Maryland Administrative Code

.09 Referral and Reporting Health Care Practitioners. A. An agency may not knowingly provide or refer a heath care practitioner to render temporary services who is not authorized under Health Occupations Article, Annotated Code of Maryland, to practice their profession in Marylan…

.10 Civil Money Penalties — Imposition. A. The Department may impose a civil money penalty if a deficiency exists. B. In determining whether a civil money penalty is to be imposed, the Department shall consider the following factors: (1) The number, nature, and seriousness of the…

.11 Civil Money Penalties — Amount of Penalty. A. A civil money penalty imposed under this chapter for a first offense may not exceed: (1) $2,500 for each instance of violation; or (2) $2,500 per day until correction of the deficiency or deficiencies has been verified and complia…

.12 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 on which the civil money penalty is based first occurred. B. Per-Day Civil Money Penalty. (1…

.13 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, if a request for a hearing has not been received; or (2) Receipt of a written …

.14 Civil Money Penalties — Hearings. 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.

.15 Emergency Suspensions. 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, §10-226(c), Annotated Code of Maryland. B. The Department shall deliver…

.16 Denial or Revocation of License. A. Denial or Revocation of License. The Secretary, for cause shown, may notify the agency of the decision to revoke or deny the license. Except as provided in Regulation .15 of this chapter, the denial or revocation shall be stayed if a hearin…

.17 Hearings. A. An agency shall file a request for a hearing with the Office of Administrative Hearings, with a copy to the Office of Health Care Quality of the Department, not later than 30 calendar days after receipt of notice of the Secretary's action. This request shall incl…

.01 Scope. A. The treatment and care of emotionally disturbed children and adolescents are of great concern to various State agencies including the Maryland Department of Health, Department of Human Services, Maryland State Department of Education and Department of Juvenile Justi…

.02 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Accreditation organization” means a private entity that conducts inspections and surveys of health care facilities based on nationally recognized and developed standards. …

.03 License Requirements. A. License Required. A person may not establish, conduct, maintain, or operate in the State a center without first obtaining a license from the Secretary. B. Separate License Required. Centers maintained on separate premises shall obtain separate license…

.04 Licensing Procedure. A. Application. Applicants shall conform to the following: (1) An applicant desiring to open or to continue the operation of an existing center shall file with the Secretary, on a written or electronic form provided by the Secretary: (a) The name of the a…

.05 Denial or Revocation of License. A. The Secretary shall deny a license to a person who has been convicted of a felony that relates to Medicaid or to a nursing home. B. The Secretary shall revoke the license of any licensee convicted of a felony that relates to Medicaid or to …

.06 Inspection. Open to Inspection. A center licensed under this chapter and any premises proposed to be operated by an applicant for a license shall be open at all reasonable times to inspection by: A. The Secretary or designee; B. The Department of Human Services; C. The Maryla…

.07 New Construction or Alteration. A. Submission of Plans. Plans shall be submitted to the Secretary before construction or alterations begin affecting its functional structure or normal bed capacity. These plans shall have the prior approval of local zoning authorities and the …

.08 Physical Plant. A. Construction. A new building designated as a residential treatment center and any existing building proposed for conversion for this use shall meet the following: (1) The construction of the building shall prevent the entrance and harborage of rats and othe…

.09 Fire Regulations. A center shall be free from fire hazards and shall comply with all applicable local fire and building codes and the safety requirements of the National Fire Protection Association, NFPA 101 “Life Safety Code”, which is incorporated by reference at COMAR 29.0…

.10 General Requirements. A. Cleanliness and Maintenance. The following shall be observed: (1) The building and all its parts and facilities shall be kept in good repair, neat, and attractive. The safety and comfort of the residents shall be the first consideration. (2) All walls…

.11 Food Services. A. Dietary Requirements. The following minimum requirements shall be observed: (1) A minimum of three meals in each 24 hour period shall be served. In addition, nutritious between meal and bedtime snacks should be offered to all residents no less than 1-1/2 to …

.12 Management Requirements. A. Responsibility. The licensee is responsible for conformance with licensing regulations. B. Responsible Person. The licensee or administrator appointed by the licensee and all persons in supervisory or other responsible positions shall be 21 years o…

.13 Health Services. A. Supervision of Treatment Program. Treatment at any center shall be under the direction of a qualified psychiatrist who is responsible for the adequacy, quality, and appropriateness of the treatment program for each resident. There shall be sufficient profe…

.14 Staffing Requirements. A. The administrator shall employ sufficient and qualified personnel to ensure adequate treatment and care of the residents and the maintenance, cleaning, and housekeeping. B. The staff shall be sufficient in number so that the individual needs of resid…

.15 Accommodations. A. Usable Living Space Needed. (1) Each center shall provide at least 35 square feet of usable floor space per resident, in addition to bedroom space, in order to meet minimal requirements for dining, living, and recreational facilities. (2) A minimum of 80 sq…

.16 Restraints and Seclusion. The use of restraints and seclusion shall be in compliance with 42 CFR §§483.352—483.376 Condition of Participation for the Use of Seclusion and Restraint in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services For In…

.17 Complaint Investigations. A. Notwithstanding any other provision of this chapter, residential treatment centers shall be open to inspections by the Department to investigate and resolve any complaint concerning: (1) Resident care; (2) Safety; (3) Medical and nursing supervisi…

.18 Reports. A. The center shall furnish to the Secretary reports covering the following: (1) Deaths, serious injuries, or unusual incidents, including suicide attempts, by no later than the close of business of the next business day following the event; and (2) Any occurrences w…

.19 Civil Money Penalties. A. Civil Money Penalties. The Secretary may impose a civil money penalty on a person if: (1) The person maintains or operates an unlicensed center; or (2) A serious or life-threatening patient care deficiency exists and the center fails to correct the d…

.20 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…

.21 Notifications. A. Within 24 hours of an event or change in condition and in accordance with State and federal confidentiality laws, a center shall attempt to notify a resident and a resident’s representative, family member, legal guardian, or custodian of: (1) A change in the…

.22 Resident Rights. A. The center shall post the list of resident rights in areas of the center where the residents can read the posting. A resident of a residential treatment center has the right to: (1) Be treated with respect; (2) Have their cultural spiritual, personal belie…

.01 Purpose. The purpose of this chapter is to establish minimum standards for licensure of residential service agencies that conduct business in Maryland. Cross References 10.07.05.17B 10.07.05.18A 10.07.05.19A

.02 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Activities of daily living” means normal daily activities including: (a) Eating or being fed; (b) Grooming, bathing, oral hygiene including brushing teeth, shaving, and co…

.03 License Required. A. A person, partnership, corporation, association, or other entity may not conduct or operate an agency in this State without first obtaining a license from the Secretary and complying with the regulations of this chapter. B. An agency that provides only ho…

.04 Licensing Procedures. A. Application for License. (1) To obtain and maintain a license, an applicant shall meet all of the requirements of: (a) This chapter; and (b) Other applicable federal, State, and local laws and regulations. (2) An applicant shall submit: (a) An applica…

.05 Changes in an Agency That Affect the Operating License. A. Change of Services or Name. (1) During the licensure period, a licensee may not: (a) Provide services for which it has not been approved to provide; or (b) Change the name under which the program is doing business wit…

.05-1 Special Requirements for the Provision of Home Medical Equipment Services. A. A provider of home medical equipment services shall meet the requirements of this regulation in addition to meeting the requirements of Regulations .02—.03 of this chapter. B. An agency shall: (1)…

.06 Public Representation. A. An agency shall include the following information in all of the agency’s advertising and marketing materials: (1) The agency’s license number; and (2) The statement “Licensed as a residential service agency by the Maryland Department of Health, Offic…

.07 Inspection by the Department. A. Residential Service Agency to be Open for Inspection. (1) The Department or its designee may conduct announced or unannounced licensure inspections or complaint investigations to ensure compliance with the requirements of this chapter. (2) The…

.08 Administration. A. Governing Authority. (1) The agency shall have a governing authority. (2) The governing authority shall: (a) Convene at least annually with management staff to review and advise the agency on policies; and (b) Keep minutes, including: (i) The participants o…

.09 Complaint Process. A. Internal Complaint Process. An agency shall institute an internal client complaint process that includes: (1) Notice to the client or the client representative of the complaint process; (2) Protocols to investigate complaints; and (3) A mechanism for the…

.10 Employee, Independent Contractor, and Contractual Employee Requirements. A. An agency shall develop and implement policies and procedures to screen a prospective employee, independent contractor, or contractual employee who will provide services to clients. B. Screening. (1) …

.11 Training. A. An agency shall ensure that individuals that are referred are trained appropriately to provide care that is needed by the agency’s clients. B. Sources other than the agency may provide training, as approved in writing by the Office of Health Care Quality. C. At a…

.12 Services Provided. A. An agency shall take reasonable measures to ensure that all individuals who are referred to provide services to clients do so in accordance with Maryland laws and regulations, including but not limited to the Health Occupations Article, Annotated Code of…

.13 Client Representative. A. An agency shall recognize the authority of: (1) A guardian of the person under Estates and Trusts Article, §13-705, Annotated Code of Maryland; (2) A guardian of the property under Estates and Trusts Article, §13-201, Annotated Code of Maryland; (3) …

.14 Clinical Records. A. With the exception of §B of this regulation, an agency shall ensure that a clinical record is maintained for each client in a manner that ensures security and confidentiality, and includes at a minimum: (1) The documentation required by §D of this regulat…

.15 Maintenance of Records. A. The agency shall maintain a client’s record for 5 years after the client is discharged. For a client younger than 18 years old, the agency shall maintain the client’s record after discharge until the resident is 21 years old, or for 5 years after th…