Title 44 — Charitable and Curative Institutions.

The purpose of this chapter is to set uniform, minimum standards of licensure for community residence facilities currently regulated under Chapter 34 of Title 22 of the District of Columbia Municipal Regulations and other facilities when they provide services that assist resident…

(a) The philosophy of assisted living emphasizes personal dignity, autonomy, independence, privacy, and freedom of choice. Further, the services and physical environment of an assisted living residence should enhance a person’s ability to age in place in a homelike setting by inc…

For purposes of this chapter, the term: (1) “Activities of Daily Living” or “ADLs” means activities including eating, bathing, toileting, grooming, dressing, undressing, mobility, and in place transfers. (2) “Aging in place” means minimizing the circumstances which require a pers…

It shall be unlawful to operate an assisted living residence in the District of Columbia without being licensed and in compliance with the provisions of this chapter.

(a) Applications for licensure shall be made in writing on a form or forms prescribed by the Mayor at least 60 days prior to the date needed. (b) An applicant for ALR licensure shall pay a licensure fee as determined by the Mayor. (c) An ALR license issued by the Mayor shall stat…

Expired.

(a) An ALR license shall be renewed every 12 months. (b) Applications for renewal of a license shall be made in writing on a form or forms prescribed by the Mayor at least 60 days prior to the expiration of the license. The Mayor shall renew a license after receiving an applicati…

(a) The following changes occurring within an ALR shall require revision of the license: (1) Change in the maximum number of residents for which the facility is licensed; (2) Name change of the ALR; (3) Change in ownership of the ALR; (4) Change in location of the ALR; or (5) Vol…

(a) In addition to the inspections required by § 44-103.02(e), the Mayor may inspect an ALR at the Mayor’s discretion to ensure compliance with this chapter. (b) The Mayor shall at all times ensure that any ALR licensed pursuant to this chapter is able to continually provide appr…

(a) An ALR licensed pursuant to this chapter shall not use in its title the words “hospital,” “sanitorium,” “nursing,” “convalescent,” “rehabilitive,” “subacute,” or “hospice.” (b) Only a licensed ALR may describe, market, and offer itself as such. No other entity, whether licens…

Appeals under this subchapter may be taken pursuant to subchapter XII of this chapter.

(a) The sanctions set forth in § 44-509. (b) On determining that a licensee has violated this chapter, the Mayor, in addition to the sanctions required by subsection (a) of this section, may: (1) Restrict the number of residents the licensee may admit; (2) Require the licensee to…

(a) The Mayor may impose one or more of the civil penalties authorized under § 44-509 against persons who: (1) Maintain or operate an unlicensed ALR; or (2) Otherwise violate provisions of this chapter. (b) Notwithstanding any other provision of law, penalties authorized under § …

The criminal penalties set forth in § 44-509 shall apply to an ALR.

(a) The Mayor may immediately suspend, as an emergency action, a license on finding that the licensee’s premises are unsafe for human habitation or pose an immediate threat to the health and safety of its residents. (b) The Mayor shall deliver a written notice to the licensee inf…

(a) An ALR must care for its residents in a manner and in an environment that promotes maintenance and enhancement of the residents’ quality of life and independence. (b) In order to promote resident independence and aging in place in a residential setting, at a minimum, an ALR s…

(a) A resident shall have the right to be treated at all times as follows: (1) Courteously; (2) Respectfully; (3) With full recognition of personal dignity and individuality; and (4) With assurance of privacy and the opportunity to act autonomously and share in the responsibility…

A resident shall have the right to the following: (1) A safe, clean, comfortable, stimulating, and homelike environment allowing the resident to use personal belongings to the greatest extent possible; (2) Control time, space, and lifestyle; (3) Free access to visitors of his or …

A resident shall have the right to the following: (1) To receive adequate and appropriate services and treatment with reasonable accommodation of individual needs and preferences consistent with their health and physical and mental capabilities and the health or safety of other r…

(a) A resident shall have the right to the following: (1) To designate a person as his or her surrogate or to have their guardian, or advance directives or surrogate health decision maker, act for them if for any reason the resident cannot act for him or herself; (2) To uncoerced…

(a) A resident shall have the right to the following: (1) To access their ALA and healthcare records on demand; (2) To have their records kept confidential and released only in accordance with their informed uncoerced consent in accordance with District and federal law; (3) To ha…

A resident shall have the right to full disclosure of contract terms and billing practices that are fair and reasonable.

An ALR shall place a copy of a document delineating the resident’s rights, as set forth in this chapter, in a conspicuous location, plainly visible and easily read by residents, staff, and visitors and provide a copy to each resident and resident’s surrogate upon admission and at…

(a) An ALR shall develop and implement policies and procedures prohibiting abuse, neglect, and exploitation of residents. (b)(1) An ALR, employee of an ALR, or other person who believes that a resident has been subjected to abuse, neglect, or exploitation shall report the alleged…

(a) An ALR shall accept as residents only individuals for whom the ALR can provide appropriate services unless the ALR arranges for third party services or the resident does so with the agreement of the ALR. (b) Prior to admission of a resident, the ALA or designee shall determin…

(a) A written contract must be provided to the resident prior to admission and signed by the resident or surrogate, if necessary, and a representative of the ALR. The nonfinancial portions of the contract shall include the following: (1) The ALR’s organizational affiliations (inc…

(a) The written resident agreement required by § 44-106.02 shall include financial provisions which indicate the following: (1) The obligations of the ALR, the resident, or the resident’s surrogate as to performance of the following: (A) The handling of the finances of the reside…

(a)(1) An ISP shall be developed for each resident prior to admission. (2) An ISP shall be developed following the completion of the “post move-in” assessment. (3) The ISP shall be written by a healthcare practitioner using information from the assessment. (4) The ISP shall be de…

(a) Whenever disagreements arise as to lifestyle, personal behavior, safety, and service plans the ALR staff, resident or surrogate, and other relevant service providers shall attempt to develop a shared responsibility agreement. (b) A shared responsibility agreements represents …

A record shall be maintained for every resident and include the following: (1) The resident agreement required by this subchapter, including the “Resident’s Rights” statement and any additional agreements; (2) The functional assessment of ADLs; (3) A physician’s statement, includ…

(a) An ALR shall provide or ensure the provision of the following: (1) Twenty-four hour supervision and oversight to ensure the well-being and safety of its residents; (2) Three nutritious and attractive meals and additional snacks, modified to individual dietary needs as necessa…

(a) When a resident wishes to be discharged from an ALR, the resident or surrogate shall give 30 days written notice to the ALR. (b) When a sudden, unexpected, and life-threatening medical emergency arises necessitating the immediate transfer of the resident to an acute care faci…

(a) An ALR shall be supervised by an ALA who shall be responsible for all personnel and services within the ALR. (b) The ALA shall ensure that each resident has access to appropriate medical, rehabilitation, and psychosocial services as established in the ISP and that there is ap…

(a) All staff shall be properly trained and be able to demonstrate proficiency in the skills required to effectively meet the requirements of this chapter. Prior to the date of hire, an employee must meet or possess one of the following criteria: (1) Be certified as a nurse’s aid…

A resident assessment required by this subchapter shall form the basis for the development of the resident’s service plan, and shall be completed for all routine admissions to the ALR.

(a) A medical, rehabilitation, and psychosocial assessment of the resident shall be completed within 30 days prior to admission. (b) The ALR shall maintain resident information obtained from a standardized physician’s statement approved by the Mayor. The information shall include…

Within 30 days prior to admission, the facility shall collect, on a standardized form approved by the Mayor, the following information regarding each applicant: (1) Level of functioning in activities of daily living including bathing, dressing, grooming, eating, toileting, and mo…

For individuals who will stay in the ALR no longer than 30 days, only the following information is required for admission to the ALR: (1) An analysis of the individual’s current physical condition, medical status, and functional assessment as set out in this subchapter; and (2) A…

A resident admitted as an emergency placement, not to exceed 14 days, must comply with admission, physical examination, and assessment requirements of this chapter.

An ALA shall ensure that an initial assessment identifies whether a resident: (1) Is capable of self-administering his or her own medications; (2) Is capable of self-administering his or her own medication, but requires a reminder to take medications or requires physical assistan…

Within 30 days prior to admission, the ALR shall consult with the prospective resident’s healthcare practitioner regarding: (1) The prospective resident’s current medication profile, including a review of nonprescription drugs; (2) Possible adverse interactions; (3) Common expect…

The ALR shall arrange for an on-site review by a registered nurse every 45 days to: (1) Supervise the administration of medications by Trained Medication Employees; (2) Assess the resident’s response to medication; and (3) Assess the resident’s ability to continue to self-adminis…

(a) The ALA shall provide a secured space for medication storage with access to a sink and cold storage in the same area. Space for necessary medical supplies and equipment shall be provided. (b) The storage area shall be kept locked when not in use. (c) The storage area shall be…

(a) Licensed nurses, physicians, physician assistants, and TMEs may administer medications to residents or assist residents with taking their medications. (b)(1) Each resident shall be identified prior to drug administration. (2) Drugs prescribed for one resident shall not be adm…

(a) The Mayor shall develop medication management training courses which shall be approved by the Board of Nursing. The medication administration training program shall include instruction in the following areas: (1) Cuing, coaching, and monitoring residents who self-administer m…

(a) Each resident shall be identified prior to drug administration. (b) Drugs prescribed for one resident shall not be administered to another resident. (c) Staff shall report drug errors and adverse drug reactions immediately to the ALA or ALA designee who shall report, as appro…

(a) An ALR shall meet applicable zoning, building, housing, sewer, water, fire prevention codes, rules, and regulations of the District of Columbia. (b) An ALR shall maintain all structures, installed equipment, grounds, and individual living units in good repair and operable. (c…

An ALR shall comply with the Life Safety Code of the National Fire Protection Association, NFPA 101, 1997 edition as follows: (1) An ALR shall be in compliance with Chapter 22, New Residential Board and Care Occupancies, Life Safety Code of the National Fire Protection Associatio…

(a) An ALR shall ensure that the exterior of its facility, including walkways, yards, porches, chimney, gutters, downspouts, paintable surfaces, and accessory buildings are maintained structurally sound, sanitary, and in good repair. (b) An ALR that provides services to residents…

(a) An ALR shall ensure that the interior of its facility including walls, ceilings, doors, windows, equipment, and fixtures are maintained structurally sound, sanitary, and in good repair. (b) An ALR shall ensure that floors and stairways provide a clean, slip-resistant, and saf…