1. A. Qualifications.

   1. (1) An individual shall be licensed as required by Health Occupations Article, §9-3A-01, Annotated Code of Maryland, before the individual may practice as an assisted living manager in Maryland.

   2. (2) The assisted living manager shall at a minimum:

      1. (a) Be 21 years old or older;
      2. (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;

      3. (c) For level 3 licensed programs, have:

         1. (i) A 4-year, college-level degree; or
         2. (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
         3. (iii) 2 years experience in a health care related field and successful completion of an 80-hour assisted living manager training course approved by the Department;
      4. (d) Be free from tuberculosis in a communicable form in accordance with Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Facilities;
      5. (e) Be immune to measles, mumps, rubella, and varicella as evidenced by history of disease or vaccination;
      6. (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 background check, completed within 1 month before employment;
      7. (g) Have sufficient skills, training, and experience to serve the residents in a manner that is consistent with the philosophy of assisted living;

      8. (h) Have verifiable knowledge in:

         1. (i) The health and psychosocial needs of the population being served;
         2. (ii) The resident assessment process;
         3. (iii) Use of service plans;
         4. (iv) Cuing, coaching, and monitoring residents who self-administer medications, with or without assistance;
         5. (v) Providing assistance with ambulation, personal hygiene, dressing, toileting, and feeding; and
         6. (vi) Resident rights;

      9. (i) Receive initial and annual training in:

         1. (i) Fire and life safety;
         2. (ii) Infection control, including standard precautions;
         3. (iii) Emergency disaster plans; and
         4. (iv) Basic food safety; and

      10. (j) Receive initial certification and recertification every 2 years for:

          1. (i) Basic first aid taught by a first aid instructor certified by a national organization; and
          2. (ii) Basic cardiopulmonary resuscitation (CPR), including a hands-on component, taught by a CPR instructor certified by a nationally recognized organization.
   3. (3) 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.
2. 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 assisted living program intends to serve.

3. C. Duties. The assisted living manager shall:

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

   2. (2) Have overall responsibility for:

      1. (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 background check is conducted consistent with the requirements of Health-General Article, Title 19, Subtitle 19, Annotated Code of Maryland;
      2. (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;
      3. (c) The development and implementation of all policies, programs, and services as required by this chapter;
      4. (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;
      5. (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 .28 of this chapter;
      6. (f) Ensuring that there is appropriate coordination of all components of a resident’s service plan, including necessary transportation and delivery of needed supplies;
      7. (g) Ensuring that there is appropriate oversight and monitoring of the implementation of each resident’s service plan;
      8. (h) Ensuring that all record keeping conforms to the requirements of this chapter and other applicable laws;
      9. (i) Ensuring that all requirements of this chapter and other applicable laws are met;
      10. (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;

      11. (k) Notifying the Department:

          1. (i) When the manager terminates the program’s contract with or employment of a delegating nurse; and
          2. (ii) Of the reason why the contract or employment was terminated;

      12. (l) Notifying the resident and, if applicable, the resident representative or interested family member of any:

          1. (i) Significant change in condition of the resident;
          2. (ii) Adverse event that may result in a change in condition;
          3. (iii) Outcome of the resident’s care that results in an unanticipated consequence; and
          4. (iv) Corrective action, if any;
      13. (m) Ensuring that the annual influenza vaccine has been advised in accordance with current CDC recommendations and documented surveillance of non-immune staff when indicators of local influenza activity are elevated; and
      14. (n) Ensuring that the COVID-19 vaccine has been advised in accordance with current CDC recommendations and documented surveillance of non-immune staff when indicators of local COVID-19 activity are elevated.

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)