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<section article="ghg" article_name="Health - General" number="19-3B-03" title_number="19" title_name="Health Care Facilities" subtitle_number="3B" subtitle_name="Freestanding Ambulatory Care Facilities">
  <level label="a">
    <level label="1">
      <text>After consultation with representatives of payors, health care practitioners, and freestanding ambulatory care facilities, the Secretary shall by regulation establish:</text>
      <level label="i">
        <text>Procedures to implement the provisions of this subtitle; and</text>
      </level>
      <level label="ii">
        <text>Standards to ensure quality of care and patient safety that shall include:</text>
        <level label="1">
          <text>Procedures for credentialing and practitioner performance evaluation;</text>
        </level>
        <level label="2">
          <text>Qualifications of health care practitioners and support personnel;</text>
        </level>
        <level label="3">
          <text>Procedures to be followed in the event of an emergency, including a requirement that in the event of an emergency the patient be transported to the nearest appropriate emergency care facility;</text>
        </level>
        <level label="4">
          <text>Procedures for quality control of any biomedical equipment;</text>
        </level>
        <level label="5">
          <text>Procedures for postoperative recovery;</text>
        </level>
        <level label="6">
          <text>Procedures for discharge;</text>
        </level>
        <level label="7">
          <text>Procedures for ensuring that an anesthesia practitioner is not precluded from providing the highest level of anesthesia support that may be required to safely treat patients undergoing procedures in a freestanding ambulatory surgical facility performed in a nonsterile procedure room or a sterile operating room;</text>
        </level>
        <level label="8">
          <text>The use of ultrasound imaging in a freestanding birthing center;</text>
        </level>
        <level label="9">
          <text>Minimum perinatal care standards for a freestanding birthing center that meet or exceed the Maryland Perinatal System Standards that a freestanding birthing center shall meet as a condition of licensure; and</text>
        </level>
        <level label="10">
          <text>Any other procedures that the Secretary considers necessary for quality of care and patient safety.</text>
        </level>
      </level>
    </level>
    <level label="2">
      <text>The procedures for practitioner performance evaluation required under paragraph (1)(ii)1 of this subsection shall include a review of care provided to patients at the freestanding ambulatory care facility by members of the medical staff.</text>
    </level>
    <level label="3">
      <text>The review of care shall:</text>
      <level label="i">
        <text>Be undertaken for cases chosen at random and for cases with unexpected adverse outcomes;</text>
      </level>
      <level label="ii">
        <text>Be based on objective review standards;</text>
      </level>
      <level label="iii">
        <text>Include a review of the appropriateness of the plan of care for the patient, particularly any medical procedures performed on the patient, in relation to the patient’s condition; and</text>
      </level>
      <level label="iv">
        <text>Except as provided in paragraph (4) of this subsection, be conducted by at least two members of the medical staff who:</text>
        <level label="1">
          <text>As appropriate, are of the same specialty as the member of the medical staff under review; and</text>
        </level>
        <level label="2">
          <text>Have been trained in the freestanding ambulatory care facility’s policies and procedures regarding practitioner performance evaluation.</text>
        </level>
      </level>
    </level>
    <level label="4">
      <text>A review of the care provided by a member of the medical staff who is a solo practitioner shall be conducted by an external reviewer.</text>
    </level>
    <level label="5">
      <text>A freestanding ambulatory care facility shall take into account the results of the practitioner performance evaluation process for a member of the medical staff in the reappointment process.</text>
    </level>
  </level>
  <level label="b">
    <text>If appropriate certification by Medicare is available, obtaining the certification shall be a condition of licensure for:</text>
    <level label="1">
      <text>An ambulatory surgical facility; and</text>
    </level>
    <level label="2">
      <text>A kidney dialysis center.</text>
    </level>
  </level>
  <level label="c">
    <text>Each freestanding ambulatory care facility shall provide assurances satisfactory to the Secretary that the freestanding ambulatory care facility does not discriminate against patients, including discrimination based on ability to pay for nonelective procedures.</text>
  </level>
  <level label="d">
    <text>The Secretary may delegate to the Kidney Disease Commission the Secretary’s authority under § 19–3B–07 of this subtitle to inspect kidney dialysis centers.</text>
  </level>
  <level label="e">
    <level label="1">
      <text>Except as provided in paragraph (2) of this subsection, the Department shall survey freestanding ambulatory care facilities in accordance with federal regulations.</text>
    </level>
    <level label="2">
      <text>The Department shall survey each freestanding birthing center at least once per calendar year.</text>
    </level>
  </level>
</section>
