Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 07 - HOSPITALS
Chapter 10.07.14 - Assisted Living Programs
Section 10.07.14.46 - Emergency Preparedness
Universal Citation: MD Code Reg 10.07.14.46
Current through Register Vol. 51, No. 19, September 20, 2024
A. The facility shall comply with:
(1) All applicable
local fire and building codes; and
(2) The Life Safety Code, NFPA 101, including
Chapter 24 of NFPA 101 if the facility is a one or two family dwelling as
defined by NFPA 101.
B. Fire Extinguishers. An assisted living program shall:
(1) Ensure that fire extinguishers are:
(a) Located on each floor and adjacent to, or
in, special hazard areas, such as:
(i)
Furnace rooms;
(ii) Boiler
rooms;
(iii) Kitchens; or
(iv) Laundries;
(b) Of standard and approved types;
and
(c) Installed and maintained to
be conveniently available for use at all times; and
(2) Initially and at least annually instruct
staff in the use of fire extinguishers.
C. Emergency and Disaster Plan.
(1) The assisted living program shall develop
an emergency and disaster plan that includes procedures that shall be followed
before, during, and after an emergency or disaster, including:
(a) Evacuation, transportation, or shelter
in-place of residents;
(b)
Notification of families and staff regarding the action that will be taken
concerning the safety and well-being of the residents;
(c) Staff coverage, organization, and
assignment of responsibilities for ongoing shelter in-place or evacuation,
including identification of staff members available to report to work or remain
for extended periods; and
(d) The
continuity of services, including:
(i)
Operations, planning, financial, and logistical arrangements;
(ii) Procuring essential goods, equipment,
and services to sustain operations for at least 72 hours;
(iii) Relocation to alternate facilities or
other locations; and
(iv)
Reasonable efforts to continue care.
(2) The licensee shall have a tracking system
to locate and identify residents in the event of displacement, an emergency, or
a disaster that includes at a minimum the:
(a)
Resident's name;
(b) Time that the
resident was sent to the initial alternative facility or location;
and
(c) Name of the initial
alternative facility or location where the resident was sent.
(3) When the assisted living
program relocates residents, the program shall send a brief medical fact sheet
with each resident that includes at a minimum the resident's:
(a) Name;
(b) Medical condition or diagnosis;
(c) Medications;
(d) Allergies;
(e) Special diets or dietary restrictions;
and
(f) Family or legal
representative contact information.
(4) The brief medical fact sheet for each
resident described in §C(3) of this regulation shall be:
(a) Updated upon the occurrence of change in
any of the required information;
(b) Reviewed at least monthly; and
(c) Maintained in a central location readily
accessible and available to accompany residents in case of an emergency
evacuation.
(5) The
licensee shall review the emergency and disaster plan at least annually and
update the plan as necessary.
(6)
The licensee shall:
(a) Identify a facility,
facilities, or alternate location or locations that have agreed to house the
licensee's residents during an emergency evacuation; and
(b) Document an agreement with each facility
or location.
(7) The
licensee shall:
(a) Identify a source or
sources of transportation that have agreed to safely transport residents during
an emergency evacuation; and
(b)
Document an agreement with each transportation source.
(8) Upon request, a licensee shall provide a
copy of the facility's emergency and disaster plan to the local emergency
management organization for the purpose of coordinating local emergency
planning. The licensee shall provide the emergency and disaster plan in a
format that is mutually agreeable to the local emergency management
organization.
(9) The licensee
shall identify an emergency and disaster planning liaison for the facility and
shall provide the liaison's contact information to the local emergency
management organization.
(10) The
licensee shall prepare an executive summary of its evacuation procedures to
provide to a resident, family member, or legal representative upon request. The
executive summary shall, at a minimum:
(a)
List means of potential transportation to be used in the event of
evacuation;
(b) List potential
alternative facilities or locations to be used in the event of
evacuation;
(c) Describe means of
communication with family members and legal representatives;
(d) Describe the role of the resident, family
member, or legal representative in the event of an emergency situation;
and
(e) Notify families that the
information provided may change depending upon the nature or scope of the
emergency or disaster.
D. Evacuation Plans. The facility shall conspicuously post individual floor plans with designated evacuation routes on each floor.
E. Orientation and Drills.
(1) The licensee shall:
(a) Orient staff to the emergency and
disaster plan and to their individual responsibilities within 24 hours of the
commencement of job duties; and
(b)
Document completion of the orientation in the staff member's personnel file
through the signature of the employee.
(2) Fire Drills.
(a) The assisted living program shall conduct
fire drills at least quarterly on all shifts.
(b) Documentation. The assisted living
program shall:
(i) Document completion of each
drill;
(ii) Have all staff who
participated in the drill sign the document; and
(iii) Maintain the documentation on file for
a minimum of 2 years.
(3) Semiannual Disaster Drill.
(a) The assisted living program shall conduct
a semiannual emergency and disaster drill on all shifts during which it
practices evacuating residents or sheltering in-place so that each is practiced
at least one time a year.
(b) The
drills may be conducted via a table-top exercise if the program can demonstrate
that moving residents will be harmful to the residents.
(c) Documentation. The assisted living
program shall:
(i) Document completion of each
disaster drill or training session;
(ii) Have all staff who participated in the
drill or training sign the document;
(iii) Document any opportunities for
improvement as identified as a result of the drill; and
(iv) Keep the documentation on file for a
minimum of 2 years.
(4) The licensee shall cooperate with the
local emergency management agency in emergency planning, training, and drills
and in the event of an actual emergency.
F. Emergency Electrical Power Generator.
(1) Generator Required. By October 1, 2009,
an assisted living program with 50 or more residents shall have an emergency
electrical power generator on the premises, unless the program meets the
requirements of §F(7) of this regulation.
(2) Generator Specifications. The power
source shall be a generating set and prime mover located on the program's
premises with automatic transfer. The emergency generator shall:
(a) Be activated immediately when normal
electrical service fails to operate;
(b) Come to full speed and load acceptance
within 10 seconds; and
(c) Have the
capability of 48 hours of operation of the systems listed in §F(5) of this
regulation from fuel stored on-site.
(3) Test of Emergency Power System.
(a) The program shall test the emergency
power system once each month.
(b)
During testing of the emergency power system, the generator shall be exercised
for a minimum of 30 minutes under normal emergency facility connected
load.
(c) Results of the test shall
be recorded in a permanent log book that is maintained for that
purpose.
(d) The licensee shall
monitor the fuel level of the emergency generator after each test.
(4) The emergency power system
shall provide lighting in the following areas of the facility:
(a) Areas of egress and protection as
required by the State Fire Prevention Code and Life Safety Code 101 as adopted
by the State Fire Prevention Commission;
(b) Nurses' station;
(c) Drug distribution station or unit dose
storage;
(d) An area for emergency
telephone use;
(e) Boiler or
mechanical room;
(f)
Kitchen;
(g) Emergency generator
location and switch gear location;
(h) Elevator, if operable on emergency
power;
(i) Areas where life support
equipment is used;
(j) If
applicable, common areas or areas of refuge; and
(k) If applicable, toilet rooms of common
areas or areas of refuge.
(5) Emergency electrical power shall be
provided for the following:
(a) Nurses' call
system;
(b) At least one telephone
in order to make and receive calls;
(c) Fire pump;
(d) Well pump;
(e) Sewerage pump and sump pump;
(f) If required, for evacuation purposes an
elevator;
(g) If necessary, heating
equipment needed to maintain a minimum temperature of 70°F (24°C) in
all common areas or areas of refuge;
(h) Life support equipment; and
(i) Nonflammable medical gas
systems.
(6) Common
Areas or Areas of Refuge. If the emergency power system does not provide heat
to all resident rooms and toilet rooms, the program shall provide common areas
or areas of refuge for all residents. The areas shall meet the following
requirements:
(a) The common area or areas of
refuge shall maintain a minimum temperature of 70°F (24°C);
(b) Heated toilet rooms shall be provided
adjacent to the common areas or areas of refuge; and
(c) The program facility shall provide to the
Department a written plan that defines the:
(i) Specified common areas or areas of
refuge;
(ii) Paths of egress from
the common areas or areas of refuge; and
(iii) Provision for light, heat, food
service, and washing and toileting of residents.
(7) Applicability of Emergency
Power Requirements.
(a) Within 36 months of
the effective date of this chapter, existing programs with 50 or more beds
shall complete the installation and acceptance of a working system as required
in this regulation.
(b) An assisted
living program shall be exempt from the requirements of §F of this
regulation if the program can safely transfer residents through an enclosed
corridor to a building that is equipped with an electrical power generator that
satisfies the requirements of §E of this regulation.
(c) An assisted living program may request a
waiver from the requirements of §F of the regulation in accordance with
the procedures outlined in COMAR
10.07.14.08B on a
year-to-year basis. The program shall demonstrate in the waiver request
financial hardship that would adversely affect the program's
viability.
(d) When the Department
grants a waiver to an assisted living program for the requirements of §F
of this regulation, the assisted living program shall:
(i) Disclose in writing to current and
prospective residents that the program does not have an emergency generator;
and
(ii) Develop a plan to follow
in the event of a loss of electrical power.
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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