Section 16-3603. HEALTH FACILITY AND COMMUNITY RESIDENCE FACILITY INFRACTIONS

 

3603.1Violation of any of the following provisions shall be a Class 1 infraction:

 

(a)22 DCMR § 3102.1 (operating a health care or community residence facility without a license);

 

(b)Section 201 of the D.C. Ambulatory Surgical Treatment Center Licensure Act, effective Apr. 6, 1978 (D.C. Law 2-66; 24 DCR 6836) (operating an ambulatory surgical treatment center without a license);

 

(c)22 DCMR § 2602.1 (operating a maternity center without a license).

 

3603.2Violation of any of the following provisions shall be a Class 2 infraction:

 

(a)22 DCMR § 3101.1 (failure to allow an authorized official to enter and inspect a health care or community residence facility);

 

(b)22 DCMR § 3101.3 (failure to give authorized official access to records necessary to determine compliance);

 

(c)22 DCMR § 3105.2 (failure to allow authorized official to enter and investigate complaints);

 

(d)22 DCMR § 3102.9 (transfer of a license to another person or place without government approval);

 

(e)22 DCMR § 3401.4 (failure of a community residence facility to ensure that a resident has an annual medical exam);

 

(f)22 DCMR § 3401.5 (failure of a large facility as specified to retain a physician to advise and handle emergencies);

 

(g)22 DCMR § 3402.1 (failure to provide sufficient staff);

 

(h)22 DCMR § 3404.3 (failure to ensure that medical care is secured for a resident in case of serious illness or accident);

 

(i)22 DCMR § 3404.4 (failure to secure medical care from backup physician if primary physician is unavailable);

 

(j)22 DCMR § 3405.1 (failure to notify sponsor or physician when resident's condition deteriorates to need ongoing nursing care);

 

(k)22 DCMR § 3405.2 (providing nursing care for longer than 72 hours or without appropriate physical environment or professional services);

 

(l)22 DCMR § 3405.3 (failure to notify when unable to obtain appropriate medical care for a resident);

 

(m)22 DCMR § 3405.6 (failure to notify physician and/or obtain assistance when a resident may do harm to self or others);

 

(n)22 DCMR § 3406.7 (failure to ensure that residents are not harassed or abused);

 

(o)22 DCMR § 3415.6 (failure to ensure that staff do not employ abuse);

 

(p)22 DCMR § 3427.3 (failure to ensure that water supply is automatically controlled not to exceed 110 degrees Fahrenheit);

 

(q)Section 303 of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (failure of an ambulatory surgical treatment center to comply with requirements concerning professional staffing);

 

(r)Section 305 of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (failure to comply with requirements concerning post-operative care);

 

(s)Section 401 of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (failure to comply with requirements concerning supplies, equipment, and medication);

 

(t)Section 501 of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (failure to allow government inspectors access to facility records);

 

(u)Section 502(a) of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (performing a surgical procedure requiring general anesthesia without the immediate medical direction of a licensed and qualified anesthesiologist);

 

(v)Section 502(b) of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (failure to report to the OCC a referral wherein a fee was charged);

 

(w)Section 502(c) of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (sharing a fee for a service or a referral with a physician, person, agency or clinic);

 

(x)22 DCMR § 2604.7 (failure of a maternity center to permit entry and inspection by government inspectors);

 

(y)2 DCMR § 2609.12 (failure to provide, maintain, and document maintenance of emergency, diagnostic, and sterilization equipment);

 

(z)22 DCMR § 2613.5 (failure to have a qualified OB/GYN as Director of Medical Affairs or failure of Director of Medical Affairs to carry out responsibilities);

 

(aa)22 DCMR § 2613.6 (failure to have a certified nurse-midwife as Director of Midwifery Services if such services are offered);

 

(bb)22 DCMR § 2614.5 (failure to have a patient in labor attended by a certified nurse-midwife or a physician with special training in obstetrics at all times from admission through immediate post-partum);

 

(cc)22 DCMR § 2614.6 (failure to have two attendants present at every birth, one of whom is a physician or CNM, and both of whom are certified in adult CPR and neonatal CPR);

 

(dd)22 DCMR § 2614.7 (failure to have qualified personnel on duty at all times when patients are admitted, including a licensed nurse-midwife and/or a board-certified physician either on the premises or on call);

 

(ee)22 DCMR § 2614.11 (failure to have a written practice agreement with an OB/GYN and a pediatrician or neonatologist for 24-hour consultation and referral or transfer to hospital if needed);

 

(ff)22 DCMR § 2614.12(b) (failure to have a written transfer agreement with a hospital for transfer of patients no longer "low risk");

 

(gg)22 DCMR § 2614.13 (failure to provide adequate emergency transportation services);

 

(hh)22 DCMR § 2615.3 (failure to have sufficient qualified personnel to perform the services offered);

 

(ii)22 DCMR § 2616.1 (admitting an individual for labor and delivery who is not "low risk" as specified);

 

(jj)22 DCMR § 2617.1 (failure to conduct an evaluation of a patient admitted while in labor);

 

(kk)22 DCMR § 2619 (failure to comply with requirements concerning discharge planning and postpartum care);

 

(ll)22 DCMR § 2620.2 (use of general or regional anesthesia, or use of systemic analgesia without a physician's or CNM's determination, or use of anesthesia for episiotomy not in accordance with facility practice guidelines); or

 

(mm)Section 301 of the Nursing and Community Residence Facility Residents' Protections Act of 1985, effective Apr. 18, 1986 (D.C. Law 6-108; D.C. Official Code § 44-1003.01) (discharge, transfer or relocation of a resident of a long-term care facility for reasons other than those specified).

 

3603.3Violation of any of the following provisions shall be a Class 3 infraction:

 

(a)22 DCMR § 3102.7 (failure of a health care or community residence facility to inform of a change in operation, program or services that might affect licensure);

 

(b)22 DCMR § 3102.8 (failure to return license upon suspension, revocation, non-renewal, forfeiture, or discontinuation of operation);

 

(c)22 DCMR § 3102.18 (failure to meet minimum requirements for insurance);

 

(d)22 DCMR § 3103.9 (failure to submit a plan of correction in relation to an initial licensure inspection);

 

(e)22 DCMR § 3104.5 (failure to submit a plan of correction in relation to a renewal licensure inspection);

 

(f)22 DCMR § 3105.4 (failure to submit a plan of correction in relation to a complaint investigation inspection);

 

(g)22 DCMR § 3400 (failure of a community residence facility to comply with requirements concerning the Residence Director);

 

(h)22 DCMR § 3401.3 (failure to obtain proof that a resident has a medical exam within 30 days before admission and annually thereafter);

 

(i)22 DCMR § 3402.3 (failure to ensure that each employee has a pre-employment medical exam and obtains an annual health certificate);

 

(j)22 DCMR § 3403 (failure to comply with requirements concerning admission policies);

 

(k)22 DCMR § 3404.1 (failure to obtain and maintain proof of a resident's annual medical exam);

 

(l)22 DCMR § 3404.5 (failure to notify a resident's sponsor and/or next of kin of a serious illness or accident);

 

(m)22 DCMR § 3404.7 (failure to promptly notify a resident's physician and sponsor and/or next of kin of the resident's death);

 

(n)22 DCMR § 3404.8 (failure to permit a physician to determine and pronounce a resident's death or failure to permit investigation of a resident's death);

 

(o)22 DCMR § 3405.4 (failure to comply with requirements concerning transfer and discharge);

 

(p)22 DCMR § 3405.5 (imposing a curfew or preventing a resident from leaving the facility);

 

(q)22 DCMR § 3406, except § 3406.7 (failure to comply with requirements concerning residents' rights);

 

(r)22 DCMR § 3407 (failure to comply with requirements concerning residents' personal property);

 

(s)22 DCMR § 3411 (failure to comply with requirements concerning residents' records);

 

(t)22 DCMR § 3412 (failure to comply with requirements concerning confidentiality of records);

 

(u)22 DCMR § 3415, except § 3415.6 (failure to comply with requirements concerning restraint, confinement, and behavior modification);

 

(v)22 DCMR § 3416 (failure to comply with requirements concerning medication storage and disposal);

 

(w)22 DCMR § 3417 (failure to comply with requirements concerning dietary services);

 

(x)22 DCMR § 3418 (failure to comply with requirements concerning therapeutic diets);

 

(y)22 DCMR § 3420 (failure to comply with requirements concerning rehabilitation);

 

(z)22 DCMR § 3421 (failure to comply with requirements concerning housekeeping, sanitation, maintenance, and laundry);

 

(aa)22 DCMR § 3422 (failure to comply with requirements concerning social services);

 

(bb)22 DCMR § 3423.1 (failure of a large facility as specified to employ a qualified resident activities specialist);

 

(cc)22 DCMR § 3424.1 (failure to locate within easy walking distance of public transportation);

 

(dd)22 DCMR § 3424.2 (failure to provide transportation); (ee) 22 DCMR § 3424.3 (failure to locate away from noise);

 

(ff)22 DCMR § 3424.4 (failure to locate away from noxious or hazardous vapors);

 

(gg)22 DCMR § 3425 (failure to comply with structural requirements or to notify when altering physical structure of facility);

 

(hh)22 DCMR § 3427, except 3427.3 (failure to comply with requirements concerning water supply);

 

(ii)22 DCMR § 3428 (failure to comply with requirements concerning heat, ventilation, and insulation);

 

(jj)22 DCMR § 3431 (failure to comply with requirements concerning bedrooms);

 

(kk)22 DCMR § 3432 (failure to comply with requirements concerning bathrooms);

 

(ll)22 DCMR § 3442 (failure to comply with requirements concerning insurance);

 

(mm)Section 203 of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (failure of an ambulatory surgical treatment center to comply with requirements concerning insurance coverage);

 

(nn)Section 301 of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (failure to comply with requirements concerning facility governance and procedures);

 

(oo)Section 302 of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (failure to comply with requirements concerning administrative operation and responsibility);

 

(pp)Section 304 of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (failure to comply with requirements concerning pre-operative care);

 

(qq)Section 306 of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (failure to comply with requirements concerning recordkeeping and reporting);

 

(rr)Section 402 of the D.C. Ambulatory Surgical Treatment Center Licensure Act (D.C. Law 2-66; 24 DCR 6836) (failure to comply with requirements concerning environmental conditions and maintenance);

 

(ss)22 DCMR § 2600.8 (failure of a maternity center to comply with requirements concerning newborn infant screening);

 

(tt)22 DCMR § 2602.3 (failure to specify on an application the care to be offered or other information requested);

 

(uu)22 DCMR § 2605.1 (relocation of center without government approval);

 

(vv)22 DCMR § 2608 (failure to comply with requirements concerning design, construction, and safety);

 

(ww)22 DCMR § 2609, except § 2609.12 (failure to comply with requirements concerning facilities and equipment);

 

(xx)22 DCMR § 2611.1 (installation or use of a nonconforming fixture, appurtenance, material, or method without governmental approval);

 

(yy)22 DCMR § 2612 (failure to comply with requirements concerning environmental services and infection control);

 

(zz)2 DCMR § 2613.1 (failure to identify who has authority and responsibility for overall policy and fiscal management);

 

(aaa)22 DCMR § 2613.2 (failure to develop an organizational plan or to appoint a qualified Director and Director of Medical Affairs);

 

(bbb)22 DCMR § 2614.1 (failure to develop, implement, or review Practice Guidelines for normal and emergency care);

 

(ccc)22 DCMR § 2614.2 (failure to develop, implement, or review Practice Guidelines for standards of services provided);

 

(ddd)22 DCMR § 2614.3 (failure to have Practice Guidelines adequately address the scope and conduct of maternity care provided);

 

(eee)22 DCMR § 2614.4 (failure to have Practice Guidelines for intrapartum care developed by the Director, Director of Medical Affairs, and Director of Midwifery Services, or failure to have these guidelines include all specified elements);

 

(fff)22 DCMR § 2614.8 (failure to develop and implement policies and procedures, including all specified elements);

 

(ggg)22 DCMR § 2614.9 (failure to develop and implement a quality assurance plan);

 

(hhh)22 DCMR § 2614.10 (failure to evaluate and revise the quality assurance plan or to document and make available facility actions relevant thereto);

 

(iii)22 DCMR § 2614.12(a) (failure to have written policies and procedures for emergencies);

 

(jjj)22 DCMR § 2615, except § 2615.3 (failure to comply with personnel health, training, and recordkeeping requirements);

 

(kkk)22 DCMR § 2616.2 (failure to inform a patient of risks and benefits or to obtain informed consent);

 

(lll)22 DCMR § 2616.3 (failure to include specified elements, including all District of Columbia requirements, on the patient consent form);

 

(mmm)22 DCMR § 2617, except § 2617.1 (failure to comply with requirements concerning patient records);

 

(nnn)22 DCMR § 2618 (failure to comply with requirements concerning antepartum care and recordkeeping);

 

(ooo)22 DCMR § 2620, except § 2620.2 (failure to comply with requirements concerning medication);

 

(ppp) 22 DCMR § 2621 (failure to comply with requirements concerning medical records and reporting); or

 

(qqq)Section 302 of the Nursing and Community Residence Facility Residents' Protections Act of 1985 (D.C. Official Code § 44-1003.02) (failure to provide a notice of transfer or discharge from a long-term care facility, and procedures for contesting same, to a resident and to his or her representative as required by law).

 

3603.4Violation of any of the following provisions shall be a Class 4 infraction:

 

(a)22 DCMR § 3102.2 (failure of a health care or community residence facility to submit an initial application timely);

 

(b)22 DCMR § 3102.4 (failure of a health care or community residence facility to submit a renewal application timely);

 

(c)22 DCMR § 3402.2 (failure of a community residence facility to develop and to make available its personnel policies);

 

(d)22 DCMR § 3402.4 (failure to maintain accurate personnel records);

 

(e)22 DCMR § 3402.5 (failure to maintain complete personnel records);

 

(f)22 DCMR § 3404.2 (failure to communicate periodically with a resident's sponsor, if any);

 

(g)22 DCMR § 3410 (failure to comply with requirements concerning administrative records);

 

(h)22 DCMR § 3413 (failure to develop a program statement);

 

(i)22 DCMR § 3423, except § 3423.1 (failure to comply with requirements concerning resident activities);

 

(j)22 DCMR § 3424.6 (using a misleading or improper name);

 

(k)22 DCMR § 3426 (failure to comply with lighting requirements);

 

(l)22 DCMR § 3430 (failure to comply with architectural and space requirements);

 

(m)22 DCMR § 2602.5 (failure of a maternity center to submit an initial application or a renewal application timely);

 

(n)22 DCMR § 2604.5 (failure to frame and post license conspicuously);

 

(o)22 DCMR § 2605.3 (failure to notify of change in ownership or name);

 

(p)22 DCMR § 2613.3 (failure to post names comprising governing entity and organizational chart in an area available to patients);

 

(q)22 DCMR § 2616.4 (failure to provide an orientation program including all specified elements);

 

(r)22 DCMR § 2616.5 (failure to develop policies for visits with families and other support persons);

 

(s)Section 302(d) of the Nursing and Community Residence Facility Residents' Protections Act of 1985 (D.C. Official Code § 44-1003.02(d)) (failure to provide timely, complete or correct notice of a transfer or discharge from a long-term care facility, and procedures for contesting same, to a resident and his or her representative);

 

(t)Section 304 of the Nursing and Community Residence Facility Residents' Protections Act of 1985 (D.C. Official Code § 44-1003.04) (failure to discuss a transfer, discharge, or relocation with the resident and his or her representative, or failure to offer counseling concerning the action); or

 

(a)Section 311 of the Nursing and Community Residence Facility Residents' Protections Act of 1985 (D.C. Official Code § 44-1003.11) (failure to provide each resident, his or her representative, and the Long-Term Care Ombudsman correct, timely notice when the facility is closing because of an adverse action by the Mayor or is voluntarily closing).

 

source

Final Rulemaking published at 52 DCR 4989 (May 27, 2005).