Maryland Administrative Code

.03 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Department” means the Maryland Department of Health. (2) “Facility” means an intermediate care facility for individuals with intellectual disabilities or persons with rela…

.04 Licensing Procedure. A. A person shall be licensed by the Secretary before the person may operate a facility in the State. B. An applicant for a license shall: (1) Submit to the Secretary an application: (a) In the form and manner prescribed by the Secretary on the written or…

.05 Standards of Operation. A. General. Whether or not a facility participates in Medicare or Medicaid, the facility shall meet the requirements set forth in 42 CFR § 483.400 et seq., which is incorporated by reference. B. Safety and Sanitation. The facility, its grounds, fixture…

.06 Tuberculosis Screening. A. An employee or volunteer may be certified as required in Regulation .05D(3) in one of the following four ways: (1) If the individual has documentation of a negative tuberculin test by the Mantoux method within the past 24 months and has, by history,…

.07 Inspections. A. The Department shall inspect each facility at least annually to determine compliance with these regulations. B. A licensed facility and any facility applying for a license shall be open to inspection by the Department at all times.

.01 Scope and Purpose. This chapter applies to any general or limited hospice care program as defined in Health-General Article, §19-901, Annotated Code of Maryland.

.02 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Attending physician” means the physician having the most significant role in the determination and delivery of the hospice patient's medical care. (2) Bereavement Services…

.03 License Required. A. A person may not operate or represent itself as operating a hospice care program in this State, without first obtaining a license from the Secretary. B. Section A of this regulation applies to a home health agency, hospital, related institution, or other …

.04 Application Procedure. A. Before a person may apply for a license to operate a general hospice care program, the person shall obtain a certificate of need from the Maryland Health Resources Planning Commission under Health-General Article, Title 19, Annotated Code of Maryland…

.05 Inspection by the Department. A. A licensee, or a program seeking licensure under this chapter, shall be open at all times to inspection by the Department, and any agency designated by the Secretary, to conduct an inspection. B. The Department may: (1) Periodically inspect a …

.06 Administration. A. Responsibility of Licensee. A licensee shall ensure that the operation of the hospice care program complies with Health-General Article, Title 19, Subtitle 9, Annotated Code of Maryland, and this chapter. B. Governing Body. (1) A licensee shall have a gover…

.07 Policies and Procedures. The hospice care program shall adopt and implement written policies and procedures for: A. The use of advance directives; B. Identifying, reviewing, and discussing ethical dilemmas which arise in the care of patients and family; C. The use of specific…

.08 Personnel. A. The hospice care program shall maintain sufficient health care professionals and volunteers to meet patient care needs. B. The hospice care program shall identify an interdisciplinary care team with responsibility for ensuring continuous assessment of the patien…

.09 Quality Assurance. A. The governing body shall ensure that the hospice care program conducts ongoing quality assurance and utilization review. B. Quality Assurance Program. The governing body shall assure that the hospice care program develops and implements a quality assuran…

.10 The Interdisciplinary Plan of Care. A. The interdisciplinary team shall develop a written plan of care for each patient and family. The plan of care shall reflect current standards of practice. The hospice care program shall document the attending physician's participation in…

.11 Continuity of Care. A. The hospice care program shall coordinate care to ensure continuity of care for the patient and family. B. Any changes in service delivery are to be based on an assessment of the patient's and family's needs and desires for hospice services and a hospic…

.12 Transfer or Discharge. A. If the hospice care program does not provide inpatient hospice services directly, the hospice care program shall have a written transfer agreement with a hospice care program which provides those services. B. The hospice care program shall provide ad…

.13 Physician Services. A. Medical Director. The hospice care program shall have a medical director who shall be: (1) A physician licensed to practice medicine in this State; and (2) Knowledgeable about the psychosocial and medical aspects of hospice care. B. Medical Director Dut…

.14 Nursing Services. A. Nursing services shall be provided by licensed or certified personnel, trained or experienced in hospice care and supervised by a registered nurse with training or experience in hospice nursing. All nursing services shall be provided in accordance with th…

.15 Ancillary Services. A. The hospice care program shall have a written plan for the provision of pharmacy, laboratory, radiology, chemotherapy, and other ancillary services. When the service is provided by an organization other than the hospice care program, the hospice care pr…

.16 Counseling Services. A. Counseling Services. The hospice care program shall provide counseling services which address the needs of patients and families. The hospice care program shall provide counseling services as set forth in §§B—E of this regulation. B. Social Work Servic…

.17 Emergency Services. A. The hospice care program shall ensure that emergency services are available 24 hours per day, 7 days a week. B. Emergency services are to include, at a minimum: (1) Registered nurse and physician services; (2) Palliative medications; and (3) Other servi…

.18 Volunteer Services. A. The hospice care program's volunteer services shall play a vital role in enhancing the quality of care delivered to the patient and family by encouraging community participation in the overall hospice care program. B. Volunteers may assist with patient …

.19 Medical Records. A. The hospice care program shall establish and maintain a clinical record for each patient in accordance with accepted principles of practice for maintaining medical records. The record is to be complete, accurately documented, readily accessible, and system…

.20 Patient's Representative. A. A hospice care program 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 o…

.21 Patient's Rights. A. The hospice care program shall provide the patient or representative with a written notice of the patient's rights in advance of furnishing care. Documentation verifying receipt of and understanding of this information shall be included as part of the pat…

.22 Complaint Procedure. A. A hospice care program shall establish a procedure under which a patient or family member may make a complaint to a representative of the hospice care program. B. The hospice care program shall investigate and seek to resolve the complaint. C. The hosp…

.23 Infection Control. A. The hospice care program shall have an infection control program in all care settings. B. There is to be a written plan for identifying, preventing, and controlling the spread of infection, which includes: (1) Identifying an individual responsible for im…

.24 Safety and Emergency Preparedness. A. The hospice care program shall have a safety and emergency preparedness program that includes, at a minimum: (1) A plan for reporting, monitoring, and following up on all accidents, injuries, and safety hazards; (2) Education for patient …

.25 Home-Based Hospice Care Provided in a Licensed Health Care Facility. A. Professional Management. (1) When a hospice care program delivers hospice care to a resident of a licensed health care facility, the hospice care program shall assume full responsibility for professional …

.26 Inpatient Hospice Care. A. In addition to the other requirements of this chapter, when a hospice care program delivers inpatient care, the hospice care program shall provide nursing services 24 hours a day in a manner sufficient to meet the total nursing needs identified in t…

.27 Penalties. A. Administrative Penalty. (1) The Secretary may, for noncompliance with any regulation under this chapter, impose an administrative penalty of up to: (a) $500 for a first violation; and (b) $1,000 for a subsequent repeated violation. (2) When considering whether t…

.28 Hearings. A. A request for a hearing shall be filed with the Office of Administrative Hearings, with a copy to the Licensing and Certification Administration of the Department, not later than 30 days after receipt of notice of the Secretary's action. The request shall include…

.01 Scope and Purpose. A. This chapter is effective January 1, 2014. B. This chapter applies to all general hospice care programs that operate a hospice house. C. An operator of a hospice house shall also comply with all the requirements contained in COMAR 10.07.21 that are appli…

.02 Definitions. A. In addition to the definition contained in §B of this regulation, definitions set forth in COMAR 10.07.21.02 are applicable to this chapter. B. Terms Defined. (1) “Hospice house” means a residence operated by a Maryland licensed general hospice care program th…

.03 Incorporation by Reference. In this chapter, the following document is incorporated by reference: NFPA 101, The Life Safety Code, as adopted by the State Fire Prevention Commission in COMAR 29.06.01.

.04 License Required. A person may not operate a hospice house without first obtaining a license to operate a general hospice care program.

.05 Staffing Plan. A. Following an analysis of the number of beds the hospice house intends to serve and the individual needs of each resident, the general hospice care program shall develop a staffing plan that identifies the type and number of staff needed to provide the servic…

.06 Management of the Hospice House. A. The administrator of the general hospice care program shall identify a manager of the hospice house who has full responsibility for the day-to-day operations of the hospice house. B. The administrator shall evaluate the manager’s performanc…

.07 Staff Qualifications. A. The hospice house shall be staffed by sufficient numbers of personnel to ensure that the hospice house is capable of meeting the requirements of this chapter, and all applicable federal, State, and local laws and regulations. B. In addition to meeting…

.08 Admission Requirements. A hospice patient appropriate for care in their own home who does not require general inpatient services may be eligible for care in a hospice house, in accordance with the hospice house admission policy.

.09 Residential Agreement. A. Patients admitted to the hospice house or their representatives shall sign, before or at the time of admission, a patient agreement that: (1) Is a clear and complete statement of commitments agreed to by the parties and the services provided in the h…

.10 Patient Record. The hospice house shall: A. Maintain the privacy and confidentiality of a patient’s medical records; B. Release medical records or medical information about a patient only with the consent of the patient or patient’s representative, or as permitted by Health-G…

.11 Food. A. A patient’s food preferences shall be assessed at the time of admission. The assessment shall be maintained in the patient record. B. Patients shall be provided meals and snacks as requested. C. Patients shall be offered 3 meals and additional snacks during each 24-h…

.12 Personal Care Services. The hospice house staff shall provide all necessary personal care services to the patient in accordance with the plan of care and as desired by the patient.

.13 Medication Management and Administration. A. All medications shall be administered consistent with applicable requirements of COMAR 10.27.11. B. Medications and treatments shall be administered consistent with current medical orders and using acceptable professional standards…

.14 Incident Reports. A. The staff of the hospice house shall complete an incident report in accordance with hospice policy within 24 hours of having knowledge that an incident has occurred. B. All incident reports shall include: (1) Time, date, place, and individuals present; (2…