Md. Code Regs. 10.07.02.40 – Emergency and Disaster Plan.

A. Emergency and Disaster Plan.
1. (1) The licensee shall develop an emergency and disaster plan that includes procedures that shall be followed before, during, and after an emergency or disaster, including:
  1. (a) Evacuation, transportation, or shelter in place of residents;
  2. (b) Notification of families and staff regarding the action that will be taken concerning the safety and well-being of the residents;
  3. (c) Staff coverage, organization, and assignment of responsibilities for ongoing shelter in place or evacuation, including identification of staff members available to report to work or remain for extended periods; and
  4. (d) The continuity of services, including:
    1. (i) Operations, planning, and financial and logistical arrangements;
    2. (ii) Procuring essential goods, equipment, and services to sustain operations for at least 72 hours;
    3. (iii) Relocation to alternate facilities or other locations; and
    4. (iv) Reasonable efforts to continue care.
2. (2) The licensee shall have a tracking system to locate and identify residents in the event of displacement due to an emergency or disaster that includes at a minimum the:
  1. (a) Resident's name;
  2. (b) Time that the resident was sent to the initial alternative facility or location; and
  3. (c) Name of the initial alternative facility or location where the resident was sent.
3. (3) When the nursing home relocates residents, the nursing home shall send a medical fact sheet and any medically related information with each resident that includes at a minimum the resident’s:
  1. (a) Name;
  2. (b) Medical condition or diagnosis;
  3. (c) Medications;
  4. (d) Allergies;
  5. (e) Special diets or dietary restrictions;
  6. (f) Family or legal representative contact information; and
  7. (g) Advance directives, living will, or a copy of the resident’s Maryland’s Medical Orders for Life-Sustaining Treatment (MOLST) form.
4. (4) The brief medical fact sheet for each resident described in §A(3) of this regulation shall be:
  1. (a) Updated upon the occurrence of any change of information on the medical fact sheet;
  2. (b) Reviewed at least monthly; and
  3. (c) Maintained in a written, electronic, or printed form in a central location readily accessible and available to accompany residents in case of an emergency evacuation.
5. (5) The licensee shall review the emergency and disaster plan at least annually and update the plan as necessary.
6. (6) The licensee shall:
  1. (a) Identify a facility, facilities, alternate location, or alternate locations that have agreed to house the licensee's residents during an emergency evacuation; and
  2. (b) Document an agreement with each facility or location.
7. (7) The licensee shall:
  1. (a) Identify a source or sources of transportation that have agreed to safely transport residents during an emergency evacuation; and
  2. (b) Document an agreement with each transportation source.
8. (8) Upon request, a licensee shall provide a copy of the facility's emergency and disaster plan to the local emergency management organization for the purposes of coordinating local emergency planning. The licensee shall provide the emergency and disaster plan in a format that is mutually agreeable to the local emergency management organization.
9. (9) The licensee shall identify an emergency and disaster planning liaison for the facility and shall provide the liaison's contact information to the local emergency management organization.
10. (10) The licensee shall prepare an executive summary of its evacuation procedures to provide to a resident, family member, or legal representative upon request. The summary shall, at a minimum:
  1. (a) List means of potential transportation to be used in the event of evacuation;
  2. (b) List potential alternative facilities or locations to be used in the event of evacuation;
  3. (c) Describe means of communication with family members and legal representatives;
  4. (d) Describe the role and responsibilities of the resident, family member, or legal representative in the event of an emergency situation; and
  5. (e) Notify families that the information provided may change depending upon the nature or scope of the emergency or disaster.
11. (11) Maryland Health Alert Network.
  1. (a) A nursing home shall register with the Maryland Health Alert Network.
  2. (b) A nursing home shall register at least four representatives, including the administrator and the director of nursing.
  3. (c) Following any changes in the initial registration of the four representatives, a nursing home shall update the information within 5 business days of the change.
12. (12) The licensee shall:
  1. (a) Identify an emergency and disaster planning liaison for the nursing home; and
  2. (b) Provide the liaison’s contact information to the local emergency management organization.
13. (13) The licensee shall prepare an executive summary of the nursing home’s evacuation procedures to provide to a resident, family member, or resident’s representative upon request. The summary shall, at a minimum:
  1. (a) List potential means of transportation to be used in the event of evacuation;
  2. (b) List potential alternative facilities or locations to be used in the event of evacuation;
  3. (c) Describe means of communication with family members and resident’s representatives;
  4. (d) Describe the role and responsibilities of the resident, family member, or resident’s representative in the event of an emergency situation; and
  5. (e) Notify families that the information provided may change depending on the nature or scope of the emergency or disaster.
B. Evacuation Plans. The facility shall conspicuously post individual floor plans with designated evacuation routes on each floor.
C. Orientation and Drills.
1. (1) The licensee shall:
  1. (a) Orient staff to the emergency and disaster plan and to their individual responsibilities in relation to the plan within 24 hours of the commencement of job duties;
  2. (b) Document completion of the orientation in the staff member’s personnel file through the signature of the employee; and
  3. (c) Within 24 hours of admission, notify and direct residents to the nursing home’s emergency plans and maps, including evacuation procedures.
2. (2) Fire Drills.
  1. (a) The licensee shall conduct fire drills at least quarterly on all shifts.
  2. (b) The licensee shall:
    1. (i) Document completion of each drill;
    2. (ii) Have all staff who participated in the drill sign the document; and
    3. (iii) Maintain the documentation on file for a minimum of 2 years.
3. (3) Semiannual Emergency and Disaster Drill.
  1. (a) The licensee shall conduct a semiannual emergency and disaster drill on all shifts during which the facility practices evacuating residents or sheltering in place so that each is practiced at least one time a year.
  2. (b) The drills may be conducted via a table-top exercise if the licensee can demonstrate that moving residents will be harmful to the residents.
  3. (c) Documentation. The licensee shall:
    1. (i) Document completion of each drill or training session;
    2. (ii) Have all staff who participated in the drill or training sign the document;
    3. (iii) Document any opportunities for improvement as identified as a result of the drill; and
    4. (iv) Keep the documentation on file for a minimum of 2 years.
4. (4) The licensee shall cooperate with the local emergency management agency in emergency planning, training, and drills and in the event of an actual emergency.

Authority: Health-General Article, §§19-308, 19-308.1, 19-323, and 19-1401 et seq.;
Public Safety Article, §14-110.1; Annotated Code of Maryland

Effective date: June 30, 1978 (5:13 Md. R. 1053)

This chapter is a compilation and revision of prior regulations contained in COMAR 10.07.02, Nursing Homes—Extended Care, and COMAR 10.07.05, Intermediate Care Facilities—Long-term Care (Type A). COMAR 10.07.02 was effective January 1, 1967; amended effective March 27, 1973 and April 16, 1975 (2:8 Md. R. 565). COMAR 10.07.05 was effective July 1, 1969 and amended effective March 27, 1973.

Regulation .01B amended effective January 7, 1991 (17:26 Md. R. 2975); June 22, 1992 (19:12 Md. R. 1134); January 17, 1994 (21:1 Md. R. 33); August 15, 1994 (21:16 Md. R. 1383); June 30, 1997 (24:13 Md. R. 931); June 1, 1998 (25:11 Md. R. 821)

Regulation .01B amended as an emergency provision effective January 1, 2001 (28:4 Md. R. 414); amended permanently effective May 14, 2001 (28:9 Md. R. 885)

Regulation .01B amended effective September 16, 2002 (29:18 Md. R. 1442); March 3, 2003 (30:4 Md. R. 316); September 13, 2004 (31:18 Md. R. 1350)

Regulation .01I-1, L-1, O-1, GG-1 adopted effective January 13, 1986 (13:1 Md. R. 16)

Regulation .01GG-1, KK-1 adopted effective August 3, 1981 (8:15 Md. R. 1306)

Regulation .01II-1 adopted effective January 26, 1987 (14:2 Md. R. 128)

Regulation .01-1 adopted effective June 1, 1998 (25:11 Md. R. 821)

Regulation .01-1 amended effective January 6, 2005 (31:26 Md. R. 1862)

Regulation .02 amended effective January 14, 1988 (15:1 Md. R. 20)

Regulation .02 repealed and new Regulation .02 adopted effective May 10, 1993 (20:9 Md. R. 778)

Regulation .02 amended effective August 24, 2009 (36:17 Md. R. 1312)

Regulation .02F amended effective April 8, 1996 (23:7 Md. R. 551)

Regulation .02G adopted effective September 16, 2002 (29:18 Md. R. 1442)

Regulation .03 amended effective May 10, 1993 (20:9 Md. R. 778); August 27, 2007 (34:17 Md. R. 1507); August 24, 2009 (36:17 Md. R. 1312); August 29, 2016 (43:17 Md. R. 953)

Regulation .03A amended effective May 24, 1982 (9:10 Md. R. 1021); June 22, 1992 (19:12 Md. R. 1134)

Regulation .03B amended effective August 1, 1994 (21:15 Md. R. 1304)

Regulation .03-1 adopted effective May 10, 1993 (20:9 Md. R. 778)

Regulation .04B amended effective December 7, 1992 (19:24 Md. R. 2125)

Regulation .05 amended effective August 1, 2016 (43:15 Md. R. 864)

Regulation .05B amended effective January 17, 1994 (21:1 Md. R. 33)

Regulation .05C amended effective January 25, 1980 (7:2 Md. R. 115)

Regulation .07 amended effective January 26, 1987 (14:2 Md. R. 128); May 20, 1996 (23:10 Md. R. 731); August 24, 2009 (36:17 Md. R. 1312)

Regulation .07A amended effective August 3, 1981 (8:15 Md. R. 1306)

Regulation .07G amended effective May 24, 1982 (9:10 Md. R. 1021); January 26, 1987 (14:2 Md. R. 128); March 3, 2003 (30:4 Md. R. 316)

Regulation .07-1 adopted effective January 1, 2007 (33:26 Md. R. 1996)

Regulation .08 amended effective June 22, 1992 (19:12 Md. R. 1134)

Regulation .08A, B, D amended effective January 26, 1987 (14:2 Md. R. 128)

Regulation .08A, E amended effective January 13, 1986 (13:1 Md. R. 16)

Regulation .08-1 adopted effective September 16, 2002 (29:18 Md. R. 1442)

Regulation .09A amended effective November 8, 1982 (9:22 Md. R. 2196); January 13, 1986 (13:1 Md. R. 16); January 17, 1994 (21:1 Md. R. 33)

Regulation .09B-1 adopted effective August 3, 1981 (8:15 Md. R. 1306)

Regulation .09C, D amended effective August 24, 2009 (36:17 Md. R. 1312)

Regulation .10 amended effective January 26, 1987 (14:2 Md. R. 128); June 30, 1997 (24:13 Md. R. 931)

Regulation .10E amended effective November 8, 1982 (9:22 Md. R. 2196)

Regulation .10H amended effective May 24, 1982 (9:10 Md. R. 1021)

Regulation .10 repealed and new Regulation .10 adopted effective August 6, 2001 (28:15 Md. R. 1396)

Regulation .11 amended effective January 26, 1987 (14:2 Md. R. 128)

Regulation .11O amended effective November 8, 1982 (9:22 Md. R. 2196)

Regulation .11 repealed and new Regulation .11 adopted effective August 6, 2001 (28:15 Md. R. 1396)

Regulation .11-1 adopted effective August 6, 2001 (28:15 Md. R. 1396)

Regulation .11-2 adopted effective August 6, 2001 (28:15 Md. R. 1396)

Regulations .12, .13, .18—.21 amended effective January 13, 1986 (13:1 Md. R. 16)

Regulation .12 amended effective January 26, 1987 (14:2 Md. R. 128)

Regulation .13 amended effective January 26, 1987 (14:2 Md. R. 128)

Regulation .14-1 adopted effective August 15, 1994 (21:16 Md. R. 1383)

Regulation .14-2 adopted effective August 15, 1994 (21:16 Md. R. 1383)

Regulation .15 amended effective January 26, 1987 (14:2 Md. R. 128); September 22, 2008 (35:19 Md. R. 1716)

Regulation .15B amended effective March 16, 1992 (19:5 Md. R. 577); June 5, 1995 (22:11 Md. R. 820)

Regulation .17 amended effective January 26, 1987 (14:2 Md. R. 128)

Regulation .18B amended effective January 26, 1987 (14:2 Md. R. 128)

Regulation .19A, B amended effective January 26, 1987 (14:2 Md. R. 128)

Regulation .20 amended effective January 26, 1987 (14:2 Md. R. 128)

Regulation .21 amended effective June 1, 1998 (25:11 Md. R. 821)

Regulation .21 repealed and new Regulation .21 adopted effective January 6, 2005 (31:26 Md. R. 1862)

Regulation .21E amended effective November 8, 1982 (9:22 Md. R. 2196)

Regulation .21-1 adopted effective January 17, 1994 (21:1 Md. R. 33)

Regulation .21-1 repealed and new Regulation .21-1 adopted effective January 6, 2005 (31:26 Md. R. 1862)

Regulation .21-2 adopted effective January 6, 2005 (31:26 Md. R. 1862)

Regulation .21-3 adopted effective January 6, 2005 (31:26 Md. R. 1862)

Regulation .21-4 adopted effective January 6, 2005 (31:26 Md. R. 1862)

Regulation .22B amended effective August 3, 1981 (8:15 Md. R. 1306)

Regulation .24 repealed and new Regulation .24 adopted effective April 21, 2008 (35:8 Md. R. 805)

Regulation .26F amended and .26G—H repealed effective January 17, 1983 (10:1 Md. R. 28)

Regulation .26EE amended effective October 25, 1982 (9:21 Md. R. 2106); September 16, 2002 (29:18 Md. R. 1442)

Regulation .27A, B amended effective March 3, 2003 (30:4 Md. R. 316)

Regulation .27B amended effective January 26, 1987 (14:2 Md. R. 128)

Regulation .28 amended effective January 26, 1987 (14:2 Md. R. 128); January 17, 1994 (21:1 Md. R. 33)

Regulation .28C amended effective January 14, 1988 (15:1 Md. R. 20)

Regulation .31A amended effective September 16, 2002 (29:18 Md. R. 1442)

Regulation .32F amended effective January 17, 1994 (21:1 Md. R. 33)

Regulation .32G amended effective January 26, 1987 (14:2 Md. R. 128)

Regulation .33E amended effective January 26, 1987 (14:2 Md. R. 128)

Regulations .35—.41 adopted effective January 13, 1986 (13:1 Md. R. 16)

Regulation .35 amended effective December 16, 1996 (23:25 Md. R. 1785)

Regulation .36 amended effective December 16, 1996 (23:25 Md. R. 1785); September 16, 2002 (29:18 Md. R. 1442)

Regulation .36C amended effective March 3, 2003 (30:4 Md. R. 316)

Regulation .37 amended effective December 16, 1996 (23:25 Md. R. 1785); September 16, 2002 (29:18 Md. R. 1442)

Regulation .38 amended effective December 16, 1996 (23:25 Md. R. 1785)

Regulation .39A and B amended effective October 1, 1990 (17:19 Md. R. 2320)

Regulation .39C and D repealed effective October 1, 1990 (17:19 Md. R. 2320)

Regulation .39G amended effective June 30, 1986 (13:13 Md. R. 1491)

Regulation .40A amended effective June 30, 1986 (13:13 Md. R. 1491)

Regulations .40 and .41 recodified to Regulations .43 and .44, respectively, Appendix recodified as Regulation .40 and amended, and new Regulations .41 and .42 adopted effective October 1, 1990 (17:19 Md. R. 2320)

Regulation .41 repealed and new Regulation .41 adopted effective September 13, 2004 (31:18 Md. R. 1350)

Regulation .41A amended effective August 1, 1994 (21:15 Md. R. 1304)

Regulation .41D amended effective June 30, 1986 (13:13 Md. R. 1491)

Regulation .43C adopted effective October 1, 1990 (17:19 Md. R. 2320)

Regulations .45—.51 adopted effective January 7, 1991 (17:26 Md. R. 2975)

Regulations .45—.51 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 .45—.60 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)

Regulation .49D amended effective September 16, 2002 (29:18 Md. R. 1442)

Regulation .54D adopted effective March 3, 2003 (30:4 Md. R. 316)

Regulation .61 adopted effective August 24, 2009 (36:17 Md. R. 1312)

Chapter revised effective June 17, 2019 (46:12 Md. R. 536)