2013 Maryland Code
HEALTH - GENERAL
§ 19-307 - Classifications of hospitals and related institutions

§19-307.

(a) (1) A hospital shall be classified:

(i) As a general hospital if the hospital at least has the facilities and provides the services that are necessary for the general medical and surgical care of patients;

(ii) As a special hospital if the hospital:

1. Defines a program of specialized services, such as obstetrics, mental health, tuberculosis, orthopedy, chronic disease, or communicable disease;

2. Admits only patients with medical or surgical needs within the program; and

3. Has the facilities for and provides those specialized services;

(iii) As a special rehabilitation hospital if the hospital meets the requirements of this subtitle and Subtitle 12 of this title; or

(iv) As a limited service hospital if the health care facility:

1. Is licensed as a hospital on or after January 1, 1999;

2. Changes the type or scope of services offered by eliminating the capability to admit or retain individuals for overnight hospitalization;

3. Retains an emergency or urgent care center; and

4. Complies with the regulations adopted by the Secretary under § 19-307.1 of this subtitle.

(2) The Secretary may set, by rule or regulation, other reasonable classifications for hospitals.

(b) A related institution shall be classified:

(1) As a care home if the related institution provides care to individuals who, because of advanced age or physical or mental disability, require domiciliary care or personal care in a protective environment; or

(2) As a nursing home if the related institution:

(i) Provides nursing care for chronically ill or convalescent patients; or

(ii) Offers to provide 24-hour a day nursing care of patients in a home-type facility such as:

1. A convalescent home;

2. A nursing unit of a home for the aged;

3. A psychiatric nursing home;

4. A nursing facility for individuals with disabilities;

5. A home for alcoholics; or

6. A halfway house.

§ 19-307 - 1. Regulations for limited service hospitals

The Department shall adopt regulations for a limited service hospital that include the following standards:

(1) The limited service hospital shall be open 24 hours a day, 7 days a week;

(2) There shall be at least one physician credentialed in emergency medicine at the limited service hospital at all times;

(3) A sufficient number of registered nurses and other health professionals shall be available at the limited service hospital to provide advanced life support;

(4) Basic X-ray and laboratory facilities shall be available at the limited service hospital and operable at all times by one radiology technician and one laboratory technician;

(5) Resuscitation equipment, including monitor, defibrillator, cardiac medications, intubation equipment, and intravenous line equipment shall be available at the limited service hospital and operable at all times;

(6) Standard procedures in accordance with the State Emergency Medical Services Plan shall exist for the immediate transport of individuals in need of hospitalization or other more definitive care;

(7) A specific defined role in the Emergency Medical Services System with appropriate telephone communication shall exist;

(8) Emergency services shall be available to all persons regardless of ability to pay;

(9) Adoption, implementation, and enforcement of a policy shall exist that requires, except in an emergency life-threatening situation where it is not feasible or practicable, compliance by all employees and medical staff involved in patient care services with the Centers for Disease Control and Prevention's guidelines on universal precautions; and

(10) Any other standard that the Secretary deems necessary to ensure the quality of the services provided by a limited service hospital.

§ 19-307 - 2. Licensed bed capacity

(a) General hospitals. -- For a hospital classified as a general hospital, the Secretary shall annually calculate the hospital's licensed bed capacity.

(b) Calculations. -- The annual licensed bed calculation for each hospital shall equal 140 percent of the average daily census for the 12-month period immediately preceding the calculation.

(c) Exceeding the licensed bed capacity. -- If necessary to adequately meet demand for services, a hospital may exceed its licensed bed capacity if:

(1) On average for the 12-month period, the hospital does not exceed its licensed bed capacity based on the annual calculation; and

(2) The hospital includes in its monthly report to the Health Services Cost Review Commission the following information:

(i) The number of days in the month the hospital exceeded its licensed bed capacity; and

(ii) The number of beds that were in excess on each of those days.

(d) Delicensing licensed hospital beds. -- Before July 1, 2000 and each July 1 thereafter, the Secretary shall delicense any licensed hospital beds determined to be excess bed capacity under subsection (b) of this section.