Current through Register 1531, September 27, 2024
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)
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)
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)
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)
Staffing Levels.
(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.
(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)
Special Care Residence Staffing.
(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.
(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.
(c)
Exemption.
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:
a. the physical design of the Special Care
Residence is conducive to the provision of sufficient care to all
Residents;
b. staff members possess
the means to conduct immediate communication with each another;
c. the waiver request is not based on a
fluctuation in Residence occupancy; and
d. the safety and welfare of Residents are
not compromised.
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)
Emergency
Situations. The Residence shall have a plan to secure staffing
necessary to respond to emergency, safety and disaster situations affecting
Residents.
(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)
Contagious
Disease and Vaccination Requirements.
(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).
(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.
(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.
(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.
(e)
Influenza
Vaccine.
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. Each Residence shall
provide all personnel with information about the risks and benefits of
influenza vaccine.
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.
(f)
Coronavirus Disease 2019
(COVID-19) Vaccine.
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. Subject to the
provisions of 651 CMR 12.06(8)(g), each Residence shall ensure all personnel
have received the COVID-19 vaccination.
3. Each Residence shall provide all personnel
with information about the risks and benefits of COVID-19
vaccination.
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.
(g)
Exemptions.
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. 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. For any individual subject to the
exemption, the Residence shall require such individual to take mitigation
measures, consistent with guidance from EOEA.
(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.
(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.
(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).
(9)
Vaccination
Requirements.
(a) For purposes of
651 CMR 12.06(9), "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.
(b) Subject to the provisions
of 651 CMR 12.06(9)(d), 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. Each
Residence shall provide all personnel with information about the risks and
benefits of influenza vaccine.
(c)
Subject to the provisions of 651 CMR 12.06(9)(d), 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.
(d)
Exceptions.
1. A
Residence shall not require personnel to receive a vaccine pursuant to 651 CMR
12.06(9)(b) or (c) if:
a. the vaccine is
medically contraindicated, which means administration of an influenza vaccine
to that individual would likely be detrimental to the individual's
health;
b. the individual objects
to vaccination on the basis of a sincerely held religious belief; or
c. the individual declines the vaccine;
and
d. the individual is able to
perform his or her essential job functions with a reasonable accommodation that
is not an undue burden on the Residence.
2. Personnel that decline vaccination for any
reason shall sign a declination statement certifying that they received
information about the risks and benefits of the vaccine and such statement
shall be maintained by the Residence.
(e) A Residence shall require, and maintain
for all personnel, proof of current vaccination pursuant to 651 CMR 12.06(9)(b)
and (c), or the personnel's declination statement as required by 651 CMR
12.06(9)(d). Such information shall be made available by the Residence for
review by EOEA during a Compliance Review pursuant to
651 CMR
12.09.
(f)
Coronavirus Disease 2019
(COVID-19) Vaccine Requirement.
1. For purposes of 651 CMR 12.06(9)(f),
"COVID-19 vaccination" means the full required regimen of vaccine doses of a
vaccine approved or authorized for use by the Food and Drug Administration
(FDA) or the World Health Organization (WHO) to provide acquired immunity
against COVID-19. COVID-19 vaccination is the full required regimen as
determined by the FDA, Centers for Disease Control and Prevention (CDC), or
WHO.
2. Each Residence shall ensure
all personnel have received COVID-19 vaccination, unless an individual is
subject to an exception pursuant to 651 CMR 12.06(9)(f)5. Consistent with any
guidelines, schedule, and reporting requirements established by the Secretary,
each Residence shall ensure that all personnel maintain full COVID-19
vaccination pursuant to the CDC's Advisory Council on Immunization Practices
recommendations as those recommendations may be updated (e.g.,
personnel shall obtain all recommended boosters).
3. Each Residence shall provide all personnel
with information about the risks and benefits of COVID-19
vaccination.
4. Each Residence
shall notify all personnel of the COVID-19 vaccination requirements of 651 CMR
12.06(9)(f) and provide guidance to personnel regarding how to receive COVID-19
vaccination.
5.
Exceptions.
a. A
Residence shall exempt personnel from the COVID-19 vaccination requirement in
651 CMR 12.06(9)(f)2. if:
i. the vaccine is
medically contraindicated, which means administration of COVID-19 vaccine to
that individual would likely be detrimental to the individual's health,
provided that the individual provides supporting documentation; or
ii. the individual objects to vaccination on
the basis of a sincerely held religious belief; and
iii. the individual is able to perform their
essential job functions with a reasonable accommodation that is not an undue
burden on the Residence.
b. Personnel that decline vaccination due to
medical contraindication or a sincerely held religious belief shall sign a
declination statement certifying that they received information about the risks
and benefits of COVID-19 vaccination.
6. A Residence shall require, and maintain
for all personnel, proof of current COVID-19 vaccination as required by 651CMR
12.06(9)(f)2., or the personnel's declination statement pursuant to the
provisions of 651CMR 12.06(9)(f)5.b. Such information shall be made available
by the Residence for review by EOEA during a Compliance Review pursuant to
651 CMR
12.09.
