Md. Code Regs. 10.07.14.37 - Abuse, Neglect, and Financial Exploitation
A. An assisted living program shall develop and implement policies and procedures prohibiting abuse, neglect, and financial exploitation of residents.
B. An assisted living program may not knowingly employ an individual who has any criminal conviction or other criminal history that indicates behavior that is potentially harmful to residents, documented through either a criminal history records check or a background check.
C. Reports of Abuse, Neglect, or Financial Exploitation.
(1) An assisted living program or employee of an assisted living program who has witnessed, or otherwise has reason to believe, that a resident has been subjected to abuse, neglect, or financial exploitation shall report the alleged abuse, neglect, or financial exploitation within 24 hours to the:
(a) Appropriate law enforcement agency;
(b) Office of Health Care Quality of the Department;
(c) Ombudsman within the Department of Aging or local area agency on aging;
(d) Local Department of Human Services or Adult Protective Services; and
(e) Assisted living manager unless they are believed to be involved with the abuse, neglect, or financial exploitation.
(2) An assisted living program or an employee may be subject to a penalty imposed by the Secretary of up to $1,000 for failing to make a report required by §C(1) of this regulation within 3 days after learning of the alleged abuse, neglect, or financial exploitation.
(3) A person aggrieved by the action of the Secretary under §C of this regulation may appeal the Secretary's action by filing a request for a hearing in accordance with Regulation .65 of this chapter.
(4) A licensed or certified individual who has knowledge of, but does not report, suspected abuse, neglect, or financial exploitation may be referred to their respective health occupation board.
D. Investigations. An assisted living program shall:
(1) Thoroughly investigate all allegations of abuse, neglect, or financial exploitation and maintain on-site written documentation of the investigation; and
(2) Take appropriate action to prevent further incidents of abuse, neglect, or financial exploitation while the investigation is in progress.
E. Investigation Reports.
(1) The assisted living program or any government agency that investigates the abuse, neglect, or financial exploitation shall send a report to the:
(a) Appropriate law enforcement agency;
(b) Office of Health Care Quality of the Department;
(c) Ombudsman within the Department of Aging or local area agency on aging; and
(d) Local Department of Human Services or Adult Protective Services.
(2) The entities set forth in §E(1) of this regulation may make a referral, if appropriate, to:
(a) The State's attorney's office; or
(b) The Medicaid Fraud Control Unit of the Criminal Division of the Office of the Attorney General.
F. Immunity from Civil Liability. An individual who, acting in good faith, makes a report under this regulation has immunity from liability as described in Health-General Article, §19-347(g), Annotated Code of Maryland.
G. Notice. The assisted living program shall post signs that set forth the reporting requirements of §C(1) of this regulation, conspicuously in the employee and public areas of the facility.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
A. The resident has the right to be free of restraints used in violation of this chapter.
B. A protective device as defined in Regulation .02B of this chapter is not considered a restraint .
C. Improper Use of Chemicals or Drugs. Chemicals or drugs may not be used for residents in the following ways:
(1) In excessive dose, including duplicate drug therapy;
(2) For excessive duration, without adequate monitoring;
(3) Without adequate indications for its use; or
(4) In the presence of adverse consequences which indicate the dose should be reduced or discontinued.
D. Improper Use of Physical Restraints. Residents may not be physically restrained:
(1) For discipline or convenience; or
(2) If a restraint is not ordered by a physician to treat the resident 's symptoms or medical conditions.
E. Restraint Orders.
(1) Any restraint shall be ordered by a physician and shall specify:
(a) The purpose of the restraint ;
(b) The type of restraint to be used; and
(c) The length of time the restraint shall be used.
(2) A resident may not have an as-needed restraint order.
(3) Orders for the use of a restraint shall be time specific.
(4) A resident may not remain in a restraint for more than 2 hours without a change in position and toileting opportunity.
(5) If an order for the use of a restraint is to be continued, the order shall be renewed at least every 7 days by a physician .
(6) The delegating nurse shall provide training to staff in the appropriate use of the restraint ordered by the physician .
F. Bed Rails. Bed rails may be considered restraints depending upon the reason for the use of bed rails and how the bed rails are used. This determination is based upon the resident and the effect that bed rails would have upon the resident , as documented in the resident 's record.
G. The program shall notify the resident 's family or the resident's representative each time a restraint is used.