Chapter 01. General Regulations
Regulation .01 Scope.LinkCopy Citation
This subtitle governs the licensure, practice, and discipline of nursing home administrators and assisted living managers in the State.
Regulation .02 Definitions.LinkCopy Citation
A.
In this subtitle, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Administrator-in-training (AIT)” means an applicant approved by the Board to train to practice as a nursing home administrator in a nursing home under the supervision of a preceptor pursuant to this subtitle.
(2)
“Administrator-in-training (AIT) contract” means a document signed by an AIT and a preceptor which includes requirements of the AIT program.
(3)
“Administrator-in-training (AIT) program” means a Board-approved program which consists of practical training and experience in nursing home administration.
(4)
“Alternate assisted living manager” means an individual who is available to assume the duties of the licensed assisted living manager for a licensed assisted living program when the licensed assisted living manager is temporarily unavailable to perform the duties of an assisted living manager.
(5)
“Assisted living manager” means an individual who is:
(a)
Designated by an assisted living program to oversee the overall day-to-day operations of an assisted living program; and
(b)
Responsible for the duties set forth under COMAR 10.07.14.15.
(6)
Assisted Living Program.
(a)
“Assisted living program” means a residential or facility-based program for two or more residents that provides long-term housing and supportive services, supervision, personalized assistance, health-related services, or a combination of those that meets the needs of the individuals who are unable to perform or who need assistance in performing the activities of daily living or instrumental activities of daily living in a way that promotes optimum dignity and independence for the individuals.
(b)
“Assisted living program” does not include:
(i)
A nursing home as defined by Health-General Article, §19-1401, Annotated Code of Maryland;
(ii)
A nursing facility as defined by Health-General Article, §19-301, Annotated Code of Maryland;
(iii)
A State facility, as defined under Health-General Article, §10-101, Annotated Code of Maryland;
(iv)
A program licensed or approved by the Department under Health-General Article, Title 7 or Title 10, Annotated Code of Maryland;
(v)
A hospice care program licensed by the Department under Health-General Article, Title 19, Annotated Code of Maryland;
(vi)
Services provided by family members;
(vii)
Services provided by a licensed residential service agency or licensed home health agency in an individual’s own home; or
(viii)
A Certified Adult Residential Environment Program that is certified by the Department of Human Services under Human Services Article, §§6-508—6-513, Annotated Code of Maryland.
(7)
“Board” means the State Board of Long-Term Care Administrators.
(8)
“Central Repository” means the Criminal Justice Information System Central Repository of the Maryland Department of Public Safety and Correctional Services.
(9)
“Department” means the Maryland Department of Health.
(10)
“Endorsement applicant” means an individual applying for a license to practice nursing home administration in the State who is licensed in another state to practice nursing home administration.
(11)
“Family” means:
(a)
A spouse;
(b)
A child;
(c)
A sibling;
(d)
A parent;
(e)
A grandparent;
(f)
A niece or nephew; or
(g)
An uncle or aunt.
(12)
“Family-owned or family-operated nursing facility” means a nursing home owned or operated by any one or more of the following relatives of the AIT:
(a)
A spouse;
(b)
A parent;
(c)
A child;
(d)
A sibling;
(e)
A grandparent;
(f)
A grandchild;
(g)
A stepparent;
(h)
A stepchild;
(i)
An uncle or aunt;
(j)
A first cousin;
(k)
A nephew or niece;
(l)
A father-in-law or mother-in law;
(m)
A son-in-law or daughter-in-law; or
(n)
A brother-in-law or sister-in-law.
(13)
“License” means, unless the context requires otherwise, official authorization issued by the Board to practice as:
(a)
A nursing home administrator under Health Occupations Article, Title 9, Subtitle 3, Annotated Code of Maryland; or
(b)
An assisted living manager under Health Occupations Article, Title 9, Subtitle 3A, Annotated Code of Maryland.
(14)
“Licensee” means, unless the context requires otherwise, an individual licensed by the Board to practice as:
(a)
A nursing home administrator; or
(b)
An assisted living manager.
(15)
“National Association of Long Term Care Administrator Boards (NAB)” means the organization that commissions the services of a third-party administrator of the State and national examinations for long term care administrators.
(16)
“Nursing home” means a facility or institution as defined in Health Occupations Article, §9-101(i), Annotated Code of Maryland, and includes:
(a)
A comprehensive care facility or extended care facility which offers non-acute inpatient care to residents who:
(i)
Have a disease, chronic illness, condition, disability of advanced age, or terminal disease requiring maximal nursing care without continuous hospital services; and
(ii)
Require medical services and nursing services rendered by or under the supervision of a licensed nurse together with convalescent, restorative, or rehabilitative services; and
(b)
A nursing facility as defined under federal or State law.
(17)
“Nursing home administrator” means an individual licensed by the Board, who:
(a)
Administers, directs, manages, supervises, or is in general administrative charge of a nursing home, whether or not the individual has an ownership interest in the facility, and whether or not the individual's functions and duties are shared with one or more individuals; or
(b)
Is in supervisory control over one or more nursing home administrators of one or more nursing homes and has authority to substitute the supervisor's judgment for that of the administrator of record in the day-to-day operation of the facility.
(18)
“Person” means any individual, guardian, personal representative, company, corporation, partnership, limited liability company, association, representative of any kind, or non-governmental entity.
(19)
“Practice of assisted living management” means the exercise of final authority of any act or in the making of any decision involved in the planning, organizing, directing, or controlling of the day-to-day operation of an assisted living program.
(20)
“Practice of nursing home administration” means the exercise of final authority of any act or in the making of any decision involved in the planning, organizing, directing, or controlling of the day-to-day operation of a nursing home.
(21)
“Preceptor” means an individual certified to serve as an instructor in an AIT program to be a nursing home administrator, pursuant to this subtitle.
(22)
“State standards exam” means an examination developed by the Board based on the following chapters:
(a)
COMAR 10.07.02;
(b)
COMAR 10.07.09;
(c)
COMAR 10.09.10;
(d)
COMAR 10.09.24; and
(e)
COMAR 10.15.03.
Regulation .03 General Powers of the Board.LinkCopy Citation
A.
The Board shall exercise the powers provided by the laws of this State pertaining to the licensure, practice, and discipline of nursing home administrators and assisted living managers.
B.
Board staff and designees of the Board:
(1)
May enter any nursing home and assisted living program in the State in order to carry out its functions; and
(2)
Shall have access to the records related to licensure of any nursing home and assisted living program in the State in order to carry out its functions.
C.
The Office of Health Care Quality may assist the Board in carrying out its functions.
D.
The Board has the authority to utilize consultant experts, as needed, in areas of its concern.
E.
From time to time, the Board shall make and publish regulations for the execution and enforcement of the laws related to the licensure, license renewal, and discipline of nursing home administrators and assisted living managers.
Regulation .04 Severability.LinkCopy Citation
If any provision of the regulations in this subtitle is declared unconstitutional or invalid, or the application of these regulations to any person or circumstances is held invalid, the applicability of the provision to other persons and circumstances and the constitutionality or validity of every other provision of these regulations is not to be affected.
Chapter annotations
Authority: Health-General Article, §2-104; Health Occupations Article, §§9-101—9-501; Annotated Code of Maryland
History: Effective date: July 15, 1971
History: Regulations .01, .02, .06, .08, .10A, .13, .14, .15, .16, and .24 amended effective January 22, 1975 (2:2 Md. R. 86)
History: Regulations .01—.24 repealed effective December 15, 1986 (13:25 Md. R. 2260)
History: Annotation: COMAR 10.33.01.07 cited in Attorney General Opinion No. 85-030 (December 13, 1985)
History: Regulations .01—.22 adopted effective December 15, 1986 (13:25 Md. R. 2660)
History: Regulation .02 amended effective April 1, 2002 (29:6 Md. R. 567)
History: Regulation .02B amended effective January 25, 2010 (37:2 Md. R. 68); March 21, 2011 (38:6 Md. R. 395)
History: Regulation .02D amended effective May 23, 1994 (21:10 Md. R. 844)
History: Regulation .03A and C amended effective April 27, 1992 (19:8 Md. R. 804)
History: Regulation .04 amended effective January 25, 2010 (37:2 Md. R. 68)
History: Regulation .05B amended effective May 23, 1994 (21:10 Md. R. 844); September 23, 1996 (23:19 Md. R. 1376)
History: Regulation .05C, E amended effective May 23, 1994 (21:10 Md. R. 844)
History: Regulation .05D, F amended effective January 25, 2010 (37:2 Md. R. 68)
History: Regulation .06 amended effective April 27, 1992 (19:8 Md. R. 804); January 25, 2010 (37:2 Md. R. 68)
History: Regulation .06C amended effective May 23, 1994 (21:10 Md. R. 844); September 23, 1996 (23:19 Md. R. 1376)
History: Regulation .06E amended effective September 23, 1996 (23:19 Md. R. 1376)
History: Regulation .07 amended effective May 23, 1994 (21:10 Md. R. 844); April 1, 2002 (29:6 Md. R. 567)
History: Regulation .07D amended effective January 25, 2010 (37:2 Md. R. 68)
History: Regulation .07D-1 adopted effective January 25, 2010 (37:2 Md. R. 68)
History: Regulation .07E amended effective March 21, 2011 (38:6 Md. R. 395)
History: Regulation .07F, G amended effective April 27, 1992 (19:8 Md. R. 804)
History: Regulation .08 amended effective April 1, 2002 (29:6 Md. R. 567)
History: Regulation .08D amended as an emergency provision effective November 3, 2005 (32:25 Md. R. 1938); amended permanently effective February 27, 2006 (33:4 Md. R. 352)
History: Regulation .08D amended effective January 25, 2010 (37:2 Md. R. 68)
History: Regulation .08E amended effective April 27, 1992 (19:8 Md. R. 804); May 23, 1994 (21:10 Md. R. 844); September 23, 1996 (23:19 Md. R. 1376)
History: Regulation .08E amended as an emergency provision effective November 17, 1999 (26:25 Md. R. 1896); amended permanently effective March 20, 2000 (27:5 Md. R. 584)
History: Regulation .09 amended effective January 25, 2010 (37:2 Md. R. 68)
History: Regulation .10C amended effective April 27, 1992 (19:8 Md. R. 804); May 23, 1994 (21:10 Md. R. 844); September 23, 1996 (23:19 Md. R. 1376); January 25, 2010 (37:2 Md. R. 68)
History: Regulation .11A amended effective April 27, 1992 (19:8 Md. R. 804)
History: Regulation .12 amended effective May 23, 1994 (21:10 Md. R. 844); April 1, 2002 (29:6 Md. R. 567); January 25, 2010 (37:2 Md. R. 68)
History: Regulation .12A—C amended effective April 27, 1992 (19:8 Md. R. 804)
History: Regulation .12B, C amended effective March 21, 2011 (38:6 Md. R. 395)
History: Regulation .13 amended effective April 27, 1992 (19:8 Md. R. 804); April 1, 2002 (29:6 Md. R. 567); January 25, 2010 (37:2 Md. R. 68); March 21, 2011 (38:6 Md. R. 395)
History: Regulation .13D amended as an emergency provision effective February 22, 1996 (23:6 Md. R. 472); amended permanently effective June 17, 1996 (23:12 Md. R. 871)
History: Regulation .13F amended effective May 23, 1994 (21:10 Md. R. 844); September 23, 1996 (23:19 Md. R. 1376); June 28, 1999 (26:13 Md. R. 1019)
History: Regulation .14 amended effective May 23, 1994 (21:10 Md. R. 844); January 25, 2010 (37:2 Md. R. 68)
History: Regulation .14B amended effective April 27, 1992 (19:8 Md. R. 804); March 20, 2000 (27:5 Md. R. 584); March 21, 2011 (38:6 Md. R. 395)
History: Regulation .14C amended effective April 27, 1992 (19:8 Md. R. 804)
History: Regulation .15A amended effective October 4, 1999 (26:20 Md. R. 1546); January 25, 2010 (37:2 Md. R. 68)
History: Regulation .17D amended effective December 13, 1999 (26:25 Md. R. 1898)
History: Regulation .17E amended effective April 27, 1992 (19:8 Md. R. 804); April 1, 2002 (29:6 Md. R. 567); January 25, 2010 (37:2 Md. R. 68)
History: Regulation .17F amended effective April 27, 1992 (19:8 Md. R. 804)
History: Regulation .17-1 adopted effective April 1, 2002 (29:6 Md. R. 567)
History: Regulation .18C amended effective January 25, 2010 (37:2 Md. R. 68)
History: Chapter revised effective March 19, 2012 (39:5 Md. R. 383)
History: Regulation .03A amended effective April 15, 2013 (40:7 Md. R. 611)
History: Regulation .08D amended effective April 15, 2013 (40:7 Md. R. 611)
History: Regulation .13A amended effective April 15, 2013 (40:7 Md. R. 611)
History: Regulation .13F amended effective May 20, 2019 (46:10 Md. R. 489)
History: Regulation .14A amended effective February 27, 2017 (44:4 Md. R. 254)
History: Regulation .16E amended effective May 20, 2019 (46:10 Md. R. 489)
History: Regulations .01 — .29 under COMAR 10.33.01 Nursing Home Administrators, under Subtitle 10.33 Board of Nursing Home Administrators, repealed effective January 19, 2026 (53:1 Md. R 22)
History: Regulations .01 — .04 under COMAR 10.33.01 Nursing Home Administrators, under Subtitle 10.33 Board of Long-Term Care Administrators, adopted effective January 19, 2026 (53:1 Md. R 22)