Title 10 — Subtitle 05. Freestanding Ambulatory Care Facilities

A felony that relates to Medicaid or Medicare, or

A crime involving moral turpitude; or

As appropriate, are of the same specialty as the member of the medical staff under review; and

Have been trained in the freestanding ambulatory care facility’s policies and procedures regarding practitioner performance evaluation.

Birthing services that are licensed or accredited as a unit of a hospital; or

The private residence of the patient.

Noncompliance with this chapter;

Serious injury, harm, or death; and

The need for immediate action.

Board certification in a specialty that provides services for pregnant and postpartum patients; or

Appropriate experience in the care of pregnant and postpartum patients; and

Physician;

Certified nurse midwife; or

Licensed certified midwife.

The patient or the patient’s designee, if the patient chooses;

A registered nurse;

A physician;

A nurse practitioner or physician assistant treating the patient for ESRD;

A social worker; and

A dietitian; and

Be 21 years old or older;

Possess a high school diploma or a high school equivalency diploma and have experience to conduct the responsibilities specified in §B(2) of this regulation;

Have at least 1 year of dialysis experience; and

Have no criminal conviction or other criminal history that indicates behavior that is potentially harmful to patients, documented through either a criminal history records check or a criminal background check completed within 1 month before employment.

Infection control;

Principles of dialysis;

Water treatment;

Reuse;

Data collection and quality assurance;

Emergency procedures;

Fiscal operations, including business management and personnel;

Regulations; and

Policies and procedures.

Implementing the facility's policies and coordinating the provision of services that the facility provides;

Organizing and coordinating the administrative functions of the facility;

Establishing procedures for the accountability of those personnel involved in patient care;

Familiarizing the staff with the facility's policies and procedures, and with applicable federal, State, and local laws and regulations;

Participating in the development, negotiation, and implementation of agreements or contracts into which the facility enters;

Participating in the development of organizational and fiscal planning for the facility;

Implementing and evaluating, under the direction of the clinical team, the patient care plan and the long-term care program for each patient; and

Informing patients of the availability of emergency services.

Administrator-in-training curriculum, including course outline and supporting materials;

Center's requirements for individuals who are selected to participate in the administrator-in-training program; and

Protocols in place that assure that the approval of the waiver will not adversely affect the quality of care received by patients.

Inspect the kidney dialysis center; or

Confer with the governing body.

The administrator-in-training program sufficiently meets the requirements of this regulation; and

A waiver will not adversely affect patients.

The Department shall issue and mail to the licensee a final written decision regarding a waiver request submitted under this regulation within 45 days from receipt of the request.

If the Department grants a waiver, the written decision shall include the waiver's duration and any conditions imposed by the Department.

Reviewed by staff at least annually and are revised as necessary; and

Available at all times for staff inspection and use; and

A minimum of one staff member to three participants; and

Sufficient to meet the needs of patients.

A minimum of one staff member to five participants; and

Sufficient to meet the needs of the patients.

When there are nine or fewer patients; or

In the event of an emergency.

The date and shift of the exception;

A description of the emergency staffing situation;

Actions taken in response; and

Any measures taken to ensure the center's future compliance.

Operates exclusively for the purpose of providing surgical services to patients requiring a period of postoperative observation but not requiring hospitalization and in which the expected duration of services would not exceed 24 hours following admission; and

Seeks reimbursement from payors as a freestanding ambulatory surgical facility.

The office of one or more health care practitioners seeking only professional reimbursement for the provision of medical services unless the office operates under contract or other agreement with a payor as a freestanding ambulatory surgical facility, regardless of whether it is paid a technical or facility fee, or the office is designated to receive ambulatory surgical referrals in accordance with utilization review or other policies adopted by a payor;

A facility or service owned or operated by a hospital and regulated under Health-General Article, Title 19, Subtitle 2, Annotated Code of Maryland;

The office of a health care practitioner with not more than one operating room if the office does not receive a technical or facility fee, and the operating room is used exclusively by the health care practitioner for patients of the health care practitioner;

The office of a group of health care practitioners with not more than one operating room if the office does not receive a technical or facility fee, and the operating room is used exclusively by members of the group practice for patients of the group practice; or

An office owned or operated by one or more dentists licensed under the Health Occupations Article, Annotated Code of Maryland, for the sole purpose of practicing dentistry.

For the testing, diagnosis, or treatment of a medical disorder in conjunction with the use of microscopic, endoscopic, or laparoscopic equipment that is inserted in a naturally occurring orifice of the body; and

That seeks reimbursement as a freestanding endoscopy facility from third-party payors.

The office of one or more health care practitioners unless the office operates under a contract or other agreement with a payor as a freestanding endoscopy facility, regardless of whether it is paid a technical or facility fee, or the office is designated to receive endoscopic referrals in accordance with utilization review or other policies adopted by a payor; or

A facility or service operated by a hospital and regulated under Health-General Article, Title 19, Subtitle 2, Annotated Code of Maryland.

The diagnostic or therapeutic treatment of conditions or disease processes by any instruments causing localized alteration or transposition of live human tissue which include, lasers, ultrasound, ionizing radiation, scalpels, probes, and needles;

Cut, burned, vaporized, frozen, sutured, probed, or manipulated tissue by closed reductions for major dislocations or fractures, or otherwise altered by mechanical, thermal, light-based, electromagnetic, or chemical means; or

Injection of diagnostic or therapeutic substances into body cavities, internal organs, joints, sensory organs, and the central nervous system.

Any board certification or specialty training of the physician, dentist, or podiatrist, and

Any post-graduate training;

Suspended, or

Revoked;

The name of the hospital,

The term of appointment or employment, and

Privileges held and any disciplinary action taken, including suspension, revocation, limitation, or voluntary surrender;

The physician's, dentist's, or podiatrist's present carrier,

The physician's, dentist's, or podiatrist's current limits of coverage,

The physician's, dentist's, or podiatrist's current types of coverage, and

Restrictions on the physician's, dentist's, or podiatrist's coverage;

A current license or certificate to practice in this State; and

Malpractice insurance, if required by the facility.