District of Columbia Administrative Code

3107 DENIAL, SUSPENSION, OR REVOCATION OF A HEALTH CARE FACILITY LICENSE 3107.1 The Director may refuse to issue or renew or may revoke, or may suspend a license issued pursuant to this chapter for one or more of the reasons listed in §5(a)(2)(f) of the Act. 3107.2 Except for a c…

3108 SUMMARY SUSPENSION AND LICENSURE CONVERSION, HEARINGS 3108.1 Notwithstanding any other provision of these rules, the Director, pursuant to §6(d)(l) of the Act, D.C. Code, 2001 Ed. §44-505(d)(1), and under conditions described in that section may do the following: (a) Convert…

3109 SERVICE OF NOTICE 3109.1 Any notice required by this chapter may be served either personally or by certified mail, return receipt requested, directed to the applicant or licensee at the last known address as shown by the records of the Department of Consumer and Regulatory A…

3110 CONDUCT OF HEARINGS 3110.1 Every hearing before the Director shall be open to the public. 3110.2 An applicant or licensee entitled to a hearing shall have the following rights: (a) To be represented by counsel; (b) To examine all opposing witnesses on any matter relevant to …

3111 FINDINGS AND DECISIONS 3111.1 The Director shall render a decision, in writing, as soon as practicable, but no later than fifteen (15) calendar days, after the hearing is completed. 3111.2 A summary suspension or emergency licensure conversion shall be either affirmed or vac…

3112 RECONSIDERATION 3112.1 A petition for reconsideration may be filed by a party within ten (10) days after service of the decision by the Director. 3112.2 Neither the filing nor the granting of that petition shall operate as a stay of a final order unless specifically ordered …

3113 APPEALS 3113.1 Any adverse decision (except a summary action pursuant to §3108) by the Director may be appealed to the Board of Appeals and Review by filing a petition with that Board, in accordance with its rules, within fifteen (15) days of the decision of the Director or …

3114 FEES FOR COMMUNITY RESIDENCE FACILITIES AND HEALTH CARE FACILITIES 3114.1 License fees for community residence facilities are as follows: (a) 1-5 beds Annual Fee $50.00 Late Fee 25.00 (b) 6-10 beds Annual Fee 75.00 Late Fee 37.50 (c) 11-20 beds Annual Fee 100.00 Late Fee 50.…

3199 DEFINITIONS 3199.1 For purposes of these chapters, the following terms and phrases shall have the meanings ascribed (unless the context indicates otherwise): Act - D.C. Law 5-48, the District of Columbia Health Care and Community Residence Facility, Hospice and Home Care Lic…

3200 PURPOSE 3200.1 Each nursing facility shall comply with the Act, these rules and the requirements of 42 C.F.R. Part 483, Subpart B, Sections 483.1 to 483.75; Subpart D, Sections 483.150 to 483.158; and Subpart E, section 483.200 to 483.206, all of which shall constitute licen…

3201 ADMINISTRATIVE MANAGEMENT 3201.1 An Administrator shall be present forty (40) hours per week during regular business hours, and shall be responsible for the operation of the facility twenty-four (24) hours per day, seven (7) days per week. 3201.2 The Administrator shall be: …

3202 PERSONNEL POLICIES 3202.1 Personnel policies shall be in writing and maintained in an employee manual that is given to each employee during orientation and shall be made available to the licensing agency. 3202.2 Each facility shall develop and maintain personnel policies whi…

3203 LICENSES AND ADMINISTRATIVE RECORDS 3203.1 No facility shall operate without a license issued pursuant to the Act. 3203.2 A list of all employees, with the appropriate current license or certification numbers, shall be on file at the facility and available to the Director. 3…

3204 FEES 3204.1 License fees are established according to the number of resident beds in the facility and are as follows: (a) 1 - 50 Beds Annual Fee $ 400 Late Fee $ 150 (b) 51 - 100 Beds Annual Fee $ 500 Late Fee $ 200 (c) 101 or More Beds Annual Fee $ 600 Late Fee $ 250 SOURCE…

3205 INSURANCE COVERAGE 3205.1 Each facility shall carry sufficient insurance to cover the following exposures: (a) Hazard (fire, extended coverage, and vandalism); (b) Consequential (indirect) loss from operation breakdown; (c) Theft; and (d) Legal risk (liability). 3205.2 The l…

3206 RESIDENT CARE POLICIES 3206.1 There shall be written policies to govern nursing care and related medical and other services provided, including written policies on: (a) Nursing services; (b) Physician services; (c) Emergency care; (d) Dental services; (e) Ventilator services…

3207 PHYSICIAN SERVICES AND MEDICAL SUPERVISION OF RESIDENTS 3207.1 The Medical Director shall assume full responsibility for the overall supervision of the medical care provided in the facility. If the Medical Director is absent, he or she shall delegate the continuity and super…

3208 NURSING SERVICES 3208.1 A licensed registered nurse shall be employed full-time as Director of Nursing Services, except as provided in this section. 3208.2 If the Director of Nursing is temporarily absent, the responsibility for continuity and supervision of nursing services…

3209 NURSING SERVICES SUPERVISION 3209.1 A Nursing Services Supervisor shall be on duty at all times. 3209.2 Each Nursing Services Supervisor shall: (a) Be qualified by education or experience in geriatric, rehabilitation or psychiatric nursing or other appropriate nursing discip…

3210 LICENSED NURSING COVERAGE 3210.1 Each facility shall employ a charge nurse on each unit twenty-four (24) hours a day. 3210.2 Each charge nurse shall be a licensed registered nurse or licensed practical nurse in the District with experience in geriatric, rehabilitation, psych…

3211 NURSING PERSONNEL AND REQUIRED STAFFING LEVELS 3211.1 Sufficient nursing time shall be given to each resident to ensure that the resident receives the following: (a) Treatments, medications, diet and nutritional supplements and fluids as prescribed, and rehabilitative nursin…

3212 TEMPORARY NURSING PERSONNEL 3212.1 Each facility may hire temporary nurses, including contract nurses, who shall be licensed in the District of Columbia. 3212.2 The facility shall have policies and procedures for orienting qualified temporary nursing personnel to the facilit…

3213 RESTORATIVE NURSING CARE PROGRAM 3213.1 The facility shall have a restorative nursing care program to assist in maintaining the highest practicable level of physical, mental and psychosocial well-being of each resident. 3213.2 Each nursing employee shall provide restorative …

3214 IN-SERVICE EDUCATION FOR NURSING PERSONNEL 3214.1 A comprehensive on-going in-service education program shall be provided by the facility and shall include training on the provision of resident care. 3214.2 Each nursing employee shall be trained in emergency procedures, disa…

3215 VENTILATOR CARE SERVICES 3215.1 The facility may care for ventilator patients in a ventilator care area upon compliance with Title III of the Nursing Home and Community Residence Facility Residents' Protections Act of 1985, effective April 18, 1986, D.C. Law 6-108, D.C. Code…

3216 FREEDOM FROM RESTRAINTS 3216.1 Each resident has the right to be free from unnecessary physical and chemical restraints. 3216.2 Each facility shall have written policies which define its approach to the use of physical and chemical restraints. 3216.3 If the facility employs …

3217 INFECTION CONTROL 3217.1 The facility shall have an Infection Control Committee composed of the Administrator or designee and members of the medical, nursing, dietary, pharmacy, housekeeping, maintenance, and other services. 3217.2 The Chairperson of the Infection Control Co…

3218 DIETARY SUPERVISION 3218.1 Nursing employees shall ensure that each resident receives the diet prescribed and shall note any dietary problem in the resident's medical record. 3218.2 Each resident who needs assistance to eat shall receive it promptly upon the serving of his o…

3219 DIETARY SERVICES 3219.1 Food and drink shall be clean, wholesome, free from spoilage, safe for human consumption, and served in accordance with the requirements set forth in Title 23, Subtitle B, D.C. Municipal Regulations (DCMR), Chapters 24 through 40. 3219.2 Each facility…

3220 GENERAL DIETARY REQUIREMENTS 3220.1 Meals shall be adjusted to include fresh fruits and vegetables in season. 3220.2 The temperature for cold foods shall not exceed forty-five degrees (45 [degrees]) Fahrenheit, and for hot foods shall be above one hundred and forty degrees (…

3221 DIETARY MANAGEMENT AND RECORDS 3221.1 Each menu, as planned and served, shall be filed and retained for one year. 3221.2 Documentation of the food purchased shall be retained for ninety (90) days. 3221.3 A three (3) day supply of non-perishable staples shall be maintained on…

3222 IMMUNIZATIONS 3222.1 As described further in this Section, each facility shall ensure that each resident and each employee has either received immunization against influenza virus or has refused such vaccination, and that each resident and each employee indicated in subsecti…

3223 REHABILITATIVE SERVICES 3223.1 Each rehabilitative service aide shall be under the supervision of a licensed therapist. 3223.2 There shall be a regularly scheduled program of in-service education programs for the rehabilitative services staff. 3223.3 Rehabilitative services …

3224 SUPERVISION OF PHARMACEUTICAL SERVICES 3224.1 Each facility shall establish methods and written procedures for dispensing and administering drugs and biologicals. 3224.2 The pharmaceutical services shall be under the supervision of a licensed pharmacist for developing, coord…

3225 PHYSICIAN ORDERS FOR MEDICATIONS 3225.1 A medication may only be administered to a resident if it has been ordered in writing by a physician, except as provided by subsection 3225.2. 3225.2 Medication may be ordered by telephone if: (a) The order is given by a physician or l…

3226 ADMINISTRATION OF MEDICATION 3226.1 Unless administered under a self-administer order, all medication shall be prepared and administered only by a licensed physician or by a licensed nurse. 3226.2 Each dose of medication shall be properly and promptly recorded and initialed …

3227 LABELING AND STORAGE OF MEDICATION 3227.1 Medication shall be stored in accordance with this section. 3227.2 Each medication area, including each cabinet or cart shall be well lighted and large enough to permit storage without crowding and shall be clean and orderly. 3227.3 …

3228 PODIATRY SERVICES PROGRAM 3228.1 Each facility shall have a written agreement for obtaining regular podiatry services with a podiatrist licensed in the District of Columbia. 3228.2 Podiatry services shall include direct services to residents, as well as consultation and in-s…

3229 SOCIAL SERVICES 3229.1 The facility shall provide social services to attain and maintain the highest practicable physical, mental, and psychosocial well-being of each resident. 3229.2 A nursing facility with more than 120 beds shall employ a full-time social worker who is li…

3230 RESIDENT ACTIVITIES 3230.1 In facilities of sixty (60) or more licensed beds, the activities program shall be directed by a recreational therapist or activities staff certified or recognized by an accredited body. 3230.2 Each resident shall be encouraged, but not required, t…

3231 MEDICAL RECORDS 3231.1 The facility Administrator or designee shall be responsible for implementing and maintaining the medical records service. 3231.2 A designated employee of the facility shall be assigned the responsibility for ensuring that each medical record is maintai…

3232 INCIDENT REPORTING 3232.1 Each facility shall maintain and keep for three (3) years, from the date of the incident, summaries and analyses of unusual incidents within the facility or on the premises with regard to a resident, visitor or employee, including but not limited to…

3233 GRIEVANCES 3233.1 Each facility shall provide each resident, or Resident's Representative, an opportunity to file a grievance with the Administrator, either orally or in writing, concerning any aspect of the resident's care, treatment or living conditions at the facility. 32…

3234 ENVIRONMENTAL REQUIREMENTS 3234.1 Each facility shall be designed, constructed, located, equipped, and maintained to provide a functional, healthful, safe, comfortable, and supportive environment for each resident, employee and the visiting public. 3234.2 Each facility shall…

3235 ELECTRICAL SYSTEMS 3235.1 Each electrical system shall be designed, constructed, maintained, and inspected in accordance with the 1996 NFPA National Electrical Code, and all other applicable District rules and regulations. 3235.2 Each electrical cord, appliance, and equipmen…

3236 WATER SUPPLY AND DISTRIBUTION 3236.1 Each water supply and distribution system shall conform with the 1995 BOCA International Plumbing Code, District of Columbia Construction Code Supplement, Title 12 DCMR, and all other applicable District laws and regulations. 3236.2 There…

3237 SEWAGE AND SOLID WASTE DISPOSAL 3237.1 Each system for the disposal of water-carried sewerage shall be constructed, operated, and maintained in accordance with the 1995 BOCA International National Plumbing Code, District of Columbia Construction Code Supplement, Title 12 DCM…

3238 HEATING AND COOLING 3238.1 Each piece of heating and air conditioning equipment and its installation shall comply with the 1996 BOCA International Mechanical Code (Heating, Air Conditioning and Refrigeration), and all other applicable District laws and regulations. 3238.2 Ea…

3239 VENTILATION AND EXHAUST 3239.1 Each facility shall be well ventilated through the use of windows, forced air, or both. 3239.2 Both natural and mechanical ventilation and exhaust shall comply with the provisions of the 1996 BOCA International Mechanical Code (Heating, Air Con…

3240 ACOUSTICAL INSULATION AND NOISE REDUCTION 3240.1 No resident room or area shall have a general noise level from external sources in excess of forty-five (45) decibels. 3240.2 In addition to meeting the requirement of subsection 3240.1 every effort shall be made in the facili…