2600

2601

2601.1 A long-term care insurance policy delivered or issued for delivery in the District of Columbia shall not use any of the following terms unless the term is defined in the policy and is defined as set forth in section 2699:

1. (a) “Activities of daily living”;
2. (b) “Acute condition”;
3. (c) “Adult day care”;
4. (d) “Bathing”;
5. (e) “Cognitive impairment”;
6. (f) “Continence”;
7. (g) “Dressing”;
8. (h) “Eating”;
9. (i) “Hands-on assistance”;
10. (j) “Home health care services”;
11. (k) “Medicare”;
12. (l) “Personal care”;
13. (m) “Toileting”; and
14. (n) “Transferring”.

2601.2 A long-term care insurance policy delivered or issued for delivery in the District of Columbia shall not define the phrase “mental or nervous disorder,” or a phrase of similar import, to include more than neurosis, psychoneurosis, psychopathy, psychosis, or mental or emotional disease or disorder.

2601.3 When used in a long-term care insurance policy delivered or issued for delivery in the District of Columbia, the terms “skilled nursing care,”

“intermediate care,” “personal care,” “home care,” and other services shall be defined in relation to the level of skill required, the nature of the care, and the setting in which care must be delivered.

2601.4 All terms referring to providers of services, including “skilled nursing facility,” “extended care facility,” “intermediate care facility,” “convalescent nursing home,” “personal care facility,” and “home care agency,” shall be defined in a long-term care insurance policy delivered or issued for delivery in the District of Columbia in relation to the services and facilities required to be available and the licensure or degree status of those providing or supervising the services. The definition may require that the provider be appropriately licensed or certified.

SOURCE: Final Rulemaking published at 52 DCR 10902 (December 16, 2005); as amended by Final Rulemaking published at 55 DCR 3759 (April 11, 2008).