Md. Code Regs. 10.09.93.03

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

Section 10.09.93.03 - Cost Settlement for State-operated Chronic Hospitals - Payments and Appeals

A. A provider shall meet all conditions for participation as set forth in COMAR 10.09.36.03.

B. To participate in the Program as a chronic hospital services provider, the provider shall:

(1) Meet the requirements of Title XLX of the Social Security Act for participation as a hospital, as issued by the U.S. Department of Health and Human Services;

(2) 24 hours per day, 7 days per week, meet the following staffing requirements:

(a) On-call or on-site physician services;

(b) On-site registered nurses;

(c) On-site respiratory therapist services; and

(d) On-site advanced cardiac life support services;

(3) Directly provide or make available through contractual arrangements or transfer agreements, medically necessary covered services;

(4) Accept payment by the Program as payment in full for the covered service;

(5) Make available to the Department or its designee the participant's medical record for review and certification of medical necessity for admission and continuation of stay; and

(6) Maintain documentation of each contact with the participant as part of the complete medical record, which, at a minimum, includes:

(a) Date of service;

(b) The participant's chief medical complaint or reason for admission;

(c) A description of the services provided, including:

(i) Progress notes;

(ii) Imaging studies;

(iii) Laboratory results;

(iv) Medication administration records; and

(v) Discharge summary; and

(d) A signature, electronic or handwritten, along with the printed or typed name of the individual providing care, with the appropriate title.

Md. Code Regs. 10.09.93.03

Regulation .03 adopted effective 44:7 Md. R. 354, eff. 4/10/2017