Sec. 10.07.14.15. Assisted Living Manager

A. Qualifications.

(1) The assisted living manager shall at a minimum:

(a) Be 21 years old or older;

(b) 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;

(c) For level 3 licensed programs, have:

(i) A 4-year, college-level degree;

(ii) 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

(iii) 2 years experience in a health care related field and successful completion of the 80-hour assisted living manager training program;

(d) Be free from tuberculosis in a communicable form in accordance with Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Facilities (that is, tuberculin skin testing (TST) upon hire or annual sign/symptom screen for those individuals with previous positive TST);

(e) Be immune to measles, mumps, rubella, and varicella as evidenced by history of disease or vaccination;

(f) 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 criminal background check completed within 1 month before employment;

(g) Have sufficient skills, training, and experience to serve the residents in a manner that is consistent with the philosophy of assisted living;

(h) Have verifiable knowledge in:

(i) The health and psychosocial needs of the population being served;

(ii) The resident assessment process;

(iii) Use of service plans;

(iv) Cuing, coaching, and monitoring residents who self-administer medications, with or without assistance;

(v) Providing assistance with ambulation, personal hygiene, dressing, toileting, and feeding; and

(vi) Resident rights;

(i) Receive initial and annual training in:

(i) Fire and life safety;

(ii) Infection control, including standard precautions;

(iii) Emergency disaster plans; and

(iv) Basic food safety; and

(j) Receive initial certification and recertification, when required for:

(i) Basic first aid by a certified first aid instructor; and

(ii) Basic cardiopulmonary resuscitation (CPR) by a certified CPR instructor.

(2) 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.

B. 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 licensee intends to serve.

C. Duties. The assisted living manager shall:

(1) Be on-site or available on call; and

(2) Have overall responsibility for:

(a) 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 criminal background check is conducted consistent with the requirements of Health-General Article, Title 19, Subtitle 19, Annotated Code of Maryland;

(b) 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;

(c) The development and implementation of all policies, programs, and services as required by this chapter;

(d) 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;

(e) 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 .26 of this chapter;

(f) Ensuring that there is appropriate coordination of all components of a resident's service plan, including necessary transportation and delivery of needed supplies;

(g) Ensuring that there is appropriate oversight and monitoring of the implementation of each resident's service plan;

(h) Ensuring that all record keeping conforms to the requirements of this chapter and other applicable laws;

(i) Ensuring that all requirements of this chapter and other applicable laws are met;

(j) Implementing a nursing or clinical order of the delegating nurse or documenting in the resident's record why the order should not be implemented;

(k) Notifying the OHCQ:

(i) When the manager terminates the program's contract with or employment of a delegating nurse; and

(ii) Of the reason why the contract or employment was terminated; and

(l) Notifying the resident and, if applicable, the resident's legally authorized representative or interested family member of any:

(i) Significant change in condition of the resident;

(ii) Adverse event that may result in a change in condition;

(iii) Outcome of the resident's care that results in an unanticipated consequence; and

(iv) Corrective action, if any.