1. A. A hand and upper extremity trauma center shall:

   1. (1) Be licensed as an acute care hospital by the hospital licensing authority in the jurisdiction in which it is located;
   2. (2) Be accredited by [the Joint Commission on Accreditation of Health Care Organizations] an organization that has been granted deeming authority by the Centers for Medicare & Medicaid Services and approved by the Maryland Department of Health to accredit hospitals in the State, with a designated hand surgery service;

   3. (3) Have an emergency department which offers comprehensive emergency care 24 hours a day with:

      1. (a) At least one physician experienced in emergency care on duty in the emergency care area; and

      2. (b) In-hospital physician coverage by members of the medical staff or by senior-level residents who are postgraduate year 3 or higher for the following services:

         1. (i) Medical;
         2. (ii) Surgical;
         3. (iii) Orthopedic; and
         4. (iv) Anesthesia;

   4. (4) Have a resolution adopted by the Board of Directors of the hospital committing the hospital to:

      1. (a) Participate in State and regional emergency medical services; and

      2. (b) Maintain the infrastructure necessary to support the hospital's provision of state-of-the-art hand and upper extremity trauma care including the following resources necessary to the provision of such service:

         1. (i) Financial;
         2. (ii) Human; and
         3. (iii) Physical.

2. B. The hand and upper extremity trauma center shall have:

   1. (1) A medical director;
   2. (2) Appropriately educated nurse leaders and clinical staff to provide care for hand and upper extremity trauma patients;
   3. (3) A fellowship training program in hand surgery accredited by the ACGME;
   4. (4) A comprehensive post-trauma rehabilitation program accredited by CARF;
   5. (5) A quality improvement program which participates in State and regional emergency medical services quality management;
   6. (6) An educational program for physicians, nurses, and therapists who treat trauma patients with single system upper extremity trauma;
   7. (7) A policy committee that oversees the activities of the hand and upper extremity trauma center;
   8. (8) An internal morbidity and mortality conference scheduled to meet at least monthly to record and discuss any complications;
   9. (9) A maintained hand registry; and
   10. (10) Timely submission of data to the MIEMSS State trauma registry.

Authority: Education Article, §13-509, Annotated Code of Maryland

Effective date: August 13, 2007 (34:16 Md. R. 1433)

Regulation .02A amended effective July 21, 2025 (52:14 Md. R. 714)