District of Columbia Assisted Living Information

District of Columbia defines assisted living homes as Community Residence Facilities and Assisted Living Residences. CRFs are defined as any facility that provides safe, sheltered living arrangements for one or more people 18 years old or more, who are ambulatory and able to perform day to day living activities with little assistance. This includes facilities that provide living arrangements for those needing supervision or assistance within a protective environment because of physical, mental, familial, or social circumstances. An ALR means an entity that combines housing, health, and personalized assistance for the support of anyone unrelated to the owner or operator of the entity. This does not include a group home for mentally retarded persons or a mental health community residence.

District of Columbia Assisted Living Facility Scope of Care

Both CRF’s and Assisted Living Residences in District of Columbia provide 24-hour care and supervision of their residents. Under certain conditions, ALR residents have the right to arrange directly with an outside agency for medical or personal care.

District of Columbia Assisted Living Admission Requirements

For CRF’s, residents cannot be admitted when in need of professional nursing care, unable to perform day to day living tasks with minimal assistance, not capable of proper judgment, and disoriented about people and places. For ALRs, residents cannot be admitted after being assessed as a danger to themselves or others, or exhibit behavior significantly and negatively impacting the lives of others; who are in need of more than intermittent skilled nursing; or require treatment of stage III or IV skin ulcers, ventilator services, or treatment for an infectious, and reportable disease or a disease or condition that requires more than contact isolation.

District of Columbia Assisted Living Care Plan Requirements

For CRFs, each resident’s personal physician must certify that the resident is free of communicable disease and must provide the facility with a written report, including information health information used to assist the CRF in providing adequate care, including any treatment orders, medications, nutritional needs, and a rehabilitation program. For ALRs, an Individualized Service Plan must be created prior to admission.

District of Columbia Assisted Living Medication Management Requirements

Residents may store medication within the facility, and facility staff may assist residents with the self-administration of medication.

District of Columbia Assisted Living Facility Requirements

The combined total of community space provided by the facility must be at least 25 square feet above the basement per resident. A maximum of four residents are allowed per unit. There must be one commode per every 30 residents.

District of Columbia Assisted Living Staffing Requirements

For CRFs, a residence director must be responsible for the daily management of the facility. There must be a sufficient number of staff to provide for the residents at all times of day and night. Facilities with more than 50 residents must employ a full-time activities specialist. Facilities with more than 20 residents must provide services provided by a social worker a minimum of eight hours a week; facilities with more than 80 residents must provide the services of a social worker at least 20 hours a week; and facilities with 100 or more residents must employ a full-time social worker. For ALRs, an Administrator must be responsible for personnel and services within the facility. The ALR must develop a staffing plan in accordance with the Assisted Living Residence Act to assure the safety and proper care of residents. The residence director of any CRF must be at least 21 years old, and if there are 30 or more residents in the facility the director must have a bachelor's degree or at least three years of experience related to the administration of the program or services of the facility. The Assisted Living Administrator for an ALR must be at least 21 years old and have at least a high school diploma or general equivalency diploma, or have served as an operator or administrator of a licensed CRF in the District of Columbia for at least one of the past three years. An Assisted Living Administrator is required to complete 12 hours of training on cognitive impairments each year. All staff must be trained and demonstrate proficiency in the skills required by the state. Staff members must complete 12 hours of in-service training each year.

District of Columbia Assisted Living Medicaid Policy

The Department of Health, Medical Assistance Administration, is currently reviewing and developing policy and reimbursement rates for a Medicaid waiver to cover the cost of services provided in ALRs.

Washington D.C. Health Regulation Administration