Related Resources: Physical Plant Requirements for Assisted Living Facilities in Maryland

Topics	Related Physical Plant Resources That You May Find Helpful
General Physical Plant	According to a national study, the most frequent complaints involving assisted living facilities involve medication administration, menu quality, discharge eviction planning/notice, dignity/respect of staff, and equipment/building problems. (Report to Congress. Long-Term Care Ombudsmen Report, Fiscal Year 2004. Washington, DC: U.S. Department of Health and Human Services, Administration on Aging). The Maryland regulations on General Physical Plant requirements COMAR 10.07.14.31 and security COMAR 10.07.14.34 Tips on finding and screening contractors willing to take on small jobs Americans with Disabilities Act Accessibility Guidelines Checklist - details on the technical requirements for access by persons with disabilities under federal law. Also included are useful general guidelines for ALF operators. Looking for help with your floor plans or other facility drawings? You can find resources at your local public library or you can find easy-to-use and inexpensive software on-line. Here are some examples of architectural drawing software that may help you work with contractors or provide drawings to OHCQ. This website does not endorse any of these commercial products. (HomePlanPro or SmartDraw) Applying for an ALF of 17 beds or more? According to the Office of Health Care Quality application packet, if you are applying for an ALF of 17 beds or more, you must send in “an approved plans review…from a Maryland State Architect (410-767-5930).”
Water and Sewer	The Maryland regulations on water supply COMAR 10.07.14.32. and sewage disposal COMAR 10.07.14.33.
Bathrooms & Laundry	The Maryland regulations on the requirement to have on- or off-site laundry facilities COMAR 10.07.14.44. and bathrooms for residents COMAR 10.07.14.40.
Heating and Cooling	The Maryland regulations on heating, cooling and ventilation COMAR 10.07.14.42. and radiators COMAR 10.07.14.43. Tips on how to handle a heat wave
Floor Plans	“Looking for help with your floor plans or other facility drawings? You can find resources at your local public library or you can find easy-to-use and inexpensive software on-line. Here is some examples architectural drawing software that may help you work with contractor or provide drawings to OHCQ. This website does not endorse any of these commercial products. (HomePlanPro or SmartDraw )
Lighting	The Maryland regulations on the illumination COMAR 10.07.14.41 Lighted outdoor activity space required – If your facility is licensed for nine or more beds, your outside activity space must “lighted, with security and supervision necessary to meet the needs of the residents”. See COMAR 10.07.14.38C Practical Tips on How to Understand and Meet the COMAR Illumination Requirements - The regulations use the term “footcandles” to describe the amount of illumination required in a resident’s room. COMAR 10.07.14.41 Light bulbs are sold marked with the illumination measurements, “watts” and “lumens”. The question for an ALF operator is how to measure “foot candles”. A “foot candle” is essentially the amount of light that actually falls on a given surface. It is a more useful measurement for an ALF operator than just “watts”. The number of “foot candles” of light will depend on how far you are from the source when you measure it. So how do you measure “foot candles”? Basically you have two "do-it-yourself" choices. You can purchase a light meter and measure the number of foot candles to make sure that it meets the requirements. You would read the meter while seated at the place in the resident’s room where s/he would be likely to read. The meters cost anywhere between $60 and over $200 for used and new meters (based on a recent search on-line). If you have access to a manual camera with a built-in light meter, you can use that instead. Here are some tips on how to use a camera to make a foot candle measurement from Wikipedia, a web-based free encyclopedia written by other members of the public. Practically speaking, perhaps the best test is to ask each resident if the light is adequate. Since residents may have visual problems, simply complying with the regulations may not be sufficient to provide adequate light for each individual. More tools to understand illumination More about the definitions and terms used to describe light (probably more than you ever wanted to know from a commercial lighting business) a 2 page PDF document. An on-line illumination measurement conversion tool that allows you to convert watts to “lumens”, foot candles and other lighting measurements. It is highly technical and will probably be more useful to an electrician than to an ALF operator. Tips on accommodating the visual changes due to aging - A nonprofit organization which offers clear descriptions of the major changes in vision due to aging. ALF staff and operators will be able to use this information to better accommodate residents over the age of 40. Note: The pages are slow to load, but the information is very helpful. Also see additional useful information from this nonprofit, AWARE - Associates for World Action in Rehabilitation & Education whose mission is “to offer self-help vision rehabilitation hints and adaptive techniques, and disseminate information on services and independent living resources to individuals with recent vision loss, their family members, and those who work with them.”

Source: Legal Aid Bureau’s Maryland Legal Assistance Network, in partnership with the Senior Legal Helpline, and the Assisted Living Project the under a grant from the Maryland Department on Aging to the Legal Aid Bureau

Date last reviewed (no legal content): 10/15//07 (MLAN/DL/AC)