Subtitle 07 HOSPITALS › Chapter 02 Nursing Homes

.51 Resident Bathroom Amenities. A. Bathing. (1) There shall be at least one separate room or compartment with a bathtub, shower, or other bathing device, as approved by the Department, for every 15 licensed beds. (2) The compartment shall be large enough to accommodate: (a) The …

.52 Equipment and Supplies for Bedside Care and Therapy. A. Needs of Residents. (1) There shall be sufficient equipment to meet the needs of the residents admitted. (2) The administrator shall obtain specific items required for individual cases where requested by the attending ph…

.53 Rehabilitation Facilities — Space and Equipment. A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home. B. General Requirements. (1) Space. (a) A nursing home shall provide adequate space to: (i) Receive, examine, …

.54 Dayroom and Dining Area. A. General Requirements. Resident Dining, Occupational Therapy, and Activities Program. The nursing home shall provide one or more attractively furnished areas of adequate size for resident dining, occupational therapy, and social activities. Activiti…

.55 Dietetic Service Area. A. General Requirements. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home. B. Food Service Department. (1) The size and location of the food service area shall comply with COMAR 10.15.03. (…

.56 Administrative Areas. A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home. B. Administrative Areas — New Construction. (1) A nursing home shall provide a separate room or rooms for the administrator and administr…

.57 Housekeeping Services, Pest Control, and Laundry. A. General Requirements. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home. B. Staff. Sufficient housekeeping and maintenance personnel shall be employed to mainta…

.58 Resident Care Management System. A. Each comprehensive care facility and extended care facility shall establish and maintain a resident care management system. B. The resident care management system shall consist of three related components: (1) Resident status assessment and…

.59 Resident Status Assessment. A. A nursing home shall use the following forms and procedures for resident assessment as described in the CMS Manual System, Pub. 100-07 State Operations Provider Certification and in the CMS Long-term Care Facility Resident Assessment Instrument …

.60 Care Planning. A. An interdisciplinary team shall complete or revise as necessary a resident-specific care plan for each resident within 7 calendar days following completion of assessments, including: (1) Admission assessment; (2) Annual assessment; (3) Quarterly assessment; …

.61 Skin Record. A. The facility shall establish a skin care record documenting skin, hair, and nail condition on admission, if any abnormal conditions exist. B. The staff shall document progress of the condition or conditions weekly until the condition or conditions have healed.…

.62 Geriatric Nursing Assistant Training Program. A. Nursing Home Responsibilities. (1) A nursing home shall conduct or arrange a geriatric nursing assistant training program for unlicensed personnel assigned to direct resident care duties. The Maryland Board of Nursing shall app…

.63 Paid Feeding Assistants. A. A facility may use a paid feeding assistant who has successfully completed a State-approved training course as described in §E of this regulation. B. Supervision. (1) A paid feeding assistant shall work under the supervision of a licensed nurse. (2…

.64 Quality Assurance Program. A. A nursing home shall establish an effective quality assurance program that includes components described in this regulation and Regulation .65 of this chapter. B. The nursing home shall appoint a qualified individual to manage quality assurance a…

.65 Quality Assurance Plan. A. The nursing home’s quality assurance committee shall develop and implement a quality assurance plan that includes procedures for: (1) Concurrent review; (2) Ongoing monitoring; (3) Resident complaints; (4) Accidents and incidents; and (5) Abuse and …

.66 Relocation of Residents. A. The facility shall develop and implement a written plan to provide for the smooth and orderly transfer of residents if the facility closes. B. The plan for relocation shall include: (1) A description of how residents, families, or guardians will be…

.67 Posting of Staffing. A. A nursing home shall post a notice on each floor or unit of the nursing home, for each shift, a notice that gives the ratio of licensed and unlicensed staff to residents. B. The posting on each floor shall include: (1) Names of the staff members on dut…

.68 Sanctions. A. If a deficiency exists, the Department, in addition to the sanctions set forth in this regulation and Regulations .67—.74 of this chapter, may: (1) Restrict the number of residents the nursing facility may admit in accordance with Health-General Article, §19-328…

.69 Mandated Staffing Pattern. A. When the Department determines that a deficiency or deficiencies exist, the Department shall notify the nursing facility of the deficiency or deficiencies and may either: (1) Mandate a staffing pattern which specifies the number of personnel or p…

.70 Civil Money Penalties — Imposition. A. A civil money penalty may be imposed when: (1) A deficiency exists; or (2) An ongoing pattern of deficiencies exist in a nursing facility. B. In determining whether a civil money penalty is to be imposed, the Department shall consider th…

.71 Civil Money Penalties — Amount of Penalty. A. A civil money penalty imposed under this chapter for potential for more than minimal harm deficiencies may not exceed: (1) $10,000 per instance; or (2) $1,000 per day for an ongoing pattern of deficiencies until correction of the …

.72 Civil Money Penalties — Effective Date and Duration of Penalty. A. Per Instance Civil Money Penalty. The effective date may be as early as the date that the deficiency or deficiencies upon which the civil money penalty is based first occurred. B. Per Day Civil Money Penalty. …

.73 Civil Money Penalties — Payment of Penalty/Establishment of Escrow Account. A. A civil money penalty payment is due 15 calendar days after: (1) The time period for requesting a hearing has expired and a request for hearing was not received; or (2) Receipt of a written request…

.74 Civil Money Penalties — Hearings. A. A licensee aggrieved by the imposition of a civil money penalty may appeal the action by filing a request for a hearing in accordance with State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland. B. The Secretary has the…

.75 Criminal Penalties. A. A person maintaining or operating a nursing home without 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 conviction in accordance …

.76 Emergency Suspension. A. The Secretary may immediately suspend a license on finding that the public health, safety, or welfare imperatively requires emergency action pursuant to State Government Article, §10-405(b), Annotated Code of Maryland. B. The Department shall deliver …

.77 Denial or Revocation of License. A. Denial or Revocation of License. The Secretary, for cause shown, may notify the nursing facility of the decision to revoke or deny the nursing facility's license. The denial or revocation shall be stayed if a hearing is requested. B. The De…

.78 Hearings. A. A request for a hearing shall be filed with the Office of Administrative Hearings, with a copy to the Office of Health Care Quality of the Department, not later than 30 days after receipt of notice of the Secretary's action. This request shall include a copy of t…

.79 Health Care Quality Account. A. The Department shall establish a health care quality account in the Department. B. The health care quality account shall be funded by civil money penalties paid by nursing homes. C. The Department shall use funds from the health care quality ac…

.80 Financial Disclosure. A. A licensee shall have financial resources in accordance with this regulation in order to: (1) Satisfy obligations; and (2) Ensure at all times the delivery of essential care and services, such as nursing, dietary services, or utilities. B. A licensee …