1. A. This regulation applies to intravenous or related therapy provided in the home.
2. B. A provider of intravenous or related therapies shall meet the requirements of this regulation in addition to meeting the requirements of Regulations .01—.16 of this chapter.
3. C. Specialized intravenous therapies and nutritional support services administered enterally or parenterally shall be considered skilled nursing functions.

4. D. Medications.

   1. (1) Medications and preparations used in the provision of intravenous or nutritional support shall be obtained from a licensed pharmacy.
   2. (2) The agency shall document any adverse reactions associated with the therapy and notify the client’s physician.

5. E. Education and Training. When an agency provides intravenous or related therapies, the agency shall provide:

   1. (1) Education, training, and written instructions to the client, client representative, or the individual caring for the client before the initiation of treatment, which includes:

      1. (a) Feeding formulation or medication preparation;
      2. (b) Administration of the therapy;
      3. (c) Accessing private care;
      4. (d) Equipment maintenance;
      5. (e) Recognition of complications of therapy, adverse medication reactions, and equipment malfunctions; and
      6. (f) Mechanisms for accessing a clinician during business hours and at any time after hours for questions related to drug therapy, drug administration, or equipment troubleshooting or malfunctions; and
   2. (2) Retraining and a review to the client, client representative, or the individual caring for the client as needed or requested.

6. F. The agency shall maintain a clinical record for a client receiving intravenous or related therapies, which, in addition to the documents required to be maintained in accordance with the provisions set forth in Regulations .14 and .15 of this chapter, includes the following:

   1. (1) Results of training or retraining of the client, client representative, or the individual caring for the client;
   2. (2) Composition, indication for use, role, and mode of administration of feeding formulas or medications; and
   3. (3) Summary statement at termination of the intravenous or related therapy which includes the results of therapy, complications, outcome, and disposition of the client.

Authority: Health-General Article, Title 19, Subtitle 4A, Annotated Code of Maryland

Effective date: January 17, 1994 (21:1 Md. R. 33)

Regulation .01B amended effective June 2, 1997 (24:11 Md. R. 793)

Regulation .02 amended effective June 2, 1997 (24:11 Md. R. 793)

Regulation .03C repealed effective June 2, 1997 (24:11 Md. R. 793)

Regulation .05-1 adopted effective June 2, 1997 (24:11 Md. R. 793)

Regulations .01—.08 repealed and new Regulations .01—.28 adopted effective May 1, 2012 (38:21 Md. R. 1277)

Regulation .04A amended effective December 21, 2015 (42:25 Md. R. 1543); March 28, 2016 (43:6 Md. R. 406)

Regulation .04A, I amended effective August 19, 2013 (40:16 Md. R. 1343); January 6, 2014 (40:26 Md. R. 2162); March 13, 2017 (44:5 Md. R. 292)

Regulation .04H amended effective January 6, 2014 (40:26 Md. R. 2162)

Regulation .04H, I amended effective July 4, 2016 (43:13 Md. R. 712)

Regulation .12E amended as an emergency provision effective June 1, 2012 (39:13 Md. R. 784); amended permanently effective September 3, 2012 (39:17 Md. R. 1148)