medical Director Qualifications.. A. Medical Director Qualifications. The nursing facility 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;c) Successful completion of a curriculum in physician management or administration from the American
10.07.02.11-1.htm 10.07.02.11-1. 11-1 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 outcomes of the health care, including clinical and physician services provided to the facility's residents; and3) Designating an alternate medical director with sufficient training and experience to perform the responsibilities of the medical director as descri
10.07.02.11-2.htm 10.07.02.11-2. 11-2 Facility's Responsibilities in Relation to the Facility'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
10.07.02.12.htm 10.07.02.12. 12 Nursing Services.. A. Organization, Policies, and Procedures. Nursing service shall provide the care appropriate to the patients' needs with the organizational plan, authority, functions, and duties clearly defined. Nurses and supportive personnel shall be chosen for their training, experience, and ability. Policies and procedures shall be adopted and made available to all nursing personnel.B. Director of Nursing. The facility shall provide for an organized nursing
10.07.02.13.htm 10.07.02.13. 13 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 facilities exceeding 50 beds, overall supervisory responsibilities fo
10.07.02.14.htm 10.07.02.14. 14 Specialized Rehabilitative Services ― Occupational Therapy Services, Physical Therapy Services, Speech Pathology and Audiology Services.A. Rehabilitative Services―Admission Policies. In those facilities which do not accept patients 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 patient's ability to carry out the activities of d
10.07.02.14-1.htm 10.07.02.14-1. 14-1 Special Care Units ― General.. A. A facility which holds a current and valid operating license may establish special care units with the approval of the Office of Licensing and Certification Programs and the Department's Division of Engineering and Maintenance.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.
10.07.02.14-2.htm 10.07.02.14-2. 14-2 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 .14-1 of this chapter; and2) Requirements of this regulation.. B. The facility shall submit to the Department and obtain approval of the following:. 1) All documents required in Regulation .14-1C of this chapter;. 2) Policies and procedures for all aspects of care as outlined in Regulatio
10.07.02.15.htm 10.07.02.15. 15 Pharmaceutical Services.. A. Facility Responsible for Pharmacy Services. The facility shall provide appropriate methods and procedures for administering drugs and biologicals. The facility shall be responsible for providing drugs and biologicals for its patients. Pharmaceutical services shall be provided in accordance with accepted professional principles and appropriate federal, State, and local laws. Any regulation in this chapter shall govern if higher.
10.07.02.16.htm 10.07.02.16. 16 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
10.07.02.17.htm 10.07.02.17. 17 Dental Services.. A. Provision for Dental Care. Patients shall be assisted to obtain routine and emergency dental care.B. Advisory Dentist. There shall be an advisory dentist, licensed to practice in the State, who shall:1) Recommend oral hygiene policies and practices for the care of the patients 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 u
10.07.02.18.htm 10.07.02.18. 18 Social Work Services.. A. Services Provided. The facility shall provide or make arrangements for services to identify and meet the patient's medically related social and emotional needs.B. Designated Staff Responsibility. A member of the facility's staff shall be assigned responsibility for social services. If the designee is not a certified social worker, the facility shall effect an agreement with a qualified social work consultant. The agreement shall pr
10.07.02.19.htm 10.07.02.19. 19 Patient Activities.. A. Activities Program. The facility shall provide for a program of structured and unstructured activities, designed and monitored appropriately to meet the day-to-day needs and interests of each patient, to encourage self-care, resumption of normal activities, and maintenance of an optional level of psychosocial functioning.B. Staffing. A staff member qualified by experience or training shall be appointed to be responsible for the activities progr
10.07.02.20.htm 10.07.02.20. 20 Clinical Records.. A. Records for all Patients. Records for all patients shall be maintained in accordance with accepted professional standards and practices.B. Contents of Record. Contents of record shall be:. 1) Identification and summary sheet or sheets including patient's name, social security number, armed forces status, citizenship, marital status, age, sex, home address, and religion;2) Names, addresses, and telephone numbers of referral agencies (including
10.07.02.21.htm 10.07.02.21. 21 Infection Control Program.. A. Infection Control Program. The facility shall establish, maintain, and implement an effective infection 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.
10.07.02.21-1.htm 10.07.02.21-1. 21-1 Employee Health Program.. A. The facility's infection control program shall monitor the relevant health status of all employees, as it relates to infection control. The following guidelines shall aid the facility in implementing its employee health program:1) Guideline for Infection Control in Health Care Personnel;. 2) Immunization of Health-Care Workers: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control
10.07.02.21-2.htm 10.07.02.21-2. 21-2 Resident Health Program.. A. The facility's 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.B. Tuberculosis Assessment.. 1) The facility shall assess residents for tuberculosis according to the following guidelines:. a) Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health Care Facilities; and
10.07.02.21-3.htm 10.07.02.21-3. 21-3 Volunteer Health Program.. A. The facility shall urge that volunteers, defined as individuals who spend an average of 8 hours per week or more in the institution patient care areas and who receive no pay or benefits, accept annual influenza vaccination and tuberculin testing as considered necessary by the facility. The facility shall give appropriate health care information to such volunteers to provide maximum protection to residents.B. The facility shall mai
10.07.02.21-4.htm 10.07.02.21-4. 21-4 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) Guideline for Isolation Precautions in Hospitals; and. 2) COMAR 09.12.31.. B. The infection control program shall include the handling of medical waste as defined in COMAR 10.06.06.
10.07.02.22.htm 10.07.02.22. 22 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..
10.07.02.23.htm 10.07.02.23. 23 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 patient care will be made available promptly;2) Advance discussion with the patient regarding the reason for the transfer and any available alternatives;3) Notification to the next of kin or responsible person regarding the anticipated transfer;.
10.07.02.24.htm 10.07.02.24. 24 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
10.07.02.25.htm 10.07.02.25. 25 Location and Communication.. The site of the facility shall be approved by the Department. It shall be located in an area convenient to professional personnel and other employees. The environment shall be free from excessive noise and air pollution. In new facilities sound transmission limitations shall be in accordance with Standard No. E 90 of the American Society for Testing and Materials (ASTM) as revised from time to time. The facility shall be located on a well-drained
10.07.02.26.htm 10.07.02.26. 26 Physical Plant General Requirements.. Unless otherwise indicated, all general requirements apply to both new construction and existing facilities.A. Construction―New Facilities. Facilities shall be constructed, equipped, and maintained to protect the health and safety of patients, personnel, and the public.B. Construction of New Facilities. New facilities shall be defined as facilities for which plans have been submitted and approved subsequent to the adoption of these regulatio
10.07.02.27.htm 10.07.02.27. 27 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. Service Areas Required in New Construction or for New Facilities.. 1) Nurses' Station. The nurses' station shall be centrally located in relation to beds served and shall provide easy view of corridors outside of rooms. The Department may specify the location and size of a nurses' station wh
10.07.02.28.htm 10.07.02.28. 28 Resident Bedroom and Toilet Facilities.. A. Unless otherwise noted, requirements are applicable to existing facilities as well as new facilities.B. Bedroom Accommodations. The following requirements shall be met:. 1) Each patient's room shall have direct access to an exit as specified by the Life Safety Code.. 2) A room which opens into the kitchen may not be used as a patient bedroom.. 3) A room may not be used as a patient bedroom which necessitates passing t
10.07.02.29.htm 10.07.02.29. 29 Equipment and Supplies for Bedside Care.. A. Needs of Patients. There shall be sufficient equipment to meet the needs of the type patients admitted. It shall be the responsibility of the administrator to obtain specific items required for individual cases where requested by the attending physician or supervisor of care services. The Department may require specific types of equipment based on the needs of the patients. All facilities shall establish and enforce a
10.07.02.30.htm 10.07.02.30. 30 Rehabilitation Facilities ― Space and Equipment.. A. Space.. 1) There shall be adequate space for the reception, examination, and treatment of patients; storage of supplies and equipment including wheelchairs and stretchers; and office space for the personnel employed;2) Seventy-five square feet shall be allotted for treatment area per patient based on peak treatment schedules:Agency Note: Recommended space: Storage―10 percent of area designated for exercise and rehabilitatio
10.07.02.31.htm 10.07.02.31. 31 Dayroom and Dining Area.. A. Resident Dining, Occupational Therapy, and Activities Program. There shall be provided one or more attractively furnished areas of adequate size for resident dining, occupational therapy, and social activities. Activities space of adequate size to meet the needs of the residents shall be located on each floor occupied by residents.B. Dining Area. In all facilities, the dining area shall be large enough to accommodate all patients
10.07.02.32.htm 10.07.02.32. 32 Dietetic Service Area.. A. Food Service Department. The location of the food service are shall be approved by the Department. A facility which holds full licensure as of the adoption of these regulations shall be considered as having an appropriately located food service area. A catered or satellite system shall be covered by a contract approved by the Department.B. Outside Service Entrance. A convenient outside service entrance shall be planned to facilitate re
10.07.02.33.htm 10.07.02.33. 33 Administrative Areas.. A. New Construction. In new construction, a separate room or rooms shall be provided for the administrator and staff. Sufficient areas shall be provided to accommodate all necessary office furniture, files, and other equipment, including provision for the safe storage of patients' valuables.B. Existing Facilities. In existing facilities, an administrative area shall be provided which is suitable for conducting business or discussing in pr
10.07.02.34.htm 10.07.02.34. 34 Housekeeping Services, Pest Control, and Laundry.. A. 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.B. Cleanliness and Maintenance. The following shall be observed:. 1) The building and all its parts and facilities shall be kept in good repair, neat and attractive. The safety and comfort of the patients shall be the first consideration.
10.07.02.35.htm 10.07.02.35. 35 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 be comprised of three interrelated components:. 1) Resident status assessment and data gathering;. 2) Care planning; and. 3) Actions in response to care plan approaches..
10.07.02.36.htm 10.07.02.36. 36 Resident Status Assessment.. A. Disciplines shall record all assessments on a form approved by the Department.. B. State Operations Manual for Provider Certification, Appendix R―Resident Assessment Instrument for Long-Term Care Facilities, Transmittal No. 272, April 1995 and Transmittal No. 22, December 2000, U.S. Department of Health and Human Services, Center for Medicare and Medicaid Services, is incorporated by reference.C. A facility shall use the following forms and pr
10.07.02.37.htm 10.07.02.37. 37 Care Planning.. A. An interdisciplinary team shall complete a resident specific care plan for each resident within 7 calendar days following completion of all assessments.B. A care plan under this regulation shall be based upon assessments conducted at the following times:1) Admission;. 2) Annual;. 3) Quarterly; and. 4) Significant change in the resident's condition.. C. A facility shall give a family member or resident's representative 7 calendar days advance notice
10.07.02.38.htm 10.07.02.38. 38 Special 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 progression 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.
10.07.02.39.htm 10.07.02.39. 39 Geriatric Nursing Assistant Program.. A. Facility Responsibilities.. 1) Each facility shall conduct or arrange a nurses' aide training program for unlicensed personnel assigned direct patient care duties. This requirement does not extend to physical or occupational therapy assistants or to other employees performing delegated, non-nursing functions. The facility may use an outside program if it has been reviewed and approved by the Department.2) Each facility shall su
10.07.02.40.htm 10.07.02.40. 40 Curriculum for the Geriatric Nursing Assistant Program.. A. Introduction.. 1) Role of nursing assistant;. 2) Relationships of nursing assistant to health care team;. 3) Purpose of long-term care;. 4) Patient's rights.. B. Approaches of Caring for the Aging Patient.. 1) Observation/reporting:. a) Changing function and behavior-normal vs. abnormal,. b) Confidentiality;. 2) Communication:. a) Forms (examples, body language, verbal and nonverbal). b) Patient, family and staff;.
10.07.02.41.htm 10.07.02.41. 41 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 facility that uses a
10.07.02.42.htm 10.07.02.42. 42 Geriatric Nursing Assistant Program ― Competency Evaluation and Registry.. A. Geriatric Nursing Assistant Competency Evaluation.. 1) The Department shall provide for the evaluation and certification of the competency of geriatric nursing assistants.2) The Department will approve one or more competency evaluation programs meeting the criteria set forth by the Health Care Financing Administration of the United States Department of Health and Human Services for registratio
10.07.02.43.htm 10.07.02.43. 43 Medicine Aide ― Scope of Responsibility.. A. Upon successful completion of the Department of Health and Mental Hygiene approved Medicine Aide Course, and when applicable, the continuing education course, the medicine aide may perform all medication administration functions except for those prohibited in §B of this regulation. These functions, including the following delegated nursing functions may only be performed by the aide under the direct supervision of a re
10.07.02.44.htm 10.07.02.44. 44 Medicine Aide Course Requirements.. A. Successful course completion will be recognized by the Department when:. 1) Before admission to the program, the applicant meets the following requirements:. a) Possesses at least 1 year of full-time experience or its equivalent as a nursing assistant in a comprehensive care facility or extended care facility in Maryland;b) Evidences experience in basic patient care procedures; and. c) Is currently employed as a geriatric nursing as
10.07.02.45.htm 10.07.02.45. 45 Quality Assurance Program.. A. By January 1, 2001, each nursing facility shall establish an effective quality assurance program that includes components described in this regulation and Regulation .46 of this chapter.B. The nursing facility shall appoint a qualified individual to manage quality assurance activities within the nursing facility.C. The nursing facility shall establish a quality assurance committee that includes at least:. 1) A director of nursing;.
10.07.02.46.htm 10.07.02.46. 46 Quality Assurance Plan.. A. The facility's quality assurance committee shall develop and implement a quality assurance plan that includes procedures for:1) Concurrent review;. 2) Ongoing monitoring;. 3) Patient 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:.
10.07.02.47.htm 10.07.02.47. 47 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;.
10.07.02.48.htm 10.07.02.48. 48 Posting of Staffing.. A. A nursing home shall post on each floor or unit of the nursing home, for each shift, a notice that explains 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 that each is assigned;. 2) Name of the charge nurse or person in charge of the unit; and. 3) Name of the medicine aide or person responsible for medication administration..
10.07.02.49.htm 10.07.02.49. 49 Sanctions.. A. If a deficiency exists, the Department, in addition to the sanctions set forth in this regulation and Regulations .50―58 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
10.07.02.50.htm 10.07.02.50. 50 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
10.07.02.51.htm 10.07.02.51. 51 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 prec3) The degree of risk to
10.07.02.52.htm 10.07.02.52. 52 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
10.07.02.53.htm 10.07.02.53. 53 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
10.07.02.54.htm 10.07.02.54. 54 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
10.07.02.55.htm 10.07.02.55. 55 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.
10.07.02.56.htm 10.07.02.56. 56 Criminal Penalties.. A. A person maintaining or operating a nursing facility 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. Each day that the nursing facility continues to operate without a license after the first conviction is a subsequent offense and may subject the operator to further criminal prosecution.B. A person maintaining a
10.07.02.57.htm 10.07.02.57. 57 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
10.07.02.58.htm 10.07.02.58. 58 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
10.07.02.59.htm 10.07.02.59. 59 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;.
10.07.02.60.htm 10.07.02.60. 60 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:.
10.07.02.61.htm 10.07.02.61. 61 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