reglab/statecodes huggingface dataset:
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.9 - Certification or Recertification of an Accredited Program-application Process

Current through Register Vol. 47, No. 3, July 24, 2024
(1) An applicant
				for certification or recertification of a program accredited by a recognized
				accrediting entity shall:
a. Submit a
				completed application packet obtained from the department. Application
				materials may be obtained from the health facilities division Web site at
				https://dia-hfd.iowa.gov/DIA HFD/ Home.do [File Link Not Available]; by mail
				from the Department of Inspections and Appeals, Adult Services Bureau, Lucas
				State Office Building, Third Floor, 321 E. 12th Street, Des Moines, Iowa
				50319-0083; or by telephone at (515)281-6325.
b. Submit a copy of the current accreditation
				outcome from the recognized accrediting entity.
c. Apply for certification or recertification
				within 90 calendar days following verification of compliance with life safety
				requirements pursuant to this chapter.
d. Maintain compliance with the state fire
				marshal division's requirements.
e.
				Submit the appropriate fees as set forth in Iowa Code section 231C. 18.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.10 - Certification or Recertification of an Accredited Program-application Content

Current through Register Vol. 47, No. 3, July 24, 2024
An application for certification or recertification of an
				  accredited program shall include the following:
(1) A list that includes the names, addresses
				and percentage of stock, shares, partnership or other equity interest of all
				officers, members of the board of directors, and trustees, as well as
				stockholders, partners or any individuals who have greater than a 10 percent
				equity interest in each of the following, as applicable:
a. The real estate owner or lessor;
b. The lessee; and
c. The management company responsible for the
				day-to-day operation of the program.
The program shall notify the department of any changes in the
				  list no later than ten working days after the effective date of the
				  change.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.11 - Initial Certification Process for an Accredited Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Within 20
				working days of receiving all finalized documentation, including state fire
				marshal approval, the department shall determine and notify the accredited
				program whether or not the accredited program meets applicable requirements and
				whether or not certification will be issued.
(2) If the decision is to certify, a
				certification shall be issued for the term of the accreditation not to exceed
				three years, unless the certification is conditionally issued, suspended or
				revoked by either the department or the recognized accrediting
				entity.
(3) If the decision is to
				deny certification, the department shall provide the applicant an opportunity
				for hearing in accordance with rule
				481-67.13
				(17A,231B,231C,231D).
(4) Unless
				conditionally issued, suspended or revoked, certification for a program shall
				expire at the end of the time period specified on the certificate.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.12 - Recertification Process for an Accredited Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The department shall send recertification
				application materials to each program at least 120 calendar days prior to
				expiration of the program's certification.
(2) To obtain recertification, an accredited
				program shall submit one copy of the completed application, associated
				documentation, and the administrative fee as stated in Iowa Code section 231C.
				18 to the department at the address stated in subrule 69.9(1) at least 90
				calendar days prior to the expiration of the program's certification.
(3) Within 20 working days of receiving all
				finalized documentation, including state fire marshal approval, the department
				shall determine the program's compliance with applicable requirements and make
				a recertification decision.
(4) The
				department shall notify the accredited program within 10 working days of the
				final recertification decision.
a. If the
				decision is to recertify, a full certification shall be issued for the term of
				the accreditation not to exceed three years, unless the certification is
				conditionally issued, suspended or revoked by either the department or the
				recognized accrediting entity.
b.
				If the decision is to deny recertification, the department shall provide the
				applicant an opportunity for hearing in accordance with rule
				481-67.13
				(17A,231B,231C,231D).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.13 - Listing of All Certified Programs

Current through Register Vol. 47, No. 3, July 24, 2024
The department shall maintain a list of all certified
				  programs, which is available online at
https://dia-hfd.iowa.gov/DIA_HFD/Home.do
under the "Entities Book" tab.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.14 - Recognized Accrediting Entity

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The department designates CARF as a
				recognized accrediting entity for programs.
(2) To apply for designation by the
				department as a recognized accrediting entity for programs, an accrediting
				entity shall submit a letter of request, and its standards shall, at minimum,
				meet the applicable requirements for programs.
(3) The designation shall remain in effect
				for as long as the accreditation standards continue to meet, at minimum, the
				applicable requirements for programs.
(4) An accrediting entity shall provide
				annually to the department, at no cost, a current edition of the applicable
				standards manual and survey preparation guide, and training thereon, within 120
				working days after the publications are released.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.15 - Requirements for an Accredited Program

Current through Register Vol. 47, No. 3, July 24, 2024
Each accredited program that is certified by the department
				  shall:
(1) Provide the department a
				copy of all survey reports including outcomes, quality improvement plans and
				annual conformance to quality reports generated or received, as applicable,
				within ten working days of receipt of the reports.
(2) Notify the department by the most
				expeditious means possible of all credible reports of alleged improper or
				inappropriate conduct or conditions within the program and any actions taken by
				the accrediting entity with respect thereto.
(3) Notify the department immediately of the
				expiration, suspension, revocation or other loss of the program's
				accreditation.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.16 - Maintenance of Program Accreditation

Current through Register Vol. 47, No. 3, July 24, 2024
(1) An accredited program shall continue to
				be recognized for certification by the department if both of the following
				requirements are met:
a. The program complies
				with the requirements outlined in rule
				481-69.15
				(231C).
b. The program maintains
				its voluntary accreditation status for the duration of the time-limited
				certification period.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.17 - Change of Ownership-notification to the Department

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Certification, unless conditionally
				issued, suspended or revoked, may be transferable. If the program's
				certification has been conditionally issued, the department must approve a
				change of ownership prior to the transfer of the certification.
(2) In order to transfer certification, the
				applicant must:
a. Meet the requirements of
				the rules, regulations and standards contained in Iowa Code chapter 231C and
				481-Chapter 67 and this chapter; and
b. At least 30 days prior to the change of
				ownership of the program, make application on forms provided by the
				department.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.18 - Plan Reviews of a Building for a New Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Before a building is constructed or
				remodeled for use in a new program, the state fire marshal division of the
				department of public safety shall review the blueprints for compliance with
				requirements pursuant to this chapter. Construction or remodeling includes new
				construction, remodeling of any part of an existing building, addition of a new
				wing or floor to an existing building, or conversion of an existing
				building.
(2) A program applicant
				shall submit blueprints wet-sealed by an Iowa-licensed architect or
				Iowa-licensed engineer and the blueprint plan review fee as stated in Iowa Code
				section 231C. 18 to the Department of Public Safety, State Fire Marshal
				Division, 215 E. 7th Street, Third Floor, Des Moines, Iowa 50319.
(3) Failure to submit the blueprint plan
				review fee with the blueprints shall result in delay of the blueprint plan
				review until the fee is received.
(4) The state fire marshal division of the
				department of public safety shall review the blueprints and notify the
				Iowa-licensed architect or Iowa-licensed engineer in writing regarding the
				status of compliance with requirements.
(5) The Iowa-licensed architect or
				Iowa-licensed engineer shall respond to the state fire marshal division of the
				department of public safety to state how any noncompliance will be
				resolved.
(6) Upon final
				notification by the state fire marshal division of the department of public
				safety that the blueprints meet the state fire marshal division's requirements,
				construction or remodeling of the building may commence.
(7) The state fire marshal division of the
				department of public safety shall schedule an on-site visit of the building
				site with the contractor, or Iowa-licensed architect or Iowa-licensed engineer,
				during the construction or remodeling process to ensure compliance with the
				approved blueprints. Any noncompliance must be resolved prior to approval for
				certification.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.19 - Plan Review Prior to the Remodeling of a Building for a Certified Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Before a
				building for a certified program is remodeled, the state fire marshal division
				of the department of public safety shall review the blueprints for compliance
				with requirements set forth in rule
				481-69.35
				(231C). Remodeling includes modification of any part of an existing building,
				addition of a new wing or floor to an existing building, or conversion of an
				existing building.
(2) A certified
				program shall submit blueprints wet-sealed by an Iowa-licensed architect or
				Iowa-licensed engineer and the blueprint plan review fee as stated in Iowa Code
				section 231C. 18 to the Department of Public Safety, State Fire Marshal
				Division, 215 E. 7th Street, Third Floor, Des Moines, Iowa 50319.
(3) Failure to submit the blueprint plan
				review fee with the blueprints shall result in delay of the blueprint plan
				review until the fee is received.
(4) Upon final notification by the state fire
				marshal division of the department of public safety that the blueprints meet
				structural and life safety requirements, remodeling of the building may
				commence.
(5) The state fire
				marshal division of the department of public safety shall schedule an on-site
				visit of the building with the contractor, or Iowa-licensed architect or
				Iowa-licensed engineer, during the remodeling process to ensure compliance with
				the approved blueprints. Any noncompliance must be resolved prior to approval
				for continued certification or recertification of the program.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.20 - Cessation of Program Operation

Current through Register Vol. 47, No. 3, July 24, 2024
(1) If a certified program ceases operation,
				which includes seeking decertification, at any time prior to expiration of the
				program's certification, the program shall submit the certificate to the
				department. At least 90 days in advance of cessation or decertification, the
				program shall provide to the department and the office of long-term care
				ombudsman written notification of the date on which the program will cease
				operation or decertify.
(2) If a
				certified program plans to cease operation, which includes seeking
				decertification, at the time the program's certification expires, the program
				shall provide written notice of this fact to the department and the office of
				long-term care ombudsman at least 90 days prior to expiration of the
				certification.
(3) At the time a
				program decides to cease operation, which includes seeking decertification, the
				program shall submit a plan to the department and make arrangements for the
				safe and orderly transfer or transition of all tenants within the 90-day period
				specified by subrule 69.20(2).
(4)
				The department may conduct a monitoring during the 90-day period to ensure the
				safety of tenants during the transfer process or transition process.
(5) The department may conduct an on-site
				visit to verify that the program has ceased operation as a certified program in
				accordance with the notice provided by the program.
(6) When a program ceases operation, which
				includes seeking decertification, representatives from the office of long-term
				care ombudsman shall be allowed by the program to privately meet with tenants
				to provide education and service options.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.21 - Occupancy Agreement

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The
				occupancy agreement shall be in 12-point type or larger, shall be written in
				plain language using commonly understood terms and shall be easy for the tenant
				or the tenant's legal representative to understand.
(2) In addition to the requirements of Iowa
				Code section
				231C.5,
				the written occupancy agreement shall include, but not be limited to, the
				following information in the body of the agreement or in the supporting
				documents and attachments:
a. The telephone
				number for filing a complaint with the department.
b. The telephone number for the office of
				long-term care ombudsman.
c. The
				telephone number for reporting dependent adult abuse.
d. A copy of the program's statement on
				tenants' rights.
e. A statement
				that the tenant landlord law applies to assisted living programs.
f. A statement that the program will notify
				the tenant at least 90 days in advance of any planned program cessation, which
				includes voluntary decertification, except in cases of
				emergency.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.22 - Evaluation of Tenant

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Evaluation prior to occupancy.
A program shall evaluate each
				prospective tenant's functional, cognitive and health status prior to the
				tenant's signing the occupancy agreement and taking occupancy of a dwelling
				unit in order to determine the tenant's eligibility for the program, including
				whether the services needed are available. The cognitive evaluation shall
				utilize a scored, objective tool. When the score from the cognitive evaluation
				indicates moderate cognitive decline and risk, the Global Deterioration Scale
				(GDS) shall be used at all subsequent intervals, if applicable. If the tenant
				subsequently returns to the tenant's mildly cognitively impaired state, the
				program may discontinue the GDS and revert to a scored cognitive screening
				tool. The evaluation shall be conducted by a health care professional or a
				human service professional.
(2)
Evaluation within 30 days of occupancy.
A program shall
				evaluate each tenant's functional, cognitive and health status within 30 days
				of occupancy. The evaluation shall be conducted by a health care professional,
				a human service professional, or a licensed practical nurse via nurse
				delegation when the tenant has not exhibited a significant change.
(3)
Evaluation annually and with
				significant change.
A program shall evaluate each tenant's functional,
				cognitive and health status as needed with significant change, but not less
				than annually, to determine the tenant's continued eligibility for the program
				and to determine any changes to services needed. The evaluation shall be
				conducted by a health care professional, a human service professional, or a
				licensed practical nurse via nurse delegation when the tenant has not exhibited
				a significant change. A licensed practical nurse shall not complete the
				evaluation when the tenant has exhibited a significant change.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.23 - Criteria for Admission and Retention of Tenants

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Persons who may not be admitted
				or retained.
A program shall not knowingly admit or retain a tenant
				who:
a. Is bed-bound; or
b. Requires routine, two-person assistance
				with standing, transfer or evacuation; or
c. Is dangerous to self or other tenants or
				staff, including but not limited to a tenant who:
(1) Despite intervention chronically elopes,
				is sexually or physically aggressive or abusive, or displays unmanageable
				verbal abuse or aggression; or
(2)
				Displays behavior that places another tenant at risk; or
d. Is in an acute stage of alcoholism, drug
				addiction, or uncontrolled mental illness; or
e. Is under the age of 18; or
f. Requires more than part-time or
				intermittent health-related care; or
g. Has unmanageable incontinence on a routine
				basis despite an individualized toileting program; or
h. Is medically unstable; or
i. Requires maximal assistance with
				activities of daily living; or
j.
				Despite intervention, chronically urinates or defecates in places that are not
				considered acceptable according to societal norms, such as on the floor or in a
				potted plant.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.24 - Involuntary Transfer From the Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Program initiation of
				transfer.
If a program initiates the involuntary transfer of a tenant
				and the action is not the result of a monitoring, including a complaint
				investigation or program-reported incident investigation, by the department and
				if the tenant or tenant's legal representative contests the transfer, the
				following procedures shall apply:
a. The
				program shall notify the tenant or tenant's legal representative, in accordance
				with the occupancy agreement, of the need to transfer the tenant and of the
				reason for the transfer and shall include the contact information for the
				office of long-term care ombudsman.
b. The program shall immediately provide to
				the office of long-term care ombudsman, by certified mail, a copy of the
				notification and notify the tenant's treating physician, if any.
c. Pursuant to statute, the office of
				long-term care ombudsman shall offer the notified tenant or tenant's legal
				representative assistance with the program's internal appeal process. The
				tenant or tenant's legal representative is not required to accept the
				assistance of the office of long-term care ombudsman.
d. If, following the internal appeal process,
				the program upholds the transfer decision, the tenant or tenant's legal
				representative may utilize other remedies authorized by law to contest the
				transfer.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.25 - Tenant Documents

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
				Documentation for each tenant shall be maintained by the program and shall
				include:
a. An occupancy record including the
				tenant's name, birth date, and home address; identification numbers; date of
				occupancy; name, address and telephone number of health professional(s);
				diagnosis; and names, addresses and telephone numbers of family members,
				friends or other designated people to contact in the event of illness or an
				emergency;
b. Application
				forms;
c. The initial evaluations
				and updates;
d. A nutritional
				assessment as necessary;
e. The
				initial individual service plan and updates;
f. Signed authorizations for permission to
				release medical information, photographs, or other media information as
				necessary;
g. A signed
				authorization for the tenant to receive emergency medical care as
				necessary;
h. A signed managed risk
				policy and signed managed risk consensus agreements, if any;
i. When any personal or health-related care
				is delegated to the program, the medical information sheet; documentation of
				health professionals' orders, such as those for treatment, therapy, and
				medication; and nurses' notes written by exception;
j. Medication lists, which shall be
				maintained in conformance with 481-paragraph
				67.5(2)
"d";
k.
				Advance health care directives as applicable;
l. A complete copy of the tenant's occupancy
				agreement, including any updates;
m. A written acknowledgment that the tenant
				or the tenant's legal representative, if applicable, has been fully informed of
				the tenant's rights;
n. A copy of
				guardianship, durable power of attorney for health care, power of attorney, or
				conservatorship or other documentation of a legal representative;
o. Incident reports involving the tenant,
				including but not limited to those related to medication errors, accidents,
				falls, and elopements (such reports shall be maintained by the program but need
				not be included in the tenant's medical record);
p. A copy of waivers of admission or
				retention criteria, if any;
q. When
				the tenant is unable to advocate on the tenant's own behalf or the tenant has
				multiple service providers, including hospice care providers, accurate
				documentation of the completion of routine personal or health-related care is
				required on task sheets. If tasks are doctor-ordered, the tasks shall be part
				of the medication administration records (MARs); and
r. Authorizations for the release of
				information, if any.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.26 - Service Plans

Current through Register Vol. 47, No. 3, July 24, 2024
(1) A service
				plan shall be developed for each tenant based on the evaluations conducted in
				accordance with subrules 69.22(1) and 69.22(2) and shall be designed to meet
				the specific service needs of the individual tenant. The service plan shall
				subsequently be updated at least annually and whenever changes are
				needed.
(2) Prior to the tenant's
				signing the occupancy agreement and taking occupancy of a dwelling unit, a
				preliminary service plan shall be developed by a health care professional or
				human service professional in consultation with the tenant and, at the tenant's
				request, with other individuals identified by the tenant, and, if applicable,
				with the tenant's legal representative. All persons who develop the plan and
				the tenant or the tenant's legal representative shall sign the plan.
(3) When a tenant needs personal care or
				health-related care, the service plan shall be updated within 3 0 days of the
				tenant's occupancy and as needed with significant change, but not less than
				annually.
a. If a significant change triggers
				the review and update of the service plan, the updated service plan shall be
				signed and dated by all parties.
b.
				If a significant change does not exist, the program may, after nurse review,
				add minor discretionary changes to the service plan without a comprehensive
				evaluation and without obtaining signatures on the service plan.
c. If a significant change relates to a
				recurring or chronic condition, a previous evaluation and service plan of the
				recurring condition may be utilized without new signatures being obtained. For
				example, with chronic exacerbation of a urinary tract infection, nurse review
				is adequate to institute the previously written evaluation and service
				plan.
d. The service plan updated
				within 30 days of the tenant's occupancy shall be signed and dated by all
				parties.
e. The service plan shall
				be reviewed, updated if necessary, and signed and dated by all parties at least
				annually.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.27 - Nurse Review

Current through Register Vol. 47, No. 3, July 24, 2024
(1) If a tenant
				does not receive personal or health-related care, but an observed significant
				change in the tenant's condition occurs, a nurse review shall be conducted. If
				a tenant receives personal or health-related care, the program shall provide
				for a registered nurse:
a. To monitor, at
				least every 90 days, or after a significant change in the tenant's condition,
				any tenant who receives program-administered prescription medications for
				adverse reactions to the medications and to make appropriate interventions or
				referrals, and to ensure that the prescription medication orders are current
				and that the prescription medications are administered consistent with such
				orders; and
b. To ensure that
				health care professionals' orders are current for tenants who receive health
				care professional-directed care from the program; and
c. To assess and document the health status
				of each tenant, to make recommendations and referrals as appropriate, and to
				monitor progress relating to previous recommendations at least every 90 days
				and whenever there are changes in the tenant's health status; and
d. To provide the program with written
				documentation of the nurse review, showing the time, date and signature.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.28 - Food Service

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The
				program shall provide or coordinate with other community providers to provide a
				hot or other appropriate meal(s) at least once a day or shall make arrangements
				for the availability of meals.
(2)
				Meals and snacks provided by the program but not prepared on site shall be
				obtained from or provided by an entity that meets the standards of state and
				local health laws and ordinances concerning the preparation and serving of
				food.
(3) Menus shall be planned to
				provide the following percentage of the daily recommended dietary allowances as
				established by the Food and Nutrition Board of the National Research Council of
				the National Academy of Sciences based on the number of meals provided by the
				program:
a. A minimum of
				331/3 percent if the program
				provides one meal per day;
b. A
				minimum of 662/3 percent if
				the program provides two meals per day; and
c. One hundred percent if the program
				provides three meals per day.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.30 - Dementia-specific Education for Program Personnel

Current through Register Vol. 47, No. 3, July 24, 2024
(1) All personnel employed by or contracting
				with a dementia-specific program shall receive a minimum of eight hours of
				dementia-specific education and training within 30 days of either employment or
				the beginning date of the contract, as applicable.
(2) The dementia-specific education or
				training shall include, at a minimum, the following:
a. An explanation of Alzheimer's disease and
				related disorders;
b. The program's
				specialized dementia care philosophy and program;
c. Skills for communicating with persons with
				dementia;
d. Skills for
				communicating with family and friends of persons with dementia;
e. An explanation of family issues such as
				role reversal, grief and loss, guilt, relinquishing the care-giving role, and
				family dynamics;
f. The importance
				of planned and spontaneous activities;
g. Skills in providing assistance with
				instrumental activities of daily living;
h. The importance of the service plan and
				social history information;
i.
				Skills in working with challenging tenants;
j. Techniques for simplifying, cueing, and
				redirecting;
k. Staff support and
				stress reduction; and
l.
				Medication management and nonpharmacological interventions.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.31 - Managed Risk Policy and Managed Risk Consensus Agreements

Current through Register Vol. 47, No. 3, July 24, 2024
The program shall have a managed risk policy. The managed
				  risk policy shall be provided to the tenant along with the occupancy agreement.
				  The managed risk policy shall include the following:
(1) An acknowledgment of the shared
				responsibility for identifying and meeting the needs of the tenant and the
				process for managing risk and for upholding tenant autonomy when tenant
				decision making could result in poor outcomes for the tenant or others;
				and
(2) A consensus-based process
				to address specific risk situations. Program staff and the tenant shall
				participate in the process. The result of the consensus-based process may be a
				managed risk consensus agreement. The managed risk consensus agreement shall
				include the signature of the tenant and the signatures of all others who
				participated in the process. The managed risk consensus agreement shall be
				included in the tenant's file.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.32 - Life Safety-emergency Policies and Procedures and Structural Safety Requirements

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
				The program shall submit to the department and follow written emergency
				policies and procedures, which shall include the following:
a. An emergency plan, which shall include
				procedures for natural disasters (identify where the plan is located for easy
				reference);
b. Fire safety
				procedures;
c. Other general or
				personal emergency procedures;
d.
				Provisions for amending or revising the emergency plan;
e. Provisions for periodic training of all
				employees;
f. Procedures for fire
				drills;
g. Regulations regarding
				smoking;
h. Monitoring and testing
				of smoke-control systems;
i. Tenant
				evacuation procedures; and
j.
				Procedures for reporting and documentation.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.33 - Transportation

Current through Register Vol. 47, No. 3, July 24, 2024
When transportation services are provided directly or under
				  contract with the program:
(1) The
				vehicle shall be accessible and appropriate to the tenants who use it, with
				consideration for any physical disabilities and impairments.
(2) Every tenant transported shall have a
				seat in the vehicle, except for a tenant who remains in a wheelchair during
				transport.
(3) Vehicles shall have
				adequate seat belts and securing devices for ambulatory and wheelchair-using
				passengers.
(4) Wheelchairs shall
				be secured when the vehicle is in motion.
(5) During loading and unloading of a tenant,
				the driver shall be in the proximate area of the tenants in a
				vehicle.
(6) The driver shall have
				a valid and appropriate Iowa driver's license or commercial driver's license as
				required by law for the vehicle being utilized for transport. If the driver is
				licensed in another state, the license shall be valid and appropriate for the
				vehicle being utilized for transport. The driver shall meet any state or
				federal requirements for licensure or certification for the vehicle
				operated.
(7) Each vehicle shall
				have a first-aid kit, fire extinguisher, safety triangles and a device for
				two-way communication.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.34 - Activities

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The program
				shall provide appropriate activities for each tenant. Activities shall reflect
				individual differences in age, health status, sensory deficits, lifestyle,
				ethnic and cultural beliefs, religious beliefs, values, experiences, needs,
				interests, abilities and skills by providing opportunities for a variety of
				types and levels of involvement.
(2) Activities shall be planned to support
				the tenant's service plan and shall be consistent with the program statement
				and occupancy policies.
(3) A
				written schedule of activities shall be developed at least monthly and made
				available to tenants and their legal representatives.
(4) Tenants shall be given the opportunity to
				choose their levels of participation in all activities offered in the
				program.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.35 - Structural Requirements

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
General requirements.
a. The structure of the program shall be
				designed and operated to meet the needs of the tenants.
b. The buildings and grounds shall be
				well-maintained, clean, safe and sanitary.
c. Programs shall have private dwelling units
				with a single-action, lockable entrance door.
d. A program serving persons with cognitive
				impairment or dementia, whether in a general or dementia-specific setting,
				shall have the means to disable or remove the lock on an entrance door and
				shall disable or remove the lock if its presence presents a danger to the
				health and safety of the tenant.
e.
				The structure in which a program is housed shall comply with the administrative
				rules promulgated by the state fire marshal.
f. Programs may have individual cooking
				facilities within the private dwelling units. Any program serving persons with
				cognitive impairment or dementia, whether in a general or dementia-specific
				setting, shall have the means to disable or easily remove appliances and shall
				disable or remove them if their presence presents a danger to the health and
				safety of the tenant or others.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.36 - Dwelling Units in Dementia-specific Programs

Current through Register Vol. 47, No. 3, July 24, 2024
Dementia-specific programs are exempt from the requirements
				  in subrules 69.35(2) to 69.35(4) as follows:
(1) For a program built in a family or
				neighborhood design:
a. Each dwelling unit
				used for single occupancy shall have a total square footage of not less than
				150 square feet of floor area, excluding a bathroom; and
b. Each dwelling unit used for double
				occupancy shall have a total square footage of not less than 250 square feet of
				floor area, excluding a bathroom.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.38 - Identification of Veteran's Benefit Eligibility

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Within 30 days of a tenant's admission to
				an assisted living program that receives reimbursement through the medical
				assistance program under Iowa Code chapter 249A, the program shall ask the
				tenant or the tenant's personal representative whether the tenant is a veteran
				or whether the tenant is the spouse, widow, or dependent of a veteran and shall
				document the response.
(2) If the
				program determines that the tenant may be a veteran or the spouse, widow, or
				dependent of a veteran, the program shall report the tenant's name along with
				the name of the veteran, if applicable, as well as the name of the contact
				person for this information, to the Iowa department of veterans affairs. When
				appropriate, the program may also report such information to the Iowa
				department of human services.
(3)
				If a tenant is eligible for benefits through the U.S. Department of Veterans
				Affairs or other third-party payor, the program first shall seek reimbursement
				from the identified payor source before seeking reimbursement from the medical
				assistance program established under Iowa Code chapter 249A.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 69 - Assisted Living Programs › Rule 481-69.39 - Respite Care Services

Current through Register Vol. 47, No. 3, July 24, 2024
"Respite care services" means an organized program of
				  temporary supportive care provided for 24 hours or more to a person in order to
				  relieve the usual caregiver of the person from providing continual care to the
				  person. "Respite care individual" means an individual receiving respite care
				  services. An assisted living program which chooses to provide respite care
				  services must meet the following requirements related to respite care services
				  and must be certified as an assisted living program.
(1) Length of stay. Respite care services
				shall be provided for no more than 30 consecutive days and for a total of no
				more than 60 days in a consecutive 12-month period. The 12-month period begins
				on the first day of the respite care individual's stay in the
				program.
(2) No separate
				certificate. An assisted living program that chooses to provide respite care
				services is not required to obtain a separate certificate or pay a
				certification fee.
(3) Assessment.
				The program nurse shall conduct an assessment of the respite care individual
				prior to the respite care individual's stay. The assessment shall be documented
				and shall include, at a minimum:
a. Safety
				and supervision needs;
b. Medical
				needs;
c. Dietary needs;
				and
d. Bowel and bladder
				function.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 70 - Adult Day Services › Rule 481-70.2 - Program Certification

Current through Register Vol. 47, No. 3, July 24, 2024
A program may obtain certification by meeting all applicable
				  requirements. In addition, a program may be voluntarily accredited by a
				  recognized accreditation entity. For the purpose of these rules, certification
				  is equivalent to licensure.
(1)
Posting requirements. A
program's current certificate shall be
				visibly displayed within the designated operation area of the program. In
				addition, the latest monitoring report, state fire marshal report, and food
				establishment inspections report issued pursuant to Iowa Code chapter 137F
				shall be made available to the public by the program upon request.
(2)
Dementia-specific programs and
				door alarms.
If a program meets the definition of a dementia-specific
				adult day services program during two sequential certification monitorings, the
				program shall meet all requirements for a dementia-specific program, including
				the requirements set forth in rule
				481-70.30
				(23 ID) and in subrule 70.32(2), which includes the requirements relating to
				door alarms.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 70 - Adult Day Services › Rule 481-70.3 - Certification of a Nonaccredited Program-application Process

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The applicant shall complete an
				application packet obtained from the department. Application materials may be
				obtained from the health facilities division Web site at
https://dia-hfd.iowa.gov/DIA_HFD/Home.do;
by mail from the Department of Inspections and Appeals, Adult Services Bureau,
				Lucas State Office Building, Third Floor, 321 E. 12th Street, Des Moines, Iowa
				50319-0083; or by telephone at (515)281-6325.
(2) The applicant shall submit one copy of
				the completed application and all supporting documentation to the department at
				the above address at least 90 calendar days prior to the expected date of
				beginning operation.
(3) The
				appropriate fee as stated in Iowa Code section
				231D.4 shall
				accompany each application and be payable by check or money order to the
				Department of Inspections and Appeals. Fees are nonrefundable.
(4) The department shall consider the
				application when all supporting documents and fees are received.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 70 - Adult Day Services › Rule 481-70.4 - Nonaccredited Program-application Content

Current through Register Vol. 47, No. 3, July 24, 2024
An application for certification or recertification of a
				  nonaccredited program shall include the following:
(1) A list that includes the names,
				addresses, and percentage of stock, shares, partnership or other equity
				interest of all officers, members of the board of directors and trustees, as
				well as stockholders, partners or any individuals who have greater than a 10
				percent equity interest in each of the following, as applicable:
a. The real estate owner or lessor;
b. The lessee; and
c. The management company responsible for the
				day-to-day operation of the program.
The program shall notify the department of any changes in the
				  list no later than ten working days after the effective date of the
				  change.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 70 - Adult Day Services › Rule 481-70.5 - Initial Certification Process for a Nonaccredited Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Upon receipt of
				all completed documentation, including state fire marshal approval and
				structural and evacuation review approval, the department shall determine
				whether the proposed program meets applicable requirements.
(2) If, based upon the review of the complete
				application, including all required supporting documents, the department
				determines the proposed program meets the requirements for certification, a
				provisional certification shall be issued to the program to begin operation and
				accept participants.
(3) Within 180
				calendar days following issuance of provisional certification, the department
				shall conduct a monitoring to determine the program's compliance with
				applicable requirements.
(4) If a
				regulatory insufficiency is identified as a result of the monitoring, the
				process in rule
				481-67.10
				(17A,231B,231C,231D) shall be followed.
(5) The department shall make a final
				certification decision based on the results of the monitoring and review of an
				acceptable plan of correction.
(6)
				The department shall notify the program of a final certification decision
				within 10 working days following the finalization of the monitoring report or
				receipt of an acceptable plan of correction, whichever is applicable.
(7) If the decision is to continue
				certification, the department shall issue a full two-year certification
				effective from the date of the original provisional certification.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 70 - Adult Day Services › Rule 481-70.6 - Expiration of the Certification of a Nonaccredited Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Unless conditionally issued, suspended or
				revoked, certification of a program shall expire at the end of the time period
				specified on the certificate.
(2)
				The department shall send recertification application materials to each program
				at least 120 calendar days prior to expiration of the program's
				certification.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 70 - Adult Day Services › Rule 481-70.7 - Recertification Process for a Nonaccredited Program

Current through Register Vol. 47, No. 3, July 24, 2024
To obtain recertification, a program shall:
(1) Submit one copy of the completed
				application, including the information required in rule
				481-70.4
				(231D), associated documentation, and the recertification fee as listed in Iowa
				Code section
				231D.4 to
				the department at the address stated in subrule 70.3(1) at least 90 calendar
				days prior to the expiration of the program's certification. The program need
				not submit policies and procedures that have been previously submitted to the
				department and remain unchanged. The program shall provide a list of the
				policies and procedures that have been previously submitted and are not being
				resubmitted.
(2) Submit additional
				documentation that each of the following has been inspected by a qualified
				professional and found to be maintained in conformance with the manufacturer's
				recommendations and nationally recognized standards: heating system, cooling
				system, water heater, electrical system, plumbing, sewage system, artificial
				lighting, and ventilation system; and, if located on site, garbage disposal,
				kitchen appliances, washing machines and dryers, and elevators.