Care-facility inspections
How nursing homes and care facilities in District of Columbia are inspected, licensed, and held to account.
12 laws · 18 enforcement actions · 5 guides · 1 court decision
See the details
The laws 12
- D.C. Official Code §44-501, Definitions (Title 44, Chapter 5, Subchapter I, "Health-Care and Community Residence Facility, Hospice and Home Care Licensure Act of 1983"): defines "facility" and "agency" terms this Act licenses, including amb… code.dccouncil.gov
- D.C. Official Code §44-502, License requirements: makes it unlawful to operate a health-care facility or agency in DC, public or private, for profit or not, without being licensed by the Mayor, with narrow exceptions (federal-government-ope… code.dccouncil.gov
- D.C. Official Code §44-503, Authority of Mayor: directs the Mayor to align facility-licensing rules with the District's certificate-of-need rules/state health plan and to conduct an initial facility bed-capacity inventory; code.dccouncil.gov
- D.C. Official Code §44-506, Provisional and restricted licenses: lets the Mayor, as an alternative to denial/nonrenewal/suspension/revocation, issue a provisional license (facility taking agreed ameliorative action, max 90 days, renewable o… code.dccouncil.gov
- D.C. Official Code §44-509, Penalties; enforcement - the core enforcement statute for the Chapter 5 licensing Act: criminal fines/imprisonment for impeding an inspection (up to $1,000/day or 90 days); code.dccouncil.gov
- D.C. Official Code §44-101.01, Purpose (Title 44, Chapter 1, "Assisted Living Residence Regulatory Act of 2000"): states the chapter's purpose is to set uniform, minimum licensure standards for community residence facilities (previously reg… code.dccouncil.gov
- D.C. Official Code §44-104.01 to §44-104.04 (Ch.1, ALR Act): the ALR-specific sanctions ladder. code.dccouncil.gov
- D.C. Official Code §44-105.09, Abuse, neglect, and exploitation (Ch.1, ALR Act, Subchapter V Resident's Rights): requires every ALR to develop and implement anti-abuse/neglect/exploitation policies; code.dccouncil.gov
- D.C. Official Code §44-1001.01, Definitions (Title 44, Chapter 10, "Nursing Home and Community Residence Facility Residents' Protections"): defines "Facility" (a nursing home, ALR, or community residence facility operating in DC), "Administ… code.dccouncil.gov
- D.C. Official Code §44-1002.01 to §44-1002.02 (Ch.10, Subchapter II, Receivership): §44-1002.01 states a court-appointed receivership's purpose is to safeguard residents' health/safety/welfare and continuity of care when seriously endangere… code.dccouncil.gov
- D.C. Official Code §44-1004.03, Civil action for damages (Ch.10, Subchapter IV, Enforcement): lets a resident or resident's representative sue for actual and punitive damages arising from a violation of the chapter's transfer/discharge prot… code.dccouncil.gov
- D.C. Official Code §44-1051.01 et seq. (Title 44, Chapter 10A, "Nurse Staffing Agency Act of 2003"): licenses and regulates nurse staffing agencies that supply temporary nursing personnel to DC health-care facilities (including nursing home… code.dccouncil.gov
Know your rights 5
- HRLA's 'Advisory on Staffing Ratios in Nursing Homes' (Aug. 25, 2008): surveyor/provider guidance walking through how to calculate compliance with DC's minimum nursing-staffing-ratio law - a minimum daily average of 3.5 nursing hours per re… dchealth.dc.gov
- HRLA's own 'HCFD and ICFD Regulations Quick Reference Guide': the authoritative index compliance guide mapping every DC facility/agency type this index covers to its 22-B DCMR chapter number - Ch.20 Hospitals, Ch.26 Maternity Centers, Ch.31… dchealth.dc.gov
- HRLA's companion 'HCFD & ICFD Statutes Quick Reference Guide': maps each facility/agency type to its enabling D.C. dchealth.dc.gov
- DC Health's Intermediate Care Facilities Division (ICFD) overview: explains ICFD licenses and surveys eight facility/agency types (group homes for persons with intellectual/developmental/physical disabilities, home care agencies, home suppo… dchealth.dc.gov
- DC Health's 'Study of Long-Term Care Facilities and Long-Term Care Services' report (June 2023), produced under the Study of Long-Term Care Facilities and Long-Term Care Services Act of 2018: a comprehensive assessment of the availability o… dchealth.dc.gov
Enforcement actions 4
- DC Health/HRLA's own 'Enforcement Actions' page, dividing nursing-home/hospital enforcement into 'Federal Actions' (CMS Civil Monetary Penalties - out of scope here, federal) and 'District Actions' (Civil Infractions - Nursing Homes; dchealth.dc.gov
- DC Health/HRLA's 'Civil Infractions - Nursing Homes' list: a named-facility record of District (not federal) Notices of Infraction from 2003 onward, each row giving the NOI date, facility name, whether it arose from a Survey/Complaint/Incid… dchealth.dc.gov
- DC Health/HRLA's 'Nursing Homes Survey Reports' directory: names every currently licensed DC nursing facility under a 'Current' heading (e.g. dchealth.dc.gov
- HRLA's Assisted Living Facilities Business Directory: a named-facility licensing record for every DC-licensed ALR, giving facility name, street address, ward, administrator name/contact, and licensed bed number (e.g. Mass. Sr. dchealth.dc.gov
Orders & settlements 14
- 22-B DCMR §3100, General Provisions (DCMR Title 22-B, Chapter 31, "Licensing of Health Care and Community Residence Facilities" - the general licensing/enforcement rules implementing the Title 44 Ch.5 Act for every facility type except hosp… dcregs.dc.gov
- 22-B DCMR §3102, License Requirements (Ch.31): makes it unlawful to operate a health care facility without a license; sets initial-application (60 days pre-operation) and renewal (90 days pre-expiration) filing deadlines; dcregs.dc.gov
- 22-B DCMR §3105, Complaint Investigations (Ch.31): authorizes the Director to receive complaints and conduct unannounced investigations; sets a 10-day written-report deadline and a 10-day facility plan-of-correction deadline; dcregs.dc.gov
- 22-B DCMR §3107, Denial, Suspension, or Revocation of a Health Care Facility License (Ch.31): the chapter's core license-enforcement due-process rule - lists the notice-and-hearing rights (15 days to request a hearing) owed before a denial,… dcregs.dc.gov
- 22-B DCMR §3200, Purpose (DCMR Title 22-B, Chapter 32, "Nursing Facilities" - the DC nursing-home licensing standards chapter): requires every nursing facility to comply with the Act, these rules, and the federal 42 C.F.R. dcregs.dc.gov
- 22-B DCMR §3266, Enforcement (Ch.32, Nursing Facilities): the nursing-facility chapter's own enforcement rule, which incorporates by reference the general facility-enforcement rules of DCMR Chapter 31 ("Enforcement of the provisions of this… dcregs.dc.gov
- 22-B DCMR §10100, General Provisions (DCMR Title 22-B, Chapter 101, "Assisted Living Residences" - implementing the Title 44 Ch.1 ALR Act, last amended 2020): states these rules supplement the Act (D.C. dcregs.dc.gov
- 22-B DCMR §10102, Authority to Operate an Assisted Living Residence in the District of Columbia (Ch.101): requires a separate ALR license per location regardless of common ownership; requires the license be conspicuously posted; dcregs.dc.gov
- 22-B DCMR §10125, Reporting Complaints to the Director; Reporting Abuse, Neglect, Exploitation, and Unusual Incidents (Ch.101): requires an ALR to immediately phone-notify DC Health, DC Adult Protective Services, and the DC Long-Term Care O… dcregs.dc.gov
- 22-B DCMR §10126, Denial, Restriction, Suspension, or Revocation of a License (Ch.101, ALR): the ALR-specific license-enforcement rule, cross-referencing the Act's §401 sanctions (D.C. dcregs.dc.gov
- 22-B DCMR §10127, Sanctions (Ch.101, ALR): implements the Act's §401 sanctions ladder (D.C. Code §44-104.01) at the regulatory level, letting the Director impose those sanctions on finding a chapter violation, and to suspend/revoke a licens… dcregs.dc.gov
- 22-B DCMR §3900, General Provisions (DCMR Title 22-B, Chapter 39, "Home Care Agencies"): requires every home care agency serving DC patients to be licensed and to comply with both this chapter and 22-B DCMR Chapter 31's inspection/licensing… dcregs.dc.gov
- 22-B DCMR §3400, Residence Directors (DCMR Title 22-B, Chapter 34, "Community Residence Facilities"): requires every CRF to have a Residence Director (may be the licensee) who is at least 21, annually physician-certified as fit and free of… dcregs.dc.gov
- 22-B DCMR §3405, Transfer and Discharge Policies (Ch.34, CRF): requires prompt notice to a resident's sponsor/physician on deterioration requiring transfer to a higher level of care; dcregs.dc.gov
Court decisions 1
Official notices 3
- HRLA Provider Alert memorandum, 'Staffing Concerns at Home Care Agencies,' Nov. 29, 2023, from Ranada Cooper, Associate Director, Office of Health Facilities, to home care agency (HCA) and home health agency (HHA) providers: warns that some… dchealth.dc.gov
- HRLA Provider Alert, 'Jurisdictional Approval for Nurse Staffing Agencies,' notifying nurse staffing agencies (which supply contract nursing personnel to DC nursing homes, ALRs, and CRFs) of a jurisdictional-approval requirement under the N… dchealth.dc.gov
- DC Health/HRLA's 'Nursing Home Notices' landing page, collecting the division's standalone provider notices to licensed nursing facilities, including a 2008 nurse-staffing advisory (22 DCMR §3211.3), a non-resident-pharmacy registration not… dchealth.dc.gov