<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".15" citation="COMAR 10.07.14.15" title_num="10" subtitle_num="07" chapter_num="14" heading="Assisted Living Manager.">
  <paragraph num="A.">
    <text>Qualifications.</text>
    <paragraph num="(1)">
      <text>An individual shall be licensed as required by Health Occupations Article, §9-3A-01, Annotated Code of Maryland, before the individual may practice as an assisted living manager in Maryland.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The assisted living manager shall at a minimum:</text>
      <paragraph num="(a)">
        <text>Be 21 years old or older;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Possess a high school diploma, a high school equivalency diploma, or other appropriate education and have experience to conduct the responsibilities specified in §C of this regulation;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>For level 3 licensed programs, have:</text>
        <paragraph num="(i)">
          <text>A 4-year, college-level degree; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>2 years experience in a health care related field and 1 year of experience as an assisted living program manager or alternate assisted living manager; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>2 years experience in a health care related field and successful completion of an 80-hour assisted living manager training course approved by the Department;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>Be free from tuberculosis in a communicable form in accordance with Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Facilities;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Be immune to measles, mumps, rubella, and varicella as evidenced by history of disease or vaccination;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Have no criminal convictions or other criminal history that indicates behavior that is potentially harmful to residents, documented through either a criminal history records check or a  background check, completed within 1 month before employment;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Have sufficient skills, training, and experience to serve the residents in a manner that is consistent with the philosophy of assisted living;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Have verifiable knowledge in:</text>
        <paragraph num="(i)">
          <text>The health and psychosocial needs of the population being served;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The resident assessment process;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Use of service plans;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Cuing, coaching, and monitoring residents who self-administer medications, with or without assistance;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Providing assistance with ambulation, personal hygiene, dressing, toileting, and feeding; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Resident rights;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(i)">
        <text>Receive initial and annual training in:</text>
        <paragraph num="(i)">
          <text>Fire and life safety;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Infection control, including standard precautions;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Emergency disaster plans; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Basic food safety; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(j)">
        <text>Receive initial certification and recertification every 2 years for:</text>
        <paragraph num="(i)">
          <text>Basic first aid taught by a first aid instructor certified by a national organization; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Basic cardiopulmonary resuscitation (CPR), including a hands-on component, taught by a CPR instructor certified by a nationally recognized organization.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>An assisted living manager who has completed the training and passed the examination set forth in Regulation .16 of this chapter shall be presumed to have met the knowledge requirements of §A(1)(g) and (h) of this regulation.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The Department may determine that an individual is not sufficiently qualified to serve as an assisted living manager if that individual’s managerial or administrative experience, or education, is not sufficient to perform the responsibilities set forth in §C of this regulation for the residents the assisted living program intends to serve.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Duties. The assisted living manager shall:</text>
    <paragraph num="(1)">
      <text>Be on-site or available on call; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Have overall responsibility for:</text>
      <paragraph num="(a)">
        <text>The management of the assisted living program, including recruiting, hiring, training, and supervising all staff, and ensuring that either a criminal history records check or a  background check is conducted consistent with the requirements of Health-General Article, Title 19, Subtitle 19, Annotated Code of Maryland;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The development and implementation of a staffing plan, which includes an orientation and ongoing training program for all staff, with specific training in the management, assessment, and programming for the resident with cognitive impairment as required by Health-General Article, §19-319.1, Annotated Code of Maryland;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The development and implementation of all policies, programs, and services as required by this chapter;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Requiring all employees to perform hand hygiene with either soap and water or an alcohol-based hand sanitizer before and after each direct resident contact for which hand hygiene is indicated by acceptable practice;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Providing or ensuring, through the coordination of community services, that each resident has access to appropriate medical and psychosocial services, as established in the resident service plan developed under Regulation .28 of this chapter;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Ensuring that there is appropriate coordination of all components of a resident’s service plan, including necessary transportation and delivery of needed supplies;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Ensuring that there is appropriate oversight and monitoring of the implementation of each resident’s service plan;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Ensuring that all record keeping conforms to the requirements of this chapter and other applicable laws;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Ensuring that all requirements of this chapter and other applicable laws are met;</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Implementing a nursing or clinical order of the delegating nurse or documenting in the resident’s record why the order should not be implemented;</text>
      </paragraph>
      <paragraph num="(k)">
        <text>Notifying the Department:</text>
        <paragraph num="(i)">
          <text>When the manager terminates the program’s contract with or employment of a delegating nurse; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Of the reason why the contract or employment was terminated;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(l)">
        <text>Notifying the resident and, if applicable, the resident representative or interested family member of any:</text>
        <paragraph num="(i)">
          <text>Significant change in condition of the resident;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Adverse event that may result in a change in condition;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Outcome of the resident’s care that results in an unanticipated consequence; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Corrective action, if any;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(m)">
        <text>Ensuring that the annual influenza vaccine has been advised in accordance with current CDC recommendations and documented surveillance of non-immune staff when indicators of local influenza activity are elevated; and</text>
      </paragraph>
      <paragraph num="(n)">
        <text>Ensuring that the COVID-19 vaccine has been advised in accordance with current CDC recommendations and documented surveillance of non-immune staff when indicators of local COVID-19 activity are elevated.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>