Please enable scripts and reload this page. Medical Director Qualifications. The proposed action has minimal or no economic impact on small businesses. (b) On request, provide the resident with copies of the residents medical records at a reasonable cost and in the residents preferred format. (7) Recommended Dietary Allowances (10thEdition, Food and Nutritional Board, Commission on Life Sciences, and National Research Council, 1989). [(2) Nurses StationExisting Facility. [B.] The administrator of the facility shall be responsible for seeing that appropriate procedures and reporting are carried out. The State of Maryland pledges The[facility]nursing homeshall select[a resident]eligibleresidents based on the: E. State-Approved Training. Complete the form below for state-specific nurse licensure . (iii) These policies shall address the condition of the personal furnishings, presence of insects or vermin, and overall safety to ensure that the use of the residents belongings does not create any safety or health issues. 410-585-1900 Modification of the following minimum space will be made in the event that the facility can demonstrate that the use of convenience food, disposables, or equipment, require less space for operation. Q Who pays for the chemical dependency evaluation and the drug screens? (e) If windows can be opened, but the nursing home has concern over the window being opened due to resident safety issues and elopement, the window sash may be restricted by hardware as approved by the Department. (b) Laundry service shall be provided to meet the residents needs. (vii) A bedsidelamp, over-bed lamp,or other directional light source forresidentreadingandbedside care. (3) Nursing, housekeeping, laundry, or other personnel may not be[utilized]usedas[dietetic]food servicestaff. Please enable scripts and reload this page. There shall be an active program of restorative nursing care aimed at assisting each resident to achieve and maintainthe individualshighest level of independent function, including activities of daily living. [Patients]Residentsshall be assisted to obtain routine and emergency dental care. Otherwise, a dedicated enunciator connected to the wireless call system will be needed. (c) A room may not be used as aresidentbedroomif it can only be reached bypassing through a kitchen. [Policies shall be reviewed at least annually by a]. D. Reports of Findings. In COMAR 10.32.22.03C, there is a list of common occurrences that do not have to be reported. 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. Copyright Maryland.gov. , then PI must report to the health officer when a specimen evidences the diseases/conditions listed in the statute. Thisallowance shall be substantially increased proportionate tothe number of residents who depend on using awheelchair[cases]. COMAR regulations are Maryland State agency regulations, which are referenced by Title numbers (currently 1-36). D. A licensee[aggrieved by]that disagrees withthe imposition of a sanction under A(1) or (5) of this regulation may appeal the Secretarys action by filing a request for a hearing in accordance with Regulation[.59].78of this chapter. The Maryland Board of Nursing does Summary of Economic Impact. Nursing Assistant (CNA), Licensed Practical Nurse (LPN), Registered Nurse(RN), (c) Maintenanceof an[optional]optimallevel of psychosocial functioning. [(5)](6)Pest Control. Contents of Record. As you may recall . A member of the facilitys staff shall be assigned responsibility for social services. (1)[In a decentralized]There shall be at least onefood service[,the area or areas for]floor[pantries shall be approved by the Department]pantry per nursing care unit. (2) If the social worker is not a licensed certified social worker (LCSW) or a licensed certified social worker-clinical (LCSW-C), the nursing home shall arrange for an LCSW or LCSW-C to provide sufficient hours of supervision. (ii) Passed the national accreditation examination for accredited record technicians. If the social worker is not a licensed certified social worker LCSW or a licensed certified social worker-clinical LCSW-C, the facility shall provide for an LCSW or LCSW-C to provide sufficient hours of supervision. C. When the attending physician and medical director agree that a particular[facility-developed]nursing home developedprotocol is required to ensure that quality medical care is delivered to the[facilitys]nursing homesresidents, that protocol shall be implemented unless the[facility]nursing homedocuments in the[facilitys patient]nursing homes residentcare committee minutes the reason or reasons why the protocol should not be implemented. The audible signal may not be turned off at the nursing station. indicate "N/A". [(5)](4)Transfer or Assignment of License. There shall be provision for the laundering of patients clothing. (b) Controlled medications to be stored within medication storage cabinets in a residents room shall be held within a separate compartment that is locked and inside of the larger medication storage cabinet in that room. (5) Janitors ClosetNew Construction. B. (c) Within 24 hours of admission, notify and direct residents to the nursing homes emergency plans and maps, including evacuation procedures. E. The social work industry and trade groups would benefit due to the increase in hiring and contracting with licensed social workers. (1) New Construction. (36) Management firm means an organization, under contract with an applicant for a license or a current licensee, that is intended to have or has full responsibility and control for the day-to-day operations of the nursing home. Arrangements shall be made, when necessary, for the. (24) Geriatric nursing assistant means a CNA who has successfully completed the requirements for a GNA set forth in 42 CFR 483.151483.156 and COMAR 10.39.01. [Heating pads may not be used instead of hot water bottles.]. Extra pillows shall be available. public is protected from incompetent or impaired nurses. 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. (3) Laundry use,as referencedin the 2007Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. A. (2) For hand washing purposes, there shall be a towel dispenser and a supply of paper towels and soap dispenser adjacent to each sink. I. (2) The[facility]nursing homeshall ensure that floor space allocated to each bed meets minimum requirements listed in Regulation[.28C].49ofthis chapter, andis sufficient to accommodate the special equipment necessary to meet the needs of residents. Minimum equipment shall include the following: (b) Cabinets for dry storage and supplies; (d) Sink for purposes other than handwashing; dwashing sink with soap and towel dispenser or approved drying device.]. The identity of the patient making the threat; and 3. (1) The nursing home shall arrange for pharmacies that provide medications for residents in the nursing home. (1) Medications shall be accurately and plainly labeled. JavaScript is required to use content on this page. C. Director of Nursings Vacancy Exceeding 30 Days. (a) Air handling duct systems shall meet the requirements applicable to nursing homes cited in NFPA 99 Health Care Facilities Code. For example: Type in Consumer Protection and you will see eleven (11) different Titles covering this topic. The nature of the threat; 2. For general inquiries (Safe Practice Program): mbon.nursemonitoringdept@maryland.gov. copies of text messages or social network pages. (1) An applicant desiring to open a comprehensive care facility or an extended care facility[or to continue the operation of an existing facility as a comprehensive care facility or an extended care facility]shall file an application with the Secretary, on awritten or electronicform provided by the Secretary. Arrangements shall be made, when necessary, for the[patient]residentto be transported to the dentists office. The safety and comfort of the[patients]residentsshall be the[first]primaryconsideration. COMAR regulations are Maryland State agency regulations, which are referenced by Title numbers (currently 1-36). F. Charge Nurses Daily Rounds. Temperatures. (b) Provide the liaisons contact information to the local emergency management organization. (2) Working hours shall be scheduled to ensure that the[dietetic]nutritionalneeds of the[patients]residentsare met. A. (1) A nursing home shall develop policies and procedures to ensure that a resident or, if the resident lacks the capacity, the residents family or other individual accompanying the resident is informed, both orally and in writing, on how the resident shall safely and correctly take the residents medications during a short-term leave of absence of 24 hours or less. (k) The written procedure shall include the disposal of the dirty water. (2) A call system shall be maintained in a manner that will provide visible and audible signal communication between nursing service personnel and residents. (1) The nursing home shall providean administrative area[shall be provided which]thatis suitable for conducting business or discussing[in privacy problems]problems privatelywith the[patients sponsor]residents representative. A physician or physician assistant may find the registration requirements outlined in COMAR 10.62.03.01, . General Requirements. (2)A nursing home desiring to provide services other than thosefor which it is alreadylicensed shall obtain prior approval from the Department. C. Laundries-New Facilities. (2) Benefit to the public health, safety or welfare, or the environment: This requirement ensures that a licensed social worker is providing services to residents of the facility and ensures that residents receive adequate discharge planning and care coordination. Responsibilities delegated to other staff besides the director of nursing shall have a clear delegation of authority. (b) Tuberculosis in a communicable form does not include: (i) When the individual who has presumptive or confirmed active disease, has had three negative AFB smears, collected 824 hours apart, shows clinical improvement, and has received chemotherapy to which the strain is susceptible for at least 14 days; or. As long as the cumulative days of suspension imposed solely for the five reasons listed in COMAR 10.32.22.03C(7) do not exceed 30 in a calendar year, that suspension need not be reported. (8) The audible signal shall be loud enough to be heard at the nurses station. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. (1)Current medical records and those of discharged[patients]residentsshall be completed promptly. fraud and/or abuse of State government B. New construction providing a conventional type food service program shall have the following minimal space requirements (excluding bulk food-storage areas, dining areas, and separate floor pantries). Maryland Board of Physicians | 4201 Patterson Avenue | Baltimore, MD 21215. The physician shall, E. Objective. For brevity's sake in these FAQs, the Board will use the term "hospital" to indicate the entity that is required to report. The Maryland Medical Cannabis Commission (MMCC) certifies and registers certifying providers for medical cannabis. (7) In cases where the cost of any medication obtained from the pharmacy selected by the resident exceeds the cost of the same or equivalent medication available through a pharmacy that the nursing home has contracted with to provide pharmaceutical services, the resident shall be responsible for the additional amount. accessible and convenient, and that might be grounds for action under 8-316 or Subtitle 6A of this title, the Contents of Record. The director may not disclose, directly or indirectly, the identity of any individual tested. [E.]I. These written procedures shall: (1) Be a part of the nursing homes Emergency and Disaster Plan, in conformance with Regulation .40 of this chapter; and. Agency Note: Utilization Review. Policies shall provide for the coordination of rehabilitative services and the rehabilitative aspects of nursing. 410.764.4777 | Toll Free 800.492.6836. The nursing home shall meet the requirements for handling, treatment, and disposal of special medical wastes as provided in COMAR 10.06.06. (Identified by Impact Letter and Number from Section II.). 3. D. Assistance by Nursing Service Personnel. (g) Storage for trays, tableware, flatware, and utensils. (c) The janitors closet shall be connected to mechanically operated exhaust ventilation. (c) After being fully informed of the health risks associated with not receiving a vaccine, the resident refuses the immunization. After meeting requirements of the Board of Nursing (Maryland application, Criminal History Record Check, Declaration of State Primary Residence Form, TOEFL iBT or IELTS CES report), complete registration with NCLEX. There are currently 36 subjects and 101 Articles in the Annotated code. [(a)]Guidelines for Preventing the Transmission of Mycobacterium[Tuberculosis]tuberculosisin Health-Care[Facilities; and]Settings. (c) Air ducts that pass through a required smoke barrier shall be provided with a smoke damper at the barrier. [Comprehensive care facilities or extended care facilities]A nursing homelicensed under this regulation may not usethe word hospitalin[their]itstitle[the word Hospital]. After registering with NCLEX you will receive an Authorization To Test letter (ATT) (75) Tuberculosis in a Communicable Form. (1) If a nursequestionsthe care provided to anyresidentor believes that appropriate consultation is needed and has not been obtained, the nurse shallinformthe supervisor. Before or at admission, a contract shall be executed by the administrator and[patient]resident,guardian, or responsible agency which is consistent with the requirements of Health-General Article, 19-344, Annotated Code of Maryland, Rights of Individuals. Unless otherwise indicated, all general requirements apply to both new constructionand anexisting nursing home. (iv) All soiled areas within a laundry shall be connected to mechanically operated exhaust ventilation. The[facilitys]nursing homesquality assurance committee shall develop and implement a quality assurance plan that includes procedures for: B. Concurrent Review. When the Commission on Graduates of Foreign Nursing Schools receive all three required applications, they will complete the report and mail it to the Maryland Board of Nursing. Please enable JavaScript in your browser. (2) Medications shall be administered by: (a) Appropriately licensed personnel in accordance with laws and regulations governing these acts; or. The attending physician shall also be notified.] [.07].09Administration and Resident Care. Transcripts must be evaluated by the Commission on Foreign Nursing Schools (CGFNS). (3) Other emergency lighting shall be as follows: (b) Drug distribution station or unit dose storage; (c) A lighted area for emergency telephone use; (f) Generator set location and switch gear location; (g) Elevator, if operable on emergency power; (h) Areas where life support equipment is used; (i) If applicable, lighting for the common area of refuge; and. truthful and transparent services. You may be trying to access this site from a secured browser on the server. (2)The nursing home shall require that employees who are not immune to measles, mumps, rubella, and varicella receive immunization for measles, mumps, rubella, or varicella, unlessmedically contraindicated or against the employees religious beliefs. No. The[goal]goalsshall be realistic, practical, and tailored to the residents needs. (c) Aportablewindowair-conditioning unit may not block window space. This instruction shall include the following topics: (e) Communication and interpersonal skills.]. Currently there is an estimated $11,000 salary differential between the salary of a non-licensed employee performing social work services and a licensed social work employee. Anursing home may not burn or incinerate garbage at the nursing home. (ii) Maintain a minimum clearance of 3 feet at the foot of the bed. E. Space. of Legislative Audits operates a toll-free (44) Nursing care has the meaning stated in Health-General Article, 19-301(k), Annotated Code of Maryland. Baltimore, Maryland, 21215-2254. (3) Analysis of additional burden or cost on the regulated person: The proposed requirement that social work services be performed by a licensed social worker becomes effective January 1, 2021. The Department shall be notified of the name of the assistant director of nursing. C. A[facility]nursing homethat uses a paid feeding assistant shall ensure that the paid feeding assistant feeds only residents who do not have complicated feeding conditions including, but not limited to: (3) Recurrent lung[aspirations]aspiration; or. [The written social history]Within 7 days after admission, thesocial workershall[be initiated within 7 days after admission. (2) Upon request, the director or assistant director of nursing may accompany physicians visiting residents. (a)A distance of at least 3 feet shall be maintained between each bed. See Regulation .21G of this chapter for tuberculosis surveillance requirements.] (3) The individual who prepares medications shall give and record them. C. The nursing[facility]nursing homeshall establish a quality assurance committee that includes at least: (1)[A]The nursing homedirector of nursing; (4)[A]The nursing homemedical director; (5) A[dietitian]dietitian-nutritionist; and. (b)A nursing care unit[also]bathroomshall include: [(a)](i)A toilet, within the care unit, for the use of personnel[, a]; and. For this reason, they will not be printed in the Maryland Register or the Code of Maryland Regulations (COMAR). For a bedroom that has sloping walls, only 50 percent of the floor area with a ceiling height between 4 feet and 7 feet, 6 inches, shall be credited, provided that at least 50 percent of the total area of the bedroom has a ceiling height of 8 feet. (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]. of Legislative Audits operates a toll-free These studies have listed reoccurring . Would you know your responsibility as a nurse and mandated reporter if you suspected a patient . Emergency procedures shall be established and documentedthatenable the nursing home to provide water in all essential areas in the event of the loss of the normal water supplyor if the nursing home would have to shelter in place during an emergency or disaster. Please enable JavaScript in your browser. Designated Staff Responsibility. (66) Resident Assessment Instrument (RAI). [(b) Medicine storage cabinet with locks. Nursing homes that employ an individual on or before January 1, 2021 shall be exempt from the requirement to have a licensed social worker employed. (c)It is recommended that 2 square feetper[patient]residentbe provided and that thedry food storagearea be located within easy access to the receiving area and the kitchen. Tonya Spruill Nurse Practitioners. These actions are involuntary if they occur after any of four specified events. If the employee formerly worked in a]; (5) Pastnursing home[, consideration shall be given to the record as it relates to]employment documentation, including any past instances ofabuse of[patients]residents, theft, and fires[. OHCQ through this proposal intends to require that after January 1, 2021 all social work services be provided by a licensed certified social worker. [(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. copies of patient [(3) The course instructor shall have overall supervisory responsibility for the operation of the program, and shall: (a) Be a registered nurse licensed in Maryland; (b) Have at least 2 years of nursing experience, at least 1 year of which shall have been in caring for the elderly or chronically ill in the past 5 years; and. (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. (b) Written plans that describe how all residents, staff, and the general public will be kept safe during the duration of the project. Rollaway type beds, cots, or folding beds may not be used. (b) Increase or decrease in capacity of an existing nursing home. (1) Shall be provided on each side of all corridors in resident areas; and. (iii) The clean area shall allow for drying and folding of clean laundry. (5) A nursing home that administers Schedule II drugs shall maintain a drug record that documents: (b) The date, time, kind, dosage, and method of administration of all Schedule II drugs; and. The water heating equipment shall supply adequate amounts ofheatedwater according to the following temperature guidelines for: (1)Resident use, the water temperature shall be between 100F (38C) and 120F (49C): (2) Food preparation use,as referencedin COMAR 10.15.03; and. the satisfactory completion of the program in each employees personnel record, (2) The course content shall adhere to the. (7) National Fire Protection Association, NFPA 99 Health Care Facilities Code (2015 Edition). (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.