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10.07.01.23

.23 Guidelines Governing the Transfer of Patients Between Hospitals.

A. If a hospital is able to provide adequate care to a patient, the hospital may not transfer the patient to another hospital unless:

(1) One or more of the following circumstances is present:

(a) The patient does not have a physician with privileges at the hospital and the patient refuses treatment by any physician with privileges at the hospital;

(b) The patient or a legally authorized representative of the patient requests the transfer;

(c) The transfer is in compliance with relevant sections of Health-General Article, Title 10, Subtitle 8, Annotated Code of Maryland;

(d) The transfer is in compliance with the Interstate Compact on Mental Health as adopted in Health-General Article, Title 11, Annotated Code of Maryland; or

(e) The transfer is in compliance with any agreement entered into between the Mental Hygiene Administration and a hospital for the provision of acute inpatient psychiatric care in State hospital conversion beds;

(2) These circumstances are documented in the patient's medical record; and

(3) The provisions of this regulation are met.

B. A hospital may not use the inability of a patient to pay or the source of payment for a patient as a reason to transfer the patient to another hospital.

C. Before moving a patient, the transferring hospital shall:

(1) Determine that the patient can be transferred without causing harm to the patient;

(2) Notify the receiving hospital of the transfer; and

(3) Unless otherwise provided for in an agreement with the Mental Hygiene Administration for State hospital conversion beds, obtain from the receiving hospital confirmation that:

(a) The receiving hospital consents to accept the patient; and

(b) The patient meets any criteria that the receiving hospital has established for admission regarding:

(i) The patient's required level of care;

(ii) Physician services available; and

(iii) Other services necessary to treat the patient.

D. Explanation of transfer.

(1) Except as otherwise provided in §C(2),, of this regulation, before moving a patient, the transferring hospital shall provide explanation of the reasons for the transfer and any alternative to the transfer to the patient or to a legally authorized representative of the patient.

(2) If the transferring hospital can document that the necessity to move the patient to the receiving hospital is immediate to protect the health, safety, or welfare of the patient, the transferring hospital may give the explanation required in §C(1), of this regulation, concurrently with the transfer.

E. In effecting a transfer, the transferring hospital shall provide that:

(1) Medically appropriate life-support measures that a reasonable and prudent physician exercising ordinary care would use are used to stabilize the patient before transfer and sustain the patient during transfer;

(2) Appropriate personnel and equipment that a reasonable and prudent physician exercising ordinary care would use are provided and used in the transfer; and

(3) All records necessary for continuing the patient's care are transferred with the patient.

F. The Department shall inspect hospitals for compliance with this regulation as provided in Regulations .07 and .08 of this chapter.

G. Penalties.

(1) The Secretary may impose a penalty not exceeding $1,000 per violation on any hospital that violates this regulation.

(2) In determining the amount of the penalty, the Secretary shall consider:

(a) The hospital's history of previous violations;

(b) The seriousness of the violation;

(c) Whether the hospital demonstrated good faith in attempting to comply with this regulation; and

(d) Whether the violation threatened the health or safety of:

(i) A patient; or

(ii) The public.

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