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<regulation prefix="Regulation" num=".17" citation="COMAR 10.07.14.17" title_num="10" subtitle_num="07" chapter_num="14" heading="80-Hour Assisted Living Manager Basic Training Course.">
  <paragraph num="A.">
    <text>The 80-hour assisted living manager basic training course shall include the following content:</text>
    <paragraph num="(1)">
      <text>Philosophy of assisted living, 2 hours, including:</text>
      <paragraph num="(a)">
        <text>Philosophy and background of assisted living and aging in place;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Objectives and principles of assisted living resident programs;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Comparison of assisted living to other residential programs;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Basic concepts of choice, independence, privacy, individuality, and dignity; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Normalization of the environment;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Aging process and its impact, 4 hours, including:</text>
      <paragraph num="(a)">
        <text>Physical characteristics of the assisted living residents;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Psychosocial characteristics of the assisted living residents;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Basic needs of the elderly and disabled; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Activities of daily living;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Assessment and level of care waiver, 6 hours, including:</text>
      <paragraph num="(a)">
        <text>Purpose and process;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Guidelines for conducting assessments;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Level of care assessments; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Collaboration with the delegating nurse;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Service planning, 6 hours, including:</text>
      <paragraph num="(a)">
        <text>Required services;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Enhanced scope of services;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Development of individualized service plans;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Scheduling of appropriate activities;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Structure of activities;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Care notes; and</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Collaboration with the delegating nurse;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Clinical management, 20 hours, including:</text>
      <paragraph num="(a)">
        <text>Role of the delegating nurse;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Appropriate nurse delegation;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Concept of self-administration of medications;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Concept of medication management;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Assistance with self-administration of medications;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Administration of medications;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Coordination of services and care providers;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Collaboration with the delegating nurse;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Preventing medication errors;</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Patient safety;</text>
      </paragraph>
      <paragraph num="(k)">
        <text>Medication monitoring;</text>
      </paragraph>
      <paragraph num="(l)">
        <text>Pharmacy consultation;</text>
      </paragraph>
      <paragraph num="(m)">
        <text>Medication storage;</text>
      </paragraph>
      <paragraph num="(n)">
        <text>Infection prevention and control to include:</text>
        <paragraph num="(i)">
          <text>Standard and contact precautions;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Bloodborne pathogens;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Standard hand hygiene practices;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Safe injection practices;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Use of personal protective equipment; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Cleaning and disinfection of equipment and the environment;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(o)">
        <text>Appropriate staffing patterns;</text>
      </paragraph>
      <paragraph num="(p)">
        <text>Pressure sores;</text>
      </paragraph>
      <paragraph num="(q)">
        <text>Effective pain management;</text>
      </paragraph>
      <paragraph num="(r)">
        <text>Basic first aid taught by a first aid instructor certified by a national organization;</text>
      </paragraph>
      <paragraph num="(s)">
        <text>Basic cardiopulmonary resuscitation (CPR), including a hands-on component, taught by a CPR instructor certified by a nationally recognized organization;</text>
      </paragraph>
      <paragraph num="(t)">
        <text>Substance abuse;</text>
      </paragraph>
      <paragraph num="(u)">
        <text>Trauma-informed care; and</text>
      </paragraph>
      <paragraph num="(v)">
        <text>A trauma-informed approach to care delivery;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Admission and discharge criteria, 4 hours, including:</text>
      <paragraph num="(a)">
        <text>Overview of criteria for admission and discharge;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Resident contracts;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Resident rights;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Financial management of resident’s funds; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Working with families of residents;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>Nutrition and food safety, 8 hours, including:</text>
      <paragraph num="(a)">
        <text>Menu and meal planning;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Basic nutritional needs;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Safe food handling;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Preventing food-borne illnesses;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Therapeutic diets; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Dehydration;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>Dementia, mental health, and behavior management, 12 hours, including:</text>
      <paragraph num="(a)">
        <text>An overview consisting of:</text>
        <paragraph num="(i)">
          <text>Description of normal aging and conditions causing cognitive impairment;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Description of normal aging and conditions causing mental illness;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Risk factors for cognitive impairment;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Risk factors for mental illness;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Health conditions that affect cognitive impairment;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Health conditions that affect mental illness;</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>Early identification and intervention for cognitive impairment;</text>
        </paragraph>
        <paragraph num="(viii)">
          <text>Early identification and intervention for mental illness; and</text>
        </paragraph>
        <paragraph num="(ix)">
          <text>Procedures for reporting cognitive, behavioral, and mood changes;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Effective communication consisting of:</text>
        <paragraph num="(i)">
          <text>Effect of cognitive impairment on expressive and receptive communication;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Effect of mental illness on expressive and receptive communication;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Effective communication techniques, including verbal, nonverbal, tone and volume of voice, and word choice; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Environmental stimuli and influences on communication, including setting, noise, and visual cues;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Behavioral intervention consisting of:</text>
        <paragraph num="(i)">
          <text>Identifying and interpreting behavioral symptoms;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Problem solving for appropriate intervention;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Risk factors and safety precautions to protect other residents and the individual;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>De-escalation techniques; and</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Collaboration with the delegating nurse;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>Making activities meaningful consisting of:</text>
        <paragraph num="(i)">
          <text>Understanding the therapeutic role of activities;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Creating opportunities for activities, including productive, leisure, and self-care; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Structuring the day;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(e)">
        <text>Staff and family interaction consisting of:</text>
        <paragraph num="(i)">
          <text>Building a partnership for goal-directed care;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Understanding family needs; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Effective communication between family and staff; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(f)">
        <text>Managing staff stress consisting of:</text>
        <paragraph num="(i)">
          <text>Understanding the impact of stress on job performance, staff relations, and overall facility environment;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Identification of stress triggers;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Self-care skills;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>De-escalating techniques; and</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Devising support systems and action plans;</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>End of life care, 4 hours, including:</text>
      <paragraph num="(a)">
        <text>Advance directives;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Hospice care;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Maryland Medical Orders for Life-Sustaining Treatment (MOLST) order form;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Power of attorney;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Appointment of a health care agent;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Living will;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Pain management;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Providing comfort and dignity; and</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Supporting the family;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>Management and operation, 4 hours, including:</text>
      <paragraph num="(a)">
        <text>Role of the assisted living manager;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Overview of accounting, accounts payable, and accounts receivable;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The revenue cycle and budgeting;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The basics of financial statements;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Hiring and training of staff;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Developing personnel policies and procedures;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Census development; and</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Marketing;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(11)">
      <text>Emergency planning, 4 hours, including:</text>
      <paragraph num="(a)">
        <text>Fire, disaster, and emergency preparedness;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Occupational Safety and Health Administration (OSHA) requirements;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Maintaining the building, grounds, and equipment;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Elopements;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Transfers to the hospital;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Evacuations;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Power outages;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Severe weather;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Fire;</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Emergency response systems; and</text>
      </paragraph>
      <paragraph num="(k)">
        <text>Security systems;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(12)">
      <text>Quality assurance, 4 hours, including:</text>
      <paragraph num="(a)">
        <text>Incident report processes; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Quality improvement processes; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(13)">
      <text>Survey process, 2 hours, including:</text>
      <paragraph num="(a)">
        <text>State statutes and regulations;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>What to expect during a survey; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Documentation.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>A person seeking to offer the assisted living manager training course shall request and obtain approval by the Department by:</text>
    <paragraph num="(1)">
      <text>Submitting the proposed curriculum and training materials to the Department; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Being available for an in-person or telephone interview by the Department.</text>
    </paragraph>
  </paragraph>
</regulation>