Maryland Administrative Code

.19 Special Requirements for the Provision of Home Medical Equipment Services. A. An agency that provides home medical equipment services shall meet the requirements of this regulation in addition to meeting the requirements of Regulations .01—.16 of this chapter. B. Education an…

.20 Sanctions. A. If the Secretary determines that an agency has violated this chapter, the Secretary, in addition to the sanctions set forth in Regulations .21—.27 of this chapter may: (1) Restrict the number of clients the agency may serve; (2) Limit the types of clients an age…

.21 Civil Money Penalties. A. The Secretary may impose a civil money penalty on an agency if a deficiency or continuing pattern of deficiencies exists in the residential service agency. B. In determining whether a civil money penalty will be imposed, the Secretary shall consider …

.22 Amount of Civil Money Penalties. A. A civil money penalty imposed on a person under this chapter may not exceed $10,000 per instance or, as provided in Regulation .21 of this chapter, $1,000 per day. B. In setting the amount of the civil money penalty under this chapter, the …

.23 Civil Money Penalties — Hearings. A. A hearing on the appeal shall be held consistent with State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland. B. The Secretary shall have the burden of proof with respect to the imposition of the civil money penalties u…

.24 Emergency Suspension. A. The Secretary may immediately suspend a license on finding that the public health, safety, or welfare imperatively requires emergency action B. The Department shall deliver a written notice to the licensee: (1) Informing the licensee of the emergency …

.25 Denial or Revocation of a License. The Secretary, for cause shown, may deny, revoke, or refuse to reissue any license issued for inability or failure to comply with the regulations of this chapter. This action is subject to the provisions of the Administrative Procedure Act, …

.26 Notice to Clients. Unless otherwise ordered by the Secretary, the agency shall notify each competent client and each client representative within at least 30 days of: A. Any significant change of licensure status; B. A voluntary surrender of its agency license; or C. Denial, …

.27 Penalty for Unlicensed Operation. A person that operates a residential service agency without a license may be assessed a civil money penalty by the Department not to exceed $10,000 per violation and, additionally, is guilty of a misdemeanor and, on conviction, is subject to …

.28 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, not later than 30 days after receipt of notice of the Secretary’s action. The request shall include a copy of the Secretary’…

.01 Purpose. The purpose of this chapter is to provide a safe environment for patients by requiring hospitals to: A. Identify adverse events; B. Encourage reporting of near-misses; C. Assess and prioritize near-misses and adverse events based on level of disability or potential d…

.02 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Action plan” means a written document that includes: (a) Specific measures to correct problems or areas of concerns; (b) Specific measures to address areas of system impro…

.03 Patient Safety Program. A. General. On or before March 15, 2004, a hospital shall have in effect a patient safety program that meets the requirements of this chapter. B. Duties of the Hospital. (1) The hospital shall identify an individual as patient safety coordinator who sh…

.04 Near-Miss and Adverse Event Reporting and Determination of Appropriate Response. A. The hospital shall develop and encourage a supportive environment that permits spontaneous identification, open discussion, and timely and accurate reporting of near-misses and adverse events.…

.05 Procedures for Level 1 and 2 Adverse Events and Certain Near-Misses. A. When a level 1 or 2 adverse event, or a near-miss that warrants a root cause analysis occurs, the hospital shall: (1) Provide immediate care to the patient; (2) Identify any immediate corrective action to…

.06 Root Cause Analysis. A. The hospital shall appoint an interdisciplinary root cause analysis team that shall include: (1) Individuals who have knowledge of the event or near-miss; (2) Representatives of hospital leadership; and (3) Individuals with expertise in the subject mat…

.07 Procedures for Level 3 Adverse Events and Certain Near-Misses. A. If the event is not a level 1 or 2 event or a near-miss that warrants a root cause analysis, the hospital shall conduct an evaluation of the event to determine any problem area and corrective action. B. All eve…

.08 Information Sharing. The patient safety program shall require that the quality assurance and other medical review committees share information and take any appropriate action concerning near-misses and adverse events.

.09 Reports to the Department. A. A hospital shall report any level 1 adverse event to the Department within 5 days of the hospital's knowledge that the event occurred. B. A hospital shall submit the root cause analysis and action plan for the level 1 adverse event to the Departm…

.10 Documentation. Actions taken by the quality assurance and medical staff credentialing and peer review committees shall be documented in committee minutes.

.11 Patient Complaint Program. A. In accordance with this regulation, the patient safety program shall include a formal written program for addressing patient complaints. B. The hospital shall provide patients with information regarding the hospital's patient complaint program in…

.12 Interhospital Notification Of Level 1 or Level 2 Adverse Events. A. A hospital that admits a patient with a condition resulting from a level 1 or level 2 adverse event that the hospital perceives may be related to care that was provided at another Maryland hospital and that a…

.13 Records. The hospital shall maintain records that document the operation of its patient safety program.

.14 Documentation. A. On or before March 15, 2004, the hospital shall send to the Secretary a written description of its patient safety program that includes: (1) The name of the patient safety coordinator; (2) The board policy statement relevant to patient safety activities incl…

.15 Plan of Correction. A. If the Department notifies a hospital that the patient safety program of the hospital does not meet the requirements of this chapter, the hospital shall submit a plan indicating the steps the hospital shall take to meet the requirements of this chapter.…

.16 Penalties. If a hospital fails to have in effect a patient safety program in accordance with this chapter, then the Secretary may impose on the hospital the following penalties: A. Revocation of the hospital's license; or B. A fine of $500 for each day that the hospital is in…

.17 Departmental Obligations. The Department shall: A. Provide feedback to hospitals regarding submitted root cause analyses within 60 days of receipt; and B. Release an annual public report containing a compilation of de-identified data regarding the type and outcomes of reporte…

.01 Purpose. The purpose of this chapter is to set minimum standards for licensure of nursing referral service agencies in Maryland. This chapter does not preclude a nursing referral service agency from operating with independent contractors.

.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) Bathing, toileting, and personal hygiene; (b) Dressing; (c) Meal preparation and eating; (d) Compa…

.03 License Required. A. A person, partnership, corporation, association, or other business entity may not conduct, operate, or maintain a nursing referral service agency in this State before being licensed by the Secretary. B. This chapter does not limit the right of any person …

.04 Licensing Procedures. A. Application for License. (1) A person desiring to conduct, operate, or maintain a nursing referral service agency in this State shall file an application with the Secretary, on the written or electronic form provided by the Secretary. (2) The applicat…

.05 Posting Of License. A nursing referral service agency shall post its license conspicuously onsite so that it is clearly visible to the general public.

.06 Restrictions on a License. A. A licensee may not, under any circumstances, transfer or reassign its nursing referral service agency license to another person. B. If the agency ceases to operate for any reason, the license is void and the licensee shall immediately return the …

.07 Inspections by the Secretary of Health. A. An applicant or a licensee shall maintain records to support compliance with this chapter and ensure that all records are open to inspection by the Department. B. An applicant or a licensee shall assist the Department in conducting a…

.08 Administration. A. Contractual Arrangements. The regulations of this chapter do not preclude a nursing referral service agency from operating with independent contractors. B. Agency Referrals. An agency shall: (1) Develop and implement policies and procedures to screen licens…

.09 Sanctions. A. The Secretary may deny, suspend, revoke, or refuse to reissue any license for inability or failure to comply with this chapter. Any action taken to deny, suspend, or refuse to issue a license is subject to provisions of the Administrative Procedure Act, State Go…

.10 Penalty for Unlicensed Operation. A person that operates a nursing referral services agency without a license is guilty of a misdemeanor, and on conviction is subject to a fine not exceeding $1,000 for the first offense and $10,000 for each subsequent offense. Each day that a…

.01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Accredited hospital” means a hospital accredited by the Joint Commission on Accreditation of Healthcare Organizations. (2) “ACEP” means the American College of Emergency P…

.02 Incorporation by Reference. A. In this chapter, the following documents are incorporated by reference. B. Documents Incorporated. (1) Interhospital Transfer Guidelines Manual; Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland (January 2002). (2) A…

.03 Restrictions. A freestanding medical facility may not use the name “emergency room”, “emergency department”, or “hospital” in its title or advertisements or on any signage.

.04 Licensure Application Procedure. A. A hospital may not establish, operate, or continue to operate an existing freestanding medical facility without first obtaining a license from the Secretary. B. A hospital desiring to establish a freestanding medical facility shall apply to…

.05 Renewal of License. A. A licensee shall file an application for license renewal with the Secretary on a written or electronic form provided by the Secretary. B. A licensed freestanding medical facility shall apply for licensure within 60 days of the expiration date of its cur…

.06 Inspections. A. A freestanding medical facility shall be open to inspection at all times by the Department for annual licensure surveys, revisit surveys, and complaint investigations. B. Licensure Standards. When conducting a licensure or complaint survey, the Department shal…

.07 Waiver. A. Facilities that are providing services on or before February 12, 2007, but do not meet all requirements of this chapter, may request a waiver of specific requirements from the Department. B. All other freestanding medical facilities seeking a waiver from this chapt…

.08 Affiliated Hospitals. A. The freestanding medical facility shall be reviewed under the affiliated hospital's accreditation by the Joint Commission on Accreditation of Healthcare Organizations. B. The governing body of the affiliated hospital shall provide administrative and c…

.09 Treatment of Patients. Regardless of a patient's medical condition, insurance status, or ability to pay, the freestanding medical facility shall provide stabilizing treatment to a patient presenting with an emergency medical condition.

.10 Personnel. A. Administrative Director. The freestanding medical facility shall have a full-time administrative director who: (1) Acts as a liaison with the affiliated hospital; (2) Directs the daily operation of the facility; and (3) Ensures that employees are capable of prov…