(7) Each trainee shall be clearly identified as a trainee during all skills training portions of the training. resources. (vi) Appropriate use of antiseptics and disinfectants[.] The Maryland Board of Nursing requires written, verified evidence of completion of the appropriate education requirements in accordance with Md. The[facility]nursing homeshall provide[for a]: (1)Aprogram of structured and unstructured activities[,]; and. (ii)Those disciplineswho provided the service. The quality assurance plan shall include: (1) A description of a complaint process that effectively addresses resident[or]andfamily concerns including: (a) The designated person or persons and their phone numbers to receive complaints[or]andconcerns; (c) The time frames for investigating complaints[dependent upon], depending onthe nature or seriousness of the complaint; E. Accidents and Injuries. Members of the residents family or the responsible party for the resident may not deliver medications to the resident or to the nursing home. G. Before discharge the nursing home shall: (1) Verify that the transfer and discharge to an assisted living nursing home is licensed and appropriate to meet the needs of the resident; and. (1) The nursing home shall providea multi-purpose room[is used]for dining, occupationaltherapy,physicaltherapy,and social activities[, there]. B. 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. The Secretary of Health proposes to repeal the Preface and Regulations.01,.01-1,.06,.12,.15,.25,.26,.28,.40, and.42.44, adopt new Regulations.01,.02,.08,.18.20,.25.27,.41.46,.4851, amend and recodify existing Regulations.02,.03,.03-1,.05,.07,.07-1,.08,.08-1,.09.11,.11-1, .11-2,.13,.14,.14-1,.14-2,.16.21-4,.22.24,.27,.29.39,.41,.45,.46,.48,.49, and.56to be Regulations.03,.04,.05,.07,.09.17,.21.24,.28.40,.47,.52.68, and.75, and recodify existing Regulations.04,.47,.50.55, and.57.61to be Regulations.06,.66,.69.74, and.76.80underCOMAR 10.07.02 Nursing Homes. (13) Deficiency means a condition existing in a nursing home or an action or inaction by the nursing home staff that results in potential for more than minimal harm, actual harm, or serious and immediate threat to one or more residents. All rights reserved. (b) The clean utility room shall contain: (i)[Wall and base cabinets with stain resistantcountertop; (ii)]A small sink[set into the counter, or with drainboards; sink shall be]equipped with gooseneck spout and wrist blades; (ii) Soap and individual paper towels in a dispenser; (iii) Adequate storage and work counter space for storage and assembly of supplies for nursing procedures;and. The director may not disclose, directly or indirectly, the identity of any individual tested. (2)Theadministratorshall[to]obtain specific items required for individual cases where requested by the attending physician or[supervisor of care services]medical director. [C.](3)Toilet Facilities in Rehabilitation AreaNew Construction. (2) In compliance with NFPA 101 Life Safety Code, NFPA 99 Health Care Facilities Code, and other applicable codes, and all federal, State, and local codes. The[facility]nursing homeshall establish,implement, andmaintain[, and implement]aneffective infectionprevention andcontrol program that: (3) Maintains a record of infections in the[facility,]nursing homeand the corrective actions that were taken related to infections; and, (a) Effectiveness of the infectionprevention andcontrol program by surveying rates of infection, especially of[those residents who have an especially high risk of]infectionrates that are significantly higher than usual; and. It is suggested that there be established a multi-discipline audit team to participate in an ongoing system of internal patient care audit. (3)The[facility]nursing homeshall be kept free of unnecessary accumulations of personal possessions, boxes, trunks, suitcases, papers, unused furniture, bed clothing, linens, bric-a-brac, and similar items. gaussian elimination row echelon form calculator. E.Water Supply. This table below refers to the filter efficiencies for central ventilation and air conditioning systems in a nursing home other than chronic disease hospitals. There are currently 229 licensed nursing homes of which 75 percent or 172 nursing homes would need to hire or contract with a licensed social worker to comply with the regulations. It you scrolled down to Title 20 (Public Service Commission), and click on the Title, you are presented with a list of Subtitles. (45) Nursing home means a comprehensive care facility or extended care facility which offers nonacute inpatient care to patients: (a) Suffering from a disease, chronic illness, condition, disability of advanced age, or terminal disease requiring maximal nursing care without continuous hospital services; and. Call us at (425) 485-6059. I. JavaScript is required to use content on this page. (68) Restraint means any physical or chemical restraint as defined in thischapter. (2) The nursing home shall provide pharmaceutical services in accordance with accepted professional standards and related federal, State, and local laws. The charge nurse or nurses shall make daily roundsonall nursing units for which they are responsible, performing such functions as: (2)Reviewing clinical records, medication orders, resident care plans, and staff assignments; and. (1)[Each facility]A nursing homeshall conduct or arrange a[nurses aide]geriatric nursing assistanttraining program for unlicensed personnel assignedtodirect[patient]residentcare duties. resources. (e) Notify families that the information provided may change depending on the nature or scope of the emergency or disaster. As an example, click only Title 20, then in the search box, type submeters. The search would take you directly to Title 20, Subtitle 25. (g) The plumbing fixtures for all water supply connections to washing machines and the plumbing fixtures for all utility sinks shall have an integrated atmospheric vacuum breaker or other approved back-flow prevention devices. (c) Toilets and bathing rooms within arehabilitationarea shall be equipped with a nurse call system. Frequently Asked Questions & Practice Topics, National Human Trafficking Hotline - 24/7 Confidential. Medical Director Qualifications. (1) A sufficient number of food service personnel shall be employed to, (2) Working hours shall be scheduled to ensure that the, (3) Nursing, housekeeping, laundry, or other personnel may not be, (1) Therapeutic diets shall be planned by a. (2) A facility with more than 120 beds must employ a qualified social worker on a full-time basis. You may be trying to access this site from a secured browser on the server. 272, April 1995 and Transmittal No. (2)The Department shall be notified of the name of the assistant director of nursing. F. Space, Supplies. Written Policies. (b) Licensedby the Board of Examiners of Nursing Home Administrators for the State. (57) Principal physician means an individual licensed to practice medicine in this State who agrees to perform certain medical services under contract with a nursing home, consistent with the policies of the nursing home. (3)The Diet Manual for Long-Term Care[Patients]Residents,as published by the Department,[which]or any other similar reference material thatcontains food allowances and guides for regular and therapeutic diets[may],shallbe used. (4) Each month, the nursing home shall perform a drug regimen review on each residents records at the nursing home and document the findings in the residents medical record. E. The Department shall make a site visit and conduct a full survey of each licensed nursing home at least once per calendar year. 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. (5) The pharmacy shall be responsible for delivering medications to the nursing home. (26) Health officer means the health officer or the designated representative in each of the 23 counties and the Commissioner of Health in Baltimore City. (5) The nursing home shall notify each prospective resident of the immunization requirements and request that the resident agree to be immunized. B. 22, referenced in B of this regulation. (2)The physician may document on the record that[his]thereevaluation may be less frequent but in no case may[his]thereevaluation exceed 60 days. New York State Licensed Professions. (4) Supplementary instructors shall be drawn from qualified resource personnel such as registered nurses, licensed practical/vocational nurses, pharmacists, dieticians, social workers, sanitarians, fire safety experts, nursing home administrators, gerontologists, psychologists, physicians, physical and occupational therapists, activities specialists, speech/language/hearing therapists, and residents rights experts, as well as persons with relevant experience, such as residents or experienced aides. 4140 Patterson Avenue. [C.]B. 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. J. C. Secured units shall meet the established standards applicable to nursing home set forth in NFPA 99 Health Care Facilities Code and NFPA 101 Life Safety Code. A sticker bearing the date of the most current inspection shall be affixed on each piece of equipment. Restrictions on Admission and Retention of[Patients]Residents. The minimum requirements are: D. Call SystemExisting Facilities. (3) The[facility]nursing homeshall obtain information concerning the[communicable]infectiousdisease status of any resident being transferred or[discharged]admittedto the[facility]nursing homefromelsewhere. The director may not disclose, directly or indirectly, the identity of any individual tested. (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. Assumptions. (7) The facility shall request that each employee receive immunization from influenza virus in accordance with Health-General Article, 18-404, Annotated Code of Maryland. (3)The responsible departments approval shall be in writing, signed by the appropriate department head whose license number, if applicable, shall be recorded in the record. (4)In new facilities,the director of nursing and supervisors of[the various services,]dietaryservices, housekeeping, rehabilitationservices, and social services[,]shall be responsible for orienting the new[supportive]supportpersonnel to the[facilitys]nursing homepolicies and procedures and to the physical plant. A person maintaining or operating a nursing. In, Initiation of services to meet the rehabilitative needs of the. If the medical records supervisor is not a qualified medical record practitioner, the Department may require that the supervisor receive consultation from aqualifiedperson[so qualified]. (1) For every four licensed beds, there shall be at least one hand washing sink. We're available on the following channels. [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.]. (4) If a facility can demonstrate that because of the experience and training of its personnel and the physical layout and equipment, less supervisory personnel is required, the Department may modify the above requirements for supervision. (75) Tuberculosis in a Communicable Form. [Comprehensive care facilities or extended care facilities]A nursing homelicensed under this regulation may not usethe word hospitalin[their]itstitle[the word Hospital]. General Responsibilities. 272, April 1995 and Transmittal No. (f) Smoke dampers shall be equipped with automatic remote control reset devices, except that manual reopening will be permitted if smoke dampers are accessible. Janet.McIntyre@maryland.gov, Safe Practice Monitor: (2) Ifcorrected, will result in an unreasonable,substantial financial burdenon the nursing home. There are currently 36 subjects and 101 Articles in the Annotated code. D. Call SystemExisting Facilities. (1) Medications, legend and non-legend, administered to residents shall be ordered in writing by the residents physician. For general inquiries (Discipline): mbon.nursingdiscipline@maryland.gov. Waiting for proof may involve grave risk to the child and . (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. (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. (1)Medical records shall be retained for a period of[not less than]at least5 years from the date of discharge or, in the case of a minor, 3 years after the[patient]residentbecomes of age or 5 years, whichever is longer. Currently, a license has not been required for an individual to operate in this role. (8) The nurses call system shall require resetting at the station where the call originates. (20) Extended care facility means a nursing home that offers sub-acute care and provides medical treatment services for residents who require inpatient care but who do not currently require continuous hospital services. (2) The janitors closet or service alcove. When the designee is replaced, the Department shall be notified of the name of the registered nurse filling the vacancy. (3) Information regarding the residents and familys plans regarding discharge. (3)Audiologist means an individual who holds a Maryland license issued by the State Board of Audiologists, Hearing Aid Dealers, and Speech-Language Pathologists. (3) The oldest foods shall be used first, known as the first in, first out method. The mandatory reporting . Elevatorsshall meet the requirements for elevators in a long-term care nursing home as set forth in theGuidelines for Design and Construction of Health Care Facilities. (69) Secretary means the Secretary of Health. Staffing. First determine if what the hospital did was a "change" according to the regulations. Thus 172 times $11,000 equals an annual benefit of $1,892,000 to the social worker industry and trade groups. Exceptions may be made in part at the discretion of the Department for an individual facility only when the facility can demonstrate compliance with the intent of this section by showing an effective patient call system to provide quality patient care.]. (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. Dry Food Storage. Immediately treat ill effects to resident. (g) Receives prompt and appropriate responses to requests for assistance. For brevity's sake in these FAQs, the Board will use the term "hospital" to indicate the entity that is required to report. [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. Assistance by Nursing Personnel. We're available on the following channels. The audible signal may not be turned off at the nursing station. Contents of record shall, (1) Identification and summary sheet or sheets including, (2) Names, addresses, and telephone numbers of referral agencies, D. Consultation. C. Ongoing Monitoring. The kitchen may not be used for any purpose other than the preparation of food. 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. Maryland Board of Physicians | 4201 Patterson Avenue | Baltimore, MD 21215. [Patients]Residentsmay not be admitted or retained if, in the judgment of the attending physician, they are: [G. Admissions Procedures for Patients With Communicable Diseases. customers, and stakeholders with (3) Guidelines for Design and Construction of Residential Health, Care, and Support Facilities. (4) A[patient]residentin a protective device or devices shall be observed periodically by personnel, to[insure]ensurethat the[patients]residentshealthand personal careneeds are met. The facilitys infection control program shall include monitoring of the health status of all residents to determine if the residents are free from tuberculosis in a communicable form. (1) All policies and procedures for the mobile food cart shall be approved by the Department and the nursing homes local health department before implementation. Please see the Nurse Practice Act 8-505.Report of certain A. Hot water temperatures in laundries shall conform to applicable standards of the International Fabric Care Institute for laundry water supply. (2)Existing Facilities. (1)Thearchitectorprofessional engineer of record shall submit stamped and sealedfinal constructiondrawings to the Department. ; Public Safety Article, 14-110.1; Annotated Code of Maryland. (b) Receives nursing services rendered by or under the supervision of a registered nurse. [Records shall be maintained]. The following requirements shall bemet:]Distributions. (2)The current weeks basic menu shall be posted in one or more easily accessible places in the[dietetic service]food servicesdepartment and in the[patient area]common areas. 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. [E.]I. (vii) A bedsidelamp, over-bed lamp,or other directional light source forresidentreadingandbedside care. The nursing home shall be staffed as referenced in A and B of this regulation. (v) The medicine storage cabinet, medicine preparation area, and biological refrigerator shall be under the direct visual control of the nursing or pharmacy staff. An investigator who is a health practitioner, police officer, educator, or human service worker, acting in a professional capacity in this State, who has reason to believe that a child has been subject to abuse, shall notify the local department or appropriate law enforcement agency. (2)All clinical information pertaining to a[patients]residentsstay shall be centralized in the[patients]residentsmedical record. Please enable scripts and reload this page. F. Delegation of Responsibilities. (1) A new nursing home shall be constructed, equipped, and maintained to protect the health and safety ofresidents,personnel, and the public. [B.] (46) Nursing service personnel means staff licensed or certified by the Maryland Board of Nursing. When no specific storage directions or limitations are provided in the individual monograph,[it is to be understood that]the storage conditionsshallinclude protection from moisture, freezing, and excessive heat. In some cases, the statutory language that requires reporting seems to contemplate the existence of a patient-provider relationship, while in others the reporting requirements apply broadly to any person, which would include members of the research team. Nursing. (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. State resources. 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 residents. Other forms of evidence may include pictures, The Maryland General Assemblys Office Masks are required inside all of our care facilities. (4) Medicine may not be returned to the container. 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[. It looks like your browser does not have JavaScript enabled. (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. (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. Updated (1) A nursing home shall be staffed with at least one registered nurse, 24 hours per day and 7 days per week. ]; [(11)](10)[Patient]Residentactivities[. B. Policies shall provide for the coordination of rehabilitative services and the rehabilitative aspects of nursing. The installation of a portable air-conditioning unit shall be approved by the: (d) If windows cannot be opened for ventilation, a central HVAC system shall be provided and maintained. E. Objective. Contents of Record. 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. (2) The nursing home shall keep poisons and medications marked for external use only separate from general medications and Schedule II drugs. (12) Exhaust Hoods. A. Controlled room temperature is a temperature maintained thermostatically between[15C and 30C (59 and 86F)]59F and 86 F or 15C and 30C. (1) In[facilities exceeding]a nursing home with more than50 beds, overall supervisory responsibilities for the[dietetic]foodservicedepartment and food productionshall be assigned to a full-time qualified dietetic service supervisor. (1)[Effective with employees hired on or after July 1, 1990, the]Thegeriatric nursing assistanttraining program[course]shall consist of 75 hours or more, and include at least 37.5 hours of classroom instruction and[not less than]at least37.5 hours of supervised clinical experience in long-term care. An evaluation of foreign education is required to complete an endorsement application (COMAR 10.27.01.09A (4). .20 Nursing ServicesDirector of Nursing. 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. (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. Mandated reporting is required when: Title 24 M.R.S. (ii) Ahand washing sink equipped with[4 inch wrist blades,]goose-neck spout,[and]separate soap dispensers,anddisposable papertowel dispensers. (2)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. ], (1) The administrator shall plan anongoing educational program[shall be planned and conducted for the development and improvement of]to develop and improve theskills of all the[facilitys]nursing homespersonnel, including training related to problems and needs of the aged, ill, and disabled. A. A. Current license from Maryland Board of Nursing or Compact State as Registered Nurse (RN). B. [B.] (iv) Be tested once a month, for at least 30 minutes under normal emergency nursing home connected load, and the test recorded in a permanent log book maintained for that purpose. COMAR 10.32.22.03B(15) covers other actions that "may constitute a violation" of the Act or other applicable laws. (2) The duty described under this section is deemed to have been discharged if the mental health care provider or administrator makes reasonable and timely efforts t. (i) Seek civil commitment of the patient; (ii) Formulate a diagnostic impression and establish and undertake a documented treatment plan calculated to eliminate the possibility that the patient will carry out the threat; or. (50) Paid feeding assistant means an individual who: (a) Meets the requirements of Regulation .58 of this chapter; and. (1) A system of water supply, plumbing, sewerage, electrical power, garbage or refuse disposal may not be installed or extended untilthe architect or professional engineer of record submits stamped and sealed final construction drawings for Department record and provisional approval in accordance with A of this regulation. Maryland Board of Nursing Minimum Requirements. hotline in the past has helped to eliminate (4) A food service floor panty shall include the following: (d) Sink for purposes other than hand washing; (e)Hand washing sink with soap dispenser and disposable paper towel dispenser; and. [(b)](c)CoolAny temperature between[8C and 15C (46 and 59F)]46F and 59F or 8C and 15. The[facility]nursing homeshall ensure that: (1)The nurse manager or the director of nursing of vent units has a background in ventilator care or is qualified in ventilator management; [(1)](2)Respiratory care services are provided by a sufficient number of qualified personnel;and. ]; [(16)](15)Tuberculosis[Surveillance. possible. When a resident has signs and symptoms of tuberculosis, a physician shall[within 48 hours]be notified to: (a) Evaluate the resident forpossibletuberculosis in a communicable form; (c) Coordinate management of the resident and the residents contacts with thelocalhealth officer. A copy of the clinical record, identification, and summary sheet described in Regulation[.20B].32shall be used as an admission record. 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. (1)Adequate refrigerated storage, refrigerators,and frozen food storage cabinets[,]shall be provided[which are]andregulated to maintain temperatures prescribed in COMAR 10.15.03[Food Service Facilities]. (2)A visible signal in the corridor above the corridor door of eachpatientsbedroom, visible from all parts of the corridor. 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. (f) Each living room forresidentsuse shall be provided with a sufficient number of reading lamps, tables, and comfortable chairs or sofas. (iii) Prevents a resident from a precipitating potential physical problem. (8) The audible signal shall be loud enough to be heard at the nurses station. address of all witnesses). If the position of director of nursing remains vacant for a period exceeding 30 days, the nursing homes license may be revoked unless the administrator and the governing body are able to demonstrate that they have made every effort to obtain a replacement. In this chapter, the following terms have the meanings indicated. (2) Working hours shall be scheduled to ensure that the[dietetic]nutritionalneeds of the[patients]residentsare met. (iii) Provideofficespace for theemployedpersonnel[employed;]to work. Each care unit shall have a nurses station provided with a medicine storage cabinet and preparation counter or table having adequate lighting overhead. 10.34.14 Opening and Closing of Pharmacies, Effective July 8, 2013. (1)If no approved public sewerage system is available, a private sewage disposal may be accepted, if approved by the Department. Therapeutic diets shall be planned, prepared, and served as prescribed by the attending physician: (1) Therapeutic diets shall be planned by alicensedregistered dietitian[or other qualified person]; (2) Preparation and serving shall be supervised by a qualified dietetic supervisor;and. [Agency Note: The following equipment is recommended: (a) Equipment to maintain food at correct temperature; (e) Ice-making machine or ice-storage container; (g) Equipment for delivery of completed trays; (h) Three-compartment sink or dishwasher; (i) Cabinet for dry storage and supplies; (j) Storage for trays, tableware, flatware, and utensils; (k) Hand washing sink with soap and towel dispenser or approved drying device. For questions or . [(3) In facilities with 25 beds or fewer, responsibility may be assigned to the full-time cook. (2) Nurses StationExisting Facility. No. (1) The nursing home shall return all prescribed medications, for residents who have been discharged or otherwise departed, to the pharmacy in accordance with the nursing homes policy. 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[. A written application shall be on file for each employee and shall containat least the: (1) Employees[social security]Social Securitynumber[.