reglab/statecodes huggingface dataset:
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 49 - Ambulatory Surgical Centers › Rule 481-49.2 - Application and Licensing

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Application and licensing.
An ambulatory surgical center shall
				obtain a license from the department in accordance with Iowa Code section
				135R.2.
a. An ambulatory surgical center
				seeking licensure will make application on forms provided by the department or
				through the department's online application system. Upon receipt of a completed
				application, including completion of the building and plan review set forth in
				paragraph 49.2(1)
"b,"
and receipt of the $50 fee set forth in
				Iowa Code section 135R.3(3), the
				application will be considered.
b.
				An ambulatory surgical center applicant shall submit architectural technical
				documents, engineering documents, and plans and specifications to the
				department's building and construction division in accordance with rule
				661-300.4 (103A) that
				demonstrate the applicant's compliance with the construction and physical
				environment requirements of subrule 49.4(2). The submission may be completed by
				an authorized agent of the applicant or the responsible design professional,
				who shall certify that the building or building plans meet the construction and
				physical environment standards within subrule 49.4(2) or that a waiver has been
				granted by the department for any noncompliant standard. If the applicant was
				operating prior to and continuously since July 1, 2023, the applicant is
				permitted up to six months after submission of its license application to
				submit plans demonstrating compliance with subrule 49.4(1) or obtaining waivers
				for the construction and physical environment standards in accordance with
				subrule 49.4(2).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 49 - Ambulatory Surgical Centers › Rule 481-49.3 - Inspections

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Frequency.
Inspections may be initiated because of a complaint
				or other information received by the department or upon referral from other
				agencies. The department will perform inspections at the same frequency and
				utilize any priority tier structure for survey and certification activities
				required for inspections of Medicare-certified ambulatory surgical centers. The
				department will recognize, in lieu of its own licensure inspection, the
				comparable inspection and findings of a Medicare survey or an accrediting
				organization survey from an accrediting organization approved by CMS for
				federal certification. An ambulatory surgical center utilizing an accrediting
				organization survey to satisfy the requirements of this subrule shall submit an
				accreditation certificate to the department within 30 days of completion of
				each accrediting organization survey.
(2)
Access to records.
An
				inspector with the department may enter an ambulatory surgical center without a
				warrant and may examine and copy all records and items pertaining to the
				inspection unless the record or item is protected by some other legal
				privilege.
(3)
Evaluation
				of allegations and referral to other agencies.
If an inspection is
				initiated, the department will evaluate the allegations to determine whether
				the allegations should also be referred to other local, state, or federal
				agencies. If the department believes a criminal or regulatory violation has
				occurred or is occurring, the department shall notify the appropriate law
				enforcement or regulatory agencies.
(4)
Final findings.
The
				department will notify the ambulatory surgical center and any complainant, in
				writing, of the final findings of an inspection.
(5)
Inspector conflict of
				interest.
An employee of the department will be excluded from
				participating in the inspection of an ambulatory surgical facility described by
				Iowa Code section 135R.5(3).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 49 - Ambulatory Surgical Centers › Rule 481-49.4 - General Licensing Standards

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Federal
				specific conditions of coverage.
A state-licensed ambulatory surgical
				center shall comply with the specific conditions for coverage in the federal
				Medicare program for ambulatory surgical centers under 42 CFR Part 416, Subpart
				C, as amended to July 1, 2023, and federal interpretive guidelines for such
				regulations, including Appendix L of the State Operations Manual published by
				CMS, Rev. 215, as amended to July 21, 2023, or an accreditation standard of The
				Joint Commission, the American Association for Accreditation of Ambulatory
				Surgical Facilities, the Accreditation Association for Ambulatory Health Care,
				or an accrediting organization approved by CMS for federal certification if the
				state-licensed ambulatory surgical center is inspected by an accrediting
				organization pursuant to subrule 49.3(1).
(2)
Construction and physical
				environment standards.
In accordance with subrule 49.4(1), the
				construction and physical environment standards of
				42 CFR
				416.44 as amended to July 1, 2023, are
				adopted. Ambulatory surgical centers built in compliance with construction and
				environment standards applicable at the time of building approval or building
				plan approval under subrule 49.2(1) are deemed in compliance with subsequent
				regulations, with the exception of any structural renovations, additions,
				functional alterations, or changes in space utilization after the date of
				approval. Any such structural renovations, additions, functional alterations,
				or changes in space utilization that will occur after the licensee's initial
				approval shall be reviewed and approved in accordance with paragraph
				49.2(3)
"b"
prior to such changes being made.
(3)
External reporting.
An
				ambulatory surgical center shall report quality data to the Iowa department of
				health and human services consistent with the data required to be reported to
				CMS in accordance with rules promulgated by the Iowa department of health and
				human services.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 49 - Ambulatory Surgical Centers › Rule 481-49.5 - Enforcement and Penalties

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Denial,
				suspension, or revocation.
The license for an ambulatory surgical
				center may be denied, suspended, or revoked for failure to comply with Iowa
				Code chapter 135R or this chapter, including any reason for which an ambulatory
				surgical center could be denied, suspended, or terminated from the federal
				Medicare program for ambulatory surgical centers under 42 CFR Part 416 as
				amended to July 1, 2023, and federal interpretive guidelines, including
				Appendix L of the State Operations Manual published by CMS, Rev. 215, as
				amended to July 21, 2023.
(2)
Effective date and contested case appeals.
Unless otherwise
				stated, a denial, suspension or revocation of license is effective 30 days
				after certified mailing or personal service of the notice upon the licensee.
				The licensee may request a contested case hearing by submitting a request, in
				writing, to the department within 30 days of the mailing or service. Contested
				case appeals and hearings are governed by 481-Chapter 9, 481-Chapter 10, and
				481-Chapter 16.
(3)
Enjoining an unlicensed ambulatory surgical center.
An
				injunction or other process against any person to restrain or prevent the
				establishment, operation, or maintenance of an ambulatory surgical center
				without a license may be pursued by the department in accordance with Iowa Code
				section 135R.7.
(4)
Operation of unlicensed
				ambulatory surgical center-serious misdemeanor.
A person establishing,
				operating, or maintaining an ambulatory surgical center without a license
				commits a serious misdemeanor as set forth in Iowa Code section
				135R.9.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 49 - Ambulatory Surgical Centers › Rule 481-49.6 - Public and Confidential Information

Current through Register Vol. 47, No. 3, July 24, 2024
The department's final findings with respect to compliance by
				  an ambulatory surgical center with requirements for licensing will be made
				  available to the public on the department's website. Other information relating
				  to an ambulatory surgical center obtained by the department that does not
				  constitute the department's final findings from an inspection, including the
				  name and identifying information about a complainant, are confidential in
				  accordance with Iowa Code section
				  135R.6. This rule does not
				  inhibit the referral of otherwise confidential information to other law
				  enforcement or regulatory agencies pursuant to Iowa Code section
				  10A.105(5).
(1)
Public disclosure.
The
				following records are open and available for inspection:
a. License application forms and accompanying
				materials;
b. Final findings of the
				department's inspections;
c.
				Official notices of any enforcement action.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 49 - Ambulatory Surgical Centers › Rule 481-49.7 - Waivers

Current through Register Vol. 47, No. 3, July 24, 2024
Requests for waiver may be submitted to the department in
				  accordance with 481-Chapter 6. Waivers may be granted by the director of the
				  department when, in the director's discretion, good and sufficient reasons
				  underlying the need for a waiver have been established; no substantial risk to
				  the health, safety, or welfare of patients is presented by approving the
				  waiver; and alternate means are employed or compensating circumstances exist to
				  justify the waiver. Any waiver granted is limited to the specific project under
				  consideration and does not establish a precedent for similar acceptance in
				  other cases.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 50 - Health Care Facilities Administration › Rule 481-50.1 - Inspections

Current through Register Vol. 47, No. 3, July 24, 2024
The health facilities division inspects health care
				  facilities, hospitals, and providers and suppliers of medical services in Iowa.
				  Standards to obtain a license are explained in this chapter
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 50 - Health Care Facilities Administration › Rule 481-50.2 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
"Administrator"
means the person
				  coordinating the administration of the division.
"Department"
means the department of
				  inspections and appeals.
"Director"
means the director of inspections
				  and appeals.
"Division"
means the health facilities
				  division.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 50 - Health Care Facilities Administration › Rule 481-50.3 - Licensing

Current through Register Vol. 47, No. 3, July 24, 2024
All hospitals and health care facilities shall be licensed by
				  the department. Applications are available from the Health Facilities Division,
				  Lucas State Office Building, Des Moines, Iowa 50319-0083. Completed
				  applications are returned to the division with the fee.
(1) Initial fees for hospitals are:
a. Fifty beds or less, $15;
b. More than 50 and not more than 100 beds,
				$25;
c. Any greater number of beds,
				$50.
A fee of $10 is charged to renew a hospital license each
				  year.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 50 - Health Care Facilities Administration › Rule 481-50.5 - Denial, Suspension or Revocation

Current through Register Vol. 47, No. 3, July 24, 2024
(1) A denial, suspension or revocation shall
				be effective 30 days after certified mailing or personal service of the
				notice.
(2) A hearing may be
				requested and the request must be made in writing to the department within 30
				days of the mailing or service.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 50 - Health Care Facilities Administration › Rule 481-50.6 - Formal Hearing

Current through Register Vol. 47, No. 3, July 24, 2024
All decisions of the division may be contested. Appeals and
				  hearings are controlled by 481-Chapter 9, "Contested Cases," and 481-Chapter
				  10, "Rules of Procedure and Practice Before the Administrative Hearings
				  Division."
(1) The proposed decision
				of the hearing officer becomes final 15 days after it is mailed.
(2) Any request for administrative review of
				a proposed decision must:
1. Be made in
				writing,
2. Be mailed by certified
				mail to the director, within 15 days after the proposed decision was mailed to
				the aggrieved party,
3. State the
				reason(s) for the request.
A copy shall also be sent to the hearing officer at the
				  Department of Inspections and Appeals, Lucas State Office Building, Des Moines,
				  Iowa 50319.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 50 - Health Care Facilities Administration › Rule 481-50.7 - Additional Notification

Current through Register Vol. 47, No. 3, July 24, 2024
A health care facility shall notify the department within 24
				  hours, or the next business day, by the most expeditious means available (I,
				  II, III):
(1) Of any accident causing
				major injury.
a. "Major injury" shall be
				defined as any injury which:
(1) Results in
				death; or
(2) Requires admission to
				a higher level of care for treatment, other than for observation; or
(3) Requires consultation with the attending
				physician, designee of the physician, or physician extender who determines, in
				writing on a form designated by the department, that an injury is a "major
				injury" based upon the circumstances of the accident, the previous functional
				ability of the resident, and the resident's prognosis.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 50 - Health Care Facilities Administration › Rule 481-50.8 - Records

Current through Register Vol. 47, No. 3, July 24, 2024
The division collects and stores a variety of records in the
				  course of licensing and inspecting hospitals and health care facilities, as
				  described in 481-Chapter 5. The records contain both public and confidential
				  information.
(1)
Public
				information.
The following are general categories of public
				information:
a. The department's final
				findings or the final findings of an accreditation organization with respect to
				compliance by a hospital or health care facility with requirements for
				licensing or accreditation, including any plan of correction;
b. Applications for licensing or
				certification, accompanying materials, and status of any application;
c. Reports from the state fire
				marshal;
d. Information regarding
				complaints, unless otherwise confidential pursuant to subrule 50.8(2) or Iowa
				Code section 22.7;
e. Waiver requests and responses;
f. Official notices of licensing or
				certification sanctions.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 50 - Health Care Facilities Administration › Rule 481-50.10 - Inspections, Exit Interviews, Plans of Correction, and Revisits

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Frequency of
				inspection. The department shall inspect a licensed health care facility at
				least once within a 30-month period. Facilities participating in the Medicare
				or Medicaid programs may be inspected more frequently as a part of a joint
				state and federal inspection.
(2)
				Accessibility of records, the facility and persons. An inspector of the
				department may enter any licensed health care facility without a warrant and
				may examine all records pertaining to the care provided to residents of the
				facility. An inspector of the department may contact or interview any resident,
				employee, or any other person who might have knowledge about the operation of a
				health care facility. The inspector may duplicate records and take photographs
				as part of the inspection.
(3) Exit
				interviews. The health care facility shall be provided an exit interview at the
				conclusion of an inspection, and the facility representative shall be informed
				of all issues and areas of concern related to the deficiencies.
a. Methods of conducting exit interview. The
				department may conduct the exit interview either in person or by
				telephone.
b. Second exit
				interviews. The department shall conduct a second exit interview if any
				additional areas of concern are identified.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 50 - Health Care Facilities Administration › Rule 481-50.11 - Complaint and Self-reported Incident Investigation Procedure

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Complaint.
The process for filing a complaint is as follows:
a. Any person with concerns regarding a
				facility may file a complaint with the Department of Inspections and Appeals,
				Complaint/Incident Bureau, Lucas State Office Building, Third Floor, 321 E.
				12th Street, Des Moines, Iowa 50319-0083; by use of the complaint hotline,
				1-877-686-0027; by facsimile sent to (515)281-7106; or through the website
				address
dia-hfd.iowa.gov.
b. When the nature of the complaint is
				outside the department's authority, the department shall forward the complaint
				or refer the complainant to the appropriate investigatory entity.
c. The complainant shall include as much of
				the following information as possible in the complaint: the complainant's name,
				address and telephone number; the complainant's relationship to the facility or
				resident; and the reason for the complaint.
d. The complainant's name shall be
				confidential information and shall not be released by the department.
e. The department shall act on anonymous
				complaints unless the department determines that the complaint is intended to
				harass the facility.
f. If the
				department, upon preliminary review, determines that the complaint is intended
				as harassment or is without a reasonable basis, the department may dismiss the
				complaint.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 50 - Health Care Facilities Administration › Rule 481-50.12 - Requirements for Service

Current through Register Vol. 47, No. 3, July 24, 2024
At each inspection, the facility shall provide the most
				  current contact information for the purpose of service of departmental notices.
				  A statement of deficiencies or citation shall be served upon a facility using
				  one of the following methods.
(1)
Electronic mail.
If a facility has electronic mail, electronic
				mail shall be used for service of statements of deficiencies and citations. If
				electronic mail is used, the following shall be complied with:
a. The department shall send the electronic
				message return receipt requested. The response from the return receipt shall
				officially document receipt of the service and the date of receipt.
b. A facility shall allow the electronic
				return receipt to be returned to the department and shall not delay the sending
				of the return receipt.
c. If the
				department has not received the return receipt within three business days of
				sending the service via electronic mail, the department shall contact the
				facility to verify the receipt of the service.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 50 - Health Care Facilities Administration › Rule 481-50.13 - Inspectors' Conflicts of Interest

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Conflicts.
Any of the
				following circumstances disqualifies an inspector from inspecting a particular
				health care facility licensed under Iowa Code chapter 135C:
a. The inspector currently works or, within
				the past two years, has worked as an employee or employment agency staff at the
				health care facility, or as an officer, consultant, or agent for the health
				care facility to be inspected.
b.
				The inspector has any financial interest or any ownership interest in the
				facility. For purposes of this paragraph, indirect ownership, such as through a
				broad-based mutual fund, does not constitute a financial or ownership
				interest.
c. The inspector has an
				immediate family member who has a relationship with the facility as described
				in subrule 50.13(1), paragraphs
"a"
and
"b."
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.2 - Classification, Compliance and License

Current through Register Vol. 47, No. 3, July 24, 2024
(1) All hospitals
				subject to licensure under this chapter will be classified as a critical access
				hospital, general hospital, long-term acute care hospital, rural emergency
				hospital, or specialized hospital. The license issued by the department will
				clearly identify the classification of the hospital, and such designation will
				be set forth on the hospital's license.
(2) A hospital shall comply with all of the
				general regulations for hospitals and any rules pertaining to specialized
				services, if specialized services are provided in the hospital.
(3) A separate license is required for each
				hospital even though more than one is operated under the same management. A
				separate license is not required for separate buildings of a hospital located
				on separate parcels of land, which are not adjoining but provide elements of
				the hospital's full range of services for the diagnosis, care, and treatment of
				human illness, including convalescence and rehabilitation, and which are
				organized under a single owner or governing board with a single designated
				administrator and medical staff.
(4) The license shall be conspicuously posted
				on the main premises of the hospital.
(5) The department shall recognize, in lieu
				of its own licensure inspection, the comparable inspections and findings of an
				accrediting organization approved by the Centers for Medicare and Medicaid
				Services (CMS) for federal certification if the department is provided with
				copies of all requested materials relating to the inspection process. In cases
				of the initial licensure, the department may require its own inspection when
				needed in addition to comparable accreditations to allow the hospital to begin
				operations. The department may also initiate its own inspection when it is
				determined that the inspection findings of the accrediting organization are
				insufficient to address concerns identified as possible licensure
				issues.
(6) The department may
				recognize, in lieu of its own licensure inspection, the comparable inspection
				and inspection findings of a Medicare conditions of participation survey of a
				hospital certified by CMS. Hospitals that are not federally certified will be
				inspected utilizing the requirements of this chapter.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.3 - Quality Improvement Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1) There shall be
				an ongoing hospital wide quality improvement program. This program is to be
				designed to improve, as needed, the quality of patient care by:
a. Assessing clinical patient care;
b. Assessing nonclinical and patient-related
				services within the hospital;
c.
				Developing remedial action as needed; and
d. Ongoing monitoring and evaluating of the
				progress of remedial action taken.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.4 - Long-term Acute Care Hospital Located Within a General Hospital

Current through Register Vol. 47, No. 3, July 24, 2024
(1) A long-term
				acute care hospital shall meet the requirements for a general hospital,
				including emergency services, except that obstetrical facilities are not
				required, and, if the long-term acute care hospital is located within a
				separately licensed hospital and does not provide its own emergency services,
				the long-term acute care hospital shall contract for emergency services with
				the host general hospital.
(2) If a
				long-term acute care hospital occupies the same premises of a general hospital,
				all treatment facilities and administrative offices for each hospital shall be
				clearly marked and separated from each other and located within the licensed
				premises of each licensee. Treatment facilities shall be sufficient to meet the
				medical needs of the patients. Administrative offices include, but are not
				limited to, record rooms and personnel offices. Nothing prohibits a long-term
				acute care hospital that is occupying the same premises as a general hospital
				from utilizing the entrance, hallway, stairs, elevators or escalators of the
				general hospital to provide access to the long-term acute care hospital's
				separate entrance, but there should be clearly identifiable and distinguishable
				signs for each hospital.
(3) A
				long-term acute care hospital located within a general hospital shall have
				sufficient staff to meet the patients' needs. No nursing services staff can be
				simultaneously assigned patient duties in both licensed hospitals.
(4) Each long-term acute care hospital
				located within a general hospital and the general hospital shall have a
				separate and distinct governing board in control of the respective hospital. No
				more than one board member shall serve in a common capacity on the governing
				board of each licensed hospital. For the purposes of this rule, control exists
				if an individual or an organization has the power, directly or indirectly, to
				significantly influence or direct the actions or policies of an organization or
				institution.
(5) A long-term acute
				care hospital located within a general hospital may contract with the host
				general hospital for the provision of services. All contracts shall clearly
				delineate the responsibilities of and services provided by the long-term acute
				care hospital and the general hospital and be executed by the respective
				governing boards.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.5 - Medical Staff

Current through Register Vol. 47, No. 3, July 24, 2024
(1) A roster of
				medical staff members shall be kept.
(2) All hospitals shall have one or more
				licensed physicians designated for emergency call service at all
				times.
(3) A hospital shall not
				deny clinical privileges as set forth in Iowa Code section
				135B.7(2).
(4) A hospital shall establish and implement
				written criteria for the granting of clinical privileges that include but are
				not limited to consideration of the:
a.
				Ability of the applicant to provide patient care services independently or
				appropriately in the hospital;
b.
				License held by the applicant to practice;
c. Training, experience, and competence of
				the applicant;
d. Relationship
				between the applicant's request for privileges and the hospital's current scope
				of patient care services;
e.
				Applicant's ability to provide comprehensive, appropriate and cost-effective
				services.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.6 - Patient Rights and Responsibilities

Current through Register Vol. 47, No. 3, July 24, 2024
The hospital governing board shall adopt a statement of
				  principles relating to patient rights and responsibilities that is made
				  available to patients of the hospital and addresses, at a minimum:
(1) Access to treatment regardless of age,
				race, creed, ethnicity, religion, culture, language, physical or mental
				disability, socioeconomic status, sex, sexual orientation, gender identity or
				expression, diagnosis, or source of payment for care;
(2) Preservation of individual dignity and
				protection of personal privacy in receipt of care;
(3) Confidentiality of medical and other
				appropriate information;
(4)
				Assurance of reasonable safety within the hospital;
(5) Knowledge of the identity of the
				physician or other practitioner primarily responsible for the patient's care as
				well as identity and professional status of others providing services to the
				patient while in the hospital;
(6)
				Nature of patient's right to information regarding the patient's medical
				condition unless medically contraindicated, to consult with a specialist at the
				patient's request and expense, and to refuse treatment to the extent authorized
				by law;
(7) Access to and
				explanation of patient billings;
(8) Process for patient pursuit of
				grievances; and
(9) Patient
				responsibilities, including to provide accurate and complete information
				regarding the patient's health status; to follow recommended treatment plans;
				to abide by hospital rules and regulations affecting patient care and conduct
				and be considerate of the rights of other patients and hospital personnel; and
				to fulfill the patient's financial obligations as soon as possible following
				discharge.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.7 - Abuse

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Definitions.
"Abuse"
means the willful infliction of
				  injury, unreasonable confinement, intimidation, or punishment, with resulting
				  physical harm, pain or mental anguish. Neglect is a form of abuse and is
				  defined as the failure to provide goods and services necessary to avoid
				  physical harm, mental anguish, or mental illness.
"Child abuse"
means the same as defined in
				  Iowa Code section 232.68.
"Dependent adult abuse"
means the same as
				  defined in Iowa Code section
				  235E.1 and 481-Chapter
				  52.
"Domestic abuse"
means the same as defined
				  in Iowa Code section 236.2.
"Elder abuse"
means the same as defined in
				  Iowa Code section 235F.1.
"Family or household members"
means the same
				  as defined in Iowa Code section
				  236.2.
(2)
Abuse prohibited.
Each
				patient shall receive kind and considerate care at all times and shall be free
				from all forms of abuse or harassment.
a.
				Restraints shall be applied only when they are necessary to prevent injury to
				the patient or to others and shall be used only when alternative measures are
				not sufficient to accomplish their purposes.
b. There must be a written order signed by
				the attending physician approving the use of restraints either at the time they
				are applied or as soon thereafter as possible.
c. Careful consideration shall be given to
				the methods by which the restraints can be speedily removed in case of fire or
				other emergency.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.8 - Organ, Tissue and Eye Procurement

Current through Register Vol. 47, No. 3, July 24, 2024
Each hospital shall have written policies and protocols for
				  organ, tissue and eye donation consistent with Iowa Code chapter 142C and
				  42 CFR
				  482.45 as amended to November 7, 2023, or
				  42 CFR
				  485.643 as amended to November 7,
				  2023.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.9 - Nursing Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The hospital
				shall have an organized nursing service that provides complete and efficient
				nursing care to each patient. The authority, responsibility and function of
				each nurse shall be clearly defined.
(2) Registered nurses shall utilize the
				nursing process in the practice of nursing, consistent with accepted and
				prevailing practice. The nursing process is ongoing and includes:
a. Nursing assessments about the health
				status of an individual or group.
b. Formulation of a nursing diagnosis based
				on analysis of the data from the nursing assessment.
c. Planning of nursing care, which includes
				determining goals and priorities for actions that are based on the nursing
				diagnosis.
d. Nursing interventions
				implementing the plan of care.
e.
				Evaluation of the individual's or group's status in relation to established
				goals and the plan of care.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.10 - Records and Reports

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Medical
				records.
Accurate and complete medical records shall be maintained for
				all patients and signed by the appropriate provider. These records shall be
				filed and stored in an accessible manner and in accordance with the statute of
				limitations as specified in Iowa Code chapter 614.
(2)
Hospital records.
A
				hospital shall maintain the following records:
a.
Admission records.
A
				register of all admissions to the hospital.
b.
Death records.
A record
				of all deaths in the hospital, including all information on a standard death
				certificate as specified in Iowa Code chapter 144.
c.
Birth records.
A record
				of all births in the hospital, including all information on a standard birth
				certificate as specified in Iowa Code chapter 144.
d.
Controlled substance
				records.
Controlled substance records in accordance with state and
				federal laws, rules and regulations.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.11 - Pharmaceutical Service

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
General
				requirements.
Hospital pharmaceutical services shall be licensed in
				accordance with Iowa board of pharmacy rules.
(2)
Medication
				administration.
All drugs and biologicals must be administered by, or
				under the supervision of, nursing or other trained personnel in accordance with
				hospital policies and procedures. The person assigned the responsibility of
				medication administration must complete the entire procedure by personally
				preparing the dose from a multiple-dose container or using a prepackaged unit
				dose, personally administering it to the patient, and observing the act of the
				medication being taken.
(3)
Standing orders.
Standing orders for drugs may be used for
				specified patients when authorized by the prescribing practitioner. These
				standing orders shall be in accordance with policies and procedures established
				by the appropriate committee within each hospital. At a minimum, the standing
				orders shall:
a. Specify the clinical
				situations under which the drug is to be administered;
b. Specify the types of medical conditions of
				the patients for whom the standing orders are intended;
c. Be reviewed and revised by the hospital's
				pharmacy and therapeutics or similar committee on a regular basis as specified
				by hospital policies and procedures;
d. Be specific as to the drug, dosage, route,
				and frequency of administration; and
e. Be dated, authorized by signature or other
				secure electronic method by the prescribing practitioner within a period not to
				exceed 30 days following a patient's discharge, and included in the patient's
				medical record.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.12 - Verbal Orders

Current through Register Vol. 47, No. 3, July 24, 2024
All verbal orders must be authenticated by the prescribing or
				  ordering practitioner within a period not to exceed 30 days following a
				  patient's discharge. When verbal or electronic mechanisms are used to transmit
				  orders, the orders must be accepted only by personnel who are authorized to do
				  so by hospital policies and procedures in a manner consistent with federal and
				  state law.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.13 - Radiological Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The hospital
				must maintain, or have available, radiological services to meet the needs of
				the patients.
(2) All radiological
				services shall be furnished in compliance with any applicable state law or
				state rules, including 641-Chapters 38 through 42.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.14 - Laboratory Service

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The hospital
				must maintain, or have available, adequate laboratory and pathology services
				and facilities to meet the needs of its patients. The medical staff determine
				which laboratory tests are necessary to be performed on site to meet the needs
				of the patients.
(2) Emergency
				laboratory services must be available 24 hours a day.
(3) Laboratory services must be performed in
				a laboratory certified and operating in accordance with 42 CFR Part 493 as
				amended to November 7, 2023.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.17 - Infection Control

Current through Register Vol. 47, No. 3, July 24, 2024
There shall be proper policies and procedures for the
				  prevention and control of communicable diseases, including compliance with the
				  current rules for the control of communicable disease as provided by the Iowa
				  department of health and human services and current Centers for Disease Control
				  and Prevention (CDC) guidelines for isolation precautions.
(1)
Segregation.
There shall
				be proper arrangement of areas, rooms and patients' beds to provide for the
				prevention of cross-infections and the control of communicable diseases. There
				shall also be proper cleansing of rooms and surgeries immediately following the
				care of a communicable case and utilization of proper isolation techniques for
				patients and staff to prevent cross-infection.
(2)
Visitors.
The hospital
				shall establish proper policies and procedures for the control of visitors to
				all services in the hospital.
(3)
Health assessments.
Health assessments for all contracted or
				employed personnel who provide direct services shall be required at the
				commencement of employment and thereafter at least every four years.
a. "Direct services" means services provided
				through person-to-person contact. "Direct services" excludes services provided
				by individuals such as building contractors, repair workers, or others who are
				in the hospital for a very limited purpose, who are not in the hospital on a
				regular basis, and who do not provide any treatment or services for the
				patients of the hospital.
b. The
				health assessment may be performed by the person's primary care
				provider.
c. The health assessment
				shall include, at a minimum, vital signs and an assessment for infectious or
				communicable diseases.
d. Screening
				and testing for tuberculosis shall be conducted pursuant to 481-Chapter
				59.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.18 - Surgical Services

Current through Register Vol. 47, No. 3, July 24, 2024
All hospitals providing surgical services shall be properly
				  organized and equipped to provide for the safe and aseptic treatment of
				  surgical patients.
(1) Written
				policies and procedures governing surgical services shall be developed and
				implemented in consultation with the hospital's medical staff and, at a
				minimum, provide for:
a. Surgical services
				under the direction of a qualified doctor of medicine or osteopathy.
b. Delineation of the privileges and
				qualifications of individuals authorized to provide surgical services as set
				forth in the hospital's medical staff bylaws and in accordance with subrule
				51.5(4), including a periodic review and update of surgical privileges not to
				exceed every three years or other term permitted by an accrediting organization
				approved by CMS for federal certification, whichever is longer. The surgical
				service must maintain a roster of these individuals specifying the surgical
				privileges of each.
c. Immediate
				availability of at least one registered nurse for the operating room suites to
				respond to emergencies.
d. The
				qualifications and job descriptions of nursing personnel, surgical technicians,
				and other support personnel and continuing education required.
e. Appropriate staffing for surgical
				services, including physician and anesthesia coverage and other support
				personnel.
f. Availability of
				ancillary services for surgical patients, including but not limited to blood
				banking, laboratory, radiology, and anesthesia.
g. Infection control and disease prevention,
				including aseptic surveillance and practice, identification of infected and
				noninfected cases, sterilization and disinfection procedures, and ongoing
				monitoring of infections and infection rates.
h. Housekeeping requirements.
i. Safety practices.
j. Ongoing quality assessment, performance
				improvement, and process improvement.
k. The pathological examination of tissue
				specimens either directly or through contractual arrangements.
l. Appropriate preoperative teaching and
				discharge planning.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.19 - Anesthesia Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1) There shall be
				written policies and procedures governing anesthesia services that are
				consistent with the needs and resources of the hospital. Written policies and
				procedures governing anesthesia services shall be developed and implemented in
				consultation with and with the approval of the hospital's medical staff and, at
				a minimum, provide for:
a. Anesthesia services
				under the direction of a qualified doctor of medicine or osteopathy.
b. The qualifications of individuals
				authorized to administer anesthesia as set out in the hospital's medical staff
				bylaws or medical staff rules and regulations.
c. Preanesthesia evaluation, appraisal of a
				patient's current condition, preparation of an intraoperative anesthesia
				record, and discharge criteria for patients.
d. Equipment functioning and safety,
				including ensuring that a qualified medical doctor, osteopathic physician and
				surgeon or anesthetist checks, prior to the administration of anesthesia, the
				readiness, availability, cleanliness, and working condition of all equipment to
				be used in the administration of anesthetic agents and minimizing electrical
				hazard in anesthesia areas.
e.
				Quality assurance, including infection control procedures; integration of
				anesthesia services into various areas of the hospital; and ongoing monitoring,
				review, and evaluation of anesthesia services, processes, and
				procedures.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.20 - Emergency Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1) All hospitals
				shall provide for emergency services that offers reasonable care within the
				medical capabilities of the facility in determining whether an emergency
				exists, renders care appropriate to the facility and, at a minimum, renders
				lifesaving first aid and makes appropriate referral to a facility that is
				capable of providing needed services.
(2) The hospital shall have written policies
				and procedures specifying the scope and conduct of patient care to be provided
				in the emergency service. The policies shall:
a. Provide for training of all personnel
				providing patient care in the emergency service.
b. Require that a medical record be kept on
				every patient given treatment in the emergency service and establish the
				medical record documentation. The documentation should include, at a minimum,
				appropriate information regarding the medical screening provided, except where
				the person refuses, then notation of patient refusal; physician documentation
				of the presence or absence of an emergency medical condition or active labor;
				physician documentation of transfer or discharge, stating the basis for
				transfer or discharge; and, where transfer occurs, identity of the facility of
				transfer, acceptance of the patient by the facility of transfer, and means of
				transfer of the patient.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.21 - Obstetric and Neonatal Services

Current through Register Vol. 47, No. 3, July 24, 2024
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.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.22 - Pediatric Services

Current through Register Vol. 47, No. 3, July 24, 2024
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.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 51 - Hospitals › Rule 481-51.23 - Psychiatric Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
General
				requirements.
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. Comply with the requirements of this
				chapter applicable to hospitals. If medical and surgical diagnostic and
				treatment services are not available within the hospital, the hospital 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.