10.07.17.05

.05 Standards for Service.

A. A facility shall comply with applicable federal, State, and local laws and regulations.

B. Restriction of License—Nomenclature. A limited service hospital may not use in its title the words "emergency department", "emergency center", "emergency room", or any other terminology in referring to the limited service hospital or any part of the facility that may convey to the public that the facility is prepared to provide the full range of emergency services that are normally provided by a hospital.

C. Hours of Operation. The facility shall be open 24 hours a day, 7 days a week.

D. Staff.

(1) At least one physician who is credentialed in emergency medicine shall be at the facility at all times.

(2) The facility shall have a sufficient number of registered nurses and other health professionals with appropriate training to provide advanced life support.

E. Laboratory and Radiologic Services. The facility shall have basic x-ray and laboratory services available at all times and be staffed by at least:

(1) One radiology technician; and

(2) One laboratory technician.

F. Pharmaceutical Services.

(1) Pharmaceutical services shall be supervised by a pharmacist licensed to practice in this State.

(2) The facility shall provide pharmaceutical services in accordance with accepted professional principles and appropriate federal, State, and local laws and regulations.

G. Clinical Records.

(1) The facility shall maintain clinical records for all patients in accordance with accepted professional standards and practices.

(2) Clinical records shall contain:

(a) Identification and summary, including, at least, the patient's name, Social Security number, marital status, age, sex, and home address;

(b) Name, address, and telephone number of the personal physician, dentist, parent or next of kin, or authorized representative;

(c) Evidence of assessment of the patient's needs, of establishment of an appropriate plan of initial and ongoing treatment, and of the care or services provided;

(d) Consent forms when required;

(e) Diagnostic and therapeutic orders;

(f) Reports of medication administration, treatments, and clinical findings; and

(g) Discharge summary including final diagnosis and prognosis.

(3) Current clinical records and those of discharged patients shall be completed promptly. All clinical information pertaining to a patient shall be centralized in the patient's clinical record.

(4) Clinical records shall be retained for a period of not less than 5 years from the date of discharge or, in the case of a minor, 3 years after the patient becomes of age or 5 years, whichever is longer.

H. Equipment.

(1) A facility shall have the equipment necessary to provide at least the following care:

(a) Cardiac monitoring, defibrillation, and external pacing;

(b) Medication administration;

(c) Oxygen therapy;

(d) Airway management including endotracheal intubation;

(e) Respiratory ventilation; and

(f) Intravenous and intraosseous access and fluid therapy.

(2) All equipment at the facility shall be in good operating condition at all times.

I. Infection Control. A facility shall:

(1) Develop and implement policies and procedures on the use of standard precautions for infection control; and

(2) Comply with the requirements of COMAR 10.06.01.07, except in an emergency life-threatening situation when it is not feasible or practical to comply with the infection control measures.