MIEMSSCommercial Ambulance

Licensing and Regulation

COMMERCIAL—MAIS

USER’SMANUAL

July 2000REV. 07/05/00

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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

1

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 beretained 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 througha scanner, stapling, taping, or attaching items such as ECG strips creates asignificant problem.

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3

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 CertificationStatement 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 codeAddress

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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" toindicate no or not applicable.

Pt Pri Indicate the patient priority. Refer to the Maryland Medical Protocols for EMS Providersfor descriptions.

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

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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 medicalconsultation. The latter may not apply, if so, leave blank.

See attached Facility Code List for appropriate codes.

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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 thespace provided next to 1st Vitals Time and 2nd Vitals Time. Vital signs are recorded usingcombinations of responses for hundreds 100, 200), tens (10-90). and units (1-9). A systolicpressure 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 torecord that a blood pressure was taken by palpation.

Txport Reason Complete only one esponse. that best describes the reason for the transport. If none applyleave blank. Note: always be sure to document reason for transport in the narrative area ofthe 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 patientexperienced signs or Symptoms other than those listed, you should mark the “Other” response and note the signs/symptoms in the narrative area.

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SECTION 5: AIRWAY/VENTILATION, CIRCULATION, and OTHER

Lung Sounds Mark Decreased for decreased breath sounds, indicating the Left or Right side. This fieldmay apply even if Crackles, Wheeze. or Normal is indicated' for other areas of the lungassessment. Mark Crackles if your primary assessment found difficulty In breathing accompanied by rattling, rales, or rhonchi sounds. Mark the Normal response if yourprimary 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 fora 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 todocument 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 BOTHzero responses. The number of hours needs to be recorded in the narrative section of theMAIS (this is in addition to any nursing notes).

Patients between the ages of 1 and 31 days old should have the “D” responsemarked 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, anddarken the responses corresponding to their age in years.

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

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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 EMSProviders 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, theappropriate 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. ifthere 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 coughedor sneezed in close proximity to any member of this unit, or if the patient exhibited othersigns of respiratory illness, mark this response.

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

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SECTION 6: CARE, SKILLS, MEDICATIONS and SPECIAL ITEMS

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

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

AbbreviationsET Endotracheal Intubation.NT Nasotracheal intubationNG Nasogastric tubeThoracost Thoracostomy or Needle Decompression Thoracostomy (NDT)CPR MANUAL Cardio-Pulmonary ResuscitationCPR Mech MECHANICAL Cardio-Pulmonary ResuscitationSpinal Imb Spinal ImmobilizationTract/Splint Use of a traction, rigid splint, or other methodPASG Pneumatic Anti-Shock Garment (or MAST). This response indicates that

PASG/MAST was INFLATED.Cntrl Bleed Control BleedingDefib Defibrillation (Unsvnchronized)Cardiovert CardioversionPacing EXTERNAL Pacing3 Lead Standard 3, lead cardiac monitoring12 Lead 12 lead ElectrocardiogramIV line #1 lntravenous line #1 was SUCCESSFULLY placedIV 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-BExt Jugular External JugularIntra Ossc Intraosseous lineGlucometer Indicate the crewmember # and INITIAL reading in the space provided.

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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 CPRAED (Automated External Deffibrillation), if used, indicate who was the FIRST to applythe 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 NOTinclude 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 AdditionalNarrative form. Follow the specific directions of your Service and Medical Director on which one to use.

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Appendix A—Facility Codes

345 10th Street Medical Center, Ocean City, MD409 126th Street Medical Center, Ocean City, MD346 26th Street Medical Center, Ocean City, MD379 63rd Street Medical Center, Ocean City, MD380 75th Street Medical Center, Ocean City, MD347 93rd Street Medical Center, Ocean City, MD230 Alexandria Hospital, VA751 Alfred I. DuPont Hospital for Children (formerly listed as Alfred I

DuPont Institute)422 Alleghany General Hospital, Alleghany, PA397 Altoona Rehabilitation Hospital231 Andrew Rader Clinic, VA221 Anne Arundel General Hospital382 Anne Arundel Medical Park550 Annie M. Warner Hospital233 Arlington Hospital, VA381 Atlantic General Hospital520 Baltimore City Public Service Infirmary350 Bayhealth Medical Center, Kent Hospital (formerly listed as Kent

General)359 Bayhealth Medical Center, Milford Hospital (formerly listed as

Milford Memorial Hospital)551 Bedford County Memorial Hospital, PA358 Beebe Medical Center (formerly listed as Beebe Hospital of

Sussex County)234 Beebe Medical Center, Millville Center (formerly listed as

Bethany Emergency enter)355 Bethesda Naval Hospital / National Capital Region Naval

Medical Command208 Bon Secours Hospital353 Bowie Health Center235 Brooke Lane Psychiatric Center236 Brunswick Medical Center553 Bryn Mawr Hospital752 Bryn Mawr Rehabilitation Hospital754 Bryn Mawr Rehabilitation Hospital at Maryland General Hospital771 Calvert County Nursing Home Center266 Calvert Memorial Hospital237 Capitol Hill Hospital, DC (closed per Region V Office)554 Carlisle Hospital555 Carpenter's Clinic219 Carroll County General Hospital238 Carter Community Mental Health & Retardation Center755 Central Industrial Medical Center276 Chambersburg Hospital, PA284 Charlestown Area Medical Center241 Chemtrec Chem Mfgrs Assn Chemical Transportation Emergency

Center, Wash., D.C.243 Chestnut Lodge Hospital419 Children's Hospital - Hershey Medical Center - Hershey, PA.225 Children's Hospital & Center for Reconstructive Surgery -

Baltimore, MD756 Children's Hospital of Pennsylvania818 Children's National Medical Center Neonatal Center - Wash., D.C.

(formerly listed as Children's Hospital National Medical Center Neonatal Center - Wash., D.C.

718 Children's National Medical Center Pediatric Burn Center- Wash., D.C. (formerly listed as Children's Hospital National Medical Center Ped. Burn Center - Wash., D.C.)

717 Children's National Medical Center Pediatric Trauma Center - Wash., D.C. (formerly listed as Children's Hospital National Medical Center Ped. Trauma Center – D.C.)

317 Children's National Medical Center, D.C. (formerly listed as Children's Hospital National Medical Center, D.C.)

304 Christiana Care Health Systems, Christiana Hospital (formerly listed as listed as listed as listed as Christiana Hospital)

299 Christiana Care Health Systems, Wilmington Hospital (formerly listed as Wilmington Hospital)

202 Church Hospital341 City Hospital, Martinsburg, WV291 Civista, (formerly listed as Physicians Memorial Hospital)245 Columbia Hospital for Women Medical Center, Washington, D.C.383 Columbia Medical Plan757 Cooper Trauma Center, N.J.248 Crownsville State Hospital252 Cullen Center320 Cumberland Memorial Hospital & Medical Center620 Cumberland Memorial Hospital & Medical Center Trauma Center342 DC General Hospital842 DC General Hospital Neonatal Center254 Deaton Hospital & Medical Center of Christ Lutheran Church293 Deer's Head State Hospital556 Delaware Memorial Hospital, DE256 DeWitt Army Hospital, VA329 Doctor's Community Hospital (formerly listed as Doctor's

Hospital of Prince George's County (AMI Doctor's))257 Dominion Hospital, VA310 Dover U.S. Air Force Clinic (formerly listed as Dover U.S. Air

Force Hospital)302 DuPont Memorial Hospital421 Eastern Neurological Rehabilitation Hospital331 Eastern Shore State Hospital557 Elizabethtown Children's Hospital306 Ellsmere Veteran's Administration Hospital, DE558 Emmitsburg Hospital340 Fair Oaks Hospital, VA (formerly listed as Commonwealth

Hospital)305 Fairfax Hospital, VA224 Fallston General Hospital258 Finan Center State Psychiatric Facility279 Fort Dietrick Medical Center247 Fort Howard Veteran's Administration Hospital522 Fort Washington Hospital203 Franklin Square Hospital239 Frederick Memorial Hospital253 Freeman Hospital319 Frostburg Hospital286 Fulton County Medical Center, PA322 Garrett County Memorial Hospital580 Geisinger Medical Center, PA335 George Washington University Hospital, DC737 Georgetown University Hospital Eye Trauma Center, DC337 Georgetown University Hospital, DC240 Gettysburg Hospital, PA759 Gladys Spellman Nursing Center226 Good Samaritan Hospital of Maryland559 Grant Memorial Hospital217 Greater Baltimore Medical Center817 Greater Baltimore Medical Center Neonatal Center

Code Hospital Name Code Hospital Name

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Appendix A—Facility Codes

261 Greater Northeast Medical Center, DC (see also Northeast Georgetown #313)

316 Greater Southeast Community Hospital, DC348 Groupe Memorial Hospital263 Gundry Hospital363 Hadley Memorial Hospital, DC560 Hagerstown State Hospital561 Hampshire Memorial Hospital, WV242 Hanover General Hospital, PA211 Harbor Hospital Center (formerly listed as South Baltimore

General Hospital)220 Harford Memorial Hospital562 Harryon State Hospital399 Health South Chesapeake Rehabilitation Center (formerly listed as

Chesapeake Rehabilitation Hospital)420 Health South Rehabilitation Hospital of Altoona267 Highland State Health Facility Psychiatric Unit244 Holy Cross Hospital of Silver Spring450 Hospice of Baltimore - Gilchrist Center - Baltimore, MD268 Hospital for Sick Children, DC223 Howard County General Hospital270 Howard University Hospital, DC349 Isle of Wight Medical Center273 Jefferson Memorial Hospital, Arlington, VA314 Jefferson Memorial Hospital, Ranson, WV601 Johns Hopkins Bayview Adult Trauma Center701 Johns Hopkins Bayview Burn Unit201 Johns Hopkins Bayview Medical Center801 Johns Hopkins Bayview Neonatal Center901 Johns Hopkins Bayview Perinatal Center761 Johns Hopkins Comprehensive Geriatric Center204 Johns Hopkins Hospital604 Johns Hopkins Hospital Adult Trauma Center705 Johns Hopkins Hospital Eye Trauma Center706 Johns Hopkins Hospital Inpatient Rehabilitation Center804 Johns Hopkins Hospital Neonatal Intensive Care Unit704 Johns Hopkins Hospital Pediatric Trauma Center904 Johns Hopkins Hospital Perinatal Center451 Joseph Richey Hospice - Joseph Richey House, Baltimore, MD274 Kennedy-Krieger Institute (formerly listed as John F. Kennedy

Institute for Handicapped Children)296 Kent and Queen Anne's Hospital227 Kernan Hospital277 Keswick Home for the Incurables of Baltimore City262 Kimbrough Army Hospital563 Kings Daughters Hospital, WV259 Kirk Army Hospital403 Lancaster General Hospital, PA564 Lancaster Osteopathic Hospital, PA773 Laurel Regional Hospital - Rehabilitation352 Laurel Regional Hospital (formerly listed as Greater Laurel

Beltsville Hospital)565 Leesburg Hospital, VA251 Leland Memorial Hospital (closed per Region V office)278 Levindale Hebrew Geriatric Center & Hospital209 Liberty Medical Center (formerly listed as Provident Hospital)205 Liberty Medical Center Psychiatric Center (formerly listed as

Lutheran Hospital)255 Lincoln Memorial Hospital326 Loudoun Memorial Hospital, VA354 Malcolm Grow U.S. Air Force Medical Center

280 Mary Washington Hospital, VA206 Maryland General Hospital281 Maryland Penitentiary Hospital300 Maryland Poison Information Center at UMAB285 Masonic Eastern Star Home, DC566 McConnellsburg Hospital332 McCready Memorial Hospital339 McGuire Veteran's Administration Hospital, VA398 Mechanicsburg Rehabilitation Hospital774 Medlink, D.C.404 Memorial Hospital, PA567 Memorial Osteopathic Hospital, PA207 Mercy Medical Center, Baltimore, MD807 Mercy Medical Center, Neonatal Center - Baltimore, MD907 Mercy Medical Center, Perinatal Center - Baltimore, MD271 Monongalia General Hospital, WV228 Montebello Center - Baltimore, MD264 Montgomery General Hospital282 Morgan County War Memorial Hospital, WV287 Mount Vernon Hospital, VA292 Mount Washington Pediatric Hospital400 Myersdale Hospital, PA351 Nanticoke Memorial Hospital295 National Capital Poison Center, Washington,D.C. (formerly listed

as National Capital Poison Center at Georgetown University, DC)334 National Hospital for Orthopedics & Rehabilitation, VA308 National Institute of Mental Health356 National Institutes of Health Clinical Center307 Newark Emergency Center, Newark, DE568 Newark Hospital, NJ762 Newmedico Rehabilitation222 North Arundel General Hospital753 Northampton-Accomac Memorial Hospital313 Northeast Georgetown Medical Center (see also Greater Northeast

# 261)315 Northern Virginia Doctor's Hospital, VA218 Northwest Hospital Center309 NRH Regional Rehabilitation @ Irving Street, Wash.,D.C.

(formerly listed as Nartional Rehabilitation Hospital)888 Other facility330 Parkwood Hospital (formerly listed as Clinton Hospital --

Closed per Region V Office)336 Patuxent River Naval Air Station Hospital (Closed per Region V

Office)408 Peninsula Regional Medical Center454 Peninsula Regional Medical Center, Transitional Care Unit608 Peninsula Regional Medical Center, Trauma Center (formerly

listed as Peninsula General Hospital Medical Center Adult Trauma Center)

301 Pennsylvania State University Hospital (Hershey Medical Center), PA

318 Perkins State Hospital357 Perry Point Veteran's Administration Hospital569 Pittsburgh Institute for Rehabilitation362 Pocomoke City Medical Center361 Pocomoke Family Health Center338 Police & Fire Clinic, Washington, DC325 Potomac Hospital, VA401 Potomac Valley Hospital, WV632 Prince George's Hospital Center (formerly listed as Prince George's

General Hospital and Medical Center Adult Trauma Center)

Code Hospital Name Code Hospital Name

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Appendix A—Facility Codes

232 Prince George's Hospital Center (formerly listed as Prince George's General Hospital and Medical Center)

832 Prince George's Hospital Center Neonatal Center344 Prince William Hospital, VA288 Providence Hospital, DC378 Psychiatric Institute of DC364 Psychiatric Institute of Montgomery County634 R Adams Cowley Shock Trauma Center - Adult Trauma Unit734 R Adams Cowley Shock Trauma Center - Hyperbaric Unit735 R Adams Cowley Shock Trauma Center - Neurotrauma Unit570 Reading Medical Center571 Riverside Hospital, DE311 Riverside Hospital, VA365 Rosewood State Facility461 Ruby Hospital Morgantown, WV321 Sacred Heart Hospital572 Sacred Heart Hospital, PA573 Saint Agnes Burn Center, PA (formerly listed as a Delaware

facility)212 Saint Agnes Hospital812 Saint Agnes Hospital Neonatal Center912 Saint Agnes Hospital Perinatal Center366 Saint Elizabeth's Hospital, Washington, D.C.303 Saint Francis Hospital, WV213 Saint Joseph Hospital, MD405 Saint Joseph Hospital, PA367 Saint Luke Institute333 Saint Mary's Hospital455 Salisbury Genisis Center265 Shady Grove Adventist Hospital368 Sheppard & Enoch Pratt Hospital294 Shore Health Systems, Dorchester General Hospital (formerly

listed as Dorchester General Hospital)297 Shore Health Systems, Easton Memorial Hospital (formerly listed

as Easton Memorial Hospital)324 Sibley Memorial Hospital, Washington, D.C.750 Sinai Head Injury Rehabilitation Hospital210 Sinai Hospital of Baltimore610 Sinai Hospital of Baltimore Adult Trauma Center810 Sinai Hospital of Baltimore Neonatal Center910 Sinai Hospital of Baltimore Perinatal Center770 Sinai Rehabilitation Hospital772 Solomon's Nursing Home Center360 Southern Chester County Medical Center, PA343 Southern Maryland Hospital Center643 Southern Maryland Hospital Center Adult Trauma Center

(Closed per Region V Office)369 Spring Grove State Hospital406 Springfield State Hospital370 Springwood Psychiatric Institute, VA460 St. Francis Hospital, Wilmington DE521 State Post Mortem Examiner's (Morgue)452 Stella Maris Hospice - Dulaney Valley Road - Timonium, MD453 Stella Maris Hospice at Mercy Medical Center - Baltimore, MD249 Suburban Hospital Association649 Suburban Hospital Association Adult Trauma Center763 Suburban Hospital, Inc., Skilled Nursing Facility371 Tawes-Bland Bryant Nursing Center574 Taylor Hospital, WV312 Taylor Manor Hospital372 TB Clinic

760 The Greenery373 Tidewater Memorial Hospital, VA374 U.S. Naval Academy Primary Care Clinic576 U.S. Public Health Hospital, MD375 U.S. Soldier's and Airmen's Home, DC298 Union Hospital of Cecil County214 Union Memorial Hospital714 Union Memorial Hospital, Curtis Hand Center615 University of Maryland Hospital Adult Trauma Center (No longer

exists per Region III Office)915 University of Maryland Medical System (formerly listed as

University of Maryland Hospital Perinatal Center)215 University of Maryland Medical System (formerly listed as

University of Maryland Hospital)815 University of Maryland Medical System Neonatal Center

(formerly listed as University of Maryland Hospital Neonatal Center)

575 University of Pennsylvania Hospital407 Upper Shore Mental Health Center246 Veteran's Administration Hospital - Baltimore, MD577 Veteran's Administration Hospital - Wilmington, DE376 Veteran's Administration Medical Center, DC275 Veterans Affairs Medical Center Martinsburg VA (formerly listed

as Martinsburg V.A. Hospital and Newton T. Baker Hospital)250 Walter Reed Army Medical Center, DC377 Walter Reed Hospital Annex552 War Memorial Hospital, Berkeley Springs W.V. (formerly listed

as Berkeley Springs Hospital, W.V)328 Washington Adventist Hospital689 Washington County Health System Adult Trauma Center

(formerly listed as Washington County Hospital Association, MD, Adult Trauma Center)

789 Washington County Health System, Comprehensive Inpatient Rehabilitation Services, MD

289 Washington County Health System, MD (formerly listed as Washington County Hospital Association, MD)

456 Washington County Health System, Psychiatric Unit 764 Washington County Health System, Skilled Nursing Facility, MD727 Washington Hospital Center Burn Center, Washington DC327 Washington Hospital Center, DC728 Washington Hospital Center, DC, Adult Trauma Center269 Waynesboro Hospital (formerly listed as Waynesboro General

Hospital, Waynesboro, PA)323 West Virginia University Hospital, WV290 Western Maryland Center, MD402 Western Pennsylvania University Hospital, PA283 Winchester Medical Center578 Woodrow Wilson Rehabilitation Center, VA579 Yale - New Haven Hospital272 York Hospital, PA765 York Rehabilitation Hospital, PA

Code Hospital Name Code Hospital Name