Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 07 - HOSPITALS
Chapter 10.07.02 - Nursing Homes
Section 10.07.02.38 - Reports and Action Required in Unusual Circumstances
Universal Citation: MD Code Reg 10.07.02.38
Current through Register Vol. 51, No. 19, September 20, 2024
A. Serious Emotional Disturbances. A facility may not accept or keep patients who destroy property or are dangerous to themselves or others, or who have acute symptoms of mental illness.
B. Action to Be Taken if a Patient Becomes Actively Disturbed. The following action shall be taken:
(1) If a patient becomes actively disturbed,
the personal physician shall be notified immediately.
(2) A restraint may be used only if all of
the following conditions are met:
(a) Failure
to use a restraint or restraints is likely to endanger the health or safety of
the patient or others;
(b) There is
a written physician's order for the use of the restraint or restraints, which
shall comply with the following requirements:
(i) The physician's written order for the
restraint or restraints shall be for a specified maximum period of time, not to
exceed 24 hours.
(ii) The necessity
for the use of the restraint or restraints shall be documented, and
(iii) The frequency of patient observations
by licensed personnel on not less than an hourly basis during the period of
time that the restraint or restraints or the effects of the restraint or
restraints are present shall be indicated;
(c) Appropriate documentation by licensed
personnel shall be recorded in the clinical record;
(d) The facility may not re-impose a
restraint or restraints except upon the written order of a physician who has
personally observed the patient since the previous restraint or restraints
order was imposed.
(3) A
restraint or restraints may not be ordered PRN.
(4) If a physician is not immediately
available, a registered nurse may authorize the use of a physical restraint or
restraints for a period not to exceed 4 hours in any 30-day period. Licensed
personnel shall observe the patient hourly. The patient shall be seen by a
physician if the restraint or restraints are to be applied for more than the
initial 4-hour period.
C. Unusual Occurrences.
(1) The administrator of the nursing home
shall immediately report to the local health department and the Department the
occurrence of:
(a) Infectious
disease;
(b) Poisoning;
(c) Internal emergency or disaster;
(d) External emergency or disaster,
(e) Any symptomatic condition of importance
to public health that affects the nursing home; or
(f) Any other serious occurrence that
threatens the welfare, safety, or health of any resident.
(2) The administrator of the nursing home
shall be responsible for ensuring that appropriate procedures and reporting are
carried out for all reportable infections. An occurrence of a confirmed or
suspected infection shall be reported and acted on in accordance with COMAR
10.06.01 and COMAR 10.15.03.
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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