Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 07 - HOSPITALS
Chapter 10.07.02 - Nursing Homes
Section 10.07.02.09 - Administration and Resident Care
Universal Citation: MD Code Reg 10.07.02.09
Current through Register Vol. 51, No. 19, September 20, 2024
A. Responsibility.
(1) The licensee shall be
responsible for the overall conduct of the comprehensive care facility or
extended care facility and for compliance with applicable laws and
regulations.
(2) The administrator
shall be responsible for the implementation and enforcement of all provisions
of the Patient's Bill of Rights Regulations under COMAR 10.07.09.
B. Delegation to Administrator.
(1) The licensee, if not acting as an
administrator, shall appoint as administrator a responsible person who is:
(a) Qualified by training and experience;
and
(b) Licensed by the Board of
Examiners of Nursing Home Administrators for the State.
(2) The administrator shall:
(a) Be responsible for the control of the
operation on a 24-hour basis; and
(b) With the exception of §B(3) of this
regulation, serve full-time.
(3) With the Department's approval, an
administrator may serve on a less than full-time basis for a maximum of two
nursing facilities, one of which shall have a licensed capacity of 35 beds or
fewer.
(4) The Department shall
consider the following factors when deciding whether to approve an
administrator to serve on a less than full-time basis:
(a) Geographic location of the
facilities;
(b) Ownership of the
facilities;
(c) Organizational
structure of the facilities;
(d)
Size of the facilities; and
(e)
Background and experience of the administrator.
C. Absence of Administrator.
(1) In the absence of the administrator, the
nursing home at all times shall be under the direct and personal supervision of
an experienced, trained, competent employee.
(2) When serving as relief for the
administrator, the director of nursing shall designate an experienced,
qualified registered nurse to direct the nursing service.
(3) The relief director of nursing shall be
freed from other responsibilities.
D. Excessive Absenteeism of Administrator.
(1) If the director of nursing's absence
while covering for the administrator is having an adverse effect on resident
care, the Department may require the designation of a specific registered nurse
who shall be named the assistant director of nursing.
(2) The Department shall be notified of the
name of the assistant director of nursing.
(3) When the designee is replaced, the
Department shall be notified of the name of the registered nurse filling the
vacancy.
E. Character. The administrator shall:
(1) Be of good moral
character;
(2) Be in good physical
and mental health; and
(3)
Demonstrate a genuine interest in the well-being and welfare of residents in
the nursing home.
F. Staffing.
(1) The administrator shall employ
sufficient and satisfactory personnel as specified in this chapter to:
(a) Provide maintenance, cleaning, and
housekeeping;
(b) Assist residents
with eating; and
(c) Give adequate
resident care.
(2)
Voluntary Admissions Ceiling.
(a) A nursing
home may request a voluntary admissions ceiling by submitting a written request
to the Department to authorize a temporary restriction on resident admissions
based upon anticipated bed usage.
(b) When the nursing home wishes to request
that the restriction be removed, the request shall include the specific
effective date and a statement that personnel staffing is sufficient to meet
the State's requirements at the designated census level.
(c) The Department shall approve the increase
in beds within 72 hours following receipt of the nursing home's documentation
that the required additional staff is in position to serve the increased number
of beds.
(d) Management of the
nursing home may not permit the resident census to exceed the admissions
ceiling without prior approval from the Department.
G. Educational Program.
(1) The administrator shall plan an ongoing
educational program to develop and improve the skills of all the nursing home's
personnel, including training related to problems and needs of the aged, ill,
and disabled.
(2) The administrator
shall maintain records reflecting attendance, by name and title, and training
content.
(3) In-service training
shall include at least:
(a) Prevention and
control of infections;
(b) Fire
prevention programs and resident related safety procedures in emergency
situations or conditions;
(c)
Accident prevention;
(d)
Confidentiality of resident information;
(e) Preservation of resident dignity,
including protection of the resident's privacy and personal and property
rights;
(f) Physical, functional,
and psychosocial needs of the aged ill individuals;
(g) Receipt by each employee of appropriate
orientation to the facility and its policies, and to the employee's position
and duties;
(h) Approval by the
Department of the orientation and training programs.
H. Employment Records. A written application shall be on file for each employee and shall contain at least the:
(1) Employee's Social Security
number;
(2) Home address;
(3) Educational background;
(4) Past employment documentation with
references;
(5) Past nursing home
employment documentation, including any past instances of abuse of residents,
theft, and fires;
(6) Verified
licensure of personnel employed; and
(7) Proof of criminal background
check.
I. Support Personnel.
(1) To support placement in a
specific position, there shall be sufficient documentation in the employee's
record reflecting training and experience.
(2) In instances when an aide is to be
assigned to a particular service such as dietary, physical therapy, or
occupational therapy, the person in charge of the service shall be responsible
for evaluating and approving or disapproving the qualifications.
J. New Support Personnel.
(1) New support personnel shall be credited
for 50 percent of their working time until the employee's orientation program,
as approved by the Department, is completed.
(2) Employee Orientation Program.
(a) New support personnel shall have an
employee orientation program.
(b)
The person in charge of the service to which the employee is assigned shall:
(i) Have input into the contents of the
orientation program;
(ii) Determine
the number of hours of orientation required for the various levels of support
personnel; and
(iii) Following the
period of orientation, indicate whether the employee satisfactorily completed
the orientation program.
(3) The responsible department's approval
shall be in writing, signed by the appropriate department head whose license
number, if applicable, shall be recorded in the record.
(4) In new facilities, the director of
nursing and supervisors of dietary services, housekeeping, rehabilitation
services, and social services shall be responsible for orienting the new
support personnel to the nursing home policies and procedures and to the
physical plant.
(5) There shall be
a complete orientation for all the employees in life safety and disaster
preparedness.
(6) The number of
daily admissions of residents shall be controlled to allow sufficient time for
on-the-job training.
(7) Before the
opening of the nursing home, support personnel shall have a minimum of 2 days
of orientation training.
K. Relief Personnel. Provision shall be made for qualified relief personnel during vacations or other relief periods.
L. Availability of Information. The administrator shall make available to the Secretary such information as may be requested to insure that the facility is meeting the requirements of these and other applicable regulations.
M. Except where inappropriate for safety reasons, an employee and any other individual who provides a health care service within or on the premises of the nursing home shall wear a personal identification tag that:
(1) States the name
of the individual;
(2) States the
profession or other title of the individual; and
(3) Is in a readily visible type font and
size.
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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