Staffing Requirements

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
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 StaffingRequirements. 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 an 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
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 Secretarymay 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) Health Screening 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), and submit an incident report pursuant to 651 CMR 12.04(11)(d) as is
appropriate.
(b) All persons working in a Residence shall complete a pre-employment physical
examination, including an assessment for tuberculosis, and shall submit evidence that they
have completed a periodic physical examination at least every two years.
(c) Subject to the provisions of 651 CMR 12.06(8)(e), each Residence shall ensure that all
persons working in the Residence 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 staff with information about the risks and benefits
of influenza vaccine.
(d) Subject to the provisions of 651 CMR 12.06(8)(e), 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.
(e) A Residence shall not require an employee to receive an influenza vaccine if:
1. the vaccine is medically contraindicated, which means administration of an influenza
vaccine to that individual would likely be detrimental to the individual’s health;
2. vaccination is against the individual’s religious beliefs; or
3. the individual declines the vaccine. An individual who declines vaccination for any
reason shall sign a statement certifying he or she received information about the risks and
benefits of influenza vaccine and such statement shall be maintained by the Residence.
(f) A Residence shall require and maintain for each employee proof of current vaccination
pursuant to 651 CMR 12.06(8)(c) and (d), or the individual’s declination statement pursuant
to 651 CMR 12.06(8)(e). Such information shall be made available for review by EOEA
during a Compliance Review pursuant to 651 CMR 12.09.

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