[.111].16Medical Director Responsibilities. [B.] A. 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. [(5)](e)All flammables shall be stored in compliance with NFPA[30,flammableandcombustible liquids code]99 Health Care Facilities. (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. 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. E. Administration of Medications for Leave of Absence of 24 Hours or Less. Required . [D.]C.The[facility]nursing homeshall hold the care planning conference not later than 7 calendar days after[completion of]completingthe assessment, but may hold the conference[earlier]soonerif agreed to by the resident, a family member, or a residents representative. [(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. (d) Privileges at a hospital in this state, participant in an HMO network, or credentialed by a credentialing organization approved by the Department. [(a)](b)ColdAny temperature[not exceeding 8C (46F)]at or below46F or 8C. Please enable scripts and reload this page. (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) The vendor or staff may provide the following services: (c) The nursing home shall ensure that all piped medical gas systems adhere to the following standards: (i) NFPA 99 Health Care Facilities Code; and. Agency Note: 10 foot ceiling height is recommended. 4140 Patterson Avenue, Baltimore, MD 21215-2254, Direct Entry Midwifery Advisory Committee, Credentials Evaluation Service Application (CGFNS), CREDENTIALS EVALUATION SERVICE APPLICATION, Complete on-line application and fee to CGFNS. (1) The nursing home shall inform a residents designated pharmacy about the nursing homes written policies concerning the provision of drugs. (3) The[facility]nursing homeshall prohibit employees with[a communicable]an infectiousdisease or with infected skin lesions fromhavingdirect contact with residents or their food if direct contact could transmit the disease. C. Staffing. (3)When the designee is replaced, the Department shall be notified of the name of the registered nurse filling the vacancy. The[facility]nursing homeshall ensure that each unit is sufficiently staffed with qualified personnel to provide appropriate treatmentand[special]meet thecare needs of the residents. (1) A pharmaceutical services committee, or its equivalent, shall develop written policies and procedures for safe and effective drug therapy, distribution, control, and use. customers, and stakeholders with Department of Health Professions Perimeter Center 9960 Mayland Drive, Suite 300 Henrico, Virginia 23233-1463. (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]. The Mandated 10-Day Report Form is required. (8) National Fire Protection Association, NFPA 101 Life Safety Code, which is incorporated by reference at COMAR investigator will be assigned. D. It is estimated that 25 percent of nursing homes currently have a licensed social worker (Bachelors level degree). fraud hotline to receive allegations of Professional specialty certifications may be required, in accordance with departmental standards or role . (1)To support placement in a specific position, there shall be sufficient documentation in the employees record reflecting his training and experience. (ii) The nursing home shall make its residents personal furnishing policies available for review by residents and the residents representative. The[facility]nursing homeshall provide or make arrangements for services to identify and meet the[patients]residentsmedically relatedphysical,social, and[emotional]behavioral healthneeds. 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.]. (2) Transmit assessment data as specified in the CMS Long-term Care Facility Resident Assessment Instrument 3.0 Users Manual except as excluded in E of this regulation. (2) The certification of the . [Signed]The nursing home shall file signedand dated reports of diagnostic services[shall be filed with]inthe[patients]residentsmedical record. 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. (a)The nurses[station]work areashall be[centrally]located[in relation to beds served]on the unitand[shall provide]withineasy view of corridors outside ofresidentsrooms. [.16].28Laboratory and Radiologic Services. [B. friendly and courteous, timely and (ii) To avoid injury to the resident, the mattress and foundation shall fit the bed. Licensed Practical Nurses. The facility shall document refusals and shall conduct surveillance of nonimmune employees during the recognized influenza season.]. A facility which holds full licensure as of the adoption of these regulations shall be considered as having an adequate size dietetic service department. (2)A substantial evening meal is an offering of three or more menu items at one time, one of which includes a high quality protein such as meat, fish, eggs, or cheese. If you have the exact number, subtitle, and chapter, type it in. The posting on each floor shall include: (1) Names of the staff members on duty and the room numbers of the residents[that]to whomeach is assigned; (2)Name of the charge nurse or personwho isin charge of the unit;[and], (3) If the person in charge is not a registered nurse, the name of the registered nurse responsible for the unit; and. Only one of these is specific to Title 20 violations for investigation by the Public Service Commission. (19) Distinct part extended care facility means a portion of a nursing home that is licensed as an extended care facility. Patients may not be kept behind locked doors, that is, doors which patients cannot open. (3) Approaches to accomplishing each goal shall be established. (46) Nursing service personnel means staff licensed or certified by the Maryland Board of Nursing. (8) The nurses call system shall require resetting at the station where the call originates. (1) Require that each new employee receive a one-dose booster immunization for pertussis, unless medically contraindicated or against the employees religious beliefs; (2) Inform all new and current employees of the health risks of not being immunized; (3) Document any refusals of immunization; and. The Maryland General Assemblys Office Incidents are to be reported as soon as they are suspected. The State of Maryland pledges to provide constituents, businesses, ), Comments may be sent to Jake Whitaker, Acting Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to mdh.regs@maryland.gov, or fax to 410-767-6483. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home. (4)[All facilities]A nursing homeshall establish and enforce a written preventive maintenance program to ensure that all[essential mechanical, electrical, and patient care]resident care and therapyequipment is maintained in safe operating condition. (1) The nursing home shall arrange for pharmacies that provide medications for residents in the nursing home. (a) Results of tuberculin skin tests, recorded in millimeters of induration with dates of administration, dates of reading, results of test, and the manufacturer and lot number of the purified protein derivative (PPD) solution used; (b) Results of chest x-rays required in this regulation; and. (a) Resident Assessment Instrument (RAI) meansa standardized and reproducible resident assessment process based on completion of Minimum Data Set (MDS) screening items, and including the MDS Care Area Assessment process, and related process for care planning and evaluation. A. The Maryland General Assemblys Office (d) A nursing home may distribute space in the following manner: (i) Storage space shall comprise at least 10 percent of the area designated for exercise and rehabilitation; and. (5) Janitors ClosetNew Construction. (a)If the sale, transfer, assignment, or lease of a[facility]nursing homecauses a change in the person or persons who control or operate the[facility]nursing home, the[facility]nursing homeshall be considered a new[facility]nursing home and the licensee shall conform to all regulations applicable at the time of transfer of operations. (4) 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (Centers for Disease Control and Prevention (CDC), Healthcare Infection Control Practices Advisory Committee (HIPAC), 2007). (33) Licensed or certified professional health care practitioner means a nurse practitioner, physician assistant, or other practitioner licensed or certified under the Health Occupations Article, Annotated Code of Maryland. (6) Medical and social history ofthe[patient]resident; (13)[Discipline assessment]Assessments done by various disciplines; and. COVID-19 Wastage and Temperature Excursion Reporting Form| 5.3.21; Maryland Department of Health Statement on the Reintroduction of Johnson & Johnson's Janssen COVID-19 Vaccine | 4.24.21 . resources. 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. Copyright Maryland.gov. [The administrator or the administrators designee shall notify the private or public agency or relative responsible for the patient when the patientis transferred from the facility for any reason or at time of death. C. Locked Doors Prohibited. Spaces housing medicine storage cabinet, medicine preparation area, and biological refrigerator shall be under the direct visual control of the nursing or pharmacy staff.]. Assumptions. copies of text messages or social network pages. .08 New Construction, Conversion, Alteration, or Addition. The physician shall, E. Objective. Determine if a report should be madeif yes you MUST report immediately to the State Agency (see below). fraud and/or abuse of State government Director of Nursing. A nursing home shall provide cubicle curtains and tracks in multiple occupancy bedrooms between beds to insure privacy of residents. This program shall include: (1) Periodic service and testing of items as recommended by manufacturers of at least the following: (e) Resident bathing and shower equipment; (2) Ongoing staff monitoring for evidence of malfunction or deterioration; and. A physician in attendance upon a patient having syphilis shall request the health officer to conduct a contact investigation or report to the health officer any untreated individual identified as having had potentially infectious contact with an individual having syphilis. L. Resident Directed Meal Pattern. (b) The filter bed shall be located upstream of the air conditioning equipment, unless a prefilter is employe. ], [Agency Note: It is recommended that the comprehensive care facility arrange for a similar transfer agreement with an extended care facility.]. It looks like your browser does not have JavaScript enabled. 410.764.4777 | Toll Free 800.492.6836 A janitorscloset or service alcove fortheexclusive use of food service areas shall be provided in, or adjacent to, the dietetic service department. (b)The transfer of any stock which results in a change of the person or persons who control the[facility]nursing home, or a 25 percent or greater change in any form of ownership interest, constitutes a sale. This instruction shall include the following topics: (e) Communication and interpersonal skills.]. 410.764.4777 | Toll Free 800.492.6836. Call systems shall be maintained in a manner that will provide visible and audible signal communication between nursing personnel andpatients. A bodyholdingroom shall be located to facilitate quiet and unobtrusive ingress and egress of bodies, convenient to the elevator and with an isolated exit. The Board concluded that reliance on any one institutions terminology would result in uneven reporting. (1) A nursing home shall develop resident, group of professional personnel including one or more physicians and one or more registered nurses, Written policies shall be kept current with the policies used to administer the, (5) For a resident who is to be transferred to the care of another. [E.]D.The[facilitys]nursing homescommunication mechanism shall ensure that theadministrator, director of nursing, and the medical director receive and address reports of infectionprevention andcontrol findings and recommendations in a timely manner. The provider industry is in agreement with the proposed changes in this requirement. Designated Staff Responsibility. (1) If the nursing home terminates the services of the director of nursing, the nursing home immediately shall notify the Department of the termination. [A facility shall give a]Care Plan Meeting. A[facility]nursing homewhich holds a current and valid operating license may establish special care units with the approval of the: (1)Office of[Licensing and Certification Programs and the Departments Division of Engineering and Maintenance]Health Care Quality;and. (5) Before invoking stop order policies, the residents attending physician shall be contacted for instructions so that continuity of the residents therapeutic regimen is not interrupted. [C. Effective January 1, 2005, the facilitys infection control coordinator shall attend a basic infection control training course that is approved by the Office of Health Care Quality and the Office of Epidemiology and Disease Control Program for the Department.]. (71) Special care unit means a nursing home unit that provides intensive specialized care, such as respiratory, rehabilitative, dementia, or dialysis care, continuously on a 24-hour basis. (3) BedroomExisting Construction. [E.]F.Employee FacilitiesExisting Facilities. 18008 Bothell Everett Hwy SE # F, Bothell, WA 98012. Public records report utah county real . (1) Adequate equipment for preparation, serving, and distribution of food shall be provided[;]. This status is required for RNs who wish to practice nursing in the state of California. When the attending physician and medical director document a residents medical need for a particular treatment, assistive device, or equipment, C. When the attending physician and medical director agree that a particular. (7)The kitchen space requirement[in F(6) of this regulation]as described inthisregulationdoes not apply to occasional special functions such as picnics or dinners for residents, volunteers, families,or community groups[provided]as long asthe[facility]nursing homecertifies to the Department that[the provision of]providingmeals for[the particular]aspecial function will not adversely affect or detract from the timely provision of meals to thenursing homesresidents[of the facility]. Space near the utility sink shall be provided for the storage of brooms, mops, and cleaning materials. If the attending physician cannot be reached, the medical director shall be contacted for instructions. All employees shall be assessed for risk of tuberculosis following guidelines referenced in B of this regulation.]. (62) Registered nurse means an individual licensed to practice as a registered nurse in this State. An article for which storage in a cool place is directed may, alternatively, be stored in a refrigerator, unless otherwise specified in the individual monograph. You may be asked to demonstrate that your license is active, for which you must meet all the necessary continuing education requirements. (3) The course instructor shall have overall supervisory responsibility for the operation of the program, and shall: (e) Communication and interpersonal skills. However, the national certification agency you are registered with will have requirements that you must complete. LoginAsk is here to help you access Maryland Board Of Accountancy Cpe Central quickly and handle each specific case you encounter. In COMAR, there is a list of common occurrences that do not have to be reported. A person maintaining or operating a nursing. A. Rehabilitative ServicesAdmission Policies. Acall system shall be installed and maintained in operating order in all nursing units. In person purchases can be made at 16 Francis Street - Wineland Building, To provide for this, a nursing home shall have at least one private bedroom with an attached private bathroom that includes a: [.22] .38Reports and Action Required in Unusual Circumstances. [(1)](a)Equipment shall[be of a type that will provide]allow for providingsafe and effective[patient]residentcare. Telephone service and drinking fountains which meet ANSI standards also shall be provided.]. Storage and Handling Requirements for . patient identification, specific nurse behavior, action, or inaction. the Maryland Board of Nursing respectfully submits . [The location of thefood serviceareshall be approved by the Department. Issue/renew license to Advanced Practice Registered Nurses meeting established requirements. (2) In orderto prevent accidents and promote efficiency of service, the nursing home shall ensure that the following areas have sufficient artificial lighting: G.Minimally Maintained Lighting Levels. Karen E. B. Evans. ]; [(8)](7)Laboratory and radiologic services[. (1) For every four licensed beds, there shall be at least one hand washing sink. Clean linen shall be stored separately from[non-clean]uncleanitems. C. NursingCare 24 Hours a Day. (2) A dumbwaiter, elevator, or ramp shall be provided in a[facility]nursing homeof more than one story where more than eight[patients]residentsabove or below the kitchen level[,]receive bedside tray service[;]. (f) Smoke dampers shall be equipped with automatic remote control reset devices, except that manual reopening will be permitted if smoke dampers are accessible. State resources. In compliance with Executive Order 01.01.1996.03, this proposed regulation is more restrictive or stringent than corresponding federal standards as follows: (1) Regulation citation and manner in which it is more restrictive than the applicable federal standard: (1) The facility must provide medically-related social services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. Upon successful completion of the curriculum, the graduate is granted the AS in nursing and is eligible to take the state board examination for registered nurse licensure. (ii) A bed that is certified for Medicaid to a distinct part of the nursing home that is a skilled nursing facility. Human Service Worker. [.30].53Rehabilitation Facilities Space and Equipment. 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. [Facilities]A nursing homeshall maintain a permanent[patient]residentregistry in which the name of each[patient]residentis entered in chronological order with the date and number of entry. The event must be reported within ten days of any change made by the hospital. (a) Identify an emergency and disaster planning liaison for the nursing home; and. (b) Certified graduates of a State-approved medicine aide course. C.A person maintaining and operating a nursing[facility]homethat is in violation of this chapter is guilty of a misdemeanor, and, on conviction, shall be fined not more than $1,000under the authority of Health-General Article, 19-359, Annotated Code of Maryland. The facility shall document refusals and shall conduct surveillance of nonimmune employees during the recognized influenza season. An interdisciplinary team shall complete. Updated (3) Menus shall include alternatives of similar nutritive value that give residents the opportunity to choose meals that they prefer. Nursing personnel shall assist the, E. Transportation. B Social Work Staff Responsibility. E. Responsibilities of the Director of Nursing. A. Construction inan Existing Structure. (1) Adequate equipment for preparation, serving, and distribution of food shall be provided, (2) A dumbwaiter, elevator, or ramp shall be provided in a, (3) Equipment to protect food from dust or contamination and to maintain food at proper temperature shall be provided, (2) The storeroom shall be cool and well-ventilated. (b) Effective implementation of the policies and procedures that are outlined in[F(1)]E(1)of this regulation. (2) The compartment shall be large enough to accommodate: (c) A wheelchair, shower chair, or shower bed. Any individual (other than those listed above) who has reason to suspect elder abuse/neglect may file a report. A. resources. B. copies of patient The printed version is considered the official version. (3) Prevention of backflowshall beensured by proper installation of: C.Sewage. (e) Special diets or dietary restrictions; (f) Family or legal representative contact information, (a) Orient staff to the emergency and disaster plan and to their individual responsibilities, (b) Document completion of the orientation in the staff members personnel file through the signature of the employee, (d) A filter or filter efficiency shall comply with the standards of, the Guidelines for Design and Construction of Residential Health, Care, and Support Facilities, The Department may specify the location and size of a nurses.