reglab/statecodes huggingface dataset:
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.7 - Licenses for Distinct Parts

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
				Separate licenses may be issued for distinct parts of a health care facility
				which are clearly identifiable, containing contiguous rooms in a separate wing
				or building or on a separate floor of the facility and which provide care and
				services of separate categories.
(2) The following requirements shall be met
				for a separate licensing of a distinct part:
a. The distinct part shall serve only
				residents who require the category of care and services immediately available
				to them within that part; (III)
b.
				The distinct part shall meet all the standards, rules, and regulations
				pertaining to the category for which a license is being sought;
c. A distinct part must be operationally and
				financially feasible;
d. A separate
				staff with qualifications appropriate to the care and services being rendered
				must be regularly assigned and working in the distinct part under responsible
				management; (III)
e. Separately
				licensed distinct parts may have certain services such as management, building
				maintenance, laundry, and dietary in common with each other.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.8 - Administrator

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Each
				nursing facility shall have one person in charge, duly licensed as a nursing
				home administrator or acting in a provisional capacity. (III)
(2) A licensed administrator may act as an
				administrator for not more than two nursing facilities.
a. The distance between the two facilities
				shall be no greater than 75 miles. (II)
b. The administrator shall spend the
				equivalent of three full eight-hour days per week in each facility.
				(II)
c. The administrator may be
				responsible for no more than 150 beds in total if the administrator is an
				administrator of more than one facility. (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.9 - Administration

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The licensee
				shall:
a. Assume the responsibility for the
				overall operation of the nursing facility; (III)
b. Be responsible for compliance with all
				applicable laws and with the rules of the department; (III)
c. Establish written policies, which shall be
				available for review, for the operation of the nursing facility.
				(Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.10 - General Policies

Current through Register Vol. 47, No. 3, July 24, 2024
(1) There shall
				be written personnel policies in facilities of more than 15 beds to include
				hours of work, and attendance at educational programs. (III)
(2) There shall be a written job description
				developed for each category of worker. The job description shall include title
				of job, job summary, qualifications (formal education and experience), skills
				needed, physical requirements, and responsibilities. (III)
(3) There shall be written personnel policies
				for each facility. Personnel policies shall include the following requirements:
a. Employees shall have a physical
				examination before employment. (I, II, III)
b. Employees shall have a physical
				examination at least every four years. (I, II, III)
c. Screening and testing for tuberculosis
				shall be conducted pursuant to 481-Chapter 59. (I, II, III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.11 - Personnel

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
General qualifications.
a.
				No person with a current record of habitual alcohol intoxication or addiction
				to the use of drugs shall serve in a managerial role of a nursing facility.
				(II)
b. No person under the
				influence of alcohol or intoxicating drugs shall be permitted to provide
				services in a nursing facility. (II)
c. No person shall be allowed to provide
				services in a facility if the person has a disease:
(1) Which is transmissible through required
				workplace contact, (I, II, III)
(2)
				Which presents a significant risk of infecting others, (I, II, III)
(3) Which presents a substantial possibility
				of harming others, and (I, II, III)
(4) For which no reasonable accommodation can
				eliminate the risk. (I, II, III)
Refer to guidelines issued by the Centers for Disease Control
				  and Prevention, U.S. Department of Health and Human Services, to determine (1),
				  (2), (3) and (4).
d. Individuals with either physical or mental
				disabilities may be employed for specific duties, but only if that disability
				is unrelated to that individual's ability to perform the duties of the job.
				(III)
e. Persons employed in all
				departments, except the nursing department of a nursing facility, shall be
				qualified through formal training or through prior experience to perform the
				type of work for which they have been employed. Prior experience means at least
				240 hours of full-time employment in a field related to their duties. Persons
				may be hired in laundry, housekeeping, activities and dietary without
				experience or training if the facility institutes a formal in-service training
				program to fit the job description in question and documents such as having
				taken place within 30 days after the initial hiring of such untrained
				employees. (III)
f. The health
				services supervisor shall be a qualified nurse as defined in these regulations.
				(II)
g. There shall be an organized
				ongoing in-service educational and training program planned in advance for all
				personnel in all departments. (II, III)
h. Nurse aides may be utilized in accordance
				with the requirements in 441-subrule 81.13(19) and rule
				441-81.16 (249A). Nurse aides
				who have received training other than the Iowa state-approved program must pass
				a competency evaluation approved by the department of inspections and appeals
				in accordance with 441-subrule 81.13(19) and rule
				441-81.16 (249A). Evidence of
				prior formal training must be presented to the facility or institution
				conducting the challenge examination before the examination is given. The
				approved facility or institution, following department of inspections and
				appeals guidelines, shall make the determination of who is qualified to take
				the examination. Documentation of the challenge examinations administered shall
				be maintained.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.13 - Contracts

Current through Register Vol. 47, No. 3, July 24, 2024
Each contract shall:
(1) State the base rate or scale per day or
				per month, the services included, and the method of payment; (III)
(2) Contain a complete schedule of all
				offered services for which a fee may be charged in addition to the base rate.
				Furthermore, the contract shall: (III)
a.
				Stipulate that no further additional fees shall be charged for items not
				contained in complete schedule of services as set forth in 58.13(3);
				(III)
b. State the method of
				payment of additional charges; (III)
c. Contain an explanation of the method of
				assessment of such additional charges and an explanation of the method of
				periodic reassessment, if any, resulting in changing such additional charges;
				(III)
d. State that additional fees
				may be charged to the resident for nonprescription drugs, other personal
				supplies, and services by a barber, beautician, etc.; (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.14 - Medical Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Each
				resident in a nursing facility shall designate a licensed physician who may be
				called when needed. Professional management of a resident's care shall be the
				responsibility of the hospice program when:
a.
				The resident is terminally ill, and
b. The resident has elected to receive
				hospice services under the federal Medicare program from a Medicare-certified
				hospice program, and
c. The
				facility and the hospice program have entered into a written agreement under
				which the hospice program takes full responsibility for the professional
				management of hospice care.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.15 - Records

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Resident admission record.
The licensee shall keep a permanent
				record on all residents admitted to a nursing facility with all entries
				current, dated, and signed. This shall be a part of the resident clinical
				record. (III) The admission record form shall include:
a. Name and previous address of resident;
				(III)
b. Birth date, sex, and
				marital status of resident; (III)
c. Church affiliation; (III)
d. Physician'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. Mortician's name, telephone number, and
				address; (III)
i. Pharmacist's
				name, telephone number, and address. (III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.16 - Resident Care and Personal Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Beds shall be made daily and adjusted as
				necessary. A complete change of linen shall be made at least once a week and
				more often if necessary. (Ill)
(2)
				Residents shall receive sufficient supervision so that their personal
				cleanliness is maintained. (II, III)
(3) Residents shall have clean clothing as
				needed to present a neat appearance, to be free of odors, and to be
				comfortable. Clothing shall be based on resident choice and shall be
				appropriate to residents' activities and to the weather (III)
(4) Rescinded, effective 7/14/82.
(5) Residents shall be encouraged to leave
				their rooms and make use of the recreational room or living room of the
				facility. (Ill)
(6) Residents shall
				not be required to pass through another's bedroom to reach a bathroom, living
				room, dining room, corridor, or other common areas of the facility.
				(Ill)
(7) Rescinded, effective
				7/14/82.
(8) Uncontrollable
				residents shall be transferred or discharged from the facility in accordance
				with contract arrangements and requirements of Iowa Code chapter 135C. (II,
				III)
(9) Except for those who
				request differently, residents who are not bedfast shall be fully dressed each
				day to maintain self-esteem and promote the residents' normal lifestyles.
				(Ill)
(10) Residents shall receive
				a bath of their choice, based on the facility's accommodations, as needed to
				maintain proper hygiene. (II, III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.18 - Nursing Care

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Individual
				health care plans shall be based on resident treatment decisions, the nature of
				the illness or disability, treatment, and care prescribed. Goals shall be
				developed by each discipline providing service, treatment, and care. These
				plans shall be in writing, revised as necessary, and kept current. They shall
				be made available to all those rendering the services and for review by the
				department. (Ill)
(2) Rescinded IAB
				4/2/2014, effective 5/7/2014.
(3)
				The facility shall provide resident and family education as an integral part of
				restorative and supportive care. (Ill)
(4) The facility shall provide prompt
				response from qualified staff for the resident's use of the nurse call system.
				(II, III) (Prompt response being considered as no longer than 15
				minutes.)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.19 - Required Nursing Services for Residents

Current through Register Vol. 47, No. 3, July 24, 2024
The resident shall receive and the facility shall provide,
				  as appropriate, the following required nursing services under the 24-hour
				  direction of qualified nurses with ancillary coverage as set forth in these
				  rules:
(1)
Activities of daily
				living.
a. Bathing; (II,
				III)
b. Daily oral hygiene (denture
				care); (II, III)
c. Routine
				shampoo; (II, III)
d. Nail care;
				(III)
e. Shaving; (III)
f. Daily care and application of prostheses
				(glasses, hearing aids, glass eyes, limb prosthetics, braces, or other
				assistive devices); (II, III)
g.
				Ambulation with equipment if applicable, or transferring, or positioning; (I,
				II, III)
h. Daily routine range of
				motion; (II, III)
i. Mobility
				(assistance with wheelchair, mechanical lift, or other means of locomotion);
				(I, II, HI)
j. Elimination.
(1) Assistance to and from the bathroom and
				perineal care; (II, III)
(2) Bedpan
				assistance; (II, III)
(3) Care for
				incontinent residents; (II, III)
(4) Bowel and bladder training programs
				including in-dwelling catheter care (i.e., insertion and irrigation), enema and
				suppository administration, and monitoring and recording of intake and output,
				including solid waste; (I, II, III)
k. Colostomy care (to be performed only by a
				registered nurse or licensed practical nurse or by a qualified aide under the
				direction of a registered nurse or licensed practical nurse); (I, II,
				III)
l. Ileostomy care (to be
				performed only by a registered nurse or licensed practical nurse or by a
				qualified aide under the direction of a registered nurse or licensed practical
				nurse); (I, II, III)
m. All linens
				necessary; (III)
n. Nutrition and
				meal service.
(1) Regular, therapeutic,
				modified diets, and snacks; (I, II, III)
(2) Mealtime preparation of resident; (II,
				III)
(3) Assistance to and from
				meals; (II, III)
(4) In-room meal
				service or tray service; (II, III)
(5) Assistance with food preparation and meal
				assistance including total assistance if needed; (II, III)
(6) Assistance with adaptive devices; (II,
				III)
(7) Enteral nutrition (to be
				performed by a registered nurse or licensed practical nurse only); (I, II,
				III)
(8) Sufficient fluid intake to
				maintain proper hydration and health; (I, II, III)
o. Promote initiation of self-care for
				elements of resident care; (II, III)
p. Oral suctioning (to be performed only by a
				registered nurse or licensed practical nurse or by a qualified aide under the
				direction of a registered nurse or licensed practical nurse). (I, II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.20 - Duties of Health Service Supervisor

Current through Register Vol. 47, No. 3, July 24, 2024
Every nursing facility shall have a health service supervisor
				  who shall:
(1) Direct the
				implementation of the physician's orders; (I, II)
(2) Plan for and direct the nursing care,
				services, treatments, procedures, and other services in order that each
				resident's needs and choices, where practicable, are met; (II, III)
(3) Review the health care needs and choices,
				where practicable, of each resident admitted to the facility and assist the
				attending physician in planning for the resident's care; (II, III)
(4) Develop and implement a written health
				care plan in cooperation with, to the extent practicable, the resident, the
				resident's family or the resident's legal representative, and others in
				accordance with instructions of the attending physician as follows:
a. The written health care plan, based on the
				assessment and reassessment of the resident's health needs and choices, where
				practicable, is personalized for the individual resident and indicates care to
				be given, goals to be accomplished, and methods, approaches, and modifications
				necessary to achieve best results; (III)
b. The health service supervisor is
				responsible for preparing, reviewing, supervising the implementation, and
				revising the written health care plan; (III)
c. The health care plan is readily available
				for use by all personnel caring for the resident; (III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.21 - Drugs, Storage, and Handling

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Drug
				storage for residents who are unable to take their own medications and require
				supervision shall meet the following requirements:
a. A cabinet with a lock, convenient to
				nursing service, shall be provided and used for storage of all drugs,
				solutions, and prescriptions; (III)
b. The drug storage cabinet shall be kept
				locked when not in use; (III)
c.
				The medication cabinet key shall be in the possession of the person directly
				responsible for issuing medications; (II, III)
d. Double-locked storage of Schedule II drugs
				shall not be required under single unit package drug distribution systems in
				which the quantity stored does not exceed a three-day supply and a missing dose
				can be readily detected. (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.22 - Rehabilitative Services

Current through Register Vol. 47, No. 3, July 24, 2024
Rehabilitative services shall be provided to maintain
				  function or improve the resident's ability to carry out the activities of daily
				  living.
(1)
Physical therapy
				services.
a. Each facility shall
				have a written agreement with a licensed physical therapist to provide physical
				therapy services. (III)
b. Physical
				therapy shall be rendered only by a physical therapist licensed to practice in
				the state of Iowa. All personnel assisting with the physical therapy of
				residents must be under the direction of a licensed physical therapist. (II,
				III)
c. The licensed physical
				therapist shall:
(1) Evaluate the resident
				and prepare a physical therapy treatment plan conforming to the medical orders
				and goals; (III)
(2) Consult with
				other personnel in the facility who are providing resident care and plan with
				them for the integration of a physical therapy treatment program into the
				overall health care plan; (III)
(3)
				Instruct the nursing personnel responsible for administering selected
				restorative procedures between treatments; (III)
(4) Present programs in the facility's
				in-service education programs. (III)
d. Treatment records in the resident's
				medical chart shall include:
(1) The
				prescription for treatment; (III)
(2) An initial evaluation note by the
				physical therapist; (III)
(3) The
				physical therapy care plan defining clearly the long-term and short-term goals
				and outlining the current treatment program; (III)
(4) Notes of the treatments given and changes
				in the resident's condition; (III)
(5) A complete discharge summary to include
				recommendations for nursing staff and family. (III)
e. There shall be adequate facilities, space,
				appropriate equipment, and storage areas as are essential to the treatment or
				examinations of residents. (III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.23 - Dental, Diagnostic, and Other Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Dental services.
a. The nursing facility personnel shall
				assist residents to obtain regular and emergency dental services.
				(Ill)
b. Transportation
				arrangements shall be made when necessary for the resident to be transported to
				the dentist's office. (Ill)
c.
				Dental services shall be performed only on the request of the resident,
				responsible relative, or legal representative. The resident's physician shall
				be advised of the resident's dental problems. (Ill)
d. All dental reports or progress notes shall
				be included in the clinical record. (Ill)
e. Nursing personnel shall assist the
				resident in carrying out dentist's recommendations. (Ill)
f. Dentists shall be asked to participate in
				the in-service program of the facility. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.24 - Dietary

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Organization of dietetic services.
The facility shall meet the
				needs of the residents and provide the services listed in this standard. If a
				service is contracted out, the contractor shall meet the same standard. A
				written agreement shall be formulated between the facility and the contractor
				and shall convey to the department the right to inspect the food service
				facilities of the contractor. (III)
a. There
				shall be written policies and procedures for dietetic services that include
				staffing, nutrition, menu planning, therapeutic diets, preparation, food
				service, ordering, receiving, storage, sanitation, and staff hygiene. The
				policies and procedures shall be made available for use by dietetic services.
				(III)
b. There shall be written job
				descriptions for each position in dietetic services. The job descriptions shall
				be made available for use by dietetic services. (III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.25 - Social Services Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The
				administrator or designee shall be responsible for developing a written,
				organized orientation program for all residents. (Ill)
(2) The program shall be planned and
				implemented to resolve or reduce personal, family, business, and emotional
				problems that may interfere with the medical or health care, recovery, and
				rehabilitation of the individual. (Ill)
(3) The social services plan, including
				specific goals and regular evaluation of progress, shall be incorporated into
				the overall plan of care. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.26 - Resident Activities Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Organized activities.
Each nursing facility shall provide an
				organized resident activity program for the group and for the individual
				resident which shall include suitable activities for evenings and weekends.
				(III)
a. The activity 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 physician. This shall include helping residents continue in their
				individual interests or hobbies. (III)
b. The program shall include individual goals
				for each resident. (III)
c. The
				program shall include both group and individual activities. (III)
d. No resident shall be forced to participate
				in the activity program. (III)
e.
				The activity program shall include suitable activities for those residents
				unable to leave their rooms. (III)
f. The program shall be incorporated into the
				overall health plan and shall be designed to meet the goals as written in the
				plan.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.28 - Safety

Current through Register Vol. 47, No. 3, July 24, 2024
The licensee of a nursing facility shall be responsible for
				  the provision and maintenance of a safe environment for residents and
				  personnel. (Ill)
(1) Fire safety.
a. All nursing 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 58 - Nursing Facilities › Rule 481-58.29 - Resident Care

Current through Register Vol. 47, No. 3, July 24, 2024
(1) There shall
				be a readily available supply of self-help and ambulation devices such as
				wheelchairs, walkers, and such other devices maintained in good repair that
				will meet the current needs of all residents. (Ill)
(2) The facility shall ensure that each
				ambulatory resident has well-fitting shoes to provide
support and prevent slipping. (Ill)
(3) Equipment for personal care shall be
				maintained in a safe and sanitary condition. (II, III)
(4) The expiration date for sterile equipment
				shall be exhibited on its wrappings. (Ill)
(5) Residents who have been known to wander
				shall be provided with appropriate means of identification. (II, III)
(6) Electric heating pads, blankets, or
				sheets shall be used only on the written order of a physician, when allowed by
				the Life Safety Code or applicable state or local fire regulations. (II,
				III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.31 - 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
				unit 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. (Ill)
(4) A hallway or
				corridor shall not be used for storage of equipment. (Ill)
(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. (Ill)
(9) Polishes used on floors shall provide a
				nonslip finish. (Ill)
(10) *Throw
				or scatter rugs shall not be permitted. (Ill)
*Objection, see filed rules (Ch 58) published lAC Supp.
				  9/7/77, 10/5/77.
(11)
				Entrances, exits, steps, and outside walkways shall be kept free from ice,
				snow, and other hazards. (II, III)
(12) Residents shall not have access to
				storage areas for all cleaning agents, bleaches, insecticides, or any other
				poisonous, dangerous, or flammable materials. (II, III)
(13) Sufficient numbers of noncombustible
				trash containers, which have covers, shall be available. (Ill)
(14) Definite procedures shall be established
				for training housekeeping personnel. (Ill)
(15) Rescinded lAB 12/6/06, effective
				1/10/07.
(16) There shall be
				provisions for the cleaning and storage of housekeeping equipment and supplies
				for each nursing unit. (Ill)
(17)
				Bathtubs, shower stalls, or lavatories shall not be used for laundering,
				cleaning of utensils and mops, or for storage. (Ill)
(18) Bedside utensils shall be stored in
				enclosed cabinets. (Ill)
(19)
				Kitchen sinks shall not be used for the cleaning of mops, soaking of laundry,
				cleaning of bedside utensils, nursing utensils, or dumping of wastewater
				(III)
(20) Personal possessions of
				residents which may constitute hazards to themselves or others shall be removed
				and stored. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.32 - Maintenance

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Each facility
				shall establish a maintenance program in writing to ensure the continued
				maintenance of the facility, to promote good housekeeping procedures, and to
				ensure sanitary practices throughout the facility. (Ill)
(2) The building, grounds, and other
				buildings shall be maintained in a clean, orderly condition and in good repair
				(III)
(3) Draperies and furniture
				shall be clean and in good repair. (Ill)
(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 (III)
(5) The electrical systems, including
				appliances, cords, and switches, shall be maintained to guarantee safe
				functioning and comply with the national electrical code. (Ill)
(6) All plumbing fixtures shall function
				properly and comply with the state plumbing code. (Ill)
(7) Yearly inspections of the heating and
				cooling systems shall be made to guarantee safe operation. Documentation of
				these inspections shall be available for review. (Ill)
(8) The building, grounds, and other
				buildings shall be kept free of breeding areas for flies, other insects, and
				rodents. (Ill)
(9) The facility
				shall be kept free of flies, other insects, and rodents. (Ill)
(10) Maintenance personnel.
a. A written program shall be established for
				the orientation of maintenance personnel. (Ill)
b. Maintenance personnel shall:
(1) Follow established written maintenance
				programs; (III)
(2) Be provided
				with appropriate, well-constructed, and properly maintained equipment.
				(Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.33 - Laundry

Current through Register Vol. 47, No. 3, July 24, 2024
(1) All soiled
				linens shall be collected in 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. (Ill)
(5) Bed linens, towels, and washcloths shall
				be clean and stain-free. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.34 - 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, rodent-proof, and have tight-fitting covers. (Ill)
(3) All containers shall be thoroughly
				cleaned each time the containers are emptied. (Ill)
(4) All wastes shall be properly disposed of
				in compliance with local ordinances and state codes. (Ill)
(5) Special provision shall be made for the
				disposal of soiled dressings and similar items in a safe, sanitary manner
				(III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.35 - Buildings, Furnishings, and Equipment

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Buildings-general requirements.
a. For purposes of computation of usable
				floor space in bedrooms and other living areas of the facility, that part of
				the room having no less than seven feet of ceiling height shall be used. Usable
				floor space may include irregularities in the rooms such as alcoves and offsets
				with approval of the department. Usable floor space shall not include space
				needed for corridor door swings or wardrobes being used as a substitute for
				closet space. (III)
b. Portable
				emergency lights in good working condition shall be available at all times, at
				a ratio of one light per one employee on duty from 6 p.m. to 6 a.m.
				(III)
c. All windows shall be
				supplied with curtains and shades or drapes which are kept clean and in good
				repair. (III)
d. Light fixtures
				shall be so equipped to prevent glare and to prevent hazards to the residents.
				(III)
e. Exposed heating pipes, hot
				water pipes, or radiators in rooms and areas used by residents and within reach
				of residents shall be covered or protected to prevent injury or burns to
				residents. (II, III)
f. All fans
				located within seven feet of the floor shall be protected by screen guards of
				not more than one-half-inch mesh. (III)
g. Whenever glass sliding doors or
				transparent panels are used, they shall be marked conspicuously.
				(III)
h. The facility shall meet
				the equivalent requirements of the appropriate group occupancy of the state
				building code. (III)
i. No part of
				any room shall be enclosed, subdivided, or partitioned unless such part is
				separately lighted and ventilated and meets such other requirements as its
				usage and occupancy dictates, except closets used for the storage of residents'
				clothing. (III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.36 - Family and Employee Accommodations

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Children under 14 years of age shall not
				be allowed into the service areas. (Ill)
(2) The residents' bedrooms shall not be
				occupied by employees or family members of the licensee. (Ill)
(3) In facilities where the total occupancy
				of family, employees, and residents is five or less, one toilet and one tub or
				shower shall be the minimum requirement. (Ill)
(4) 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 residents. (Ill)
(5) In all health care 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 residents. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.38 - 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. (III)
b. A complete change of bed linens shall be
				available in the linen storage area for each bed. (III)
c. Sufficient lightweight, clean, serviceable
				blankets shall be available. All blankets shall be laundered as often as
				necessary for cleanliness and freedom from odors. (III)
d. Each bed shall be provided with clean,
				washable bedspreads. There shall be a supply available when changes are
				necessary. (III)
e. Uncrowded and
				convenient storage shall be provided for linens, pillows, and bedding.
				(III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.39 - Residents' Rights in General

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, all of the following provisions (subrules 58.39(2)
				to 58.39(6)) and which govern all areas of service provided by the facility.
				These policies and procedures shall be available to staff, residents, their
				families or legal representatives and the public and shall be reviewed
				annually. (II)
(2) Policies and
				procedures shall address the admission and retention of persons with histories
				of dangerous or disturbing behavior. For the purposes of the subrule, persons
				with histories of dangerous or disturbing behavior are those persons who have
				been found to be seriously mentally impaired pursuant to Iowa Code section
				229.13 within six months of the
				request for admission to the facility. In addition to establishing the criteria
				for admission and retention of persons so defined, the policies and procedures
				shall provide for:
a. Reasonable precautions
				to prevent the resident from harming self, other residents, or employees of the
				facility.
b. Treatment of persons
				with mental illness as defined in Iowa Code section 229.1(1) and which is
				provided in accordance with the individualized health care plan.
c. Ongoing and documented staff training on
				individualized health care planning for persons with mental
				illness.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.40 - Involuntary Discharge or Transfer

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Involuntary discharge or transfer permitted.
A facility may
				involuntarily discharge or transfer a resident for only one of the following
				reasons:
a. Medical reasons;
b. The resident's welfare or that of other
				residents;
c. Nonpayment for the
				resident's stay, as described in the contract for the resident's
				stay;
d. Due to action pursuant to
				Iowa Code chapter 229;
e. By reason
				of negative action by the Iowa department of human services; or
f. By reason of negative action by the
				quality improvement organization (QIO). (I, II, III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.41 - Residents' Rights

Current through Register Vol. 47, No. 3, July 24, 2024
Each resident shall be encouraged and assisted throughout the
				  resident's period of stay, to exercise rights as a resident and as a citizen
				  and may voice grievances and recommend changes in policies and services to
				  administrative staff or to outside representatives of the resident's choice,
				  free from interference, coercion, discrimination, or reprisal. (II)
(1) The facility shall provide ongoing
				opportunities for residents to be aware of and to exercise their rights as
				residents. Residents shall be kept informed of issues or pending decisions of
				the facility that affect them and their views shall be solicited prior to
				action. (II)
(2) The facility shall
				implement a written procedure for registering and resolving grievances and
				recommendations by residents or their responsible party. The procedure shall
				ensure protection of the resident from any form of reprisal or intimidation.
				The written procedure shall include:
a.
				Designation of an employee responsible for handling grievances and
				recommendations. (II)
b. A method
				of investigating and assessing the validity of a grievance or recommendation.
				(II)
c. Methods of resolving
				grievances. (II)
d. Methods of
				recording grievances and actions taken. (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.42 - 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, and to the extent, under written authorization by the resident that
				  the facility assists in management, 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(2).
				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 confused or intellectually disabled resident, the resident's
				responsible party shall designate a method of disbursing the resident's funds.
				(II)
(4) If the facility makes
				financial transactions on a resident's behalf, the resident must receive or
				acknowledge that the resident has seen 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 guardian.
				(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 guardian. The department
				may report findings that resident funds have been used without written consent
				to the audits division or the local law enforcement agency, as appropriate.
				(II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.44 - Resident Records

Current through Register Vol. 47, No. 3, July 24, 2024
Each resident shall be ensured confidential treatment of all
				  information contained in the resident's records, including information
				  contained in an automatic data bank. The resident's written consent shall be
				  required for the release of information to persons not otherwise authorized
				  under law to receive it. (II)
(1) The
				facility shall limit access to any medical records to staff and consultants
				providing professional service to the resident. This is not meant to preclude
				access by representatives of state and federal regulatory agencies.
				(II)
(2) Similar procedures shall
				safeguard the confidentiality of residents' personal records, e.g., financial
				records and social services records. Only those personnel concerned with the
				financial affairs of the residents may have access to the financial records.
				This is not meant to preclude access by representatives of state and federal
				regulatory agencies. (II)
(3) The
				resident, or the resident's responsible party, shall be entitled to examine all
				information contained in the resident's record and shall have the right to
				secure full copies of the record at reasonable cost upon request.
				(II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.46 - 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 sections
				  35D.14 and
				  347B.5. Residents may perform
				  services for the facility if such services are performed in accordance with
				  42 CFR
				  483.10(f)(9).
				  (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.47 - 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) Residents shall be permitted
				to receive visitors in accordance with
				42 CFR
				483.10(f)(4) and the federal
				interpretive guidelines. A particular visitor may be restricted by the facility
				if 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)
(2) Decisions to restrict a visitor are
				reviewed and reevaluated: each time the medical orders are reviewed by the
				physician, at least quarterly by the facility's staff, or at the resident's
				request. (II)
(3) Space shall be
				provided for residents to receive visitors in reasonable comfort and privacy.
				(II)
(4) Telephones shall be
				available and accessible for residents to make and receive calls with privacy
				in accordance with 42 CFR
				483.10(g)(6) and (7).
				Residents who need help shall be assisted in using the telephone.
				(II)
(5) Arrangements shall be made
				to provide assistance to residents who require help in reading or sending mail.
				(II)
(6) Residents shall be
				permitted to leave the facility and environs at reasonable times unless there
				are justifiable reasons established in writing by the attending physician,
				qualified intellectual disabilities professional or facility administrator for
				refusing permission. (II)
(7)
				Residents shall not have their personal lives regulated beyond reasonable
				adherence to meal schedules, bedtime hours, and other written policies which
				may be necessary for the orderly management of the facility and as required by
				these rules. However, residents shall be encouraged to participate in
				recreational programs. (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 58 - Nursing Facilities › Rule 481-58.48 - Resident Activities

Current through Register Vol. 47, No. 3, July 24, 2024
Each resident may participate in activities of social,
				  religious, and community groups at the resident's discretion unless
				  contraindicated for reasons documented by the attending physician or qualified
				  intellectual disabilities professional as appropriate in the resident's record.
				  (II)
(1) 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)
(2) All
				residents shall have the freedom to refuse to participate in these activities.
				(II)