<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.07.20.05" title_num="10" subtitle_num="07" chapter_num="20" heading="Standards of Operation.">
  <paragraph num="A.">
    <text>General. Whether or not a facility participates in Medicare or Medicaid, the facility shall meet the requirements set forth in 42 CFR § 483.400 et seq., which is incorporated by reference.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Safety and Sanitation. The facility, its grounds, fixtures and equipment shall be:</text>
    <paragraph num="(1)">
      <text>Maintained in good repair, clean, and attractive;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Free of unnecessary accumulations of personal property or debris; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Free of hazards, insects, and rodents.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Infection Control. The administrator shall:</text>
    <paragraph num="(1)">
      <text>Establish policies and procedures to investigate, control, and prevent infections in the facility; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Ensure that facility staff follow these policies and procedures.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Personnel.</text>
    <paragraph num="(1)">
      <text>The administrator shall provide orientation and training for all staff and volunteers.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the center provides care for individuals with Alzheimer's disease or related disorders:</text>
      <paragraph num="(a)">
        <text>The administrator shall provide annual in-service education on the care of individuals with dementia; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Each employee shall complete an instructional unit on dementia as described in COMAR 10.07.02.40H before the later of:</text>
        <paragraph num="(i)">
          <text>180 days from beginning of employment, or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>One year from the effective date of these regulations.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Employee Health Screening. A facility shall obtain certification that an employee or volunteer is free from tuberculosis in a communicable form as provided in Regulation .06 only if the employee or volunteer:</text>
      <paragraph num="(a)">
        <text>Will be involved in the direct care of tuberculosis patients; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Is an immigrant from Africa, Asia, or Latin America.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Emergency Management Plans. State residential centers shall develop an emergency plan for all types of emergencies and disasters that shall include:</text>
    <paragraph num="(1)">
      <text>Procedures that will be followed before, during, and after an emergency to address the following:</text>
      <paragraph num="(a)">
        <text>The evacuation, transportation, or 72-hour shelter-in-place of individuals and staff served;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Holding an annual practice drill coordinated with local emergency planners for sheltering-in-place or evacuating;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Preparing an after action report and improvement plan after drills that evaluates the plan and takes corrective actions;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Ensuring that individuals served and staff have identification with current health, contact, and other important information that is immediately accessible in the event of evacuation;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>The role of the resident, family member, or legal representative in the event of evacuation;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Arranging for medical needs and other accommodations for individuals served and staff at alternative facilities or shelters; and</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Establishing a communication protocol among all appropriate parties that includes redundant communication means;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The notification to families, staff, and respective DDA regional office regarding the action that will be taken concerning the safety and well-being of the individuals served;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The staff coverage, organization, and assignment of responsibilities that includes:</text>
      <paragraph num="(a)">
        <text>Planning staff coverage needs for ongoing shelter-in-place or evacuations;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Identifying staff members available to report for work or remain during extended periods; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Establishing staff notification and recall contingency plans and procedures;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>The continuity of operations, including, but not limited to, redundant communications systems, preservation of records and electronic data, the procurement of essential goods, equipment, and services, plans to secure vacated facilities, and the relocation to alternate facilities;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Procedures to:</text>
      <paragraph num="(a)">
        <text>Backup and electronically store off-site, appropriate records and data of consumers and staff and facility documents, for access under emergency conditions; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Ensure access to an electronic copy of the emergency plans when requested by local, State, or federal emergency management organizations;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Provisions to ensure that the facility's emergency and disaster plans are shared with local emergency management organizations for the purpose of coordinating local emergency planning;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>An executive summary of the evacuation procedures that shall be provided to the family member of a resident on request; and</text>
    </paragraph>
    <paragraph num="(8)">
      <text>A summary statement of the facility's community surge capacity abilities.</text>
    </paragraph>
  </paragraph>
</regulation>