New Mexico Staff Qualifications – Assisted Living

by | Jun 5, 2024 | Uncategorized

A facility shall employ staff with the following

Administrator, director, operator: an assisted living facility shall be supervised by a full-time Multiple facilities that are located within a 40 mile radius may have one full-time administrator. The administrator shall:

      • be at least 21 years of age;
      • have a high school diploma or its equivalent;
      • comply with the requirements of the New Mexico Caregivers Criminal History Screening Act, 1.9 NMAC;
      • complete a state approved certification program for assisted living administrators;
      • be able to communicate with the residents in the language spoken by the majority of the residents;
      • not work while under the influence of alcohol or illegal drugs;
      • 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;
      • provide three notarized letters of reference from persons unrelated to the applicant; and
      • comply with the pre-employment requirements pursuant to the Employee Abuse Registry, 1.12 NMAC.

Direct care staff:

  • shall be at least 17 years of age;
  • shall have adequate education, relevant training, or experience to provide for the needs of the residents;
  • shall comply with the pre-employment requirements pursuant to the Employee Abuse
  • shall comply with the current requirements of reporting and investigating incidents pursuant to Incident Reporting, Intake Processing and Training Requirements, 1.13 NMAC;
  • 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 valid New Mexico driver’s license with the appropriate classification for the vehicle that is used to transport residents;
    • documentation of training in transportation safety for the elderly and disabled, including safe vehicle operation;
    • proof of insurance; and
    • documentation of a clean driving record;
  • 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, 7.1.9 NMAC, shall provide current (within the last 6 months) proof of the caregivers criminal history screening to the facility; the facility shall maintain and have proof of such screening readily available; and
  • employers shall comply with the requirements of the Caregivers Criminal History Screening Requirements, 7.1.9

Staff Training:

  1. Training and orientation for each new employee and volunteer that provides direct care shall include a minimum of sixteen (16) hours of supervised training prior to providing unsupervised care for
  2. Documentation of orientation and subsequent trainings shall be kept in the personnel file at thefacility.
  3. Training shall be provided at orientation and at least twelve (12) hours annually, the orientation, training and proof of competency shall include:
  • fire safety and evacuation training;
  • first aid;
  • safe food handling practices (for persons involved in food preparation), to include:
    • instructions in proper storage;
    • preparation and serving of food;
    • safety in food handling;
    • appropriate personal hygiene; and
    • infectious and communicable disease control;
  • confidentiality of records and resident information;
  • infection control;
  • resident rights;
  • reporting requirements for abuse, neglect or exploitation in accordance with 1.13 NMAC;
  • smoking policy for staff, residents and visitors;
  • methods to provide quality resident care;
  • emergency procedures;
  • medication assistance, including the certificate of training for staff that assist with medication delivery; and
  • the proper way to implement a resident ISP for staff that assist with
  • 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.

Policies: The facility shall have and implement written personnel policies for the following:

      1. staff, private duty attendant and volunteer qualifications;
      2. staff, private duty attendant and volunteer conduct;
      3. staff, private duty attendant and volunteer training policies;
      4. staff and private duty attendant and volunteer criminal history screening;
      5. emergency procedures;
      6. medication administration;
      7. the retention and maintenance of current and past personnel records; and
      8. facilities shall maintain records and files that reflect compliance with NM and federal employment rules.

    STAFFING RATIOS: The following staffing levels are the minimum

      1. 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’
        • During resident waking hours, facilities shall have at least one (1) direct care staff person on duty and awake at all times for each fifteen (15)
        • During resident sleeping hours, facilities with fifteen (15) or fewer residents shall have at least one (1) direct care staff person on duty, awake and responsible for the care and supervision of the
        • During resident sleeping hours, facilities with sixteen (16) to thirty (30) residents shall have at least one (1) direct care staff person on duty and awake at all times and at least one (1) additional staff person available on the
        • During resident sleeping hours, facilities with thirty-one (31) to sixty (60) residents shall have at least two (2) direct care staff persons on duty and awake at all times and at least one (1) additional staff person immediately available on the
        • During resident sleeping hours, facilities with more than sixty-one (61) residents shall have at least three (3) direct care staff persons on duty and awake at all times and one (1) additional staff person immediately available on the premises for each additional thirty (30) residents or fraction thereof in the
      2. Upon request of the department, the facility shall provide the staffing ratios per each twenty-four (24) hour day for the past thirty (30) days.

    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

      1. Admission The admission agreement shall include the following information:
        • the parties to the agreement;
        • the program narrative;
        • the facility’s rules;
        • the cost of services and the method of payment;
        • the refund provision in case of death, transfer, voluntary or involuntary discharge;
        • information to formulate advance directives;
        • a written description of the legal rights of the residents translated into another language, if necessary;
    • the facility’s staffing ratio;
    • written authorization for staff to assist with medications;
    • notification of rights and responsibilities pursuant to the Incident Reporting Intake, Processing and Training Requirements, 7.1.13 NMAC;
    • the facility’s bed hold policy; and
    • the admission agreement may be terminated if an appropriate placement is found for the resident, under the following circumstances:
      • there shall be a fifteen (15) day written notice of termination given to the resident or his or her surrogate decision maker, unless the resident requests the termination; agreement; resident; the services of the facility; following reasons: welfare; endangered;
    • the resident has failed to pay for a stay at the facility as defined in the admission
    • the facility ceases to operate or is no longer able to provide services to the
    • the resident’s health has improved sufficiently and therefore no longer requires
    • termination without prior notice is permitted in emergency situations 
    • the transfer or discharge is necessary for the resident’s safety
    • the resident’s needs cannot safely be met in the facility; 
    • the safety and health of other residents and staff in the facility 
    • the facility shall provide a thirty (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; 
    • facilities representing their services as “specialized” must disclose evidence of staff specialty training.

    Restriction in admission. The facility shall not admit or retain individuals that require twenty- four (24) hour continuous nursing care, refer to Subsection U of 7.8.2.7 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:

      • ventilator dependency;
      • pressure sores and decubitus ulcers (stage III or IV);
      • intravenous therapy or injections;
      • any condition requiring either physical or chemical restraints;
      • nasogastric tubes;
      • tracheostomy care;
      • residents that present an imminent physical threat or danger to self or others;
      • residents whose psychological or physical condition has declined and placement in the current facility is no longer appropriate as determined by the PCP;
      • residents with a diagnosis that requires isolation techniques;
      • residents that require the use of a Hoyer lift; and
      • ostomy (unless resident is able to provide self care).

    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

      • Convene a team, comprised of:
        • the facility administrator and a facility health care professional if desired;
        • the resident or resident’s surrogate decision maker; and
        • the hospice or home health
      • 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:
        • 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;
        • ensure that if the facility is licensed for more than eight (8) 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);
        • evaluate and outline how meeting the specific needs of the resident will impact the staff and the other residents; and
        • include an independent advocate such as a certified ombudsman if requested by the resident, the family or the
      • The team recommendation shall be maintained on site in the resident’s file.
    • When a resident is discharged, the facility shall record where the resident was discharged to and what medications were released with the resident.

    Coordination of care. 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

    • 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.