3825.1 A MHCRF shall admit and retain only those persons with a principal diagnosis of mental illness:

1. (a) For whom the MHCRF can safely and adequately provide care; and
2. (b) Who require the level of care and supervision available at the facility.

3825.2 Prior to a prospective resident's admission and in accordance with the Mental Health Information Act, each MHCRF shall obtain the following:

1. (a) A medical certification completed and signed by a licensed physician, nurse practitioner, or physician assistant within ninety (90) days prior to the prospective resident's admission to the MHCRF. The certification shall:
2. (1) Verify that the prospective resident has had a physical examination within the past year;
3. (2) Identify the prospective resident's known medical conditions including any significant changes in the prospective resident's health status since the last full physical examination; and
4. (3) Include a statement that the prospective resident is free of any communicable disease, including tuberculosis, or that any communicable disease the prospective resident has does not pose a health risk to other residents or staff and is not in an acute stage;
5. (b) The most recent diagnostic assessment for the prospective resident, completed not more than six (6) months prior to admission. Any significant changes since the most recent assessment, should be documented in a signed statement by a member of the treatment team;
6. (c) Current doctor's orders including all currently prescribed medications (medical and psychiatric), and a list of each known allergy;
7. (d) Special diet instructions, if applicable;
8. (e) Current IRP completed or updated within one hundred eighty (180) days prior to admission, or in accordance with an amended time frame set forth in a duly adopted Departmental policy published on the Department's website;
9. (f) For prospective residents within the Department's system of care, the

Department's approved functional assessment prepared in accordance with a tool approved by DBH that defines the level of the prospective resident's housing and personal care needs and is consistent with the level of care provided at the MHCRF, including whether the prospective resident is capable of taking his or her own medication or needs assistance with medication administration;

(g) A copy of the prospective resident's records and face sheet, as described in § 3846.2 including demographic information from the MHCRF, CRF, nursing home, or other institution where the prospective resident last resided;

(h) At least a seven (7) day supply of all currently prescribed medications;

(i) Identification of representative payee, legal guardian, or conservator, if applicable; and

(j) Income verification or statement of party responsible for payment.

3825.3 When a MHCRF accepts a resident on an emergency basis, the Director may extend the time within which the MHCRF must obtain documents required by § 3825.2, except that in all cases the resident shall be tested for tuberculosis and test results shall be obtained within seven (7) days of acceptance. Current medications shall be obtained within twenty-four (24) hours.

3825.4 The MHCRF shall obtain documents from the resident's Core Services Agency or other healthcare provider and shall immediately inform the Director if a resident's CSA is not cooperating in providing the MHCRF with documents required pursuant to § 3825.2.

3825.5 A MHCRF shall comply with the Americans with Disabilities Act and the Human Rights Act in the admission, placement, and retention of residents and in the provision of services to residents. No MHCRF shall deny admission based upon the person's age, gender, race, physical or mental disability, HIV status, religion, sexual orientation, gender identity or expression, national origin, marital status, or source of payment for the service.

3825.6 No MHCRF shall refuse to make reasonable accommodations in accordance with the Americans with Disabilities Act and the Human Rights Act necessary to admit or retain a resident who is deaf, blind, non-English speaking, non-ambulatory, or otherwise physically or mentally disabled.

3825.7 In addition to the requirements of § 3825.5, no MHCRF shall deny admission to an individual with a Department-approved level of care determination because the

person:

(a) Needs assistance with medication administration, including injections, by a licensed health care professional or Trained Medication Employee or Medication Aide certified by the D.C. Board of Nursing and those services are available to the MHCRF;

(b) Has active substance abuse issues in addition to serious mental illness or has a history of substance abuse or has participated in a substance abuse treatment program;

(c) Needs limited or intermittent nursing care; or

(d) Does not currently attend or wish to attend a day program outside of the MHCRF.

3825.8 Whenever an MHCRF denies admission to a potential resident, it shall provide written reasons for the denial on the form prescribed by the Department within three (3) days to the Director, the person's treatment team, and to the person denied admission. A copy of the written reason for the denial shall be included in the MHCRF's records. The Director may order the person's admission to the MHCRF if the admission is consistent with the Department-approved level of care, the MHCRF is licensed to provide the approved level of care, and the MHCRF has a vacant bed.

3825.9 An MHCRF that receives contract funding from the Department shall comply with any additional admission requirements contained in the contract.

3825.10 No MHCRF shall limit its admissions to persons served by a particular CSA or agency. Whenever a MHCRF that receives contract funding from the Department has vacancies, it shall immediately report the vacancies to the Director so that they may be listed on the Director's current vacancy listing.

SOURCE: Final Rulemaking published at 65 DCR 1633 (February 16, 2018).