4238.1 In order to receive Medicaid reimbursement, assisted living services shall consist of personal care and supportive services that are furnished to beneficiaries who reside in a homelike, non-institutional setting that includes twenty-four (24) hour on-site response capability to meet any scheduled or unscheduled needs of the beneficiaries and to provide supervision, safety, and security.

4238.2 Assisted living services shall include all of the following services, as necessary to meet a beneficiary's needs, in accordance with his or her written PCSP:

(a) Twenty-four (24) hour supervision and oversight to ensure the well-being and safety of a beneficiary;

(b) Assistance with activities of daily living and instrumental activities of daily living, such as PCA services, to meet the scheduled and unscheduled service needs of a beneficiary;

(c) Laundry and housekeeping tasks that a beneficiary is unable to perform and that would otherwise be provided under the Chore Aide or Homemaker services benefit;

(d) Coordination of social and recreational activities;

(e) Coordination of activities to enable access to health and social services, including social work, nursing, rehabilitative, hospice, medical, dental, dietary, counseling, and psychiatric services;

(f) Coordination of scheduled transportation to community-based activities; and

(g) Medication administration services provided by an RN or Certified Medication Aide (MA-C), in accordance with District regulations.

4238.3 Consistent with Subsection 4238.2(e), the assisted living provider shall coordinate the delivery of all services provided by third parties, including but not limited to home care agencies, hospitals, clinics, and Adult Day Health providers.

SOURCE: Final Rulemaking published at 54 DCR 9165 (September 21, 2007); as amended by Final Rulemaking published at 64 DCR 6784 (July 21, 2017); as amended by Final Rulemaking published at 72 DCR 004996 (April 25, 2025).