[Code of Federal Regulations]
[Title 38, Volume 1]
[Revised as of July 1, 2002]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR17.63]

[Page 607-609]
 
            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
 
                CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS
 
PART 17--MEDICAL--Table of Contents
 
Sec. 17.63  Approval of community residential care facilities.

    The approving official may approve a community residential care 
facility, based on the report of a VA inspection

[[Page 608]]

and on any findings of necessary interim monitoring of the facility, if 
that facility meets the following standards:
    (a) Health and safety standards. The facility must:
    (1) Meet all State and local regulations including construction, 
maintenance, and sanitation regulations;
    (2) Meet the requirements of chapters 1-7, 22-23, and 31 and 
Appendix A of the NFPA 101, National Fire Protection Association's Life 
Safety Code (1994 edition), and NFPA 101A, Guide on Alternative 
Approaches to Life Safety (1995 edition), which are incorporated by 
reference. The institution shall provide sufficient staff to assist 
patients in the event of fire or other emergency. Incorporation by 
reference of these materials was approved by the Director of the Federal 
Register, in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. These 
materials incorporated by reference are available for inspection at the 
Office of the Federal Register, Suite 700, 800 North Capitol Street, 
NW., Washington, DC, and the Department of Veterans Affairs, Office of 
Regulations Management (02D), Room 1154, 810 Vermont Avenue, NW., 
Washington, DC 20420. Copies may be obtained from the National Fire 
Protection Association, Battery March Park, Quincy, MA 02269. (For 
ordering information, call toll-free 1-800-344-3555.) Any equivalencies 
or variances to Department of Veterans Affairs requirements must be 
approved by the appropriate Veterans Health Administration Veterans 
Integrated Service Networks (VISN) Director;
    (3) Have safe and functioning systems for heating, hot and cold 
water, electricity, plumbing, sewage, cooking, laundry, artificial and 
natural light, and ventilation.
    (b) Health services. The facility must agree to assist residents in 
obtaining the statement of needed care developed by VA.
    (c) Interior plan. The facility must:
    (1) Have comfortable dining areas, adequate in size for the number 
of residents;
    (2) Have confortable living room areas, adequate in size to 
accommodate a reasonable proportion of residents; and
    (3) Maintain at least one functional toilet and lavatory, and 
bathing or shower facility for every six people living in the facility, 
including provider and staff.
    (d) Laundry service. The facility must provide or arrange for 
laundry service.
    (e) Residents' bedrooms. Residents' bedrooms must:
    (1) Contain no more than four beds;
    (2) Measure, exclusive of closet space, at least 100 square feet for 
a single-resident room, or 80 square feet for each resident in a 
multiresident room; and
    (3) Contain a suitable bed for each resident and appropriate 
furniture and furnishings.
    (f) Nutrition. The facility must:
    (1) Provide a safe and sanitary food service that meets individual 
nutritional requirements and residents' preferences;
    (2) Plan menus to meet currently recommended dietary allowances;
    (g) Activities. The facility must plan and facilitate appropriate 
recreational and leisure activities to meet individual needs specified 
in the statement of heeded care.
    (h) Residents' rights. The facility must have written policies and 
procedures that ensure the following rights for each resident:
    (1) Each resident has the right to:
    (i) Be informed of the rights described in this section;
    (ii) The confidentiality and nondisclosure of information obtained 
by community residential care facility staff on the residents and the 
residents' records subject to the requirements of applicable law;
    (iii) Be able to inspect the residents' own records kept by the 
community residential care facility;
    (iv) Exercise rights as a citizen; and
    (v) Voice grievances and make recommendations concerning the 
policies and procedures of the facility.
    (2) Financial affairs. Residents must be allowed to manage their own 
personal financial affairs, except when the resident has been restricted 
in this right by law. If a resident requests assistance from the 
facility in managing personal financial affairs the request must be 
documented.
    (3) Privacy. Residents must:

[[Page 609]]

    (i) Be treated with respect, consideration, and dignity;
    (ii) Have access, in reasonable privacy, to a telephone within the 
facility;
    (iii) Be able to send and receive mail unopened and uncensored; and
    (iv) Have privacy of self and possessions.
    (4) Work. No resident will perform household duties, other than 
personal housekeeping tasks, unless the resident receives compensation 
for these duties or is told in advance they are voluntary and the 
patient agrees to do them.
    (5) Freedom of association. Residents have the right to:
    (i) Receive visitors and associate freely with persons and groups of 
their own choosing both within and outside the facility;
    (ii) Make contacts in the community and achieve the highest level of 
independence, autonomy, and interaction in the community of which the 
resident is capable;
    (iii) Leave and return freely to the facility, and
    (iv) Practice the religion of their own choosing or choose to 
abstain from religious practice.
    (6) Transfer. Residents have the right to transfer to another 
facility or to an independent living situation.
    (i) Records. (1) The facility must maintain records on each resident 
in a secure place.
    (2) Facility records must include:
    (i) A copy of the statement of needed care;
    (ii) Emergency notification procedures; and
    (iii) A copy of all signed agreements with the resident.
    (3) Records may only be disclosed with the resident's permission, or 
when required by law.

(Approved by the Office of Management and Budget under control number 
2900-0491)
    (j) Staff requirements. (1) Sufficient, qualified staff must be on 
duty and available to care for the resident and ensure the health and 
safety of each resident.
    (2) The community residential care provider and staff must have the 
following qualifications: Adequate education, training, or experience to 
maintain the facility.
    (k) Cost of community residential care. (1) Payment for the charges 
of community residential care is not the responsibility of the United 
States Government or VA.
    (2) The resident or an authorized personal representative and a 
representative of the community residential care facility must agree 
upon the charge and payment procedures for community residential care.
    (3) The charges for community residential care must be reasonable:
    (i) For residents in a community residential care facility as of 
June 14, 1989, the rates charged for care are pegged to the facility's 
basic rate for care as of July 31, 1987. Increases in the pegged rate 
during any calendar year cannot exceed the annual percentage increase in 
the National Consumer Price Index (CPI) for that year;
    (ii) For community residential care facilities approved after July 
31, 1987, the rates for care shall not exceed 110 percent of the average 
rate for approved facilities in that State as of March 31, 1987. 
Increases in this rate during any calendar year cannot exceed the annual 
percentage increase in the National Consumer Price Index (CPI) for that 
year.
    (iii) The approving official may approve a deviation from the 
requirements of paragraphs (k)(3)(i) through (ii) of this section upon 
request from a community residential care facility representative, a 
resident in the facility, or an applicant for residency, if the 
approving official determines that the cost of care for the resident 
will be greater than the average cost of care for other residents, or if 
the resident chooses to pay more for the care provided at a facility 
which exceeds VA standards.

(Authority: 38 U.S.C. 1730)

[54 FR 20842, May 15, 1989, as amended at 54 FR 22754, May 26, 1989. 
Redesignated at 61 FR 21965, May 13, 1996, as amended at 61 FR 63720, 
Dec. 2, 1996]