10116.1 An ALR shall be supervised by an assisted living administrator (ALA) who shall be responsible for all personnel and services within the ALR, including, but not limited to, resident care and services, personnel, finances, adherence to the ALR's own policies and procedures, and the ALR's physical premises.

10116.2 A Licensee may designate a person to serve as ALA to supervise the ALR provided that the designee holds a current, valid license to practice assisted living administration issued by the District of Columbia's Board of Long-Term Care Administration. The Licensee shall submit the name of the person designated to be ALA to the Director on a form approved by the Director not more than ten (10) days after the designation is made or the designee has begun employment as the ALA, whichever occurs first.

10116.3 In addition to the staffing standards for ALAs set forth by § 701 of the Act (D.C. Official Code § 44-107.01), an ALA shall meet all requirements to practice assisted living administration prescribed by the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code § 3-1203.02(14) (2016 Repl.)), and all requirements to practice assisted living administration set forth by the Director by rulemaking.

10116.4 At all times one (1) or more residents are on the premises of an ALR, an ALA or Acting Administrator shall also be on the premises. At all times an ALA is not on the premises, an ALA shall:

(a) Ensure that an Acting Administrator is designated and assumes the responsibilities of the ALA required by the Act and this chapter, and that the Acting Administrator is a staff member who is at least eighteen (18) years of age, meets the staffing standards for an ALA required by § 701 of the Act (D.C. Official Code § 44-107.01), and is authorized to temporarily practice as an Acting Administrator without an ALA license by rulemaking promulgated by the Director to regulate the practice of assisted living administration; and

(b) Be available to the ALR staff by telephone, at a minimum, and shall respond to the ALR staff's attempts to contact him or her by telephone within 1 hour of the staff's initial attempt, except as provided for in § 10116.6.

10116.5 The Licensee or ALA may, during an ALA's leave of absence, designate a staff member who meets the requirements in paragraph (a) of § 10116.4 to serve as Acting Administrator for the ALR and perform the duties of the ALA for up to six (6) cumulative weeks in a twelve (12) month period. For purposes of this section, a "leave of absence" shall mean an ALA's scheduled or unscheduled absence from his or her supervision of the ALR for more than one (1) work day during which

the ALA would normally have been expected to oversee the ALR's day-to-day operations.

10116.6 An ALA shall not be subject to § 10116.4(b) during a leave of absence described in § 10116.5.

10116.7 An Acting Administrator who is designated pursuant to § 10116.5 shall be held responsible for all duties prescribed to an ALA under the Act and this chapter for the duration of the ALA's leave of absence, or until relieved from duty as the Acting Administrator.

10116.8 An Acting Administrator who is designated pursuant to § 10116.5 shall, at all times one (1) or more residents are on the ALR's premises and he or she is not, comply with paragraphs (a) and (b) of § 10116.4.

10116.9 An ALR shall not be administrated by any person other than a licensed ALA for more than six (6) cumulative weeks in a twelve (12) month period without prior, written approval by the Director. A request for written authorization under this subsection shall be submitted to the Director in writing, and shall contain all information deemed necessary by the Director to determine the qualifications of the individual or individuals who will be serving as an Acting Administrator beyond the sixth (6th) cumulative week of the ALA's leave of absence.

10116.10 An ALR shall not permit any person or persons, other than a licensed ALA, to administrate the ALR for more than a total of twelve (12) cumulative weeks in a twelve (12) month period.

10116.11 An ALR shall give to the Director prior written notice if an ALA's leave of absence will be for a period longer than three (3) consecutive weeks in duration. The notice shall include the name or names of the staff member or members designated to serve as Acting Administrator during the ALA's leave of absence, as well as the telephone number by which the Acting Administrators are to be contacted pursuant to § 10116.4(b).

10116.12 An ALR shall be responsible for maintaining accurate record of the ALA's leaves of absence from the ALR. Record of the ALA's leaves of absence shall be made available to the Director or the Director's designee upon request during an inspection of an ALR authorized by this chapter or the Act.

10116.13 An ALR shall cause no less than one (1) registered nurse to be available to the ALA and the ALR's staff members twenty-four (24) hours a day, seven (7) days a week. For the purpose of this subsection, "available" means the registered nurse is required to:

1. (a) Be accessible to the ALA and ALR staff members in-person or by real-time communication methods, such as telephone, text message, or video call; and
2. (b) Respond to the ALA or ALR staff members' attempts to contact him or her within 1 hour; and
3. (c) Be able to present him or herself, in person, to the ALR's premises to respond to a significant change in a resident's health status if the nurse determines, in his or her professional opinion, that the change in health status necessitates his or her presence.10116.14 The contact information for the available registered nurse shall be posted conspicuously for, and shall be easily accessible to, the ALR staff.10116.15 Personnel records maintained by the ALA for each employee pursuant to § 701(d)(11) of the Act (D.C. Official Code § 44-107.01(d)(11)) shall be accurate and current and shall contain documentation including, but not limited to, the following:- (a) A description of the employment, signed and dated by the employee, that includes the employee's duties and responsibilities, and the qualifications required for the position;
4. (b) Initial date of hire;
5. (c) Proof of license, registration, certificate, or other authority for the employee to practice his or her profession in the District, if applicable;
6. (d) A completed criminal background check, performed as required by the District laws and regulations applicable to each individual;
7. (e) Employee training required by the Act or this chapter, or the individual's exemption therefrom; and
8. (f) A healthcare practitioner's written statement as to whether the employee bears any communicable diseases, including communicable tuberculosis.10116.16 Employee records shall be made available for review by the Department of Health upon request during any inspection of an ALR that is authorized by the Act or this chapter.10116.17 All employees, including the ALA, shall be required on an annual basis to document freedom from tuberculosis in a communicable form. Documentation shall be provided by the employee's licensed healthcare practitioner.

10116.18 All employees shall wear identification badges on their persons, which shall not be obscured, but shall always remain visible while the employee is on the ALR premises. The identification badge shall prominently and conspicuously display the employee's full name and job title.

10116.19 The first name, last name, and job title of the ALA, or Acting Administrator, on duty shall be posted in a manner conspicuous to residents and visitors.

SOURCE: Final Rulemaking published at 54 DCR 5591 (June 8, 2007); as amended by Final Rulemaking published at 67 DCR 3717 (April 3, 2020).