Washington, DC Home Care Policy and Procedure Manual
For agencies in Washington, DC licensed by DC Health as a home support agency, the District's license for agencies that give non-medical personal care only. The manual has 50 policies and 65 client and agency forms, with every client form in English and Spanish, written to 22-B DCMR Chapter 99, the home support agency rules, and the District's background check rules in Chapter 47. Each policy opens with a plain-English summary and names the rule section it follows, and every one is filled in with your agency's details. You get Word and PDF files to keep, and your staff sign off on their phones.
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Washington, DC · Home care
50 policies written to the Washington, DC rules, with 65 forms. Every one is filled in with your agency's details.
- A plain-English summary first
- The rule each policy follows
- Word and PDF downloads, yours to keep
- Policies
- 50
- Forms
- 65
- Categories
- 13
- Policy Pack · required
- $700one-timeIncludes 90 days in the portal with Premium. To keep it open after that, Premium is $79 a month or $790 a year.
Read before you buy
3 free sample policies, shown in full for a sample agency.
DC-HC-CMP-01Free sample
Client rights
Complaints
The Agency's complaint process under 22-B DCMR §9917: how clients and others may complain, orally or in writing and in confidence, the written summary given on acceptance or denial of services, the posted DC Health Complaint Hotline, the response within 14 days of receipt and the investigation and results, the written response within 30 days when the client is not satisfied (listing every District government agency that takes complaints), protection from reprisal, and the complaint log.
Read the full policy DC-HC-ANE-01Free sample SafeguardingRecognizing and Reporting Abuse, Neglect, Self-Neglect, and Exploitation of Adults
How every employee recognizes and reports suspected abuse, neglect, self-neglect and exploitation of an adult client: the District definitions in D.C. Code §7-1901, who must report immediately to Adult Protective Services under §7-1903 and the Agency's rule that every employee reports, what the report contains, protection for reporters, what the Agency does when an employee is accused, and the other reports to DC Health the same event may need.
Read the full policy DC-HC-IC-01Free sample Infection controlInfection Control and Universal Precautions
Sets out the infection control practices every staff member follows in every client's home: hand hygiene, gloves and other protective equipment, respiratory hygiene, cleaning, laundry, waste and food safety; extra precautions when a client has an infection; when staff must not work; outbreaks; client education; and how practice is checked.
Read the full policy
Washington, DC rules
What 22-B DCMR Chapter 99 asks your policies to cover
- Requests for services. Each person who asks for services is told within 48 hours after the referral or request whether the agency can serve them, and why not if it cannot. 22-B DCMR §9910.5
- Nurse oversight. A registered nurse supervises personal care on site at least once every 90 days and reviews each client's service plan at least every 90 days. 22-B DCMR §9918.2 and §9913.4
- Discharge notice. Written notice of a discharge or referral at least seven days before it happens. Oral notice is allowed only in the cases the rule lists, such as a medical or social emergency. 22-B DCMR §9912.2
- Complaints. A response within 14 days of receipt. If the client is not satisfied, a written response within 30 days that lists the District complaint agencies and the Complaint Hotline. 22-B DCMR §9917.5 and §9917.6
- Incidents. An incident involving a client in the presence of staff is reported to DC Health within 48 hours, and a complete investigation report follows within 30 days. 22-B DCMR §9917.7 and §9917.8
- Background checks. A criminal background check within the 45 days before employment starts, looking back 7 years, repeated every 4 years. 22-B DCMR §4701
Questions a surveyor may ask
Every policy lists questions a surveyor may ask about it, so your staff can practice the answers. A few from this manual:
How do you make sure a request that comes in on a Friday evening is answered within 48 hours?DC-HC-ADM-01Requests for Services, Response Within 48 Hours, and Denials
How long do you have to respond to a complaint? What happens if the client is not satisfied?DC-HC-CMP-01Complaints
Show me the 48-hour report and the 30-day investigation report for this incident.DC-HC-INC-01Incident Management and Reporting to DC Health
Show me the criminal background check for this aide. Was it done within the 45 days before the first day of employment?DC-HC-HR-02Criminal Background Checks and Registry Checks
Show me your public website. Where are your services, ownership, key personnel, phone number and email?DC-HC-GOV-04Operating Office, Public Website, and Agency Name
The full pack
Browse all 50 policies
Search by title, policy number or rule. Open any policy to see its summary, the rules it follows and what is inside.
All 50 policies
Client rights4
DC-HC-CMP-01Free sample
Complaints
The Agency's complaint process under 22-B DCMR §9917: how clients and others may complain, orally or in writing and in confidence, the written summary given on acceptance or denial of services, the posted DC Health Complaint Hotline, the response within 14 days of receipt and the investigation and results, the written response within 30 days when the client is not satisfied (listing every District government agency that takes complaints), protection from reprisal, and the complaint log.
22-B DCMR §9917.5
DC-HC-CR-01
Client Rights and Responsibilities
Sets out the rights every client of the Agency has under 22-B DCMR §9916.2, the client responsibilities in §9916.4, how and when the written statement of rights and responsibilities is given and explained, how staff protect each right in daily practice, how the statement is made public, and how a client who cannot read or needs another language receives it.
22-B DCMR §9916.2
DC-HC-CR-02
Client Representatives, Advance Directives, and MOST
Sets out who may act as a client representative and how the Agency records and works with one, how the Agency asks about, records and locates each client's advance directives (living will and durable power of attorney for health care), general power of attorney or guardianship papers and MOST form, what staff do and never do with these documents, and how they are used in an emergency.
22-B DCMR §9910.1(e)
DC-HC-CR-03
Admission Information, Communication Access, and Consent to Share Information
Sets out the written information every prospective client may ask for and every client receives on admission (the summary of admission policies, the rights statement, the complaint process, the service agreement and schedule of charges), how the Agency makes sure a client who cannot read or needs another language understands it, and how the client's written consent is obtained before information is shared with other providers.
22-B DCMR §9910.2
Service delivery13
DC-HC-ADM-01
Requests for Services, Response Within 48 Hours, and Denials
Sets out how the Agency receives every request or referral for services, at any hour, how it decides whether it can meet the person's needs, how it tells every person within 48 hours whether service is available and why, how a denial is given and recorded, the records kept for at least one year on every request not accepted, and where the Agency refers people whose needs it cannot meet.
22-B DCMR §9910.5
DC-HC-ADM-02
Initial RN Assessment and Admission
Sets out the initial assessment that a registered nurse carries out, with a home visit, before any personal care service starts: who does it, what information is reviewed, what the assessment covers, how the nurse decides whether the client needs services outside personal care and whether the Agency can provide services safely and consistently, and the steps from acceptance to the first aide visit.
22-B DCMR §9910.4
DC-HC-ADM-03
Client Service Agreement
Sets out the written service agreement every client must have before services start: each element 22-B DCMR §9911.1 requires (services, schedule, accompaniment and transportation, emergency medical response, conditions for discharge and appeal, missed visits, financial arrangements, the client representative, emergency contacts and the DC Health Complaint Hotline), who signs it and when, and how it is kept up to date.
22-B DCMR §9911.1
DC-HC-DC-01
Discharge, Transfer, and Referral
Sets out the Agency's criteria and procedures for discharging, transferring or referring a client: the reasons for which services may end, the written notice at least seven days before the action and the four situations in which oral notice may be given at any time (22-B DCMR §9912.2), what the notice says, how a client asks the Director to review a discharge decision, discharge planning and hand-over to another provider, discharges to protect staff, client-initiated discharges, and the discharge summary that closes the client record.
22-B DCMR §9912.2
DC-HC-SAF-01
Medical Emergencies and Death in the Home
Sets out how the Agency prepares for a medical emergency with each client, what staff do step by step when a client is very ill or injured, how MOST forms and advance directives are handed to emergency responders, what staff do when a client may have died, and how emergencies and deaths are reported and recorded.
22-B DCMR §9911.1(a)(3)
DC-HC-SCH-01
Scheduling, Missed Visits, and Backup Coverage
Sets out how the Agency builds and shares each client's schedule from the days and hours in the service agreement, how visits are recorded, what happens when an aide cannot work a visit, how a replacement aide is found and oriented, how and when the client is told that a visit cannot be kept (the procedure 22-B DCMR §9911.1(b) requires in every service agreement), what staff do when an aide is late or a client does not answer the door, how after-hours and backup coverage work, and how missed and late visits are logged and reviewed.
22-B DCMR §9911.1(b)
DC-HC-SP-01
Client Service Plan and 90-Day RN Review
Sets out how a registered nurse develops each client's written service plan on admission from the initial assessment and in agreement with the client, what the plan must contain under 22-B DCMR §9913.3 (including parameters for vital signs and measurements), how the client receives a copy and the assigned aides are oriented to it, how aides follow it, and how a registered nurse reviews and evaluates it at least every 90 days, and sooner whenever the client's needs change.
22-B DCMR §9913
DC-HC-SP-02
Coordination of Services and Communication with Other Providers
Sets out how the Agency coordinates the services it gives with its own staff and with the client's other providers: how the division of services is agreed and recorded when another provider also serves the client, how the client is told what the Agency will do to coordinate, how aides, nurses and office staff share information, how the Agency communicates with physicians and other health care professionals with the client's consent, when case conferences are held and minuted, what happens when a client goes into and comes home from a hospital, and how teaching given to the client and family caregivers is recorded.
22-B DCMR §9919
DC-HC-SP-03
Changes in Condition and Needs Beyond Personal Care Services
Sets out what aides watch for and report about a client's condition and how fast, how a registered nurse responds to each report, and the Agency's written criteria, procedure and time frames for referral, transfer or discharge when a client is found to need services beyond personal care services, as 22-B DCMR §9912.1 requires. It also covers what happens when a client declines a referral.
22-B DCMR §9912.1
DC-HC-SUP-01
RN Supervision of Home Health Aides and 90-Day On-Site Visits
Sets out how registered nurses supervise every home health aide, how and when the on-site supervisory visit required at least once every 90 days is scheduled and carried out, what the nurse checks and records, how findings are acted on, and what happens when a visit is refused or falls overdue.
22-B DCMR §9918.2
DC-HC-SUP-02
On-Call Coverage and After-Hours Response
Sets out who is on call outside business hours and how they are designated in writing, how after-hours calls are answered, what the on-call person does with each kind of call, how calls are logged and handed back to the office, and how the after-hours line is tested.
22-B DCMR §9907.8
DC-HC-SVC-01
Scope of Personal Care Services and Tasks Aides May Not Do
Sets out the personal care services the Agency may provide under its home support agency license, the rule that aides perform only the tasks written in the client's service plan, the tasks aides never perform because they are skilled services or fall outside the license, and what staff do when a client or family asks for something outside the plan.
22-B DCMR §9918.4
DC-HC-SVC-05
Homemaker, Companion, Meals, Shopping, and Accompaniment
Sets out how aides prepare meals and help clients eat, keep the client's living area clean and comfortable, shop for the client, provide companion services, and accompany or transport the client to appointments, work and recreation, including the written transportation and accompaniment agreement.
22-B DCMR §9918.4(h)
Clinical tasks3
DC-HC-SVC-02
Personal Care, Safe Transfers, and Falls Prevention
Sets out how aides give basic personal care, incontinence care, and help with transfers, walking and prescribed exercise with dignity and safety, how the registered nurse identifies fall risks and writes safety measures into the service plan, and what staff do when a client falls.
22-B DCMR §9918.4(a)
DC-HC-SVC-03
Assistance with Self-Administration of Medication
Sets out what aides may and may not do when helping a client take his or her own medication, how the registered nurse decides whether a client can self-administer, how the medication list and allergies are kept, how assistance is recorded, and what staff do about refusals, missed doses, errors and missing medication.
22-B DCMR §9918.4(d)
DC-HC-SVC-04
Vital Signs, Observation, and Reporting Changes in Condition
Sets out how aides take and record temperature, pulse, respiration, blood pressure, height and weight when the service plan sets the parameters, what aides watch for at every visit, how quickly they report what they see, and how the registered nurse follows up.
22-B DCMR §9918.4(e)
Safeguarding3
DC-HC-ANE-01Free sample
Recognizing and Reporting Abuse, Neglect, Self-Neglect, and Exploitation of Adults
How every employee recognizes and reports suspected abuse, neglect, self-neglect and exploitation of an adult client: the District definitions in D.C. Code §7-1901, who must report immediately to Adult Protective Services under §7-1903 and the Agency's rule that every employee reports, what the report contains, protection for reporters, what the Agency does when an employee is accused, and the other reports to DC Health the same event may need.
D.C. Code §7-1903
DC-HC-ANE-02
Reporting Suspected Child Abuse and Neglect
What staff do when they suspect that a child they know through their work, whether a client under 18 or a child in a client's home, is abused or neglected: who is a mandatory reporter under D.C. Code §4-1321.02, the immediate oral report to the Child and Family Services Agency or the Metropolitan Police Department under §4-1321.03, what the report contains, notice to the Director, immunity for good-faith reports, and the penalty for failing to report.
D.C. Code §4-1321.02
DC-HC-INC-01
Incident Management and Reporting to DC Health
How the Agency recognizes, responds to, reports and investigates incidents: immediate action at the scene, the internal report on Form DC-HC-INC-01-A, the report to DC Health within 48 hours of any incident involving a client in the presence of staff, the complete investigation report to DC Health within 30 days of the occurrence or of first awareness, the other reports the same event may need, the Agency's approach to the District's adverse event reporting system, and the incident log shared with complaints.
22-B DCMR §9917.7
Infection control2
DC-HC-IC-01Free sample
Infection Control and Universal Precautions
Sets out the infection control practices every staff member follows in every client's home: hand hygiene, gloves and other protective equipment, respiratory hygiene, cleaning, laundry, waste and food safety; extra precautions when a client has an infection; when staff must not work; outbreaks; client education; and how practice is checked.
22-B DCMR §9908.2(k)
DC-HC-IC-02
Bloodborne Pathogens Exposure Control Plan
The Agency's written exposure control plan under the federal bloodborne pathogens standard: which jobs and tasks involve occupational exposure, the controls and protective equipment used, hepatitis B vaccination, what to do after an exposure incident, training, recordkeeping, and the annual review of the plan.
29 CFR §1910.1030(c)(1)
Emergency preparedness1
Records2
DC-HC-REC-01
Client Records and Service Delivery Notes
Sets out what every client record must contain under 22-B DCMR §9914.2, how home health aides write service delivery notes, the Agency's documentation standards for late entries, corrections and electronic signatures, where records are kept and how fast they are produced for DC Health, and how clients see their own records.
22-B DCMR §9914
DC-HC-REC-02
Records Retention, Storage, and Disposal
The Agency's records system under 22-B DCMR §9915: written policies for the protection, confidentiality, retention, storage and maintenance of all Agency records, the retention schedule (client records five years after discharge, complaints and incidents five years, personnel records five years after separation, criminal records destroyed one year after employment ends), legal holds, secure destruction, and what happens to records if the Agency closes.
22-B DCMR §9915
Privacy2
DC-HC-PRV-01
Confidentiality and Privacy of Client Information
How the Agency keeps client information confidential, as 22-B DCMR §9916.2(i) requires: whether the HIPAA Privacy Rule applies to the Agency and how the Director decides, the confidentiality rules every employee follows in the office and in clients' homes, when information may be shared without an authorization, how a written authorization is obtained (Form DC-HC-PRV-01-A), and clients' rights to see their records and to complain.
22-B DCMR §9916.2(i)
DC-HC-PRV-02
Information Security and Data Breach Notification
The Agency's security safeguards for client and employee information under D.C. Code §28-3852.01, how staff report a lost device or misdirected message, how the Director assesses a security incident on Form DC-HC-PRV-02-A, and the notices District law requires after a breach: to affected District residents without unreasonable delay, to the Office of the Attorney General when 50 or more District residents are affected, to consumer reporting agencies when more than 1,000 persons are notified, and free identity theft protection when Social Security or taxpayer numbers are involved, plus the HIPAA breach notices if the Agency is a covered entity.
D.C. Code §28-3852
Human resources8
DC-HC-HR-01
Personnel Policies, Recruitment, and Hiring
Sets out the Agency's written personnel policies required by 22-B DCMR §9909.1, the terms of employment, who the Agency must employ and their minimum qualifications, fair recruitment under the DC Human Rights Act, and the step-by-step hiring procedure that must be finished before anyone is assigned to a client.
22-B DCMR §9909.1
DC-HC-HR-02
Criminal Background Checks and Registry Checks
Sets out who must have a criminal background check and registry checks, when they must be done, how fingerprinting and the sworn statement work, which convictions bar employment, repeat checks every four years, and how background records are kept confidential and destroyed.
22-B DCMR §4701
DC-HC-HR-03
Home Health Aide Certification and Verification of Licenses
Sets out the credentials each clinical position must hold, how the Agency verifies them before hire and keeps them current, how it handles trainees and the proposed change from home health aide to certified nurse aide credentials, and how aides practice within their certification.
22-B DCMR §9918.1
DC-HC-HR-04
Employee Health Screening and Fitness for Duty
Sets out the health screening every employee must have within the six months before hire, ongoing screening under CDC guidance, the hepatitis B vaccine offer and declination, when an employee may not work because of illness, alcohol or drugs, and how employee health information is kept confidential.
22-B DCMR §9909.6
DC-HC-HR-05
Personnel Records
Lists everything each personnel record must contain under 22-B DCMR §9909.2, how the record is organized so that confidential health and criminal information is kept apart, where records are kept and how fast they are produced for DC Health, each employee's right to review his or her record, and how long records are kept.
22-B DCMR §9909.2
DC-HC-HR-06
Orientation, In-Service Training, Competency, and Annual Performance Evaluation
Sets out the position description for each category of employee, what every new employee learns in orientation, how aides' competency is checked before and after they work alone, the in-service training the Agency provides each year, the annual performance evaluation, and the Agency identification every employee shows before entering a client's home.
22-B DCMR §9909.1(e)
DC-HC-HR-07
Discipline, Separation, Employee Grievances, and Reports to DC Health
Sets out the probationary period, promotions, progressive discipline and immediate removal from client care, the employee grievance procedure, what happens when employment ends (including final pay), and the two reports the Agency must send DC Health: a separation for criminal, unprofessional or unethical conduct within 10 days, and a matter affecting a nurse's or aide's fitness to practice within 5 business days.
22-B DCMR §9909.1(c)
DC-HC-SAF-02
Staff Safety in the Home
Sets out how the Agency identifies and reduces risks to staff working alone in clients' homes and in the community, the safe work practices staff follow, how staff respond to aggression, threats and harassment, when staff leave a home, how concerns and work injuries are reported and followed up, and when a client may be discharged to protect staff.
22-B DCMR §9912.2(c)
Governance6
DC-HC-GOV-01
Governing Body, Bylaws, and Adoption of Policies
Identifies the governing body of the Agency, sets out the duties DC Health's home support agency rules give it, lists every written policy those rules require and where it is found in this manual, and sets the procedure for adopting, issuing, reviewing and withdrawing policies.
22-B DCMR §9906
DC-HC-GOV-02
Director, Acting Director, and Client Service Coordinator
Sets out how the Director is designated, the Director's qualifications and duties, the written designation of an Acting Director, when a registered nurse Client Service Coordinator is required and what that nurse does, on-call coverage outside business hours, and the notices DC Health must receive when the Director changes.
22-B DCMR §9907
DC-HC-GOV-03
Licensure, Renewal, and Notifications to DC Health
Explains what the Agency's home support agency license allows, how the provisional and permanent license work, how the license is renewed on time, the fees, and every notice the Agency must send to DC Health, with its time frame.
22-B DCMR §9903
DC-HC-GOV-04
Operating Office, Public Website, and Agency Name
Sets out how the Agency's operating office in the District of Columbia is staffed, what is posted there, what records are kept there and how fast other records are produced for DC Health, what the required public website must show, the rule against using the word "health" in the Agency's name, and the steps and notices before the office moves.
22-B DCMR §9901
DC-HC-GOV-05
DC Health Inspections, Complaint Investigations, and Enforcement
Sets out how the Agency receives DC Health surveyors and complaint investigators, what it gives them and how fast, how it answers a written report of findings with a plan of correction on time, and what enforcement DC Health may take.
22-B DCMR §3105
DC-HC-GOV-06
Change of Ownership, Closure, and Dissolution
Sets out what the Agency must do before any sale, transfer or reorganization of ownership, and how it closes safely if it stops operating: notice and transition for each client, notices to DC Health, keeping client records retrievable for five years, and returning the license.
22-B DCMR §9903.8
Quality1
Business2
DC-HC-BUS-01
Charges, Billing, Payments, and Refunds
Sets out how the Agency tells clients what each service costs before they agree to it, the financial terms the service agreement must contain, how bills are prepared and paid, the rule that clients pay only the Agency and never an employee, how charges change, refunds and billing disputes, and how non-payment is handled.
22-B DCMR §9911.1(c)
DC-HC-BUS-02
Insurance Coverage
Sets out the minimum malpractice and general liability insurance DC Health requires of a home support agency, the other insurance the Agency carries as its own standard, the checks on staff who drive clients, and how the Agency keeps every policy in force and reports claims.
22-B DCMR §9905.1
Ethics3
DC-HC-ETH-01
Code of Conduct, Professional Boundaries, and Client Property
Sets the standards of conduct every employee follows in a client's home, the professional boundaries that protect clients and staff, the rules for handling a client's money and property on errands, gifts, honesty, and the duty to report concerns.
22-B DCMR §9916.2(h)
DC-HC-ETH-02
Compliance Program, Conflicts of Interest, and Fraud Prevention
Sets up the Agency's compliance program: who leads it, how staff raise concerns, accurate records and billing, conflicts of interest, exclusion screening, audits, and how problems are investigated, corrected and reported.
22-B DCMR §9900.3
DC-HC-ETH-03
Nondiscrimination, Accessibility, and Language Access
Commits the Agency to serve clients without discrimination under the DC Human Rights Act and the Americans with Disabilities Act, sets out how it communicates with clients who cannot read, speak another language or need another communication method, how it documents those steps, and how requests about staff assignment and complaints of discrimination are handled.
D.C. Code §2-1402.31
Questions
Questions about this manual
Is this the right manual for my license?
It is for agencies licensed by DC Health as a home support agency. An agency that directly provides skilled nursing and at least one other therapeutic service is a home care agency under D.C. Code §44-501(a)(7) and needs the Washington, DC home health manual. Medicare-certified hospices need the Washington, DC hospice manual.
Can a home support agency bill DC Medicaid for personal care?
DC Medicaid pays for personal care aide services only through a licensed home care agency enrolled as a Medicare home health agency (29 DCMR §5001.1). This manual is written for private-pay services.
Do our aides need District certification?
Yes. The agency must "employ qualified home health aides pursuant to 17 DCMR §§ 9300 et seq." (22-B DCMR §9918.1), and aide certification expires October 31 of each odd-numbered year. DC Health proposed on September 11, 2026 to move aides to a certified nurse aide credential. That rule was not final when this manual was last reviewed, so the policies follow the rules in force today.
What do the 50 policies cover?
Client rights (4), service delivery (13), clinical tasks (3), safeguarding (3), infection control (2), emergency preparedness (1), records (2), privacy (2), human resources (8), governance (6), quality (1), business (2) and ethics (3).
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