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<regulation prefix="Regulation" num=".24" citation="COMAR 10.07.22.24" title_num="10" subtitle_num="07" chapter_num="22" heading="Emergency Preparedness.">
  <paragraph num="A.">
    <text>The facility shall be constructed consistent with:</text>
    <paragraph num="(1)">
      <text>All applicable local fire and building codes; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The Life Safety Code, NFPA 101, including Chapter 24 of NFPA 101.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Hand Extinguishers. Fire extinguishers shall be located on each floor and adjacent to, or in, special hazard areas, such as furnace rooms, boiler rooms, kitchens, or laundries. Fire extinguishers shall be of standard and approved types, and installed and maintained to be conveniently available for use at all times. The hospice house shall properly instruct staff in the use of fire extinguishers.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Emergency Plan.</text>
    <paragraph num="(1)">
      <text>The hospice house shall develop an emergency plan that includes procedures that will be followed before, during, and after an emergency. The emergency plan shall address:</text>
      <paragraph num="(a)">
        <text>The evacuation, transportation, or shelter in-place of patients;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Notification to families, staff, and the Office of Health Care Quality regarding the action that will be taken concerning the safety and well-being of the patients;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Staff coverage, organization, and assignment of responsibilities; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The continuity of operation, including:</text>
        <paragraph num="(i)">
          <text>Procuring essential goods, equipment, and services; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Relocation to alternate facilities.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The Hospice House shall have a signed agreement with the facility that will house the program’s patients during an emergency evacuation.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Upon request, the hospice house shall provide access to its emergency plan to local organizations for emergency management and for purposes of coordinating local emergency planning.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The hospice house shall prepare a summary of its evacuation procedures to provide to the patient, family member, or legal representative upon request. The summary shall, at a minimum:</text>
      <paragraph num="(a)">
        <text>List means of transportation to be used in the event of evacuation;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>List alternative facilities to be used in the event of evacuation;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Describe means of communication with family members and legal representatives; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Describe the role of the patient, family member, or legal representative in the event of evacuation.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Evacuation Plans. The facility shall conspicuously post individual floor plans with designated evacuation routes on each floor.</text>
  </paragraph>
  <paragraph num="E.">
    <text>Emergency Electrical Power Generator.</text>
    <paragraph num="(1)">
      <text>Generator Required. A hospice house with 6 or more beds shall have an emergency electrical power generator on the premises.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Generator Specifications. The power source shall be a generating set and prime mover located on the program’s premises with automatic transfer. The emergency generator shall:</text>
      <paragraph num="(a)">
        <text>Be activated immediately when normal electrical service fails to operate;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Come to full speed and load acceptance within 10 seconds; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Have the capability of 48 hours of operation from fuel stored on-site.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Test of Emergency Power System.</text>
    <paragraph num="(1)">
      <text>The program shall test the emergency power system once each month.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>During testing of the emergency power system, the generator shall be exercised for a minimum of 30 minutes under normal emergency facility connected load.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Results of the test shall be recorded in a permanent log book that is maintained for that purpose.</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>The emergency power system shall provide lighting in the following areas of the facility:</text>
    <paragraph num="(1)">
      <text>Areas of egress and protection as required by COMAR 29.06.01 State Fire Prevention Code and Life Safety Code 101 as adopted by the State Fire Prevention Commission in COMAR 29.06.01;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Nurses’ station;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Medication area;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>An area for emergency telephone use;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Boiler or mechanical room;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Kitchen;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Emergency generator location and switch gear location;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>If applicable, elevator, if operable on emergency power;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>If applicable, areas where life-support equipment is used;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>If applicable, common areas or areas of refuge; and</text>
    </paragraph>
    <paragraph num="(11)">
      <text>If applicable, toilet rooms of common areas or areas of refuge.</text>
    </paragraph>
  </paragraph>
  <paragraph num="H.">
    <text>Emergency electrical power shall be provided for the following, if applicable:</text>
    <paragraph num="(1)">
      <text>Nurses’ call system;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>At least one telephone in order to make and receive calls;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Fire pump;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Sewerage pump and sump pump;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>If applicable, an elevator, if required, for evacuation purposes;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>If necessary, heating equipment needed to maintain a minimum temperature of 70ºF (24ºC);</text>
    </paragraph>
    <paragraph num="(7)">
      <text>If applicable, life support equipment; and</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Nonflammable medical gas systems.</text>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>Common Areas or Areas of Refuge. If the emergency power system does not provide heat to all patient rooms and toilet rooms, the program shall provide common areas or areas of refuge for all patients. The areas shall meet the following requirements:</text>
    <paragraph num="(1)">
      <text>The common area or areas of refuge shall maintain a minimum temperature of 70ºF (24ºC); and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Heated toilet rooms shall be provided adjacent to the common areas or areas of refuge.</text>
    </paragraph>
  </paragraph>
  <paragraph num="J.">
    <text>Orientation. The hospice house shall:</text>
    <paragraph num="(1)">
      <text>Orient staff to the emergency plan and to their individual responsibilities within 24 hours of the commencement of job duties; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Document completion of the orientation in the staff member’s personnel file through the signature of the employee.</text>
    </paragraph>
  </paragraph>
  <paragraph num="K.">
    <text>Drills.</text>
    <paragraph num="(1)">
      <text>Fire Drills. The hospice house shall:</text>
      <paragraph num="(a)">
        <text>Conduct fire drills at least quarterly on all shifts; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Document completion of each drill.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Documentation. The hospice house shall:</text>
      <paragraph num="(a)">
        <text>Have the documentation referenced in §K(1)(b) of this regulation signed by all staff who participated in the drill; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Maintain the documentation on file for a minimum of 2 years.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="L.">
    <text>Disaster Drill or Training Session.</text>
    <paragraph num="(1)">
      <text>The hospice house shall:</text>
      <paragraph num="(a)">
        <text>Conduct an annual disaster drill or training session, other than a fire drill, on all shifts; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Document completion of each disaster drill or training session.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Documentation. The hospice house shall:</text>
      <paragraph num="(a)">
        <text>Have the documentation referenced in §L(1)(b) of this regulation signed by all staff who participated in the drill or training; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Keep the documentation on file for a minimum of 2 years.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>