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<regulation prefix="Regulation" num=".01" citation="COMAR 10.05.02.01" title_num="10" subtitle_num="05" chapter_num="02" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Board” means the Board of Nursing.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Certified nurse midwife” has the meaning stated in COMAR 10.27.05.01.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Freestanding Birthing Center.</text>
      <paragraph num="(a)">
        <text>“Freestanding birthing center” means a facility that provides nurse midwife services through individuals licensed to practice under Health Occupations Article, Title 8, Subtitle 6, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Freestanding birthing center” does not include:</text>
        <paragraph num="(i)">
          <text>Birthing services that are licensed or accredited as a unit of a hospital; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The private residence of the patient.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>“Immediate action” means all actions the freestanding birthing center has taken or will take to immediately address the noncompliance that resulted in or made serious injury, serious harm, serious impairment, or death likely.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Immediate Jeopardy.</text>
      <paragraph num="(a)">
        <text>“Immediate jeopardy” means a situation in which immediate corrective action is necessary because the freestanding birthing center's noncompliance with one or more licensure requirements has already caused, is causing, or is likely to cause, at any time, serious injury or harm, or death, to individuals served by the freestanding birthing center or to the health or safety of the general public.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Immediate jeopardy” consists of three components:</text>
        <paragraph num="(i)">
          <text>Noncompliance with this chapter;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Serious injury, harm, or death; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The need for immediate action.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>“Informal dispute resolution (IDR)” means an informal process that provides a freestanding birthing center the opportunity to dispute one or more deficiencies cited in a written Statement of Deficiencies issued by the Department or the Department’s designee related to a recent survey.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Licensed certified midwife” has the meaning stated in Health Occupations Article, §8-6D-01, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Licensed direct-entry midwife” has the meaning stated in COMAR 10.64.01.01.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Midwifery” means the antepartum, intrapartum, and postpartum management and care of birthing persons and their newborns.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Need for immediate action” means that immediate corrective action is necessary to remove the jeopardy.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Newborn” means an infant in the first 28 days of life.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Noncompliance” means the freestanding birthing center is non-compliant with one or more licensure requirements of this chapter.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Normal Maternity.</text>
      <paragraph num="(a)">
        <text>“Normal maternity” means a low risk, uncomplicated prenatal course as determined by adequate prenatal care and prospects for a normal, uncomplicated birth as defined by reasonable and generally accepted criteria of maternal and fetal health.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Normal maternity” does not include the use of drugs for induction or augmentation of labor, general and regional anesthesia, vacuum extractors, forceps, recorded electronic fetal monitors, cesarean section, surgical procedures other than episiotomy or perineal repair, intrapartum care provided prior to 36 weeks gestation, or intrapartum care provided after 42 weeks gestation.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(14)">
      <text>“Office of Health Care Quality (OHCQ)” means the Office of Healthcare Quality of the Maryland Department of Health.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Plan of Correction” means a written plan submitted by the freestanding birthing center to the OHCQ which documents steps the freestanding birthing center will take to come into compliance with the licensure requirements.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>“Removal of the immediate jeopardy” means that the freestanding birthing center has implemented the removal plan, and the OHCQ has verified that all actions the freestanding birthing center took were effective in removing the likelihood that serious injury, serious harm, serious impairment, or death would occur or recur.</text>
    </paragraph>
    <paragraph num="(17)">
      <text>“Serious injury, harm, or death” means a situation which has already caused, is causing, or is likely to cause, at any time, serious injury or harm, or death, to individuals served by the freestanding birthing center or to the health or safety of the general public.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Statement of Deficiencies” means the written notification that the OHCQ issues to the free standing birthing center that contains a listing of deficiencies cited that require correction.</text>
    </paragraph>
  </paragraph>
</regulation>