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<regulation prefix="Regulation" num=".05" citation="COMAR 10.07.17.05" title_num="10" subtitle_num="07" chapter_num="17" heading="Standards for Service.">
  <paragraph num="A.">
    <text>A facility shall comply with applicable federal, State, and local laws and regulations.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Restriction of License—Nomenclature. A limited service hospital may not use in its title the words “emergency department”, “emergency center”, “emergency room”, or any other terminology in referring to the limited service hospital or any part of the facility that may convey to the public that the facility is prepared to provide the full range of emergency services that are normally provided by a hospital.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Hours of Operation. The facility shall be open 24 hours a day, 7 days a week.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Staff.</text>
    <paragraph num="(1)">
      <text>At least one physician who is credentialed in emergency medicine shall be at the facility at all times.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The facility shall have a sufficient number of registered nurses and other health professionals with appropriate training to provide advanced life support.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Laboratory and Radiologic Services. The facility shall have basic x-ray and laboratory services available at all times and be staffed by at least:</text>
    <paragraph num="(1)">
      <text>One radiology technician; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>One laboratory technician.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Pharmaceutical Services.</text>
    <paragraph num="(1)">
      <text>Pharmaceutical services shall be supervised by a pharmacist licensed to practice in this State.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The facility shall provide pharmaceutical services in accordance with accepted professional principles and appropriate federal, State, and local laws and regulations.</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Clinical Records.</text>
    <paragraph num="(1)">
      <text>The facility shall maintain clinical records for all patients in accordance with accepted professional standards and practices.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Clinical records shall contain:</text>
      <paragraph num="(a)">
        <text>Identification and summary, including, at least, the patient's name, Social Security number, marital status, age, sex, and home address;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Name, address, and telephone number of the personal physician, dentist, parent or next of kin, or authorized representative;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Evidence of assessment of the patient's needs, of establishment of an appropriate plan of initial and ongoing treatment, and of the care or services provided;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Consent forms when required;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Diagnostic and therapeutic orders;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Reports of medication administration, treatments, and clinical findings; and</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Discharge summary including final diagnosis and prognosis.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Current clinical records and those of discharged patients shall be completed promptly. All clinical information pertaining to a patient shall be centralized in the patient's clinical record.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Clinical records shall be retained for a period of not less than 5 years from the date of discharge or, in the case of a minor, 3 years after the patient becomes of age or 5 years, whichever is longer.</text>
    </paragraph>
  </paragraph>
  <paragraph num="H.">
    <text>Equipment.</text>
    <paragraph num="(1)">
      <text>A facility shall have the equipment necessary to provide at least the following care:</text>
      <paragraph num="(a)">
        <text>Cardiac monitoring, defibrillation, and external pacing;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Medication administration;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Oxygen therapy;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Airway management including endotracheal intubation;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Respiratory ventilation; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Intravenous and intraosseous access and fluid therapy.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>All equipment at the facility shall be in good operating condition at all times.</text>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>Infection Control. A facility shall:</text>
    <paragraph num="(1)">
      <text>Develop and implement policies and procedures on the use of standard precautions for infection control; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Comply with the requirements of COMAR 10.06.01.07, except in an emergency life-threatening situation when it is not feasible or practical to comply with the infection control measures.</text>
    </paragraph>
  </paragraph>
</regulation>