Transmittals

System Account — Tue, 12 Mar 2013 03:17:14 GMT

Wiki Content:

TRANSMITTALS

Date: 01/10/2013 Re: Centers for Medicare and Medicaid Services' Hand in Hand Training Series
Date: 09/07/2012 Re: Posting of sanctions
Date: 07/23/2012 Re: Notice of Proposed Involuntary Discharge or Transfer
Date: 06/29/2012 Re: Reporting of Environmental Issues related to Extreme Weather Events
Date: 05/16/2012 Re: Remittances to Medicaid Recoveries
Date: 05/03/2012 Re: Changes in Bed Size
Date: 02/24/2012 Re: Obstructions in Exit Corridors
Date: 02/24/2012 Re: Requests for Medical Records in Electronic Format
Date: 12/19/2011 Re: Reporting Reasonable Suspicion of a Crime in a Long-Term Care Facility
Date: 08/29/2011 Re: MOLST Order Form
Date: 08/23/2011 Re: Reporting of Environmental Hazards
Date: 07/20/2011 Re: Non-reporting of Environmental Hazards
Date: 04/28/2011 Re: Requests for Medical Records
Date: 12/06/2010 Re: Emergency Preparedness Plan Update
Date: 10/20/2010 Re: Holiday Decorations in Health Care Facilities
Date: 10/13/2010 Re: Revised List of Approved Over the Counter Medications that May be Purchased in Bulk
Date: 07/09/2010 Re: Non-reporting of Environmental Hazards
Date: 06/08/2010 NH-10-01 Re: Renewal License Application
Date: 12/23/2009 NH-09-07 Re: OHCQ Update
Date: 12/15/2009 NH-09-06 Re: Administration of Medications for Leave of Absence of 24 Hours or Less
Date: 12/10/2009 NH-09-05 Re: Advancing Excellence in America's Nursing Homes Campaign
Date: 11/03/2009 NH-09-04 Re: Holiday decorations in Health Care Facilities
Date: 11/03/2009 NH-09-03 Re: Quality Indicator Survey (QIS), Access Resident Weight Requirements
Date: 10/19/2009 NH-09-02 Re: Regulatory Standards for Physician Documentation
Date: 01/15/2009 NH-09-01 Re: New CDC Study--Infection Control Practices and Outbreaks
Date: 12/15/2008 Subject: Prevention of Pressure Ulcers / Pressure Ulcer Brochure
Note: For an editable copy of the Pressure Ulcer Brochure in Microsoft® Office Publisher Click here.
Date: 08/18/2008 Subject: Implementation of Senate Bill 566--Health Care Facility Visitation and Medical Decisions--Domestic Partners
Date: 05/30/2008 Subject: New COMAR 10.07.02.24 Emergency and Disaster Plans
Date: 03/25/2008 Subject: Bed Side Rails
Date: 12/28/2007 Subject: Voter Registration & Absentee Voting
Date: 12/10/2006 Subject: Bulk purchase of OTC medications-Comprehensive Care Facilities
Date: 12/10/2006 Subject: Electronic Signatures
Date: 08/15/2006 Subject: Discharge and Transfer Planning
Date: 08/07/2006 Subject: Voter Registration & Absentee Voting
Date: 05/31/2006 Subject: Tuberculosis Screening in Hospital-Based Transitional Care Units
Date: 11/21/2005 Subject: Part I. Required Screening of Potential Employees, Part II. Abuse Reporting Follow-Up
Date: 04/12/2005 Subject: CMS Clarification of Nursing Home Reporting Requirements for All Alleged Violations of Neglect and Abuse, Including Injuries of Unknown Source, and Misappropriation of Resident Property
Date: 11/29/2004 Subject: HFAM Guidelines for Resident Behavior and the Implementation Guide
Date: 11/15/2000 Subject: Maintaining Residents' Confidentiality in Plans of Correction Submitted by Nursing Homes
Date: 05/19/2000 Subject: Notice of Proposed Involuntary Discharge or Transfer.
Date: 02/25/1998 Subject: Safety Alert - Use of Lead Based Ceramic Glazes In Art Therapy Programs

Long Term Care
Alerts Licensure or Renewal Application Transmittals MHCC Consumer Guide to LTC (Nursing Homes) Forms Reports File a Complaint MDS 3.0 Advancing Excellence in America’s Nursing Homes Nursing Home Compare

Forms

System Account — Tue, 12 Mar 2013 03:17:08 GMT

Wiki Content:

Forms

Notice of Proposed Involuntary Discharge or Transfer

Click here for the form in Microsoft® Word

Click here for the form in Adobe® Acrobat

Sample Template for Development of Emergency Plans for Nursing Homes
Click here for the template in Microsoft® Word

Click here for the template in Adobe® Acrobat

NOTE: This sample template is used to assist nursing homes in complying with COMAR 10.07.02.24 (Emergency Preparedness). It is not meant to exclude other formats so long as they include all elements of the regulations.

Model Admission Agreements for Resident and Resident's Agent
Click here for Resident Agreement 2012

Click here for Resident's Agent Agreement 2012

Emergency Preparedness Survey for Nursing Homes from Montgomery County Advanced Practice Center (APC) for Public Health Preparedness

Nursing Home Self-Report Form

Instructions for using the Comprehensive Care Facilities & Extended Care Facilities Self-Report Form

The form was created for use by facilities to self-report alleged violations of neglect and abuse, including injuries of unknown source, and misappropriation of resident property/funds (refer to April 12, 2005 memorandum from Carol Benner regarding the clarification of reporting requirements). It is not mandatory that facilities use this form, but a facility must include, at a minimum, the information requested on this form.

The form should be used to forward both the “first report” and “results of investigation” to the OHCQ/Long Term Care Unit via fax 410-402-8113 or e-mail nhselfreport@dhmh.state.md.us.

The facility should complete the top of the form for the “first report” and forward to OHCQ within 24 hours of the incident.

The results of the investigation of the reported incident, should then be entered on the bottom of the form and be forwarded to OHCQ. One complete form (i.e., includes the first report and investigation results) should be forwarded within 5 days of the incident.

The Nursing Home Self-Report Form can be downloaded and viewed with Microsoft® or Word Adobe Acrobat®.

Choose the document type you need below:

nh_self_report.doc (click for the form in Microsoft® Word)
nh_self_report.pdf (click for the form in Adobe® Acrobat)

If you do not have Microsoft® Word click here to download the Microsoft® Word Viewer.
If you do not have Adobe® Acrobat click here to download the Adobe® Reader.

Diet Manual for Long Term Care Residents
Click here for the order form for the Diet Manual, 2007 Edition
Click here for the Table of Contents for the Diet Manual, 2007 Edition

Note:
The Office of Health Care Quality does not accept cash as a form of payment for purchases. Certified Bank Checks, Money Orders and Personal Checks will be the only form of payment accepted for the purchase of: Regulations and/ or Diet Manuals.

Thank You
Management

SAMPLE STAFFING
A sample of how a facility could use an erasable white board with names hand written in to be in compliance with .55 A and B about staffing. Remember this is to be done per shift per unit or floor

Long Term Care
Alerts Licensure or Renewal Application Transmittals MHCC Consumer Guide to LTC (Nursing Homes) Forms Reports File a Complaint MDS 3.0 Advancing Excellence in America’s Nursing Homes Nursing Home Compare

Long Term Care: Site Pages

Transmittals

TRANSMITTALS

Forms