District of Columbia Administrative Code

3241 ELEVATORS 3241.1 Each elevator shall be designed, constructed, maintained, and inspected in accordance with the 1996 NFPA National Elevator Code, and all other applicable District laws and regulations. 3241.2 An electric or electrohydraulic elevator shall be installed in the…

3242 WALLS, CEILINGS, FLOORS, AND FINISHES 3242.1 Walls and floors shall be designed and maintained to minimize the incidence of accidents. 3242.2 Walls shall be made of materials that will permit frequent washing. 3242.3 The finish in areas exposed to water, high humidity, or gr…

3243 RAMPS, STAIRS, AND CORRIDORS 3243.1 Doorway, passageway, and stairwell designs shall meet the requirements of the 1996 BOCA National Building Code and applicable District laws and regulations, NFPA Standard No. 101, Section 10-1 and 10-2, and the Uniform Federal Accessibilit…

3244 OUTDOOR SPACE 3244.1 Each facility shall provide in its design and on its property some outdoor area for use by residents, staff, and the visiting public for quiet recreation. 3244.2 No set of steps shall be included in the design of the outdoor space, and the space shall be…

3245 NURSING UNIT DESIGN 3245.1 A nursing station space shall be provided on each unit for the supervision and care of each resident. 3245.2 No resident's bedroom shall be located more than one-hundred and twenty (120) feet from the nursing station. 3245.3 Adequate space and faci…

3246 RESIDENT BEDROOMS 3246.1 Each resident bedroom shall be designed and equipped for providing adequate nursing care, comfort, and privacy of residents. 3246.2 Each bedroom shall provide a personal, home-like atmosphere which includes the use of an eye-level mirror, and other p…

3247 RESIDENT TOILETS AND BATHROOM 3247.1 A toilet room shall be directly accessible from each resident's room and from each central bathing area without going through the general corridor. 3247.2 One (1) toilet room may serve two (2) resident rooms, but not more than four (4) be…

3248 REFRESHMENT STATIONS 3248.1 Each nursing unit shall have a refreshment station area for use by the staff for the storage and serving of between-meal snacks to residents. 3248.2 The refreshment station area shall contain a refrigerator for food stuffs only, a sink, and equipm…

3249 RESIDENT RECREATION AND SOCIAL AREAS 3249.1 Each nursing unit shall have, on the same floor as the unit, social recreation spaces in the amount of twenty (20) square feet per the average number of residents in the unit. 3249.2 Sound-insulated flexible partitions may be used …

3250 FOOD SERVICE AREAS 3250.1 Each food service area shall be planned, equipped, and operated in accordance with Title 23 DCMR, Chapters 22, 23 and 24, and with all other applicable District laws and regulations. 3250.2 Each facility shall have a kitchen area adequate to meet it…

3251 THERAPY SERVICE AREAS 3251.1 Each facility shall have therapy areas of sufficient size to accommodate and store all necessary equipment and supply items, and to facilitate the movement of the residents and staff. 3251.2 Appropriate equipment for each function performed in th…

3252 OTHER RESIDENT SERVICE AREAS 3252.1 Each facility shall provide a gift shop or resident store for a minimum of two (2) hours a day, five (5) days per week, or a gift shop cart must be accessible two (2) hours per day, five (5) days per week. 3252.2 Various services provided …

3253 PUBLIC AND STAFF FACILITIES 3253.1 Toilet and washroom facilities shall be provided for the public. 3253.2 Toilets and sinks shall be provided for the staff. 3253.3 In existing facilities, a locker shall be provided for each employee and provision shall be made for the use o…

3254 LAUNDRY AREAS 3254.1 An employee of the facility shall be responsible for ensuring that linens are in good condition. 3254.2 There shall be a separate area provided for the reception of all resident laundry, and it shall not be in any area where residents sleep, eat or other…

3255 HOUSEKEEPING AND MAINTENANCE 3255.1 Adequate provision shall be made for the storage of each housekeeping supply item and each piece of equipment in a janitorial closet that is separate from any toilet or utility room. 3255.2 Each janitorial closet shall be well-lighted and …

3256 HOUSEKEEPING AND MAINTENANCE SERVICES 3256.1 Each facility shall provide housekeeping and maintenance services necessary to maintain the exterior and the interior of the facility in a safe, sanitary, orderly, comfortable and attractive manner. 3256.2 Each housekeeping employ…

3257 PEST CONTROL 3257.1 The facility shall have a pest control program that includes integrated pest management (IPM) principles to minimize the use of pesticides and encourage the use of the least toxic and least flammable effective insecticides and rodenticides. 3257.2 Pest co…

3258 GENERAL SAFETY AND INSPECTION 3258.1 The facility shall have detailed written plans and procedures to meet all potential emergencies and disasters such as fire, severe weather, and missing residents. 3258.2 First aid supplies shall be readily available on each unit to each e…

3259 FIRE AND EMERGENCY PREPAREDNESS 3259.1 The facility shall have a manual of action to be taken in the event of a fire, approved by the D.C. Fire Department. 3259.2 The fire instructions manual shall specify the following: (a) The plan to be followed in case of fire, explosion…

3264 PHYSICAL STRUCTURE AND CONSTRUCTION 3264.1 Each physical plant of a facility shall conform to all applicable District and Federal rules and regulations pertaining to construction requirements. 3264.2 Each new construction of a facility, and each addition to or repair, and re…

3265 WHEELCHAIR ACCESS AND HANDICAPPED ACCESS 3265.1 Ramps shall be generally designed for wheelchair use, with the maximum gradient of one (1) to twelve (12), or eight and thirty-three one hundredths percent (8.33%). 3265.2 At least one (1) toilet room and stall that is large en…

3266 ENFORCEMENT 3266.1 Enforcement of the provisions of this chapter shall be in accordance with and pursuant to 22 DCMR Chapter 31. SOURCE: Notice of Final Rulemaking published at 49 DCR 473 (January 18, 2002).

3267 MRSA INFECTION PREVENTION 3267.1 Each nursing facility shall have written infection prevention and control policies and procedures. 3267.2 Each nursing facility shall identify MRSA colonized patients in an intensive care unit or other at-risk unit. 3267.3 Each patient coloni…

3268 TEMPORARY MANAGERS AND MONITORS 3268.1 If a facility is issued a restricted or provisional license, the Director may, if he or she determines it is appropriate, appoint a temporary manager or monitor in accordance with a mutually agreed upon timetable or until the facility i…

3269 RESIDENTS’ RIGHTS 3269.1 Each resident in a nursing facility shall have the right to the following: Freedom from discrimination in treatment or access to services based on reasons prohibited by the Human Rights Act of 1977, effective December 13, 1977 (D.C. Law 2-38; D.C. Of…

3270 DISCHARGE PLANNING 3270.1 A transfer or discharge of a resident from a nursing facility shall be done in accordance with the Nursing Home and Community Residence Facility Residents’ Protection Act of 1985, effective April 18, 1986 (D.C. Law 6-108; D.C. Official Code §§ 44-10…

3271 PROVISION OF ON-SITE SERVICES 3271.1 For the purpose of reducing the need to transport residents off-site for routine health services, each facility shall provide needed services on-site if the Department has determined that the provision of such on-site services is appropri…

3299 DEFINITIONS For purposes of this Chapter, the following terms shall have the meanings ascribed: Act - Health-Care and Community Residence Facility, Hospice and Home Care Licensure Act of 1983, effective February 24, 1984, D.C. Law 5-48, D.C. Official Code § 44-501 et seq. Ad…

3300 GENERAL PROVISIONS This chapter shall govern eligibility determinations for the District of Columbia (District) Health Care Alliance program (Alliance program) authorized under D.C. Official Code § 7-1401. Pursuant to D.C. Official Code § 7-1401, the Department of Health Car…

3301 APPLICATION, REDETERMINATION, AND RENEWAL An applicant shall apply for the Alliance program by submitting to the Department an application form designated by the Department, which may be found on its website at HYPERLINK "https://dhcf.dc.gov/service/how-apply-medical-coverag…

3302 RESIDENCY An individual shall be a resident of the District and document such residency as a condition of Alliance program eligibility. 3302.2 In verifying an applicant's residency, the Department shall require at least two (2) forms of proof that reasonably attests to Distr…

3303 VERIFICATION OF ADDITIONAL NON-FINANCIAL ELIGIBLITY FACTORS The Department shall verify non-financial eligibility factors necessary for an eligibility determination at the time of application, at each renewal of eligibility, and at each redetermination of eligibility. The De…

3304 FINANCIAL ELIGIBILITY REQUIREMENTS 3304.1 The Department shall determine an applicant’s financial eligibility by determining countable income pursuant to § 3300.5(d) following Modified Adjusted Gross Income (MAGI) methodologies (based on federal income tax rules) to determin…

3305 ENROLLMENT AND SERVICES 3305.1 Beneficiaries who are determined eligible for the Alliance program shall be automatically enrolled into a managed care plan, and shall be considered enrolled on the first day of the month in which an application is received by the Department pu…

3306 INMATES 3306.1 If an Alliance beneficiary becomes an inmate, the Department shall suspend capitation payments to the MCO in which the Alliance beneficiary is enrolled for the duration of the Alliance beneficiary’s incarceration. Alliance program participation and capitation …

3309 MORATORIUM ON NEW ENROLLMENT; EXIT OF INDIVIDUALS 3309.1 (a) Effective October 1, 2025, no individual aged twenty-six (26) or over shall be eligible for new enrollment into the Alliance program. (b) An enrollee who newly enrolled in the Alliance program between October 1, 20…

3399 DEFINITIONS For the purposes of this chapter, the following terms shall have the meanings ascribed: American Indian/Alaska Native – Any individual who is a member of any Indian tribe, band, nation, or other organized group or community, including any Alaska Native village or…

3400 RESIDENCE DIRECTORS 3400.1 A community residence facility shall have a Residence Director who may be the licensee of the community residence facility and who shall have the following qualifications: (a) He or she shall be at least twenty-one (21) years of age; (b) He or she …

3401 MEDICAL COVERAGE 3401.1 Each resident shall provide for his or her own medical care, at his or her own expense, if able, or under Titles 17 and 19 of the Social Security Act, or at the expense of any other public or private plan or agency. 3401.2 Nothing in this section shal…

3402 PERSONNEL 3402.1 There shall be a sufficient number of qualified employees, staff, or other adults in each community residence facility to provide for the welfare, comfort, and safety of residents at all times of the day and night. 3402.2 In a community residence facility wi…

3403 ADMISSION POLICIES 3403.1 A prospective resident shall be admitted to and retained by a community residence facility only if the prospective resident, the sponsor (if any), and the Residence Director agree, and the resident’s personal physician certifies in writing, that the…

3404 RESIDENT STATUS POLICIES 3404.1 In addition to the pre-admission medical examination required by § 3403.8, each resident shall have an annual examination by a physician. The physician’s report and his or her recommendations shall be included in the resident’s permanent file.…

3405 TRANSFER AND DISCHARGE POLICIES 3405.1 The Residence Director shall promptly notify a resident’s sponsor, if any, or physician when a resident’s physical or mental condition deteriorates so that the resident needs continuing professional nursing services and should be transf…

3406 RESIDENTS’ RIGHTS 3406.1 A supportive and protective environment shall be provided to each resident to promote his or her comfort, self-esteem, and personal dignity, and to ensure that the resident’s property and civil rights are respected. 3406.2 A written copy of the right…