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<regulation prefix="Regulation" num=".11" citation="COMAR 10.07.14.11" title_num="10" subtitle_num="07" chapter_num="14" heading="Investigation by Department.">
  <paragraph num="A.">
    <text>Assisted Living Program to Be Open for Inspection.</text>
    <paragraph num="(1)">
      <text>An assisted living program operated by a licensee, and any premises proposed to be operated as an assisted living program, shall be open at all times to announced or unannounced inspections by the Department and by any agency designated by the Department.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Any part of the facility, and any surrounding accessory buildings which may be entered by staff or residents, are considered part of the facility and are subject to inspection.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>An assisted living program and any premises proposed to be operated as an assisted living program may not deny access to the Department or any agency designated by the Department.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>At all times, the staff on duty at an assisted living program shall know how to contact the assisted living manager, alternate assisted living manager, delegating nurse, and alternate delegating nurse.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Records and Reports.</text>
    <paragraph num="(1)">
      <text>Inspection.</text>
      <paragraph num="(a)">
        <text>An assisted living program shall maintain records and reports.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The records and reports may be paper or electronic documents.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The records and reports shall be open to inspection by the Department or its designee.</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Except for the records permitted to be stored off-site, an assisted living program shall immediately, upon request, provide copies of records and reports, including medical records of residents, to the Department or its designee.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Maintenance.</text>
      <paragraph num="(a)">
        <text>The assisted living program shall maintain files on-site pertaining to:</text>
        <paragraph num="(i)">
          <text>Current residents;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Residents who have been discharged within the last 6 months;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Staff; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Quality assurance activities.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>The files listed in §B(2)(a) of this regulation shall be maintained on-site at the licensed assisted living program where residents receive assisted living services.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>All other records may be stored off-site but shall be available for inspection within 24 hours of a request from the Department or the Department’s designee.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Posting of Documents. An assisted living program shall post the following documents in a conspicuous place that is visible to residents, potential residents, and other interested parties:</text>
    <paragraph num="(1)">
      <text>All of the following:</text>
      <paragraph num="(a)">
        <text>The notice of compliance or the statement of deficiencies and the plan of correction for the most recent annual licensure survey; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The notice of compliance or the statement of deficiencies and the plan of correction for all surveys conducted since the last annual licensure survey; or</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>A notice describing where in the facility the items listed in §C(1) of this regulation may be found.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Notice of Deficiencies.</text>
    <paragraph num="(1)">
      <text>If a survey identifies noncompliance with a requirement, the Secretary shall issue a notice:</text>
      <paragraph num="(a)">
        <text>Citing each deficiency;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Requiring the assisted living program to submit an acceptable plan of correction within 10 calendar days of receipt of the statement of deficiencies;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Notifying the assisted living program of sanctions or that failure to correct the violation may result in sanctions; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Offering the assisted living program the opportunity for informal dispute resolution (IDR).</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The plan of correction referred to in §D(1)(b) of this regulation shall include:</text>
      <paragraph num="(a)">
        <text>How the assisted living program will correct each deficiency;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The date by which each deficient practice will be corrected;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>How the assisted living program will prevent the deficient practice from recurring; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Who will be responsible for ensuring the deficiency will not reoccur.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Failure to return an acceptable plan of correction within the allotted time frame may result in a sanction.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A request for an IDR does not change the assisted living program’s requirement to submit a plan of correction for all deficiencies within 10 calendar days after receipt of the notice of deficiency.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Informal Dispute Resolution (IDR).</text>
    <paragraph num="(1)">
      <text>An assisted living program may request an IDR to dispute one or more deficiencies in a statement of deficiencies.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The assisted living program shall submit the request for an IDR to the Department within 10 calendar days of receiving the statement of deficiencies.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The written request for an IDR shall fully describe the disagreement with the statement of deficiencies and be accompanied by all evidence for the Department’s consideration.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>At the discretion of the Department, the IDR may be held in person, by telephone, by video conference, or in writing.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>IDRs are informal in nature and are not attended by legal counsel representing the assisted living program or the Department.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>The IDR process may not delay the effective date of any enforcement action.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>In the event an assisted living program requests an IDR of a deficiency written by a designee of the Department, the Department shall request the designee to participate in the IDR process.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>There is no appeal of the Department’s decision in an IDR.</text>
    </paragraph>
  </paragraph>
</regulation>