New Mexico Register / Volume XXXVI,
Issue 5 / March 11, 2025
NOTICE
OF PUBLIC HEARING
The New Mexico
Health Care Authority Division of Health Improvement is finalizing repeal and
replacement of the rule 8.370.14 Assisted Living Facilities for Adults. These regulations apply to any assisted
living facility for adults as defined by Subsection D of 24-1-2 NMSA 1978, as
amended, which is licensed or is required to be licensed, which is operated for
the maintenance or care of two or more adults who need or desire assistance
with one or more activities of daily living.
The purpose of these regulations is to update and clarify the
requirements to current standards of care and practice.
8.370.14 NMAC
This is a repeal
and replacement of the NMAC requirements for Assisted Living Facilities for
Adults.
A public hearing
to receive testimony on this proposed rule will be held on April 16th,
2025 at 11:00 am, in the Hozho conference room #109, 5300 Homestead Rd. NE,
Albuquerque NM 87110
The public hearing will be a Hybrid, via Zoom as well as in person, pursuant to Section 14-4-5.6 NMSA 1978.
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Repeal and Replacement of rule 8.370.14 Assisted Living Facilities for Adults
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All written comment may be dropped off during the scheduled hearing time (see above) at the Division of Health Improvement offices, at the Hozho conference room #109, 5300 Homestead Rd. NE, Albuquerque NM 87110.
Individuals
wishing to testify may contact the Division of Health Improvement (DHI), P.O.
Box H, Santa Fe, NM 87504, or by calling (505) 476-9093.
Individuals who do
not wish to attend the hearing may submit written or recorded comments. Written or recorded comments must be received
by 5:00 p.m. on the date of the hearing, 4/16/2025. Please send comments to: Division of Health
Improvement P.O. Box H Santa Fe, NM 87504, Recorded comments may be left at
(505) 476-9093. You may send comments
via email to: dan.lanari@hca.nm.gov .
Written and recorded comments will be posted to the agency’s website
within 3 days of receipt. All comments
will be given the same consideration as oral testimony made at the public
hearing.
If you are a
person with a disability and you require this information in an alternative
format, or you require a special accommodation to participate in any HSD public
hearing, program, or service, please contact the American Disabilities Act
Coordinator, at Office-505-709-5468, Fax-505-827-6286 or through the New Mexico
Relay system, toll free at #711. The
Department requests at least a 10-day advance notice to provide requested
alternative formats and special accommodations.
TITLE 8 SOCIAL
SERVICES
CHAPTER 370 OVERSIGHT
OF LICENSED HEALTHCARE FACILITIES AND
COMMUNITY
BASED WAIVER PROGRAMS
PART 14 ASSISTED LIVING FACILITIES FOR
ADULTS
8.370.14.1 ISSUING
AGENCY: New Mexico Health Care Authority.
[8.370.14.1
NMAC - Rp, 8.370.14.1 NMAC, xx/xx/2025]
8.370.14.2 SCOPE: This rule applies to all assisted living
facilities, any facility which is operated for the maintenance or care of two
or more adults who need or desire assistance with one or more activities of
daily living. This rule does not apply
to the residence of an individual who maintains or cares for a maximum of two
relatives.
[8.370.14.2
NMAC - Rp, 8.370.14.2 NMAC, xx/xx/2025]
8.370.14.3 STATUTORY
AUTHORITY: The requirements forth herein are promulgated
by the secretary of the health care authority by authority of Subsection E of
Section 9-8-6 NMSA 1978, and Sections 24-1-2, 24-1-3, 24-1-5 and 24-1-5.2 of
the Public Health Act, NMSA 1978, as amended. Section 9-8-1 et seq. NMSA 1978
establishes the health care authority (authority) as a single, unified
department to administer laws and exercise functions relating health care
purchasing and regulation.
[8.370.14.3 NMAC -
Rp, 8.370.14.3 NMAC, xx/xx/2025]
8.370.14.4 DURATION: Permanent.
[8.370.14.4 NMAC - Rp, 8.370.14.4 NMAC,
xx/xx/2025]
8.370.14.5 EFFECTIVE DATE: xx, xx, 2025, unless a later date is cited at
the end of a section.
[8.370.14.5 NMAC -
Rp, 8.370.14.5 NMAC, xx/xx/2025]
A. Establish
standards for licensing assisted living facilities in order to ensure that
residents receive appropriate care and services, and regulate to ensure that
the health, safety, and welfare of individuals residing and working in such
facilities are protected.
B. Establish
requirements for the construction, maintenance and operation of licensed
assisted living facilities that will provide a safe, humane and homelike
environment for adults who need assistance or supervision with activities of
daily living but who do not need acute care, continuous nursing care, skilled
nursing care or care in an intermediate care facility for the mentally
retarded.
C. Regulate
facilities in providing care for residents and utilizing available supportive
services in the community to meet the needs of the residents.
D. Ensure facility
compliance with these rules through established protocols to identify
circumstances which could be harmful or dangerous to the health, safety, or
welfare of the resident.
[8.370.14.6 NMAC -
Rp, 8.370.14.6 NMAC, xx/xx/2025]
A. Definitions
beginning with “A”:
(1) “Abuse” means:
(a) knowingly, intentionally, or
negligently and without justifiable cause inflicting physical pain, injury or
mental anguish;
(b) the intentional deprivation by a
caretaker or other person of services necessary to maintain the mental and
physical health of a person; or
(c) sexual abuse, including criminal
sexual contact, incest, and criminal sexual penetration.
(d) verbal abuse, including profane,
threatening, derogatory, or demeaning language, spoken or conveyed with the
intent to cause mental anguish; or
(e) the most current definition as found
in 8.370.9 NMAC.
(2) “Activities
of daily living” (ADLs) as per 42 CFR Section 441.505 2016 “means
basic personal everyday activities including, but not limited to, tasks such as
eating, toileting, grooming, dressing, bathing, and transferring”, and also
includes general hygiene and mobility.
(3) “Administration
of Medication” or “Medication Administration” means a
process whereby a prescribed drug or biological agent is given to a resident by
a person licensed or certified by the board (board of nursing) to administer
medications; as set forth in Paragraph (2) of Subsection A of 16.12.2.7 NMAC,
and includes preparing, giving and evaluating the effectiveness of prescription
and nonprescription drugs per the nursing interventions classification (NIC).
(4) “Adult” means a person who has a chronological age of 18 years or older or is
emancipated by court order.
(5) “Adult
day care” means a licensed facility where care, services, and
supervision are provided to adults.
(6) “Administrator,
director, or operator” means the individual in
charge of the day-to-day operation of an assisted living facility who has the
responsibility to ensure facility compliance with this rule.
(7) “Advance
directives” means an individual instruction or a power of
attorney for health care made, in either case, while the individual has
capacity.
(8) “Agent” means an individual designated in a power of attorney for health care to
make a health-care decision for the individual granting the power; or the
resident's surrogate decision maker.
(9) “Ambulatory” means able to walk without assistance.
(10) “Ancillary
Services” means the diagnostic or therapeutic services
provided by an outside agency.
(11) “Assistance” means act of helping, aiding, or supporting an individual by another.
(12) “Assistance
with Self-Administration of Medication” means the
assistance that is rendered by a non-licensed person to assist the resident who
has the capability to self-administer medications by prompting, reminders,
hand-over-hand assistance, handing the medication container to the resident,
opening the medication container, or placing the medication in the resident’s
hand.
(13) “Assisted
living facility” means a licensed facility operated for the
maintenance or care of two or more adults who need or desire assistance with
one or more activities of daily living, If a facility is referred to by another
name but is providing the requirements and services of an assisted living, the
facility shall be licensed in accordance with 8.370.14 NMAC.
(14) “Assisted
living facility with memory care unit” means an
assisted living facility or part of an assisted living facility that provides
added security, enhanced programming, and staffing appropriate for residents
with a diagnosis of dementia or other related disorders causing memory
impairments whose functional needs require a specialized program and a secured
environment.
(15) “Authority
or department” means the New Mexico health care authority.
B. Definitions
beginning with “B”:
(1) “Bathing
unit” means a tub, shower or combination unit.
(2) “Bed
hold” means the facility's policy for retaining a bed or
room for a resident during the time that the resident is temporarily absent
from the facility; the policy shall include time frames for the bed hold,
acceptable conditions for the bed hold and any associated charges.
C. Definitions
beginning with “C”:
(1) “Capacity” means the maximum number of residents that a facility has been licensed
to accommodate.
(2) “Census” means the total number of individual residents residing in the facility
each day, including relatives who are residents. The facility census shall never exceed the
licensed capacity.
(3) “Certified
medication aide” (CMA) means a person who is certified by the New
Mexico board of nursing to administer medications under the supervision and at
the direction of a registered nurse or a licensed practical nurse, pursuant to
"the Nursing Practice Act," Section 61-3-1 through 61-3-30 NMSA 1978.
(4) “Change
of Ownership” means any transaction that results in a change of
the person, entity or form of entity that controls capital assets of an
assisted living facility.
(5) “Chemical
restraint” means a drug or medication used as a restriction to
manage a resident’s behavior or restrict a resident’s freedom of movement, and
not in the standard treatment or dosage for a resident’s condition.
(6) “Cognitive
status” means an individual's level of awareness with
perception, reasoning, judgment, intuition, and memory to manage his or her own
affairs and direct his or her own care.
(7) “Communicate” means the ability to exchange information personally or through an
interpreter or assistive technology.
(8) “Consent” means an informed, written agreement, that identifies permission(s) or
action(s) to be delegated to another on behalf of resident or to assist the
resident, that is signed by the resident or surrogate decision maker or other
legally appointed decision maker.
(10) “Consulting
pharmacist” means a pharmacist who is responsible to the
administrator of the facility and the Board of Pharmacy for the development of
the drug storage and distribution and record keeping requirements as set forth
in 16.19.11 NMAC.
(11) “Continuous
nursing care” means 24- hour nursing services which a resident
requires based on the complexity of their medical needs.
(12) “Convenience” means any action taken by a facility to control resident behavior or
manage residents with less effort by the facility and that is not in the
resident's best interest or wishes.
(13) “Crisis
prevention or intervention plan” means
documented actions to be taken to keep a resident and others safe that provides
guidance and strategies to staff when a resident has a medical condition or
challenging behavior that has the potential to escalate to a severity level
that poses a great risk of harm to the resident or others. (e.g., diabetic,
seizure disorder, aggression, or combativeness).
D. Definitions
beginning with “D”:
(1) “Decision
making capacity” means the ability of the resident to understand and
comprehend the consequences of a proposed decision, including the benefits and
risks of and alternatives to any such proposed decision and to reach an
informed decision.
(2) “Designee” means an individual appointed to assume responsibility for specific
assigned duties.
(3) “Direct
care staff” means any person who is employed, contracted or
volunteers at a facility that works directly with the residents in the oversite
and delivery of care and supervision.
(4) “Discipline” means any action taken by the facility for the purpose of punishing or
penalizing any resident.
E. Definitions
beginning with “E”:
(1) “Exploitation” means an unjust or improper use of a person's money or property for
another person's profit or advantage, financial or otherwise, as defined in the
incident reporting intake, processing & training requirements, 8.370.9
NMAC. Exploitation includes but is not
limited to:
(a) manipulating the resident by whatever
mechanism to give money or property to any facility staff or management member;
(b) misappropriation or misuse of monies
belonging to a resident or the unauthorized sale, or transfer or use of a
residents property;
(c) loans of any kind from a resident to
family, operator or families of staff or operator;
(d) accepting monetary or other gifts
from a resident or their family with a value in excess of $25 and not to exceed
a total value of $300 in one year;
(e) All gifts received by facility
operators, their families or staff of the facility must be documented and
acknowledged by person giving the gift and the recipient;
(f) Exception: Testamentary gifts, such as wills, are not,
per se, considered financial exploitation.
F. Definitions
beginning with “F”:
(1) “Facility” means an assisted living facility.
(2) “Facility
license” means the document issued by the licensing
authority which authorizes the operation of a facility.
G. Definitions
beginning with “G”: “General
supervision” means the availability of direct care staff in the
facility, on a twenty-four hour basis, to respond to the needs of the residents
and to perform periodic checks on the residents.
H. Definitions
beginning with “H”: “Health
care professional” means a New Mexico licensed health care
professional such as a physician, chiropractor, pharmacist, advance practice
registered nurse, physician assistant, registered nurse, licensed practical
nurse, physical therapist, speech therapist, occupational therapist,
psychologist, social worker, dietitian, or dentist.
I. Definitions
beginning with “I”:
(1) “Independent”
means the ability to perform activities of daily
living without assistance.
(2) “Individual
service plan” or “ISP” means a person-centered
comprehensive plan that identifies the level of assistances and services that
the resident will require with activities of daily living and with medications.
(3) “Instrumental
activities of daily living (IADLs) “means
activities related to living independently in the community, including but not
limited to, meal planning and preparation, managing finances, shopping for
food, clothing, and other essential items, performing essential household
chores, communicating by phone or other media, and traveling around and
participating in the community” as defined in 42 CFR Section 441.505.
(4) “Intramuscular
injection” or “IM” means the insertion of a needle into a muscle to
administer medication.
(5) “Intravenous”
or “IV” means the insertion of a needle into a vein to
administer medication.
J. Definitions beginning with “J”: [RESERVED]
K. Definitions beginning with “K”: [RESERVED]
L. Definitions beginning with “L”:
(1) “Licensee”
means the person who, or the organization that, has
ownership, leasehold, or similar interest in a facility and in whose name a
license for an assisted living facility has been issued, who is legally
responsible for compliance with this rule.
(2) “Licensing
authority” means the New Mexico health care authority,
division of health improvement (DHI).
(3) “Licensed
or certified personnel” means New Mexico licensed
registered nurses (RNs), licensed practical nurses (LPNs) and certified
medication aides (CMAs), licensed or certified by the New Mexico board of
nursing pursuant to "the nursing practice act", 61-3-1 through
61-3-31 NMSA 1978.
(4) “Licensed
practical nurse (LPN)” means a person who is
licensed by the New Mexico board of nursing pursuant to the "nursing
practice act," 61-3-1 through 61-3-31 NMSA 1978.
(5) “Life
safey code (LSC)” is
another way to describe NFPA 101, which is a set of regulations developed by
the National fire protection association (NFPA). It provides minimum
requirements for the design, construction, operation and maintenance of
buildings to protect occupants from fire and other hazards.
M. Definitions
beginning with “M”:
(1) “Medication
administration record” (MAR) means the document
that is used to record the details of medication administration. The MAR shall
include all of the information pursuant to Subsection G of 8.370.14.36 NMAC of
this rule.
(2) “Medication
delivery” means handing a medication container to a resident,
opening the resident’s medication container, using an enabler, or placing the
medication in the resident’s hand, and other such means of delivering
medication to a resident in order to facilitate self-administration.
(3) “Medication
delivery method” means the method by which a resident takes or
receives medication (i.e., pills, eye drops, intramuscular injection, other).
(4) “Medication
error” means the administration of any medication
incorrectly (i.e., dosage, selection of drug, selection of resident, time or
method of administration, omission of prescribed medication or the
administration of a medication without a valid order).
(5) “Medication
route” means the method of medication entry into a
resident’s body (e.g., oral, ocular, rectal, topical, nasal, injection and
intravenous).
(6) “Mini
mental status exam (MMSE)” means a 30-point
questionnaire that is used extensively in clinical and research settings to
measure cognitive impairment, published by psychological assessment resources
based on its original 1975 conceptualization.
(7) “Misappropriation”:
See “exploitation” means the
deliberate misplacement of a resident’s property, or wrongful, temporary or
permanent use of a resident’s belongings or money without the resident’s
consent and is defined in the incident reporting intake, processing & training
requirements, 8.370.9 NMAC.
(8) “Mobile” means able to walk with assistance, or the ability to move from place to
place with the use of a device such as a walker, cane, crutches, prosthetic or
a wheelchair and the capability of making independent bed-to-chair transfers.
N. Definitions
beginning with “N”:
(1) “Nebulizer” means an atomizer equipped to produce a fine mist for deep inhalation
into the lungs.
(2) “Neglect” means the failure to provide goods and services necessary to avoid
physical harm, mental anguish or mental illness and is defined in the incident
reporting intake, processing & training requirements, 8.370.9 NMAC.
(3) “New
facility” means any building not previously or currently
licensed as an assisted living facility.
(4) “NFPA”
means the National fire protection association which
sets codes and standards for fire and life safety. NFPA 11 and related
standards, current edition as required by the authority.
O. Definitions beginning with “O”: [RESERVED]
P. Definitions
beginning with “P”:
(1) Person
centered care: means
doctors and other health care providers work collaboratively with residents and
other health care providers to do what is best for the residents’ health and
well-being. It offers health care
providers the necessary supports like access to residents’ health data to
understand their resident’s comprehensive needs. By providing doctors and other health care
providers with this big-picture information, they are better equipped to
develop individual service plans (ISP) that include empathy, dignity and
respect with residents, their families, and other caregivers.
(2) “Physician
extender” means the term used to refer to physician
assistants (working in conjunction with a physician) and nurse practitioners.
(3) “Physical restraint” means any
manual, physical or mechanical device, any material or equipment attached to or
adjacent to a resident's body that the resident cannot easily remove and that
restricts freedom of movement or is used for discipline or for the convenience
of the facility.
(4) “Plan
of removal” means the immediate action to be taken by the
facility and documented in writing after being notified that an Immediate
Jeopardy exists and must be corrected.
(5) “Plan
review” means the evaluation of the building plans.
(6) “Primary
care practitioner” (PCP) means a physician, nurse practitioner or
physician’s assistant (licensed in the state of New Mexico) who oversees the
health care of the resident.
(7) “Private
duty attendant” means an individual that provides direct care under
the definitions of the NM caregivers criminal history screening program,
8.370.5 NMAC. The individual is hired by
the resident or family through a licensed agency, hired directly or works
through a separate arrangement with the family.
(8) “Pro
re nata medication (PRN)” means prescribed or
over-the-counter medications, including comfort medications that are
administered or taken only on an as needed basis when symptoms warrant or as
directed by the primary care practitioner (PCP). PRN medications can only be given by an
unlicensed staff person if the conditions of Paragraph (12) of Subsection A of
8.370.14.7 NMAC “assistance with self-administration of medication” and
8.370.14.36 NMAC Medications” apply.
(9) “Policy”
means a statement of principle that guides and
determines present and future decisions and actions.
(10) “Procedure” means the action(s) that shall be taken in order to implement a policy.
(11) “Protocols” are the specific means by which a procedure or treatment is to take
place.
(12) “Programmatic
services” means services provided to residents as defined by
the facilities program narrative.
(13) “Program
narrative” is a written statement identifying the primary
population to be served and the services that will be provided to meet these
needs.
Q. Definitions
beginning with “Q”: “Qualified service animal” means any qualified service dog or qualified service miniature horse that
has been or is being trained to provide assistance to an individual with a
disability. “Qualified service animal”
does not include a pet, an emotional support animal, a comfort animal, or a
therapy animal;
R. Definitions
beginning with “R”:
(1) “Registered
nurse” (RN) means a person that has specialized training
and is licensed by the New Mexico board of nursing pursuant to the “nursing
practice act,” 61-3-1 through 61-3-31 NMSA 1978.
(2) “Relative”
means husband, wife, significant other, mother,
father, son, daughter, brother, sister, brother-in-law, sister-in-law,
father-in-law, mother-in-law, grandfather, grandmother, half-brother or
half-sister.
(3) “Resident” means an individual receiving services and residing in the licensed
facility; including the relatives of a licensee.
(4) “Resident
evaluation form” means a written document of the information
acquired during the assessment of a resident's functional capacities and
limitations. This form is to be utilized for pre-admission and ongoing
evaluation of a resident.
(5) “Resident
preference” means the resident’s
choice or preferred choice among the available options.
(6) “Restraints” means use of a physical restraint or chemical restraints imposed, for
the purposes of discipline or convenience, to physically restrict a resident’s
freedom of movement, performance of physical activity, or normal access to
their body.
(7) “Room
and board” means the living/sleeping space, meals and snacks
appropriate to meet the needs of the residents.
S. Definitions beginning with “S”:
(1) “Sanctions” means a measure imposed on a licensee for a violation(s) of applicable
licensing requirements other than license revocation, suspension, or denial of
renewal of license as provided for by health facility sanctions and civil
monetary penalties, 8.370.4 NMAC.
(2) “Self-administration
of medication” the process of an individual administering a
pharmacological substance to oneself.
(3) “Self-care” means the performance of ADLs, activities or tasks by the residents
themselves rather than performed by or assisted with the facility staff.
(4) “Side
effect” means a result of a drug or other form of therapy
in addition to or in extension of the desired therapeutic effect.
(5) “Self-medication” means administration of PCP prescribed medication by the resident to
whom it was prescribed.
(6) "Significant change in health
status" means the resident has experienced one or more of
the following: a decline or improvement in physical ability; a decline or
improvement in cognitive or functional ability; a new diagnosis or event that
requires a change in medication, or treatment or that requires a revision to an
individual service plan; or a change in medication or the medication route that
would permanently alter the level of assistance with medication delivery.
(7) “Supportive
services” means services provided through coordination with
service agencies to assist residents in maintaining the individual’s quality of
life.
(8) “Surrogate
decision maker” means the resident's agent, guardian or surrogate
as defined in the “uniform health-care decisions act,” 24-7A-1 through
24-7A-186 NMSA 1978 or other legally appointed decision maker.
(9) “Survey” means a monitoring visit by the licensing authority to examine a
facility’s premises and records and to interview the residents and staff.
(10) “Stable” means the resident’s condition is unchanged; signs or symptoms are
within established ranges, frequencies or patterns. The resident’s condition does not require
frequent monitoring by a licensed nurse to determine the resident’s status or
the resident’s response to medication or treatment.
(11) “Staff
or employees” means the individuals hired or subcontracted by the
facility to implement the individual service plan for the residents.
(12) “Subcutaneous
injection” means the insertion of a needle under the skin but
above the muscle layer to administer medication.
T. Definitions
beginning with “T”: “Therapeutic diet” means a diet other than a
regular diet, ordered by a physician to manage a health condition.
U. Definitions
beginning with “U”: [RESERVED]
V. Definitions beginning with “V”:
(1) “Volunteers” means unpaid individuals who provide care or services for the residents.
(2) “Variance” means a decision that is made at the discretion of the licensing
authority to allow a facility to deviate from a portion(s) or to modify a
provision of this rule for an unspecified period of time, provided that the
health, safety, or welfare of the residents and staff are not in danger.
(3) “Visit
notes” means the documentation of services provided by
outside agencies for ongoing care coordination of the resident.
W. Definitions
beginning with “W”: “Waive/waiver” means to refrain from pressing or enforcing compliance with a portion or
portions of these regulations for a limited period of time provided the health,
safety, or welfare of the residents and staff are not in danger. Waivers are
issued at the sole discretion of the licensing authority.
X. Definitions beginning with “X”: [RESERVED]
Y. Definitions beginning with “Y”; [RESERVED]
Z. Definitions Beginning with “Z”: [RESERVED]
[8.370.14.7 NMAC -
Rp, 8.370.14.7 NMAC, xx/xx/2025]
8.370.14.8 GENERAL
LICENSING REQUIREMENTS:
A. Licensure is required. No person or entity shall establish, maintain
or operate an assisted living facility without first obtaining a license.
B. Application for licensure. An initial or renewal application shall be
made on the forms (paper or electronic) prescribed by and available from the
licensing authority. The issuance of an
application form is not a guarantee that the completed application will be
accepted, or that the authority will issue a license. Information provided by the facility and used
by the licensing authority for the licensing process shall be accurate and
truthful. The
licensing authority will not issue a new license if the applicant has had a
health facility license revoked or renewal denied or has surrendered a license
under threat of revocation or denial of renewal. The licensing authority may not issue a new
license if the applicant has been cited repeatedly for violations of applicable
rules found to be class A or class B deficiencies as defined in health facility
sanctions and civil monetary penalties, 8.370.4 NMAC or has been non-compliant
with plans of correction. The licensing
authority will not issue a license until the applicant has supplied all of the
information that is required by this rule.
Any facility that fails to participate in good faith by falsifying
information presented in the licensing process shall be denied licensure by the
authority. The following information
shall be submitted to the licensing authority for approval:
(1) a
letter of intent that includes the proposed physical address, the primary
population of the facility and a summary of the proposed services; after the
letter of intent has been received, an application packet including; the
application form, fee schedule and the licensing rule will be issued to the
applicant by the licensing authority;
(2) the
completed application and the appropriate non-refundable fee(s);
(3) a
program narrative identifying and detailing the geographic service area, the
primary population including any special needs requirements, along with a full
description of the services that the applicant proposes to provide including:
(a) a
description of the characteristics of the proposed population of the facility;
(b) a
description of the services and care that will be provided to the residents;
(c) a
description of the anticipated professional services to be offered to the
residents; and
(d) a
description of the facility’s relationship to other services and related
programs in the service area and how the applicant will collaborate with them
to achieve a system of care for the residents.
(4) policies
and procedures annotated to this rule;
(5) evidence
to establish that the applicant has sufficient financial assets to permit
operation of the facility for a period of six months; the evidence shall
include a credit report from one of the three recognized credit bureaus with a
minimum credit score of 650 or above;
(6) copies
of organizational documents to include the following list of items:
(a) the
names of all persons or business entities that have at least five percent
ownership interest in the facility, whether direct or indirect and whether in
profits, land or building; this includes the owners of any business entity
which owns all or part of the land or building;
(b) the
identities of all creditors that hold a security interest in the premises,
whether land or building;
(c) in cases in which the owner is
organized as a partnership, the identity of each partner and a copy of the
partnership agreement.
(7) a
statement from the administrator of the facility, acknowledging that the
facility is responsible for any funds that are handled for the residents by the
facility or its staff, including personal allowance funds, together with an
acknowledgement that the failure to make restitution within ten working days
for lost or stolen funds will result in non-renewal of licensure, or other
sanctions;
(8) building plans as required at
8.370.14.42 NMAC of this rule;
(9) fire
authority approval as required at 8.370.14.61 NMAC of this rule;
(10) a
letter of approval or exemption from the local health authority having
jurisdiction for the food service and the kitchen facility;
(11) a
copy of liquid waste disposal and treatment system permit from local health
authority having jurisdiction;
(12) approval
from local zoning authority;
(13) building
approval (certificate of occupancy);
(14) copy
of appropriate drug permit issued by the state board of pharmacy, if
applicable: and
(15) any other information that the
applicant wishes to provide or that the licensing authority may request.
C. Annual license:
An annual license is issued for one year for a facility that has met all
the requirements of this rule.
D. Application for amended license: A licensee shall submit an application for an
amended license and the required non-refundable fee to the licensing authority
prior to a change with the facility. An
amended license is required for a change of: location, administrator, facility
name, capacity or any modification or addition to the building.
(1) An
application for a change of the facility administrator or change of the
administrator’s name shall be submitted to the licensing authority within 10
business days of the change.
(2) An
application for increase in capacity shall be accompanied by a building plan
pursuant to 8.370.14.41 NMAC of this rule.
A facility shall not increase census until the licensing authority has
reviewed and approved the increase and has issued a new license that reflects
the approved increase in capacity.
D. Application for license renewal: Each facility shall apply for a renewal of
the annual license within 30 business days prior to the license expiration date
by submitting the following items:
(1) an
application and the required fee;
(2) an
updated program narrative, if the facility has changed the program or the focus
of services;
(3) the
annual fire inspection report; and
(4) the
licensing authority may not issue a new license if the applicant has been cited
repeatedly for violations of this rule or has been noncompliant with plans of
correction or payment of civil monetary penalties.
E. License: Any person or entity that establishes,
maintains or operates an assisted living facility shall obtain a license as
required in this rule before accepting residents for care or providing
services.
(1) Each
facility that provides care or treatment shall obtain a separate license. The license is non-transferable and is only
valid for the facility to which it is originally issued and for the owner or
operator to whom it is issued. It shall
not be sold, reassigned or transferred.
(2) The
maximum capacity specified on the license shall not be exceeded.
(3) If
the facility is closed and the residents are removed from the facility, the
license shall be returned to the licensing authority. Written notification shall be issued to all
residents or the residents’ surrogate decision maker and the licensing
authority at least 30 calendar days prior to the closure.
F. Change of Ownership:
When
a change of ownership occurs, the new owner must submit an initial license
application pursuant to the requirements in this section. The new owner must demonstrate compliance
with these regulations at the time it takes responsibility of the
facility. The licensing authority may,
at its sole discretion, approve a change of ownership. In addition to the requirements in subsection
B – Application for licensure, the new owner must submit the following at least
60 days prior to completion of the change of ownership:
(1) a letter of intent that explains
the terms of the change of ownership and
the date the ownership will change;
(2) documents evidencing the change of
ownership such as proof of sale or donation, lease of any portion of the
facility, or other relevant documents;
(3) building plans of the current
structure with any modifications known to the current or new owner;
(4) a continuity of care transition plan
that describes how the new owner will keep residents safe and meet the
requirements of these regulations at the time it takes responsibility of the
facility. The plan must state the
actions that will occur, the party responsible for taking each action, and the
expected date of completion for each action.
The plan must include the following:
(a) a list of all residents at the time
of notice to the licensing authority;
(b) a current and accurate review and
update of all resident assessments;
(c) review and update of all individual
service plans. All plans must be current
and accurate;
(d) staffing ratios as required in
section 8.370.14.19 and the number and positions of current staff that will be
hired by the new owner;
(e) staff training as required in section
8.370.14.17;
(f) transfer of resident accounts;
(g) identification of all waivers or
variances held by the current owner, and submission of any necessary waivers or
variances for the new owner because all waivers or variances held by the
current owner are void upon the change of ownership.
(h) a waiver to have more than three
residents under a temporary license, if applicable.
(5) record of notification of residents
and families of the proposed change; and
(6) record of notification of the state
long-term care ombudsman.
G. Temporary license:
(1) A
temporary license may be issued to a new facility before residents are admitted
provided that the facility has met all of the life safety code requirements as
stated in this rule and policies and procedures for the facility have been
reviewed and approved.
(2) Upon
receipt of a temporary license, the facility may begin to admit up to three
residents.
(3) After
the facility has admitted up to three residents, the facility operator or owner
shall request an initial health survey from the licensing authority.
(4) Following
a determination of compliance with this rule by the licensing authority, an
annual license will be issued. The
renewal date of the annual license is based on the initial date of the first
temporary license.
(5) The
licensing authority has the right to determine compliance or noncompliance.
(6) A
temporary license shall cover a period of time, not to exceed 120 calendar
days.
(7) No
more than two consecutive temporary licenses shall be issued. If a second temporary license is issued, an
additional non-refundable fee is required.
If all requirements are not met within the 240 day time frame, the
applicant shall repeat the application process.
H. Display of license: The facility shall display the license in a
conspicuous public place that is visible to residents, staff and visitors.
I. Unlicensed
facilities: Any person or entity
that opens or maintains an assisted living facility without a license is
subject to the imposition of civil monetary penalties by the licensing
authority. Failure to comply with the
licensure requirements of this rule within 10 days of notice by the licensing
authority may result in the following penalties pursuant to health facility
sanctions and civil monetary penalties, 8.370.4 NMAC.
(1) A
civil monetary penalty not to exceed $5,000 per day.
(2) A
base civil monetary penalty, plus a per-day civil monetary penalty, plus the
doubling of penalties as applicable, that continues until the facility is in
compliance with the licensing requirements in this rule.
(3) A
cease and desist order to discontinue operation of a facility that is operating without a license.
(4) Additional
criminal penalties may apply and shall be imposed as necessary.
[8.370.14.8 NMAC -
Rp, 8.370.14.8 NMAC, xx/xx/2025]
8.370.14.9 WAIVERS
AND VARIANCES. The licensing authority may vary or waive
certain licensure requirements for facilities, provided that it would not
adversely affect the health, safety or welfare of the residents or staff.
A. Requests for a
variance or waiver may be made at any time, shall be made in writing to the
licensing authority and shall specify the following:
(1) the
section of the rule for which the variance or wavier is requested;
(2) the
time period for which the waiver is requested;
(3) if
the request is for a variance; the specific alternative action that the
facility proposes;
(4) the
reason(s) for the request and an explanation of why and how the health, safety
and welfare of the residents or staff are not endangered by the requested
variance or waiver; and
(5) justification
that the goal or purpose of the rule would be satisfied with a waiver or
variance.
B. The licensing
authority may require additional information from the facility prior to acting
on the request.
C. The licensing
authority may impose conditions on the variance or waiver.
D. The licensing
authority shall limit the duration of any waiver.
E. Variances and
waivers are nontransferable and shall be kept on file and readily available at
the facility.
F. Variances and
waivers are granted at the discretion of the licensing authority.
[8.370.14.9
NMAC - Rp, 8.370.14.9 NMAC, xx/xx/2025]
8.370.14.10 AUTOMATIC
EXPIRATION OF A LICENSE: A license
shall automatically expire:
A. at midnight on
the day indicated as the expiration date on the license;
B. when the
operation of a facility is discontinued;
C. when a facility
is sold or leased or the licensee changes; or
D. when there is a change of location
for a facility.
[8.370.14.10 NMAC
- Rp, 8.370.14.10 NMAC, xx/xx/2025]
8.370.14.11 SURVEY
OR MONITORING VISITS:
A. The licensing
authority shall perform unannounced on-site survey or monitoring visits at all
assisted living facilities to determine compliance with this rule.
B. The facility
shall provide the licensing authority full access to all facility operations,
buildings and information related to the operation of the facility. This includes interviews with facility staff. The facility shall develop and implement
written policies and procedures that promote a culture of safety, open
communication in the work environment, including prohibiting retaliation
against an employee who cooperates with the survey process and interviews.
C. The most recent
survey inspection reports and related correspondence shall be posted in a
conspicuous public place in the facility.
D. Failure by the
facility to provide the licensing authority access to the premises or
information, including resident records and interviews with any party with
relevant information, may result in the imposition of sanctions including but
not limited to civil monetary penalties, license revocation or an order to
cease and desist, in accordance with 8.370.4 NMAC, as deemed appropriate by the
licensing authority. Impeding the survey
or investigation includes the following:
(1) Failure of the facility to provide
resident records, medical records, staff records, or other records necessary
for the survey process. The facility
must make available a printout of any record or part of a record upon request
in a timeframe that does not impede the survey process.
(2) Failure of the facility to provide
records. Undue delays in the production
of records are unacceptable.
[8.370.14.11 NMAC
- Rp, 8.370.14.11 NMAC, xx/xx/2025]
8.370.14.12 CORRECTIVE ACTION: If violations of this rule are cited, the
facility will be provided with an official statement of deficiencies within 10
business days following the survey.
A. Informal dispute
review (IDR): The facility may request an informal review
of survey deficiencies by providing a written request to the licensing
authority within 10 calendar days of receipt of the written survey findings. With the request, the facility shall include
information or evidence that justifies the disagreement with a cited
deficiency.
(1) The
licensing authority will review the submitted information and make a
determination.
(2) If
the deficiency is removed, a new statement of deficiencies will be issued to
the facility.
(3) The
facility shall provide a new plan of correction for all remaining deficiencies
upon receipt of the new statement of deficiencies.
(4) A
copy of the “IDR operating rules” is available upon request or by accessing the
DHI website.
B. Plan of correction
(POC): The facility shall submit a
plan of correction within 10 calendar days of receipt of the statement of
deficiencies and after receipt of a revised statement of deficiencies, when the
findings are changed pursuant to an IDR.
(1) The
licensing authority may either accept, direct or reject a plan of correction
(POC).
(2) If the first POC is rejected by the
licensing authority, the facility will be sent a second copy of the statement
of deficiencies. The facility shall
complete and return the second copy of the statement of deficiencies with an
acceptable plan of correction within three business days. The process will repeat until an acceptable
plan of correction is received by the authority.
(3) Failure
to provide an acceptable plan of correction within a reasonable period of time,
may lead to civil monetary penalties or other sanctions.
(4) The
plan of correction shall:
(a) address
how all violations identified in the official statement of deficiencies will be
corrected;
(b) address
how the facility will monitor the corrective action and ensure ongoing
compliance; and
(c) specify
the date that the corrective action will be completed.
(5) All
cited violations shall be corrected within 30 calendar days from the date of
the survey; unless the licensing authority approves an extended date.
(6) Failure
to submit an acceptable plan of correction may result in sanctions, including
but not limited to civil monetary penalties, suspension or non-renewal of the
facility license.
[8.370.14.12
NMAC - Rp, 8.370.14.12 NMAC, xx/xx/2025]
8.370.14.13 GROUNDS
FOR REVOCATION, SUSPENSION OR DENIAL OF INITIAL OR RENEWAL OF LICENSE, OR THE
IMPOSITION OF SANCTIONS OR CIVIL MONETARY PENALTIES:
A. When the licensing authority
determines that it will deny an application for the renewal of a license or
that it will revoke a license, it shall provide notification to the facility,
the residents and the surrogate decision makers for the residents.
B. After notice to
the facility and an opportunity for a hearing, the authority may deny an
initial or renewal application, revoke or suspend the license of a facility or
may impose an intermediate sanction and a civil monetary penalty as provided in
accordance with the Health Care Code, Section 24a-1-5.2 NMSA 1978.
C. Grounds for implementing these
penalties may be based on the following:
(1) failure
to comply with any provision of this rule;
(2) failure
to allow a survey by authorized representatives of the licensing authority;
(3) the
hiring or retaining of any staff or permitting any private duty attendant or
volunteer to work with residents that has a disqualifying conviction under the
requirements of the caregiver’s criminal history screening program, 8.370.5
NMAC;
(4) the
misrepresentation or falsification of any information on the application forms
or other documents provided to the licensing authority;
(5) repeat
violations of this rule;
(6) failure
to maintain or provide services as required by this rule;
(7) exceeding
licensed capacity;
(8) failure
to provide an acceptable plan of correction within the time period established
by the licensing authority;
(9) failure
to correct deficiencies within the time period established by the licensing
authority;
(10) failure
to comply with the incident reporting requirements pursuant to incident
reporting, intake processing and training requirements, 8.370.9 NMAC;
(11) failure
to pay civil monetary penalties pursuant to health facility sanctions and civil
monetary penalties, 8.370.4 NMAC; or
[8.370.14.13 NMAC
- Rp, 8.370.14.13 NMAC, xx/xx/2025]
8.370.14.14 HEARING PROCEDURES:
A. Hearing
procedures for an adverse action taken against a facility by the authority will
be conducted in accordance with adjudicatory hearings for licensed facilities,
8.370.2 NMAC.
B. The facility
will receive a copy of the hearing procedures at the time that an adverse
action is taken or may request a copy by contacting the licensing authority.
C. If immediate
action is required to protect human health and safety, the licensing authority
may suspend a license or impose an intermediate sanction pending a hearing,
provided that the hearing is held within five working days of the suspension or
the sanction, unless waived by the facility, in accordance with the Public
Health Act, Subsection H of Section 24a-1-5 NMSA.
[8.370.14.14 NMAC
- Rp, 8.370.14.14 NMAC, xx/xx/2025]
A. A licensee that
is subject to an adverse action may request an administrative appeal. Hearing procedures for an administrative
appeal of an adverse action taken by the licensing authority against the
facility is in accordance with adjudicatory hearings for licensed facilities,
8.370.2 NMAC.
B. A copy of the
adjudicatory hearing procedures will be forwarded to the facility when an
adverse action is taken against the licensee by the licensing authority.
C. All notices,
orders or decisions which the licensing authority issues to a facility prior to
a transfer of ownership shall be in effect against both the former owner and
the new owner, unless the transfer of penalties to the new owner is rescinded
in writing by the authority.
[8.370.14.15
NMAC - Rp, 8.370.14.152 NMAC, xx/xx/2025]
8.370.14.16 STAFF
QUALIFICATIONS: A facility shall employ staff with the
following qualifications.
A. Administrator,
director, operator: an assisted
living facility shall be supervised by a full-time on-site administrator. Multiple facilities that are located within a
40-mile radius may have one full-time administrator. The administrator shall:
(1) be
at least 21 years of age;
(2) have
a high school diploma or its equivalent;
(3) comply
with the requirements of the New Mexico caregivers criminal history screening
act, 8.370.5 NMAC;
(4) complete
a state approved certification program for assisted living administrators, or a
current license as a nursing home administrator (NHA).
(5) be
able to communicate with the residents in the language spoken by the majority
of the residents;
(6) not
work while under the influence of alcohol or illegal drugs;
(7) have
evidence of education and experience to prove the ability to administer, direct
and operate an assisted living facility; the evidence of education and
experience shall be directly related to the services that are provided at the
facility;
(8) provide
three letters of reference from persons unrelated to the applicant; and
(9) comply
with the pre-employment requirements pursuant to the employee abuse registry,
8.370.8 NMAC and shall comply with the requirements of the caregivers criminal
history screening requirements, 8.370.5 NMAC.
B. Direct care staff:
(1) shall
be at least 16 years of age;
(2) shall
have adequate education, relevant training, or experience to provide for the
needs of the residents;
(3) shall
comply with the pre-employment requirements pursuant to the employee abuse registry,
8.370.8 NMAC; and
(4) shall
comply with the current requirements of reporting and investigating incidents
pursuant to incident reporting, intake processing and training requirements,
8.370.9 NMAC;
(5) shall not work while under the
influence of alcohol or mind altering drugs;
(6) if
a facility provides transportation for residents, the employees of the facility
who drive vehicles and transport residents shall have copies of the following
documents on file at the facility:
(a) a
valid New Mexico driver’s license with the appropriate classification for the
vehicle that is used to transport residents;
(b) documentation
of training in transportation safety for the elderly and disabled, including
safe vehicle operation;
(c) proof
of insurance; and
(d) documentation
of a clean driving record;
(7) any
person who provides direct care who is not employed by an agency that is
covered by the requirements of the caregivers criminal history screening
requirements, 8.370.5 NMAC, shall provide current (within the last 6 months)
proof of the caregiver’s criminal history screening to the facility; the
facility shall maintain and have proof of such screening readily available; and
(8) employers
shall comply with the requirements of the caregivers criminal history screening
requirements, 8.370.5 NMAC.
[8.370.14.16 NMAC
- Rp, 8.370.14.16 NMAC, xx/xx/2025]
8.370.14.17 STAFF
TRAINING:
A. Training and
orientation for each new employee and volunteer that provides direct care shall
include a minimum of 16 hours of supervised training prior to providing
unsupervised care for residents.
B. Documentation of
orientation and subsequent trainings shall be kept in the personnel file at the
facility.
C. Training shall
be provided at orientation and at least 12 hours annually, the orientation,
training and proof of competency shall include:
(1) fire
safety and evacuation training;
(2) first
aid;
(3) safe
food handling practices (for persons involved in food preparation), to include:
(a) instructions
in proper storage;
(b) preparation
and serving of food;
(c) safety
in food handling;
(d) appropriate
personal hygiene; and
(e) infectious
and communicable disease control;
(4) confidentiality
of records and resident information;
(5) infection
control;
(6) resident
rights;
(7) reporting
requirements for abuse, neglect or exploitation in accordance with 8.370.9
NMAC;
(8) smoking
policy for staff, residents and visitors;
(9) methods
to provide quality resident care;
(10) emergency
procedures;
(11) medication
assistance, including the certificate of training for staff that assist with
medication delivery; and
(12) the
proper way to implement a resident ISP for staff
that assist with ISPs.
D. If a facility
provides transportation to residents, employees of the facility who drive
vehicles and transport residents shall have training in transportation safety
for the elderly and disabled, including safe vehicle operation.
[8.370.14.17 NMAC
- Rp, 8.370.14.17 NMAC, xx/xx/2025]
8.370.14.18 POLICIES: The facility shall have and implement written
personnel policies for the following:
A. staff, private
duty attendant and volunteer qualifications;
B. staff, private
duty attendant and volunteer conduct;
C. staff, private
duty attendant and volunteer training policies;
D. staff and
private duty attendant and volunteer criminal history screening;
E. emergency
procedures;
F. medication
administration and assisting with self-administration of medication:
G. the retention
and maintenance of current and past personnel records; and
H. facilities shall
maintain records and files that reflect compliance with NM and federal
employment rules.
[8.370.14.18
NMAC - Rp, 8.370.14.18 NMAC, xx/xx/2025]
8.370.14.19 STAFFING
RATIOS: The following staffing levels are the minimum requirements.
A. The facility
shall employ the sufficient number of staff to provide the basic care, resident
assistance and the required supervision based on the assessment of the
residents’ needs.
(1) During
resident waking hours, facilities shall have at least one direct care staff
person on duty and awake at all times for each 15 residents.
(2) During
resident sleeping hours, facilities with 15 or fewer residents shall have at
least one direct care staff person on duty, awake and responsible for the care
and supervision of the residents.
(3) During
resident sleeping hours, facilities with 16 to 30 residents shall have at least
one direct care staff person on duty and awake at all times and at least one
additional staff person available on the premises.
(4) During
resident sleeping hours, facilities with 31 to 60 residents shall have at least
two direct care staff persons on duty and awake at all times and at least one
additional staff person immediately available on the premises.
(5) During
resident sleeping hours, facilities with more than 61 residents shall have at
least three direct care staff persons on duty and awake at all times and one
additional staff person immediately available on the premises for each
additional 30 residents or fraction thereof in the facility.
B. Upon request of
the authority, the facility shall provide the staffing ratios per each 24 hour
day for the past 30 days.
[8.370.14.19
NMAC - Rp, 8.370.14.19 NMAC, xx/xx/2025]
8.370.14.20 ADMISSIONS
AND DISCHARGE: The facility shall complete an admission
agreement for each resident. The
administrator of the facility or a designee responsible for admission decisions
shall meet with the resident or the resident’s surrogate decision maker prior
to admission. No resident shall be
admitted who is below the age of eighteen (18) or for whom the facility is
unable to provide appropriate care.
A. Admission agreement: The admission agreement shall include the
following information:
(1) the
parties to the agreement;
(2) the
program narrative;
(3) the
facility's rules;
(4) the
cost of services and the method of payment;
(5) the
refund provision in case of death, transfer, voluntary or involuntary
discharge;
(6) information
to formulate advance directives;
(7) a
written description of the legal rights of the residents translated into
another language, if necessary;
(8) the
facility's staffing ratio;
(9) written
authorization for staff to assist with medications;
(10) notification
of rights and responsibilities pursuant to the incident reporting intake,
processing and training requirements, 8.370.9 NMAC;
(11) the
facility’s bed hold policy; and
(12) the
admission agreement may be terminated if an appropriate placement is found for
the resident, under the following circumstances:
(a) there
shall be a 15 day written notice of termination given to the resident or his or
her surrogate decision maker, unless the resident requests the termination;
(b) the
resident has failed to pay for a stay at the facility as defined in the
admission agreement;
(c) the
facility ceases to operate or is no longer able to provide services to the
resident;
(d) the
resident’s health has improved sufficiently and
therefore no longer requires the services of the facility;
(e) termination
without prior notice is permitted in emergency situations for the following
reasons:
(i) the transfer or discharge is
necessary for the resident's safety and welfare;
(ii) the
resident's needs cannot safely be met in the facility; or
(iii) the
safety and health of other residents and staff in the facility are endangered;
(13) the
facility shall provide a 30 day written notice to residents regarding any
changes in the cost or the material services provided; a new or amended
admission agreement must be executed whenever services, costs or other material
terms are changed; and
(14) facilities
representing their services as “specialized” must disclose evidence of staff
specialty training to prospective residents.
B. Restrictions in
admission: The facility shall not
admit or retain individuals that require 24 hour continuous nursing care, refer
to Subsection U of 8.370.14.7 NMAC definitions.
This rule does not apply to hospice residents who have elected to
receive the hospice benefit. Conditions
or circumstances that usually require continuous nursing care may include but
are not limited to the following:
(1) ventilator
dependency;
(2) pressure
sores and decubitus ulcers (stage III or IV);
(3) intravenous
therapy or injections;
(4) any
condition requiring either physical or chemical restraints;
(5) nasogastric
tubes;
(6) tracheostomy
care;
(7) residents
that present an imminent physical threat or danger to self or others;
(8) residents
whose psychological or physical condition has declined and placement in the
current facility is no longer appropriate as determined by the PCP;
(9) residents
with a diagnosis that requires isolation techniques;
(10) residents
that require the use of a hoyer lift; and
(11) ostomy
(unless resident is able to provide self-care).
C. Exceptions to
admission, readmission and
retention: If a resident requires a
greater degree of care than the facility would normally provide or is permitted
to provide and the resident wishes to be re-admitted or remain in the facility
and the facility wishes to re-admit or retain the resident. The facility shall comply with the following
requirements.
(1) Convene
a team, comprised of:
(a) the
facility administrator and a facility health care professional if desired;
(b) the
resident or resident’s surrogate decision maker; and
(c) the
hospice or home health clinician.
(2) The
team shall jointly determine if the resident should be admitted, readmitted or
allowed to remain in the facility. Team
approval shall be in writing, signed and dated by all team members and the
approval shall be maintained in the resident's record and shall:
(a) be
based upon an individual service plan (ISP) which identifies the resident's
specific needs and addresses the manner that such needs will be met;
(b) ensure
that if the facility is licensed for more than eight residents and does not
have complete fire sprinkler coverage, the facility shall maintain an
evacuation rating score of prompt as determined by the fire safety equivalency
system (FSES);
(c) evaluate
and outline how meeting the specific needs of the resident will impact the
staff and the other residents; and
(d) include
an independent advocate such as a certified ombudsman if requested by the
resident, the family or the facility.
(3) The
team recommendation shall be maintained on site in the resident’s file.
(4) When
a resident is discharged, the facility shall record where the resident was
discharged to and what medications were released with the resident.
D. Coordination
of care:
(1) Assisted
living facilities shall have evidence of care coordination on an ISP for all
services that are provided in the facility by an outside health care provider,
such as hospice or home health providers.
(2) Residents
shall be given a list of providers, including hospice and home health if
applicable, and have the right to choose their provider. If applicable, the referring party shall
disclose any ownership interest in a recommended or listed provider.
[8.370.14.20 NMAC
- Rp, 8.370.14.20 NMAC, xx/xx/2025]
A. Record contents: A record for each resident shall be
maintained in accordance with the specific requirements of this section. Entries in each resident's record shall be
legible, dated and authenticated by the signature of the person making the
entry. Resident records shall be readily
available on site and organized utilizing a table of contents. Each resident record shall include:
(1) the
admission agreement records, as set forth in 8.370.14.20 NMAC;
(2) the
resident evaluation form, that is to
be completed within 15 days prior to admission and updated at a minimum of
every six months;
(3) the
current ISP, that is to be completed within 10 calendar days of admission and
updated at a minimum of every six months;
(4) the
physical examination report; the physical examination report shall have been
completed within the past six months, by a primary care physician, a nurse
practitioner or a physician’s assistant and shall be on file in the resident’s
record within 10 days of admission;
(5) personal
and demographic information for the resident, to include:
(a) current
names, addresses, relationship and phone numbers of family members, or
surrogate decision makers updated as necessary;
(b) resident's
name;
(c) age;
(d) recent
photograph;
(e) marital
status;
(f) date
of birth;
(g) sex;
(h) address
prior to admission;
(i) religion (optional);
(j) personal
physician;
(k) dentist;
(l) social
history;
(m) surrogate
decision maker or other emergency contact person;
(n) language
spoken and understood;
(o) legal
documentation relevant to commitment or guardianship status;
(p) current
medications list; and
(q) required
diet;
(6) unless
included in the admission agreement, a separate written agreement between the
facility and the resident relating to the resident's funds, in accordance with
the facility's policy and procedures;
(7) entries
by direct care staff, appropriate health care professionals and others
authorized to care for the resident; entries shall be dated and signed by the
person making the entry and shall include significant information related to
the ISP;
(8) entries
that provide a written account of all accidents, injuries, illnesses, medical
and dental appointments, any problems or improvements observed in the resident,
any condition that would indicate a need for alternative placement or medical
attention and entries reflecting appropriate follow-up; the maintenance of such
written documentation in the resident record may be by copy of an incident or
accident report, if the original incident or accident report is maintained
elsewhere by the facility;
(9) the
medication administration record (MAR); the MAR is the document that details
the resident's medication; the MAR shall include all of the information
pursuant to Subsection G of 8.370.14.35 NMAC of this rule;
(10) progress
notes completed by any contract
agency (e.g., hospice, home health); the progress notes shall include the date,
time and type of health services provided;
(11) copies
of all completed and signed transfer
forms from the accepting facility when a resident is transferred to a hospital
or another health care facility and when the resident is transferred back to
the facility; and
(12) upon
the death or transfer of a resident, documentation of the disposition of the resident's personal effects and money or valuables that are
deposited with the assisted living facility.
B. Resident records maintenance:
(1) Current
resident records shall be maintained on-site and stored in an organized,
accessible and permanent manner.
(2) The
facility shall establish a policy to maintain and ensure the confidentiality of
resident records, including the authorized release of information from the
resident records.
(3) Non-current
resident records shall be maintained by the facility against loss, destruction
and unauthorized use for a period of not less than five years from the date of
discharge and readily available within 24 hours of request.
(4) There
shall be a policy and procedure in place for record retention in the event of
facility closure.
(5) Failure
to follow facility policies is grounds for sanctions.
[8.370.14.21
NMAC - Rp, 8.370.14.21 NMAC, xx/xx/2025]
8.370.14.22 FACILITY
REPORTS, RECORDS, RULES, POLICIES AND PROCEDURES:
A. Reports and records: Each facility shall keep the following
reports, records, policies and procedures on file at the facility and make them
available for review upon request by the licensing authority, residents,
potential residents or their surrogate decision makers:
(1) fire
inspection report;
(2) zoning
approval;
(3) building
official approval (certificate of occupancy);
(4) a
copy of the approved building plans;
(5) a
copy of the most recent survey conducted by the licensing authority, to include
adverse actions or appeals and complaints;
(6) for
facilities with food establishments/kitchens that require a permit from the
local health authority that has jurisdiction, a copy of the current inspection
report in accordance with the applicable, municipal, or federal laws and
regulations and pursuant to Subsection B of 7.6.2.8 NMAC, regarding kitchen and
food management; if a facility is considered a licensed private home and not
required to meet specific requirements by the local health authority, a copy of
that determination must also be maintained;
(7) where
necessary, a copy of the liquid waste disposal and treatment system permit from
the local health authority that has jurisdiction;
(8) 30
days of menus as planned, including snacks and 30 days of menus as served,
including snacks;
(9) record
of monthly fire drills conducted at the facility and the fire safety evaluation
system (FSES) rating, if applicable;
(10) written
emergency plans, policies and procedures for medical emergencies, power
failure, fire or natural disaster; plans shall include evacuation, persons to
be notified, emergency equipment, evacuation routes, refuge areas and the
responsibilities of personnel during emergencies; plans shall also include a
list of transportation resources that are immediately available to transport
the residents to another location in an emergency; the emergency preparedness
plan shall address two types of emergencies:
(a) an
emergency that affects just the facility; and
(b) a
region/area wide emergency;
(11) a
copy of this rule, requirements for assisted living facilities for adults,
8.370.14 NMAC;
(12) for
facilities with two or more residents (that are not related to the owner), a
valid custodial drug permit issued by the NM board of pharmacy, that supervise
administration and self-administration of medications or safeguards with regard
to medications for the residents; and
(13) vaccination
records for pets in the facility.
B. Reports and records: Each facility shall keep the following
reports, records, policies and procedures on file at the facility and make them
available for review upon request by the licensing authority:
(1) a
copy of the facility license;
(2) employee
personnel records, including an application for employment, training records
and personnel actions:
(a) caregiver
criminal history screening documentation pursuant to 8.370.5 NMAC;
(b) employee
abuse registry documentation pursuant to 8.370.8 NMAC; and
(3) a
copy of all waivers or variances granted by the licensing authority.
C. Rules: Prior to admission to a facility a
prospective resident or his or her representative shall be given a copy of the
facility rules. Each facility shall have
written rules pertaining to resident’s rights and shall include the following:
(1) resident
use of tobacco and alcohol;
(2) resident
use of facility telephone or personal cell phone;
(3) resident
use of television, radio, stereo and cd;
(4) the
use and safekeeping of residents’ personal property;
(5) meal
availability and times;
(6) resident
use of common areas;
(7) accommodation
of resident’s pets; and
(8) resident
use of electric blankets and appliances.
D. Policies and
procedures: All facilities shall
have written policies and procedures covering the following areas:
(1) actions
to be taken in case of accidents or emergencies;
(2) policy
and procedure for updating and consolidating the resident’s current physician
or PCP orders, treatments and diet plans every six months or when a significant
change occurs, such as a hospital admission;
(3) policy
for medication errors;
(4) method
of staying informed when residents are away from the facility (e.g., sign-out
sheets or other record indicating where the resident will be, cell phone
contact, etc.);
(5) the
handling of resident's funds, if the facility provides such services;
(6) reporting
of incidents, including abuse, neglect and misappropriation of property,
injuries of unknown cause, environmental hazards and law enforcement
interventions in accordance with 8.370.9 NMAC;
(7) reporting
and investigating internal complaints;
(8) reporting
and investigating complaints to the incident management bureau;
(9) staff
and resident fire and safety training;
(10) smoking
policy for staff, residents and visitors;
(11) the
facility's bed hold policy;
(12) admission
agreement;
(13) admission
records;
(14) resident
records including maintenance and record retention if the facility closes;
(15) program
narrative;
(16) resident's
rights with regard to making health care decisions and the formulation of
advance directives;
(17) personnel
policies;
(18) identifying
and safeguarding resident possessions;
(19) securing
medical assistance if a resident's own physician is not available;
(20) staff
training appropriate to staff responsibilities;
(21) staff
training for employees who provide assistance to residents with boarding or
alighting from motor vehicles and safe operation of motor vehicles to transport
residents;
(22) witnessed
destruction of unused, outdated or recalled medication by the facility
administrator with the consulting pharmacist present; and
(23) mealtimes,
daily snacks, menus, special diets, resident’s personal preference for eating
alone or in the dining room setting.
(24) infection control; the policies shall
identify the nationally or state recognized guidelines upon which the policies
are based. The policies and procedures shall include at a minimum, all of the
following criteria:
(a) ensure a safe and sanitary
environment for residents and personnel,
(b) the method for tracking infection and
initiating a response,
(c) the method for determining when to
seek assistance from a medical professional or the local health department,
(d) isolation techniques, and
(e) appropriate handling of linen and
clothing of residents with communicable infections. Any item containing blood,
body fluid, or body waste from a resident with a contagious condition shall be
presumed to be infectious waste and disposed of in accordance with the state's infectious
waste disposal requirements, 20.9.8.13 NMAC (8/2/2007).
[8.370.14.22
NMAC - Rp, 8.370.14.22 NMAC, xx/xx/2025]
8.370.14.23 PETS: Pets are permitted in a licensed facility, in
accordance with the facility's rules.
A. Prohibited areas: Animals are not permitted in food processing,
preparation, storage, display and serving areas, or in equipment or utensil
washing areas. Guide dogs for the blind
and deaf and service animals for the handicapped shall be permitted in dining
areas pursuant to Subsection K of 7.6.2.9 NMAC.
B. Vaccination: Pets shall be vaccinated in accordance with
all state and local requirements and records of such vaccination shall be kept
on file in the facility.
[8.370.14.23
NMAC - Rp, 8.370.14.23 NMAC, xx/xx/2025]
8.370.14.24 ASSISTANCE
WITH DAILY LIVING: The facility shall supervise and assist the
residents, as necessary, with health, hygiene and grooming needs, to include
but not limited to the following:
A. eating;
B. dressing;
C. oral hygiene;
D. bathing;
E. grooming;
F. mobility; and
G. toileting.
[8.370.14.24
NMAC - Rp, 8.370.14.24 NMAC, xx/xx/2025]
8.370.14.25 RESIDENT
EVALUATION:
A. A resident evaluation shall be
completed by an appropriate staff member within 15 days prior to admission to
determine the level of assistance that is needed and if the level of services
required by the resident can be met by the facility.
B. The initial
resident evaluation shall establish a baseline in the resident’s functional
status and thereafter assist with identifying resident changes. The resident evaluation shall be reviewed and
updated at a minimum of every six months or when there is a significant change
in the resident’s health status.
C. The resident’s evaluation shall be documented on a
resident evaluation form and at a minimum include the following abilities,
behaviors or status:
(1) activities of daily living including:
(a) toileting pattern, bowel, and bladder
control;
(b) dressing, grooming, bathing, and
personal hygiene;
(c) mobility, including ambulation,
transfers, and assistive devices; and
(d) eating, dental status, oral care, and
assistive devices and dentures, if applicable.
(2) cognitive
abilities; reasoning and perception; the ability to articulate thoughts, memory
function or impairment, etc.;
(3) communication
and hearing; ability to communicate needs and understand instructions, etc.;
(4) vision;
(5) physical
functioning and skeletal problems;
(6) incontinence
of bowel/bladder;
(7) psychosocial
well-being;
(8) mood
and behavior;
(9) activity
interests;
(10) diagnoses;
(11) health
conditions;
(12) nutritional
status;
(13) oral
or dental status;
(14) skin
conditions;
(15) medication
use including prescriptions, over-the-counter medications, and supplements, and
for each:
(a) the reason taken;
(b) any side effects, contraindications,
allergic or adverse reactions, and actions to address these issues;
(c) the dosage;
(d) the frequency of use;
(e) the route administered or taken;
(f) any difficulties the resident faces
in taking the medication;
(g) whether the resident self administers the medication;
(h) the resident's preferences in how to
take medication;
(i) interventions
needed in management of medications to prevent diversion of medication by the
resident or others who may have access to the medications; and
(j) provide instructions to the resident
and resident's legal or designated representatives on interventions to manage
the resident's medications and prevent diversion of medications.
(16) special
treatments and procedures or special medical needs such as hospice; and
(17) safety
needs/high risk behaviors; history of falls agitation, wandering, fire safety
issues, etc.
(18) instrumental activities of daily
living, including:
(a) ability to self
manage medications;
(b) housework and laundry; and
(c) transportation.
(19) Risk indicators, including:
(a) risk for falls including history of
falls;
(b) emergency evacuation ability;
(c) complex medication regimen;
(d) risk for dehydration, including
history of urinary tract infections and current fluid intake pattern;
(e) risk for emotional or psychological
distress due to personal losses;
(f) unsuccessful prior placements;
(g) elopement risk including history or
previous elopements;
(h) smoking, including the ability to
smoke without causing burns or injury to the resident or others or damage to
property; and
(i) alcohol
and drug use, including the resident's alcohol use or drug use not prescribed
by a physician.
D. The resident evaluation shall
include a history and physical examination and an evaluation report by a
physician or a physician extender within six months of admission. A resident shall have a medical evaluation by
a physician or a physician extender at least annually.
E. The resident evaluation shall be
reviewed and if needed revised by a licensed practical nurse, registered nurse
or physician extender at the time the individual service plan is reviewed, at a
minimum of every six months or when a significant change in health status
occurs.
[8.370.14.25
NMAC - Rp, 8.370.14.25 NMAC, xx/xx/2025]
8.370.14.26 INDIVIDUAL
SERVICE PLAN (ISP): An ISP shall be developed and implemented
within 10 calendar days of admission for each resident residing in the
facility.
A. The ISP shall
address those areas of need as identified in the resident evaluation and
through staff observation.
(1) The
ISP shall detail the services that are provided by the facility as well as the
services to be provided by other agencies.
(2) The
resident evaluation and the ISP shall be reviewed and if needed revised by a
licensed practical nurse, registered nurse or a physician extender.
(3) The
ISP shall be reviewed and or revised at a minimum of every six months or when
there is a significant change in the resident’s
health status.
B. The ISP shall include the
following:
(1) a
description of identified needs as noted in the resident evaluation;
(2) a
written description of all services to be provided;
(3) who
will provide the services;
(4) when
or how often the services will be provided;
(5) how
the services will be provided;
(6) where
the services will be provided;
(7) expected
goals and outcomes of the services;
(8) documentation
of the facility’s determination that it is able to meet the needs of the
resident;
(9) the
level of assistance that the resident will require with activities of daily
living and with medications;
(10) a
crisis prevention/intervention plan when indicated by diagnosis or behavior;
and
(11) current
orders for all medications, including those authorized for PRN usage.
[8.370.14.26
NMAC - Rp, 8.370.14.26 NMAC, xx/xx/2025]
8.370.14.27 RESIDENT
ACTIVITIES: Each facility shall provide or make available
recreational and social activities appropriate to the residents’ abilities that
meet their psychosocial needs and are relevant to their social history;
including a balance of cognitive, reminiscence, physical and social
activities. The facility shall post the
activities and encourage residents to participate.
[8.370.14.27
NMAC - Rp, 8.370.14.27 NMAC, xx/xx/2025]
8.370.14.28 PERSONAL
POSSESSIONS:
A. Each resident shall be permitted to
keep personal property in their possession at the facility, if it is not
detrimental to the health and safety of anyone in the facility. These possessions may include, but are not
limited to the following items:
(1) clothing;
the facility shall ensure that each resident has his or her own clothing;
residents shall be allowed and encouraged to select their daily clothing and
change their clothing to suit their activities and the weather conditions;
(2) personal
care items; each resident shall have his or her own personal care items such
as, but not limited to, a comb, razor, hairbrush, toothbrush, toothpaste and
like items.
B. The facility shall have policies
and procedures for identifying and safeguarding resident possessions.
[8.370.14.28
NMAC - Rp, 8.370.14.28 NMAC, xx/xx/2025]
8.370.14.29 TRANSPORTATION: The facility shall either provide
transportation or assist the resident in using public transportation.
A. The facility’s motor vehicle
transportation assistance program shall include the following elements:
(1) resident
evaluation;
(2) staff
training in hazardous driving conditions;
(3) safe
passenger transport and assistance;
(4) emergency
procedures and use of equipment;
(5) supervised
practice in the safe operation of motor vehicles, maintenance and safety record
keeping; and
(6) copies
of employee training certificates that give evidence of successful completion
of any applicable course(s) shall be kept on site in the employee files.
B. To assist residents in using public
transportation, the facility shall provide information on bus schedules,
location of bus stops and telephone numbers of taxi cab companies.
[8.370.14.29
NMAC - Rp, 8.370.14.29 NMAC, xx/xx/2025]
8.370.14.30 HANDLING
OF RESIDENT FUNDS:
A. Each resident has the right to
manage their personal funds in accordance with state or federal laws.
B. If the facility agrees, the
resident may entrust his or her personal funds to the facility for safekeeping
and management. In such cases, the
facility shall:
(1) have
written authorization from the resident or his or her surrogate decision maker;
(2) maintain
a written record of all financial transactions and arrangements involving the
resident's funds and make this written record available upon request, to the
resident, his or her surrogate decision maker and the licensing authority;
(3) safeguard
any and all funds received from the resident in an account separate from all
other funds of, or held by, the facility;
(4) upon
written or verbal request by the resident or his or her surrogate decision
maker, return to the resident all or any part of the resident's funds given to
the facility for safekeeping and management, including all accrued interest if
applicable; and
(5) upon
the resident's death, will transfer all personal funds held by the facility to
the resident’s estate in accordance with Section 45-3-709 NMSA 1978.
C. The facility shall not commingle
the resident’s funds, valuables or property with that of the licensee. Resident’s funds, valuables or property shall
be maintained separate, intact and free from any liability of the licensee,
staff and management.
[8.370.14.30
NMAC - Rp, 8.370.14.30 NMAC, xx/xx/2025]
8.370.14.31 EMERGENCY
PREPAREDNESS REQUIREMENTS:
The assisted living facility must comply with all federal, state and
local emergency preparedness requirements (42 CFR 483.73). The assisted living facility must establish
and maintain an emergency preparedness program that meets the requirements of
this section. The emergency preparedness program must include, but not be
limited to the following elements:
A. Emergency plan: The assisted
living facility must develop and maintain an emergency preparedness plan that
must be reviewed and updated at least annually. The plan must do all of the
following:
(1) Be based on and include a
documented, facility-based and community-based risk assessment, utilizing an
all-hazards approach, including missing residents.
(2) Include strategies for addressing
emergency events identified by the risk assessment.
(3) Address resident population,
including, but not limited to, persons at-risk; the type of services the
assisted living facility has the ability to provide in an emergency; and
continuity of operations, including delegations of authority and succession plans.
(4) Include a process for cooperation and
collaboration with local, tribal, regional, state, or federal emergency
preparedness officials' efforts to maintain an integrated response during a
disaster or emergency situation.
B. Policies and procedures: The assisted living facility must develop and
implement emergency preparedness policies and procedures, based on the
emergency plan set forth in Subsection A of 8.370.14.31 NMAC, risk assessment
at Paragraph (1) of Subsection A of 8.370.14.31 NMAC, and the communication
plan at Subsection C of 8.370.14.31
NMAC. The policies and procedures must
be reviewed and updated at least annually. At a minimum, the policies and
procedures must address the following:
(1) The provision of subsistence needs
for staff and residents, whether they evacuate or shelter in place, include,
but are not limited to the following:
(a) food, water, medical, and
pharmaceutical supplies;
(b) alternate sources of energy to
maintain;
(i) temperatures
to protect resident health and safety and for the safe and sanitary storage of
provisions;
(ii) emergency lighting;
(iii) fire detection, extinguishing, and
alarm systems; and
(iv) sewage and waste disposal.
(2) A system to track the location of on-duty
staff and sheltered residents in the assisted living facility's care during and
after an emergency. If on-duty staff and sheltered residents are relocated
during the emergency, the ALF facility must document the specific name and
location of the receiving facility or other location.
(3) Safe evacuation from the ALF
facility, which includes consideration of care and treatment needs of evacuees;
staff responsibilities; transportation; identification of evacuation
location(s); and primary and alternate means of communication with external sources
of assistance.
(4) A means to shelter in place for
residents, staff, and volunteers who remain in the ALF facility.
(5) A system of medical documentation
that preserves resident information, protects confidentiality of resident
information, and secures and maintains the availability of records.
(6) The use of volunteers in an emergency
or other emergency staffing strategies, including the process and role for
integration of State or Federally designated health care professionals to
address surge needs during an emergency.
(7) The development of arrangements with
other assisted living facilities and other providers to receive residents in
the event of limitations or cessation of operations to maintain the continuity
of services to residents.
(8) The role of the assisted living
facility in the provision of care and treatment at an alternative care site
identified by emergency management officials.
C. Communication plan: The assisted living facility must develop
and maintain an emergency preparedness communication plan that complies with federal,
state, and local laws and must be reviewed and updated at least annually. The communication plan must include all of the
following:
(1) names and contact information for the
following:
(a) staff;
(b) entities providing services under
arrangement;
(c) residents' physicians;
(d) other assisted living facilities;
(e) volunteers;
(2) Contact information for the
following:
(a) federal, state, tribal, regional, or
local emergency preparedness staff;
(b) the state licensing and certification
agency;
(c) the office of the state long-term care
ombudsman;
(d) other sources of assistance;
(3) Primary and alternate means for
communicating with the following:
(a) assisted living facility's staff;
(b) federal, state, tribal, regional, or
local emergency management agencies;
(4) A method for sharing information and
medical documentation for residents under the assisted living facility's care,
as necessary, with other health care providers to maintain the continuity of
care.
(5) A means, in the event of an
evacuation, to release resident information as permitted under 45 CFR
164.510(b)(1)(ii).
(6) A means of providing information
about the general condition and location of residents under the facility's care
as permitted under 45 CFR 164.510(b)(4).
(7) A means of providing information
about the assisted living facility's occupancy, needs, and its ability to
provide assistance, to the authority having jurisdiction or the incident command
center, or designee.
(8) A method for sharing information from
the emergency plan that the facility has determined is appropriate with
residents and their families or representatives.
D. Training and testing: The assisted living facility must develop
and maintain an emergency preparedness training and testing program that is
based on the emergency plan set forth in paragraph (a) of this section, risk
assessment at paragraph (a)(1) of this section, policies and procedures at
paragraph (b) of this section, and the communication plan at paragraph (c) of
this section. The training and testing program must be reviewed and updated at
least annually.
(1) Training program: The assisted living facility must do all of
the following:
(a) Initial training in emergency
preparedness policies and procedures to all new and existing staff, individuals
providing services under arrangement, and volunteers, consistent with their
expected roles.
(b) Provide emergency preparedness
training at least annually.
(c) Maintain documentation of the
training.
(d) Demonstrate staff knowledge of
emergency procedures.
(2) Testing: The ALF facility must conduct exercises to
test the emergency plan at least twice per year, including unannounced staff
drills using the emergency procedures. The
ALF facility must do the following:
(a) participate in an annual full-scale
exercise that is community-based; or
(i) when
a community-based exercise is not accessible, conduct an annual individual,
facility-based functional exercise:
(ii) if the ALF facility experiences an
actual natural or man-made emergency that requires activation of the emergency
plan, the ALF facility is exempt from engaging its next required a full-scale
community-based or individual, facility-based functional exercise following the
onset of the emergency event;
(b) conduct an additional annual exercise
that may include, but is not limited to the following:
(i) a
second full-scale exercise that is community-based or an individual,
facility-based functional exercise; or
(ii) a mock disaster drill; or
(iii) a tabletop exercise or workshop that is
led by a facilitator includes a group discussion, using a narrated,
clinically-relevant emergency scenario, and a set of problem statements,
directed messages, or prepared questions designed to challenge an emergency
plan.
(c) analyze the assisted living
facility's response to and maintain documentation of all drills, tabletop
exercises, and emergency events, and revise the assisted living facility's
emergency plan, as needed.
E. Emergency and standby power systems: If the assisted living facility has
residents that depend on medical equipment that requires electricity to
function, the facility must have in their emergency plan how they will address
the power outage and the needs of the resident to keep them safe.
F. Integrated healthcare systems: If an assisted living facility is part of a
healthcare system consisting of multiple separately certified healthcare
facilities that elects to have a unified and integrated emergency preparedness
program, the assisted living facility may choose to participate in the
healthcare system's coordinated emergency preparedness program. If elected, the unified and integrated
emergency preparedness program must do all of the following:
(1) Demonstrate that each separately
certified facility within the system actively participated in the development
of the unified and integrated emergency preparedness program.
(2) Be developed and maintained in a
manner that takes into account each separately certified facility's unique
circumstances, resident populations, and services offered.
(3) Demonstrate that each separately
certified facility is capable of actively using the unified and integrated
emergency preparedness program and is in compliance with the program.
(4) Include a unified and integrated
emergency plan that meets the requirements of Subsection A of 8.370.14.31 NMAC,
and Paragraphs (2), (3), and (4) of Subsection F of 8.370.14.31 NMAC. The
unified and integrated emergency plan must also be based on and include:
(a) A documented community-based risk
assessment, utilizing an all-hazards approach.
(b) A documented individual
facility-based risk assessment for each separately certified facility within
the health system, utilizing an all-hazards approach.
(5) Include integrated policies and
procedures that meet the requirements set forth in Subsection B of 8.370.14.31
NMAC, a coordinated communication plan and training and testing programs that
meet the requirements of Subsection C and D of 8.370.14.31 NMAC, respectively.
[8.370.14.31 NMAC
- N, xx/xx/2025]
8.370.14.32 HANDLING
OF MEDICAL EMERGENCIES:
A. Upon admission,
each resident or surrogate decision maker shall designate a primary care
practitioner (PCP) to be called in case of a medical necessity. Each resident or representative shall also
designate a concerned person to be called in case of an emergency. The facility shall establish a policy to
secure medical assistance if the resident's own
physician is not available. In the event
of an illness or an injury to the resident, the PCP or a physician extender
shall be notified by the facility.
B. The facility
shall have a first aid kit that contains at a minimum, gauze, adhesive tape,
antiseptic ointment and bandages for emergencies. The first aid kit shall be kept in a
designated, easily accessible place within the facility.
C. An easily
accessible and functional telephone shall be available in each facility for
summoning help in case of an emergency.
A pay telephone does not fulfill this requirement.
D. A list of
emergency numbers including: fire department, police department, ambulance
services and poison control shall be posted near each public telephone in the
facility.
[8.370.14.32
NMAC - Rp, 8.370.14.31 NMAC, xx/xx/2025]
8.370.14.33 REPORTING
OF INCIDENTS:
A. The facility
shall insure that all suspected cases or known incidents of resident abuse,
neglect or exploitation are reported in accordance with 8.370.9 NMAC.
(1) The
facility shall also report any incident or unusual occurrence which has or
could threaten the health, safety, or welfare of the residents and staff to the
licensing authority complaint hotline within 24 hours or by the next business
day, if it is a weekend or a holiday.
(2) The
facility shall not delay a report to the complaint hotline while an internal
investigation is conducted.
B. The facility is
responsible for conducting and documenting the investigation of all incidents
within five business days and shall submit a copy of the investigation report
to the licensing authority. A copy of
the report and the documentation, including the date and time that it was
submitted to the licensing authority, shall be maintained on file at the
facility. The investigation shall
include the following:
(1) a
narrative description of the incident;
(2) the
result of the facility's investigation shall be recorded on the state approved
incident report form for the current year, pursuant to 8.370.9 NMAC; and
(3) plans
for further actions in response to the incident.
[8.370.14.33
NMAC - Rp, 8.370.14.32 NMAC, xx/xx/2025]
8.370.14.34 RESIDENT
RIGHTS: All licensed facilities shall understand,
protect and respect the rights of all residents.
A. Prior to
admission to a facility, a resident and legal representative shall be given a
written description of the legal rights of the resident, translated into
another language, if necessary, to meet the resident’s understanding.
B. If the resident
has no legal representative and is incapable of understanding his or her legal
rights, a written copy of the resident's legal rights shall be provided to the
most significant responsible party in the following order:
(1) the
resident's spouse;
(2) significant
other;
(3) any
of the resident's adult children;
(4) the
resident's parents;
(5) any
relative the resident has lived with for six or more months before admission;
(6) a
person who has been caring for, or paying benefits on behalf of the resident;
(7) a
placing agency;
(8) resident
advocate; or
(9) the
ombudsman.
C. The resident
rights shall be posted in a conspicuous public place in the facility and shall
include the telephone numbers for the incident management hotline and for the
state ombudsman program.
D. To protect
resident rights, the facility shall:
(1) treat
all residents with courtesy, respect, dignity and compassion;
(2) not
discriminate in admission or services based on gender, sexual orientation,
resident's age, race, religion, physical or mental disability, or nationality;
(3) provide
residents written information about all services provided by the facility and
their costs and give advance written notice of any changes;
(4) provide
residents with a safe and sanitary living environment;
(5) provide
humane care for all residents;
(6) provide
the right to privacy, including privacy during medical examinations,
consultations and treatment;
(7) protect
the confidentiality of the resident’s medical record;
(8) protect
the right to personal privacy, including privacy in personal hygiene; privacy
during visits with a spouse, family member or other visitor; and privacy in the
resident's own room;
(9) protect
the right to communicate privately and freely with any person, including
private telephone conversations and private correspondence; and the right to
receive visits from family, friends, lawyers, ombudsmen and community
organizations;
(10) prohibit
the use of any and all physical and chemical restraints;
(11) ensure
that residents:
(a) are
free from physical and emotional abuse neglect and misappropriation/or
exploitation;
(b) are
free from financial abuse and misappropriation by facility staff or management;
(c) are
free to participate in religious, social, community and other activities and
freely associate with persons in and out of the facility;
(d) are
free to leave the facility and return without unreasonable restriction;
(e) are
given a 15 calendar day, written notice before room transfers or discharge from
the facility unless there is immediate danger to self or others in the
facility;
(f) have
an environment that fosters social interaction and avoids social isolation;
(g) or
their surrogate decision makers, are informed of and consent to the services
provided by the facility;
(h) have
the right to voice grievances to the facility staff, public officials, the
ombudsmen, any state agency, or any other person, without fear of reprisal or
retaliation;
(i) have the right to have their
complaints addressed within 14 calendar days or sooner;
(j) have
the right to participate in the development of their care plan/ISP;
(k) have
the right to choose a doctor, pharmacist and other health care provider(s);
(l) have
the right to participate in medical treatment decisions and formulate advance
directives such as living wills and powers of attorney;
(m) have
the right to keep and use personal possessions without loss or damage;
(n) have
the right to manage and control their personal finances;
(o) have
the right to freely organize and participate in a resident association that may
recommend changes in the facility's policies, services and management;
(p) shall
not be required to work for the facility; and
(q) are
protected from unjustified room transfers or discharge.
E. The resident's
rights shall not be restricted unless this restriction is for the health and
safety of the resident, agreed to by the resident or the resident’s surrogate
decision maker and outlined in the resident’s individual service plan.
[8.370.14.34 NMAC
- Rp, 8.370.14.33 NMAC, xx/xx/2025]
8.370.14.35 CUSTODIAL
DRUG PERMITS: A facility with two or more residents that is
licensed pursuant to this rule and that assists with self-administration or
safeguards medications for residents shall have a current custodial drug permit
issued by the state board of pharmacy.
A. Procurement,
labeling and storage: The facility
shall provide assistance to the resident in obtaining the necessary
medications, treatment and medical supplies as identified in the ISP. The facility shall procure, label and store
medications for residents who require assistance with self-administration of
medication in compliance with state and federal laws.
(1) All
medications, including non-prescription drugs, shall be stored in a locked
compartment or in a locked room, as approved by the board of pharmacy and the
key shall be in the care of the administrator or designee.
(2) Internal
medication shall be kept separate from external medications. Drugs to be taken by mouth shall be separated
from all other delivery forms.
(3) A
separate, locked refrigerator shall be provided by the facility for
medications. The refrigerator
temperature shall be kept in compliance with the state board of pharmacy
requirements for medications.
(4) All
medications, including non-prescription medications, shall be stored in
separate compartments for each resident and all medications shall be labeled
with the resident's name.
(5) A
resident may be permitted to keep his or her own medication in a locked
compartment in his or her room for self-administration, if the physician's
order deems it appropriate.
(6) The
facility shall not require the residents to purchase medications from any
pharmacy.
(7) Medical
gases (oxygen) and equipment used for the administration of inhalation therapy
and for resuscitative purposes shall comply with the national fire protection
association (NFPA) 99.
(8) A
proof of use record shall be maintained separately for each schedule II through
IV drug (controlled substances). The
proof of use sheet shall document:
(a) the
type and strength of the schedule II through IV drugs;
(b) the
date and time staff assisted with self-administration;
(c) the
resident’s name;
(d) the
prescriber’s name;
(e) the
dose;
(f) the
signature of the person assisting with delivery of the medication; and
(g) the
balance of medication remaining.
(9) Any
remaining medication discontinued by a physician’s order, or upon discharge or
death of the resident shall be inventoried and moved to a separate locked
storage container. Such discontinued
medications shall be destroyed upon the next quarterly visit by the consulting
pharmacist in accordance with 16.19.11.10 NMAC.
(10) The
record of medication destruction shall be signed by the administrator or
designee and the pharmacist and shall be kept on file at the facility.
B. Consulting
pharmacist: The facility shall
maintain records demonstrating that the consulting pharmacist provides the
following oversight and guidance.
(1) Reviews
the medication regimen as needed, but at least quarterly/every three months, to
determine that all medications and records are accurate and current. All irregularities shall be reported to the
administrator of the facility and these irregularities shall be resolved by the
administrator within 72 hours.
(2) A
system of records of receipt and disposition of all drugs in sufficient detail
to enable an accurate reconciliation.
(3) Consultation
shall be provided on all aspects of pharmacy services in the facility,
including reference information regarding side effects and, when needed,
physician consultation in cases involving the use of psychotropic medications.
(4) The
consulting pharmacist will be responsible for assuring that the facility meets
all requirements for storage, labeling, destruction and documentation of
medications as required by the state board of pharmacy, 16.19.11.10 NMAC and
8.370.14 NMAC.
[8.370.14.35
NMAC - Rp, 8.370.14.34 NMAC, xx/xx/2025]
8.370.14.36 MEDICATIONS: Administration of medications or staff
assistance with self-administration of medications shall be in accordance with
state and federal laws. No medications,
including over-the-counter medications, PRN (as needed) medications, or
treatment shall be started, changed or discontinued by the facility without an
order from the physician, physician assistant or nurse practitioner or licensed
prescriber and without entry into the resident's record.
A. State board of nursing licensed or certified health care
professionals are responsible for the administration of medications. Administration may only be performed by these
individuals, this includes evaluating
the effectiveness of prescription and nonprescription drugs.
B. Requirements for assisting with self-administration of
medications.
(1) Assistance with self-administration
of medication may be rendered by a non-licensed person to assist the resident
who has the capability to self-administer medications, by prompting, reminders,
hand-over-hand assistance, handing the medication container to the resident,
opening the medication container, or placing the medication in the resident’s
hand.
(2) Written consent for assisting with
medication self-administration shall be signed annually and when there is any
change in either the resident’s functional ability or the designation of a new
surrogate decision maker.
(3) All staff that assist with
self-administration of medications shall have successfully completed an
assistance with self-administration of medication training program or be
licensed or certified by the state board of nursing.
(4) The individual is unable to complete
the entire process of taking medication.
(5) The individual is unable to determine
if he/she is receiving the expected response from the medication.
(6) The individual is able to communicate
to staff verbally/vocally or through gestures or other non-verbal communication
he/she is experiencing a problem, pain, or discomfort.
(7) The individual’s condition is stable
and unchanged and signs or symptoms are within established ranges, frequencies
or patterns.
(8) The individual’s condition does not
require frequent assessment or monitoring by a licensed nurse to determine or
evaluate his/her health status or his/her response to medication or treatment
C. PRN
(pro re nada) medication:
(1) Physician
or physician extender’s orders for PRN medications shall clearly indicate the
circumstances in which they are to be used, the number of doses that may be
given in a 24-hour period and indicate under what circumstances the primary
care practitioner (PCP) is to be notified.
(2) The
utilization of PRN medications shall be reviewed routinely. Frequent or escalating use of PRN medications
shall be reported to the PCP.
D. Only a licensed
nurse (RN or LPN) shall administer any medications or conduct any invasive
procedures provided by the following routes: intravenous (IV), subcutaneous
(SQ), intramuscular (IM), vaginal or rectal.
Only a licensed nurse shall administer non-premixed nebulizer
treatments. Unless otherwise allowed by
statute, the assisted living facility shall not permit a qualified medication
administration person to perform any of the following tasks:
(1) Intravenous, intramuscular or
subcutaneous injections.
(2) Gastrostomy or jejunostomy tube
feeding.
(3) Chemical debridement.
(4) Administration of medication for
purposes of restraint.
(5) Titration of oxygen.
(6) Decision making regarding PRN or “as
needed” medication administration.
(7) Assessment of residents or use of
judgment including, but not limited to, medication effect.
(8) Pre-pouring of medication.
E. Limited administration of medication may be permitted for
pouring or squirting a medication into the mouth of a resident with a syringe
or for masking or deceiving administration of a medication including, but not
limited to, concealing in food or liquid, when:
(1) There is a physician or physician
extender’s orders directing the specific administration.
(2) A team is convened comprised of
facility administrator, the resident or their surrogate decision maker and the
hospice or home health clinician, to jointly determine the method of limited
administration of medication. Team
approval shall be in writing, signed and dated by all team members and the
approval shall be maintained in the resident's record.
(3) The staff has received specific
training on the limited administration of medication for that individual by the
hospice provider or other licensed professional.
(4) A current written consent that
identifies the type of medication delivery and the assistance or administration
the individual requires that is signed by the individual/guardian/surrogate
health decision maker.
F. The facility shall have medication
reference material that contains information relating to drug interactions and
side effects on the premises. Staff that
assist in the self-administration of medications shall know interactions or
possible side effects that might occur.
G. Medications prescribed for one
resident shall not be used for another resident.
H. Medication
administration record (MAR): For
residents who are not independent and require assistance with
self-administration, the facility shall have a MAR that documents the details
of the residents' medication, including PRN and over-the-counter medication
that is assisted with self-administration by qualified staff or administered to
the resident by licensed or certified staff.
The information in the MAR shall include:
(1) the
resident's name;
(2) any
known allergies to medication that the resident has;
(3) the
name of the resident's PCP or the prescriber of the medication;
(4) the
diagnosis or reason for the medication;
(5) the
name of the medication, including the drug product brand name and the generic
name;
(6) notation
if the medication is a schedule II-IV drug;
(7) the
dosage of the medication;
(8) the
strength of the medication;
(9) the
frequency or how often the medication is to be taken or given;
(10) the
route of delivery for the medication (mouth, eye, ear, other);
(11) the
method of delivery for the medication (pills, drops, IM injection, other);
(12) the
date that the medication was started or discontinued;
(13) any
change in the medication order;
(14) pre-medication
information (i.e., pulse, respiration, blood pressure, blood sugar) as required
by the medication order;
(15) the
date and time that the medication is self-administered, administered with
assistance or is administered;
(16) the
initials and signature of the person assisting with or administering the
medication;
(17) the
desired results obtained from or problems encountered with the medication (pain
relieved, allergic reaction, etc.);
(18) any
refused dose of medication;
(19) any
missed dose of medication; and
(20) any
medication error.
I. No medication
shall be stopped or started without specific orders from the primary care
physician.
J. If a resident
refuses to take a prescribed medication, it shall be documented and the
facility shall report it to the prescriber.
K. A suspected adverse reaction to a
medication shall be documented on the MAR and reported immediately to the PCP
and the resident's surrogate decision maker.
If applicable, emergency medical treatment shall be arranged. Documentation of the event shall be kept in
the resident's record.
L. Prescription
medication, other than blister packs and unit dose containers, shall be kept in
the original container with a pharmacy label that includes the following:
(1) the
resident's name;
(2) the
name of the medication;
(3) the
date that the prescription was issued;
(4) the
prescribed dosage and the instructions for administration of the medication;
and
(5) the
name and title of the prescriber.
M. Any medication that is removed from
the pharmacy container or blister pack shall be given immediately and
documented by the staff that assisted with the medication delivery.
N. The facility shall report all
medication errors to the physician, documentation of medication errors and the
prescriber's response shall be kept in the resident's record.
O. The facility shall develop and
follow a written policy for unused, outdated, or recalled medications kept in
the facility in accordance with 16.19.11.10 NMAC.
[8.370.14.36 NMAC
- Rp, 8.370.14.35 NMAC, xx/xx/2025]
8.370.14.37 NUTRITION: The facility shall
provide planned and nutritionally balanced meals from the basic food groups in
accordance with the “recommended daily dietary allowance” of the American
dietetic association, the food and nutrition board of the national research
council, or the national academy of sciences.
Meals shall meet the nutritional needs of the residents in accordance
with the “2005 USDA dietary guidelines for Americans.” Vending machines shall not be considered a
source of snacks.
A. Dietary services
policies and procedures: The
facility will develop and implement written policies and procedures that are
maintained on the premises and that govern the following requirements.
(1) Meal service: The facility shall:
(a) serve
at least three meals or their equivalent each day at regular times with no more
than 16 hours between the evening meal and morning meal with snacks freely
available;
(b) provide
snacks of nourishing quality and post on the daily menu;
(c) develop
menus enjoyed by the residents and served at normal intervals appropriate to
the residents’ preferences;
(d) post
the weekly menu, including snacks where residents and families are able to view
it; posted menus shall be followed and any substitution shall be of equivalent
nutritional value and recorded on the posted menu; identical menus shall not be
used within a one week cycle;
(e) have
special menus or meal items following guidelines from the resident’s physician
for residents who have medically prescribed special diets;
(f) serve
all residents in a dining room except for residents with a temporary illness,
or with documented specific personal preference to have meals in their room;
(g) allow
sufficient time for meals to enable residents to eat at a leisurely pace and to
socialize; and
(h) contact
the resident’s PCP within 48 hours if a resident consistently refuses to eat.
(2) Staff in-service training: The facility shall provide an in-service
training program for staff that are involved in food preparation at orientation
and at least annually and that includes:
(a) instruction
in proper food storage;
(b) preparation
and serving food;
(c) safety
in food handling;
(d) appropriate
personal hygiene; and
(e) infectious
and communicable disease control.
B. Dietary records: The facility shall maintain the following
documentation onsite:
(1) a
systematic record of all menus and revisions, including snacks, for a minimum
of thirty (30) calendar days;
(2) a
systematic record of therapeutic diets as prescribed by a PCP;
(3) a
copy of the most recent licensing inspection and for facilities with 10 or more
residents, a copy of the New Mexico environment department inspection with
notations made by the facility of action taken to comply with recommendations
or citations; and
(4) a
daily log of the recorded temperatures for all facility refrigerators, freezers
and steam tables maintained and available for inspection for 30 calendar days.
C. Clean and sanitary
conditions: All practices shall be
in accordance with the standards of the state environment department, pursuant
to 7.6.2 NMAC.
(1) Kitchen sanitation:
(a) Equipment
and work areas shall be clean and in good repair. Surfaces with which food or beverages come
into contact shall be of smooth, impervious material free of open seams, not
readily corrodible and easily accessible for cleaning.
(b) Utensils
shall be stored in a clean, dry place protected from contamination.
(c) The
walls, ceiling and floors of all rooms that food or drink is stored, prepared
or served shall be kept clean and in good repair.
(2) Washing and sanitizing kitchenware:
(a) All
reusable tableware and kitchenware shall be cleaned in accordance with
procedures that include separate steps for prewashing, washing, rinsing and
sanitizing.
(b) Proper
dishwashing procedures and techniques shall be utilized and understood by the
dishwashing staff.
(c) Periodic
monitoring of the operation of the detergent dispenser, washing, rinsing and
sanitizing temperatures shall be performed and documented.
(d) When
a dishwashing machine is utilized, the cleanliness of the machine, its jets and
its thermostatic controls shall be monitored and documented by the
facility. A monthly log of the recorded
temperature of the dishwasher shall be maintained in the facility and available
for inspection.
(3) Sinks
for hand washing shall include hot and cold running water, hand-washing soap
and disposable towels.
(4) All
garbage and kitchen refuse that is not disposed of through a garbage disposal
unit shall be kept in watertight containers with close-fitting covers and
disposed of daily in a safe and sanitary manner.
(5) Cooks
and food handlers shall wear clean outer garments and hair nets or caps and
shall keep their hands clean at all times when engaged in handling food, drink,
utensils or equipment in accordance with the local health authority. Disposable gloves shall be used in accordance
with the local health authority.
D. Food management: The facility shall store, prepare, distribute
and serve food under sanitary conditions and in accordance with the regulations
governing food establishments of local health authority having jurisdiction.
(1) The
facility shall ensure that a minimum of a three calendar day supply of
perishables and a five calendar day supply of non-perishables or canned foods
is available for the residents.
(2) The
facility refrigerator and freezer shall have an accurate thermometer which
reads within or not more than plus or minus three degrees fahrenheit
of the required temperature, located in the warmest section of the refrigerator
and freezer and shall be accessible and easily read.
(a) The
temperature of the refrigerator shall be 35 - 41 degrees fahrenheit.
(b) Freezer
temperatures shall be maintained at zero degrees fahrenheit
or below.
(3) Refrigerators
and freezers shall be kept clean and sanitary at all times. Food stored in
refrigerators and freezers shall be covered, dated and labeled. Unused leftover food shall be discarded after
three calendar days.
(4) Steam
tables, hot food tables, slow cookers, crock pots and other hot food holding
devices shall not be used in heating or reheating food. Hot food temperatures shall be checked
periodically to insure that a minimum of 140 degrees fahrenheit
is maintained.
(5) Medication,
biological specimens, poisons, detergents and cleaning supplies shall not be
kept in the same storage areas used for storage of foods. Medications shall not be stored in the
refrigerator with food; an alternate refrigerator for medication shall be used.
(6) Canned
or preserved foods shall be procured from sources that process the food under
regulated quality and sanitation controls. This does not preclude the use of
local fresh produce. The facility shall
not use home-canned foods.
(7) Dry
or staple food items shall be stored at least six inches off the floor in a
ventilated room that is not subject to sewage, waste water back-flow or
contamination by condensation, leakage, rodents or vermin.
(8) The
facility shall ensure the following:
(a) all
perishable food is refrigerated and the temperature is maintained no higher
than 41 degrees fahrenheit;
(b) the
temperature for all hot foods is maintained at 140 degrees fahrenheit;
and
(c) all
displayed or transported food is protected from environmental contamination and
maintained at proper temperatures in clean containers, cabinets or serving
carts.
E. Milk:
(1) Raw
milk shall not be used.
(2) Condensed,
evaporated, or dried milk products that are nationally recognized may be
employed as “additives” in cooked food preparation but shall not be substituted
or served to residents in place of milk.
F. Collateral requirements: Compliance with this rule does not relieve a
facility from the responsibility of meeting more stringent municipal
regulations, ordinances or other requirements of state or federal laws
governing food service establishments.
Local health authority having jurisdiction means municipal, county,
state or federal agency(s) that have laws and regulations governing food
establishments, liquid waste disposal, treatment facilities and private wells.
[8.370.14.37 NMAC
- Rp, 8.370.14.36 NMAC, xx/xx/2025]
8.370.14.38 LAUNDRY
SERVICES:
A. General
requirements: The facility shall
provide laundry services for the residents, either on the premises or through a
commercial laundry and linen service.
(1) On-site
laundry facilities shall be located in areas separate from the resident units
and shall be provided with necessary washing and drying equipment.
(2) Soiled
laundry shall be kept separate from clean laundry, unless the laundry facility
is provided for resident use only.
(3) Staff
shall handle, store, process and transport linens with care to prevent the
spread of infectious and communicable disease.
(4) Soiled
laundry shall not be stored in the kitchen or dining areas. The building design and layout shall ensure
the separation of laundry room from kitchen and dining areas. An exterior route to the laundry room is not
an acceptable alternative, unless it is completely enclosed.
(5) In
new construction or newly licensed facilities with more than 15 residents,
washers shall be in separate rooms from dryers.
The rooms with washers shall have negative air pressure from the other
facility rooms.
(6) All
linens shall be changed as needed and at least weekly or when a new resident is
to occupy the bed.
(7) The
mattress pad, blankets and bedspread shall be laundered as needed and at least
once per month or when a new resident is to occupy the bed.
(8) Bath
linens consisting of hand towel, bath towel and washcloth shall be changed as
needed and at least weekly.
(9) There
shall be a clean, dry, well ventilated storage area
provided for clean linen.
(10) Facility
laundry supplies and cleaning supplies shall not be kept in the same storage
areas used for the storage of foods and clean storage and shall be kept in a
secured room or cabinet.
B. Residents may do
their own laundry, if it is their preference and they are capable of doing so,
or if it is part of their skill-building for independent living and is
documented as part of their ISP.
[8.370.14.38 NMAC
- Rp, 8.370.14.37 NMAC, xx/xx/2025]
8.370.14.39 HOUSEKEEPING
SERVICES: The facility shall maintain the interior and
exterior of the facility in a safe, clean, orderly and attractive manner. The facility shall be free from offensive
odors, safety hazards, insects and rodents and accumulations of dirt, rubbish
and dust.
A. All common
living areas and all bathrooms shall be cleaned as often as necessary to
maintain a clean and sanitary environment.
B. Combustibles
such as cleaning rags or flammable substances shall be stored in closed metal
containers in approved areas that provide adequate ventilation. Combustibles shall be stored away from the
food preparation areas and away from the resident rooms.
C. Poisonous or
flammable substances shall not be stored in residential areas, food preparation
areas or food storage areas. If
hazardous chemicals are stored on the property, material safety data sheets
shall be maintained and stored in the same area as the chemicals, pursuant to
state environment department requirements, 11.5.2.9 NMAC.
[8.370.14.39 NMAC
- Rp, 8.370.14.38 NMAC, xx/xx/2025]
8.370.14.40 SITE
REQUIREMENTS: The facility shall be located and maintained
free from environmental and other factors that are detrimental to the residents
and staff's health, safety or welfare.
The facility site shall be designed and maintained to encourage outdoor
activities by the residents.
[8.370.14.40 NMAC - Rp, 8.370.14.39
NMAC, xx/xx/2025]
8.370.14.41 CAPACITY
OF BUILDING(S): No facility shall house more residents than
the maximum bed capacity for which it is licensed.
A. Each individual
building containing resident activities, services or sleeping rooms on the
premises shall be separately licensed.
B. Buildings on the
grounds of the licensed facility and all rooms within the licensed buildings
that are used by the residents of the facility shall be subject to inspection
for health and safety standards.
C. All facilities
shall comply with the state building code and fire codes, pursuant to 14.7
NMAC.
(1) Facilities
with 16 residents or fewer are classified as “group R.”
(2) Facilities
with more than 16 residents are classified as “group I-1.”
(3) Facilities
with more than five residents who are not capable of self-preservation are
classified as “group I-2.”
D. Facilities shall
provide separate sleeping quarters for male and female residents unless they
are married or the arrangement is consensual.
[8.370.14.41 NMAC
- Rp, 8.370.14.40 NMAC, xx/xx/2025]
8.370.14.42 BUILDING
CONSTRUCTION: All building construction shall be based upon
the facility occupancy in accordance with the state building code and fire
codes, pursuant to 14.7 NMAC.
A. New facilities: All new facilities, relocated into existing
building(s) or remodeled facilities shall conform to the current edition of the
state building code, accessibility code, mechanical code, plumbing code, fire
code and the electrical code.
(1) With
regard to building height, allowable area or construction type, the state
building code shall prevail.
(2) Minimum
construction requirements shall comply with all applicable state building
codes.
(3) A
facility may share a building with another health care facility licensed by the
authority or other suitable facility with prior approval from the licensing
authority.
(4) Where
there are conflicts between the requirements in the codes and the provisions of
this rule, the most restrictive condition shall apply.
B. Access for persons with disabilities:
Facilities
with four or more residents shall provide
accessibility to residents with disabilities in accordance with the state
building code and the American Disabilities Act. Areas of specific concern are as follows:
(1) the
main entry into the facility and all required exits shall provide access to
persons with disabilities;
(2) the
building shall allow access to persons with disabilities to all common areas;
(3) at
least one bedroom, for every eight residents, shall have a door clearance of 36
inches for access by persons with disabilities;
(4) at
least one toilet and bathing facility, for every eight residents, shall have a
minimum door clearance of 36 inches for access by persons with disabilities;
this toilet and bathing room shall provide a minimum 60 inch diameter clear
space to accommodate the turning radius of a wheelchair;
(5) when
ramps are used, each ramp shall have a minimum slope of 12 inches horizontal
run for each one inch of vertical rise; ramps exceeding a six inch rise shall
be provided with handrails on both sides of the ramp;
(6) landings
at doorways shall have a level area, at a minimum of five feet by five feet, to
provide clear space for wheelchair maneuvering;
(7) parking
spaces shall provide access aisles with a minimum width of 60 inches and 96
inches for van parking; a minimum of one van-accessible parking space with a
minimum width of 96 inches shall be provided;
(8) an
accessible route for persons with disabilities from the parking area to the
main entrance(s) shall be provided; and
(9) changes
in elevation of one half inch or greater shall be sloped to a minimum of 12
inches horizontal run for each one inch of vertical rise.
C. Construction
drawings: Prior to commencement of
all new construction, remodeling, relocations, additions or renovations to
existing buildings; the facility shall submit preliminary plans and final
construction drawings with specifications to the licensing authority for review
and approval.
(1) Building
plans and specifications shall be submitted and approved by the authority when:
(a) construction
for a new facility is proposed;
(b) a
building that has not previously licensed as a facility is proposed as a
location for a facility;
(c) any
renovation that increases the number of beds is proposed;
(d) any
addition to an existing structure is proposed; or
(e) any
renovation to the existing structure is proposed, regardless of the size of the
facility.
(2) The
codes that are in effect at the time of the submittal of building plans shall
be the codes used through the end of the project.
(3) Drawings
and specifications shall be prepared for the architectural, structural,
mechanical and electrical branches of work for each construction project and
shall include the following:
(a) the site plan(s) showing property
lines, finish grade, location of existing and proposed structures, roadways,
walks, utilities and parking areas;
(b) the floor plan(s) showing scale
drawings of typical and special rooms, indicating all fixed and movable
equipment and major items of furniture;
(c) the separate life safety plans showing
the fire and smoke compartment(s), all means of egress and exit markings, exits
and travel distances, dimensions of compartments and calculation and tabulation
of exit units, all fire and smoke walls shall be graphically coded;
(d) the
exterior elevation of each facade;
(e) the
typical sections throughout the building;
(f) the
schedule of finishes;
(g) the
schedule of doors and windows;
(h) the
roof plans; and
(i) the building code analysis.
(4) For facilities with more than 15 residents: architectural drawings shall be stamped,
signed and dated by a licensed architect registered in New Mexico. In addition to items listed in section (3)
above, the drawings shall include the following:
(a) the
building code analysis; and
(b) when
an elevator is required, the details and dimensions of the elevator.
(5) Structural drawings: shall include the following:
(a) a
certification that all structural design and work are in compliance with all
applicable local codes;
(b) the
plans of foundations, floors, roofs and intermediate levels that show a
complete design with sizes, sections and the relative location of the various
members; and
(c) the
schedules of beams, girders and columns.
(6) Mechanical drawings: shall include the following:
(a) a
certification that all mechanical work and equipment are in compliance with all
applicable local codes and laws and that all materials are listed by recognized
testing laboratories;
(b) the
water supply, sewage and heating, ventilation and air conditioning piping
systems;
(c) the
heating, ventilating, HVAC piping and air conditioning systems with all related
piping and auxiliaries, if any, to provide a satisfactory installation;
(d) the
water supply, sewage and drainage with all lines, risers, catch-basins,
manholes and cleanouts clearly indicated as to location, size, capacities and
location and dimensions of septic tank and disposal field;
(e) the
sprinkler head layout; and
(f) the
graphic coding (with a legend) to show supply, return and exhaust systems.
(7) Electrical drawings: shall include the following:
(a) a
certification that all electrical work and equipment are in compliance with all
applicable local codes and laws and that all materials are currently listed by
recognized testing laboratories;
(b) all
electrical wiring, outlets, riser diagrams, switches, special electrical
connections, electrical service entrance with service switches, service feeders
and characteristics of the light and power current and transformers when
located within the building;
(c) a
fixture legend; and
(d) a
graphic coding (with a legend) to show all items on emergency power.
(8) Include
additional information as needed and requested by the licensing authority.
(9) Final
working drawings and specifications shall be accurately dimensioned and include
all necessary explanatory notes, schedules, legends and have all rooms
labeled. The working drawings and
specifications shall be complete and adequate for contract purposes.
(10) One
set of final plans shall be submitted to the licensing authority for review and
approval prior to the commencing of construction. All construction shall be executed in
accordance with the approved final plans and specifications.
(11) Review
and approval of building plans by the licensing authority does not eliminate
responsibility of the applicant to comply with all applicable laws, rules and
ordinances.
(12) The
final approval of building plans and specifications shall be acknowledged in
writing by the licensing authority.
(13) The
approved building plans shall be kept at the facility and readily available at
all times.
D. Fire resistance: Required building construction and fire
resistance shall be in accordance with the state building code and the fire
code. Facilities with nine or more
residents shall be protected throughout by an approved automatic fire
protection (sprinkler) system.
E. Prohibition of mobile homes: For facilities with four or more residents,
trailers and mobile homes shall not be used.
F. Construction: Construction shall commence within 180
calendar days of the date of receipt of approval (unless a written extension is
requested by the facility and approved by authority). This approval shall in no way permit or
authorize any omission or deviation from the requirements of any restrictions,
laws, ordinances, codes or standards of any regulatory agency.
[8.370.14.42 NMAC
- Rp, 8.370.14.41 NMAC, xx/xx/2025]
8.370.14.43 MAINTENANCE
OF BUILDING AND GROUNDS: The
building(s) shall be maintained in good repair at all times. Such maintenance shall include, but is not
limited to, the following areas:
A. Storage
areas/grounds: Storage areas and
grounds shall be maintained in a safe, sanitary and presentable condition at
all times. Storage areas and grounds
shall be kept free from accumulation of refuse, weeds, discarded furniture, old
newspapers or other items that create a fire hazard.
B. Floors: Floors shall be maintained stable, firm and
free of tripping hazards.
[8.370.14.43 NMAC
- Rp, 8.370.14.42 NMAC, xx/xx/2025]
8.370.14.44 HAZARDOUS
AREAS: Hazardous areas include: Fuel fired equipment rooms (not a typical
residential kitchen), bulk laundries or laundry rooms with more than 100 sq.
ft., storage rooms more than 50 sq. ft. but less than 100 sq. ft. not storing
combustibles, storage rooms with more than 100 sq. ft. storing combustibles,
chemical storage rooms with more than 50 sq. ft., garages and maintenance
shops/rooms.
A. Hazardous areas on the same floor
as, and in or abutting, a primary means of escape or a sleeping room shall be
protected by either:
(1) an
enclosure of at least one hour fire rating with self-closing or automatic
closing on smoke detection fire doors having a three-quarter of an hour rating;
or
(2) an
automatic fire protection (sprinkler) and separation of hazardous area with
self-closing doors or doors with automatic-closing on smoke detection; or
(3) other
hazardous areas shall be enclosed with walls with at least a 20 minute fire
rating and doors equivalent to one and three-quarter inches solid bonded wood
core, operated by self-closures or automatic closing on smoke detection.
B. Boiler, furnace or fuel fired water heater
rooms: For facilities with four or
more residents: all boiler, furnace or fuel fired water heater rooms shall be
protected from other parts of the building by construction having a fire
resistance rating of not less than one hour.
Doors to these rooms shall be one and three-quarter inches solid core.
[8.370.14.44 NMAC
- Rp, 8.370.14.43 NMAC, xx/xx/2025]
8.370.14.45 HEATING,
AIR-CONDITIONING AND VENTILATION:
A. Heating,
air-conditioning, piping, boilers and ventilation equipment shall be furnished,
installed and maintained to meet all requirements of current state and local
mechanical, electrical and construction codes.
All facilities shall have documentation that fuel-fire heating systems
have been checked, tested and maintained annually by qualified personnel.
B. The heating method used by the
facility shall provide a minimum temperature of 70 degrees fahrenheit,
measured at three feet above the floor, in all rooms used by the residents.
C. No open-face gas or electric heater
nor unprotected single shell gas or electric heating device shall be used for
heating the facility. Portable heating
units shall not be used for heating the facility. All heating appliances shall be permanently
anchored and kept away from flammables such as curtains, bedcovering, trash
containers, or clothing. No heating
appliance shall be located where the unit or wiring is a tripping hazard or
presents danger from electrical shock.
D. Fireplaces and open flame heating
shall not be utilized in sleeping rooms.
E. Gas fired water heaters shall not
be located in sleeping rooms, bathrooms, or rooms opening into sleeping rooms.
F. The facility shall be adequately
ventilated at all times to provide fresh air and the control of unpleasant
odors by either mechanical or natural means.
G. All openings to the outside air
used for ventilation shall be screened for the control of insects and
rodents. Screen doors shall be equipped
with self-closing devices.
H. The facility shall have a system
for maintaining the residents’ comfort during periods of hot weather. Fans shall not be located where the unit or
wiring is a tripping hazard. Fans shall
be provided with protective shields when there is a potential for contact by
any individual.
[8.370.14.45 NMAC
- Rp, 8.370.14.44 NMAC, xx/xx/2025]
8.370.14.46 WATER: Pursuant to the current New Mexico drinking
water requirements:
A. The water supply system shall be
constructed, protected, operated and maintained in conformance with applicable
local, state and federal laws, ordinances and regulations.
B. Where a facility
is supplied by its own water system, the system shall meet the sampling and
construction requirement of a non-community water system as defined by the
current New Mexico drinking water requirements.
C. All water that is not piped into
the facility directly from a public water supply system shall be from an
approved source, disinfected, transported, handled, stored and dispensed in a
sanitary manner. Such water shall be
prevented from entering potable water systems by appropriate cross connection
and backflow prevention devices.
D. Hot and cold running water, under
pressure shall be provided in all areas where food is prepared and where
equipment and utensils are washed, sinks, lavatories, washrooms and laundries.
E. The hot water temperature that is
accessible to residents shall be maintained at a minimum of 95 degrees fahrenheit and a maximum of 120 degrees fahrenheit. Hot water in excess of 120 degrees fahrenheit is permitted in kitchen and laundry areas,
provided that residents are supervised in order to prevent injury.
[8.370.14.46 NMAC
- Rp, 8.370.14.45 NMAC, xx/xx/2025]
8.370.14.47 SEWAGE
AND WASTE DISPOSAL:
A. All sewage and liquid wastes shall
be disposed of into a municipal sewage system where such facilities are
available.
B. Where a municipal sewage system is
not available, the system that is used shall be inspected and approved by the
state environmental authority, pursuant to 20.7.3 NMAC, prior to licensure.
C. Where municipal
or community garbage collection and disposal service are not available, the
method of collection, storage and disposal of garbage used by the facility
shall be environmentally safe and sound and not create an objectionable
environment and be in accordance with state environmental authority, pursuant
to 20.9.2 NMAC.
[8.370.14.47 NMAC
- Rp, 8.370.14.46 NMAC, xx/xx/2025]
8.370.14.48 LIGHTING
AND LIGHTING FIXTURES:
A. All areas of the facility,
including storerooms, stairways, hallways, and interior and exterior entrances
shall be lighted to make the area clearly visible.
B. Exits, exit-access ways and other
areas used at night by residents and staff shall be illuminated by night lights
or other continuous lighting.
C. Lighting fixtures shall be selected
and located to accommodate the needs and activities of the residents, with the
comfort and convenience of the residents in mind.
D. Lamps and
lighting fixtures shall be shaded to prevent glare to the eyes of residents and
staff, and protected from accidental breakage or shattering.
E. Facilities with
four or more residents shall have emergency lighting to light exit passageways
and the exterior area near the exits that activates automatically upon
disruption of electrical service.
F. Facilities with
three or fewer residents shall have a flashlight that is immediately available
for use in lieu of electrically interconnected emergency lighting.
[8.370.14.48 NMAC
- Rp, 8.370.14.47 NMAC, xx/xx/2025]
8.370.14.49 ELECTRICAL
SYSTEM:
A. All fuse and breaker boxes shall be
labeled to indicate the area of the facility to which each fuse or circuit
breaker provides service.
B. All staff personnel of the facility
shall know the location of the electrical disconnect switch and how to operate
it in case of emergency.
C. Electrical cords and appliances
shall be U/L approved.
(1) Electrical
cords shall be replaced as soon as they show wear.
(2) Extension
cords shall not be used. The use of a multi-socket united laboratories
approved (U/L APPROVED) surge protector with integrated circuit breaker no
greater than six feet in length is permitted for the intended purpose and not
as an extension cord.
[8.370.14.49 NMAC
- Rp, 8.370.14.48 NMAC, xx/xx/2025]
A. No door in any means of egress
shall be locked against egress when the building is occupied.
(1) Exit
doors may be provided with a night latch, dead bolt, or security chain,
provided these devices are operable from the inside, by any occupant, without
the use of a key, tool, or any special knowledge and are mounted at a height
not to exceed 48 inches above the finished floor.
(2) If
locks are not readily operable by all occupants within the building, the locks
must:
(a) unlock
upon activation of the fire detection or sprinkler system; and
(b) unlock
upon loss of power in the facility.
Prior to installing such locking devices, the facility shall have
written approval from the building, fire and licensing authorities having
jurisdiction.
B. All exit doors shall have a minimum
width of 36 inches.
(1) Facilities
with a capacity of 10 or more residents shall have exit doors leading to the
outside of the facility that open outward.
(2) Facilities
with a capacity of 50 or more residents must provide panic hardware at the exit
doors.
(3) No
door or path of travel to a means of egress shall be less than 28 inches wide.
C. All resident sleeping room doors
must be at least one and three-quarters inches solid core construction.
D. Bathroom doors
may be 24 inches wide. Facilities with
four or more residents shall have at least one bathroom for every eight
residents with a door clearance of 36 inches for access by persons with
disabilities.
E. Locks on doors to toilet rooms and
bathrooms shall be capable of release from the outside.
F. All doors shall readily open from
the inside.
G. Doors shall be
provided for all resident sleeping rooms, all restrooms and all bathrooms.
[8.370.14.50 NMAC
- Rp, 8.370.14.49 NMAC, xx/xx/2025]
8.370.14.51 EXITS:
A. The facility shall have at least
two approved exits, that do not involve windows and which are remote from each
other.
B. Facilities with
10 or more residents shall have each exit clearly marked with lighted signs
having letters at least six inches high and at least three-quarters of an inch
wide. Exit signs shall be visible at all
times.
C. Facilities with three or fewer
residents shall have a flashlight that is immediately available for use in lieu
of electrically interconnected emergency lighting.
D. Exits shall be clear of
obstructions at all times.
E. Exits, exit paths, or means of
egress shall not pass through hazardous areas, garages, storerooms, closets,
utility rooms, laundry rooms, bedrooms, or spaces subject to locking.
F. For facilities
with four or more residents, sliding doors are not acceptable as a required
exit. EXCEPTION: Assisted living facilities with three or
fewer residents may have sliding doors as required exits.
G. When the yard gate(s) is part of
the exit access and is locked, the gate shall be connected to the fire
protection system and release upon activation of the fire/smoke system or shall
have the ability to be unlocked at the gate site.
[8.370.14.51 NMAC
- Rp, 8.370.14.50 NMAC, xx/xx/2025]
8.370.14.52 SEPARATION
OF SLEEPING ROOMS:
A. All sleeping
rooms shall be separated from escape route corridors by walls and doors that
are smoke resistant. There shall be no
passages, louvers, or transfer grills penetrating the wall to other spaces in
the building.
B. All sleeping
rooms shall be provided latches suitable for keeping the doors closed.
C. Every sleeping
room shall have access to a primary means of escape that provides a path to the
exterior, without exposure to unprotected vertical openings. Where sleeping rooms are above or below the
level of exit discharge, the primary means of escape shall be:
(1) an
enclosed interior stair; or
(2) an
exterior stair; or
(3) a
horizontal exit; or
(4) an
existing approved fire escape stair.
D. Every sleeping room shall provide a
secondary means of escape which may be any one of the following:
(1) a
door leading directly to the outside, at or to grade level;
(2) a
door, stairway, passage or hall remote from the primary escape and to the
exterior; or
(3) an
outside window or door, operable without tools from the inside with a minimum
clear opening measured 20 inches wide, measured 24 inches high; the distance of
the bottom of the opening from the floor is a maximum of 44 inches; this means
of escape is acceptable if the bottom of the window is no more than 20 feet
above grade or is accessible by fire department rescue apparatus, approved by
the authority having jurisdiction, or it opens onto an exterior balcony; and
(4) bars,
grills, grates or similar devices that are installed on emergency escape or
rescue windows or doors shall be equipped with release mechanisms which are
operable from the inside without the use of a key or special knowledge or
effort.
E. Stairways and other vertical
openings between floors shall be enclosed with construction to provide a smoke
and fire resistance rating of not less than 20 minutes. Open stairways between floors shall not be
permitted.
[8.370.14.52 NMAC
- Rp, 8.370.14.51 NMAC, xx/xx/2025]
8.370.14.53 CORRIDORS:
A. Corridors in an existing building
shall have a minimum width of 36 inches.
Corridors in newly constructed facilities shall have a minimum width of
44 inches.
B. Corridors shall have a clear
ceiling height of not less than seven feet measured to the lowest projection
from the ceiling.
C. Corridors shall be maintained clear
and free of obstructions at all times.
D. The floors of
corridors and hallways shall be waterproof, greaseproof, smooth, slip-resistant
and durable.
[8.370.14.53 NMAC
- Rp, 8.370.14.52 NMAC, xx/xx/2025]
8.370.14.54 MINIMUM
ROOM DIMENSIONS:
A. All habitable rooms in a facility
shall have a ceiling height of not less than seven feet six inches. Kitchens, halls, bathrooms and toilet
compartments shall have a ceiling height of not less than seven feet.
B. Any room with sloped ceiling where
any portion of the room is less than seven feet in height is subject to review
and approval or disapproval by the licensing authority.
[8.370.14.54 NMAC
- Rp, 8.370.14.53 NMAC, xx/xx/2025]
8.370.14.55 RESIDENT
ROOMS:
A. The facility’s bed capacity shall
not exceed the capacity approved by the licensing authority.
B. Each resident room shall have an
outside room with a window. The area of
the outdoor window shall be at least one tenth of the floor area of the room.
C. Resident rooms
shall not be less than seven feet wide in any horizontal dimension.
D. There must be no through traffic in
resident rooms. Resident rooms must
connect directly to other internal common areas of the facility.
E. The window
shades, drapes, curtains, or blinds in the resident rooms shall be in good
repair and of flame-retardant materials.
F. Resident rooms may be private or
semi-private. Semi-private rooms may not
house more than two residents.
(1) Private
rooms shall have a minimum of 100 square feet of floor area. The closet and locker area shall not be
counted as part of the available floor space.
(2) Semi-private
rooms shall have a minimum of 80 square feet of floor area for each bed and
shall be furnished in such a manner that the room is not crowded and passage
out of the room is not obstructed. A
separate closet for each resident shall be provided. The closet and locker area shall not be
counted as part of the available floor space.
The beds shall be spaced at least three feet apart.
G. If a resident chooses not to bring
their own furnishings to the facility; each resident room shall be provided
with, as a minimum, the following furnishings per resident:
(1) a
bed that shall be at least 36 inches wide, of sturdy construction and in good
repair;
(2) each
bed shall be provided with a clean, comfortable mattress of at least four
inches in thickness, which is waterproof, or protected with a waterproof
covering and a mattress pad;
(3) each
bed shall be provided with a clean, comfortable pillow;
(4) each
bed shall be provided with a pillow case, two clean sheets, blankets and a
bedspread appropriate for the weather and the climate;
(5) an
individual closet or closet area with a clothes rack for hanging clothes and
shelves or drawers that are accessible to the resident;
(6) a
dresser with drawers;
(7) a
bedside table or desk;
(8) a
chair;
(9) a
reading lamp; and
(10) a
mirror.
[8.370.14.55 NMAC
- Rp, 8.370.14.54 NMAC, xx/xx/2025]
8.370.14.56 TOILET
AND BATHING FACILITIES: Toilet and
bathing facilities shall be located appropriately to meet the needs of
residents.
A. A minimum of one toilet, one sink
and one bathing unit shall be provided for every eight residents or fraction
thereof.
(1) The
facility shall provide at least one bathing unit to allow for residents bathing
preference.
(2) Facilities
with four or more residents shall provide a handicap accessible bathroom for
every 30 residents that allows for a bathing preference.
B. Facilities with
four or more residents must comply with accessibility requirements for the
disabled.
C. Toilet, sink and
bathing facilities shall be readily available to the residents. No passage through a resident room by another
resident to reach a toilet, bathing unit or sink facility shall be permitted.
D. The combination type tub and shower
shall be permitted.
E. A facility with four or more
residents that has live-in staff shall provide a separate toilet, sink and
bathing facility for staff.
F. Toilets, tubs
and showers shall be provided with grab bars.
G. Tubs and showers shall have a slip
resistant surface.
H. The floors of
bathrooms and bathing facilities shall have smooth, waterproof and slip-resistant
surfaces.
I. Toilet paper and soap shall be
provided in each toilet room.
J. The use of a common towel shall be
prohibited.
K. Bathrooms and lavatories shall be
cleaned as often as necessary to maintain a clean and sanitary condition.
[8.370.14.56 NMAC
- Rp, 8.370.14.55 NMAC, xx/xx/2025]
8.370.14.57 LIVING
OR MULTIPURPOSE ROOM: The facility shall provide a minimum of 40
square feet per resident for common living, dining and social spaces.
A. The facility shall have a living or
multipurpose room for the use of the residents.
Such rooms shall be provided with reading lamps, tables and chairs or
couches. These furnishings shall be well
constructed, comfortable and in good repair.
B. The living room or multipurpose
rooms shall be provided with supplies to meet the varied interests and needs of
the residents.
C. Each activity room shall have a
window area of at least one tenth of the floor area with a minimum of at least
ten square feet.
[8.370.14.57 NMAC
- Rp, 8.370.14.56 NMAC, xx/xx/2025]
8.370.14.58 MEETING
ROOM: The facility shall have adequate meeting
rooms and office space for use by staff and the interdisciplinary care
team. Other rooms may serve as meeting
rooms, provided resident confidentiality is maintained.
[8.370.14.58 NMAC
- Rp, 8.370.14.57 NMAC, xx/xx/2025]
8.370.14.59 DINING
AREA:
A. A dining area shall be provided for
meals. Each dining area shall be
designed and have furnishings to meet the individual needs of the residents.
(1) Facilities
with 60 or fewer residents shall have tables and chairs in the dining area to
accommodate the total number of residents in one sitting.
(2) Facilities
with more than 60 residents shall provide seating for at least 60 residents at
one time, but may serve meals in shifts to accommodate the total capacity of
the facility.
(a) No
more than three shifts are permitted for each meal.
(b) Facilities
with more than 60 residents and serving meals in shifts must have other social
areas for residents to congregate during the meal service.
(c) All
seating arrangements during meals shall allow clear access to the exits.
B. The living or multi-purpose room
may be used as a dining area if the dining area portion does not exceed fifty
percent of the available floor space and still allows a comfortable arrangement
of the necessary furnishings for a living area.
[8.370.14.59 NMAC
- Rp, 8.370.14.58 NMAC, xx/xx/2025]
8.370.14.60 WINDOWS:
A. Each sleeping
room shall be provided with an exterior window.
(1) The
window shall be operable, screened and have a clear operable area of 5.7 square
feet minimum; measured 20 inches wide minimum and measured 24 inches high
minimum.
(2) The
top of the window sill shall not be more than 44 inches above the finished
floor.
B. Screens shall be
provided on all operable windows. Screens must fit properly and shall not be
damaged.
C. The proposed use
of bars, grilles, grates or similar devices shall be reviewed and approved by
the licensing authority prior to installation.
D. Sleeping rooms,
living rooms, activity room areas and dining room areas shall have a window
area of at least one tenth of the floor area with a minimum of 10 square feet.
[8.370.14.60 NMAC
- Rp, 8.370.14.59 NMAC, xx/xx/2025]
8.370.14.61 FIRE
CLEARANCE AND INSPECTIONS:
A. Written documentation of a
facility's compliance with applicable fire prevention codes shall be obtained
from the state fire marshal’s office or the fire prevention authority with
jurisdiction and shall be submitted to the licensing authority prior to the
issuance of an initial license.
B. The facility shall request an
annual fire inspection from the local fire prevention authorities. If the policy of the local fire department
does not provide an annual inspection of the facility, the facility will document
the date the request was made and to whom and then contact licensing
authorities. If the local fire
prevention authorities do make annual inspections, a copy of the latest
inspection must be kept on file in the facility.
[8.370.14.61 NMAC
- Rp, 8.370.14.60 NMAC, xx/xx/2025]
8.370.14.62 FIRE
ALARMS, SMOKE DETECTORS AND OTHER EQUIPMENT:
A. Fire alarm system: Facilities with four or more residents shall
have a manual fire alarm system. The
manual fire alarm shall be inspected and approved in writing by the fire
authority with jurisdiction.
B. Smoke and heat detection: Approved smoke detectors shall be installed
on each floor that when activated provides an alarm which is audible in all
sleeping areas. Areas of assembly, such
as the dining and living room(s) must also be provided with smoke detectors.
(1) Detectors
shall be powered by the house electrical service and have battery backup.
(2) Construction
of new facilities or facilities remodeling or replacing existing smoke
detectors shall provide detectors in common living areas and in each sleeping
room.
(3) Smoke
detectors shall be installed in corridors at no more than 30 foot spacing.
(4) Heat
detectors shall be installed in all kitchens and also powered by the house
electrical service.
[8.370.14.62 NMAC
- Rp, 8.370.14.61 NMAC, xx/xx/2025]
8.370.14.63 AUTOMATIC
FIRE PROTECTION (SPRINKLER) SYSTEM:
Facilities with nine or more residents shall have an automatic fire
protection (sprinkler) system. The
system shall be in accordance with NFPA 13 or NFPA 13D or its subsequent
replacement as applicable.
[8.370.14.63 NMAC
- Rp, 8.370.14.62 NMAC, xx/xx/2025]
8.370.14.64 FIRE
EXTINGUISHERS: Fire extinguisher(s) must be located in the
facility, as approved by the state fire marshal or the fire prevention
authority with jurisdiction.
A. Facilities must as a minimum have
two 2A10BC fire extinguishers:
(1) one
extinguisher located in the kitchen or food preparation area;
(2) one
extinguisher centrally located in the facility;
(3) all
fire extinguishers shall be inspected yearly and recharged as needed; all fire
extinguishers must be tagged noting the date of the inspection;
(4) the
maximum distance between fire extinguishers shall be 50 feet.
B. Fire extinguishers, alarm systems,
automatic detection equipment and other firefighting equipment shall be
properly maintained and inspected as recommended by the manufacturer, state
fire marshal, or the local fire authority.
[8.370.14.64 NMAC
- Rp, 8.370.14.63 NMAC, xx/xx/2025]
8.370.14.65 FIRE
SAFETY EQUIVALENCY SYSTEM RATING: In
facilities without a sprinkler system; the fire safety equivalency system shall
be conducted at least annually. The
facility shall maintain an evacuation rating score of prompt when a fire safety
equivalency system is required.
[8.370.14.65 NMAC
- Rp, 8.370.14.64 NMAC, xx/xx/2025]
8.370.14.66 FIRE
DRILLS: All facilities shall conduct monthly fire
drills which are to be documented.
A. There shall be
at least one documented fire drill per month and at a minimum, one documented
fire drill each eight hours (day, evening, night) per quarter that employs the
use of the fire alarm system or the detector system in the facility.
B. A record of the
monthly fire drills shall be maintained on file in the facility and readily
available. Fire drill records shall
show:
(1) the
date of the drill;
(2) the
time of the drill;
(3) the
number of staff participating in the drill;
(4) any
problem noted during the drill; and
(5) the
evacuation time in total minutes.
C. If applicable,
the local fire department may be requested to supervise and participate in fire
drills.
[8.370.14.66 NMAC
- Rp, 8.370.14.65 NMAC, xx/xx/2025]
8.370.14.67 STAFF
AND RESIDENT FIRE AND SAFETY TRAINING:
A. All staff of the facility shall
know the location and the proper use of fire extinguishers and the other
procedures to be followed in case of fire or other emergencies. The facility should request the local fire
prevention authority to give periodic instructions in the use of fire
prevention and techniques of evacuation.
B. Facility staff shall be instructed
as part of their duties to constantly strive to detect and eliminate potential
safety hazards, such as loose handrails, frayed electrical cords, blocked exits
or exit-ways and any other condition which could cause burns, falls, or other
personal injury to the residents or staff.
C. Each new resident admitted to the
facility shall be given an orientation tour of the facility to include the
location of the exits, fire extinguishers and telephones and shall be
instructed in the actions to be taken in case of fire or other emergencies.
D. Fire drill procedures: The facility must conduct at least one fire
drill each month.
(1) Fire
drills shall be held at different times of the day, evening and night.
(2) The
fire alarm system or detector system in the facility shall be used in the fire
drills. During the night, the fire drill
alarm may be silenced.
(3) During
the fire drills, emphasis shall be placed upon orderly evacuation under proper
discipline rather than upon speed.
(4) A
record of the conducted fire drills shall be maintained on file in the
facility. The record shall show the date
and time of the drill, the number of personnel participating in the drill, any
problem(s) noted during the drill and the evacuation time in total minutes.
(5) The
local fire department may be requested to supervise and participate in the fire
drills.
[8.370.14.67
NMAC - Rp, 8.370.14.66 NMAC, xx/xx/2025]
8.370.14.68 SMOKING:
A. Smoking by residents and staff
shall take place only in supervised areas designated by the facility and
approved by the state fire marshal or local fire prevention authorities. Smoking shall not be allowed in a kitchen or
food preparation area.
B. All designated smoking areas shall
be provided with suitable ashtrays that are not made of combustible material.
C. Residents shall not be permitted to
smoke in bed.
D. Smoking shall not be permitted
where oxygen is in use, is present or is stored.
[8.370.14.68 NMAC
- Rp, 8.370.14.67 NMAC, xx/xx/2025]
8.370.14.69 HOSPICE: An assisted living facility that provides or
coordinates hospice care and services shall meet the requirements in this
section, in addition to the rules applicable to all assisted living facilities,
8.370.14 NMAC.
A. Definitions: in addition to the requirements for all
assisted living facilities pursuant to “definitions,” 8.370.14.7 NMAC, the
following definitions shall also apply.
(1) “Hospice agency” means an organization,
company, for-profit or non-profit corporation or any other entity which
provides a coordinated program of palliative and supportive services for
physical, psychological, social and the option of spiritual care of terminally
ill people and their families. The
services are provided by a medically directed interdisciplinary team in the
person's home and the agency is required to be licensed pursuant to 8.370.19
NMAC.
(2) “Hospice
care” means a focus on palliative,
rather than curative care. The goal of
the plan of care is to help the resident live as comfortably as possible, with
emphasis on eliminating or decreasing pain and other uncomfortable symptoms.
(3) “Licensed
assisted living provider” means a facility that provides 24 hour assisted
living and is licensed by the health care authority.
(4) “Hospice
services” means a program of palliative and supportive services which
provides physical, psychological, social and spiritual care for terminally ill
residents and their family members.
(5) “Care coordination requirements” means
a written document that outlines the care and services to be provided by the
hospice agency for assisted living residents that require hospice services.
(6) “Palliative care” means a form of medical care or treatment that is intended to reduce the severity
of disease symptoms, rather than to reverse progression of the disease itself
or provide a cure.
(7) “Terminally ill” means a diagnosis by a
physician for a resident with a prognosis of six (6) months or less to live.
(8) “Visit notes” means the documentation
of the services provided for hospice residents and includes ongoing care
coordination.
B. Employee training and support: A facility that provides hospice services
shall provide the following education and training for employees who assist
with providing these services:
(1) provide
a minimum of six hours per year of palliative/hospice care training, which
includes one hour specific to the hospice resident’s ISP, in addition to the
basic staff education requirements pursuant to 8.370.14.17 NMAC; and
(2) offer
an ongoing employee psychological support program for end of life care issues.
C. Individual service plan (ISP)
requirements:
(1) Each
resident who receives hospice services shall be provided the necessary
palliative care to meet the individual resident’s needs as outlined in the ISP
and shall include one hour of training specific to the resident for all direct
care staff.
(2) The
assisted living facility, in coordination with the hospice provider, shall
create an ISP that identifies how the resident's needs are met and includes the
following:
(a) the
requirements set forth in the “individual service plan,” 8.370.14.26 NMAC, and
“Exceptions to admission, readmission and retention,” Subsection C of
8.370.14.20 NMAC;
(b) what
services are to be provided;
(c) who
will provide the services;
(d) how
the services will be provided;
(e) a
delineation of the role(s) of the hospice provider and the assisted living
facility in the ISP process;
(f) documentation
(visit notes) of the care and services that are provided with the signature of
the person who provided the care and services; and
(g) a
list of the current medications or biologicals that the resident receives and
who is authorized to administer them.
(3) Medications
shall be self-administered, self-administered with assistance by an individual
that has completed a state approved program in medication assistance or
administered by the following individuals:
(a) a
physician;
(b) a
physician extender (PA or NP);
(c) a
licensed nurse (RN or LPN);
(d) the
resident if their PCP has approved it;
(e) family
or family designee; and
(f) any
other individual in accordance with applicable state and local laws.
D. Care coordination.
(1) The
assisted living facility shall be knowledgeable with regard to the hospice
requirements pursuant to 8.370.19 NMAC and ensure that the hospice agency is
well informed with regard to the assisted living provisions pursuant to
Subsection C of 8.370.14.20 NMAC.
(2) The
assisted living facility shall hold a team meeting prior to accepting or
retaining a hospice resident in accordance with “exceptions to admission,
readmission and retention,” Subsection C of 8.370.14.20 NMAC.
(3) Upon
admission of a resident into hospice care, the assisted living facility shall
designate a section of the resident’s record for hospice documentation.
(a) The
facility shall provide individual records for each resident.
(b) The
hospice agency shall leave documentation at the facility in the designated
section of the resident’s record.
(4) The
assisted living facility shall provide the resident and family or surrogate
decision maker with information on palliative care and shall support the
resident’s freedom of choice with regard to decisions.
(5) Hospice
services shall be available 24 hours a day, seven days a week for hospice
residents, families and facility staff and may include continuous nursing care
for hospice residents as needed. These
services shall be delivered in accordance with the resident’s individual
service plan (ISP) and pursuant to 8.370.14 26 NMAC.
(6) The
assisted living facility shall ensure the coordination of services with the
hospice agency.
(a) The
resident's individual service plan (ISP) shall be updated with significant
changes in the resident’s condition and care needs.
(b) The
assisted living facility shall receive information and communication from the
hospice staff at each visit.
(i) The information shall include the
resident status and any changes in the ISP (i.e., medication changes, etc.).
(ii) The
information shall be in the form of a verbal report to the assisted living
facility staff and also in the form of written documentation.
(c) The
assisted living facility or the family/resident shall reserve the right to
schedule care conferences as the needs of the resident and family dictate. The care conferences shall include all care
team members.
(d) Concerns
that arise with regard to the delivery of services from either the assisted
living facility or the hospice agency shall first be addressed with the
facility administrator and the hospice agency administrator.
(i) The process may be informal or
formal depending on the nature of the issue.
(ii) If
an issue cannot be resolved or if there is an immediate danger to the resident
the appropriate authority shall be notified.
E. Additional provisions: An assisted living facility that provides or
coordinates hospice care and services shall make additional provisions for the
following requirements:
(1) individual services and care: each resident receiving hospice services
shall be provided the necessary palliative procedures to meet individual needs
as defined in the ISP;
(2) private visiting space:
(a) physical
space for private family visits;
(b) accommodations
for family members to remain with the resident throughout the night; and
(c) accommodations
for family privacy after a resident’s death.
F. Medicare and medicaid
restrictions: Assisted living
facilities shall not accept a resident considered “hospice general inpatient”
which would be billable to medicare or medicaid because the facility will not qualify for payment
by medicare or medicaid.
[8.370.14.69 NMAC
- Rp, 8.370.14.68 NMAC, xx/xx/2025]
8.370.14.70 MEMORY
CARE UNITS: An assisted living facility that provides a
secure environment to serve residents with dementia shall comply with the
provisions of subsection A-J below in addition to the rules applicable to all
assisted living facilities, 8.370.14 NMAC.
A. Additional definitions: The following definitions, in addition to
those in 8.370.14.7 NMAC, shall apply.
(1) “Alzheimer’s” means a brain disorder
that destroys brain cells, causing problems with memory, thinking and behavior
that are severe enough to affect work, lifelong hobbies or social life. Alzheimer’s gets progressively worse and is
fatal.
(2) “Care coordination agreement requirement”
means a written document that outlines the care and services that are provided
by other outside agencies for assisted living residents that require additional
care and services.
(3) “Dementia” means loss of memory and
other mental abilities severe enough to interfere with daily life. It is caused by changes in the brain.
(4) “Memory care unit” means an assisted
living facility or part of or an assisted living facility that provides added
security, enhanced programming and staffing appropriate for residents with a
diagnosis of dementia, Alzheimer’s disease or other related disorders causing
memory or cognitive impairments and for residents whose functional needs
require a specialized program.
(5) “Secured environment” means locked
(secured/monitored) doors/fences that restrict access to the public way for
residents who require a secure unit.
B. Care coordination requirement: An assisted
living facility that accepts residents with memory issues shall determine which
additional services and care requirements are relevant to the resident and
disease process.
(1) The
medical diagnosis and ISP shall be utilized in the determination of the need
for additional services.
(2) The
assisted living facility shall ensure the coordination of services and shall
have evidence of an agreement of care coordination for all services provided in
the facility by an outside health care provider.
C. Employee training: In addition to the training requirements for
all assisted living facilities, pursuant to 8.370.14.17 NMAC, all employees
assisting in providing care for memory unit residents shall have a minimum of
12 hours of training per year related to dementia, Alzheimer’s disease, or
other pertinent information.
D. Individual service plan (ISP): An assisted living facility that admits
memory care unit residents shall create an ISP in coordination with the
resident’s primary care practitioner, in compliance with the requirements
outlined in “individual service plan,” 8.370.14.26 NMAC, pursuant to a team
meeting as described in “exceptions to admission, readmission and retention,”
Subsection C of 8.370.14.20 NMAC, and which ensures the following criteria:
(1) identification
of the resident's needs specific to
the memory care unit and the services that are provided; each memory unit
resident shall receive the services necessary to meet the individual resident’s
needs;
(2) medications
shall be self-administered, self-administered with assistance by an individual
that has completed a state approved program in medication assistance or
administered by the following individuals:
(a) a
physician;
(b) a
physician extender (PA or NP);
(c) a
licensed nurse (RN or LPN);
(d) the
resident if their PCP has approved it;
(e) family
or family designee; and
(f) any
other individual in accordance with applicable state and local laws.
E. Assessments and re-evaluations:
(1) An
assessment shall be completed by a registered nurse or a physician extender
within 15 days prior to admission. When
emergency placement is warranted the 15 day assessment shall be waived and the
assessment shall be completed within five days after admission.
(a) The
resident shall have a medical evaluation and documentation by a physician,
physician's assistant or a nurse practitioner within six months of admission.
(b) The
pre-admission assessment shall include written findings, an evaluation of less
restrictive alternatives and the basis for the admission to the secured
environment. The written documentation
shall include a diagnosis from the resident's PCP of Alzheimer's disease or
other dementia and the need for the resident to reside in a memory care unit.
(c) Only
those residents who require a secured environment placement or whose needs can
be met by the facility, as determined by the assessment prior to admission or
on review of the individual service plan (ISP), shall be admitted.
(2) A
re-evaluation must be completed every six months and when there is a
significant change in the medical or physical condition of the resident that
warrants intervention or different care needs, or when the resident becomes a
danger to self or others, to determine whether the resident’s stay in the
assisted living facility memory care unit is still appropriate.
F. Documentation in the resident’s
record: In addition to the required documentation
pursuant to 8.370.14.21 NMAC, the following information shall be documented in
the resident’s record:
(1) the
physician’s diagnosis for admission to a secure environment or a memory care
unit;
(2) the
pre-admission assessment; and
(3) the
re-evaluation(s).
G. Secured environment:
(1) Memory
care unit residents may require a secure environment for their safety. A secured environment is any locked
(secured/monitored) area in which doors and fences restrict access to the
public way. These include but are not
limited to:
(a) alarm
systems;
(b) gates
connected to the fire alarm; and
(c) tab
alarms for residents at risk for elopement.
(2) In
addition to the interior common areas required by this rule, the facility shall
provide a safe and secure outdoor area for the year round use by the residents.
Fencing or other enclosures shall prevent elopement and protect the safety and
security of the residents.
(3) Locked
areas shall have an access code or key which facility employees shall have
available on their person or on the locking unit itself at all times.
H. Resident rights: In addition to the requirements pursuant to
8.370.14.32 NMAC, the following shall apply:
(1) the
resident's rights may be limited as required by their condition and as
identified in the ISP;
(2) the
resident who believes that he or she has been inappropriately admitted to the
secured environment may request the facility in contact the resident’s legal
guardian, or an advocate such as the ombudsman or the primary care
practitioner; upon request, the facility shall assist the resident in making
such contact.
I. Disclosure to residents: A facility that operates a secured
environment shall disclose to the resident and the resident’s legal
representative, if applicable and prior to the resident’s admission to the
facility, that the facility operates a secured environment.
(1) The
disclosure shall include information about the types of resident diagnosis or
behaviors that the facility provides services for and for which the staff are
trained to provide care for.
(2) The
disclosure shall include information about the care, services and the type of
secured environment that the facility and trained staff provide.
J. Staffing: The facility shall provide the sufficient
number of trained staff members to meet the additional needs of the residents
in the secured environment. There must
be at least one trained staff member awake and in attendance in the secured
environment at all times.
[8.370.14.70 NMAC
- Rp, 8.370.14.69 NMAC, xx/xx/2025]
8.370.14.71 INCORPORATED AND RELATED RULES AND CODES: The facilities that are subject to this rule
are also subject to other rules, codes and standards that may, from time to
time, be amended. This includes the
following:
A. Health facility licensure fees and
procedures, New Mexico Health care authority, 8.370.3 NMAC.
B. Health facility
sanctions and civil monetary penalties, New Mexico Health care authority,
8.370.3 NMAC.
C. Adjudicatory
hearings for licensed facilities, New Mexico health care authority, 8.370.2
NMAC.
D. Caregiver's
criminal history screening requirements, 8.370.5 NMAC.
E. Employee abuse
registry 8.370.8 NMAC.
F. Incident
reporting, intake processing and training requirements 8.370.9 NMAC.
[8.370.14.71 NMAC
- Rp, 8.370.14.70 NMAC, xx/xx/2025]
History of 8.370.14 NMAC: [RESERVED]
History of
Repealed Material: 8.370.14 NMAC,
Assisted Living Facilities For Adults filed xx/xx/xxxx
Repealed effective xx/xx/2025.
Other: 8.370.14 NMAC, Assisted Living Facilities For
Adults filed xx/xx/xxxx Replaced by 8.370.14 NMAC,
Assisted Living Facilities effective xx/xx/2025.