<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".14" citation="COMAR 10.07.21.14" title_num="10" subtitle_num="07" chapter_num="21" heading="Nursing Services.">
  <paragraph num="A.">
    <text>Nursing services shall be provided by licensed or certified personnel, trained or experienced in hospice care and supervised by a registered nurse with training or experience in hospice nursing. All nursing services shall be provided in accordance with the requirements of Health Occupations Article, Title 8, Annotated Code of Maryland.</text>
  </paragraph>
  <paragraph num="B.">
    <text>The hospice care program shall provide nurse staffing levels based on:</text>
    <paragraph num="(1)">
      <text>An assessment of patient and family care needs;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The experience level of the nursing staff available to provide services; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Available assistance from support service staff.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The hospice care program shall provide nursing services in accordance with each patient's interdisciplinary plan of care.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Registered Nurse. A registered nurse shall:</text>
    <paragraph num="(1)">
      <text>Conduct the initial assessment of the patient;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Regularly reevaluate the patient's nursing needs;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Initiate the plan of care and necessary revisions;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Prepare clinical and progress notes, coordinate services, and inform the physician and other personnel of changes in the patient's condition and needs;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Inform the patient and family in regard to the patient's nursing needs; and</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Supervise other nursing personnel.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>The initial assessment or any reevaluation of the patient's care needs may not be conducted by a licensed practical nurse or nursing assistant. Licensed practical nurses and nursing assistants shall provide all services in accordance with the patient's interdisciplinary plan of care.</text>
  </paragraph>
</regulation>