# COMAR Title 10 — Maryland Department of Health

## Subtitle 09 — Medical Care Programs

### Chapter 95 — Special Psychiatric Hospitals

#### Regulation .03 Conditions for Participation.

*COMAR 10.09.95.03*

A. A provider shall meet all conditions for participation as set forth in COMAR 10.09.36.03.

B. To participate in the Program as a special psychiatric hospital services provider, the provider shall:

  (1) Meet the requirements of Title XIX of the Social Security Act for participation as a hospital, as issued by the Department of Health and Human Services;

  (2) Meet the following staffing requirements 24 hours per day, 7 days per week:

    (a) On-call or on-site physician services including psychiatric physicians;

    (b) On-site registered nurses;

    (c) On-site advanced cardiac life support services;

  (3) If licensed to provide inpatient psychiatric services for individuals younger than 21 years old:

    (a) Meet the requirements for participation as defined in 42 CFR §440.160; and

    (b) Provide acute psychiatric services as defined in 42 CFR Part 441, Subpart D;

  (4) Directly provide or make available through contractual arrangements or transfer agreements, medically necessary covered services;

  (5) Accept payment by the Program as payment in full for the covered service;

  (6) Make available to the Department or its designee the participant’s medical record for review and certification of medical necessity for admission and continuation of stay;

  (7) Maintain documentation of each contact with the participant as part of the medical record, which, at a minimum, includes:

    (a) Date of service;

    (b) A plan of treatment as defined in Regulation .01B of this chapter;

    (c) The participant’s chief medical complaint or reason for visit;

    (d) A description of the services provided, including:

      (i) Progress notes;

      (ii) Imaging studies;

      (iii) Laboratory results;

      (iv) Medication administration records; and

      (v) Discharge summary; and

    (e) A signature, electronic or handwritten, along with the printed or typed name of the individual providing care, with the appropriate title;

  (8) Submit to the Department or its designee within 5 months of the close of the hospital’s fiscal year, as required by the Department, a hospital cost report for outpatient services which are subject to cost settlement in accordance with Regulation .11 of this chapter;

C. If an out-of-State or District of Columbia hospital, the special psychiatric hospital shall:

  (1) Unless a waiver has been granted by the Secretary of Health and Human Services, have in effect a utilization review plan applicable to all participants who receive Medical Assistance under Title XVII of the Social Security Act which meets the requirements of §1861(k) of the Social Security Act; and

  (2) Comply with applicable regulations of this chapter and COMAR 10.09.36.