10.07.20.05

.05 Standards of Operation.

A. General. Whether or not a facility participates in Medicare or Medicaid, the facility shall meet the requirements set forth in 42 CFR § 483.400 et seq., which is incorporated by reference.

B. Safety and Sanitation. The facility, its grounds, fixtures and equipment shall be:

(1) Maintained in good repair, clean, and attractive;

(2) Free of unnecessary accumulations of personal property or debris; and

(3) Free of hazards, insects, and rodents.

C. Infection Control. The administrator shall:

(1) Establish policies and procedures to investigate, control, and prevent infections in the facility; and

(2) Ensure that facility staff follow these policies and procedures.

D. Personnel.

(1) The administrator shall provide orientation and training for all staff and volunteers.

(2) If the center provides care for individuals with Alzheimer's disease or related disorders:

(a) The administrator shall provide annual in-service education on the care of individuals with dementia; and

(b) Each employee shall complete an instructional unit on dementia as described in COMAR 10.07.02.40H before the later of:

(i) 180 days from beginning of employment, or

(ii) One year from the effective date of these regulations.

(3) Employee Health Screening. A facility shall obtain certification that an employee or volunteer is free from tuberculosis in a communicable form as provided in Regulation .06 only if the employee or volunteer:

(a) Will be involved in the direct care of tuberculosis patients; or

(b) Is an immigrant from Africa, Asia, or Latin America.

E. Emergency Management Plans. State residential centers shall develop an emergency plan for all types of emergencies and disasters that shall include:

(1) Procedures that will be followed before, during, and after an emergency to address the following:

(a) The evacuation, transportation, or 72-hour shelter-in-place of individuals and staff served;

(b) Holding an annual practice drill coordinated with local emergency planners for sheltering-in-place or evacuating;

(c) Preparing an after action report and improvement plan after drills that evaluates the plan and takes corrective actions;

(d) Ensuring that individuals served and staff have identification with current health, contact, and other important information that is immediately accessible in the event of evacuation;

(e) The role of the resident, family member, or legal representative in the event of evacuation;

(f) Arranging for medical needs and other accommodations for individuals served and staff at alternative facilities or shelters; and

(g) Establishing a communication protocol among all appropriate parties that includes redundant communication means;

(2) The notification to families, staff, and respective DDA regional office regarding the action that will be taken concerning the safety and well-being of the individuals served;

(3) The staff coverage, organization, and assignment of responsibilities that includes:

(a) Planning staff coverage needs for ongoing shelter-in-place or evacuations;

(b) Identifying staff members available to report for work or remain during extended periods; and

(c) Establishing staff notification and recall contingency plans and procedures;

(4) The continuity of operations, including, but not limited to, redundant communications systems, preservation of records and electronic data, the procurement of essential goods, equipment, and services, plans to secure vacated facilities, and the relocation to alternate facilities;

(5) Procedures to:

(a) Backup and electronically store off-site, appropriate records and data of consumers and staff and facility documents, for access under emergency conditions; and

(b) Ensure access to an electronic copy of the emergency plans when requested by local, State, or federal emergency management organizations;

(6) Provisions to ensure that the facility's emergency and disaster plans are shared with local emergency management organizations for the purpose of coordinating local emergency planning;

(7) An executive summary of the evacuation procedures that shall be provided to the family member of a resident on request; and

(8) A summary statement of the facility's community surge capacity abilities.