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10.07.04.00.htm 10.07.04.00. Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle 07 HOSPITALS Chapter 04 Residential Treatment Centers for Emotionally Disturbed Children and Adolescents Authority: Health-General Article, §19-301, 19-305, 19-308, 19-309, 19-320, 19-323, and 19-360, Annotated Code of Maryland
10.07.04.01.htm 10.07.04.01. 01 Scope.. A. The treatment and care of emotionally disturbed children and adolescents are of great concern to various State agencies including the Department of Health and Mental Hygiene, Department of Human Resources, Maryland State Department of Education and Department of Juvenile Justice.B. The Department of Health and Mental Hygiene, Department of Human Resources, Maryland State Department of Education, and Department of Juvenile Services, by statute, are res
10.07.04.02.htm 10.07.04.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) “Accredited residential treatment center” means a residential treatment center that is accredited by the Joint Commission.2) “Adverse event” means an unexpected occurrence that:. a) Is related to a resident’s medical or behavioral treatment; and. b) Is not related to the natural course of the resident’s illness or underlying disease condition..
10.07.04.03.htm 10.07.04.03. 03 License Requirements.. A. License Required. A person may not establish, conduct, maintain, or operate in the State a center without first obtaining a license from the Secretary.B. Separate License Required. Centers maintained on separate premises shall obtain separate licenses, even though operated under the same management.C. License Not Required Under This Chapter. The following facilities are not deemed to be within the purview of these licensing requirements and are n
10.07.04.04.htm 10.07.04.04. 04 Licensing Procedure.. A. Application. Applicants shall conform to the following:. 1) An applicant desiring to open or to continue the operation of an existing center shall file with the Secretary, on a written or electronic form provided by the Secretary:a) The name of the applicant desiring the license; and. b) The location of the center, the name of the person in charge, and any additional documents and information that the Secretary may require.2) Application on behalf
10.07.04.05.htm 10.07.04.05. 05 Denial or Revocation of License.. A. The Secretary shall deny a license to a person who has been convicted of a felony that relates to Medicaid or to a nursing home.B. The Secretary shall revoke the license of any licensee convicted of a felony that relates to Medicaid or to a nursing home.C. The Secretary may deny or revoke a license if the center does not meet the requirements of:. 1) Health-General Article, Title 19, Subtitle 3, Annotated Code of Maryland; and.
10.07.04.06.htm 10.07.04.06. 06 Inspection.. Open to Inspection. A center licensed under this chapter and any premises proposed to be operated by an applicant for a license shall be open at all reasonable times to inspection by:A. The Secretary or designee;. B. The Department of Human Resources;. C. The Maryland State Department of Education;. D. The Department of Juvenile Services; or. E. Any other agency authorized by the Secretary..
10.07.04.07.htm 10.07.04.07. 07 New Construction or Alteration.. A. Submission of Plans. Plans shall be submitted to the Secretary before construction or alterations begin affecting its functional structure or normal bed capacity. These plans shall have the prior approval of local zoning authorities and the appropriate fire authorities. The Secretary shall review promptly the plans and shall notify the applicant or licensee within 30 days that the building, alteration, additions, or changes, are approved or di
10.07.04.08.htm 10.07.04.08. 08 Physical Plant.. A. Construction. A new building designated as a residential treatment center and any existing building proposed for conversion for this use shall meet the following:1) The construction of the building shall prevent the entrance and harborage of rats and other rodents;2) The center shall comply with all other applicable governing laws or ordinances; and. 3) The center shall be constructed to comply with the requirements of the Americans with Disabilities Act.
10.07.04.09.htm 10.07.04.09. 09 Fire Regulations.. A center shall be free from fire hazards and shall comply with all applicable local fire and building codes and the safety requirements of the National Fire Protection Association, NFPA 101 "Life Safety Code" which is incorporated by reference at COMAR 29.06.01.06.
10.07.04.10.htm 10.07.04.10. 10 General Requirements.. A. 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 residents shall be the first consideration.2) All walls, floors, ceilings, windows, and fixtures shall be kept clean. Interior walls and floors shall be easily cleanable.3) Adequate storage space shall be provided for excess supplies, personal p
10.07.04.11.htm 10.07.04.11. 11 Food Services.. A. Dietary Requirements. The following minimum requirements shall be observed:. 1) A minimum of three meals in each 24 hour period shall be served. In addition, nutritious between meal and bedtime snacks should be offered to all residents no less than 1-1/2 to 2 hours before the next meal.2) There may not be an interval longer than 12 hours from the evening meal or substantial bedtime snack to breakfast. The diet shall consist of simply prepared, appropriately
10.07.04.12.htm 10.07.04.12. 12 Management Requirements.. A. Responsibility. The licensee is responsible for conformance with licensing regulations.. B. Responsible Person. The licensee or administrator appointed by the licensee and all persons in supervisory or other responsible positions shall be 21 years old or older. The licensee shall ensure 24-hour coverage by an administrator or designee.C. Qualifications of Administrator.. 1) The administrator of the center shall be a psychiatrist, psychologist, s
10.07.04.13.htm 10.07.04.13. 13 Health Services.. A. Supervision of Treatment Program. Treatment at any center shall be under the direction of a qualified psychiatrist who is responsible for the adequacy, quality, and appropriateness of the treatment program for each resident. There shall be sufficient professional personnel to ensure the implementation of the treatment program for each resident.B. Medical Supervision. A resident shall be under the medical care of a physician licensed in the St
10.07.04.14.htm 10.07.04.14. 14 Staffing Requirements.. A. The administrator shall employ sufficient and qualified personnel to ensure adequate treatment and care of the residents and the maintenance, cleaning, and housekeeping.B. The staff shall be sufficient in number so that the individual needs of residents are met.. C. Provision shall be made for relief personnel during vacations or other relief periods. The relief personnel shall have qualifications equivalent to those of the person being relieved.
10.07.04.15.htm 10.07.04.15. 15 Accommodations.. A. Usable Living Space Needed.. 1) Each center shall provide at least 35 square feet of usable floor space per resident, in addition to bedroom space, in order to meet minimal requirements for dining, living, and recreational facilities.2) A minimum of 80 square feet is required for single occupancy bedrooms, and 60 square feet per bed for multiple occupancy bedrooms.3) Usable space excludes service areas, entrance ways, door swing areas, cl
10.07.04.16.htm 10.07.04.16. 16 Restraints and Seclusion.. The use of restraints and seclusion shall be in compliance with 42 CFR §483.352―483.376 Condition of Participation for the Use of Seclusion and Restraint in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services For Individuals Under Age 21.
10.07.04.17.htm 10.07.04.17. 17 Complaint Investigations.. A. Notwithstanding any other provision of this chapter, residential treatment centers shall be open to inspections by the Department to investigate and resolve any complaint concerning:1) Resident care;. 2) Safety;. 3) Medical and nursing supervision;. 4) Physical environment;. 5) Sanitation; or. 6) Dietary matters.. B. Complaints.. 1) To expeditiously resolve a complaint that alleges the existence of any non-life-threatening defic
10.07.04.18.htm 10.07.04.18. 18 Reports.. A. The center shall furnish to the Secretary reports covering the following:. 1) Deaths, serious injuries, or unusual incidents, including suicide attempts, by no later than the close of business of the next business day following the event; and2) Any occurrences which threaten the welfare, safety, or health of any resident of the center such as fire, infectious disease outbreaks, or poisoning.B. The center shall comply with the reporting requirements of the Departmen
10.07.04.19.htm 10.07.04.19. 19 Civil Money Penalties.. A. Civil Money Penalties. The Secretary may impose a civil money penalty on a person if:. 1) The person maintains or operates an unlicensed center; or. 2) A serious or life-threatening patient care deficiency exists and the center fails to correct the deficiency through immediate corrective action.B. In determining whether a civil money penalty is to be imposed, the Secretary shall consider the following factors:
10.07.04.20.htm 10.07.04.20. 20 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;.
10.07.04.21.htm 10.07.04.21. 21 Notifications.. A. Within 24 hours of an event or change in condition and in accordance with State and federal confidentiality laws, a center shall attempt to notify a resident and a resident’s representative, family member, legal guardian, or custodian of:1) A change in the resident’s condition;. 2) An adverse event that affected the resident; and. 3) If appropriate, the corrective action taken.. B. The notification may be waived by the individual identified under Regula
10.07.04.22.htm 10.07.04.22. 22 Resident Rights.. A. The center shall post the list of resident rights in areas of the center where the residents can read the posting. A resident of a residential treatment center has the right to:1) Be treated with respect;. 2) Have their cultural spiritual, personal beliefs, values, and preferences respected;. 3) Personal privacy;. 4) Practice their religious beliefs;. 5) Receive information about care and treatment in a manner that he or she understands;.
10.07.04.9999.htm 10.07.04.9999. Administrative History Effective date: April 17, 1967. Amended effective March 27, 1973. Amended effective March 22, 1974 ―. Regulation .02C amended effective January 20, 2014 (41:1 Md. R. 13). Regulation .03 amended effective March 13, 2017 (44:5 Md. R. 292). Regulation .03A amended effective August 29, 2016 (43:17 Md. R. 953). Regulation .11B amended effective February 15, 2016 (43:3 Md. R. 272) ―. Chapter revised effective May 22, 2017 (44:10 Md. R. 472) ― Annotation: COM
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