reglab/statecodes huggingface dataset:
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.24 - Long-term Care Service

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Long-term care service definition.
Long-term care service
				means any building or distinct part of a building utilized by the hospital for
				the provision of a service that would fall within the definition of a health
				care facility in Iowa Code chapter 135C if it was not operating as part of a
				hospital licensed under Iowa Code chapter 135B.
(2)
Long-term care service general
				requirements.
The general requirements for the hospital's long-term
				care service are the same as required by Iowa Code chapter 135C or rules
				promulgated thereunder for the category of health care facility involved.
				Exceptions to those rules requiring distinct parts to be established may be
				waived where it is found to be in the best interest of the long-term care
				resident and of no detriment to the patients in the hospital. Requests for
				waivers to other applicable rules may be made in accordance with the
				appropriate health care facility rules.
(3)
Long-term care service
				staff.
Where a hospital operates a freestanding nursing care facility,
				it shall be under the administrative authority of a licensed nursing home
				administrator who will be responsible to the hospital's administrator. Where a
				hospital operates a distinct part long-term care unit under the hospital
				license, a licensed nursing home administrator is not required. Other staffing
				requirements for the hospital's long-term care service are the same as required
				by Iowa Code chapter 135C or rules promulgated thereunder.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.25 - Criminal, Dependent Adult Abuse, and Child Abuse Record Checks

Current through Register Vol. 47, No. 3, July 24, 2024
The requirements for criminal, dependent adult abuse, and
				  child abuse records checks applicable to health care facilities set forth in
				  rule 481-50.9 (135C) are applicable
				  to hospitals.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.26 - Minimum Standards for Construction

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Minimum
				standards.
The following construction standards are applicable to
				hospitals and off-site premises licensed under this chapter:
a. Construction shall be in accordance with
				the standards set forth in the Guidelines for Design and Construction of
				Hospitals, 2018 edition, published by the Facility Guidelines
				Institute.
b. Existing hospitals
				and off-site premises built in compliance with prior editions of the hospital
				construction guidelines will be deemed in compliance with subsequent
				regulations, with the exception of any new structural renovations, additions,
				functional alterations, or changes in utilization to existing facilities, which
				shall meet the standards specified in this subrule.
c. The design and construction of a hospital
				or off-site premises shall be in conformance with 661-Chapter 205.
d. In jurisdictions without a local building
				code enforcement program, the construction shall be in conformance with the
				state building code, as authorized by Iowa Code section
				103A.7, in effect at the time of
				plan submittal for review and approval. In jurisdictions with a local building
				code enforcement program, local building code enforcement must include both the
				adoption and enforcement of a local building code through plan reviews and
				inspections.
e. If an applicable
				requirement of 661-Chapter 205 is inconsistent with an applicable requirement
				of the state building code, the hospital or off-site premises is deemed to be
				in compliance with the state building code requirement if the requirement of
				661-Chapter 205 is met.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.27 - Critical Access Hospitals

Current through Register Vol. 47, No. 3, July 24, 2024
Critical access hospitals shall meet the federal conditions
				  of participation as a critical access hospital as described in 42 CFR Part 485,
				  Subpart F, as amended to November 7, 2023, and any federal interpretive
				  guidelines. The requirements of this chapter applicable to hospitals are
				  generally applicable to critical access hospitals unless compliance would be
				  inconsistent with 42 CFR Part 485, Subpart F, as amended to November 7, 2023,
				  and any interpretive guidelines. If swing-bed approval has been granted, all 25
				  beds may be used interchangeably for acute or skilled nursing facility level of
				  care services.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.28 - Rural Emergency Hospitals

Current through Register Vol. 47, No. 3, July 24, 2024
Rural emergency hospitals shall meet the federal conditions
				  of participation for rural emergency hospitals, as set forth in 42 CFR Part
				  485, Subpart E, as amended to January 1, 2023, and any federal interpretive
				  guidelines. The requirements of this chapter applicable to hospitals are
				  generally applicable to rural emergency hospitals unless compliance would be
				  inconsistent with 42 CFR Part 485, Subpart E, as amended to January 1, 2023,
				  and any federal interpretive guidelines.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.29 - Specialized Hospitals

Current through Register Vol. 47, No. 3, July 24, 2024
A specialized hospital shall meet the requirements for a
				  general hospital. The diagnosis, treatment or care at a specialized hospital
				  shall be administered by or performed under the direction of persons especially
				  qualified in the diagnosis and treatment of the particular illness, injury, or
				  infirmity.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.32 - Obstetric and Neonatal Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1) All
				hospitals providing obstetrical care shall be properly organized and equipped
				to provide accommodations for mothers and newborn infants. The supervision of
				the maternity area shall be under the direction of a qualified registered
				nurse.
(2) Written policies and
				procedures shall be implemented governing obstetric and neonatal services that
				are consistent with the needs of the patient and resources of the hospital.
a. Policies and procedures shall be developed
				in consultation with and with the approval of the hospital's medical staff. At
				a minimum, the policies and procedures shall provide for:
(1) Obstetric and neonatal services under the
				direction of a qualified doctor of medicine or osteopathy.
(2) Delineation of the privileges and
				qualifications of individuals authorized to provide obstetrical/gynecological
				service as set out in the hospital's medical staff bylaws.
(3) The qualifications of nursing personnel
				and continuing education required.
(4) Adequate staffing for obstetrical and
				newborn services.
(5) Location and
				arrangement of obstetric and newborn services.
(6) Infection control and disease
				prevention.
(7) Ongoing quality
				assessment.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.34 - Pediatric Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1) All
				hospitals providing pediatric care shall be properly organized and equipped to
				provide appropriate accommodations for children. The supervision of the
				pediatric area shall be under the direction of a qualified registered
				nurse.
(2) Written policies and
				procedures shall be implemented governing pediatric services that are
				consistent with the needs of the child and resources of the hospital.
a. Policies and procedures shall be developed
				in consultation with and the approval of the hospital's medical staff. At a
				minimum, the policies and procedures shall provide for:
(1) Pediatric services under the medical
				direction of a qualified doctor of medicine or osteopathy.
(2) Delineation of the privileges and
				qualifications of individuals authorized to provide pediatric services as set
				out in the hospital's medical staff bylaws.
(3) The qualifications of nursing personnel
				and continuing education required, including care in the event of emergency
				situations.
(4) Adequate staffing
				and equipment for pediatric services including ancillary services. Staff
				participating in the care of pediatric patients shall have education
				appropriate for the care of pediatric patients.
(5) Ancillary services for pediatric patients
				shall be available and include, but not be limited to, pharmaceutical care,
				laboratory services, respiratory therapy, physical therapy and speech
				therapy.
(6) Ongoing quality
				assessment.
(7) Written protocol
				for transfer of pediatric patients in the event the hospital does not have
				capability to provide care for these patients.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.36 - Psychiatric Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Any
				hospital operating as a psychiatric hospital or operating a psychiatric unit
				shall:
a. Be a hospital or unit primarily
				engaged in providing, by or under the supervision of a doctor of medicine or
				osteopathy, psychiatric services for the diagnosis and treatment of persons
				with psychiatric illnesses/disorders;
b. Meet the general and specialized rules of
				this chapter pertaining to general hospitals. If medical and surgical
				diagnostic and treatment services are not available within the institution, the
				institution shall have an agreement with an outside source of these services to
				ensure they are immediately available;
c. Have policies and procedures for informing
				patients of their rights and responsibilities and for ensuring the availability
				of a patient advocate; and
d. Have
				sufficient numbers of qualified professionals and support staff to evaluate
				patients, formulate written individualized comprehensive treatment plans,
				provide active treatment measures, and engage in discharge planning.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.50 - Minimum Standards for Construction

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Minimum
				standards.
Hospitals and off-site premises licensed under this chapter
				shall be built in accordance with the following construction standards.
a. Construction shall be in accordance with
				the standards set forth in the Guidelines for Design and Construction of
				Hospitals, 2018 edition, published by the Facility Guidelines
				Institute.
b. Existing hospitals
				and off-site premises built in compliance with prior editions of the hospital
				construction guidelines will be deemed in compliance with subsequent
				regulations, with the exception of any new structural renovations, additions,
				functional alterations, or changes in utilization to existing facilities, which
				shall meet the standards specified in this subrule.
c. The design and construction of a hospital
				or off-site premises shall be in conformance with the provisions of 661-Chapter
				205.
d. In jurisdictions without a
				local building code enforcement program, the construction shall be in
				conformance with the state building code, as authorized by Iowa Code section
				103A.7, in effect at the time of plan submittal for review and approval. In
				jurisdictions with a local building code enforcement program, local building
				code enforcement must include both the adoption and enforcement of a local
				building code through plan reviews and inspections.
e. In any case in which an applicable
				requirement of 661-Chapter 205 is inconsistent with an applicable requirement
				of the state building code, the hospital or off-site premises shall be deemed
				to be in compliance with the state building code requirement if the requirement
				of 661-Chapter 205 is met.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 52 - Dependent Adult Abuse in Facilities and Programs › Rule 481-52.2 - Persons Who Must Report Dependent Adult Abuse and the Reporting Procedure for Those Persons

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Persons who
				must report dependent adult abuse. The following persons shall report suspected
				dependent adult abuse in accordance with subrule 52.2(2) below.
a. A staff member. Specifically excluded from
				the definition of "staff member" only for purposes of the requirements set
				forth in this subrule are individuals who have no contact or de minimis contact
				with residents in a facility or program.
b. A health care employment agency in
				accordance with 481-Chapter 55.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 52 - Dependent Adult Abuse in Facilities and Programs › Rule 481-52.3 - Reports and Registry of Dependent Adult Abuse

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Receipt and evaluation of reports.
The department shall
				receive and evaluate reports of dependent adult abuse in facilities and
				programs. The department shall inform the department of human services of such
				evaluations and dispositions for inclusion in the central registry for
				dependent adult abuse information pursuant to Iowa Code section
				235B.5.
(2)
Reports sent to the department or
				the department of human services.
Any person who believes that a
				dependent adult has suffered dependent adult abuse may report the suspected
				dependent adult abuse to the department. The department shall transfer any
				reports received of dependent adult abuse in the community to the department of
				human services in accordance with Iowa Code section
				235E.2(5).
(3)
Reports of abuse that is minor,
				isolated, and unlikely to reoccur.
a.
Minor, isolated, and unlikely to
				reoccur-first instance.
A report of dependent adult abuse that meets
				the definition of "dependent adult abuse" as defined in Iowa Code section
				235E.1(5)
"a"
(1)(a) or (d), or section
				235E.1(5)
"a"
(3), which the department determines is minor,
				isolated, and unlikely to reoccur shall be collected and maintained by the
				department of human services for a five-year period, shall not be included in
				the central registry, and shall not be considered founded dependent adult
				abuse.
b.
Minor, isolated,
				and unlikely to reoccur-subsequent instance(s).
A subsequent report of
				dependent adult abuse that meets the definition of "dependent adult abuse" as
				defined in Iowa Code section
				235E.1(5)
"a"
(1)(a) or (d), or section
				235E.1(5)
"a"
(3), that occurs within the five-year period, and that is
				committed by the same caretaker may also be considered minor, isolated, and
				unlikely to reoccur, depending on the totality of circumstances.
c.
Retention of reports.
All
				initial and subsequent reports are collected and maintained by the department
				of human services until a five-year period has expired, so long as no
				additional reports have been filed.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 52 - Dependent Adult Abuse in Facilities and Programs › Rule 481-52.5 - Evaluation of Report

Current through Register Vol. 47, No. 3, July 24, 2024
Upon receipt of a report as defined in rule
				  481-52.1 (235E), the
				  department shall conduct an intake sufficient to determine whether the
				  allegation constitutes dependent adult abuse as defined in rule
				  481-52.1
				  (235E).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 52 - Dependent Adult Abuse in Facilities and Programs › Rule 481-52.6 - Separation of Victim and Alleged Abuser

Current through Register Vol. 47, No. 3, July 24, 2024
Upon receiving a claim of dependent adult abuse of a
				  dependent adult in a facility or program, the facility or program shall
				  separate the victim and the alleged abuser immediately and shall maintain that
				  separation until the department's abuse investigation is completed and the
				  abuse determination is made.
Note: Facilities that participate in the federal Medicare or
				  Medicaid program may be subject to additional federal requirements regarding
				  separation.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 52 - Dependent Adult Abuse in Facilities and Programs › Rule 481-52.7 - Interviews, Examination of Evidence, and Investigation of Dependent Adult Abuse Allegations

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Entering and examining evidence at a facility or program.
An
				inspector of the department may enter any facility or program without a warrant
				and may examine all records and items pertaining to residents, employees,
				former employees, and the alleged dependent adult abuser and any other records
				and items necessary to ensure the integrity of the investigation unless the
				record or item is protected by some other legal privilege.
(2)
Interviews.
a. An inspector of the department may contact
				or interview any resident, employee, former employee, or any other person who
				might have knowledge about the alleged dependent adult abuse.
b. An alleged dependent adult abuser may
				request to have an attorney present at the alleged dependent adult abuser's
				expense at any time during the interview, but the request may not unreasonably
				delay the investigation. An employee organization representative or union
				representative may observe an investigative interview conducted by the
				department of an alleged dependent adult abuser if all of the conditions set
				forth in Iowa Code section
				235E.2(13)
"a"
are met.
The purpose of the interview is a civil administrative
				  dependent adult abuse investigation under applicable law.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 52 - Dependent Adult Abuse in Facilities and Programs › Rule 481-52.8 - Notification to Subsequent Employers

Current through Register Vol. 47, No. 3, July 24, 2024
The department shall notify a facility or program that
				  subsequently employs an alleged or founded dependent adult abuser in accordance
				  with Iowa Code section
				  235E.2(11).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.1 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
The use of the word "shall" indicates mandatory standards.
				  The definitions set out in Iowa Code section
				  135J.1 shall be considered to be
				  incorporated verbatim in the rules. As used in this chapter:
"Bereavement service"
is emotional,
				  psychosocial, and spiritual support and services provided before and after the
				  death of the patient to assist with issues related to grief, loss, and
				  adjustment.
"Care setting"
means the place in which care
				  is being given, for example, patient's home, a hospital, a care facility or
				  another place of residence.
"Family"
means the immediate kin of the
				  patient, including a spouse, parent, stepparent, brother, sister, stepbrother,
				  stepsister, child, or stepchild. Additional relatives or individuals with
				  significant personal ties to the hospice patient may be included in the hospice
				  patient's family.
"Home care provider"
means a care agency
				  that contracts with the hospice to provide services in the home of the hospice
				  patient. The providers may include, but are not limited to, hospice aides,
				  homemakers, nurses, occupational therapists or physical therapists.
"Primary caregiver"
means the person with
				  major responsibility for providing care to a hospice patient.
"Protocols"
are defined as written sets of
				  directions to be followed in performing procedures. These may be routine or may
				  describe specific actions staff must follow when particular events
				  occur.
"Psychosocial needs"
involve a person's
				  mental and emotional life related to behavior to other people.
"Social services"
are services provided by
				  someone who has a bachelor's or higher degree in social work.
"Spiritual counselor"
may be clergy, a
				  hospice employee, a volunteer or someone chosen by the patient.
"Utilization review"
means a program to
				  assess the kind of care delivered and to identify needs which may not have been
				  met.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.2 - License

Current through Register Vol. 47, No. 3, July 24, 2024
Application for an initial or renewal license may be obtained
				  from the Department of Inspections and Appeals, Division of Health Facilities,
				  Lucas State Office Building, Des Moines, Iowa 50319.
(1) Prior to the issuance of a license each
				hospice must meet all the requirements set forth in this chapter.
(2) The applicant shall submit a
				nonrefundable biennial license fee of $500. If a license lapses for failure to
				make timely application for renewal, an additional 25 percent is
				required.
(3) Each hospice seeking
				licensure is surveyed before the initial license is issued and at least every
				36 months thereafter.
(4) Home care
				provider and inpatient facilities used by the hospice shall be inspected by the
				department to determine whether hospice regulations are met.
(5) Hospices certified as Medicare providers
				by the department or accredited by an organization approved by the Centers for
				Medicare and Medicaid Services for federal certification will be licensed
				without inspection.
(6) The
				department may not prohibit any entity from establishing or maintaining a
				hospice without a license.
(7) The
				department may deny, suspend or revoke a license if the department finds that a
				hospice does not comply with these rules.
(8) A license is issued only for the
				premises, person, hospital or facility named on the application. The license
				may not be transferred or assigned to another person or entity.
(9) A license expires two years after the
				date issued unless it is suspended or revoked before that date. This rule is
				intended to implement Iowa Code sections
				135J.2 and
				135J.4 to
				135J.6.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.3 - Patient Rights

Current through Register Vol. 47, No. 3, July 24, 2024
Each hospice program shall have written policies and
				  procedures that support, enhance and protect the human, civil, constitutional
				  and statutory rights of all patients.
(1) Patient rights include, but are not
				limited to, the right to:
a. Be treated with
				dignity and respect;
b. Be informed
				of the type of care and the services provided by the hospice program;
c. Information regarding diagnosis and
				prognosis and any change in either;
d. Review and participate in their plan of
				care; and
e. Privacy.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.4 - Governing Body

Current through Register Vol. 47, No. 3, July 24, 2024
The hospice shall have a local governing body which consists
				  of people who represent the geographic area for which the hospice intends to
				  provide service.
(1) The governing body
				shall:
a. Develop a written mission statement,
				goals and objectives for the hospice and meet with sufficient regularity to
				ensure accomplishment of those goals and objectives;
b. Develop, amend and implement
				bylaws;
c. Assume responsibility
				for the total operation of the hospice;
d. Appoint an administrator whose
				qualifications and duties are defined in writing and who has authority to
				manage the business affairs and to direct all programs of the
				hospice;
e. Provide for medical
				direction by a licensed physician, including naming a qualified physician to be
				available in the medical director's absence;
f. Provide appropriate, qualified personnel
				in sufficient quantity to ensure availability of hospice services listed below.
				Physician and nursing services and the provision of appropriate drugs shall be
				available 24 hours a day, seven days a week;
g. Develop and implement written policies and
				procedures relating to:
(1) Admission and
				discharge criteria,
(2) Response to
				referrals,
(3) Medical
				direction,
(4) Physician
				services,
(5) Nursing
				services,
(6) Nutritional
				services,
(7) Pharmacy
				services,
(8) Social
				services,
(9) Volunteer
				services,
(10) Spiritual
				services,
(11) Patient and family
				education,
(12) Bereavement
				services,
(13) Staff response to
				death at home and in institutions,
(14) Coordination and communication between
				all agencies serving the patient and family,
(15) Communication with community agencies,
				and
(16) Community education
				efforts;
h. Develop and
				implement written personnel policies; and
i. Develop and implement a written plan for
				review of the services delivered.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.5 - Quality Assurance and Utilization Review

Current through Register Vol. 47, No. 3, July 24, 2024
The hospice must have a written procedure for individual
				  assessment of care provided, a process for identifying problems and a system to
				  report findings and recommendations for improving the quality of care delivered
				  to the governing body.
(1) The medical
				director, patient coordinator and social worker used by the hospice program
				shall review a minimum of a 10 percent sample of combined active and inactive
				clinical records of care delivered to hospice patients on a periodic and
				ongoing basis. A written summary shall be prepared for each individual
				assessment, commenting on the amount and kind of care delivered and including
				statements addressing any unmet needs.
(2) All summaries of individual assessments
				shall be reviewed by the people responsible for coordinating quality assurance
				on a periodic and ongoing basis. A written report will be prepared addressing
				any identified problems with care, treatment services, availability of services
				and methods of care delivery.
(3)
				The quality assurance reports shall be made available to the hospice
				administrator and governing body. The reports shall be reviewed by the
				governing body at least annually, and the review recorded in the governing
				body's meeting minutes.
This rule is intended to implement Iowa Code section
				  135J.3(8).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.6 - Attending Physician Services

Current through Register Vol. 47, No. 3, July 24, 2024
The patient or family shall designate an attending physician
				  or physician assistant who is responsible for managing necessary medical care.
				  The attending physician shall:
1. Have
				an active Iowa license pursuant to Iowa Code chapter 148 or 148C;
2. Certify in conjunction with the medical
				director that each person requesting admittance is eligible as required by Iowa
				Code section 135J.1(3)  for
				hospice care;
3. Be responsible for
				the medical component of the plan of care;
4. Participate in developing and revising the
				plan of care;
5. Arrange for
				continuity of the medical management in the attending physician's absence;
				and
6. Monitor the condition of the
				patient and family by direct contact, or communication with the
				interdisciplinary team (IDT) and others.
This rule is intended to implement Iowa Code section
				  135J.3(4).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.7 - Medical Director

Current through Register Vol. 47, No. 3, July 24, 2024
Each hospice shall have a medical director who is a physician
				  licensed to practice medicine pursuant to Iowa Code chapter 148. The medical
				  director shall:
1. Be a member of the
				interdisciplinary team;
2. Monitor
				the quality of care provided;
3.
				Assist in providing assurance of the quality of care provided to the patient
				and family;
4. Maintain liaison
				with the attending physician;
5.
				Review clinical material from the patient's attending physician to certify the
				prognosis as anticipated by that physician;
6. Participate in providing direction for the
				medical component of care;
7.
				Participate in resolving conflicts regarding care to be provided; and
8. Participate in the development and review
				of patient care policies, procedures and protocols. This rule is intended to
				implement Iowa Code section
				135J.3(1).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.8 - Interdisciplinary Team (IDT)

Current through Register Vol. 47, No. 3, July 24, 2024
The IDT shall establish a plan of care for each patient based
				  on assessments performed by team members.
(1) The interdisciplinary team shall include,
				but is not limited to, the:
a. Patient, to the
				extent the patient is able and willing to participate;
b. Hospice patient's family, to the extent
				the family is able and willing to participate;
c. A doctor of medicine or osteopathy who is
				an employee of or under contract with the hospice;
d. Patient care coordinator;
e. Registered nurse;
f. Social worker; and may include
g. A pastoral or other counselor and others
				deemed appropriate by the hospice.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.9 - Nursing Services

Current through Register Vol. 47, No. 3, July 24, 2024
Nursing services shall be planned and provided or supervised
				  by a registered nurse who has a current Iowa license to practice nursing. The
				  service shall be available 24 hours a day, seven days a week.
(1) A registered nurse shall assess patient
				and family nursing needs and develop a nursing plan of care to meet these
				needs.
(2) The nursing service
				staff shall:
a. Participate in IDT meetings to
				develop and amend the plan of care;
b. Provide nursing service in accordance with
				the overall plan of care developed by the IDT;
c. Consult with the patient and family
				regarding how to meet nursing and nursing-related needs of the
				patient;
d. Document nursing care
				given and observations made regarding patient, family reactions and
				status;
e. Consult with other care
				providers and the family to enhance continuity of care;
f. Develop and implement nursing service
				objectives, policies and procedures; and
g. Assign duties to nurses and hospice aides
				consistent with their education and experience.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.11 - Coordinator of Patient Care

Current through Register Vol. 47, No. 3, July 24, 2024
(1) A registered
				nurse, social worker or health care administrator shall be designated to
				coordinate implementation of the plan of care for each patient.
(2) The coordinator of patient care shall at
				least:
a. Coordinate all aspects of patient
				care to ensure continuity, including care by all service disciplines in all
				care settings;
b. Facilitate
				exchange of information among all personnel who provide services to ensure
				complementary efforts and support for objectives outlined in the plan of
				care;
c. Facilitate communication
				between caregivers, patient and family;
d. Maintain a roster of patients;
e. Maintain a schedule for IDT review of care
				plans;
f. Chair IDT
				conferences;
g. Develop job
				descriptions for all nursing personnel;
h. Establish staff schedules to meet patient
				needs and ensure 24-hour service;
i. Develop and implement orientation and
				training programs;
j. Develop and
				implement performance evaluation for the nursing staff; and
k. Facilitate periodic meetings of the
				professional nursing staff to evaluate the nursing care provided by hospice
				personnel.
This rule is intended to implement Iowa Code section
				  135J.3(2).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.12 - Social Services

Current through Register Vol. 47, No. 3, July 24, 2024
Medical social services must be provided by a qualified
				  social worker, under the direction of a physician. Social work services must be
				  based on the patient's psychosocial assessment and the patient's and family's
				  needs and acceptance of these services.
(1) Education and experience. A qualified
				social worker is a person who:
a. Has a master
				of social work (MSW) degree from a school of social work accredited by the
				Council on Social Work Education; or
b. Has a baccalaureate degree in social work
				from an institution accredited by the Council on Social Work Education;
				or
c. Has a baccalaureate degree in
				psychology, sociology, or other field related to social work and is supervised
				by an MSW as described in paragraph 53.12(1)
"a"
; and
d. Has one year of social work experience in
				a health care setting; or
e. Has a
				baccalaureate degree from a school of social work accredited by the Council on
				Social Work Education, was employed by the hospice before December 2, 2008, and
				is not required to be supervised by an MSW.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.13 - Counseling Services

Current through Register Vol. 47, No. 3, July 24, 2024
Counseling is the process of helping people adjust to the
				  grief of illness, dying and loss. Counseling shall be provided in accordance
				  with the plan of care. When the interdisciplinary team identifies the need for
				  additional counseling services, a team member shall be designated to make an
				  appropriate referral. No referrals may be made without the agreement of the
				  patient and the family.
This rule is intended to implement Iowa Code section
				  135J.3(2).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.14 - Volunteer Services

Current through Register Vol. 47, No. 3, July 24, 2024
Each hospice shall provide volunteer services to meet patient
				  and family needs. A coordinator of volunteer services shall be designated to
				  implement written policies and procedures. Volunteers must be used in defined
				  roles and under the supervision of a designated hospice employee. The hospice
				  must maintain, document and provide volunteer orientation and training that is
				  consistent with hospice industry standards.
This rule is intended to implement Iowa Code section
				  135J.3(2).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.15 - Spiritual Counseling

Current through Register Vol. 47, No. 3, July 24, 2024
Spiritual counseling shall be available to all patients and
				  their families.
(1) Spiritual
				counseling shall:
a. Be based on the beliefs
				and values of the patient and family; and
b. Be provided in accordance with the
				interdisciplinary plan of care.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.16 - Optional Services

Current through Register Vol. 47, No. 3, July 24, 2024
Optional services are services provided by the hospice which
				  are not required. Examples are hospice aide, therapy and respite. The following
				  apply to the provision of all optional services provided by a hospice:
(1) All service providers shall be oriented
				to the hospice concept and philosophy.
(2) All services shall be provided in
				accordance with the interdisciplinary plan of care.
(3) Written and implemented policies and
				procedures shall:
a. Identify service
				providers;
b. Identify the person
				who will supervise the provision of services;
c. Require documentation of services provided
				and patient and family response; and
d. Describe a mechanism for evaluating
				quality of care provided.
This rule is intended to implement Iowa Code section
				  135J.1(7).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.17 - Contracted Services

Current through Register Vol. 47, No. 3, July 24, 2024
A hospice may contract with other health care providers for
				  the provision of all services.
(1)
				Contracts shall be written and clearly delineate the authority and
				responsibility of each party to the contract.
(2) The hospice shall maintain responsibility
				for coordinating and administering the hospice program.
(3) Contracting for a service does not
				absolve the hospice of legal responsibility for provision of that
				service.
(4) The hospice shall
				inform the patient whether the hospice is paying for the contracted services.
This rule is intended to implement Iowa Code section
				  135J.3(2).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.18 - Short-term Hospital Services

Current through Register Vol. 47, No. 3, July 24, 2024
Each hospice shall have a written agreement with a local or
				  area hospital which promotes continuation of the hospice plan of care and
				  training for hospital staff who care for hospice patients.
This rule is intended to implement Iowa Code section
				  135J.3(2).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.19 - Bereavement Services

Current through Register Vol. 47, No. 3, July 24, 2024
Bereavement services shall be available to each family after
				  the death of a patient and shall be provided in accordance with family
				  needs.
(1) Bereavement services shall
				include:
a. Exchange of information between
				people who provide bereavement services and team members who provided care
				before death;
b. Consideration of
				the family's situation, including risk factors, used to develop a plan for
				services;
c. Identification of
				types of help or intervention to be available and provided;
d. Contact with the family after the death as
				required by their needs as documented in the plan of care; and
e. A process to assess family reactions and
				hospice referrals for intervention deemed appropriate by the IDT.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 53 - Hospice License Standards › Rule 481-53.20 - Records

Current through Register Vol. 47, No. 3, July 24, 2024
In accordance with accepted principles of medical record
				  practice, each hospice shall maintain a centralized complete record on every
				  individual receiving services. This record shall be preserved for at least six
				  years following termination of services.
(1) Each entry shall be dated and signed,
				including the name and title of the person who makes the entry.
(2) The record shall include documentation of
				all services provided, whether furnished by the hospice or by contractual
				agreement. Each record shall include, but not be limited to:
a. Patient identification and demographic
				data;
b. Initial and subsequent
				assessments;
c. The plan of
				care;
d. Medical history;
e. Documentation of all services
				provided;
f. Consent and
				authorization forms;
g. Physicians'
				orders;
h. Medication
				records;
i. Discharge summary;
				and
j. Discharge and transfer
				records.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 54 - Governor's Award for Quality Care › Rule 481-54.1 - Purpose

Current through Register Vol. 47, No. 3, July 24, 2024
A governor's award for quality care is established to
				  recognize health care facilities in Iowa that demonstrate provision of the
				  highest quality care to residents. Health care facilities eligible for
				  nomination and selection must be licensed pursuant to Iowa Code chapter
				  135C.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 54 - Governor's Award for Quality Care › Rule 481-54.2 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
"Community living training services"
means
				  those activities provided to assist a person to acquire or sustain the
				  knowledge and skills essential to independent functioning to the person's
				  maximum potential in the physical and social environment.
"Department"
means the department of
				  inspections and appeals.
"Director"
means the director of the
				  department of inspections and appeals or the director's designee.
"Health care facility"
or
"facility
				  "
means residential care facilities, nursing facilities, intermediate
				  care facilities for persons with mental illness, and intermediate care
				  facilities for persons with an intellectual disability licensed pursuant to
				  Iowa Code chapter 135C.
"Nursing care"
means those services that can
				  be provided only under the direction of a registered nurse or licensed
				  practical nurse.
"Personal care"
means assistance with those
				  activities of daily living that the recipient can perform only with difficulty.
				  Examples are help in getting in and out of bed, assistance with personal
				  hygiene and bathing, help with dressing and feeding, and supervision of
				  medications that can be self-administered.
"Rehabilitative services"
means services to
				  encourage and assist restoration of optimum mental and physical capabilities of
				  the individual resident of a health care facility.
"Social services"
means services relating to
				  the psychological and social needs of the individual in adjusting to living in
				  a health care facility and minimizing stress arising from that
				  circumstance.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 54 - Governor's Award for Quality Care › Rule 481-54.3 - Nomination

Current through Register Vol. 47, No. 3, July 24, 2024
The department shall make available a nomination application
				  no later than January 1 of each year. The department shall accept nominations
				  until March 1 of each year.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 54 - Governor's Award for Quality Care › Rule 481-54.4 - Applicant Eligibility

Current through Register Vol. 47, No. 3, July 24, 2024
Eligible nominations shall be made by a resident, family
				  member of a resident, member of a resident advocacy committee, or another
				  health care facility. A health care facility cannot nominate itself for the
				  award; however, this prohibition shall not apply to facilities with common
				  ownership.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 54 - Governor's Award for Quality Care › Rule 481-54.5 - Nomination Information

Current through Register Vol. 47, No. 3, July 24, 2024
Applications for the governor's quality care award shall
				  contain but not be limited to the following information:
(1) The reasons that the nominated facility
				should be considered.
(2) Any
				unique or special care or services provided by the facility to its residents.
				Care or services include any unique or special nursing care, personal care,
				rehabilitative services, social services, or community living training services
				provided by the facility for its residents or involvement with the local
				community.
(3) Activities conducted
				by the facility to enhance the quality of life for its residents.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 54 - Governor's Award for Quality Care › Rule 481-54.6 - Evaluation

Current through Register Vol. 47, No. 3, July 24, 2024
The department shall review all nominations and select
				  finalists based upon the material(s) provided in the nomination forms. The
				  department shall also consider the following factors in making its
				  selections:
(1) The facility report
				card completed pursuant to Iowa Code section
				135C.20A.
(2) Any unique services provided by a
				facility to its residents to improve the quality of care in the
				facility.
(3) Any information
				submitted by resident advocacy committee members, residents, a resident's
				family members, or facility staff with regard to the quality of care provided
				by the facility to its residents.
(4) Whether the facility accepts residents
				for whom costs are paid under Iowa Code chapter 249A.
(5) Whether there are any outstanding
				complaints against the facility, as well as the resolution of any complaint
				already investigated by the department.
(6) Whether the annual fiscal review
				conducted by the department indicated any irregularities in the residents'
				accounts.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 54 - Governor's Award for Quality Care › Rule 481-54.7 - Selection of Finalists

Current through Register Vol. 47, No. 3, July 24, 2024
When reviewing the nominations, the department shall rank all
				  facilities according to the above criteria. The ranked list of facilities shall
				  be provided to the director for further review and consideration. When the
				  final selection is made, no more than two facilities from each congressional
				  district shall be recognized as award winners.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 54 - Governor's Award for Quality Care › Rule 481-54.8 - Certificate of Recognition

Current through Register Vol. 47, No. 3, July 24, 2024
Prior to the final selection of facilities, representatives
				  from the department will tour all facilities still in contention to determine
				  the winners. Each winning facility will receive a certificate in recognition of
				  its designation as a quality health care provider. The winning facilities shall
				  be announced and recognized annually.