(a) There is an Oversight Committee on Quality of Care in Nursing Homes and Assisted Living Facilities. (b) The Oversight Committee shall consist of the following members: (1) One member of the Senate Finance Committee, appointed by the President of the Senate; (2) One member of the Senate Education, Health, and Environmental Affairs Committee, appointed by the President of the Senate; (3) Two members of the House Health and Government Operations Committee, appointed by the Speaker of the House; (4) The Secretary of Aging, or the Secretary's designee; (5) The Secretary of Health, or the Secretary's designee; (6) The Director of the Office of Health Care Quality, or the Director's designee; (7) The Deputy Secretary for Behavioral Health, or the Deputy Secretary's designee; (8) The Secretary of Human Services, or the Secretary's designee; (9) The Secretary of Disabilities, or the Secretary's designee; (10) The State Long-Term Care Ombudsman; (11) Two representatives of area agencies on aging, one of which shall be a member of a local long-term care ombudsman program established under Title 10, Subtitle 9 of the Human Services Article, selected by the President of the Maryland Association of Area Agencies on Aging; (12) One representative of a local long-term care ombudsman entity, selected by the State Long-Term Care Ombudsman; (13) Three consumer members, selected by the State Long-Term Care Ombudsman, all of whom shall be consumers living in an assisted living facility or a nursing home or have a family member living in an assisted living facility or a nursing home; (14) The following representatives, selected by the organizations the individual represents: (i) One representative from the Health Facilities Association of Maryland; (ii) One representative from the Mid-Atlantic LifeSpan; (iii) One representative of the Hospice Network of Maryland; (iv) One representative of the Maryland Hospital Association; (v) One representative of 1199SEIU United Health Workers East; (vi) One representative of the Maryland Chapter of AARP; (vii) One representative of United Seniors of Maryland; (viii) One representative of Voices for Quality Care; (ix) One representative of the Mental Health Association of Maryland knowledgeable in issues of aging; (x) One representative of the Greater Maryland Chapter of the Alzheimer's Association; and (xi) One representative of the Maryland Association of Adult Day Services; and (15) Three representatives from the assisted living industry, of which one shall represent a program that cares for one to four residents, one shall represent a program that cares for five to nine residents, and one shall represent a program that cares for more than 10 residents. (c) The Secretary of Aging, or the Secretary's designee, shall chair the Oversight Committee. (d) The Oversight Committee shall evaluate the progress in improving nursing home care quality and assisted living facility quality statewide, which may include consideration of: (1) Quality of care standards for nursing homes and assisted living facilities; (2) Standards for the identification of the onset of dementia and Alzheimer's disease; (3) Standards for the identification of conditions appropriate for hospice services; (4) Staffing patterns and staffing standards; (5) Policies and procedures for inspecting nursing homes and assisted living facilities, and responding to quality of care complaints; (6) A comparison of Maryland standards, policies, and procedures to those in other states; (7) The labor pool available to fill nursing and nursing aide jobs; (8) State funding mechanisms for nursing homes and assisted living facilities, including the Medicaid Nursing Home Reimbursement System, potential barriers to eligibility in the Maryland Medical Assistance Program, potential barriers to the timely payment of claims submitted to the Maryland Medical Assistance Program, and regulation of nursing homes; (9) The provision and quality of dementia care and behavioral health supports and services to meet the needs of nursing home and assisted living facility residents; (10) Staff training and development; (11) The rights of residents; (12) Data on resident satisfaction; (13) Resident assessments; (14) Resident care planning; (15) The monitoring of residents; and (16) The change of resident status. (e) The Office of Health Care Quality in the Maryland Department of Health shall submit a report to the Oversight Committee annually on the status of quality of care in nursing homes and assisted living facilities. (f) The Deputy Secretary of Health Care Financing, or the Deputy Secretary's designee, shall report annually to the Oversight Committee on the status of the Medicaid Nursing Home Reimbursement System, which shall include but not be limited to: (1) Elements of the existing methodology that are no longer relevant; (2) Elements of the existing methodology that can be revised; (3) The appropriateness of redesigning the system given changing demographics of the target population; and (4) General Fund and federal fund savings from a system redesign that may be redirected to nursing home staff development in the nursing cost center. (g) The Oversight Committee shall review the reports of the Office of Health Care Quality and the Deputy Secretary of Health Care Financing and develop recommendations to continue improvement in nursing home and assisted living facility care. (h) The Oversight Committee may: (1) Review legislation introduced in the General Assembly that may affect nursing home and assisted living facility care; and (2) Make recommendations about the legislation to the General Assembly. (i) The Oversight Committee may: (1) Review proposed regulations that may affect nursing home and assisted living facility care; and (2) Make recommendations about the regulations to the departments proposing the regulations and to the Joint Committee on Administrative, Executive, and Legislative Review. (j) The Oversight Committee shall report its findings and recommendations to the Governor and, subject to § 2-1257 of the State Government Article, to the General Assembly on or before December 1 of each year. (k) The Department of Aging, with assistance from the Maryland Department of Health, the Department of Human Services, and the Department of Legislative Services, shall provide staff support for the Oversight Committee. §19-1410. IN EFFECT (a) Each nursing home shall develop and implement a quality assurance program. (b) (1) Each nursing home shall designate a qualified individual to coordinate and manage the nursing home's quality assurance program. (2) Each nursing home shall establish a quality assurance committee and shall include at least the following members: (i) The nursing home administrator; (ii) The director of nursing; (iii) The medical director; (iv) A social worker; (v) A licensed dietitian; and (vi) A geriatric nursing assistant. (3) The quality assurance committee shall: (i) Meet at least monthly; (ii) Maintain records of all quality assurance activities; (iii) Keep records of committee meetings that shall be available to the Department during any on-site visit; and (iv) Prepare monthly reports that shall be presented to the ombudsman, the resident's council, and the family council. (4) The quality assurance committee for a nursing home shall review and approve annually the quality assurance plan for the nursing home. (5) Each nursing home shall establish a written quality assurance plan that: (i) Includes procedures for concurrent review for all residents; (ii) Provides criteria that routinely monitors nursing care including medication administration, prevention of decubitus ulcers, dehydration and malnutrition, nutritional status and weight loss or gain, accidents and injuries, unexpected deaths, changes in mental or psychological status, and any other data necessary to monitor quality of care; (iii) Includes methods to identify and correct problems; and (iv) Is readily available to nursing home residents and their families, guardians, or surrogate decision makers. (6) The quality assurance plan shall be submitted to the Department every 2 years. (7) The nursing home administrator shall take appropriate remedial actions based on the recommendations of the nursing home's quality assurance committee. (8) The Secretary may not require the quality assurance committee to disclose the records and the reports prepared by the committee except as necessary to assure compliance with the requirements of this section. (9) If the Department determines that a nursing home is not implementing its quality assurance program effectively and that quality assurance activities are inadequate, the Department may impose appropriate sanctions on the nursing home to improve quality assurance including mandated employment of specified quality assurance personnel. (c) (1) Each nursing home shall display on each floor of the nursing home a notice that explains the current ratio of licensed personnel to residents and unlicensed personnel to residents. (2) The notice shall be: (i) Posted in a location that is visible and accessible to residents and their family or guardians and any potential consumers; and (ii) On a form provided by the Department. §19-1410. ** TAKES EFFECT APRIL 1, 2026 PER CHAPTER 416 OF 2025 ** (a) Each nursing home shall develop and implement a quality assurance program. (b) (1) Each nursing home shall designate a qualified individual to coordinate and manage the nursing home's quality assurance program. (2) Each nursing home shall establish a quality assurance committee and shall include at least the following members: (i) The nursing home administrator; (ii) The director of nursing; (iii) The medical director; (iv) A social worker; (v) A licensed dietitian; and (vi) A certified nursing assistant-I. (3) The quality assurance committee shall: (i) Meet at least monthly; (ii) Maintain records of all quality assurance activities; (iii) Keep records of committee meetings that shall be available to the Department during any on-site visit; and (iv) Prepare monthly reports that shall be presented to the ombudsman, the resident's council, and the family council. (4) The quality assurance committee for a nursing home shall review and approve annually the quality assurance plan for the nursing home. (5) Each nursing home shall establish a written quality assurance plan that: (i) Includes procedures for concurrent review for all residents; (ii) Provides criteria that routinely monitors nursing care including medication administration, prevention of decubitus ulcers, dehydration and malnutrition, nutritional status and weight loss or gain, accidents and injuries, unexpected deaths, changes in mental or psychological status, and any other data necessary to monitor quality of care; (iii) Includes methods to identify and correct problems; and (iv) Is readily available to nursing home residents and their families, guardians, or surrogate decision makers. (6) The quality assurance plan shall be submitted to the Department every 2 years. (7) The nursing home administrator shall take appropriate remedial actions based on the recommendations of the nursing home's quality assurance committee. (8) The Secretary may not require the quality assurance committee to disclose the records and the reports prepared by the committee except as necessary to assure compliance with the requirements of this section. (9) If the Department determines that a nursing home is not implementing its quality assurance program effectively and that quality assurance activities are inadequate, the Department may impose appropriate sanctions on the nursing home to improve quality assurance including mandated employment of specified quality assurance personnel. (c) (1) Each nursing home shall display on each floor of the nursing home a notice that explains the current ratio of licensed personnel to residents and unlicensed personnel to residents. (2) The notice shall be: (i) Posted in a location that is visible and accessible to residents and their family or guardians and any potential consumers; and (ii) On a form provided by the Department.
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