<?xml version='1.0' encoding='utf-8'?>
<subtitle article="ghg" title_number="19" subtitle_number="4B" title_name="Health Care Facilities" subtitle_name="Nursing Referral Service Agencies">
  <section article="ghg" article_name="Health - General" number="19-4B-01" title_number="19" title_name="Health Care Facilities" subtitle_number="4B" subtitle_name="Nursing Referral Service Agencies">
    <level label="a">
      <text>In this subtitle the following words have the meanings indicated.</text>
    </level>
    <level label="b">
      <text>“Background check” has the meaning stated in § 19-1901 of this title.</text>
    </level>
    <level label="c">
      <text>“Care provider” means an individual who provides health care services and assistance to a client in the activities of daily living, including:</text>
      <level label="1">
        <text>Bathing, toileting, and personal hygiene;</text>
      </level>
      <level label="2">
        <text>Dressing;</text>
      </level>
      <level label="3">
        <text>Meal preparation and eating;</text>
      </level>
      <level label="4">
        <text>Companionship; and</text>
      </level>
      <level label="5">
        <text>Assistance in physical transfer and ambulation.</text>
      </level>
    </level>
    <level label="d">
      <text>“Central Repository” means the Criminal Justice Information System Central Repository of the Department of Public Safety and Correctional Services.</text>
    </level>
    <level label="e">
      <text>“Home health aid services” means personal and health care services delivered to a client by a care provider.</text>
    </level>
    <level label="f">
      <text>“License” means a nursing referral service agency license.</text>
    </level>
    <level label="g">
      <text>“Licensed health professional” means an individual who is licensed or certified under the Health Occupations Article to provide health care services.</text>
    </level>
    <level label="h">
      <text>“Nursing referral service agency” means one or more individuals engaged in the business of screening and referring, directly or in accordance with contractual arrangements that may include independent contractors, licensed health professionals or care providers to clients for the provision of nursing services, home health aid services, or other home health care services at the request of the client.</text>
    </level>
    <level label="i">
      <text>“Private agency” has the meaning stated in § 19-1901 of this title.</text>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="19-4B-02" title_number="19" title_name="Health Care Facilities" subtitle_number="4B" subtitle_name="Nursing Referral Service Agencies">
    <text>This subtitle does not limit the right of any person who holds a license under this article to act as authorized by that license.</text>
  </section>
  <section article="ghg" article_name="Health - General" number="19-4B-03" title_number="19" title_name="Health Care Facilities" subtitle_number="4B" subtitle_name="Nursing Referral Service Agencies">
    <level label="a">
      <level label="1">
        <text>A nursing referral service agency may receive a fee or other compensation for providing its services.</text>
      </level>
      <level label="2">
        <text>A contractual arrangement may provide that a nursing referral service agency is not responsible for paying any part of the compensation to the licensed health care professionals or care providers that the nursing referral service agency screens or refers to clients.</text>
      </level>
      <level label="3">
        <text>A nursing referral service agency may provide administrative assistance.</text>
      </level>
    </level>
    <level label="b">
      <text>A nursing referral service agency shall:</text>
      <level label="1">
        <text>Obtain a license from the Department prior to operating as a nursing referral service agency;</text>
      </level>
      <level label="2">
        <text>Develop and implement a procedure to screen licensed health professionals and care providers that includes the following:</text>
        <level label="i">
          <text>In accordance with subsection (c) of this section:</text>
          <level label="1">
            <text>A State criminal history records check; or</text>
          </level>
          <level label="2">
            <text>A private agency background check;</text>
          </level>
        </level>
        <level label="ii">
          <text>Verification of current licensure or certification under the Health Occupations Article;</text>
        </level>
        <level label="iii">
          <text>A basic health screening, including a tuberculosis screening;</text>
        </level>
        <level label="iv">
          <text>Verification of references;</text>
        </level>
        <level label="v">
          <text>Verification of employment history;</text>
        </level>
        <level label="vi">
          <text>Completion of I-9 forms; and</text>
        </level>
        <level label="vii">
          <text>An in-person interview of a licensed health professional and care provider before any referral of the individual is made to a client;</text>
        </level>
      </level>
      <level label="3">
        <text>Institute an internal client complaint investigation process that includes:</text>
        <level label="i">
          <text>Notice to the client or client’s representative of the complaint process; and</text>
        </level>
        <level label="ii">
          <text>Protocols to investigate complaints;</text>
        </level>
      </level>
      <level label="4">
        <text>Provide notice to clients of the Department’s complaint hotline number for complaints about the services provided by an individual referred by the nursing referral service agency; and</text>
      </level>
      <level label="5">
        <text>Allow clients to accept or reject, at their discretion, any licensed health professional or care provider referred by the nursing referral service agency.</text>
      </level>
    </level>
    <level label="c">
      <level label="1">
        <text>For each licensed health professional and care provider, a nursing referral service agency shall:</text>
        <level label="i">
          <text>Apply to the Central Repository for a State criminal history records check; or</text>
        </level>
        <level label="ii">
          <text>Request a private agency to conduct a background check.</text>
        </level>
      </level>
      <level label="2">
        <level label="i">
          <text>As part of the application for a criminal history records check, the nursing referral service agency shall submit to the Central Repository:</text>
          <level label="1">
            <text>Two complete sets of legible fingerprints of the licensed health professional or care provider taken on forms approved by the Director of the Central Repository; and</text>
          </level>
          <level label="2">
            <text>The fee authorized under § 10-221(b)(7) of the Criminal Procedure Article for access to Maryland criminal history records.</text>
          </level>
        </level>
        <level label="ii">
          <text>In accordance with §§ 10-201 through 10-228 of the Criminal Procedure Article, the Central Repository shall forward to the licensed health professional or care provider and the nursing referral service agency a printed statement listing the criminal convictions of the licensed health professional or care provider.</text>
        </level>
        <level label="iii">
          <text>Information obtained from the Central Repository under this subsection:</text>
          <level label="1">
            <text>Is confidential and may not be redisseminated; and</text>
          </level>
          <level label="2">
            <text>May be used only for the screening purpose authorized by this subsection.</text>
          </level>
        </level>
        <level label="iv">
          <text>The subject of a criminal history records check under this subsection may contest the contents of the printed statement issued by the Central Repository as provided in § 10-223 of the Criminal Procedure Article.</text>
        </level>
      </level>
      <level label="3">
        <text>If a nursing referral service agency requests a private agency to conduct a background check:</text>
        <level label="i">
          <text>The private agency shall:</text>
          <level label="1">
            <text>Conduct a background check in each state in which the nursing referral service agency knows or has reason to know the licensed health professional or care provider worked or resided during the past 7 years; and</text>
          </level>
          <level label="2">
            <text>Issue a statement of its findings to:</text>
          </level>
          <level label="A">
            <text>On request, the licensed health professional or care provider; and</text>
          </level>
          <level label="B">
            <text>The nursing referral service agency; and</text>
          </level>
        </level>
        <level label="ii">
          <text>The licensed health professional or care provider shall have an opportunity to contest the findings.</text>
        </level>
      </level>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="19-4B-04" title_number="19" title_name="Health Care Facilities" subtitle_number="4B" subtitle_name="Nursing Referral Service Agencies">
    <level label="a">
      <level label="1">
        <text>The Department shall adopt regulations to implement the requirements of this subtitle.</text>
      </level>
      <level label="2">
        <text>The regulations may not preclude a nursing referral service agency from operating with independent contractors.</text>
      </level>
    </level>
    <level label="b">
      <text>The Department shall issue a license to a nursing referral service agency after the nursing referral service agency completes an application for licensure.</text>
    </level>
    <level label="c">
      <text>The Department may suspend or revoke a license issued under this section if the nursing referral service agency is operating in violation of the requirements of this subtitle.</text>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="19-4B-05" title_number="19" title_name="Health Care Facilities" subtitle_number="4B" subtitle_name="Nursing Referral Service Agencies">
    <level label="a">
      <text>An individual may not operate or engage in, or attempt to operate or engage in, or hold one’s self out as operating or engaging in the business of a nursing referral service agency unless the individual is licensed under this subtitle.</text>
    </level>
    <level label="b">
      <level label="1">
        <text>An individual who violates this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $1,000 for the first offense and not exceeding $10,000 for any subsequent offense.</text>
      </level>
      <level label="2">
        <text>Each day a violation is continued after the first conviction is a separate offense.</text>
      </level>
    </level>
  </section>
  <section article="ghg" article_name="Health - General" number="19-4B-06" title_number="19" title_name="Health Care Facilities" subtitle_number="4B" subtitle_name="Nursing Referral Service Agencies">
    <text>For the purposes of any other provision of law, the granting of a license under this subtitle does not constitute a finding of any fact on which the granting of the license was based and may not give rise to any presumption regarding the existence of any fact on which the granting of the license was based.</text>
  </section>
</subtitle>