MIEMSS Commercial Ambulance Licensing and Regulation

COMMERCIAL—MAIS USER’S MANUAL

July 2000 REV. 07/05/00 Table of Contents Page

General Form Identification 1

Sample Commercial MAIS form. 2

Section 1 Location, Patient, and Provider Information 3

Section 2 Unit, Crew, Date, Origen and Destination Information 4

Section 3 Documentation of Response Times and Facility Codes 5

Section 4 Vital Signs, Transport Reason, Signs and Symptoms 6

Section 5 Airway/Ventilation, Circulation, and Other 7

Section 6 Care, Skills, Medications and Special Items 9

Section 7 Narrative 10

Appendix A Receiving Facility Codes 11

b GENERAL: FORM IDENTIFICATION

MIEMSS RECORD—the TOP COPY is the SCANNABLE document to be submitted to MIEMSS.

OFFICIAL COPY–is the legal copy of the record and should be retained at the company level.

HOSPITAL COPY–is the copy to be left at the reciving facility.

PLEASE DO NOT: Staple, tape, bend, or otherwise mutilate the top copy. This copy is fed through a scanner, stapling, taping, or attaching items such as ECG strips creates a significant problem.

1 2 SECTION 1: LOCATION, PATIENT, AND PROVIDER INFORMATION

Response Location Record the location where you picked up the patient. Be as specific as possible. Ex. St. Joseph Hospital, Room 712B or 125 Smith Street, Bowie, MD

Destination Record the location where you delivered the patient. Be as specific as possible. Ex. Garrett Memorial Hosp., Room 301 or 765 North Prospect Avenue, Cumberland, MD

Patient Name Print the patient’s last name, first name, middle initial.

Patient Address Print the patient’s residential address—include street address, city, and zip code. Note that the residence address may differ from the response location or destination.

Social Security Number Print the patient’s social security number.

Patient DOB Print the patient’s entire date of birth. Ex. 04-11-1942

CMN/PCS Check appropriate box to indicate if a Certificate of Medical Need/Physician Certification Statement was obtained.

User Optional Open space for documenting company specific information.

Responsible Party Print the last name, first name, of the financially responsible party.

Responsible Party Print the responsible party residential address—include street address, city, and zip code Address

3 SECTION 2: UNIT, CREW, DATE, ORIGIN and DESTINATION INFORMATION

Run Number Your company’s unique identification number for the current call. Other Units on Scene Identify other units, commercial or jurisdictional, responding or assisting on call. Driver/Crew #1 Print the last name. and first letter of first name. Attendant/ Crew #2 Print the last name. and first letter of first name. Attendant/ Crew #3 Print the last name. and first letter of first name. Date Record the month, day, and year for your call. The month and year responses are pre-labeled. The zero, in column two, should only be marked if the day of the call is the 10th, 20th, or 30th day of the month. Origin Dest Indicate the type of facility for the origin or destination. Hosp./hospital, maybe used for patients coming from or going to an in-patient room or treatment area within a hospital, but not indicated on the list Srvc No. Commercial Ambulance Service License number, this is a unique number issued to each service. The majority of numbers wi11 only be two digits and should be entered with a leading zero. Ex. license number 40 should be entered as 040. Unit Num The unit number asslgned to the ambulance bv the service. Ex. A-10 should be entered as 010 and Medic 540 should be entered as 540.

Crew Certification/ Enter the appropriate MaryIand certification or license level for each crewmember. License

Unit License Level Indicate the licensing level issued for the vehicle. The license level is indicated on the paper license issued to and displayed in each ambulance.

Emerg.Warning Devices Indicate If lights and sirens were used to respond to the origin/scene or from the origin /scene to the hospital Also, includes area to indicate if lights and sirens were used to pick-up a specialty team (neonata/organ transplant/etc.). Some or none of these may apply. If so, please fill In "N" to indicate no or not applicable. Pt Pri Indicate the patient priority. Refer to the Maryland Medical Protocols for EMS Providers for descriptions.

4 SECTION 3: DOCUMENTATION OF RESPONSE TIMES and FACILITY CODES

Call Recv'd This field may or may not apply. If the call was on an emergent or ASAP basis the time the dispatch center received the request should be indicated (Does not apply to scheduled calls)

Dispatched The time your unit was given the call/notified to respond. (Applies to all calls)

Arrive Loc The time your unit arrived at the call origin/pick-up location. (Applies to all calls)

Depart Loc The time your Unit departed the call origin/pick-up location. (Applies to all calls)

Arrive Des The time your unit arrived at the destination. This destination may be a receiving facility, HMO, Phvsician office, the patients' residence, etc. (Applies to all calls)

Facility Codes Indicate the appropriate code for the origin, destination, or facility providing medical consultation. The latter may not apply, if so, leave blank.

See attached Facility Code List for appropriate codes.

5 SECTION 4: VITAL SIGNS, TRANSPORT REASON, SIGNS and SYMPTOMS

Vitals Time Record the first and last set of vital signs. Indicate the time they were obtained in the space provided next to 1st Vitals Time and 2nd Vitals Time. Vital signs are recorded using combinations of responses for hundreds 100, 200), tens (10-90). and units (1-9). A systolic pressure of 216 would have responses for 200, 10, and 6 filled in.

Use the 0 (zero) responses only for patients who were monitored and found to have no vital signs DO NOT mark “zero” response for patients whose vital signs are unobtainable.

The “P” response in the Diastolic blood pressure section should be marked to record that a blood pressure was taken by palpation.

Txport Reason Complete only one esponse. that best describes the reason for the transport. If none apply leave blank. Note: always be sure to document reason for transport in the narrative area of the report regardless of whether you complete this area.

Txport Code Follow directions from your Service to determine if and how to complete this area.

Signs and Symptoms Indicate signs and svmptoms related to your patient’s current condition. Note that some signs and symptoms relate to both trauma and medical. Mark all responses that apply. If your patient experienced signs or Symptoms other than those listed, you should mark the “Other” response and note the signs/symptoms in the narrative area.

6 SECTION 5: AIRWAY/VENTILATION, CIRCULATION, and OTHER

Lung Sounds Mark Decreased for decreased breath sounds, indicating the Left or Right side. This field may apply even if Crackles, Wheeze. or Normal is indicated' for other areas of the lung assessment. Mark Crackles if your primary assessment found difficulty In breathing accompanied by rattling, rales, or rhonchi sounds. Mark the Normal response if your primary assessment found equal, clear respirations. Mark Wheeze if the primary assessment found difficulty in breathing accompanied by hoarse, whistle sound.

Suction Indicate Oral or Tracheal suctioning w,as performed. Or, both if applicable.

Airway Indicate if an Oral or Nasotracheal airway was successfully placed. Or, both if applicable.

02 Delivery Device If oxygen was delivered Indicate the device(s) that was used. Mark NC for nasal cannula. NRB for non-rebreather mask, Neb for nebulizer, Venturi for venturi- mask, Mech.Vent for a mechanical ventilator, and BVM for bag-valve-mask.

02 Lpm If oxygen was delivered indicated the flow rate at the end of the transport.

Pulse Oximetry If obtained, indicate the first and last readings for pulse oximetry. Note: you should indicate the oxygen delivery, if any, at the time a reading was obtained in your patient care narrative.

ECG Document your patient’s first (F) and last (L) electrocardiogram rhythms. If you need to document a cardiac rhythm other than those listed, use the patient care narrative section.

Age For the patient LESS THAN 24 HOURS old, mark the “D” response and fill in BOTH zero responses. The number of hours needs to be recorded in the narrative section of the MAIS (this is in addition to any nursing notes).

Patients between the ages of 1 and 31 days old should have the “D” response marked along with the appropriate number of days

If Your patient is between 2 and 11 months old, you should mark the “M” response, as well as a response for the appropriate number of months.

Leave the “M” and “D” responses blank for a patient one year of age or older, and darken the responses corresponding to their age in years.

Gender Mark the response that corresponds to your patient’s gender.

7 Txport by Indicate if the patient was not transported by your ambulance. If the patient was transported, by whom, your ambulance, another commercial ambulance, or by ajurisdictional ambulance.

Radio Document the quality of the EMRC/UHF radio communications for this call.

N/A this call did not require radio communication. Good all communications were discernible. Poor some communications were not discernible and required repeated transmissions beyond normal expectations. Failed radio communications failed to permit proper or complete transmission of information.

Variables If a MIEMSS additional narrative form was completed, complete “Add Narr” field.

If the call was an Exceptional Call as defined by the Marvland Medical Protocols for EMS Providers complete the “Except Call” field.

Local Complete this section at the direction of your company.

Provider Exposure If any member of this reporting unit was exposed to a potentially infectious agent, the appropriate response(s) should be marked.

Mark the Needle response for exposure to blood or Other Potential Infectious Material (vomitus, urine, stool. CSF, etc.). This applies to percutaneous exposures. For example. if there was a needle stick, mark this response.

Mark Splash if blood or Other Potential Infectious Material (vomitus, urine, stool. CSF, etc.) splashed in the eye, nose, on broken skin.

Mark the Airborne response for exposure to airborne pathogens. If your patient coughed or sneezed in close proximity to any member of this unit, or if the patient exhibited other signs of respiratory illness, mark this response.

Mark the Other response for exposure not included above. Document specifics in the narrative section of this report.

8 SECTION 6: CARE, SKILLS, MEDICATIONS and SPECIAL ITEMS

Care /Skills Identify the crewmember ( #1, #2, or #3) for each,. procedure SUCCESSFULLY performed by the ambulance crew only. DO NOT include procedures or devices established by a hospital or sending facility.

Indicate sizes number of attempts, or other variables in the narrative section.

Abbreviations ET Endotracheal Intubation. NT Nasotracheal intubation NG Nasogastric tube Thoracost Thoracostomy or Needle Decompression Thoracostomy (NDT) CPR MANUAL Cardio-Pulmonary Resuscitation CPR Mech MECHANICAL Cardio-Pulmonary Resuscitation Spinal Imb Spinal Immobilization Tract/Splint Use of a traction, rigid splint, or other method PASG Pneumatic Anti-Shock Garment (or MAST). This response indicates that PASG/MAST was INFLATED. Cntrl Bleed Control Bleeding Defib Defibrillation (Unsvnchronized) Cardiovert Cardioversion Pacing EXTERNAL Pacing 3 Lead Standard 3, lead cardiac monitoring 12 Lead 12 lead Electrocardiogram IV line #1 lntravenous line #1 was SUCCESSFULLY placed IV line #2 Intravenous line #2 (In addition to #1 was SUCCESSFULLY placed. This DOES NOT indicate a second ATTEMPT. IV EMT-B Intravenous line was M0NITORED by an EMT-B Ext Jugular External Jugular Intra Ossc Intraosseous line Glucometer Indicate the crewmember # and INITIAL reading in the space provided.

9 Special Item Indicate procedures or devices established by a hospital or sending facility. Items not included should be documented in the narrative section.

Cardiac Arrest Witnessed - mark yes if witnessed by EMS, facility staff, or civilian. Return Spont Circ — mark yes if spontaneous circulation returns while patient is in care of EMS CPR — indicate ,vho started CPR AED (Automated External Deffibrillation), if used, indicate who was the FIRST to apply the AED.

NOTE: Times and other interventions should be included in the narrative section.

Medications Document all of the medications administered to your patient by the crew. DO NOT include medications administered by a transferring facilitv.

If your training level is EMT-B and you assist with medications, you should mark the “Assist Med” response that corresponds to vour crew number in addition to the medication you have assisted with.

SECTION 7: NARRATIVE

A narrative should be completed for EVERY transport. Use either the narrative on the C-MAIS form or an Additional Narrative form. Follow the specific directions of your Service and Medical Director on which one to use.

10 Appendix A—Facility Codes

Code Hospital Name Code Hospital Name 345 10th Street Medical Center, Ocean City, MD 717 Children's National Medical Center Pediatric Trauma Center - 409 126th Street Medical Center, Ocean City, MD Wash., D.C. (formerly listed as Children's Hospital National 346 26th Street Medical Center, Ocean City, MD Medical Center Ped. Trauma Center – D.C.) 379 63rd Street Medical Center, Ocean City, MD 317 Children's National Medical Center, D.C. (formerly listed 380 75th Street Medical Center, Ocean City, MD as Children's Hospital National Medical Center, D.C.) 347 93rd Street Medical Center, Ocean City, MD 304 Christiana Care Health Systems, Christiana Hospital 230 Alexandria Hospital, VA (formerly listed as listed as listed as listed as Christiana Hospital) 751 Alfred I. DuPont Hospital for Children (formerly listed as Alfred I 299 Christiana Care Health Systems, Wilmington Hospital DuPont Institute) (formerly listed as Wilmington Hospital) 422 Alleghany General Hospital, Alleghany, PA 202 Church Hospital 397 Altoona Rehabilitation Hospital 341 City Hospital, Martinsburg, WV 231 Andrew Rader Clinic, VA 291 Civista, (formerly listed as Physicians Memorial Hospital) 221 Anne Arundel General Hospital 245 Columbia Hospital for Women Medical Center, Washington, D.C. 382 Anne Arundel Medical Park 383 Columbia Medical Plan 550 Annie M. Warner Hospital 757 Cooper Trauma Center, N.J. 233 Arlington Hospital, VA 248 Crownsville State Hospital 381 Atlantic General Hospital 252 Cullen Center 520 Baltimore City Public Service Infirmary 320 Cumberland Memorial Hospital & Medical Center 350 Bayhealth Medical Center, Kent Hospital (formerly listed as Kent 620 Cumberland Memorial Hospital & Medical Center Trauma Center General) 342 DC General Hospital 359 Bayhealth Medical Center, Milford Hospital (formerly listed as 842 DC General Hospital Neonatal Center Milford Memorial Hospital) 254 Deaton Hospital & Medical Center of Christ Lutheran Church 551 Bedford County Memorial Hospital, PA 293 Deer's Head State Hospital 358 Beebe Medical Center (formerly listed as Beebe Hospital of 556 Delaware Memorial Hospital, DE Sussex County) 256 DeWitt Army Hospital, VA 234 Beebe Medical Center, Millville Center (formerly listed as 329 Doctor's Community Hospital (formerly listed as Doctor's Bethany Emergency enter) Hospital of Prince George's County (AMI Doctor's)) 355 Bethesda Naval Hospital / National Capital Region Naval 257 Dominion Hospital, VA Medical Command 310 Dover U.S. Air Force Clinic (formerly listed as Dover U.S. Air 208 Bon Secours Hospital Force Hospital) 353 Bowie Health Center 302 DuPont Memorial Hospital 235 Brooke Lane Psychiatric Center 421 Eastern Neurological Rehabilitation Hospital 236 Brunswick Medical Center 331 Eastern Shore State Hospital 553 Bryn Mawr Hospital 557 Elizabethtown Children's Hospital 752 Bryn Mawr Rehabilitation Hospital 306 Ellsmere Veteran's Administration Hospital, DE 754 Bryn Mawr Rehabilitation Hospital at Maryland General Hospital 558 Emmitsburg Hospital 771 Calvert County Nursing Home Center 340 Fair Oaks Hospital, VA (formerly listed as Commonwealth 266 Calvert Memorial Hospital Hospital) 237 Capitol Hill Hospital, DC (closed per Region V Office) 305 Fairfax Hospital, VA 554 Carlisle Hospital 224 Fallston General Hospital 555 Carpenter's Clinic 258 Finan Center State Psychiatric Facility 219 Carroll County General Hospital 279 Fort Dietrick Medical Center 238 Carter Community Mental Health & Retardation Center 247 Fort Howard Veteran's Administration Hospital 755 Central Industrial Medical Center 522 Fort Washington Hospital 276 Chambersburg Hospital, PA 203 Franklin Square Hospital 284 Charlestown Area Medical Center 239 Frederick Memorial Hospital 241 Chemtrec Chem Mfgrs Assn Chemical Transportation Emergency 253 Freeman Hospital Center, Wash., D.C. 319 Frostburg Hospital 243 Chestnut Lodge Hospital 286 Fulton County Medical Center, PA 419 Children's Hospital - Hershey Medical Center - Hershey, PA. 322 Garrett County Memorial Hospital 225 Children's Hospital & Center for Reconstructive Surgery - 580 Geisinger Medical Center, PA Baltimore, MD 335 George Washington University Hospital, DC 756 Children's Hospital of Pennsylvania 737 Georgetown University Hospital Eye Trauma Center, DC 818 Children's National Medical Center Neonatal Center - Wash., D.C. 337 Georgetown University Hospital, DC (formerly listed as Children's Hospital National Medical Center 240 Gettysburg Hospital, PA Neonatal Center - Wash., D.C. 759 Gladys Spellman Nursing Center 718 Children's National Medical Center Pediatric Burn Center- Wash., 226 Good Samaritan Hospital of Maryland D.C. (formerly listed as Children's Hospital National Medical 559 Grant Memorial Hospital Center Ped. Burn Center - Wash., D.C.) 217 Greater Baltimore Medical Center 817 Greater Baltimore Medical Center Neonatal Center

11 Appendix A—Facility Codes

Code Hospital Name Code Hospital Name 261 Greater Northeast Medical Center, DC (see also Northeast 280 Mary Washington Hospital, VA Georgetown #313) 206 Maryland General Hospital 316 Greater Southeast Community Hospital, DC 281 Maryland Penitentiary Hospital 348 Groupe Memorial Hospital 300 Maryland Poison Information Center at UMAB 263 Gundry Hospital 285 Masonic Eastern Star Home, DC 363 Hadley Memorial Hospital, DC 566 McConnellsburg Hospital 560 Hagerstown State Hospital 332 McCready Memorial Hospital 561 Hampshire Memorial Hospital, WV 339 McGuire Veteran's Administration Hospital, VA 242 Hanover General Hospital, PA 398 Mechanicsburg Rehabilitation Hospital 211 Harbor Hospital Center (formerly listed as South Baltimore 774 Medlink, D.C. General Hospital) 404 Memorial Hospital, PA 220 Harford Memorial Hospital 567 Memorial Osteopathic Hospital, PA 562 Harryon State Hospital 207 Mercy Medical Center, Baltimore, MD 399 Health South Chesapeake Rehabilitation Center (formerly listed as 807 Mercy Medical Center, Neonatal Center - Baltimore, MD Chesapeake Rehabilitation Hospital) 907 Mercy Medical Center, Perinatal Center - Baltimore, MD 420 Health South Rehabilitation Hospital of Altoona 271 Monongalia General Hospital, WV 267 Highland State Health Facility Psychiatric Unit 228 Montebello Center - Baltimore, MD 244 Holy Cross Hospital of Silver Spring 264 Montgomery General Hospital 450 Hospice of Baltimore - Gilchrist Center - Baltimore, MD 282 Morgan County War Memorial Hospital, WV 268 Hospital for Sick Children, DC 287 Mount Vernon Hospital, VA 223 Howard County General Hospital 292 Mount Washington Pediatric Hospital 270 Howard University Hospital, DC 400 Myersdale Hospital, PA 349 Isle of Wight Medical Center 351 Nanticoke Memorial Hospital 273 Jefferson Memorial Hospital, Arlington, VA 295 National Capital Poison Center, Washington,D.C. (formerly listed 314 Jefferson Memorial Hospital, Ranson, WV as National Capital Poison Center at Georgetown University, DC) 601 Johns Hopkins Bayview Adult Trauma Center 334 National Hospital for Orthopedics & Rehabilitation, VA 701 Johns Hopkins Bayview Burn Unit 308 National Institute of Mental Health 201 Johns Hopkins Bayview Medical Center 356 National Institutes of Health Clinical Center 801 Johns Hopkins Bayview Neonatal Center 307 Newark Emergency Center, Newark, DE 901 Johns Hopkins Bayview Perinatal Center 568 Newark Hospital, NJ 761 Johns Hopkins Comprehensive Geriatric Center 762 Newmedico Rehabilitation 204 Johns Hopkins Hospital 222 North Arundel General Hospital 604 Johns Hopkins Hospital Adult Trauma Center 753 Northampton-Accomac Memorial Hospital 705 Johns Hopkins Hospital Eye Trauma Center 313 Northeast Georgetown Medical Center (see also Greater Northeast 706 Johns Hopkins Hospital Inpatient Rehabilitation Center # 261) 804 Johns Hopkins Hospital Neonatal Intensive Care Unit 315 Northern Virginia Doctor's Hospital, VA 704 Johns Hopkins Hospital Pediatric Trauma Center 218 Northwest Hospital Center 904 Johns Hopkins Hospital Perinatal Center 309 NRH Regional Rehabilitation @ Irving Street, Wash.,D.C. 451 Joseph Richey Hospice - Joseph Richey House, Baltimore, MD (formerly listed as Nartional Rehabilitation Hospital) 274 Kennedy-Krieger Institute (formerly listed as John F. Kennedy 888 Other facility Institute for Handicapped Children) 330 Parkwood Hospital (formerly listed as Clinton Hospital -- 296 Kent and Queen Anne's Hospital Closed per Region V Office) 227 Kernan Hospital 336 Patuxent River Naval Air Station Hospital (Closed per Region V 277 Keswick Home for the Incurables of Baltimore City Office) 262 Kimbrough Army Hospital 408 Peninsula Regional Medical Center 563 Kings Daughters Hospital, WV 454 Peninsula Regional Medical Center, Transitional Care Unit 259 Kirk Army Hospital 608 Peninsula Regional Medical Center, Trauma Center (formerly 403 Lancaster General Hospital, PA listed as Peninsula General Hospital Medical Center Adult 564 Lancaster Osteopathic Hospital, PA Trauma Center) 773 Laurel Regional Hospital - Rehabilitation 301 Pennsylvania State University Hospital (Hershey Medical 352 Laurel Regional Hospital (formerly listed as Greater Laurel Center), PA Beltsville Hospital) 318 Perkins State Hospital 565 Leesburg Hospital, VA 357 Perry Point Veteran's Administration Hospital 251 Leland Memorial Hospital (closed per Region V office) 569 Pittsburgh Institute for Rehabilitation 278 Levindale Hebrew Geriatric Center & Hospital 362 Pocomoke City Medical Center 209 Liberty Medical Center (formerly listed as Provident Hospital) 361 Pocomoke Family Health Center 205 Liberty Medical Center Psychiatric Center (formerly listed as 338 Police & Fire Clinic, Washington, DC Lutheran Hospital) 325 Potomac Hospital, VA 255 Lincoln Memorial Hospital 401 Potomac Valley Hospital, WV 326 Loudoun Memorial Hospital, VA 632 Prince George's Hospital Center (formerly listed as Prince George's 354 Malcolm Grow U.S. Air Force Medical Center General Hospital and Medical Center Adult Trauma Center)

12 Appendix A—Facility Codes

Code Hospital Name Code Hospital Name 232 Prince George's Hospital Center (formerly listed as Prince 760 The Greenery George's General Hospital and Medical Center) 373 Tidewater Memorial Hospital, VA 832 Prince George's Hospital Center Neonatal Center 374 U.S. Naval Academy Primary Care Clinic 344 Prince William Hospital, VA 576 U.S. Public Health Hospital, MD 288 Providence Hospital, DC 375 U.S. Soldier's and Airmen's Home, DC 378 Psychiatric Institute of DC 298 Union Hospital of Cecil County 364 Psychiatric Institute of Montgomery County 214 Union Memorial Hospital 634 R Adams Cowley Shock Trauma Center - Adult Trauma Unit 714 Union Memorial Hospital, Curtis Hand Center 734 R Adams Cowley Shock Trauma Center - Hyperbaric Unit 615 University of Maryland Hospital Adult Trauma Center (No longer 735 R Adams Cowley Shock Trauma Center - Neurotrauma Unit exists per Region III Office) 570 Reading Medical Center 915 University of Maryland Medical System (formerly listed as 571 Riverside Hospital, DE University of Maryland Hospital Perinatal Center) 311 Riverside Hospital, VA 215 University of Maryland Medical System (formerly listed as 365 Rosewood State Facility University of Maryland Hospital) 461 Ruby Hospital Morgantown, WV 815 University of Maryland Medical System Neonatal Center 321 Sacred Heart Hospital (formerly listed as University of Maryland Hospital Neonatal 572 Sacred Heart Hospital, PA Center) 573 Saint Agnes Burn Center, PA (formerly listed as a Delaware 575 University of Pennsylvania Hospital facility) 407 Upper Shore Mental Health Center 212 Saint Agnes Hospital 246 Veteran's Administration Hospital - Baltimore, MD 812 Saint Agnes Hospital Neonatal Center 577 Veteran's Administration Hospital - Wilmington, DE 912 Saint Agnes Hospital Perinatal Center 376 Veteran's Administration Medical Center, DC 366 Saint Elizabeth's Hospital, Washington, D.C. 275 Veterans Affairs Medical Center Martinsburg VA (formerly listed 303 Saint Francis Hospital, WV as Martinsburg V.A. Hospital and Newton T. Baker Hospital) 213 Saint Joseph Hospital, MD 250 Walter Reed Army Medical Center, DC 405 Saint Joseph Hospital, PA 377 Walter Reed Hospital Annex 367 Saint Luke Institute 552 War Memorial Hospital, Berkeley Springs W.V. (formerly listed 333 Saint Mary's Hospital as Berkeley Springs Hospital, W.V) 455 Salisbury Genisis Center 328 Washington Adventist Hospital 265 Shady Grove Adventist Hospital 689 Washington County Health System Adult Trauma Center 368 Sheppard & Enoch Pratt Hospital (formerly listed as Washington County Hospital Association, MD, 294 Shore Health Systems, Dorchester General Hospital (formerly Adult Trauma Center) listed as Dorchester General Hospital) 789 Washington County Health System, Comprehensive Inpatient 297 Shore Health Systems, Easton Memorial Hospital (formerly listed Rehabilitation Services, MD as Easton Memorial Hospital) 289 Washington County Health System, MD (formerly listed as 324 Sibley Memorial Hospital, Washington, D.C. Washington County Hospital Association, MD) 750 Sinai Head Injury Rehabilitation Hospital 456 Washington County Health System, Psychiatric Unit 210 Sinai Hospital of Baltimore 764 Washington County Health System, Skilled Nursing Facility, MD 610 Sinai Hospital of Baltimore Adult Trauma Center 727 Washington Hospital Center Burn Center, Washington DC 810 Sinai Hospital of Baltimore Neonatal Center 327 Washington Hospital Center, DC 910 Sinai Hospital of Baltimore Perinatal Center 728 Washington Hospital Center, DC, Adult Trauma Center 770 Sinai Rehabilitation Hospital 269 Waynesboro Hospital (formerly listed as Waynesboro General 772 Solomon's Nursing Home Center Hospital, Waynesboro, PA) 360 Southern Chester County Medical Center, PA 323 West Virginia University Hospital, WV 343 Southern Maryland Hospital Center 290 Western Maryland Center, MD 643 Southern Maryland Hospital Center Adult Trauma Center 402 Western Pennsylvania University Hospital, PA (Closed per Region V Office) 283 Winchester Medical Center 369 Spring Grove State Hospital 578 Woodrow Wilson Rehabilitation Center, VA 406 Springfield State Hospital 579 Yale - New Haven Hospital 370 Springwood Psychiatric Institute, VA 272 York Hospital, PA 460 St. Francis Hospital, Wilmington DE 765 York Rehabilitation Hospital, PA 521 State Post Mortem Examiner's (Morgue) 452 Stella Maris Hospice - Dulaney Valley Road - Timonium, MD 453 Stella Maris Hospice at Mercy Medical Center - Baltimore, MD 249 Suburban Hospital Association 649 Suburban Hospital Association Adult Trauma Center 763 Suburban Hospital, Inc., Skilled Nursing Facility 371 Tawes-Bland Bryant Nursing Center 574 Taylor Hospital, WV 312 Taylor Manor Hospital 372 TB Clinic

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