Maximum Probable Loss Vs Maximum Possible Loss, Articles M

(a) Receives treatments, medications, and diet as prescribed; (b) Receives rehabilitative nursing care as needed; (c) Receives proper care to prevent pressure ulcers and deformities; (d) Is kept comfortable, clean, and well-groomed; (e) Is protected from accident, injury, and infection; (f) Is encouraged, assisted, and trained in self-care and group activities; and. Agency Note: It is recommended that the comprehensive care facility arrange for a similar transfer agreement with an extended care facility. (c) Have attended a program of instruction in training methodologies approved by the Department. 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. The infectionprevention andcontrol program shall include the handling ofspecialmedical waste as defined in COMAR 10.06.06. (1) CMS Long-term Care Facility Resident Assessment Instrument 3.0 Users Manual, (Version 1.14, October 2016). (5) The[facility]nursing homeshall[record]: (a) Recordthe satisfactory completion of the program in each employees personnel record[. 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. A member of the facilitys staff shall be assigned responsibility for social services. (3)The nursing home shall obtain prior approval from the Department for any part of the premises to be used for tenant occupancy or for unrelated business purposes. (b) Isresponsible for the overall care of a resident. (4) A nursing homeshallscreen with wire screen or its equivalent, not less than 16 meshes per linear inch for doors and windows that provide ventilation. (g) A manometer shall be installed across each filter bed serving central air systems. Primary source equivalent: The Nursys licensure and disciplinary database is the repository of the data provided directly from New Mexico State Board of Nursing and is primary source equivalent. Please enable scripts and reload this page. SS-07, Centers for Disease Control and Prevention (CDC), Atlanta, GA). (2) Minimum Space RequirementsNew Construction. (4)For reference purposes, copies of the[patient]residentcare policies shall be readily available to all personnel responsible for[patient]residentcare. (7) The audible signal may not be turned off at the nursing station. Persons other than licensed health care providers may report suspected abuse or neglect of a vulnerable adult. (10) The orientation may not be included in the required 75 hours of the training course. In an existing nursing home, curtains or screens shall be acceptable. 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. (1)The[facility]nursing homeshall assign at least one[individualwith education and]infection preventionistthat has attendedtraining in infection surveillance, prevention, and control to[be responsible for approving actions to prevent and control infections.] Access through Table of Contents Structure (will display table of contents by Title, Subtitle & Chapter). (6) A geriatric nursing assistant[of]atthe[facility]nursing home. [It shall be the responsibility of the]. (g) All devices shall be interlocked with the fire alarm system. (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. If a comprehensive care facility is unable to effect a transfer agreement with a hospital in the community and can document its attempts to secure an agreement, the facility shall be considered to have such an agreement in effect. (2) Approval of the pattern by both the residents physician and a licensed registered dietitian. Federal regulations require that certain services be provided by a qualified social worker, the employee would have to represent themselves as a qualified social worker and thus under Maryland law, the employee would have to obtain a license to practice social work. There are currently 36 subjects and 101 Articles in the Annotated code. Provides a drop-down list of COMAR Titles, by number and Agency. (a) A residents room shall have direct access to an exit in accordance with the requirements applicable to nursing homes specified in NFPA 101 Life Safety Code. 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. [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. (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. [A.] (b) 42 CFR 494.130494.180, as amended. (b) Has completed a minimum of 15 contact hours of infection prevention and control training that is approved by the: (i) Departments Office of Infectious Disease Epidemiology and Outbreak Response; and. To ensure that the Once the complaint is received at the Board office, an (1) A nursing home shall be staffed with at least one registered nurse, 24 hours per day and 7 days per week. (3) Information regarding the residents and familys plans regarding discharge. mbon.nurselicenserenewal@maryland.gov. (c) Coordinate management of the resident and the residents contacts with the. (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. (6) Certified medicine aide means an individual who meets the requirements as stated in COMAR 10.39.01 and 10.39.03. (c) Maintenanceof an[optional]optimallevel of psychosocial functioning. A written agreement with at least one acute hospital shall be effected which shall provide for the following actions: (1) Planning to ensure that all services required for the continuity of[patient]residentcare will be made available promptly; (2) Advance discussion with the[patient]residentregarding the reason for the transfer and any available alternatives; (4) Interchange of medical and other information necessary in the care and treatment of[patients]residentstransferred between[the]facilities, including notification of the licensed pharmacist of resident transfer; [(5) Timely admission to the hospital when the attending physician determines acute hospital care is medically appropriate;]. (a)[Because specific temperatures are often required for the safe storage of drugs, the]Thestorage[facilities]facilityshall provide for the[following]conditionslisted in C(3)(b)(g) of this regulationwhen prescribed[:]. [.14-1].23Special Care Units General. (41) NFPA means National Fire Protection Association. (3) A call station shall provide readily accessible and detachable extension cords to each residents bed in the residents rooms at all times. C. Conversion of an Existing Structure. Controlled room temperature is a temperature maintained thermostatically between[15C and 30C (59 and 86F)]59F and 86 F or 15C and 30C. [.07-1].10Employee Training on Cognitive Impairment and Mental Illness. B. Licensed, (1) The licensee, if not acting as an administrator, shall appoint as administrator a responsible person who is. from civil liability.-Except as provided in subsection (b) of this section, the (a) Be issued to all assigned direct care staff; and. (2)When[the director of nursing serves]servingas relief for the administrator,[he]the director of nursingshall designate an experienced, qualified registered nurse to direct the nursing service. of Legislative Audits operates a toll-free 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. (b) Standardize communication about resident problems and conditions: (iii) Between these facilities and outside agencies. (b) Licensedby the Board of Examiners of Nursing Home Administrators for the State. (b) Laundry service shall be provided to meet the residents needs. (e) Smoke dampers shall be controlled to close automatically to prevent flow of smoke-laden air in either direction. (2)The Department shall be notified of the name of the assistant director of nursing. (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. (49) Ongoing pattern means the occurrence of any potential for more than minimal harm or greater deficiency on two consecutive on-site visits as a result of: (b) Follow-up visits and unscheduled visits; or. (h) Obtain annual approval of infection prevention and control program activities by the infection prevention and control oversight committee. The janitors closet shall be equipped for, (a) There shall be separate clean and soiled utility rooms in each nursing unit. (2) Preparation and serving shall be supervised by a qualified dietetic supervisor; At least three meals or their equivalent shall be, 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. C. Duties of the Pharmaceutical Services Committee. Third, determine if any of the specific exceptions to those reasons apply. D. Protocol. Report must be made immediately to the health officer in the county where the physician cares for the patient. (2) The director of nursing shall obtain approval from the Department. immediately give the required information to the institution head/designee. (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. The following procedures are to be used when admitting an individual with a communicable disease into a nursing facility: (1) A facility may not deny admissions to, or involuntarily discharge, an individual solely because the individual has a communicable disease; (2) Any facility that intends to accept an individual with a communicable disease shall notify the Department before admitting the individual; and, (3) The Secretary or a designee of the Secretary may prohibit a facility from accepting an individual with a communicable disease if it is determined that admitting the individual with a communicable disease could pose a risk to the health, safety, or welfare of any other resident or individual associated with the facility.]. However, the nursing home would need to contract with a licensed social worker to provide oversight. These extension cords shall be readily accessible topatientsat all times. Featured Programs: Sponsored School(s) Sponsored School(s) All school search, finder, or match results, as well as colleges and universities displayed as . The minimum requirements are: (1)A call station or stations providing detachable extension cords to eachpatientsbed in the patientsrooms. A. 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. (6) Assistingresidentsto adjust to their disabilitiesandensuring availability anduseoftheir prosthetic and assistive devices. (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. Bedsareto be placed so that all sides of the bed are at least 18 inches from heating units. The[goal]goalsshall be realistic, practical, and tailored to the residents needs. F. Retention and Preservation of Records. B. (2) Renovations ofexistingkitchens shall be approved by the Department which will consider modification of the minimum space requirement based on space available, costs, and type of service. (3) Menus shall include alternatives of similar nutritive value that give residents the opportunity to choose meals that they prefer. This table refers to the pressure relationships and ventilation of certain areas of a nursing home other than chronic disease hospitals. (1)If no approved public sewerage system is available, a private sewage disposal may be accepted, if approved by the Department. Would you know your responsibility as a nurse and mandated reporter if you suspected a patient . Order forms can be downloaded from the Division of State Documents . (2)Progress notesrelated to rehabilitative servicesshall be written at least every 2 weeks. 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. (ii) The soiled area shall allow for sorting and washing soiled laundry. Hot water temperatures in laundries shall conform to applicable standards of the International Fabric Care Institute for laundry water supply. If the employee refuses to be immunized, the facility shall document the refusal and the reason for the refusal.] (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. In new construction,]Administrative AreasNew Construction. The]initiate a written socialhistory,whichshall be as complete as possible and shall include: (1) Social data about personal and family background to provide understanding of the[patient]residentand how[he]the residentfunctions;[and], (2) Information regarding current personal and family circumstances and attitudes as they relate to[patients]the residentsillness and care[. 272, April 1995 and Transmittal No. (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. (d) Be protected to prevent the entry and harborage of rodents and insects; (i) Screen doors that fit tightly when closed; (ii) Easily adjusted closely fitted window screens; (f) Effectively protect all openings to the outside against the entry of insects by: [C. Laundries-New Facilities. C. Call SystemNew Construction. The facility shall make information available to all employees concerning other conditions in which pneumococcal vaccine may be of benefit for certain other underlying medical conditions. A. Required: immunity (b)The janitors closet shall be equipped for[handwashing]hand washing. (j) If applicable, lighting in toilet rooms of the common area of refuge. Professional specialty certifications may be required, in accordance with departmental standards or role . Appropriate provisions shall be made for emergency auxiliary heat by means of alternate sources of electric power, alternate fuels, or standby equipment. (i) There shall be a physical separation between the clean and soiled areas. (e) Windows shall be provided with shades or draperies adequate to control glare and maintain privacy. (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. (f) Except for trays that are assembled in the main kitchen and then distributed to the nursing care units, equipment to hold hot food if bulk foods are plated and served to the residents on the nursing care unit. The basic nursing curriculum covers two academic years, is approved by the Maryland Board of Nursing, and is accredited by the National League for Nursing Accrediting Commission. Other forms of evidence may include pictures, (c) The nursing home shall provide heated toilet rooms adjacent to the common areas of refuge. Maryland Reporting Obligations that May Apply to Investigators or Other 100-07 State Operations Provider Certification (Transmittal 126, November 26, 2014, U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services); (3) 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents Healthcare Settings (Centers for Disease Control and Prevention (CDC), Healthcare Infection Control Practices Advisory Committee (HIPAC), 2007); (4) Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005 (MMWR2005; 54, No. The Maryland Board of Nursing requires written, verified evidence of completion of the appropriate education requirements in accordance with Md. Mandated Reporters - Maryland Department of Human Services ; (16) Require that unless the supervisor is a licensed registered dietitian, they shall receive regularly scheduled consultation from a licensed dietician; (17) Specifying that during admission, a resident may not be accepted unless at least one service to meet the rehabilitative needs of the resident can be initiated within the 48-hour period; (18) Allowing for the provision of a waiver of general requirements for bedrooms in long term care facilitiesboth for newly constructed bedrooms and already-existing bedrooms; and. No. (2)There shall be an allowance of at least 12 square feet per[ambulatory patient]resident[;this]. (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. Please enable JavaScript in your browser. 10.07.02 [Comprehensive Care Facilities and Extended Care Facilities]Nursing Homes, Authority: Health-General Article, 19-308, 19-308.1, 19-323, and 19-1401 et seq. (d) At least quarterly, submit a report to the pharmaceutical services committee on the status of the nursing homes pharmaceutical services and staff adherence to policies and procedures. [.07].09Administration and Resident Care. If you typed in the word submeters the Search feature would take you to the same Subtitle. (c) All laundry shall be processed and handled in a manner that prevents the spread of infections. A person maintaining or operating a nursing[facility]homewithout a license is guilty of a misdemeanor, and, on conviction, is liable for a fine of not more than $1,000 for the first offense and not more than $10,000 for each subsequent convictionin accordance with Health-General Article, 19-358, Annotated Code of Maryland. 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. [B.] The Maryland General Assemblys Office Financial Help With My Gas and Electric Bill, How to Buy an Energy-Efficient Home Appliance, Search on a word or phrase, or enter the codification number, Access through Table of Contents Structure. (7) The call system shall enable residents in the rehabilitation area to summon rehabilitation staff. The interdisciplinary team shall incorporate resident input into the care plan. The quality assurance plan shall include: (3) Procedures to take action when there is a change in the residents condition,including: (a) Communicating changes to the director of nursing or the residents attending physician; and, (b) Changing the residents plan of care as necessary; and. (1)When the director of nursing is absent, the individual shall designate an experienced, qualified registered nurse to direct the nursing service. On October 28, 2016, the Department of Health and Mental Hygiene ("DHMH") published its final regulations regarding hospitals' and certain other health care facilities' obligations to report certain actions involving physicians, allied health providers and naturopathic doctors. (2) Existing Facility. The additional cost to hire or contract with a licensed social worker is estimated to be $11,000 annually. 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. D. A federally certified nursing home shall: (1) Encode assessment data as specified in the CMS Long-term Care Facility Resident Assessment Instrument 3.0 Users Manual; and. This brings you back to the 20.25.01 General Regulations we found in Search Option 1. (4)Spacefor Storage of Linen[New Construction and Existing Facilities]. B. The dietary preferences of a resident shall be ascertained, including preferences arising from a residents religious, cultural, and ethnic heritage, and efforts shall be made to meet those preferences. (b) On request, provide the resident with copies of the residents medical records at a reasonable cost and in the residents preferred format. customers, and stakeholders with One public drinking fountainor comparable equipment as preapproved by the Departmentshall be provided[one]oneach floor, usablefrom a wheelchair. (2) Additional registered nurses, licensed practical nurses, and support personnel shall be employed to meet the needs of all the residents admitted. The frequently asked questions (FAQs) and answers set out here address mandatory reporting by certain entities of occurrences regarding health care providers. G. Appropriate Care of Residents. (2)All clinical information pertaining to a[patients]residentsstay shall be centralized in the[patients]residentsmedical record. accessible and convenient, and J. (32) Licensed graduate social worker (LGSW) means an individual authorized to practice graduate social work under Health Occupations Article, Title 19, Annotated Code of Maryland. (3)The relief director of nursing shall be freed from other responsibilities. (2)To the extent medically possible, the[current]Recommended Dietary Allowancesof the Food and Nutrition Board[of the], Commission on Life Sciences, andNational Research Council[, National Academy of Sciences], adjusted for age, sex, and activity,shall be observed. (2) The[facility]nursing homeshall take appropriate infectionprevention andcontrol[steps]measuresto prevent the transmission of[a communicable]an infectiousdisease to residents, employees, and visitors as outlined in the following guidelines: (a)2007Guideline for Isolation Precautions:Preventing Transmission of Infectious Agentsin[Hospitals]HealthcareSettings; and. copies of patient (55) Plan of correction means a written response from the nursing home addressing each deficiency cited as a result of an inspection by the Department. The medical director is responsible for: (2) Monitoring and evaluating thehealth care services andoutcomes[of the health care], including clinical and physician services provided to the[facilitys]nursing homesresidents; and. 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. Exceptions[may], such as in a culture change setting,shallbe[made only upon]based onthe written approval of the Department. If the physician so orders, patients who have a tendency to wander may be confined to their rooms by screen doors or folding gates. See Regulation .21G of this chapter for tuberculosis surveillance requirements.] (b) Maintained and applied by trained staff. Attn: Director of Complaints & Investigations. These areas may be reduced to 35 percent for all-outdoor air systems. (13) The licensee shall prepare an executive summary of the nursing homes evacuation procedures to provide to a resident, family member, or residents representative upon request. (2) A facility with more than 120 beds must employ a qualified social worker on a full-time basis. The nature of the threat; 2. (3) At least one nourishment pantry convenient to the nursing station shall be provided on each floor in facilities using a centralized food service system. Annapolis, MD. 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.