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Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.17 - Records

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Resident record.
The licensee shall keep a permanent record on
				every resident admitted to the residential care facility, and all entries in
				the permanent record shall be current, dated, and signed. (Ill) The record
				shall include:
a. Name and previous address
				of resident; (III)
b. Birth date,
				sex, and marital status of resident; (III)
c. Church affiliation, if designated;
				(III)
d. Primary care provider's
				name, telephone number, and address; (III)
e. Dentist's name, telephone number, and
				address; (III)
f. Name, address,
				and telephone number of next of kin or legal representative; (III)
g. Name, address, and telephone number of
				person to be notified in case of emergency; (III)
h. Pharmacy name, telephone number, and
				address; (III)
i. Mortuary name,
				telephone number, and address, if designated; (III)
j. Physical examination and medical history;
				(III)
k. Primary care provider's
				orders for the resident's level of care, medication, treatments, and diet. The
				orders shall be in writing and signed by the primary care provider quarterly;
				(III)
l. A notation of visits to
				primary care provider and other professional services; (III)
m. Documentation regarding services provided
				by other providers, including but not limited to home health agencies, hospice,
				day treatment and those providing medical, mental health and Medicaid waiver
				services; (III)
n. Documentation of
				any adverse change in the resident's condition; (II, III)
o. A notation describing the resident's
				condition on admission, transfer and discharge; (III)
p. A copy of instructions given to the
				resident, legal representative or facility in the event of discharge or
				transfer; (III)
q. In the event of
				a resident's death, notations of the date and time of the resident's death, the
				circumstances of the resident's death, the disposition of the resident's body,
				and the date and time the resident's family and primary care provider were
				notified of the resident's death; and (III)
r. A notation of disposition of personal
				property and medications upon the resident's transfer, discharge or death.
				(Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.18 - Resident Care and Personal Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1) A complete change of bed linen shall be
				provided at least once a week and more often if necessary. (Ill)
(2) Residents shall receive sufficient
				supervision to promote personal cleanliness. (II, III)
(3) Residents shall have clean clothing as
				needed. Clothing shall be appropriate to residents' activities and to the
				weather. (Ill)
(4) Residents shall
				be encouraged to bathe at least twice a week. (II, III)
(5) All nonambulatory residents shall be
				housed on the grade level floor unless the facility has a suitably sized
				elevator. (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.19 - Drugs

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Drug
				storage.
a. Residents who have been
				certified in writing by their primary care provider as capable of taking their
				own medications may retain these medications in their bedroom, but locked
				storage must be provided, with staff and the resident having access. Monitoring
				of the storage, administration and documentation by the resident shall be
				carried out by a person who meets the requirements of subrule 57.19(3) and is
				responsible for administering medications. (II, III)
b. Drug storage for residents who are unable
				to take their own medications and require supervision shall meet the following
				requirements:
(1) Locked storage for drugs,
				solutions, and prescriptions shall be provided. (Ill)
(2) A bathroom shall not be used for drug
				storage. (Ill)
(3) The drug storage
				shall be kept locked when not in use. (Ill)
(4) The drug storage key shall be secured and
				available only to those employees charged with the responsibility of
				administering medications. (II, III)
(5) Schedule II drugs, as defined by Iowa
				Code chapter 124, shall be kept in a locked box within the locked drug storage.
				(II, III)
(6) Medications requiring
				refrigeration shall be kept locked in a refrigerator and separated from food
				and other items. (II, III)
(7)
				Drugs for external use shall be stored separately from drugs for internal use.
				(II, III)
(8) All potent,
				poisonous, or caustic materials shall be stored separately from drugs, shall be
				plainly labeled and stored in a specific, well-illuminated cabinet, closet, or
				storeroom, and shall be made accessible only to authorized persons. (I,
				II)
(9) Inspection of drug storage
				shall be made by the administrator or designee and a registered pharmacist not
				less than once every three months. The inspection shall be verified by a report
				signed by the administrator and the pharmacist and filed with the
				administrator. The report shall include, but not be limited to, certification
				of the absence of the following: expired drugs, deteriorated drugs, improper
				labeling, drugs for which there is no current primary care provider's order,
				and drugs improperly stored. (Ill)
(10) Bulk supplies of prescription drugs for
				multiresident use shall not be kept in a residential care facility. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.20 - Dental Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The
				residential care facility personnel shall assist residents in obtaining annual
				and emergency dental services and shall arrange transportation for such
				services. (Ill)
(2) Dental services
				shall be performed only on the request of the resident, responsible party,
				legal representative, or primary care provider. The resident's primary care
				provider shall be advised of the resident's dental problems. (Ill)
(3) All dental reports or progress notes
				shall be included in the resident record as available. The facility shall make
				reasonable efforts to obtain the records following the provision of services.
				(Ill)
(4) Personal care staff shall
				assist the resident in carrying out the dentist's recommendations.
				(Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.21 - Dietary

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Dietary
				staffing.
a. A minimum of one person
				directly responsible for food preparation shall successfully complete a course
				meeting the requirements for a food protection program included in the Food
				Code adopted pursuant to Iowa Code chapter 137F. Another course may be
				substituted if the course's curriculum includes substantially similar
				competencies to a course that meets the requirements of the Food Code and the
				provider of the course files with the department a statement indicating that
				the course provides substantially similar instruction as it relates to
				sanitation and safe food handling. (Ill)
b. If the person is in the process of
				completing the food protection program in paragraph 57.21(1) "a, " the
				requirement relating to the completion of a state-approved food protection
				program shall be considered to have been met.
c. In addition to the requirement of
				paragraph 57.21(1) "a, " personnel who are responsible for food preparation or
				service, or both food preparation and service, shall have an orientation on
				sanitation and safe food handling prior to handling food and shall have annual
				in-service training on food protection. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.22 - Orientation and Service Plan

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Orientation.
Within 24
				hours of admission, each resident shall receive orientation to the facility.
				The orientation program shall be documented in the resident's file and shall
				include, but shall not be limited to, a review of the resident's rights, the
				daily schedule, house rules and the facility's evacuation plan. (II,
				III)
(2)
Initial service
				plan.
Within 48 hours of admission, the administrator or the
				administrator's designee shall develop an initial service plan to address any
				immediate health and safety needs. The plan shall be based on information
				gathered from the resident, family, referring party, primary care provider, and
				other significant persons. The plan shall be followed until the service plan
				required in subrule 57.22(3) is complete. (I, II, III)
(3)
Service plan.
Within 30
				days of admission, the administrator or the administrator's designee, in
				conjunction with the resident, the resident's responsible party, the
				interdisciplinary team, and any organization that works with or serves the
				resident, shall develop a written, individualized, and integrated service plan
				for the resident. The service plan shall be developed and implemented to
				address the resident's priorities and assessed needs, such as activities of
				daily living, rehabilitation, activity, and social, behavioral, emotional,
				physical and mental health. (I, II, III)
a.
				The service plan shall include measurable goals and objectives and the specific
				service(s) to be provided to achieve the goals. Each goal shall include the
				date of initiation and anticipated duration of service(s). Any restriction of
				rights shall be included in the service plan. (I, II, III)
b. The service plan shall include the
				documentation procedure for each goal and objective. (II, III)
c. The service plan should be modified to add
				or delete goals and objectives as the resident's needs change. Communications
				related to service plan changes or changes in the resident's condition shall
				occur within five working days of the change and shall be conveyed to all
				individuals inside and outside the residential care facility who work with the
				resident, as well as to the resident's responsible party. (I, II,
				III)
d. The service plan shall be
				reviewed at least quarterly by relevant staff, the resident and appropriate
				others, such as the resident's family, case manager and responsible party. The
				review shall include a written report which addresses a summary of the
				resident's progress toward goals and objectives and the need for continued
				services. (I, II, III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.23 - Resident Activities Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Activities program.
Each
				residential care facility shall provide an organized resident activities
				program for the group and for the individual resident which shall include
				suitable activities. The facility shall offer at least two organized evening
				group activities per week and two organized weekend group activities per month.
				(Ill)
a. The activities program shall be
				designed to meet the needs and interests of each resident and to assist
				residents in continuing normal activities within limitations set by the
				resident's primary care provider. This shall include helping residents continue
				in their individual interests or hobbies. (Ill)
b. The activities program shall include
				measureable goals for each resident. (Ill)
c. The activities program shall include both
				group and individual activities. (Ill)
d. Residents shall be encouraged, but not
				required, to participate in activities. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.24 - Residents Rights

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Each
				facility shall ensure that policies and procedures are written and implemented
				which include, at a minimum, the provisions of this rule and which govern all
				areas of service provided by the facility. These policies and procedures shall
				be available to staff, residents, residents' families or legal representatives
				and the public and shall be reviewed annually. (II, III)
(2) Policies and procedures shall include a
				method for submitting complaints and recommendations by residents or their
				responsible parties and for ensuring a response and disposition by the
				facility. (II, III) The written procedures shall:
a. Ensure the provision of assistance to
				residents as necessary to complete and submit complaints and recommendations;
				(II, III)
b. Ensure protection of
				the resident from any form of reprisal or intimidation; (II, III)
c. Include designation of an employee
				responsible for handling grievances and recommendations; (II, III)
d. Include a method of investigating and
				assessing the validity of a grievance or recommendation; (II, III)
				and
e. Include methods of recording
				grievances and actions taken. (II, III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.26 - Communications

Current through Register Vol. 47, No. 3, July 24, 2024
Each resident may communicate, associate, and meet privately
				  with persons of the resident's choice, unless to do so would infringe upon the
				  rights of other residents, and may send and receive personal mail unopened.
				  (II)
(1) Subject to reasonable
				scheduling restrictions, visiting policies and procedures shall permit
				residents to receive visits from anyone they wish. Visiting hours shall be
				posted. (II)
(2) Reasonable,
				regular visiting hours shall not be less than 12 hours per day and shall take
				into consideration the special circumstances of each visitor. A particular
				visitor(s) may be restricted by the facility for one of the following reasons:
a. The resident refuses to see the
				visitor(s). (II)
b. The resident's
				primary care provider documents specific reasons why such a visit would be
				harmful to the resident's health. (II)
c. The visitor's behavior is unreasonably
				disruptive to the functioning of the facility. This judgment must be made by
				the administrator, and the reasons shall be documented and kept on file.
				(II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.27 - Resident Activities

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Each
				resident may participate in activities of social, religious, and community
				groups at the resident's discretion unless contraindicated for reasons
				documented by the primary care provider or interdisciplinary team as
				appropriate in the resident's record. (II)
(2) Residents who wish to meet with or
				participate in activities of social, religious, or other community groups in or
				outside of the facility shall be informed, encouraged, and assisted to do so.
				(II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.28 - Resident Property

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
				Residents shall be permitted to keep reasonable amounts of personal clothing
				and possessions for their use while in the facility. The facility shall offer
				the resident the opportunity to have personal property itemized and documented
				on an inventory sheet upon the resident's admission. The inventory sheet shall
				be kept in a safe location which is convenient to the resident and shall be
				updated at least annually. At discharge, residents may sign off on a list of
				the personal property they are taking with them. (II, III)
(2) The facility shall provide for the
				safekeeping of personal effects, funds and other property of its residents. The
				facility may require that items of exceptional value or that would convey
				unreasonable responsibilities to the licensee be removed from the premises of
				the facility for safekeeping. (Ill)
(3) Funds or properties received by the
				facility, belonging or due a resident, expendable for the resident's account,
				shall be trust funds. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.29 - Financial Affairs-management

Current through Register Vol. 47, No. 3, July 24, 2024
Each resident who has not been assigned a guardian or
				  conservator by the court may manage the resident's own personal financial
				  affairs. To the extent the facility assists in management, under written
				  authorization by the resident, the management shall be carried out in
				  accordance with Iowa Code section
				  135C.24.
				  (II)
(1) The facility shall maintain a
				written account of all residents' funds received by or deposited with the
				facility. (II)
(2) An employee
				shall be designated in writing to be responsible for resident accounts.
				(II)
(3) The facility shall keep on
				deposit personal funds over which the resident has control in accordance with
				Iowa Code section
				135C.24.
				Should the resident request these funds, they shall be given to the resident on
				request with receipts maintained by the facility and a copy to the resident. In
				the case of a resident with impaired decision-making skills, the resident's
				legal representative shall designate a method of disbursing the resident's
				funds. (II)
(4) If the facility
				makes financial transactions on a resident's behalf, the facility must document
				that it has prepared and sent an itemized accounting of disbursements and
				current balances at least quarterly. A copy of this statement shall be
				maintained in the resident's financial or business record. (II)
(5) A resident's personal funds shall not be
				used without the written consent of the resident or the resident's legal
				representative. (I, II)
(6) A
				resident's personal funds shall be returned to the resident when the funds have
				been used without the written consent of the resident or the resident's legal
				representative. The department may report findings that resident funds have
				been used without written consent to the department's investigations division
				or the local law enforcement agency, as appropriate. (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.30 - Resident Work

Current through Register Vol. 47, No. 3, July 24, 2024
No resident may be required to perform services for the
				  facility, except as provided by Iowa Code section
				  347B.5.
				  (II)
(1) Residents may not be used to
				provide a source of labor for the facility against their will. Approval by the
				primary care provider is required for all work programs. (I, II)
(2) Residents who perform work for the
				facility must receive compensation unless the work is part of their approved
				training program. Persons on the resident census who perform work shall not be
				used to replace paid employees in fulfilling staffing requirements.
				(II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.31 - Family-shared Rooms

Current through Register Vol. 47, No. 3, July 24, 2024
Family members or spouses shall be permitted to share a room,
				  if available, if requested by both parties, unless the primary care provider of
				  one of the parties documents in the medical record specific reasons why such an
				  agreement would have an adverse effect on the health of the resident.
				  (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.32 - Resident Abuse Prohibited

Current through Register Vol. 47, No. 3, July 24, 2024
Each resident shall receive kind and considerate care at all
				  times and shall be free from mental, physical, sexual, and verbal abuse,
				  exploitation, neglect, and physical injury . (I, II)
(1) Mental abuse includes, but is not limited
				to, humiliation, harassment, and threats of punishment or deprivation. (I,
				II)
(2) Physical abuse includes,
				but is not limited to, corporal punishment and the use of restraints as
				punishment. (I, II)
(3) Drugs such
				as tranquilizers shall only be used in accordance with orders of the primary
				care provider . (I, II)
(4)
				Allegations of dependent adult abuse. Allegations of dependent adult abuse
				shall be reported and investigated pursuant to Iowa Code chapter 235E and
				481-Chapter 52 . (I, II, III)
(5)
				Staff shall receive training relating to the identification and reporting of
				dependent adult abuse as required by Iowa Code section
				235B.16.
				(I, II, III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.33 - Crisis Intervention

Current through Register Vol. 47, No. 3, July 24, 2024
If a facility utilizes physical restraints, the facility
				  shall have written policies that define the uses of physical restraints,
				  designate the administrator or designee as the person who may authorize their
				  use, establish a mechanism for monitoring and controlling their use, and
				  provide staff with proper training. (I, II, III)
(1) Temporary physical restraint of residents
				shall be used only under the following conditions: (I, II)
a. An emergency to prevent injury to the
				resident or to others; or (I, II)
b. For crisis intervention, but shall not be
				used for punishment, for the convenience of staff or as a substitution for
				supervision or programming; (I, II) and
c. No staff person shall use any restraint
				that obstructs the airway of the resident. (I, II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.34 - Safety

Current through Register Vol. 47, No. 3, July 24, 2024
The licensee of a residential care facility shall be
				  responsible for the provision and maintenance of a safe environment for
				  residents and personnel. (I, II, III)
(1)
Fire safety.
a. All residential care facilities shall meet
				the fire safety rules and regulations as promulgated by the state fire marshal.
				(I, II)
b. The size of the facility
				and needs of the residents shall be taken into consideration in evaluating
				safety precautions and practices.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.35 - Housekeeping

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Written
				procedures shall be established and implemented for daily and weekly cleaning
				schedules. (Ill)
(2) Each resident
				room shall be cleaned on a routine schedule. (Ill)
(3) All rooms, corridors, storage areas,
				linen closets, attics, and basements shall be kept in a clean, orderly
				condition, free of unserviceable furniture and equipment and accumulations of
				refuse. (II, III)
(4) A hallway or
				corridor shall not be used for storage of equipment. (II, III)
(5) All odors shall be kept under control by
				cleanliness and proper ventilation. (Ill)
(6) Clothing worn by personnel shall be clean
				and washable. (Ill)
(7)
				Housekeeping and maintenance personnel shall be provided with well-constructed
				and properly maintained equipment appropriate to the function for which it is
				to be used. (Ill)
(8) All
				furniture, bedding, linens, and equipment shall be cleaned periodically and
				before use by another resident. (II, III)
(9) Polishes used on floors shall provide a
				nonslip finish. (II, III)
(10)
				Throw or scatter rugs shall have nonskid backing. (II, III)
(11) Entrances, exits, steps, and outside
				walkways shall be kept free from ice, snow, and other hazards. (II,
				III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.36 - Maintenance

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Each facility
				shall establish a maintenance program to ensure the continued maintenance of
				the facility, to promote good housekeeping procedures, and to ensure sanitary
				practices throughout the facility. In facilities with more than 15 beds, the
				maintenance program shall be established in writing and available for review by
				the department. (II, III)
(2) The
				building, grounds, and other buildings shall be maintained in a clean, orderly
				condition and in good repair. (II, III)
(3) Window treatments and furniture shall be
				clean and in good repair. (II, III)
(4) Cracks in plaster, peeling wallpaper or
				paint, and tears or splits in floor coverings shall be promptly repaired or
				replaced in a professional manner. (II, III)
(5) The electrical systems, including
				appliances, cords, and switches, shall be maintained to guarantee safe
				functioning and comply with the National Electric Code. (II, III)
(6) All plumbing fixtures shall function
				properly and comply with the state plumbing code. (II, III)
(7) Yearly inspections of the heating and
				cooling systems shall be made to guarantee safe operation. (II, III)
(8) The building, grounds, and other
				buildings shall be kept free of breeding areas for flies, other insects, and
				rodents. (II, III)
(9) The facility
				shall be kept free of flies, other insects, and rodents. (II, III)
(10) Janitor's closet.
a. Facilities shall be provided with storage
				for cleaning equipment and supplies. (Ill)
b. Mops, scrub pails, and other cleaning
				equipment used in the resident areas shall not be stored or used in the dietary
				area. (Ill)
c. In facilities
				licensed for more than 15 beds, a janitor's closet shall be provided. It shall
				be equipped with water for filling scrub pails and a janitor's sink for
				emptying scrub pails. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.37 - Laundry

Current through Register Vol. 47, No. 3, July 24, 2024
(1) All soiled
				linens shall be collected and transported to the laundry room in closed,
				leakproof laundry bags or covered, impermeable containers. (Ill)
(2) Except for related activities, the
				laundry room shall not be used for other purposes. (Ill)
(3) Procedures shall be written for the
				proper handling of wet, soiled, and contaminated linens. (Ill)
(4) Residents' personal laundry shall be
				marked with an identification if comingled with other residents' personal
				laundry. (Ill)
(5) Bed linens,
				towels, and washcloths shall be clean and stain-free. (Ill)
(6) If laundry is done in the facility, the
				following shall be provided:
a. A clean, dry,
				well-lit area to accommodate a washer and dryer of adequate size to serve the
				needs of the facility. (Ill)
b. In
				facilities with more than 15 beds, the laundry room shall be divided into
				separate areas, one for sorting soiled linen and one for sorting and folding
				clean linen. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.38 - Garbage and Waste Disposal

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
				All garbage shall be gathered, stored, and disposed of in a manner that will
				not permit transmission of disease, create a nuisance, or provide a breeding or
				feeding place for vermin or insects. (Ill)
(2) All containers for refuse shall be
				watertight and rodent-proof and have tight-fitting covers. (Ill)
(3) All unlined containers shall be
				thoroughly cleaned each time the containers are emptied. (Ill)
(4) All waste shall be properly disposed of
				in compliance with local ordinances and state codes. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.39 - Supplies

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Linen
				supplies.
a. There shall be an
				adequate supply of linen so that each resident shall have at least three
				washcloths, hand towels, and bath towels per week. (Ill)
b. A complete change of bed linens shall be
				available in the linen storage area for each bed. (Ill)
c. Sufficient lightweight, clean, serviceable
				blankets shall be available. All blankets shall be laundered as often as
				necessary for cleanliness and freedom from odors. (Ill)
d. Each bed shall be provided with clean,
				washable bedspreads. There shall be a supply available when changes are
				necessary. (Ill)
e. Adequate
				storage shall be provided for linens, pillows, and bedding.
				(Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.40 - Buildings, Furnishings, and Equipment

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Buildings
-
general requirements.
a.
				All windows shall be supplied with window treatments that are kept clean and in
				good repair. (Ill)
b. Whenever
				glass sliding doors or transparent panels are used, they shall be marked
				conspicuously. (Ill)
c. The
				facility shall meet the equivalent requirements of the appropriate group
				occupancy of the state building code. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.41 - Family and Employee Accommodations

Current through Register Vol. 47, No. 3, July 24, 2024
(1) In facilities where the total occupancy
				of family, employees, and residents is more than five, separate bathing and
				toilet facilities shall be required for the family or employees distinct from
				such areas provided for the residents. (Ill)
(2) In all facilities, if the family or
				employees live within the facility, separate living quarters and recreation
				facilities shall be required for the family or employees distinct from such
				areas provided for the residents. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.43 - Another Business or Activity in a Facility

Current through Register Vol. 47, No. 3, July 24, 2024
A facility is allowed to have another business or activity in
				  a health care facility or in the same physical structure of the facility, if
				  the other business or activity is under the control of and is directly related
				  to and incidental to the operation of the health care facility, or the business
				  or activity is approved by the department and the state fire marshal. (I, II,
				  III)
(1) To obtain the approval of the
				department and the state fire marshal, the facility must submit to the
				department a written request for approval which identifies the service(s) to be
				offered by the business and addresses the factors outlined in paragraphs
				57.43(2)
"a"
through
"j. "
(I, II,
				III)
(2) The following factors will
				be considered by the department in determining whether a business or activity
				will interfere with the use of the facility by residents, interfere with
				services provided to residents, or be disturbing to residents:
a. Health and safety risks for
				residents;
b. Compatibility of the
				proposed business or activity with the facility program;
c. Noise created by the proposed business or
				activity;
d. Odors created by the
				proposed business or activity;
e.
				Use of entrances and exits for the business or activity in regard to safety and
				disturbance of residents and interference with delivery of services;
f. Use of the facility's corridors or rooms
				as thoroughfares to the business or activity in regard to safety and
				disturbance of residents and interference with delivery of services;
g. Proposed staffing for the business or
				activity;
h. Sharing of services
				and staff between the proposed business or activity and the facility;
i. Facility layout and design; and
j. Parking area utilized by the business or
				activity.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.45 - Resident Property

Current through Register Vol. 47, No. 3, July 24, 2024
Each resident may retain and use personal clothing and
				  possessions as space permits and provided such use is not otherwise prohibited
				  by these rules. (II)
(1) Residents
				shall be permitted to keep reasonable amounts of personal clothing and
				possessions for their use while in the facility. The personal property shall be
				kept in a safe location which is convenient to the resident. (II)
(2) Residents shall be advised, prior to or
				at the time of admission, of the kinds and amounts of clothing and possessions
				permitted for personal use, and whether the facility will accept responsibility
				for maintaining these items, e.g., cleaning and laundry. (II)
(3) Any personal clothing or possessions
				retained by the facility for the resident during the resident's stay shall be
				identified and recorded on admission and a record placed on the resident's
				chart. The facility shall be responsible for secure storage of the items, and
				they shall be returned to the resident promptly upon request or upon discharge
				from the facility. (II)
(4) A
				resident's personal property shall not be used without the written consent of
				the resident or the resident's guardian. (II)
(5) A resident's personal property shall be
				returned to the resident when it has been used without the written consent of
				the resident or the resident's guardian. The department may report findings
				that a resident's property has been used without written consent to the local
				law enforcement agency, as appropriate. (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.46 - Family Visits

Current through Register Vol. 47, No. 3, July 24, 2024
Each resident, if married, shall be ensured privacy for
				  visits by the resident's spouse; if both are residents in the facility, they
				  shall be permitted to share a room, if available. (II)
(1) The facility shall provide for needed
				privacy in visits between spouses. (II)
(2) Spouses who are residents in the same
				facility shall be permitted to share a room, if available, unless one of their
				attending physicians documents in the medical record those specific reasons why
				such an arrangement would have an adverse effect on the health of the resident.
				(II)
(3) Family members shall be
				permitted to share a room, if available, if requested by both parties, unless
				one of their attending physicians documents in the medical record those
				specific reasons why such an agreement would have an adverse effect on the
				health of the resident. (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.47 - Choice of Physician

Current through Register Vol. 47, No. 3, July 24, 2024
Each resident shall be permitted free choice of a physician
				  and a pharmacy, if accessible. The facility may require the pharmacy selected
				  to utilize a drug distribution system compatible with the system currently used
				  by the facility. (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.48 - Incompetent Residents

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Each
				facility shall provide that all rights and responsibilities of the resident
				devolve to the resident's responsible party when a resident is adjudicated
				incompetent in accordance with state law or, in the case of a resident who has
				not been adjudicated incompetent under the laws of the state, in accordance
				with
				42 CFR 483.10.
				This subrule is not intended to limit the authority of any individual acting
				pursuant to Iowa Code chapter 144A. (II)
(2) The fact that a resident has been
				adjudicated incompetent does not absolve the facility from advising the
				resident of these rights to the extent the resident is able to understand them.
				The facility shall also advise the responsible party, if any, and acquire a
				statement indicating an understanding of residents' rights. (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.49 - County Care Facilities

Current through Register Vol. 47, No. 3, July 24, 2024
In addition to Chapter 57 licensing rules, county care
				  facilities licensed as residential care facilities must also comply with
				  department of human services rules, 441-Chapter 37. Violations of any standard
				  established by the department of human services is a Class II violation
				  pursuant to
				  481-56.2
				  (135C).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.50 - Another Business or Activity in a Facility

Current through Register Vol. 47, No. 3, July 24, 2024
A facility is allowed to have another business or activity in
				  a health care facility or in the same physical structure of the facility, if
				  the other business or activity is under the control of and is directly related
				  to and incidental to the operation of the health care facility, or the business
				  or activity is approved by the department and the state fire marshal.
To obtain the approval of the department and the state fire
				  marshal, the facility must submit to the department a written request for
				  approval which identifies the service(s) to be offered by the business and
				  addresses the factors outlined in paragraphs
"a"
through
"j"
of this rule. (I, II, III)
(1) The following factors will be considered
				by the department in determining whether a business or activity will interfere
				with the use of the facility by residents, interfere with services provided to
				residents, or be disturbing to residents:
a.
				Health and safety risks for residents;
b. Compatibility of the proposed business or
				activity with the facility program;
c. Noise created by the proposed business or
				activity;
d. Odors created by the
				proposed business or activity;
e.
				Use of entrances and exits for the business or activity in regard to safety and
				disturbance of residents and interference with delivery of services;
f. Use of the facility's corridors or rooms
				as thoroughfares to the business or activity in regard to safety and
				disturbance of residents and interference with delivery of services;
g. Proposed staffing for the business or
				activity;
h. Sharing of services and
				staff between the proposed business or activity and the facility;
i. Facility layout and design; and
j. Parking area utilized by the business or
				activity.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 57 - Residential Care Facilities › Rule 481-57.51 - Respite Care Services

Current through Register Vol. 47, No. 3, July 24, 2024
Respite care services means an organized program of temporary
				  supportive care provided for 24 hours or more to a person in order to relieve
				  the usual caregiver of the person from providing continual care to the person.
				  A residential care facility which chooses to provide respite care services must
				  meet the following requirements related to respite services and must be
				  licensed as a residential care facility.
(1) A residential care facility which chooses
				to provide respite care services is not required to obtain a separate license
				or pay a license fee.
(2) Rule
				481-57.36 (135C),
				regarding involuntary discharge or transfer rights, does not apply to residents
				who are being cared for under a respite care contract.
(3) Pursuant to rule
				481-57.14
				(135C), the facility shall have a contract with each resident in the facility.
				When the resident is there for respite care services, the contract shall
				specify the time period during which the resident will be considered to be
				receiving respite care services. At the end of that period, the contract may be
				amended to extend that period of time. The contract shall specifically state
				the resident may be involuntarily discharged while being considered as a
				respite care resident. The contract shall meet other requirements under
				481-57.14
				(135C), except the requirements under subrule 57.14(7).
(4) Respite care services shall not be
				provided by a health care facility to persons requiring a level of care which
				is higher than the level of care the facility is licensed to provide.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.2 - Waivers

Current through Register Vol. 47, No. 3, July 24, 2024
Waivers from these rules may be granted by the director of
				  the department of inspections and appeals for good and sufficient reason when
				  the need for a waiver has been established; no danger to the health, safety, or
				  welfare of any resident results; alternate means are employed or compensating
				  circumstances exist and the waiver will apply only to an individual nursing
				  facility. Waivers will be reviewed at the discretion of the director of the
				  department of inspections and appeals.
(1) To request a waiver, the licensee must:
a. Apply for a waiver in writing on a form
				provided by the department;
b. Cite
				the rule or rules from which a waiver is desired;
c. State why compliance with the rule or
				rules cannot be accomplished;
d.
				Explain alternate arrangements or compensating circumstances which justify the
				waiver;
e. Demonstrate that the
				requested waiver will not endanger the health, safety, or welfare of any
				resident.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.3 - Application for Licensure

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Initial
				application and licensing. In order to obtain an initial nursing facility
				license, for a nursing facility which is currently licensed, the applicant
				must:
a. Meet all of the rules, regulations,
				and standards contained in 481-Chapters 58 and 61. Applicable exceptions found
				in rule 481-61.2(135C) shall apply based on the construction date of the
				facility.
b. Submit a letter of
				intent and a written resume of the resident care program and other services
				provided for departmental review and approval;
c. Make application at least 60 days prior to
				the change of ownership of the facility on forms provided by the
				department;
d. Submit a floor plan
				of each floor of the nursing facility, drawn on 8½- x- 11-inch paper
				showing room areas in proportion, room dimensions, room numbers for all rooms,
				including bathrooms, and designation of the use to which room will be put and
				window and door location;
e. Submit
				a photograph of the front and side elevation of the nursing facility;
f. Submit the statutory fee for a nursing
				facility license;
g. Meet the
				requirements of a nursing facility for which licensure application is
				made;
h. Comply with all other
				local statutes and ordinances in existence at the time of licensure;
i. Have a certificate signed by the state
				fire marshal or deputy state fire marshal as to compliance with fire safety
				rules and regulations.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.4 - General Requirements

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The license
				shall be displayed in a conspicuous place in the facility which is viewed by
				the public. (III)
(2) The license
				shall be valid only in the possession of the licensee to whom it is
				issued.
(3) The posted license
				shall accurately reflect the current status of the nursing facility.
				(III)
(4) Licenses expire one year
				after the date of issuance or as indicated on the license.
(5) A nursing facility shall not be licensed
				for more beds than have been approved by the health facilities council pursuant
				to Iowa Code chapter 135 or than the facility can accommodate pursuant to the
				minimum physical standards for nursing facilities as set forth in 481-Chapter
				61.
(6) The facility shall post in
				a place readily accessible to residents, visitors, and persons inquiring about
				placement in the facility the results of the most recent survey of the
				facility. The facility shall maintain any surveys, certifications, and
				complaint investigations made respecting the facility during the three
				preceding years, and any plan of correction in effect with respect to the
				facility, available for any individual to review upon request. (III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.5 - Notifications Required by the Department

Current through Register Vol. 47, No. 3, July 24, 2024
The department shall be notified:
(1) Within 48 hours of any reduction or loss
				of nursing or dietary staff lasting more than seven days which places the
				staffing requirements below those required for licensing. No additional
				residents shall be admitted until the minimum staffing requirements are
				achieved; (III)
(2) Thirty days
				before any proposed change in the nursing facility's functional operation or
				addition or deletion of required services; (III)
(3) Thirty days before addition, alteration,
				or new construction is begun in the nursing facility or on the premises;
				(III)
(4) Thirty days in advance of
				closure of the nursing facility; (III)
(5) Within two weeks of any change in
				administrator; (III)
(6) When any
				change in the category of license is sought; (III)
(7) Prior to the purchase, transfer,
				assignment, or lease of a nursing facility, the licensee shall:
a.  Inform the department of the pending
				sale, transfer, assignment, or lease of the facility; (III)
b. Inform the department of the name and
				address of the prospective purchaser, transferee, assignee, or lessee at least
				60 days before the sale, transfer, assignment, or lease is completed.
				(III)