No person working in an Assisted Living Residence shall have been convicted of a felony related to the theft or illegal sale of a controlled substance.

1. (1) Qualifications for the Manager. The Manager of an Assisted Living Residence shall be at least 21 years of age and must have demonstrated experience in administration, supervision, and management skills. The Manager must also have a Bachelor's degree or equivalent experience in human services management, housing management or nursing home management. The Manager must be of good moral character, and must never have been convicted of a felony.
2. (2) Qualifications for the Service Coordinator. The Service Coordinator of an Assisted Living Residence must have a minimum of two years' experience working with elders or persons with disabilities. The Service Coordinator shall be qualified by experience and training to develop, maintain and implement or arrange for the implementation of individualized service plans. The Service Coordinator must also have a Bachelor's degree or equivalent experience, and knowledge of aging and disability issues.
3. (3) General Staffing Requirements. All staff shall possess appropriate qualifications to perform the job functions assigned to them. No person working in a Residence shall have been determined by an administrative board or court to have violated any local, state or federal statute, regulation, ordinance, or other law reasonably related to the safety and well-being of a Resident at an Assisted Living Residence or patient at a health care facility.

4. (4) Staffing Levels.

   1. (a) Each Residence must develop and implement a process for determining its staffing levels. The plan must include an assessment, to be conducted at least quarterly but more frequently if the Residence so chooses, of the appropriateness of staffing levels.
   2. (b) The Residence shall have sufficient staffing at all times to meet the scheduled and reasonably foreseeable unscheduled Resident needs as required by the Residents' assessments and service plans on a 24-hour per day basis. The Residence's staffing shall be sufficient to respond promptly and effectively to individual Resident emergencies. The Residence shall have a plan to secure staffing necessary to respond to emergency, life safety and disaster situations affecting Residents.

5. (5) Special Care Residence Staffing.

   1. (a) A Special Care Residence shall have sufficient staff qualified by training and experience awake and on duty at all times to meet the 24-hour per day scheduled and reasonably foreseeable unscheduled needs of all Residents of a Special Care Residence based upon the Resident assessments and service plans. A Special Care Residence's staffing shall be sufficient to respond promptly and effectively to individual Resident emergencies.
   2. (b) For the purposes of 651 CMR 12.05(5)(b), it shall never be considered sufficient to have fewer than two staff members in a Special Care Residence.

   3. (c) Exemption.

      1. 1. At his or her sole discretion, the Secretary may grant an exemption from the requirement set forth in 651 CMR 12.06(5)(b) and allow one staff member and one Floater to be on duty during an overnight shift if it is determined that:

         1. a. the physical design of the Special Care Residence is conducive to the provision of sufficient care to all Residents;
         2. b. staff members possess the means to conduct immediate communication with each another;
         3. c. the waiver request is not based on a fluctuation in Residence occupancy; and
         4. d. the safety and welfare of Residents are not compromised.
      2. 2. The Applicant/Sponsor shall request such an exemption in writing and shall enclose supporting documentation. The Secretary may grant such an exemption at his or her sole discretion, and may, at any time, revoke such an exemption. Such decisions made by the Secretary are final.
6. (6) Emergency Situations. The Residence shall have a plan to secure staffing necessary to respond to emergency, safety and disaster situations affecting Residents.
7. (7) Special Care Residence Manager. A Special Care Residence must designate an individual who will be responsible for all Special Care operations. The Manager of a Special Care Residence shall be at least 21 years of age, must have a minimum of two years' experience working with elders or disabled individuals, knowledge of aging and disability issues, demonstrated experience in administration, and demonstrated supervisory and management skills. The Manager must also have a Bachelor's degree or equivalent experience in human services management, housing management or nursing home management. The Manager must be of good moral character and must never have been convicted of a felony.

8. (8) Contagious Disease and Vaccination Requirements.

   1. (a) No person shall be permitted to work in a Residence if infected with a contagious disease in a communicable form that could endanger the health of residents or other employees. The Residence shall maintain accurate records of illnesses and associated incidents involving staff as part of its Communicable Disease Control Plan pursuant to 651 CMR 12.04(12).
   2. (b) Consistent with any guidelines, schedules, and reporting requirements established by the Secretary, each Residence shall ensure that all personnel comply with the vaccination requirements of this section.
   3. (c) For the purposes of this section, "personnel" means an individual or individuals who either work at or come to the Residence and who are employed by or affiliated with the Residence, whether directly, by contract with another entity, or as an independent contractor, paid or unpaid including, but not limited to, employees, members of the medical staff, contract employees or staff, students, and volunteers, whether or not such individual(s) provide direct care.
   4. (d) For the purposes of this section, "mitigation measures" mean measures that personnel who are exempt from vaccination in accordance with 651 CMR 12.06(8)(g) must take to prevent viral infection and transmission.

   5. (e) Influenza Vaccine.

      1. 1. Subject to the provisions of 651 CMR 12.06(8)(g), each Residence shall ensure that all personnel are vaccinated annually with seasonal influenza vaccine, inactivated or live, or an attenuated influenza vaccine, including a seasonal influenza vaccine.
      2. 2. Each Residence shall provide all personnel with information about the risks and benefits of influenza vaccine.
      3. 3. Each Residence shall notify all personnel of the influenza vaccination requirements of this section and provide guidance to personnel regarding how to receive influenza vaccination.

   6. (f) Coronavirus Disease 2019 (COVID-19) Vaccine.

      1. 1. For the purposes of this section, "COVID-19 vaccination" means being up to date with COVID-19 vaccines as recommended by the Centers for Disease Control and Prevention (CDC).
      2. 2. Subject to the provisions of 651 CMR 12.06(8)(g), each Residence shall ensure all personnel have received the COVID-19 vaccination.
      3. 3. Each Residence shall provide all personnel with information about the risks and benefits of COVID-19 vaccination.
      4. 4. Each Residence shall notify all personnel of the COVID-19 vaccination requirements of 651 CMR 12.06(8) and provide guidance to personnel regarding how to receive COVID-19 vaccination.

   7. (g) Exemptions.

      1. 1. A Residence shall not require personnel to receive a vaccine pursuant to 651 CMR 12.06(8)(e) or (f) if the individual declines the vaccine.
      2. 2. An individual who is exempt from vaccination shall sign a statement certifying that they are exempt from vaccination and they received information about the risks and benefits of influenza vaccination and COVID-19 vaccination.
      3. 3. For any individual subject to the exemption, the Residence shall require such individual to take mitigation measures, consistent with guidance from EOEA.
   8. (h) Documentation. A Residence shall require, and maintain for all personnel, proof of current vaccination pursuant to 651 CMR 12.06(8)(e) and (f), or the personnel's exemption statement as required by 651 CMR 12.06(8)(g). Such information shall be made available by the Residence for review by EOEA during a Compliance Review pursuant to 651 CMR 12.09.
   9. (i) Each Residence shall ensure all personnel are vaccinated against other novel pandemic or novel influenza virus(es) in accordance with guidelines issued by the Commissioner of Department of Public Health.
   10. (j) Nothing in 651 CMR 12.00 et seq. shall be read to prohibit facilities from establishing policies and procedures for influenza and COVID-19 vaccination of personnel that exceed the requirements set forth in 651 CMR 12.06(8).