1. A. On or before July 1, 2000, and each July 1 thereafter, the Secretary shall determine the authorized licensed bed capacity for each hospital classified as a general hospital.

2. B. Methodology for Calculating Total Authorized Licensed Bed Capacity.

   1. (1) The average daily census for each general hospital shall be obtained from the most current Health Services Cost Review Commission inpatient utilization data for a 12-month period.
   2. (2) The calculation of average daily census shall include the utilization of inpatient medical-surgical, gynecology, obstetric, pediatric, and acute psychiatric service beds. Newborn services are excluded from the calculation of average daily census.
   3. (3) The total licensed bed capacity for each general hospital shall equal 140 percent of the calculated average daily census for all inpatient acute care hospital services.

3. C. Application for Designation of Licensed Bed Capacity by Service.

   1. (1) The Secretary shall annually forward to each general hospital its calculated total licensed bed capacity for the next licensure period and the current allocation of beds by major service category.
   2. (2) In a format specified by the Secretary, each general hospital shall notify the Department of its designation of total beds by major service category for the next licensure period.
   3. (3) The Maryland Health Care Commission shall review and approve the designation of total beds by major service category.
   4. (4) This section does not permit a general hospital to reallocate bed capacity in a manner inconsistent with applicable statute and regulations.
4. D. On or before July 1, 2000, and each July 1 thereafter, the Secretary shall delicense any licensed hospital beds determined to be excess bed capacity under Regulation .07B of this chapter.

5. E. Temporary Adjustments to Calculated Licensed Bed Capacity.

   1. (1) If necessary to adequately meet demand for services, a general hospital may exceed its calculated licensed bed capacity if:

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

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

         1. (i) The number of days in the month the hospital exceeded its licensed bed capacity, and
         2. (ii) The number of beds that were in excess on each of those days.
   2. (2) A hospital exceeding its calculated licensed bed capacity shall notify the Department within 5 business days of the effective dates of the change in a format specified by the Secretary.

Authority: Health-General Article, §§19-307.2, 19-308, 19-308.6, 19-308.8, 19-318—19-320, 19-323, 19-342, 19-349.1, and 19-380—19-385; Insurance Article, Title 4, Subtitle 4; Public Safety Article, §14-110.1; Annotated Code of Maryland

Effective date: December 19, 1946

Amended effective March 20, 1959

Amended effective September 1, 1964

Regulations .03C, G, I, K; .04B, D; .05A, B; .06C; .07B, E; .08A, B; .09B, C; .10F; .11A, B; .12F amended effective February 24, 1978 (5:4 Md. R. 226)

Regulations .01—.13 repealed and new Regulations .01—.10 adopted effective August 1, 1983 (10:15 Md. R. 1350)

Regulation .01 amended as an emergency provision effective August 12, 1985 (12:18 Md. R. 1756), emergency status expired December 10, 1985; adopted permanently effective December 16, 1985 (12:25 Md. R. 2471)

Regulation .01 amended effective May 23, 1994 (21:10 Md. R. 844)

Regulations .01, .02B, .04A, .05A, .07, .08B amended; .02C, .09D, and new .10 and .11 adopted; existing .10—.20 recodified as .12—.22 as an emergency provision effective July 1, 1986 (13:15 Md. R. 1726); adopted permanently effective December 1, 1986 (13:24 Md. R. 2558)

Regulation .01B amended effective December 28, 1987 (14:26 Md. R. 2746); August 6, 1990 (17:15 Md. R. 1858)

Regulation .01B amended as an emergency provision effective July 1, 2000 (27:15 Md. R. 1396); amended permanently effective October 30, 2000 (27:21 Md. R. 1975)

Regulation .01B amended effective November 11, 2002 (29:22 Md. R. 1721); April 21, 2008 (35:8 Md. R. 804); June 28, 2010 (37:13 Md. R. 852); April 16, 2012 (39:7 Md. R. 491); March 31, 2014 (41:6 Md. R. 378); March 27, 2017 (44:6 Md. R. 325); April 23, 2018 (45:8 Md. R. 420)

Regulation .02 recodified to be Regulation .03 and new Regulation .02 adopted effective July 4, 2016 (43:13 Md. R. 712)

Regulation .02 amended effective April 13, 2026 (53:7 Md. R. 328)

Regulation .02D adopted effective November 11, 2002 (29:22 Md. R. 1721)

Regulation .02D repealed effective June 28, 2010 (37:13 Md. R. 852)

Regulation .03 repealed and Regulation .02 recodified to be Regulation .03 effective July 4, 2016 (43:13 Md. R. 712)

Regulation .03 amended effective June 24, 1991 (18:12 Md. R. 1338)

Regulation .03A amended effective November 11, 2002 (29:22 Md. R. 1721); June 28, 2010 (37:13 Md. R. 852)

Regulation .04 amended effective June 28, 2010 (37:13 Md. R. 852)

Regulation .04A amended effective November 11, 2002 (29:22 Md. R. 1721)

Regulation .04A, C amended effective March 13, 2017 (44:5 Md. R. 292)

Regulation .04D amended effective February 26, 2007 (34:4 Md. R. 400)

Regulation .05 amended effective November 11, 2002 (29:22 Md. R. 1721)

Regulation .05A amended effective June 28, 2010 (37:13 Md. R. 852)

Regulation .06A amended as an emergency provision effective November 20, 2019 (46:26 Md. R. 1162); emergency status expired May 18, 2020

Regulation .06C adopted as an emergency provision effective November 20, 2019 (46:26 Md. R. 1162); emergency status expired May 18, 2020

Regulation .06-1 adopted as an emergency provision effective July 1, 2000 (27:15 Md. R. 1396); adopted permanently effective October 30, 2000 (27:21 Md. R. 1975)

Regulation .07 amended effective December 28, 1987 (14:26 Md. R. 2746); June 28, 2010 (37:13 Md. R. 852)

Regulation .07A amended effective November 11, 2002 (29:22 Md. R. 1721)

Regulation .08 amended effective November 11, 2002 (29:22 Md. R. 1721)

Regulation .08B adopted effective June 28, 2010 (37:13 Md. R. 852)

Regulation .08B amended effective April 13, 2026 (53:7 Md. R. 328)

Regulation .09 amended effective June 24, 1991 (18:12 Md. R. 1338); November 11, 2002 (29:22 Md. R. 1721); June 28, 2010 (37:13 Md. R. 852)

Regulation .09A amended effective February 26, 2007 (34:4 Md. R. 400); March 31, 2014 (41:6 Md. R. 378); April 13, 2026 (53:7 Md. R. 328)

Regulation .10A amended effective June 24, 1991 (18:12 Md. R. 1338); November 11, 2002 (29:22 Md. R. 1721)

Regulations .11—.20 adopted as an emergency provision effective August 12, 1985 (12:18 Md. R. 1756), emergency status expired December 10, 1985; adopted permanently effective December 16, 1985 (12:25 Md. R. 2471)

Regulation .13 amended effective May 23, 1994 (21:10 Md. R. 844)

Regulation .20 amended effective December 28, 1987 (14:26 Md. R. 2746)

Regulation .21 repealed effective March 13, 2017 (44:5 Md. R. 292)

Regulation .22 repealed effective May 23, 1994 (21:10 Md. R. 844)

Regulation .22 adopted effective April 16, 2012 (39:7 Md. R. 491)

Regulation .23 adopted effective February 22, 1988 (15:4 Md. R. 473)

Regulation .23A and C amended as an emergency provision effective June 9, 1988 (15:14 Md. R. 1653); emergency status expired December 9, 1988; adopted permanently effective December 26, 1988 (15:26 Md. R. 2982)

Regulations .24—.26 adopted effective December 28, 1987 (14:26 Md. R. 2746)

Regulation .24 amended effective March 1, 2004 (31:4 Md. R. 315); March 31, 2014 (41:6 Md. R. 378)

Regulation .24C amended as an emergency provision effective May 6, 2025 (52:11 Md. R. 531); adopted permanently effective October 13, 2025 (52:20 Md. R. 1001)

Regulation .24E amended effective April 16, 2012 (39:7 Md. R. 491)

Regulation .25 repealed effective March 15, 2004 (31:5 Md. R. 448)

Regulation .25 adopted effective February 25, 2008 (35:4 Md. R. 514)

Regulation .26 recodified to Regulation .27, and new Regulation .26 adopted effective March 20, 1989 (16:5 Md. R. 629)

Regulation .26 amended effective April 2, 1990 (17:6 Md. R. 741)

Regulations .27—.31 adopted effective August 6, 1990 (17:15 Md. R. 1858)

Regulation .27 recodified to Regulation .32 effective August 6, 1990 (17:15 Md. R. 1858)

Regulations .27—.31 repealed effective May 23, 1994 (21:10 Md. R. 844)

Regulation .27 adopted effective March 13, 2006 (33:5 Md. R. 520)

Regulation .28 adopted effective June 28, 2010 (37:13 Md. R. 852)

Regulation .28A amended effective April 13, 2026 (53:7 Md. R. 328)

Regulation .29 adopted effective March 31, 2014 (41:6 Md. R. 378)

Regulation .29F adopted effective April 23, 2018 (45:8 Md. R. 420)

Regulation .30 adopted effective July 4, 2016 (43:13 Md. R. 712)

Regulation .30A amended effective April 13, 2026 (53:7 Md. R. 328)

Regulation .31 adopted effective March 27, 2017 (44:6 Md. R. 325)

Regulation .32D amended effective November 11, 2002 (29:22 Md. R. 1721); June 28, 2010 (37:13 Md. R. 852)

Regulation .32-1 adopted effective March 13, 2006 (33:5 Md. R. 520)

Regulation .32-2 adopted effective March 13, 2006 (33:5 Md. R. 520)

Regulation .32-3 adopted effective March 13, 2006 (33:5 Md. R. 520)

Regulation .33 adopted effective November 11, 2002 (29:22 Md. R. 1721)

Regulation .33A amended effective March 2, 2015 (42:4 Md. R. 433)

Regulation .34 adopted effective April 21, 2008 (35:8 Md. R. 804)

Regulation .35 adopted effective April 23, 2018 (45:8 Md. R. 420)

Regulation .36 adopted effective April 23, 2018 (45:8 Md. R. 420)

Regulation .37 adopted effective April 23, 2018 (45:8 Md. R. 420)