Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES
Chapter 10.05.04 - Freestanding Kidney Dialysis Centers
Section 10.05.04.06 - Personnel
Universal Citation: MD Code Reg 10.05.04.06
Current through Register Vol. 52, No. 6, March 21, 2025
A. Medical Director.
(1) The medical director shall:
(a) Be a nephrologist or other physician with
at least 12 months experience in the treatment of patients requiring chronic
hemodialysis;
(b) Be responsible
for the development of patient care policies; and
(c) Provide medical guidance in the provision
of patient care.
(2) If
the medical director is not available to provide medical guidance, the
administrator shall ensure the availability of an alternate physician with the
same qualifications of the medical director as specified in §A(1)(a) of
this regulation.
B. Charge Nurse. The charge nurse shall be a registered nurse with training in the provision of kidney dialysis services and at least 6 months experience in a dialysis center.
C. Dialysis Monitoring.
(1) Staffing Ratio.
(a) In-Center Daytime Hemodialysis. When
in-center daytime hemodialysis is performed, the monitoring
individual-to-patient ratio at each center shall be:
(i) A minimum of one staff member to three
participants; and
(ii) Sufficient
to meet the needs of patients.
(b) In-Center Nocturnal Hemodialysis. When
in-center nocturnal hemodialysis is performed, the monitoring
individual-to-patient ratio at each center for in-center nocturnal hemodialysis
shall be:
(i) A minimum of one staff member to
five participants; and
(ii)
Sufficient to meet the needs of the patients.
(c) The center shall establish provisions for
back-up staff coverage during unexpected illnesses, vacations, and
holidays.
(d) The charge nurse may
not be included in the staffing ratio except:
(i) When there are nine or fewer patients;
or
(ii) In the event of an
emergency.
(2) Staffing Exception Reporting.
(a) The center shall have a staffing
exception reporting protocol in a format approved by the Department for
reporting to the governing body when emergency staffing situations arise that
require the charge nurse to be included in the staffing ratio. The report shall
include, at a minimum:
(i) The date and shift
of the exception;
(ii) A
description of the emergency staffing situation;
(iii) Actions taken in response;
and
(iv) Any measures taken to
ensure the center's future compliance.
(b) The exception reporting protocol shall be
included in the center's quality assurance process.
(c) The staffing exception reports shall be
made available to the Office of Health Care Quality and the Commission on
Kidney Disease when they are conducting an inspection or survey of the center
to assure compliance with §C(1) of this regulation.
(3) Monitoring individuals shall be trained
in dialysis procedures and may be a:
(a)
Physician;
(b) Physician
assistant;
(c) Registered
nurse;
(d) Licensed practical
nurse; or
(e) Certified nursing
assistant - dialysis technician.
D. The kidney dialysis center shall also provide dietetic and social work services and consultation by individuals with experience or training in caring for dialysis and transplant patients sufficient to meet the needs of patients.
Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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