# COMAR Title 30 — Maryland Institute for Emergency Medical Services Systems (MIEMSS)

## Subtitle 08 — Designation of Trauma and Specialty Referral Centers

### Chapter 03 — Requirements for Designated Trauma or Specialty Referral Centers

**Authority:** Education Article, §13-509, Annotated Code of Maryland

**Administrative History:** Effective date: March 24, 1997 (24:6 Md. R. 488)

**Administrative History:** Regulations .01—.03 amended effective July 1, 2002 (29:12 Md. R. 932)

**Administrative History:** Regulation .01 amended as an emergency provision effective June 1, 2006 (33:15 Md. R. 1276); amended permanently effective October 23, 2006 (33:21 Md. R. 1678)

**Administrative History:** Regulation .01A amended effective December 19, 2005 (32:25 Md. R. 1947); October 12, 2015 (42:20 Md. R. 1265)

#### Regulation .01 Requirements for Trauma or Specialty Referral Centers.

*COMAR 30.08.03.01*

A. A hospital designated as a trauma or specialty referral center shall:

  (1) Comply with the applicable standards for trauma or specialty care as developed by MIEMSS and set forth in COMAR 30.08.05—30.08.12;

  (2) Receive all trauma or specialty patients, regardless of race, color, religion, age, sex, marital status, national origin, ancestry, physical or mental disability, or ability to pay;

  (3) Upon MIEMSS' request, provide data to MIEMSS related to trauma or specialty care programs;

  (4) Allow MIEMSS to monitor compliance with applicable regulations and standards as set forth by MIEMSS, including providing MIEMSS with access to:

    (a) Patient discharge summaries,

    (b) Patient care logs,

    (c) Patient care records,

    (d) Hospital trauma or specialty care quality management program records, including minutes, and

    (e) Other documents that MIEMSS determines to be relevant; and

  (5) Require confidentiality of information relating to an individual patient, provider, and hospital care outcomes in accordance with:

    (a) Health Occupations Article, Title 1, Subtitle 4, Annotated Code of Maryland, and

    (b) General Provisions Article, Title 4, Subtitle 3, Annotated Code of Maryland.

B. Emergency Standards.

  (1) MIEMSS may impose additional requirements on a trauma or specialty referral center if it determines that the requirements are necessary for the immediate protection of trauma or specialty patients.

  (2) MIEMSS shall provide the designated trauma or specialty referral center with advance written notice of an additional emergency standard.

  (3) The designated trauma or specialty referral center shall have reasonable time to comply with the emergency standard.

#### Regulation .02 Prehospital Triage and Transport.

*COMAR 30.08.03.02*

A. MIEMSS shall develop and distribute to health care providers prehospital triage and transport protocols for patients needing trauma or specialty referral services to ensure that patients who meet the triage criteria established by the protocols are transported directly to an appropriate facility.

B. In the absence of extenuating circumstances, a health care provider shall transport a patient to the closest appropriate trauma or specialty referral center, consistent with the triage protocols.

#### Regulation .03 Prohibited Acts.

*COMAR 30.08.03.03*

A. A hospital may not represent itself to be a trauma or specialty referral center unless it is so designated by MIEMSS and approved by the EMS Board.

B. A designated trauma or specialty referral center may not advertise services or capabilities for the treatment of patients above the trauma care level or specialty for which it has been designated.