410.764.4777 | Toll Free 800.492.6836 . (iii) Describes provisions for light, heat, food service, washing, and toileting residents. [.14-1].23Special Care Units General. Clean linen shall be stored separately from[non-clean]uncleanitems. (14) Dentist means an individual licensed to practice dentistry in this State. (6) Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP), (MMWR2011; 60 No. Annapolis, MD. (3) A nursing home shall equip all screened doors with self-closing devices, to provide for the normal flow of ingress and egress of traffic. (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. (1) A nursing home shall providedining[areashall be]areaslarge enough to accommodate all[patients able to eat out of their rooms]residents who eat there at the same time. (3) A call station shall provide readily accessible and detachable extension cords to each residents bed in the residents rooms at all times. A digital passport style photograph in PNG or JPG file format, The 12 digit tracking number from under the barcode on the fingerprint card or 12 digit tracking number on the Live Scan receipt, A Visa or Masters card credit or debit card, This section applies only to nurses whose basic nursing education was completed in another country. The[facility]nursing homeshall maintain adequate space and equipment, conveniently located, to provide for efficient processing[of medical records (],reviewing, indexing, filing, and prompt retrieval[)]of medical records. (d) Theminimum horizontaldimensions of a bedroom areto be 10 feet to: (i) Facilitate the placement of beds as required inRegulation .44of thischapter;and. (9) An orientation program shall be provided to trainees for a nursing facility in which training is to occur. 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. (6) A call system shall be provided in each residents bathroom and bathing area in locations accessible to the residents. (b) At least 2 years of experience or specialized training in the medical care of geriatric or chronically ill and impaired residents; (c) Successful completion of a curriculum in physician management or administration from. (2) Foodinstorage shall be arranged so that new food items are stored behind old food items. Dry Food Storage. Masks are required inside all of our care facilities. For this reason, they will not be printed in the Maryland Register or the Code of Maryland Regulations (COMAR). 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). (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. Responsibilities delegated to other staff besides the director of nursing shall have a clear delegation of authority. responsive, accurate and consistent, (v) Equipment for the disposal of liquid and semi-solid wastes and bodily fluids via the nursing homes sanitary sewer connection or on-site sewage disposal system. (2) The[facility]nursing homeshall provide information concerning the[communicable]infectiousdisease status of any resident being transferred or discharged to any other[facility]nursing home, including a funeral home. The physician shall[note on]document inthe[patients]residentschart any restrictions applicable to the[patients]residentsparticipation in the activities program. (a) The nursing home shall provide residentswith theirown bed. If the physician so orders, patients who have a tendency to wander may be confined to their rooms by screen doors or folding gates. An employee of the[facility]nursing homeshall be designated as the person responsible for the overall supervision of the medical[record]recordsservice. D.Each day that the nursing[facility]homeoperates after the first conviction, without correction of the cited violation, is considered a subsequent offense and may subject the operator to further prosecution. Members of the residents family or the responsible party for the resident may not deliver medications to the resident or to the nursing home. Thus 172 times $11,000 equals an annual cost increase of $1,892,000 to the regulated industry. (b) An interferon-gamma release assay (IGRA) blood test. Copyright Maryland.gov. (2) The course content shall adhere to the[Geriatric Nursing Assistant Program]geriatric nursing assistant training programcurriculumapproved by the Maryland Board of Nursing[in Regulation .40 of this chapter]. The assessment shall: (2) Use a data dictionary as identified by the automated data processing requirements; and. 100-07 State Operations Provider Certification,and with RAI instructions in the CMS Long-term Care Facility Resident Assessment Instrument 3.0 Users Manual,except that data may not be[electronically]submittedelectronicallyto the Department. (4)Spacefor Storage of Linen[New Construction and Existing Facilities]. (5) A[patient]residentwho is in a protective device or devices may not be left in the same postural position for more than 2 consecutive hours. No. bio; live! (2) In a nursing home in which the director of nursing serves as relief for the administrator, the director of nursing shall designate a specific registered nurse who shall be in charge of the nursing service while the director of nursing covers for the administrator. (vi) Appropriate use of antiseptics and disinfectants[.] NCSBN assumes no liability or responsibility for any errors or omissions in the information contained in this resource. Organization, Policies, and Procedures. Please enable JavaScript in your browser. (4) The brief medical fact sheet for each resident described in A(3) of this regulation shall be: (c) Maintainedin awritten, electronic,or printed formin a central location readily accessible and available to accompany residents in case of an emergency evacuation. Body Holding RoomNew Constructionand Existing Nursing Home. 10.34.06 Reporting Pharmacist's and Pharmacy Technician's Mailing Address and Location of Employment, Effective March 18, 2013. [(d)](e)WarmAny temperature between[30C and 40C (86 and 104F)]86F and 104F or 30C and 40C. certain fraudulent activities and protect (8) National Fire Protection Association, NFPA 101 Life Safety Code, which is incorporated by reference at COMAR 29.06.01.06. (2) A call system shall be maintained in a manner that will provide visible and audible signal communication between nursing service personnel and 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.]. (j) If applicable, lighting in toilet rooms of the common area of refuge. (19) Distinct part extended care facility means a portion of a nursing home that is licensed as an extended care facility. (3) The facility shall monitor the purified protein derivative (PPD) status of employees at any time that symptoms suggestive of tuberculosis develop, and periodically, consistent with the tuberculosis control plan. Educator. (12) Culture change facility means a nursing home where physical environment and operational changes have been made to establish person-valued and person-directed care activities and services. (13) Supervision of certified medicine aides to ensure that the aides act within the limitations and restrictions placed on them. The director of a medical laboratory defined at Health-Gen 17-201(b)(1) as any facility, entity, or site that offers or performs tests or examinations in connection with the diagnosis and control of human diseases or the assessment of human health, nutritional, or medical conditions . (1) The administrator shall employ sufficient and satisfactory personnel as specified in this chapter to[give adequate patient care and to do feeding,]: (a) Providemaintenance, cleaning, and housekeeping; (a)A[facility]nursing homemay request a[]voluntary admissions ceiling[]by submitting a written request to the Department to authorize a temporary restriction on[patient]residentadmissions based upon anticipated bed usage. (72) Speech-language pathologist means an individual licensed by the State Board of Audiologists, Hearing Aid Dispensers, and Speech-Language Pathologists. Unless otherwise indicated, all general requirements apply to both new constructionand anexisting nursing home. C. Administrative AreasExisting[Facilities]Nursing Homes. Determine if a report should be madeif yes you MUST report immediately to the State Agency (see below). (2) The nursing home shall provide the Office of Health Care Quality with the documentation that verifies that the applicable local and State governmental authorities have approved work that was done. (d) Smoke dampers shall activate by smoke detectors located in the ducts at the smoke barrier, or by the smoke detectors used to close smoke barrier doors. [(f)](g)Protection from Freezing. (1)[Problems]Residents problemsand needs shall be identified, based upon the interdisciplinary assessment. Login credentials previously used within any NASBA Online Application System cannot be used to register an account within this Licensing System. (1) General requirements established for all special care units as outlined in Regulation .24 of this chapter; and. Reports under this COMAR provision must be made to the health officer within 48 hours, except for certain diseases for which reports must be made immediately by telephone. [I.] Nursing. A. Please enable scripts and reload this page. (ii) Maintain a minimum clearance of 3 feet at the foot of the bed. The Board concluded that reliance on any one institutions terminology would result in uneven reporting. A[facility]nursing homeshall use the following forms and procedures for resident assessment as described in the[State Operations Manual for Provider Certification]CMS Manual System, Pub. Amber Havensamber.havens@maryland.gov, Compliance Coordinator: The training on cognitive impairment and mental illness shall be designed to meet the specific needs of the. A. Space near the utility sink shall be provided for the storage of brooms, mops, and cleaning materials. (3) Pass standardized edits as defined by CMS and the State. We're available on the following channels. (1)Covers shall be placed on hot[water bottlesand,ice caps]packs, ice packs and other temperature-related therapeutic medical devicesbefore they are placed in a bed or on a[patient]resident. The Board: protects the public from unsafe nursing practice, provides approval for more than 200 nursing education programs, issues licenses to more than 27,000 nurses per year by examination to new graduates and by endorsement to licensees from other states seeking a Texas license, as well as providing nursing practice and education guidance . 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. customers, and stakeholders with Results will be mailed to you within five days of exam date. [F.]E.A[facility]nursing homelicensedas a[comprehensive or extended care facility]nursing homebut not certified for participation in the Medicare or Medicaid Program shall comply with the[State Operations Manual for Provider Certification]CMS Manual System, Pub. (2) Thearchitect or professional engineer of record shall submit a letter certifying thattheproject has been designedinaccordance with all applicable federal, State, and local codes, laws, ordinances, and regulations for construction. (h) All occupants of any bedroom shall be of the same sex, except in the case of a two-bed room occupiedby: (2) BedroomNew Construction. (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. A. C. Human remains shall be transported pursuant to COMAR 10.29.21. (2)A catered or satellite system shall be covered by a contractapproved by the Department. (8) The audible signal shall be loud enough to be heard at the nurses station. ; (vii) Blood borne pathogens, including hepatitis B and C and human immunodeficiency virus; (ix) Proper use and wearing of personal protective equipment, such as gloves, gowns, and eye protection; (f) Train and[monitor]perform compliance monitoring ofemployee application of infectionprevention andcontrol[and aseptic techniques; and]activities, such as hand hygiene and personal protective equipment used for isolation precautions; (g) Review the infectionprevention andcontrol programelementsat least annually and revise as necessary[. (2)Existing Facilities. Otherwise, a dedicated enunciator connected to the wireless call system will be needed. In all instances sufficient consultation shall be provided to fulfill all required responsibilities. 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. (2) Bedside hours include the care provided by: (3) Only those hours which the director of nursing spends in bedside care may be counted in the 3-hour minimum requirement. (2) The information disclosed shall explain the additional care provided in each of the following areas: (a) The Dementia special care units written statement of its overall philosophy and mission, which reflects the needs of residents with dementia; (b) The process and criteria for placement, transfer, or discharge from the unit; (c) The process used for individualized assessment and establishing the resident-centered plan of care and its implementation, including the method by which the plan of care evolves and is responsive to changes in the individuals condition; (d) Staff training and continuing education practices; (e) The physical environment and design features appropriate to support the functioning of cognitively impaired adult residents; (f) The frequency and types of resident activities; (g) The involvement of families and family support programs; and. We're available on the following channels. Thewindow opening shall be at least 28 inchesso that the total area equals 10 square feet per bed. (7)Before the opening of the[facility all supportive]nursing home, supportpersonnel shall have a minimum of 2 days of orientation training. A State-approved training course for paid feeding assistants shall consist of at least 8 hours of training that includes: (9) Successful completion of a two-part test that includes a: (b) Demonstration of proper feeding skills performed on a resident[under observation]while being observed. (37)MDS Care Area Assessmentmeansthe investigation of triggered care areas, to determine if the care area or areas require interventions and care planning. Activities Program. (b) Licensedby the Board of Examiners of Nursing Home Administrators for the State. Dayroom areas shall be provided. The[facility]nursing homeshall[be]: (a) Bemaintained free of insects and rodents by operation of an active pest-control program, either by use of maintenance personnel or by contract withapest-control company[. A person maintaining or operating a nursing. A bodyholdingroom shall be located to facilitate quiet and unobtrusive ingress and egress of bodies, convenient to the elevator and with an isolated exit. (1) Amend, repeal, recodify, and adopt new language in order to make this chapter more cohesive, comprehensive, and clear; (2) Enable the Department to accept electronic submissions of both initial applications and renewal applications and thereby improve efficiency and decrease the administrative burden on providers and the Department; (6) Incorporate by reference additional documents; (7) Require that new facilities shall satisfy the review of the Maryland Health Care Commission for the establishment of new facilities and the increase or decrease in capacity of existing facilities; (8) Require that an existing facility that wishes to convert, alter, modify, or add to the existing infrastructure shall notify the Office of Health Care Quality in writing; (9) Require that a nursing home shall employ supervisory personnel and a sufficient number of support personnel, to provide a minimum of 3 hours of bedside care per occupied bed per day, 7 days per week; (10) Require that the ratio of nursing service personnel on duty providing bedside care to resident may not at any time be less than one to 15; (11) Require that the nurse manager or the Director of Nursing of vent units shall possess a background in ventilator care or be qualified in ventilator management; (12) Require that after January 1, 2021 social services responsibilities in the facility will be assigned to a Licensed Bachelor Social Worker, Licensed Graduate Social Worker, Licensed Certified Social Worker, or Licensed Certified Social WorkerClinical; (13) Require that the facility shall assign at least one infection preventionist staffed at a ratio of1.0 Full Time Equivalentsfor every 200 beds; (14) Require that facilities shall possess a functioning automated external defibrillator (AED) as of July 1, 2020; (15) Allow Certified Dietary Managers to share cooking responsibilities with the full-time cook in facilities with fifty or fewer beds. There shall be an advisory dentist[, licensed to practice in the State,]who shall: (1) Recommend oral hygiene policies and practices for the care of the[patients]residentsand for arrangements for emergency treatment; (3) Provide direction for in-service training to give the nursing staffanunderstanding of[patients]residentsdental problems. Staff working in laundry shall be given personal protective equipment, including: (d) All laundry shall be processed through the use of sufficiently hot water, chemical agents, or a combination of the both, to remove or destroy infectious biological materials. [Heating pads may not be used instead of hot water bottles.]. The Office of Health Care Quality (OHCQ) is the agency within the Maryland Department of Health charged with monitoring the quality of care in Maryland's health care facilities and community-based programs. [(2)](4)The Department shall consider the following factors when[considering]decidingwhether to approve an administrator to serve on a less than full-time basis: (a)[Geographical]Geographiclocation of the facilities; (1)In the absence of the administrator, the[facility]nursing homeat all times shall be under the direct and personal supervision of an experienced, trained, competent employee. Pursuant to State Government Article, 7-207, Annotated Code of Maryland, the following have been declared documents generally available to the public and appropriate for incorporation by reference: (1) CMS Long-Term Care Facility Resident Assessment Instrument 3.0 Users Manual (Version 1.14, October 2016); (2) CMS Manual System, Pub. C. Body Holding RoomExisting Nursing Home. (c) Other legal representatives as set forth in COMAR 10.07.09.08 and authorized by law to obtain access. Approved employees shall read the skin test and manage the results of the skin test in accordance with Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Facilities. A respiratory care unit shall meet the: (1) General requirements established for all special care units as outlined in Regulation[.14-1].23of this chapter; and. (3)[Thenotification shall include]Includean invitation for the family member or residents representative to attend the conference. The stark reality in 21st-century America is that child abuse is reported to authorities every ten seconds.During the time they are being trafficked, 30-88% of survivors of human trafficking see a healthcare provider. (7) Respond promptly to notification of, and assess and manage adequately, reported acute and other significant clinical condition changes in residents; (8) Ensure that individuals receiving palliative care have appropriate comfort and supportive care measures, (9) Properly refer residents to specialty services and providers when the care needs of the resident exceed the scope of the attendingphysicians knowledge and skill, A. (56) Positive tuberculin skin testmeansa test provided as authorized by the Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings. 100-07 State Operations Provider Certification and in the CMS Long-term Care Facility Resident Assessment Instrument 3.0 Users Manual: (1)TheMinimum Data Set (MDS) version as determined by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, in Transmittal No.
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