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Maryland
A brief overview of assisted living
Maryland
What is it called?
· Assisted Living Program
o Three levels: I, II, or III (low, moderate, or high)
What services are provided?
· Levels I, II, and III:
o Assistance with activities of daily living and instrumental activities of daily living
o Health-related services
o Assistance with self-administration of medication
o Uncomplicated interventions to address behavior problems
o Occasional assistance with accessing social services
· Level II:
o Same services as Level I
o Provide access to necessary health services after accurately defining a resident’s health condition
o Substantial support with some, but not all, activities of daily living
o Minimal support with any number of activities of daily living
o Assistance with taking medication
o Medication administration
o Disruptive behavior management
o Ongoing assistance in accessing social and recreational services
· Level III:
o Same services as Level II
o Ongoing access to the coordination of comprehensive health services and interventions
o Monitor and provide/ensure ongoing therapeutic intervention
o Intensive supervision to manage chronic behaviors that are likely to disrupt or harm the resident or others
o Monitor and manage a variety of psychological or psychiatric episodes
Who can be admitted?
· Needs that can be met under the level at which the facility is licensed
· Terminally-ill residents receiving hospice services
Who is inappropriate?
· Must be refused admission or evicted
o Require continuous nursing care
o Need treatment of stage 3 or stage 4 pressure sores
o Need ventilator services
o Need skilled monitoring, testing, and aggressive adjustment of medication and treatments if there is a fluctuating acute condition or risk thereof
o Need monitoring of a chronic medical condition that is not controllable through readily available medications and treatments
o Need treatment for an active reportable communicable disease
o Need treatment for a disease or condition which requires more than contact isolation
· Exceptions to disqualifying conditions
o The state may grant a waiver from the above health conditions for continuing residents
o A continuing resident with a disqualifying condition may be retained up to 30 days if the disqualifying condition is expected to abate within those 30 days
What training is required for direct care staff?
· Initial training
o Emergency safety
o Infection control
o Basic food safety
o Knowledge in cuing, coaching, and assisting with activities of daily living
o 20-hour medication administration course for the staff that will administer medication
· Continuing training
o On same topics as above
o Refresher course on medication administration every two years for corresponding staff
Is any public payment available?
· Yes, the Medicaid program may pay for assisted living services through a Medicaid Home and Community Based Services Waiver
o Participants must be nursing home eligible and pass a medical test
o There is a long waiting list unless a person is already on medical assistance and in a nursing home
· As of October 2005, the Assisted Living Subsidy was $550 per month for the 4-15 bed facility through the local area agency on aging.
More Information
Department of Health and Mental Hygiene
Office of Health Care Quality
(410) 402 - 8201
Maryland Long Term Care Ombudsman
(410) 767 - 1091
www.mdoa.state.md.us/Services/Ombudsman.html
(09/09) Maryland assisted living facility loses license