# 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 .11 Qualifications of Stroke Center Director and Clinicians.

*COMAR 30.08.17.11*

A. Director.

  (1) The stroke center medical director shall be a physician with competence in caring for the acute stroke patient and be Board-certified or Board-eligible in:

    (a) Neurology;

    (b) Neurosurgery; or

    (c) Vascular neurology.

  (2) The stroke center medical director’s qualifications shall include:

    (a) Completion of a stroke fellowship or vascular neurosurgery fellowship and obtained vascular neurology certification by the American Board of Psychiatry and Neurology;

    (b) Active participation in the Stroke Quality Improvement Council (QIC);

    (c) 12 hours of category 1 CME credits related to stroke care annually;

    (d) Participation in at least one regional, national, or international stroke conference annually;

    (e) Participation in stroke patient morbidity and mortality reviews; and

    (f) Participation in stroke research and publication efforts.

B. Neurologists, Neurosurgeons, NeurInterventionalists, NeuroRadiologisst, NeuroIntensivists, and Vascular Surgeons. Qualifications for neurologists, neurosurgeons, neurointerventionalists, neuroradiologists, vascular surgeons and neurointensivists shall include:

  (1) Board certification or Board eligibility in their specialty as approved by the American Board of Medical Specialties;

  (2) Completion of:

    (a) A fellowship;

    (b) Demonstrated experience equivalent to completion of a stroke specialty fellowship appropriate to their area of expertise; or

    (c) Both of these;

  (3) 8 or more hours of category 1 or 2 CME credits per year related to stroke care;

  (4) Participation in stroke patient morbidity and mortality reviews; and

  (5) Participation in stroke research and publication efforts.

C. Emergency Physicians. The qualifications of emergency physicians who care for stroke patients shall include:

  (1) Board certification or Board eligibility in emergency medicine as approved by the American Board of Medical Specialties;

  (2) Participation in stroke patient morbidity and mortality reviews;

  (3) 4 or more hours of category 1 or 2 CME credits per year related to stroke care; and

  (4) Participation in stroke research and publication efforts.

D. Nurse Practitioners. Nurse Practitioners who care for stroke patients shall:

  (1) Hold a current license with the Maryland State Board of Nursing to practice as a registered nurse;

  (2) Maintain certification as a nurse practitioner from the American Nurses Credentialing Center or other certification organization as deemed appropriate by the Maryland State Board of Nursing; and

  (3) Be credentialed through the hospital’s credentialing process.

E. Physician Assistants. Physician assistants who care for stroke patients shall:

  (1) Have graduated from a physician assistant educational program accredited by the Accreditation Review Commission on Education for the Physician Assistant or its successor;

  (2) Maintain current certification by the National Commission on Certification of Physician Assistants;

  (3) Maintain an approved delegation agreement on file with the Maryland Board of Physicians; and

  (4) Be credentialed through the hospital credentialing process.