.09 Implementation of Residents' Bill of Rights.

A nursing facility shall:

A. Ensure that:

(1) The rights of residents as set forth in the Residents' Bill of Rights are protected, including but not limited to informing each resident of the resident's right to select a physician and pharmacy of the resident's choice;

(2) Employees of the nursing facility are trained to:

(a) Respect and enforce the Residents' Bill of Rights and the nursing facility's policies and procedures that implement the Residents' Bill of Rights; and

(b) Protect the rights of residents;

(3) The nursing facility's policies and procedures implement all rights of the residents as set forth in:

(a) Health-General Article, §§19-343—19-347 and 19-349—19-352, Annotated Code of Maryland;

(b) Title XIX of the Social Security Act;

(c) 42 CFR §483.10 et seq.; and

(d) The regulations of this chapter; and

(4) The nursing facility's policies comply with the requirements of federal and State law concerning advance directives, including but not limited to:

(a) If an applicant is incapacitated or is incapable of informing the nursing facility whether the applicant has executed an advance directive, the facility may provide advance directive information to the resident's health care representative; and

(b) Once the resident is no longer incapacitated, the facility shall provide the advance directive information to the resident directly at the appropriate time;

B. Post conspicuously in a public place accessible to residents:

(1) The Residents' Bill of Rights in large, clearly readable type;

(2) The nursing facility's complaint procedures in large, clearly readable type;

(3) The nursing facility's statement of deficiencies for the most recent survey and any subsequent complaint investigations conducted by federal or State surveyors and any plans of correction in effect with respect to the survey or complaint investigation findings; and

(4) Signs provided by the Department to notify the visiting public and residents:

(a) That complaints may be made to the Department or to the Office;

(b) How to report an instance of abuse of a resident to the Department, the Office, or law enforcement agencies; and

(c) How to file a complaint with State agencies and client advocacy agencies, such as the Licensing and Certification Administration, the Office on Aging, the Older Americans Act Legal Services providers, the Maryland Disabilities Law Center, State Medicaid Fraud Unit, and the Legal Aid Bureau, Inc.;

C. Establish and maintain identical policies and practices regarding transfer, discharge, and the provision of services under the State plan for all individuals, regardless of source of payment;

D. Provide each resident and, if applicable, the resident's appropriate representative or interested family member, with a written description of the resident's legal rights, including a:

(1) Description of the manner of protecting resident funds; and

(2) Statement that the resident may file a complaint with the Department or the Office concerning resident abuse, neglect, misappropriation of resident property in the nursing facility, and noncompliance with advance directive requirements;

E. Place the name, address, and telephone number of the physician who is responsible for the resident's care within easy access of the resident;

F. Inform the resident and the appropriate legal representative, or interested family member, and promptly consult with the resident's physician if any of the following incidents occur:

(1) An accident involving the resident which results in injury;

(2) A significant change in the resident's physical, mental, or psychosocial status;

(3) A need to alter treatment significantly; or

(4) A decision to transfer or discharge the resident from the nursing facility;

G. Consistent with State and federal confidentiality laws and, in a timely manner, notify a resident and, if applicable, the resident's representative or interested family member, of any:

(1) Change in condition;

(2) Adverse event that may result in a change in condition;

(3) Outcome of care that results in an unanticipated consequence; and

(4) Corrective action, if any;

H. Notify the resident and, when applicable, the appropriate representative, or interested family member, when there is a change in:

(1) Room or roommate assignment;

(2) The Residents' Bill of Rights; or

(3) Federal or State law and regulations relating to residents' rights;

I. Record and update the address and phone number of the resident's representatives and interested family members;

J. Permit representatives of the State Long-Term Care Ombudsman Program to accomplish their responsibilities, as set forth in 42 U.S.C. §3058g, the State Long-Term Care Ombudsman Program;

K. Encourage the activities of resident and family groups by:

(1) Providing the residents and their families with private space for meetings;

(2) Designating a staff person to provide assistance and respond to written requests from residents and their families;

(3) Listening to the views of residents and their families;

(4) Acting upon the grievances and recommendations of residents and their families concerning proposed policy and operational decisions affecting resident care and life in the nursing facility; and

(5) Advising resident and family groups of the disposition of their grievances and recommendations;

L. Educate staff, residents, representatives, and interested family members on advance directives;

M. When applicable, promptly provide the Medical Assistance Program with all required information in its possession; and

N. Provide copies of clinical records upon request, based on the following charges:

(1) A fee for copying and mailing not exceeding 50 cents per page;

(2) A discretionary fee not to exceed $15 for record retrieval and preparation;

(3) The actual cost of postage and handling of the copies; and

(4) A discretionary annual adjustment in the fees described in §M(1)—(3) of this regulation based on the current Consumer Price Index.