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<regulation prefix="Regulation" num=".05" citation="COMAR 10.07.09.05" title_num="10" subtitle_num="07" chapter_num="09" heading="Admission Prohibitions.">
  <paragraph num="A.">
    <text>The acts in §B of this regulation are admission prohibitions.</text>
  </paragraph>
  <paragraph num="B.">
    <text>A nursing facility may not:</text>
    <paragraph num="(1)">
      <text>Require or solicit, as a condition of admission into the nursing facility, the signature of an individual other than the applicant on the application or contract for admission to the nursing facility, unless the:</text>
      <paragraph num="(a)">
        <text>Applicant is adjudicated disabled in accordance with Estates and Trusts Article, §13-701, Annotated Code of Maryland; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Applicant's physician determines that the applicant is incapable of understanding or exercising the applicant's rights and responsibilities and records, in the applicant's nursing facility record, the specific reasons for the determination;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Require an individual, including an agent, to incur personal financial liability by signing the contract, although the nursing facility may require the individual to pay for nursing facility care for the resident to the extent of the resident's available income and assets;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Charge, solicit, accept, or receive, in addition to any amount otherwise required to be paid under Medicaid, a gift, money, donation, or other consideration as a precondition of admission or expedited admission to, or continued stay in, the nursing facility;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Require residents or applicants to waive their rights to Medicare or Medicaid;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Require oral or written assurances that residents or applicants are not eligible for, or will not apply for, Medicare or Medicaid benefits;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Charge individuals who are eligible for Medicaid more than the rates established by the Medical Assistance Program for these services;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Increase any charge and make the resident liable for the increase until the 46th day after the facility notifies the resident in writing;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Impose an interest penalty on charges for items and services provided to a resident until the later of the following:</text>
      <paragraph num="(a)">
        <text>45 days after the nursing facility mails an itemized statement of charges to the resident or the resident's agent; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>30 days after the end of the period covered by the itemized statement of charges;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>Condition providing care or otherwise discriminate against a resident based on whether the resident has or has not executed an advance directive;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Except for contributions toward cost of care as determined by the Medical Assistance Program, charge a resident who is eligible for Medicaid for services, unless the resident or the resident's agent knowingly has requested and received noncovered services, and the nursing facility:</text>
      <paragraph num="(a)">
        <text>Has given proper notice of the availability and cost of the services to residents; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Does not condition the resident's admission or continued stay on the request for and receipt of additional services; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(11)">
      <text>Solicit, accept, or receive a charitable, religious, or philanthropic contribution from an organization or an individual related to the resident or applicant unless the nursing facility makes clear that the contribution is not a condition of admission to, expedited admission to, or continued stay in the nursing facility.</text>
    </paragraph>
  </paragraph>
</regulation>