1. A. Assisted Living Program to Be Open for Inspection.

   1. (1) An assisted living program operated by a licensee, and any premises proposed to be operated as an assisted living program, shall be open at all times to announced or unannounced inspections by the Department and by any agency designated by the Department.
   2. (2) Any part of the facility, and any surrounding accessory buildings which may be entered by staff or residents, are considered part of the facility and are subject to inspection.
   3. (3) An assisted living program and any premises proposed to be operated as an assisted living program may not deny access to the Department or any agency designated by the Department.
   4. (4) At all times, the staff on duty at an assisted living program shall know how to contact the assisted living manager, alternate assisted living manager, delegating nurse, and alternate delegating nurse.

2. B. Records and Reports.

   1. (1) Inspection.

      1. (a) An assisted living program shall maintain records and reports.
      2. (b) The records and reports may be paper or electronic documents.
      3. (c) The records and reports shall be open to inspection by the Department or its designee.
      4. (d) Except for the records permitted to be stored off-site, an assisted living program shall immediately, upon request, provide copies of records and reports, including medical records of residents, to the Department or its designee.

   2. (2) Maintenance.

      1. (a) The assisted living program shall maintain files on-site pertaining to:

         1. (i) Current residents;
         2. (ii) Residents who have been discharged within the last 6 months;
         3. (iii) Staff; and
         4. (iv) Quality assurance activities.
      2. (b) The files listed in §B(2)(a) of this regulation shall be maintained on-site at the licensed assisted living program where residents receive assisted living services.
      3. (c) All other records may be stored off-site but shall be available for inspection within 24 hours of a request from the Department or the Department’s designee.

3. C. Posting of Documents. An assisted living program shall post the following documents in a conspicuous place that is visible to residents, potential residents, and other interested parties:

   1. (1) All of the following:

      1. (a) The notice of compliance or the statement of deficiencies and the plan of correction for the most recent annual licensure survey; and
      2. (b) The notice of compliance or the statement of deficiencies and the plan of correction for all surveys conducted since the last annual licensure survey; or
   2. (2) A notice describing where in the facility the items listed in §C(1) of this regulation may be found.

4. D. Notice of Deficiencies.

   1. (1) If a survey identifies noncompliance with a requirement, the Secretary shall issue a notice:

      1. (a) Citing each deficiency;
      2. (b) Requiring the assisted living program to submit an acceptable plan of correction within 10 calendar days of receipt of the statement of deficiencies;
      3. (c) Notifying the assisted living program of sanctions or that failure to correct the violation may result in sanctions; and
      4. (d) Offering the assisted living program the opportunity for informal dispute resolution (IDR).

   2. (2) The plan of correction referred to in §D(1)(b) of this regulation shall include:

      1. (a) How the assisted living program will correct each deficiency;
      2. (b) The date by which each deficient practice will be corrected;
      3. (c) How the assisted living program will prevent the deficient practice from recurring; and
      4. (d) Who will be responsible for ensuring the deficiency will not reoccur.
   3. (3) Failure to return an acceptable plan of correction within the allotted time frame may result in a sanction.
   4. (4) A request for an IDR does not change the assisted living program’s requirement to submit a plan of correction for all deficiencies within 10 calendar days after receipt of the notice of deficiency.

5. E. Informal Dispute Resolution (IDR).

   1. (1) An assisted living program may request an IDR to dispute one or more deficiencies in a statement of deficiencies.
   2. (2) The assisted living program shall submit the request for an IDR to the Department within 10 calendar days of receiving the statement of deficiencies.
   3. (3) The written request for an IDR shall fully describe the disagreement with the statement of deficiencies and be accompanied by all evidence for the Department’s consideration.
   4. (4) At the discretion of the Department, the IDR may be held in person, by telephone, by video conference, or in writing.
   5. (5) IDRs are informal in nature and are not attended by legal counsel representing the assisted living program or the Department.
   6. (6) The IDR process may not delay the effective date of any enforcement action.
   7. (7) In the event an assisted living program requests an IDR of a deficiency written by a designee of the Department, the Department shall request the designee to participate in the IDR process.
   8. (8) There is no appeal of the Department’s decision in an IDR.

Authority: Health-General Article, Title 19, Subtitle 18, Annotated Code of Maryland

Effective date: January 1, 1999 (25:26 Md. R. 1923)

Regulation .02B amended effective November 1, 1999 (26:22 Md. R. 1692); July 22, 2002 (29:14 Md. R. 1074)

Regulation .02B amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .03 amended effective August 21, 2000 (27:16 Md. R. 1523)

Regulation .04 amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .06 amended as an emergency provision effective August 15, 2000 (27:18 Md. R. 1664); amended permanently effective November 27, 2000 (27:23 Md. R. 2147)

Regulation .06E adopted effective March 29, 2004 (31:6 Md. R. 508)

Regulation .09B, C amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .12D, E amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .15-1 adopted effective October 10, 2005 (32:20 Md. R. 1655)

Regulation .15-2 adopted effective October 10, 2005 (32:20 Md. R. 1655)

Regulation .17B amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .17E—G adopted effective October 10, 2005 (32:20 Md. R. 1655)

Regulation .21F, K amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .21P adopted effective March 29, 2004 (31:6 Md. R. 508)

Regulation .26A amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .27C, E amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .28D amended, and E—K adopted, effective November 1, 1999 (26:22 Md. R. 1692)

Regulation .29B amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .36A amended effective March 29, 2004 (31:6 Md. R. 508); December 19, 2005 (32:25 Md. R. 1941)

Regulation .46 amended effective March 29, 2004 (31:6 Md. R. 508)

Regulation .49B amended effective July 22, 2002 (29:14 Md. R. 1074)

Regulations .01—.53 repealed and new Regulations .01—.64 adopted effective December 29, 2008 (35:26 Md. R. 2249)

Regulation .07A amended effective August 19, 2013 (40:16 Md. R. 1344); August 29, 2016 (43:17 Md. R. 953); March 13, 2017 (44:5 Md. R. 292)

Regulation .07C amended effective March 13, 2017 (44:5 Md. R. 292)

Regulation .13A amended effective June 25, 2012 (39:12 Md. R. 745)

Regulation .24D amended effective June 25, 2012 (39:12 Md. R. 745)

Regulation .29 amended effective June 25, 2012 (39:12 Md. R. 745)

Chapter revised effective April 28, 2025 (52:8 Md. R. 357)