Md. Code Regs. 10.07.14.30 - Services
A. Meals.
(1) The assisted living manager shall ensure that:
(a) A resident is provided three meals in a common dining area and additional snacks during each 24-hour period, 7 days a week;
(b) Meals and snacks are well-balanced, varied, palatable, properly prepared, and of sufficient quality and quantity to meet the daily nutritional needs of each resident with specific attention given to the preferences and needs of each resident;
(c) At a minimum, residents have access to snacks or food supplements between breakfast and lunch, between lunch and dinner, and during the evening hours;
(d) All food is prepared in accordance with all State and local sanitation and safe food handling requirements;
(e) Food preparation areas are maintained in accordance with all State and local sanitation and safe food handling requirements; and
(f) Portion sizes are in accordance with orders from a health care practitioner.
(2) The assisted living program shall ensure that menus are nutritionally adequate by having a dietitian or nutritionist review the 4-week menu:
(a) Prior to initial licensure;
(b) If substantive changes beyond accepted food substitutions have been made; and
(c) At least every 3 years.
(3) Menus.
(a) Menus shall be written at least 1 week in advance.
(b) The assisted living program shall post a weekly menu in a conspicuous place that is visible to residents and other interested parties.
(c) Menus shall be maintained on file, as served, for 6 months.
(4) Special Diets.
(a) The assisted living program staff shall:
(i) Prepare or arrange for the provision of special diets as ordered by the resident's health care practitioner or as needed by the resident's condition; and
(ii) Document special diets in the resident's record.
(b) If the diet is beyond the capability of the assisted living program, the resident or the resident's health care practitioner shall make other arrangements for the resident's care, or the assisted living program shall discharge the resident.
B. Monitoring. The assisted living manager shall ensure that each resident is monitored on a daily basis to ensure that the resident's service plan is being properly implemented.
C. Adaptive Equipment and Assistive Devices.
(1) The assisted living manager or their designee shall ensure that all adaptive equipment and assistive devices are in proper working order.
(2) The assisted living manager or designee shall facilitate the repair or replacement of adaptive equipment and assistive devices, as needed.
(3) Assisted living staff shall assist the resident, as needed, to utilize the adaptive equipment and assistive devices.
D. Nursing Services. The assisted living manager, in consultation with the delegating nurse, shall ensure that all nursing services are provided consistent with the Nurse Practice Act, Health Occupations Article, Title 8, Annotated Code of Maryland.
E. Personal Care Services. The assisted living manager shall provide or ensure the provision of all necessary personal care services, including, but not limited to, the range of assistance needed by a resident to complete the activities of daily living as defined in Regulation .02B(2) of this chapter.
F. Housekeeping Services. The assisted living manager shall ensure that:
(1) Housekeeping services are provided; and
(2) All areas of the facility are maintained in a clean and orderly condition.
G. Health Care and Social Services. The assisted living manager is responsible for facilitating access to any appropriate health care and social services for the resident as determined in the resident's assessment, including, but not limited to:
(1) Social work services;
(2) Rehabilitative services, including occupational, physical, speech, and audiology therapies;
(3) Home health services;
(4) Hospice services;
(5) Skilled nursing services;
(6) Health care practitioner services;
(7) Oral health care;
(8) Dietary consultation and services;
(9) Counseling;
(10) Psychiatric services;
(11) Psychological services; and
(12) Other specialty health services.
H. Social and Recreational Activities.
(1) In accordance with the resident's service plan, the assisted living program staff shall encourage resident participation in social and recreational activities, including:
(a) Providing or arranging for transportation to these activities in accordance with the resident's service plan; and
(b) Assisting a resident with communication, interpersonal, and social skills, including managing difficult behaviors in accordance with the resident's service plan.
(2) The assisted living manager shall provide or arrange appropriate opportunities for socialization, social interaction, and leisure activities that reflect the resident's preferences and promote the physical and mental well-being of each resident.
I. Spiritual Activities.
(1) The assisted living manager or designee shall facilitate access to spiritual and religious activities consistent with the preferences and beliefs of the resident.
(2) The assisted living manager or designee shall provide or arrange for transportation to spiritual and religious activities in accordance with the resident's service plan.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
A. Written Description. At the time of initial licensure, an assisted living program with an Alzheimer's special care unit shall submit to the Department a written description of the special care unit using a disclosure form adopted by the Department . The description shall explain how:
(1) The form of care and treatment provided by the Alzheimer's unit is specifically designed for the specialized care of individuals diagnosed with Alzheimer's disease or a related dementia; and
(2) The care in the special care unit differs from the care and treatment provided in the nonspecial care unit.
B. At the time of license renewal, an assisted living program with an Alzheimer's special care unit shall submit to the Department a written description of any changes that have been made to the special care unit and how those changes differ from the description of the unit that is on file with the Department .
C. An assisted living program with an Alzheimer's special care unit shall disclose the written description of the special care unit to:
(1) Any person on request; and
(2) The family or resident's representative before admission of the resident to the Alzheimer's special care unit or program.
D. The description of the Alzheimer's special care unit shall include:
(1) A statement of philosophy or mission;
(2) How the services of the special care unit are different from services provided in the rest of the assisted living program ;
(3) Staff training and staff job titles, including the number of hours of dementia-specific training provided annually for all staff by job classification and a summary of training content;
(4) Admission procedures, including screening criteria;
(5) Assessment and service planning protocol, including criteria to be used that would trigger a reassessment of the resident 's status before the customary 6-month review;
(6) Staffing patterns, including the ratio of direct care staff to resident for a 24-hour cycle, and a description of how the staffing pattern differs from that of the rest of the program;
(7) A description of the physical environment and any unique design features appropriate to support the functioning of cognitively impaired individuals;
(8) A description of activities, including frequency and type, how the activities meet the needs of residents with dementia, and how the activities differ from activities for residents in other parts of the program;
(9) The program's fee or fee structure for services provided by the Alzheimer's special care unit or program as part of the disclosure form that is required in Regulation .10 of this chapter;
(10) Discharge criteria and procedures;
(11) Any services, training, or other procedures that are over and above those that are provided in the existing assisted living program ; and
(12) Any other information that the Department may require.
E. The Department shall restrict admission or close the operation of a special care unit if the Department determines that the facility has not demonstrated compliance with this regulation or the health or safety of residents is at risk.