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

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

### Chapter 17 — Comprehensive Stroke Center Standards

#### Regulation .01 Designated Comprehensive Stroke Center.

*COMAR 30.08.17.01*

In addition to meeting the requirements of COMAR 30.08.11.01, a designated comprehensive stroke center hospital shall:

A. Be designated by MIEMSS as a primary stroke center at the time of application for designation as a comprehensive stroke center;

B. Continue to meet the primary stroke center requirements in COMAR 30.08.11 to the extent such requirements are consistent with designation as a comprehensive stroke center;

C. Act as a resource center for other facilities in its region or state;

D. Annually care for at least 20 Subarachnoid Hemorrhage by aneurysm patients per year;

E. Annually perform a combined total of 15 endovascular coiling and surgical clippings per year for aneurysm;

F. Annually administer fibrinolytics to 25 eligible patients per year or 50 eligible patients over 2 years:

  (1) IV fibrinolytic ordered and monitored via telemedicine at another hospital is acceptable; and

  (2) IV fibrinolytic administered at an outside hospital and transferred to CSC site is acceptable;

G. Satisfy the MIEMSS requirements for designation as a comprehensive stroke center by MIEMSS; and

H. Meet the requirements for a site review in COMAR 30.08.02.06, which may be satisfied by completing either:

  (1) An on-site review by MIEMSS; or

  (2) A site survey as part of The Joint Commission Disease Specific Care Certification Program for certification as a comprehensive stroke center if the hospital:

    (a) Authorized The Joint Commission to provide MIEMSS with survey findings, certification reports, and other information related to The Joint Commission's certification of the hospital as a comprehensive stroke center;

    (b) Allows MIEMSS to participate in the accreditation site survey; and

    (c) Provides MIEMSS any additional information required to determine it has satisfied the requirements for designation under this chapter.