Md. Code Regs. 10.07.02.47

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.07.02.47 - Nursing Care Unit

A. Size. Nursing care units may not exceed 60 beds. The Department may specify the numbers and types of personnel for each unit which exceeds 40 beds.

B. Common Space. The nursing home shall provide a living room for residents' use with a sufficient number of reading lamps, tables, and comfortable chairs or sofas.

C. Service Areas Required.

(1) Nurses' Work Area.

(a) The nurses' work area shall be located on the unit and within easy view of corridors outside of residents' rooms.

(b) The Department may specify the location and size of a nurses' work area which serves a nursing care unit exceeding 40 beds.

(2) Nursing Care Unit.

(a) A nursing care unit, regardless of size, including special care units, shall be equipped as described in this regulation.

(b) A nursing care unit bathroom shall include:

(i) A toilet, within the care unit, for the use of personnel; and

(ii) A hand-washing sink equipped with goose-neck spout, separate soap dispenser, and disposable paper towel dispenser.

(c) A nursing care unit's medicine shall be stored in accordance with the following procedures:

(i) Shall be stored in a cabinet with locks;

(ii) Schedule II drugs shall be kept in a separately locked, securely fixed box or drawer in the medicine storage cabinet under two locks, keyed differently;

(iii) The medicine storage and preparation area shall be illuminated with at least 100 foot-candles at the work counter;

(iv) The preparation area shall include a small sink set into the counter or with drain boards and a biological refrigerator; and

(v) The medicine storage cabinet, medicine preparation area, and biological refrigerator shall be under the direct visual control of the nursing or pharmacy staff.

(d) Nurses' call system.

(e) Charting desk and supplies.

(f) Storage space for miscellaneous medical supplies which shall be protected from contamination.

(g) A nursing care unit shall have sufficient space and equipment for medical records so that personnel can function effectively and maintain easily accessible records for all residents.

(3) Medication Storage in Nursing Home.

(a) The storage facility shall provide for the conditions listed in §C(3)(b)-(g) of this regulation when prescribed.

(b) Cold - Any temperature at or below 46°F or 8°C. A refrigerator is a cold place in which the temperature is maintained thermostatically between 46°F and 59°F or 8°C and 15°C. A freezer is a cold place in which the temperature is maintained thermostatically between -4°F and -14°F or -20°C and -26°C.

(c) Cool - Any temperature between 46°F and 59°F or 8°C and 15°. An article for which storage in a cool place is directed may, alternatively, be stored in a refrigerator, unless otherwise specified in the individual monograph.

(d) Room Temperature - The temperature prevailing in a working area. Controlled room temperature is a temperature maintained thermostatically between 59°F and 86° F or 15°C and 30°C.

(e) Warm - Any temperature between 86°F and 104°F or 30°C and 40°C.

(f) Excessive Heat - Any temperature above 104°F or 40°C.

(g) Protection from Freezing. The container label bears appropriate instructions to protect the product from freezing when freezing it may subject a product to:

(i) Loss of strength or potency;

(ii) Risk of breakage of the container; or

(iii) Destructive alteration of the dosage form.

(h) Storage under Non-specific Conditions. When no specific storage directions or limitations are provided in the individual monograph, the storage conditions shall include protection from moisture, freezing, and excessive heat.

(4) Space for Storage of Linen. Capacity shall be provided for storing of at least two complete linen changes per bed. Clean linen shall be stored separately from unclean items.

(5) Janitor Closet - New Construction.

(a) A nursing unit shall contain at least one janitor closet containing a floor receptor or service sink and storage space for housekeeping equipment and supplies.

(b) The janitor closet shall be equipped for hand washing.

(c) The janitor closet shall be connected to mechanically operated exhaust ventilation.

(d) The plumbing fixture for the utility or service sink within a janitor closet shall be provided with a back-flow prevention device.

(6) Utility Rooms.

(a) There shall be separate clean and soiled utility rooms in each nursing unit:

(i) Accessible to the resident area;

(ii) Each having separate entrances; and

(iii) No more than 120 feet to the most remote resident bedroom.

(b) The clean utility room shall contain:

(i) A small sink equipped with gooseneck spout and wrist blades;

(ii) Soap and individual paper towels in a dispenser;

(iii) Adequate storage and work counter space for storage and assembly of supplies for nursing procedures; and

(iv) Clean linen stored and transported in covered containers, closed linen carts, or rooms exclusively provided for this purpose.

(c) The soiled utility room shall contain:

(i) Work counter with sink, gooseneck faucet, and wrist blades;

(ii) A small sink equipped with soap and individual paper towels in a dispenser;

(iii) Space for waste receptacles and soiled linen receptacles; provision for storing and transporting soiled linen in covered leakproof containers;

(iv) Equipment to clean and sanitize bedpans, urinals, and basins; and

(v) Equipment for the disposal of liquid and semi-solid wastes and bodily fluids via the nursing home's sanitary sewer connection or on-site sewage disposal system.

(7) Culture Change Nursing Home. In a culture change nursing home, service areas shall be provided for resident care needs as approved by the Department. The culture change nursing home shall be required to have service areas that meet the specifications in this chapter for:

(a) Clean storage;

(b) Soiled holding;

(c) Laundry;

(d) Janitorial services; and

(e) Medication storage.

D. Drinking Fountains. One public drinking fountain or comparable equipment as preapproved by the Department shall be provided on each floor, usable from a wheelchair. Alternative means to provide drinking water to residents, staff, and the general public may be used as approved by the Department.

E. Automated External Defibrillator.

(1) A nursing home shall possess a functioning automated external defibrillator (AED).

(2) As of July 1, 2020, a nursing home shall install a functioning AED unit.

Md. Code Regs. 10.07.02.47

Regulations .47 adopted effective January 7, 1991 (17:26 Md. R. 2975)
Regulations .47 repealed as an emergency provision effective January 1, 2001 (28:4 Md. R. 414); repealed permanently effective May 14, 2001 (28:9 Md. R. 885)
Regulations .47 adopted as an emergency provision effective January 1, 2001 (28:4 Md. R. 414); adopted permanently effective May 14, 2001 (28:9 Md. R. 885); amended and recodified from .27 effective 46:12 Md. R. 541, eff. 6/17/2019