<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".07" citation="COMAR 10.12.01.07" title_num="10" subtitle_num="12" chapter_num="01" heading="Surgical Abortion Services.">
  <paragraph num="A.">
    <text>Surgical abortion procedures shall be performed in a safe manner by a physician credentialed by the facility under Regulation .06 of this chapter.</text>
  </paragraph>
  <paragraph num="B.">
    <text>An administrator, in consultation with the medical director, shall develop and implement policies, procedures, and protocols for the provision of surgical abortion services including but not limited to:</text>
    <paragraph num="(1)">
      <text>Personnel;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Pre-operative testing and examinations;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Surgical procedures;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Post-anesthesia care and observation;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Discharge planning;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Emergency services;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Informed consent; and</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Safety.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The administrator shall ensure that the policies, procedures and protocols referenced in §B of this regulation are:</text>
    <paragraph num="(1)">
      <text>Available on site at all times for reference; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Reviewed annually and revised as necessary.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Before conducting a surgical procedure, a physician or other qualified health professional shall conduct a history and physical examination.</text>
  </paragraph>
  <paragraph num="E.">
    <text>If anything other than an unsupplemented local anesthetic is needed to accomplish a surgical procedure, a health practitioner as described in Regulation .08 of this chapter shall conduct a pre-anesthesia evaluation and document the anesthetic risk to the patient.</text>
  </paragraph>
  <paragraph num="F.">
    <text>If the assessments required by §§D and E of this regulation are performed before the day of surgery, on the day of surgery a physician or qualified health professional shall reassess and document on the patient’s medical record any change in the patient's clinical status that could have an effect on the surgical procedure to be performed and the anesthesia to be used.</text>
  </paragraph>
  <paragraph num="G.">
    <text>Discharge. Before discharge from the facility, the patient shall be evaluated by a physician or an appropriately trained health professional. This evaluation shall be documented in the patient’s record.</text>
  </paragraph>
</regulation>