(a) A nursing care unit, regardless of size, including special care units, shall be equipped as described in this regulation. Amber Havensamber.havens@maryland.gov, Compliance Coordinator: registered nurse requirements for the Executive Director; (3) hiring and paying for an external . Comprehensive care facilities and extended care facilities shall develop written policies, consistent with these regulations, to govern the nursing care and related medical or other services they provide covering the following: (1) Admission, transfer, and discharge policies including categories of patients accepted and not accepted by the facility, or those who are required to transfer to another level of care. Office Hours: Monday - Friday 8:15AM - 5:00PM (except Holidays) (2) Upon request, the director or assistant director of nursing may accompany physicians visiting residents. The reporting requirements for a positive HIV test or low CD4+ lymphocyte count apply to facilities and offices ordering the tests, as well as to medical laboratory directors. [(f)](g)Protection from Freezing. The agreement shall provide for sufficient hours of consultation to assure that the staffs services meet the medically related social and emotional needs of the patients.]. (iii) Clean linen anda clean, comfortable pillowshall be provided. [Policies shall be reviewed at least annually by a]. (2)[All residents]A new residentshall receive atwo-steptuberculin skin test within 10 days of[initial]admissionto the nursing homeunless the resident has had[a]: (a) Adocumented negativetuberculinskin testwithin the previous[month, a]12 months; (b) Aprevious positivetuberculin skintest[,]; (c) Ahistory of preventive therapy[, or]treatment; (e) Thetreatment ofactivetuberculosis. State Operations Manual for Provider Certification, Appendix RResident Assessment Instrument for Long-Term Care Facilities, Transmittal No. (1) All air-supply and air-exhaust systems shall be mechanically operated. The[facility]nursing homeshall urge that volunteers, defined as individuals who spend an average of 8 hours per week or more in the institution[patient]residentcare areas and who receive no pay or benefits,[accept]receiveannual influenza vaccination and tuberculinskintesting as considered necessary by the[facility]nursing home. [Comprehensive care facilities or extended care facilities]A nursing homelicensed under this regulation may not usethe word hospitalin[their]itstitle[the word Hospital]. General Requirements. G. Reevaluation of[Patients]ResidentsProgress. [F.]E.InfectionPrevention andControl Policies and Procedures. The Maryland General Assemblys Office (1) A special care unit shall meet the general construction requirements of Regulations[.06,and .26].08, .42, and .41of this chapter, and the requirements in this regulation. B. In our example, you can read each and then select Subtitle 25. (3) The nursing home shall provide additional information upon request. Hot water temperatures in laundries shall conform to applicable standards of the International Fabric Care Institute for laundry water supply.]. Although NCSBN has made every effort to provide complete, accurate and up-to-date information, NCSBN makes no warranties, express or implied, or representations as to the accuracy or reliability of this information. Third, determine if any of the specific exceptions to those reasons apply. In developing these regulations, the Board learned that different hospitals use vastly different terminology to describe similar actions. [(3) The tuberculin skin test for new admissions may be a two-step skin test that is performed by the facility according to the established infection control policy of the facility. The bed shall be at least 36 inches wideandbe substantially constructed. (2)To the extent medically possible, the[current]Recommended Dietary Allowancesof the Food and Nutrition Board[of the], Commission on Life Sciences, andNational Research Council[, National Academy of Sciences], adjusted for age, sex, and activity,shall be observed. A nursing home shall posta noticeon each floor or unit of the nursing home, for each shift, a notice that[explains]givesthe ratio of licensed and unlicensed staff to residents. (2) After obtaining approval by the Maryland Health Care Commission, the nursing home shall provide written verification of the approval to the Office of Health Care Quality. The Department in these cases may require additional space to be provided. (c) Administrative, Bulk Storage and Soiled. (6) Medical and social history ofthe[patient]resident; (13)[Discipline assessment]Assessments done by various disciplines; and. (e) No morethanfour individualsmay occupy a multiple occupancy bedroom. A. A refrigerator is a cold place in which the temperature is maintained thermostatically between[2C and 8C (46 and 59F)]46F and 59F or 8C and 15C. (1) If the supervisor is not alicensed registereddietitian, the individual shall receive regularly scheduled consultation from alicensedregistered dietitian or other qualified person. A physician in attendance shall report to the health officer immediately and in writing the name and address of an individual who is receiving or has received treatment for syphilis; or is under medical observation or treatment for syphilis in an infectious or potentially infectious stage, who fails to return for observation or treatment within one week of the date of a missed appointment and is not known to be under treatment elsewhere. The administrator of the facility shall be responsible for seeing that appropriate procedures and reporting are carried out. Waivers may be granted under Regulation[.02F].03Fof this chapter. As of July 1, 2021, OHCQ oversees 19,032 providers in 45 industries . (1) The nursing home shall store medications in a locked medication storage area that: (b) Is located where personnel preparing drugs for administration will not be interrupted; (c) Is spacious enough to allow separate storage of external and internal medications; (d) Is kept in a clean, orderly and uncluttered manner; and. All rights reserved. If you save it electronically, email it to mbon.complaintsinvestigations@maryland.gov. records, name and/or statements of witnesses and/or persons involved, (2)There shall beat leastone night light in each bedroom forresidents. R. 9 (January 4, 2019), and is available online at www.dsd.state.md.us. Any occurrence such as the occurrence of suspected mental disturbance, communicable disease, or symptomatic condition of importance to public health, poisoning, or other serious occurrence which threatens the welfare, safety, or health of any patient shall be reported immediately to the local health department. (ii) The individual who has inactive pulmonary scarring,calcification, or a normal chest X-ray. (1)If no approved public sewerage system is available, a private sewage disposal may be accepted, if approved by the Department. (3) A new employee shall be assessed for risk of tuberculosis through: (a) A two-step tuberculin skin testing at the time of hire following guidelines referenced in the Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings; or. I. Infectious/Communicable Diseases, HIV Testing, AIDs Diagnoses. Karen E. B. Evans. (b) Fire and smoke dampers shall be constructed, located, and installed in accordance with the requirements of NFPA 101 Life Safety Code. Q Who pays for the chemical dependency evaluation and the drug screens? E. Character. Clean linen[may also be stored in]stored and transported in covered containers,closed linen carts,or rooms exclusively provided for this purpose[, if approved by the Department]. (53) Physician means an individual licensed to practice medicine in this State. [Adequate]The nursing home shall provide adequatespace and a variety of supplies and equipment[shall be provided by the facility]to satisfy the appropriate individual activity needs of[patients]residents. , then PI must report to the health officer when a specimen evidences the diseases/conditions listed in the statute. (2)A catered or satellite system shall be covered by a contractapproved by the Department. . In addition, any withdrawal or denial of an application made for any of the three reasons listed in COMAR 10.32.22.03C(6) need not be reported. (2) CMS Manual System, Pub. (2) The team shall establish goals for each problem or need identified, or a combination thereof. The agreement shall provide for sufficient hours of consultation to assure that the staffs services meet the medically related social and emotional needs of the patients. The Maryland Board of Nursing requires written, verified evidence of completion of the appropriate education requirements in accordance with Md. [F.]J. a genuine interest in the well-being and welfare of, (1) The administrator shall employ sufficient and satisfactory personnel as specified in this chapter to, The Department shall approve the increase in beds within 72 hours following receipt of the. There shall be provision for the laundering of patients clothing. [(d)](e)WarmAny temperature between[30C and 40C (86 and 104F)]86F and 104F or 30C and 40C. Maryland Nursing License Requirements The Maryland Board of Nursing regulates the state's Licensed Practical Nurses and Registered Nurses. (1) CMS Long-term Care Facility Resident Assessment Instrument 3.0 Users Manual, (Version 1.14, October 2016). In instances when an aide is to be assigned to a particular service such as dietary, physical therapy, or occupational therapy, the person in charge of the service shall be responsible for the evaluation and approval of the qualifications. Pharmaceutical services shall be under the general supervision of a licensed pharmacist who shall: (a) With the advice of the pharmaceutical services committee, be responsible for developing, coordinating, and supervising pharmaceutical services and provide in-service training at least twice yearly; (b) Visit the nursing home frequently enough to assure that policies and procedures established by the pharmaceutical services committee are enforced; (c) Notify the attending physician of any potential drug problems found during the drug regimen review; and. C. Body Holding RoomExisting Nursing Home. The Maryland Board of Nursing shall approve the geriatric nursing assistant training program curriculum. C. Dayroom Area. The federal regulations only require the employ of a qualified social worker (a bachelors degree in social work or a bachelors degree in a human services field) if the facility has more than 120 beds. Updated (a) Orient staff to the emergency and disaster plan and to their individual responsibilitiesin relation to the planwithin 24 hours of the commencement of job duties;[and], (b) Document completion of the orientation in the staff members personnel file through the signature of the employee; and. If the patient becomes too difficult to manage, the patient shall be transferred to a suitable facility selected by the attending physician. A. The Maryland General Assemblys Office Home; Services; (b) A nursing home shall register at least four representatives, including the administrator and the director of nursing. The nursing home shall develop written policies, consistent with this chapter and COMAR 10.07.09, to govern the nursing care, related medical, and other services that the nursing home provides regarding: (1) Admissions, transfers, and discharges; (3) Medical Assistance program information. Written Agreement. B. (6) The nursing home shall make available to residents educational and informational materials relating to immunization against influenza virus and immunization against pneumococcal disease. D. Reports of Findings. (f) Residents beds may not belocated near radiators, registers, or sources of draft. Designated Staff Responsibility. (1) The Secretary may issue a license to a[comprehensive care facility]nursing homeor an extended care facility for less than a 24-month period under any of the following conditions: (d) If new construction is completed to the point of being able to provide all necessary services to its residents but certain substantial items of equipment[of]foroptional servicesare temporarily lacking, which in the opinion of the Department will have no immediate adverse effect on the safety or health of its residents[, are lacking temporarily]; or. (1)Thearchitectorprofessional engineer of record shall submit stamped and sealedfinal constructiondrawings to the Department. You may be trying to access this site from a secured browser on the server. (55) Plan of correction means a written response from the nursing home addressing each deficiency cited as a result of an inspection by the Department. Written Policies. Advisory Dentist. ]; (b)[Care shall be exercised in the usage and storage of toxic]Use and storetoxicand flammable insecticides and rodenticideswith care[. [Service Areas Required in New Construction or for New Facilities.] The training on cognitive impairment and mental illness shall be designed to meet the specific needs of the[facilitys]nursing homespopulation as determined by the staff trainer, including the following as appropriate: (3) Behavioral[intervention]interventionsincluding: A. To support placement in a specific position, there shall be sufficient documentation in the employees record reflecting his training and experience. Body Holding RoomNew Construction. of Legislative Audits operates a toll-free COMAR regulations are Maryland State agency regulations, which are referenced by Title numbers (currently 1-36). C.The[facility]nursing homeshall maintain documentation of the discussion between the[facility]nursing homeand the volunteer concerning influenza vaccine and tuberculinskintesting. There shall be sufficient equipment to meet the needs of the. People often confuse the Code of Maryland Regulations (COMAR) with the Annotated Code of Maryland. (c) All tobacco products shall be extinguished and disposed of in noncombustible containers with self-closing lids in accordance with the provisions of NFPA 101 Life Safety Code. A. (74) Tuberculin skin test means a test to diagnose tuberculosis infection using purified protein derivative (PPD) that is injected intradermally and read within 4872 hours with results recorded in millimeters of induration. (1)The food and nutritional needs of[patients]residentsshall be met in accordance with physicians orders. State Operations Manual for Provider Certification, Appendix RResident Assessment Instrument for Long-Term Care Facilities, Transmittal No. [(4)](d)[Operators]The operatorsinstruction[booklet]manualshall be available in a designated locationor accessible electronicallyat all times. In a culture change nursing home, service areas shall be provided for resident care needs as approved bythe Department. If a comprehensive care facility is unable to effect a transfer agreement with a hospital in the community and can document its attempts to secure an agreement, the facility shall be considered to have such an agreement in effect. (b) Has completed a minimum of 15 contact hours of infection prevention and control training that is approved by the: (i) Departments Office of Infectious Disease Epidemiology and Outbreak Response; and. In existing facilities where a physical separation is not possible, exceptions as to approved laundry facilities may be made at the discretion of the Department. Contact the Discipline & Compliance Division. This brings you back to the 20.25.01 General Regulations we found in Search Option 1. (2) If the nursing home does not employ a licensed pharmacist, the nursing home shall arrange by written contract for a pharmacy to provide consultation on administering the pharmacy services in accordance with the policies and procedures established by the pharmaceutical services committee. The 3D modeling software has a user-friendly interface that can be used to create designs or machinery parts. (iii) Adequate storage and work counter space for storage and assembly of supplies for nursing procedures; (ii) A separate wall-hung hand sink for handwashing, equipped with wrist blades and soap and towel dispensers; (7) Utility RoomsExistingFacility. Space near the utility sink shall be provided for the storage of brooms, mops, and cleaning materials.]. Thus approximately 172 facilities would be impacted by this proposal. Clean linen shall be stored separately from[non-clean]uncleanitems. The sounding of the audible signal shall be continuous or intermittent until answered. (3) The use of hot and cold medical devices shall be: (a) Consistent with manufacturer guidelines and nursing home policies; and. responsive, accurate and consistent, When the designee is replaced, the Department shall be notified of the name of the registered nurse filling the vacancy. [(3)](c)All electrical equipment shall be[periodically]testedperiodicallyfor proper grounding, current leakage, and calibration where appropriate. If the hospital made a "change" for a reason listed in the regulations, and if none of the exceptions apply, the change must be reported to the Board within ten days. (6)The number of daily admissions of[patients]residentsshall be controlled to allow sufficient time for on-the-job training. (4) Other persons hired asgeriatric nursing assistants[nurse aides after July 1, 1990]shall complete an approvedgeriatric nursing assistant trainingprogram within 120 days of employment. Apply the definitions in the regulations. (a) Relocation means the movement of a resident from one room to another within: (i) The same Medicare-certified nursing home; (ii) A Medicaid-only certified nursing home; or. (6) The pharmaceutical services committee may not develop policies and procedures that prohibit or restrict a resident from receiving medications from the pharmacy of the residents choice. Licensure requirements vary by state. (b) Has 2 years of experience in a social or recreational program in a licensed health care setting within the last 5 years, 1 year of which was full time in a resident activities program with guidance froman individual identified in B(73)(a) of this regulation. NOTE 2: COMAR 10.06.01 further requires the following: (1) Health Care Providers. (1) The infectionprevention andcontrol program shall establish written policies and procedures toidentify,investigate, control, and prevent infections in the[facility]nursing home,including policies and procedures to: (a) Identify[facility]health care-associated infections and communicable diseases in accordance with COMAR 10.06.01; (b) Report occurrences of certain[communicable]infectiousdiseases and outbreaks of[communicable]infectiousdiseases to the local health department ina timely manner inaccordance with COMAR 10.06.01 and Health-General Article, 18-202, Annotated Code of Maryland; (c) Institute appropriate[infectioncontrol steps]control measureswhen an infectionor outbreak of infectionsis suspected or identified in order to control infection and prevent spread to other residents; (d) Perform surveillancefor health care-associated and community-associated infectionsof residents and employees[atappropriate intervals]using definitions and methods approved by the infection prevention and control oversight committeeto monitor and investigate causes of infection,[facility-associated and community acquired,]andthe manner in which[it was]the infection isspread; (e) Train employees about infectionprevention andcontrol,[and hygiene]including: (i)[Hand]Standard precautions andhand hygiene; (ii) Respiratory[protection]hygiene and cough etiquette; (iv) Safe handling of needles and sharpsand safe injection techniques; (v) Special medical waste handling and disposal;[and].
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