RESIDENT ACCOMMODATIONS AND RELATED PROVISIONS

22VAC40-73-740. Personal possessions.

Each resident shall be permitted to keep reasonable personal property in his possession at a facility in order to maintain individuality and personal dignity.

A facility shall ensure that each resident has his own clothing.

The use of a common clothing pool is prohibited.

If necessary, resident’s clothing shall be inconspicuously marked with his name to avoid getting mixed with others.

Residents shall be allowed and encouraged to select their daily clothing and wear clothing to suit their activities and appropriate to weather conditions.

Each resident shall have his own personal care items.

Each facility shall develop and implement a written policy regarding procedures to be followed when a resident’s clothing or other personal possessions, such as jewelry, television, radio, or other durable property, are reported missing. Attempts shall be made to determine the reason for the loss and any reasonable actions shall be taken to recover the item and to prevent or discourage future losses. The results of the investigation shall be reported in writing to the resident. Documentation shall be maintained for at least two years regarding items that were reported missing and resulting actions that were taken.

22VAC40-73-750. Resident rooms.

The resident shall be encouraged to furnish or decorate his room as space and safety considerations permit and in accordance with this chapter.

Bedrooms shall contain the following items, except as provided for in subsection C of this section:

A separate bed with comfortable mattress, springs, and pillow for each resident. Provisions for a double bed for a married couple shall be optional;

A table or its equivalent accessible to each bed;

An operable bed lamp or bedside light accessible to each resident;

A sturdy chair for each resident;

Drawer space for clothing and other personal items. If more than one resident occupies a room, ample drawer space shall be assigned to each resident;

At least one mirror – if the resident has an individual adjoining bathroom, the mirror may be in the bathroom; and

Window coverings for privacy.

If a resident specifies in writing that he does not wish to have an item or items listed in subsection B of this section and understands that he may decide otherwise at any time, the resident’s bedroom is not required to contain those specified items. The written specification shall be maintained in the resident’s record.

Adequate and accessible closet or wardrobe space shall be provided for each resident. As of December 28, 2006, in all buildings approved for construction or change in use and occupancy classification, the closet or wardrobe space shall be in the resident’s bedroom.

The facility shall have sufficient bed and bath linens in good repair so that residents always have clean:

Sheets;

Pillowcases;

Blankets;

Bedspreads;

Towels;
Washcloths; and
Waterproof mattress covers when needed.

22VAC40-73-760. Living room or multipurpose room.

Sitting rooms or recreation areas or both shall be equipped with:

Comfortable chairs (e.g., overstuffed, straight-backed, and rockers);

Tables;

Lamps;

Television, if not available in other common areas of the facility;

Radio, if not available in other common areas of the facility; and

Current newspaper, if not available in other common areas of the facility.

Space other than sleeping areas shall be provided for residents for sitting, for visiting with one another or with guests, for social and recreational activities, and for dining. These areas may be used interchangeably.

22VAC40-73-770. Dining areas.

Dining areas shall have a sufficient number of sturdy dining tables and chairs to serve all residents, either all at one time or in reasonable shifts.

22VAC40-73-780. Laundry and linens.

Residents’ clothing shall be kept clean and in good repair.

Bed and bath linens shall be changed at least every seven days and more often if needed. In facilities with common bathing areas, bath linens shall be changed after each use.

When the facility provides laundry service for residents’ clothing or personal linens, the clean items shall be sorted by individual resident.

Table coverings and napkins shall be clean at all times.

Table and kitchen linens shall be laundered separately from other washable goods.

22VAC40-73-780. Laundry and linens.

When bed, bath, table, and kitchen linens are washed, the water shall be above 140°F or the dryer shall heat the linens above 140°F as verified by the manufacturer or a sanitizing agent shall be used according to the manufacturer’s instructions.

22VAC40-73-790. Transportation.

The resident shall be assisted in making arrangements for transportation as necessary.

22VAC40-73-800. Incoming and outgoing mail.

Incoming and outgoing mail shall not be censored.

Incoming mail shall be delivered promptly.

Mail shall not be opened by staff or volunteers except upon request of the resident and in his presence or written request of the legal representative.

22VAC40-73-810. Telephones.

Each building shall have at least one operable, nonpay telephone easily accessible to staff. There shall be additional telephones or extensions as may be needed to summon help in an emergency.

The resident shall have reasonable access to a nonpay telephone on the premises.

Privacy shall be provided for residents to use a telephone.

22VAC40-73-820. Smoking.

Smoking by residents, staff, volunteers, and visitors shall be done only in areas designated by the facility and approved by the State Fire Marshal or local fire official. Smoking shall not be allowed in a kitchen or food preparation areas. A facility may prohibit smoking on its premises.

All designated smoking areas shall be provided with suitable ashtrays.

Residents shall not be permitted to smoke in or on their beds.

All common areas shall have smoke-free areas designated for nonsmokers.

22VAC40-73-830. Resident councils.

The facility shall permit and encourage the formation of a resident council by residents and shall assist the residents in its establishment.

22VAC40-73-830. Resident councils.

The purposes of the resident council shall be to:

Work with the administration in improving the quality of life for all residents;

Discuss the services offered by the facility and make recommendations for resolution of identified problems or concerns; and

Perform other functions as determined by the council.

The resident council shall be composed of residents of the facility and the council may extend membership to family members, advocates, friends, and others. Residents shall be encouraged but shall not be compelled to attend meetings.

The facility shall assist residents in maintaining the resident council, including:

Scheduling regular meetings;

Providing space for meetings;

Posting notice for meetings;

Providing assistance in attending meetings for those residents who request it; and

Preparing written reports of meetings as requested by the council for dissemination to all residents.

The facility shall provide a written response to the council prior to the next meeting regarding any recommendations made by the council for resolution of problems or concerns.

In order to promote a free exchange of ideas, at least part of each meeting shall be allowed to be conducted without the presence of any facility personnel.

If there is no council, the facility shall annually remind residents that they may establish a resident council and that the facility would assist in its formation and maintenance. The general purpose of the council shall also be explained at this time.

22VAC40-73-840. Pets living in the assisted living facility.

Each assisted living facility shall develop and implement a written policy regarding pets living on the premises that will ensure the safety and well-being of all residents and staff.

If a facility allows pets to live on the premises, the following applies:

1. The policy specified in subsection A of this section shall include:

22VAC40-73-840. Pets living in the assisted living facility.

The types of pets that are permitted in the assisted living facility; and

The conditions under which pets may be in the assisted living facility.

Before being allowed to live on the premises, pets shall have had all recommended or required immunizations and shall be certified by a licensed veterinarian to be free of diseases transmittable to humans.

Pets living on the assisted living facility premises:

Shall have regular examinations and immunizations, appropriate for the species, by a licensed veterinarian; and

Shall be restricted from central food preparation areas.

Documentation of examinations and immunizations shall be maintained at the facility.

Pets shall be well-treated and cared for in compliance with state regulations and local ordinances.

Any resident’s rights, preferences, and medical needs shall not be compromised by the presence of a pet.

Any pet living on the premises shall have a suitable temperament, be healthy, and otherwise pose no significant health or safety risks to residents, staff, volunteers, or visitors.

22VAC40-73-850. Pets visiting the assisted living facility.

If an assisted living facility allows pets to visit the premises, the following shall apply:

The facility shall have a written policy regarding such pets;

Any pet present at the facility shall be in good health and show no evidence of carrying any disease;

Any resident’s rights, preferences, and medical needs shall not be compromised by the presence of a pet; and

Any pet shall be well-treated while visiting on the premises, have a suitable temperament, and otherwise pose no significant health or safety risks to residents, staff, volunteers, or visitors.

22VAC40-73-860. General requirements.

Buildings licensed for ambulatory residents or nonambulatory residents shall be classified by and meet the specifications for the proper use and occupancy classification as required by the Virginia Uniform Statewide Building Code (13VAC5-63).

Documentation completed and signed by the building official shall be obtained as evidence of compliance with the applicable edition of the Virginia Uniform Statewide Building Code.

Before construction begins or contracts are awarded for any new construction, remodeling, or alterations, plans shall be submitted to the department for review.

Doors and windows.

All doors shall open and close readily and effectively.

Any doorway that is used for ventilation shall be effectively screened.

Any operable window (i.e., a window that may be opened) shall be effectively screened.

There shall be enclosed walkways between residents’ rooms and dining and sitting areas that are adequately lighted, heated, and ventilated.

There shall be an ample supply of hot and cold water from an approved source available to the residents at all times.

Hot water at taps available to residents shall be maintained within a range of 105°F to 120°F.

Where there is an outdoor area accessible to residents, such as a porch or lawn, it shall be equipped with furniture in season.

Each facility shall store cleaning supplies and other hazardous materials in a locked area, except as noted in subsection J of this section.

A resident may be permitted to keep his own cleaning supplies or other hazardous materials in an out-of-sight place in his room if the resident does not have a serious cognitive impairment. The cleaning supplies or other hazardous materials shall be stored so that they are not accessible to other residents.

EXCEPTION: When a resident keeps his own cleaning supplies or other hazardous materials in his room and if the facility has no residents with serious cognitive

22VAC40-73-860. General requirements.

impairments, the facility may determine that the out-of-sight and inaccessibility safeguards specified in this subsection do not apply, unless mandated by the Virginia Uniform Statewide Building Code or Virginia Statewide Fire Prevention Code (13VAC5-51).

Each facility shall develop and implement a written policy regarding weapons on the premises of the facility that will ensure the safety and well-being of all residents and staff. Any facility permitting any type of firearm on the premises must include procedures to ensure that ammunitions and firearms are stored separately and in locked locations.

22VAC40-73-870. Maintenance of buildings and grounds.

The interior and exterior of all buildings shall be maintained in good repair and kept clean and free of rubbish.

All buildings shall be well-ventilated and free from foul, stale, and musty odors.

Adequate provisions for the collection and legal disposal of garbage, ashes, and waste material shall be made.

Buildings shall be kept free of infestations of insects and vermin. The grounds shall be kept free of their breeding places.

All furnishings, fixtures, and equipment, including furniture, window coverings, sinks, toilets, bathtubs, and showers, shall be kept clean and in good repair and condition, except that furnishings and equipment owned by a resident shall be, at a minimum, in safe condition and not soiled in a manner that presents a health hazard.

All inside and outside steps, stairways, and ramps shall have nonslip surfaces.

Grounds shall be properly maintained to include mowing of grass and removal of snow and ice.

Handrails shall be provided on all stairways, ramps, elevators, and at changes of floor level.

I. Elevators, where used, shall be kept in good running condition and shall be inspected at least annually. Elevators shall be inspected in accordance with the Virginia Uniform Statewide Building Code (13VAC5-63). The signed and dated certificate of inspection issued by the local authority shall be evidence of such inspection.

22VAC40-73-880. Heating, ventilation, and cooling.

At least one movable thermometer shall be available in each building for measuring temperatures in individual rooms that do not have a fixed thermostat that shows the temperature in the room.

Heat shall be supplied from a central heating plant or an electrical heating system in accordance with the Virginia Uniform Statewide Building Code (13VAC5-63).

Provided their installation or operation has been approved by the state or local building or fire authorities, space heaters, such as but not limited to, wood burning stoves, coal burning stoves, and oil heaters, or portable heating units either vented or unvented, may be used only to provide or supplement heat in the event of a power failure or similar emergency. These appliances shall be used in accordance with the manufacturer’s instructions.

A temperature of at least 72°F shall be maintained in all areas used by residents during hours when residents are normally awake. During night hours, when residents are asleep, a temperature of at least 68°F shall be maintained. This standard applies unless otherwise mandated by federal or state authorities.

EXCEPTION: The facility may allow the temperature in a bedroom in which only one resident resides, which has a thermostat in the room, to be controlled by the resident as long as the temperature does not endanger the health, safety, or welfare of the resident.

The facility shall provide in all buildings an air conditioning system for all areas used by residents, including residents’ bedrooms and common areas. Temperatures in all areas used by residents shall not exceed 80°F.

Any electric fans shall be screened and placed for the protection of the residents.

The facility shall develop and implement a plan to protect residents from heat-related and cold-related illnesses in the event of loss of air-conditioning or heat due to emergency situations or malfunctioning or broken equipment.

22VAC40-73-890. Lighting and lighting fixtures.

Artificial lighting shall be by electricity.

All interior and exterior areas shall be adequately lighted for the safety and comfort of residents and staff.

Glare shall be kept at a minimum in rooms used by residents. When necessary to reduce glare, coverings shall be used for windows and lights.

If used, fluorescent lights shall be replaced if they flicker or make noise.

22VAC40-73-900. Sleeping areas.

Resident sleeping quarters shall provide:

For not less than 450 cubic feet of air space per resident;

For square footage as provided in this subdivision:

As of February 1, 1996, all buildings approved for construction or change in use and occupancy classification, as referenced in the Virginia

Uniform Statewide Building Code (13VAC5-63), shall have not less than 100 square feet of floor area in bedrooms accommodating one resident; otherwise not less than 80 square feet of floor area in bedrooms accommodating one resident shall be required.

As of February 1, 1996, all buildings approved for construction or change in use and occupancy classification, as referenced in the Virginia Uniform Statewide Building Code, shall have not less than 80 square feet of floor area per person in bedrooms accommodating two or more residents; otherwise not less than 60 square feet of floor area per person in bedrooms accommodating two or more persons shall be required;

For ceilings at least 7-1/2 feet in height;

For window areas as provided in this subdivision:

There shall be at least eight square feet of glazed window area in a room housing one person; and

There shall be at least six square feet of glazed window area per person in rooms occupied by two or more persons;

For occupancy as provided in this subdivision:

22VAC40-73-900. Sleeping areas.

As of December 28, 2006, in all buildings approved for construction or change in use and occupancy classification, as referenced in the Virginia Uniform Statewide Building Code (13VAC5-63), there shall be no more than two residents residing in a bedroom.

As of February 1, 2018, when there is a new facility licensee, there shall be no more than two residents residing in a bedroom.

Unless the provisions of subdivisions 5 a and 5 b of this section apply, there shall be no more than four residents residing in a bedroom;

For at least three feet of space between sides and ends of beds that are placed in the same room;

That no bedroom shall be used as a corridor to any other room;

That all beds shall be placed only in bedrooms; and

That household members and staff shall not share bedrooms with residents.

22VAC40-73-910. Common rooms.

As of October 9, 2001, buildings approved for construction or change in use and occupancy classification, as referenced in the Virginia Uniform Statewide Building Code (13VAC5-63), shall have a glazed window area above ground level in at least one of the common rooms (e.g., living room, multipurpose room, or dining room). The square footage of the glazed window area shall be at least 8.0% of the square footage of the floor area of the common room.

22VAC40-73-920. Toilet, face/hand washing, and bathing facilities.

In determining the number of toilets, face/hand washing sinks, bathtubs, or showers required, the total number of persons residing on the premises shall be considered. Unless there are separate facilities for household members or staff, they shall be counted in determining the required number of fixtures, except that for bathtubs or showers, the staff count shall include only live-in staff.

As of December 28, 2006, in all buildings approved for construction or change in use and occupancy classification, as referenced in the Virginia Uniform Statewide Building Code (13VAC5-63), on each floor where there are residents’ bedrooms, there shall be:

At least one toilet for each four persons, or portion thereof;

At least one face/hand washing sink for each four persons, or portion thereof;

22VAC40-73-920. Toilet, face/hand washing, and bathing facilities.

At least one bathtub or shower for each seven persons, or portion thereof; and

Toilets, face/hand washing sinks and bathtubs or showers in separate rooms for men and women where more than four persons live on a floor. Bathrooms equipped to accommodate more than one person at a time shall be labeled by gender. Gender designation of bathrooms shall remain constant during the course of a day.

Unless the provisions of subdivision 1 of this subsection apply, on each floor where there are residents’ bedrooms, there shall be:

At least one toilet for each seven persons, or portion thereof;

At least one face/hand washing sink for each seven persons, or portion thereof;

At least one bathtub or shower for each 10 persons, or portion thereof; and

Toilets, face/hand washing sinks and bathtubs or showers in separate rooms for men and women where more than seven persons live on a floor. Bathrooms equipped to accommodate more than one person at a time shall be labeled by gender. Gender designation of bathrooms shall remain constant during the course of a day.

As of December 28, 2006, in all buildings approved for construction or change in use and occupancy classification, as referenced in the Virginia Uniform Statewide Building Code, when residents’ rooms are located on the same floor as the main living or dining area, in addition to the requirements of subdivision 1 of this subsection, there shall be at least one more toilet and face/hand washing sink, which is available for common use. The provisions of subdivision 4 c of this subsection shall also apply.

On floors used by residents where there are no residents’ bedrooms, there shall be:

At least one toilet;

At least one face/hand washing sink; and

Toilets and face/hand washing sinks in separate rooms for men and women in facilities where there are 10 or more residents. Bathrooms equipped to accommodate more than one person at a time shall be designated by gender. Gender designation of bathrooms must remain constant during the course of a day.

22VAC40-73-920. Toilet, face/hand washing, and bathing facilities.

Bathrooms shall provide for privacy for such activities as bathing, toileting, and dressing.

There shall be ventilation to the outside in order to eliminate foul odors.

The following sturdy safeguards shall be provided, with installation in compliance with the

Virginia Uniform Statewide Building Code:

Handrails by bathtubs;

Grab bars by toilets; and

Handrails inside and stools available to stall showers.

EXCEPTION: These safeguards shall be optional for residents with independent living status.

Bathtubs and showers shall have nonskid surfacing or strips.

The face/hand washing sink shall be in the same room as the toilet or in an adjacent private area that is not part of a common use area of the assisted living facility.

The assisted living facility shall provide private or common use toilet, face/hand washing, and bathing facilities to meet the needs of each resident.

22VAC40-73-925. Toilet, face/hand washing, and bathing supplies.

The facility shall have an adequate supply of toilet tissue and soap. Toilet tissue shall be accessible to each commode and soap shall be accessible to each face/hand washing sink and each bathtub or shower.

Common face/hand washing sinks shall have paper towels or an air dryer and liquid soap for hand washing.

Residents may not share bar soap.

The facility may not charge an additional amount for toilet paper, soap, paper towels, or use of an air dryer at common sinks and commodes.

22VAC40-73-930. Provisions for signaling and call systems.

All assisted living facilities shall have a signaling device that is easily accessible to the resident in his bedroom or in a connecting bathroom that alerts the direct care staff that the resident needs assistance.

22VAC40-73-930. Provisions for signaling and call systems.

In buildings licensed to care for 20 or more residents under one roof, there shall be a signaling device that terminates at a central location that is continuously staffed and permits staff to determine the origin of the signal or is audible and visible in a manner that permits staff to determine the origin of the signal.

In buildings licensed to care for 19 or fewer residents under one roof, if the signaling device does not permit staff to determine the origin of the signal as specified in subsection B of this section, direct care staff shall make rounds at least once each hour to monitor for emergencies or other unanticipated resident needs. These rounds shall begin when the majority of the residents have gone to bed each evening and shall terminate when the majority of the residents have arisen each morning, and shall be documented as follows:

A written log shall be maintained showing the date and time rounds were made and the signature of the direct care staff member who made rounds.

Logs for the past two years shall be retained.

EXCEPTION: Rounds may be made on a different frequency if requested by the resident and agreed to by the facility. Any agreement for a different frequency must be in writing, specify the frequency, be signed and dated by the resident and the facility, and be retained in the resident’s record. The written log required in subdivision 1 of the subsection shall indicate the name of such resident. If there is a change in the resident’s condition or care needs, the agreement shall be reviewed and if necessary, the frequency of rounds shall be adjusted. If an adjustment is made, the former agreement shall be replaced with a new agreement or with compliance with the frequency specified in this subsection.

For each resident with an inability to use the signaling device, in addition to any other services, the following shall be met:

This inability shall be included in the resident’s individualized service plan.

The plan shall specify a minimal frequency of daily rounds to be made by direct care staff to monitor for emergencies or other unanticipated resident needs.

Unless subsection C of this section is applicable, once the resident has gone to bed each evening until the resident has arisen each morning, at a minimum, direct care staff shall make rounds no less often than every two hours, except that rounds may be made on a different frequency if requested by the resident and agreed to by the facility. Any agreement for a different frequency must be in writing, specify the frequency, be signed and dated by the resident and the facility, and be retained in the resident’s record. If there is a change in the resident’s condition or care needs, the agreement shall be reviewed and if necessary, the frequency of rounds shall be adjusted. If an adjustment is made, the former agreement shall be replaced with a new agreement or with compliance with the frequency specified in this subdivision.

22VAC40-73-930. Provisions for signaling and call systems.

The facility shall document the rounds that were made, which shall include the name of the resident, the date and time of the rounds, and the staff member who made the rounds. The documentation shall be retained for two years.

22VAC40-73-940. Fire safety: compliance with state regulations and local fire ordinances.

An assisted living facility shall comply with the Virginia Statewide Fire Prevention Code (13VAC5-51) as determined by at least an annual inspection by the appropriate fire official. Reports of the inspections shall be retained at the facility for at least two years.

An assisted living facility shall comply with any local fire ordinance.