<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".20" citation="COMAR 10.07.02.20" title_num="10" subtitle_num="07" chapter_num="02" heading="Nursing Services — Director of Nursing.">
  <paragraph num="A.">
    <text>Director of Nursing. The nursing home shall provide for an organized nursing service, under the direction of a full-time registered nurse.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Termination of Services of Director of Nursing.</text>
    <paragraph num="(1)">
      <text>If the nursing home terminates the services of the director of nursing, the nursing home immediately shall notify the Department of the termination.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The name and license number of the replacement director of nursing shall be supplied to the Department as soon as employment begins.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A copy of the agreement between the nursing home and the replacement shall be sent to the Department.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Director of Nursing’s Vacancy Exceeding 30 Days. If the position of director of nursing remains vacant for a period exceeding 30 days, the nursing home’s license may be revoked unless the administrator and the governing body are able to demonstrate that they have made every effort to obtain a replacement.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Relief for Director of Nursing.</text>
    <paragraph num="(1)">
      <text>When the director of nursing is absent, the individual shall designate an experienced, qualified registered nurse to direct the nursing service.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>In a nursing home in which the director of nursing serves as relief for the administrator, the director of nursing shall designate a specific registered nurse who shall be in charge of the nursing service while the director of nursing covers for the administrator.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Responsibilities of the Director of Nursing. The responsibilities of the director of nursing shall include:</text>
    <paragraph num="(1)">
      <text>Assisting in the development and updating of statements of nursing philosophy and objectives to define the type of nursing care the nursing home shall provide;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Preparation of written job descriptions for nursing service personnel;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Planning to meet the total nursing needs of residents to be met and recommending the assignment of a sufficient number of supervisory and support personnel for each tour of duty;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Development and maintenance of nursing service policies and procedures to implement the program of care;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Participation in the coordination of resident services through appropriate staff committee meetings on issues relating to:</text>
      <paragraph num="(a)">
        <text>Pharmacy;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Infection control;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Resident care policies;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Quality assurance programs; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Departmental meetings;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Cooperation with administration in planning the orientation program and the staff development program to upgrade the competency of personnel;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Ensuring that nursing personnel understand the philosophy and meet the objectives;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Participation in planning and budgeting for nursing services;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Establishment of a procedure to ensure that nursing service personnel, including private duty nurses, have valid and current Maryland licenses;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Execution of resident care policies unless delegated to the principal physician or medical director;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Participation in the selection of prospective admissions to ensure that the nursing home’s staff is capable of meeting the needs of all residents admitted;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Coordination of the interdisciplinary resident care management efforts; and</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Supervision of certified medicine aides to ensure that the aides act within the limitations and restrictions placed on them.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Delegation of Responsibilities. The director of nursing shall make clear any authority delegated to another staff member.</text>
  </paragraph>
  <paragraph num="G.">
    <text>Daily Rounds — Director of Nursing.</text>
    <paragraph num="(1)">
      <text>Although daily rounds are primarily the responsibility of the charge nurse or nurses, the director or assistant director of nursing shall periodically make clinical rounds to nursing units, randomly reviewing clinical records, medication orders, resident care plans, and staff assignments and visiting residents.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Upon request, the director or assistant director of nursing may accompany physicians visiting residents.</text>
    </paragraph>
  </paragraph>
  <paragraph num="H.">
    <text>Director of Nursing’s Continuing Education. The director of nursing shall assume responsibility for maintaining professional competence of staff through their participation in education programs.</text>
  </paragraph>
</regulation>