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10.07.22.00.htm 10.07.22.00. Title 10 MARYLAND DEPARTMENT OF HEALTH Subtitle 07 HOSPITALS Chapter 22 Hospice Care Programs: Hospice House Requirements Authority: Health-General Article, §19-903, Annotated Code of Maryland
10.07.22.01.htm 10.07.22.01. 01 Scope and Purpose.. A. This chapter is effective January 1, 2014.. B. This chapter applies to all general hospice care programs that operate a hospice house.. C. An operator of a hospice house shall also comply with all the requirements contained in COMAR 10.07.21 that are applicable to general hospice care programs.
10.07.22.02.htm 10.07.22.02. 02 Definitions.. A. In addition to the definition contained in §B of this regulation, definitions set forth in COMAR 10.07.21.02 are applicable to this chapter.B. Terms Defined.. 1) "Hospice house" means a residence operated by a Maryland licensed general hospice care program that provides home-based hospice services to hospice patients in a home-like environment and the care is not billed as general inpatient care.2) "Primary hospice nurse" means the registered nu
10.07.22.03.htm 10.07.22.03. 03 Incorporation by Reference.. In this chapter, the following document is incorporated by reference: NFPA 101, The Life Safety Code, as adopted by the State Fire Prevention Commission in COMAR 29.06.01.
10.07.22.04.htm 10.07.22.04. 04 License Required.. A person may not operate a hospice house without first obtaining a license to operate a general hospice care program.
10.07.22.05.htm 10.07.22.05. 05 Staffing Plan.. A. Following an analysis of the number of beds the hospice house intends to serve and the individual needs of each resident, the general hospice care program shall develop a staffing plan that identifies the type and number of staff needed to provide the services required by this chapter.B. The staffing plan shall include on-site staff sufficient in number and qualifications to meet the 24-hour scheduled and unscheduled needs of the reC. Relief personnel shall
10.07.22.06.htm 10.07.22.06. 06 Management of the Hospice House.. A. The administrator of the general hospice care program shall identify a manager of the hospice house who has full responsibility for the day-to-day operations of the hospice house.B. The administrator shall evaluate the manager’s performance on an annual basis.. C. In the absence of the hospice house manager, the hospice house shall remain under the continuous supervision of a designated individual with appropriate experience and training.
10.07.22.07.htm 10.07.22.07. 07 Staff Qualifications.. A. The hospice house shall be staffed by sufficient numbers of personnel to ensure that the hospice house is capable of meeting the requirements of this chapter, and all applicable federal, State, and local laws and regulations.B. In addition to meeting all of the other qualifications and requirements for hospice employees, all hospice house staff shall participate in an orientation program and annual training to ensure competency in maintaining the
10.07.22.08.htm 10.07.22.08. 08 Admission Requirements.. A hospice patient appropriate for care in their own home who does not require general inpatient services may be eligible for care in a hospice house, in accordance with the hospice house admission policy.
10.07.22.09.htm 10.07.22.09. 09 Residential Agreement.. A. Patients admitted to the hospice house or their representatives shall sign, before or at the time of admission, a patient agreement that:1) Is a clear and complete statement of commitments agreed to by the parties and the services provided in the hospice house;2) Is accurate, legible, and communicated in a language understandable to patient and family; and. 3) Conforms to all applicable federal, State, and local laws and requirements..
10.07.22.10.htm 10.07.22.10. 10 Patient Record.. The hospice house shall:. A. Maintain the privacy and confidentiality of a patient’s medical records;. B. Release medical records or medical information about a patient only with the consent of the patient or patient’s representative, or as permitted by Health-General Article, Title 4, Subtitle 3, Annotated Code of Maryland; andC. Maintain and dispose of a resident’s medical records in accordance with Health-General Article, Title 4, Subtitle 4, Annot
10.07.22.11.htm 10.07.22.11. 11 Food.. A. A patient’s food preferences shall be assessed at the time of admission. The assessment shall be maintained in the patient record.B. Patients shall be provided meals and snacks as requested.. C. Patients shall be offered 3 meals and additional snacks during each 24-hour period, 7 days a week in accordance with their individual daily nutritional needs and preferences and consistent with their plan of care.D. Food that is prepared at the hospice house shal
10.07.22.12.htm 10.07.22.12. 12 Personal Care Services.. The hospice house staff shall provide all necessary personal care services to the patient in accordance with the plan of care and as desired by the patient.
10.07.22.13.htm 10.07.22.13. 13 Medication Management and Administration.. A. All medications shall be administered consistent with applicable requirements of COMAR 10.27.11.. B. Medications and treatments shall be administered consistent with current medical orders and using acceptable professional standards of practice.C. All medications shall be stored in a secure location, at proper temperature.. D. Each patient’s medications shall be stored in the original dispensed container;. E. Each patient shall rec
10.07.22.14.htm 10.07.22.14. 14 Incident Reports.. A. The staff of the hospice house shall complete an incident report in accordance with hospice policy within 24 hours of having knowledge that an incident has occurred.B. All incident reports shall include:. 1) Time, date, place, and individuals present;. 2) Complete description of the incident;. 3) Response of the staff at the time; and. 4) Follow up action, including notification to the:. a) Patient’s primary hospice nurse or hospice nurse on call;.
10.07.22.15.htm 10.07.22.15. 15 Relocation and Discharges.. A. Relocation within the Facility. The hospice house may not relocate a patient within the facility except in accordance with the terms and conditions of the residential agreement.B. Discharge.. 1) Discharge of a patient without the consent of the patient or the patient’s representative shall be in accordance with the residential agreement.2) When the patient is discharged or transferred to another facility, the hospice house shall provid
10.07.22.16.htm 10.07.22.16. 16 Patient’s Rights.. A. In addition to all other rights as a hospice patient, the patient residing in a hospice house has the right to:1) Privacy, including the right to have a staff member knock on the patient’s door before entering;. 2) Be free from mental abuse, verbal abuse, sexual abuse, physical abuse, neglect, involuntary seclusion, and exploitation;3) Be free from physical and chemical restraints;. 4) Manage personal financial affairs;. 5) Maintain legal counsel;.
10.07.22.17.htm hygiene. 10.07.22.17. 17 Abuse, Neglect, and Exploitation.. A. The hospice house shall develop and implement policies and procedures prohibiting abuse, neglect, and exploitation of hospice house patients.B. Reports of Abuse, Neglect, or Exploitation. An employee of the hospice house who believes that a patient has been subjected to abuse, neglect, or exploitation shall report the alleged abuse, neglect, or exploitation within 24 hours to:1) The appropriate local Department of Social Serv
10.07.22.18.htm 10.07.22.18. 18 Restraint or Seclusion.. A. A hospice house shall develop a policy and procedure related to restraint and seclusion.. B. Relevant staff shall be trained in accordance with the facility’s policy and procedure related to restraint and seclusion.C. Patients have the right to be free from restraint or seclusion of any form which are imposed as a means of coercion, discipline, convenience, or retaliation by staff.D. Restraint or seclusion may only be imposed to e
10.07.22.19.htm 10.07.22.19. 19 General Physical Plant Requirements.. A. The facility, which includes buildings, common areas, and exterior grounds, shall be kept:. 1) In good repair;. 2) Clean;. 3) Free of any object, material, or condition that may create a:. a) Health hazard, accident, or fire; or. b) Public nuisance; and. 4) Free of insect infestations and rodents.. B. The hospice house shall provide adequate storage space, which is protected from the elements, for:1) Excess supplies;.
10.07.22.20.htm 10.07.22.20. 20 Water Supply.. A. Approved Source. A facility shall be served by water from an approved public water supply. If an approved public water supply is not available, a private water supply may be accepted if it is approved by the local jurisdiction in which the hospice house is located or a private certified vendor.B. Adequacy. The water supply shall be adequate in quantity and delivered under sufficient pressure to satisfactorily serve all fixtures in the facility.
10.07.22.21.htm 10.07.22.21. 21 Sewage Disposal.. The facility shall be served by an approved public sewage disposal system, if available. If an approved public sewage disposal system is not available, a private sewage disposal system may be accepted if approved by the local jurisdiction in which the program is located.
10.07.22.22.htm 10.07.22.22. 40:02 .22 Security.. The facility shall have policies and procedures in place to provide a secure environment for the patient, family, and staff.
10.07.22.23.htm 10.07.22.23. 23 Assist Rails.. A. The hospice house shall provide assist rails in stairways used by patients and for all toilets, showers, and bathtubs used by patients.B. The hospice house with a licensed capacity of 17 or more beds shall also provide assist rails on both sides of corridors used by patients.
10.07.22.24.htm 10.07.22.24. 24 Emergency Preparedness.. A. The facility shall be constructed consistent with:. 1) All applicable local fire and building codes; and. 2) The Life Safety Code, NFPA 101, including Chapter 24 of NFPA 101.. B. Hand Extinguishers. Fire extinguishers shall be located on each floor and adjacent to, or in, special hazard areas, such as furnace rooms, boiler rooms, kitchens, or laundries. Fire extinguishers shall be of standard and approved types, and installed and maintained to be
10.07.22.25.htm 10.07.22.25. 25 Smoking.. The hospice house shall prohibit indoor smoking in accordance with COMAR 10.19.04 and COMAR 10.12.27.
10.07.22.26.htm 10.07.22.26. 26 Common Use Areas.. A. Common Areas. The hospice house shall provide common areas for the use of patients and families. The common areas shall be of a size and furnished to accommodate the number of family members reasonably expected to attend the number of patients provided for by the hospice house capacity.B. Public Toilets. The hospice house shall provide public restrooms that are sufficient in number, and appropriately located, to serve family members C. Dining Area. The hospi
10.07.22.27.htm 10.07.22.27. 27 Patients’ Rooms and Furnishings.. A. Patient rooms shall be of a size and with furnishings adequate for the hospice residence staff to provide care of the patient as required by the plan of care.B. Patient rooms shall provide accommodation for one family member to remain with the patient through the night.C. Patient rooms shall be for the private use of the assigned patient or patients.. D. If a patient in a double occupancy room requests dividers, curtains, or
10.07.22.28.htm 10.07.22.28. 28 Bathrooms for Patients.. A. Toilets. The hospice house shall provide toilets in a separate room or compartment with latching hardware for privacy.B. Lavatories. Buildings with one to eight occupants shall have a minimum ratio of one lavatory to four occupants. Buildings with nine or more occupants shall have a minimum ratio of one lavatory to four occupants and a minimum of one lavatory for each floor on which a patient room is located.C. Bathtubs or Showers. T
10.07.22.29.htm 10.07.22.29. 29 Illumination.. A. The hospice house shall provide sufficient light to meet the patient’s needs.. B. Common use areas, such as entrances, hallways, inclines, ramps, cellars, attics, storerooms, kitchens, and laundries, shall have sufficient artificial lighting to prevent accidents and promote efficient service.
10.07.22.30.htm 10.07.22.30. 30 Heating, Ventilation, and Air Conditioning.. A. The hospice house may not use space heaters unless approved by the State or local fire authorities.B. Minimum Temperature. The facility shall have a system that provides in areas used by patients a minimum temperature of 70ºF in cold weather and a maximum temperature of 80ºF in hot weather.C. Temperature Control. The hospice house shall provide for each resident's room:. 1) A thermostat; or. 2) An approved mechanical
10.07.22.31.htm 10.07.22.31. 31 Laundry.. A. The hospice house shall furnish laundry service, either on-site or off-site.. B. The hospice house shall ensure that the laundry is:. 1) Adequate to meet the needs of the patients;. 2) Processed and handled in a manner to prevent the spread of infection; and. 3) Adequately sanitized by the use of sufficient hot water or appropriate chemical representatives, or a combination of both.
10.07.22.32.htm 10.07.22.32. 32 Infection Control.. A. The hospice house shall maintain an infection control program that protects patients, staff, and others by preventing and controlling infections and communicable diseases.B. The hospice house shall follow accepted standards of practice to prevent the transmission of infections and communicable diseases, including the use of standard precautions.C. The infection control program shall include the following:. 1) Education of employees, contracted providers, p
10.07.22.33.htm 10.07.22.33. 33 Pet Visitation.. A. A hospice house shall have a policy and procedure related to pet visitations.. B. Visiting dogs and cats shall have proof of a current rabies vaccination on file.. C. If another patient has an allergy or a respiratory condition that is aggravated by an animal, the animal shall remain outside of areas where that resident may be.D. The hospice house has the right to restrict any pet from the hospice house..
10.07.22.9999.htm 10.07.22.9999. Administrative History Effective date: June 10, 2013 (40:11 Md. R. 975).
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