reglab/statecodes huggingface dataset:
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 63 - Residential Care Facility-three- to Five-bed Specialized License › Rule 481-63.46 - Incompetent Resident

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Each
				facility shall provide that all rights and responsibilities of the resident
				devolve to the resident's responsible party when a resident is adjudicated
				incompetent in accordance with state law or, in the case of a resident who has
				not been adjudicated incompetent under the laws of the state, in accordance
				with
				42 CFR 483.10.
				This subrule is not intended to limit the authority of any individual acting
				pursuant to Iowa Code chapter 144A. (II)
(2) The fact that a resident has been
				adjudicated incompetent does not absolve the facility from advising the
				resident of these rights to the extent the resident is able to understand them.
				The facility shall also advise the responsible party, if any, and acquire a
				statement indicating an understanding of residents' rights. (II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 63 - Residential Care Facility-three- to Five-bed Specialized License › Rule 481-63.47 - Specialized License for Three- to Five-bed Facilities

Current through Register Vol. 47, No. 3, July 24, 2024
The specialized license is for residential care facilities
				  which serve persons with intellectual disabilities, chronic mental illness and
				  other developmental disabilities having five or fewer residents as specified in
				  Iowa Code section
				  225C.26. The facility is
				  exempt from Iowa Code section
				  135.63.
				  For this specialized license, all rules of 481-Chapter 63 apply except those
				  which are deleted or amended, as indicated in subsequent rules.
(1) The provider may apply for a specialized
				license from the department of inspections and appeals. Before the license is
				granted, the provider shall meet all of the following requirements:
a. Compliance with program requirements
				pursuant to Iowa Code chapter 135C and administrative rules relating to
				residential care facilities adopted by the state board of health, or standards
				adopted by the Accreditation Council for Services for Persons with Mental
				Retardation and Other Developmental Disabilities (1984). The program of care
				shall emphasize an age-appropriate and least restrictive program.
b . The facility shall be located in areas
				zoned for single- or multiple-family housing, or be located in an
				unincorporated area, and shall be constructed in compliance with applicable
				local housing codes and rules adopted for this classification of license by the
				state fire marshal. (II, III)
c.
				The facility shall be appropriately accessible to residents who have
				disabilities. (II, III)
d. Written
				plans shall demonstrate that the facility meets the needs of the residents
				pursuant to individual program plans meeting age-appropriate and least
				restrictive program requirements. (II)
e. Written plans shall demonstrate the
				residents have reasonable access to employment for job-related training,
				education, generic community resources, or integrated opportunities to promote
				community interaction. (II)
f.
				Unless documented as appropriate within the residents' individual program
				plans, populations with primary diagnosis of chronic mental illness or
				intellectual disability/developmental disability may not be residents of the
				same specialized license facility. (II, III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 63 - Residential Care Facility-three- to Five-bed Specialized License › Rule 481-63.49 - Another Business or Activity in a Facility

Current through Register Vol. 47, No. 3, July 24, 2024
A facility is allowed to have another business or activity in
				  a health care facility or in the same physical structure of the facility, if
				  the other business or activity is under the control of and is directly related
				  to and incidental to the operation of the health care facility, or the business
				  or activity is approved by the department and the state fire marshal.
To obtain the approval of the department and the state fire
				  marshal, the facility must submit to the department a written request for
				  approval which identifies the service(s) to be offered by the business and
				  addresses the factors outlined in paragraphs
"a"
through
"j"
of this rule. (I, II, III)
(1) The following factors will be considered
				by the department in determining whether a business or activity will interfere
				with the use of the facility by residents, interfere with services provided to
				residents, or be disturbing to residents:
a.
				Health and safety risks for residents;
b. Compatibility of the proposed business or
				activity with the facility program;
c. Noise created by the proposed business or
				activity;
d. Odors created by the
				proposed business or activity;
e.
				Use of entrances and exits for the business or activity in regard to safety and
				disturbance of residents and interference with delivery of services;
f. Use of the facility's corridors or rooms
				as thoroughfares to the business or activity in regard to safety and
				disturbance of residents and interference with delivery of services;
g. Proposed staffing for the business or
				activity;
h. Sharing of services and
				staff between the proposed business or activity and the facility;
i. Facility layout and design; and
j. Parking area utilized by the business or
				activity.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 63 - Residential Care Facility-three- to Five-bed Specialized License › Rule 481-63.50 - Respite Care Services

Current through Register Vol. 47, No. 3, July 24, 2024
Respite care services means an organized program of temporary
				  supportive care provided for 24 hours or more to a person in order to relieve
				  the usual caregiver of the person from providing continual care to the person.
				  A facility which chooses to provide respite care services must meet the
				  following requirements related to respite care services and must be licensed as
				  a health care facility.
(1) A facility
				which chooses to provide respite care services is not required to obtain a
				separate license or pay a license fee.
(2) Rules regarding involuntary discharge or
				transfer rights do not apply to residents who are being cared for under a
				respite care contract.
(3) The
				facility shall have a contract with each resident in the facility. When the
				resident is there for respite care services, the contract shall specify the
				time period during which the resident will be considered to be receiving
				respite care services. At the end of that period, the contract may be amended
				to extend that period of time. The contract shall specifically state the
				resident may be involuntarily discharged while being considered as a respite
				care resident. The contract shall meet other requirements for contracts between
				a health care facility and resident, except the requirements concerning the
				holding and charging for a bed when a resident is hospitalized or leaves the
				facility temporarily for recreational or therapeutic reasons.
(4) Respite care services shall not be
				provided by a facility to persons requiring a level of care which is higher
				than the level of care the facility is licensed to provide.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.2 - Waivers

Current through Register Vol. 47, No. 3, July 24, 2024
Waivers from these rules may be granted by the director of
				  the department of inspections and appeals for good and sufficient reason when
				  the need for a waiver has been established; no danger to the health, safety, or
				  welfare of any resident results; alternate means are employed or compensating
				  circumstances exist and the waiver will apply only to an individual
				  intermediate care facility for the intellectually disabled. Waivers will be
				  reviewed at the discretion of the director of the department of inspections and
				  appeals.
(1) To request a waiver, the
				licensee must:
a. Apply for a waiver in
				writing on a form provided by the department;
b. Cite the rule or rules from which a waiver
				is desired;
c. State why compliance
				with the rule or rules cannot be accomplished;
d. Explain alternate arrangements or
				compensating circumstances which justify the waiver;
e. Demonstrate that the requested waiver will
				not endanger the health, safety, or welfare of any resident.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.3 - Application for License

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Initial
				application. In order to obtain an initial intermediate care facility for the
				intellectually disabled license for an intermediate care facility for the
				intellectually disabled which is currently licensed, the applicant must:
a. Submit a letter of intent and a written
				resume of the resident care program and other services provided for
				departmental review and approval;
b. Make application at least 30 days prior to
				the change of ownership of the facility on forms provided by the
				department;
c. Submit a floor plan
				of each floor of the intermediate care facility, drawn on
				81/2-x11-inch paper showing room areas in
				proportion, room dimensions, room numbers for all rooms, including bathrooms,
				and designation of the use to which room will be put and window and door
				location;
d. Submit a photograph of
				the front and side elevation of the intermediate care facility for the
				intellectually disabled;
e. Submit
				the statutory fee for an intermediate care facility for the intellectually
				disabled license;
f. Meet all of
				the rules, regulations and standards contained in 481-Chapter 64.
g. Comply with federal, state, and local
				laws, codes, and regulations pertaining to health and safety, including
				procurement, dispensing, administration, safeguarding and disposal of
				medications and controlled substances; building, construction, maintenance and
				equipment standards; sanitation; communicable and reportable diseases; and
				postmortem procedures;
h. Have a
				certificate signed by the state fire marshal or deputy state fire marshal as to
				compliance with fire safety rules and regulations.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.5 - Notifications Required by the Department

Current through Register Vol. 47, No. 3, July 24, 2024
The department shall be notified:
(1) Within 48 hours, by letter, any reduction
				or loss of direct care professional or dietary staff lasting more than seven
				days which places the staffing ratio of the intermediate care facility for the
				intellectually disabled below that required by
				42 CFR
				483.430(d)(3). No additional
				residents shall be admitted until the minimum staffing requirements are
				achieved; (III)
(2) Of any proposed
				change in the intermediate care facility for the intellectually disabled's
				functional operation or addition or deletion of required services;
				(III)
(3) Thirty days before
				addition, alteration, or new construction is begun in the intermediate care
				facility for the intellectually disabled, or on the premises; (III)
(4) Thirty days in advance of closure of the
				intermediate care facility for the intellectually disabled; (III)
(5) Within two weeks of any change in
				administrator; (III)
(6) When any
				change in the category of license is sought; (III)
(7) Prior to the purchase, transfer,
				assignment, or lease of an intermediate care facility for the intellectually
				disabled, the licensee shall:
a. Inform the
				department of the pending sale, transfer, assignment, or lease of the facility;
				and (III)
b. Inform the department
				of the name and address of the prospective purchaser, transferee, assignee, or
				lessee at least 30 days before the sale, transfer, assignment, or lease is
				completed. (III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.6 - Veteran Eligibility

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Within
				30 days of a resident's admission to a health care facility receiving
				reimbursement through the medical assistance program under Iowa Code chapter
				249A, the facility shall ask the resident or the resident's personal
				representative whether the resident is a veteran and shall document the
				response. If the facility determines that the resident is a potential veteran,
				the facility shall report the resident's name along with the names of the
				resident's spouse and any dependent children, as well as the name of the
				contact person for this information, to the Iowa department of veterans
				affairs. Where appropriate, the facility may also report such information to
				the Iowa department of human services.
(2) If a resident is eligible for benefits
				through the United States Department of Veterans Affairs or other third-party
				payor, the facility first shall seek reimbursement from the identified payor
				source before seeking reimbursement from the medical assistance program
				established under Iowa Code chapter 249A.
(3) The provisions of this rule shall not
				apply to the admission of an individual as a resident to a state mental health
				institute for acute psychiatric care. (II, III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.7 - Licenses for Distinct Parts

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
				Separate licenses may be issued for distinct parts of a health care facility
				which are clearly identifiable, containing contiguous rooms in a separate wing
				or building or on a separate floor of the facility and which provide care and
				services of separate categories.
(2) The following requirements shall be met
				for a separate licensing of a distinct part:
a. The distinct part shall serve only
				residents who require the category of care and services immediately available
				to them within that part; (III)
b.
				The distinct part shall meet all the standards, rules, and regulations
				pertaining to the category for which a license is being sought;
c. The distinct part must be operationally
				and financially feasible;
d. A
				separate staff with qualifications appropriate to the care and services being
				rendered must be regularly assigned and working in the distinct part under
				responsible management; (III)
e.
				Separately licensed distinct parts may have certain services such as
				management, building maintenance, laundry, and dietary in common with each
				other
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.17 - Contracts

Current through Register Vol. 47, No. 3, July 24, 2024
Each party shall receive a copy of the signed contract. (III)
				  Each contract for residents shall:
(1)
				State the rate or scale per day or per month for services included in the rate
				or scale and method of payment; (III)
(2) Contain a complete schedule of all
				offered services for which a fee may be charged in addition to the base rate.
				(III) Furthermore, the contract shall:
a.
				Stipulate that no further additional fees shall be charged for items not
				contained in complete schedule of services as set forth in this subrule;
				(III)
b. State the method of
				payment of additional charges; (III)
c. Contain an explanation of the method of
				assessment of such additional charges and an explanation of the method of
				periodic reassessment, if any, resulting in changing such additional charges;
				(III)
d. State that additional fees
				may be charged to the resident for nonprescription drugs, other personal
				supplies, and services by a barber, beautician, etc.; (III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.18 - Records

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Resident record.
The licensee shall keep a permanent record
				about each resident, with all entries current, dated, and signed. (II) The
				record shall include:
a. Name and previous
				address of resident; (III)
b. Birth
				date, sex, and marital status of resident; (III)
c. Church affiliation of resident;
				(III)
d. Physician's name,
				telephone number, and address; (III)
e. Dentist's name, telephone number, and
				address; (III)
f. Name, address,
				and telephone number of resident's next of kin or legal representative;
				(III)
g. Name, address, and
				telephone number of the person to be notified in case of emergency;
				(III)
h. Funeral director's
				telephone number and address; (III)
i. Pharmacy's name, telephone number and
				address; (III)
j. Certification by
				the physician that the resident requires no higher level of care than the
				facility is licensed to provide; (III)
k. Physician's orders for medication and
				treatments in writing, which shall be signed by the physician quarterly, and
				diet orders, which shall be renewed yearly; (III)
l. A notation of the resident's yearly or
				other visits to physician or other professionals and all consultation reports
				and progress notes; (III)
m.
				Documentation describing any change in the resident's condition; (II,
				III)
n. A notation describing the
				resident's condition on admission, transfer, and discharge; (III)
o. In the event of a resident's death,
				notations in the resident's record shall include the date and time of the
				resident's death, the circumstances of the resident's death, the disposition of
				the resident's body, and the date and time that the resident's family and
				physician were notified of the resident's death; (III)
p. A copy of instructions given to the
				resident, the resident's legal representative, or receiving facility in the
				event of the resident's discharge or transfer; (III) and
q. Disposition of personal property.
				(III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.33 - Separation of Accused Abuser and Victim

Current through Register Vol. 47, No. 3, July 24, 2024
Upon a claim of dependent adult abuse of a resident being
				  reported, the administrator of the facility shall separate the victim and
				  accused abuser immediately and maintain the separation until the abuse
				  investigation is completed. (I, II)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.34 - Employee Criminal Record Checks, Child Abuse Checks and Dependent Adult Abuse Checks and Employment of Individuals Who Have Committed a Crime or Have a Founded Abuse

Current through Register Vol. 47, No. 3, July 24, 2024
The facility shall comply with the requirements found in Iowa
				  Code section 135C.33 and rule
				  481-50.9 (135C) related to
				  completion of criminal record checks, child abuse checks, and dependent adult
				  abuse checks and to employment of individuals who have committed a crime or
				  have a founded abuse. (I, II, III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.35 - Care Review Committee

Current through Register Vol. 47, No. 3, July 24, 2024
Each facility shall have a care review committee in
				  accordance with Iowa Code section
				  135C.25, which shall
				  operate within the scope of the rules for care review committees promulgated by
				  the department of elder affairs. (II)
(1) Role of committee in complaint
				investigations.
a. The department shall
				notify the facility's care review committee of a complaint from the public. The
				department shall not disclose the name of a complainant.
b. The department may refer complaints to the
				care review committee for initial evaluation or investigation by the committee
				pursuant to rules promulgated by the department of elder affairs. Within ten
				days of completion of the investigation, the committee shall report to the
				department in writing the results of the evaluation of the
				investigation.
c. When the
				department investigates a complaint, upon conclusion of its investigation, it
				shall notify the care review committee and the department of elder affairs of
				its findings, including any citations and fines issued.
d. Results of all complaint investigations
				addressed by the care review committee shall be forwarded to the department
				within ten days of completion of the investigation.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.36 - Involuntary Discharge or Transfer

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Involuntary discharge or transfer permitted.
A facility may
				involuntarily discharge or transfer a resident for only one of the following
				reasons:
a. Medical reasons;
b. The resident's welfare or that of other
				residents;
c. Nonpayment for the
				resident's stay, as described in the contract for the resident's
				stay;
d. Due to action pursuant to
				Iowa Code chapter 229;
e. By reason
				of negative action by the Iowa department of human services; or
f. By reason of negative action by the
				quality improvement organization (QIO). (I, II, III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.60 - Federal Regulations Adopted-conditions of Participation

Current through Register Vol. 47, No. 3, July 24, 2024
Regulations in
				  42 CFR Part 483, Subpart I,
				  Sections 410 to
				  480, are adopted by reference and
				  incorporated as part of these rules. A copy of these regulations is available
				  on request from the Health Facilities Division, Department of Inspections and
				  Appeals, Lucas State Office Building, Des Moines, Iowa 50319.
The classifications for violations are I, II, and III,
				  determined by the division using the provisions in 481-Chapter 56, "Fining and
				  Citations," to enforce a fine to cite a facility.
Note: The federal interpretive guidelines are printed
				  immediately following 481-Chapter 64.
This rule is intended to implement Iowa Code section
				  135C.2(3).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.62 - Another Business or Activity in a Facility

Current through Register Vol. 47, No. 3, July 24, 2024
A facility is allowed to have another business or activity in
				  a health care facility or in the same physical structure of the facility, if
				  the other business or activity is under the control of and is directly related
				  to and incidental to the operation of the health care facility, or the business
				  or activity is approved by the department and the state fire marshal.
To obtain the approval of the department and the state fire
				  marshal, the facility must submit to the department a written request for
				  approval which identifies the service(s) to be offered by the business and
				  addresses the factors outlined in paragraphs
"a"
through
"j"
of this rule. (I, II, III)
(1) The following factors will be considered
				by the department in determining whether a business or activity will interfere
				with the use of the facility by residents, interfere with services provided to
				residents, or be disturbing to residents:
a.
				Health and safety risks for residents;
b. Compatibility of the proposed business or
				activity with the facility program;
c. Noise created by the proposed business or
				activity;
d. Odors created by the
				proposed business or activity;
e.
				Use of entrances and exits for the business or activity in regard to safety and
				disturbance of residents and interference with delivery of services;
f. Use of the facility's corridors or rooms
				as thoroughfares to the business or activity in regard to safety and
				disturbance of residents and interference with delivery of services;
g. Proposed staffing for the business or
				activity;
h. Sharing of services and
				staff between the proposed business or activity and the facility;
i. Facility layout and design; and
j. Parking area utilized by the business or
				activity.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 64 - Intermediate Care Facilities for the Intellectually Disabled › Rule 481-64.63 - Respite Care Services

Current through Register Vol. 47, No. 3, July 24, 2024
Respite care services means an organized program of temporary
				  supportive care provided for 24 hours or more to a person in order to relieve
				  the usual caregiver of the person from providing continual care to the person.
				  A facility which chooses to provide respite care services must meet the
				  following requirements related to respite care services and must be licensed as
				  a health care facility.
(1) A facility
				which chooses to provide respite care services is not required to obtain a
				separate license or pay a license fee.
(2) Rules regarding involuntary discharge or
				transfer rights do not apply to residents who are being cared for under a
				respite care contract.
(3) The
				facility shall have a contract with each resident in the facility. When the
				resident is there for respite care services, the contract shall specify the
				time period during which the resident will be considered to be receiving
				respite care services. At the end of that period, the contract may be amended
				to extend that period of time. The contract shall specifically state the
				resident may be involuntarily discharged while being considered as a respite
				care resident. The contract shall meet other requirements for contracts between
				a health care facility and resident, except the requirements concerning the
				holding and charging for a bed when a resident is hospitalized or leaves the
				facility temporarily for recreational or therapeutic reasons.
(4) Respite care services shall not be
				provided by a facility to persons requiring a level of care which is higher
				than the level of care the facility is licensed to provide.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 65 - Intermediate Care Facilities for Persons With Mental Illness (ICF/PMI) › Rule 481-65.2 - Application for License

Current through Register Vol. 47, No. 3, July 24, 2024
In order to obtain an initial license for an ICF/PMI, the
				  applicant must comply with the rules and standards contained in Iowa Code
				  chapter 135C and the standards in 481-Chapter 61. Waivers from 481-Chapter 61
				  regulations are allowed under rule
				  481-61.2 (135C). An application
				  must be submitted to the department which states the type and category of
				  license for which the facility is applying.
(1) Each application shall include:
a. A floor plan of each floor of the facility
				drawn on 8½- x 11-inch paper showing room areas in proportion, room
				dimensions, room numbers for all rooms, including bathroom, and designation of
				the use to which room will be put and window and door location;
b. A photograph of the front and side
				elevation of the facility;
c. The
				statutory fee for an intermediate care facility license;
d. Evidence of a certificate signed by the
				state fire marshal or deputy state fire marshal as to compliance with fire
				safety rules.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 65 - Intermediate Care Facilities for Persons With Mental Illness (ICF/PMI) › Rule 481-65.3 - Licenses for Distinct Parts

Current through Register Vol. 47, No. 3, July 24, 2024
Separate licenses may be issued for distinct parts which are
				  clearly identifiable parts of a health care facility, containing contiguous
				  rooms in a separate wing or building or on a separate floor of the facility,
				  which provide care and services of separate categories.
The following requirements shall be met for a separate
				  licensing of a distinct part:
1. The
				distinct part shall serve only residents who require the category of care and
				services immediately available to them within that part. (Ill)
2. The distinct part shall meet all the
				standards, rules and regulations pertaining to the category for which a license
				is being sought.
3. The distinct
				part must be operationally and financially feasible.
4. A separate personal care staff with
				qualifications appropriate to the care and services being rendered must be
				regularly assigned and working in the distinct part under responsible
				management. (Ill)
5. Separately
				licensed distinct parts may have certain services such as management, building
				maintenance, laundry and dietary in common with each other.
This rule is intended to implement Iowa Code section
				  135C.6(2).
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 65 - Intermediate Care Facilities for Persons With Mental Illness (ICF/PMI) › Rule 481-65.4 - Waivers

Current through Register Vol. 47, No. 3, July 24, 2024
Waivers from these rules may be granted by the director of
				  the department when:
1. The need for a
				waiver has been established consistent with the rÃ©sumÃ© of care or
				the resident's individual program plan
2. There is no danger to the health, safety,
				welfare or rights of any resident.
3. The waiver will apply only to a specific
				intermediate care facility for the mentally ill.
Waivers shall be reviewed at least at the time of each
				  licensure survey and any other time by the department to see if the need for
				  the waiver is still acceptable.
(1) To
				request a waiver, the licensee must:
a. Apply
				in writing on a form provided by the department;
b. Cite the rule or rules from which a waiver
				is desired;
c. State why compliance
				with the rule or rules cannot be accomplished;
d. Explain how the waiver is consistent with
				the resume of care or the individual program plan; and
e. Demonstrate that the requested waiver will
				not endanger the health, safety, welfare or rights of any
				resident.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 65 - Intermediate Care Facilities for Persons With Mental Illness (ICF/PMI) › Rule 481-65.5 - General Requirements

Current through Register Vol. 47, No. 3, July 24, 2024
(1) A
				valid license shall be posted in each facility so the public can easily see it.
				(Ill)
(2) Each license is valid
				only for the premises and person named on the license and is not
				transferable.
(3) The posted
				license shall accurately reflect the current status of the facility.
				(Ill)
(4) Each citation or a copy
				of each citation issued by the department for a Class I or Class II violation
				shall be prominently posted by the facility in plain view of the residents,
				visitors, and persons inquiring about placement in the facility. The citation
				or copy of the citation shall remain posted until the violation is corrected to
				the satisfaction of the department. (Ill)
(5) Licenses expire one year after the date
				of issuance or as indicated on the license.
(6) There shall be no more beds erected than
				are stipulated on the license. (II, III)
This rule is intended to implement Iowa Code section
				  135C.8.
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 65 - Intermediate Care Facilities for Persons With Mental Illness (ICF/PMI) › Rule 481-65.6 - Notification Required by the Department

Current through Register Vol. 47, No. 3, July 24, 2024
The department shall be notified within 48 hours, by letter,
				  of any reduction or loss of personal care or dietary staff lasting more than
				  seven days which places the staff ratio below that required for licensing. No
				  additional residents shall be admitted until the minimum staff requirements are
				  achieved. (II, III)
(1) Other required
				notification and time periods are:
a. Within
				30 days of any proposed change in the resume of care for the ICF/PMI; (II,
				III)
b. Thirty days before
				addition, alteration, or new construction is begun in the ICF/PMI or on the
				premises; (III)
c. Thirty days
				before the ICF/PMI closes; (III)
d.
				Within two weeks of any change of administrator; (II, III) and
e. Within 30 days when any change in the
				category of license is sought. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 65 - Intermediate Care Facilities for Persons With Mental Illness (ICF/PMI) › Rule 481-65.7 - Administrator

Current through Register Vol. 47, No. 3, July 24, 2024
Each ICF/PMI shall have one person in charge, duly approved
				  by the department or acting in a provisional capacity in accordance with these
				  regulations. (II, III)
(1) The
				administrator shall be at least 21 years of age and shall meet at least one of
				the following conditions:
a. Be licensed in
				Iowa as a nursing home administrator, or certified as a residential care
				administrator No residential care facility administrator certified under a
				waiver from the department shall administrate an intermediate care facility for
				persons with mental illness. The administrator must have at least two years'
				experience in direct care or supervision of people with mental illness and at
				least one year of experience in an administrative capacity; (II, III)
				or
b. Be a qualified mental health
				professional (QMHP) with at least one year of experience in an administrative
				capacity. (II, III)
If an ICF/PMI is a distinct part of a licensed health care
				  facility, the administrator of the facility as a whole may serve as the
				  administrator of the ICF/PMI without meeting the requirements of subrule 65.7(
				  1), paragraph
"a"
or
"b."
When this occurs,
				  the person in charge of the ICF/PMI distinct part shall meet the requirements
				  of subrule 65.7(1), paragraph
"a"
or
"b."
(II, III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 65 - Intermediate Care Facilities for Persons With Mental Illness (ICF/PMI) › Rule 481-65.8 - Administration

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The licensee
				shall:
a. Be responsible for the overall
				operation of the ICF/PMI; (III)
b.
				Be responsible for compliance with all applicable laws and with the rules of
				the department; (II, III)
c.
				Establish written policies, which shall be available for review by the
				department or other agencies designated by Iowa Code section
				135C.16(3),
				for the operation of the ICF/PMI including, but not limited to: (III)
(1) Personnel; (III)
(2) Admission; (III)
(3) Evaluation services; (II, III)
(4) Programming and individual program plan;
				(II, III)
(5) Crisis intervention;
				(II, III)
(6) Discharge or
				transfer; (III)
(7) Medication
				management; (II)
(8) Resident
				property; (II, III)
(9) Financial
				affairs; (II, III)
(10) Records;
				(III)
(11) Health and safety; (II,
				III)
(12) Nutrition;
				(III)
(13) Physical facilities and
				maintenance; (III)
(14) Care review
				committee; (III)
(15) Resident
				rights; (II, III) and
d.
				Furnish statistical information concerning the operation of the facility to the
				department within 30 days of request. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 65 - Intermediate Care Facilities for Persons With Mental Illness (ICF/PMI) › Rule 481-65.9 - Personnel

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The personnel
				policies and procedures shall include the following requirements:
a. Written job descriptions for all employees
				or agreements for all consultants, which include duties and responsibilities,
				education, experience, or other requirements, and supervisory relationships;
				(III)
b. Annual performance
				evaluations of all employees and consultants which are dated and signed by the
				employee or consultant and the supervisor; (III)
c. Personnel records which are current,
				accurate, complete and confidential to the extent allowed by law. The record
				shall contain documentation of how the employee's or consultant's education and
				experience are relevant to the position for which they were hired;
				(III)
d. Roles, responsibilities,
				and limitation of student interns and volunteers; (III)
e. An orientation program for all newly hired
				employees and consultants which includes introduction to facility personnel
				policies and procedures and a discussion of the safety plan. Subparagraphs
				65.9(1)
"f"(3),
(5) and (9) shall be included; (II,
				III)
f. A plan for a continuing
				education program with a minimum of 12 in-service programs per year. There
				shall be a written, individualized staff development plan implemented for each
				employee. The plan shall take into consideration the duties of the employee and
				the needs of the facility identified in the resume of care. The plan shall
				ensure that each employee has the opportunity to develop and enhance skills and
				to broaden and increase knowledge needed to provide effective resident care
				including, but not limited to:
(1) First aid;
				(II, III)
(2) Human needs and
				behavior; (II, III)
(3) Problems
				and needs of persons with mental illness; for example, diagnosis and treatment,
				suicide assessment and prevention; (II, III)
(4) Medication; (II, III)
(5) Crisis intervention; for example, use of
				restraints and seclusion; (II)
(6)
				Delivery of services in accordance with the principles of normalization;
				(III)
(7) Infection control and
				wellness; (III)
(8) Fire safety,
				disaster, and tornado preparation; (II, III) and
(9) Resident rights. (II, III)
g. Equal opportunity and
				affirmative action employment practices; (III)
h. Procedures to be used when disciplining an
				employee; (III) and
i. Appropriate
				dress and personal hygiene for staff and residents. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 65 - Intermediate Care Facilities for Persons With Mental Illness (ICF/PMI) › Rule 481-65.11 - Evaluation Services

Current through Register Vol. 47, No. 3, July 24, 2024
Each resident admitted shall have a physical examination and
				  tuberculin test no more than 30 days before admission and a physical
				  examination annually after that. Each annual examination shall be sufficient to
				  ensure the resident has no physical condition which precludes living in the
				  facility. If the resident is admitted directly from a hospital, a copy of the
				  hospital admission physical and discharge summary may meet this requirement.
				  (II, III)
(1) In addition to the
				required initial physical examination, each resident shall be evaluated to
				identify physical health, current level of functioning and the need for
				services. This evaluation shall be completed within 30 days of admission and
				annually after that. Information from other sources may be used in the
				evaluation if the information meets the requirements of subrules 65.11(2) and
				65.11(3). (II, III)
(2) The portion
				of the evaluation which describes the resident's physical health shall:
a. Identify current illnesses and
				disabilities and include recommendations for physical and physiological
				treatment and services; (II, III)
b. Include a description of the resident's
				ability for health maintenance; (II)
c. Include a mental status examination and
				history of mental health and treatments; (II, III) and
d. Be performed by a physician with a valid
				license to practice medicine and surgery, osteopathic medicine and surgery or
				osteopathy in Iowa. If the evaluation is not conducted in Iowa, it must be by a
				physician who holds a current license in the state in which the examination is
				performed. If the doctor is not a psychiatrist, a psychiatrist or health
				service provider in psychology licensed under Iowa Code section
				154B.7
				shall be consulted regarding the results of the mental status examination. (II,
				III)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 65 - Intermediate Care Facilities for Persons With Mental Illness (ICF/PMI) › Rule 481-65.12 - Individual Program Plan (IPP)

Current through Register Vol. 47, No. 3, July 24, 2024
An initial program plan shall be developed within 24 hours
				  of admission. This plan shall be based on information gained from the resident,
				  family, physician or referring facility. Services to be provided shall be
				  addressed. Intervention to be provided, if and when the need arises, shall also
				  be addressed in the IPP. The plan shall be followed until the IPP required in
				  subrule 65.12(1) is complete. The initial plan shall be completed by a
				  registered nurse, a qualified social worker or a QMHP. (II, III)
(1) An individual program plan for each
				resident shall be developed by an interdisciplinary team. The resident or the
				resident's legal guardian has the ultimate authority to accept or reject the
				plan unless otherwise determined by the court. The IPP shall be approved and
				have implementation monitored by the QMHP (II, III)
a. The IPP shall be based on the individual
				service plan of the referring agency, if available, the information contained
				in the social history, the need for services identified in the evaluation, and
				any other pertinent information. (Ill)
b. The facility shall assist the resident in
				obtaining access to academic services, community living skills training, legal
				services, self-care training, support services, transportation, treatment, and
				vocational education as needed. These services may be provided by the facility
				or obtained from other providers. (Ill)
c. Services to the resident shall be provided
				in the least restrictive environment and shall incorporate the principle of
				normalization. (Ill)
d. If needed
				services are not available and accessible, the facility shall document the
				actions taken to locate and obtain those services. The documentation shall
				identify needs which will not be met because of the lack of available services.
				(Ill)
e. The IPP shall be developed
				within 30 days following admission to the facility and renewed at least
				annually. (II, III)
f.The IPP shall
				be written, dated, signed by the interdisciplinary team members, and maintained
				in the resident's record. (Ill)
g.
				Written notice of the meeting to develop an IPP shall be mailed or delivered to
				everyone included in the interdisciplinary team conference at least two weeks
				before the scheduled meeting. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 65 - Intermediate Care Facilities for Persons With Mental Illness (ICF/PMI) › Rule 481-65.13 - Activity Program

Current through Register Vol. 47, No. 3, July 24, 2024
Each ICF/PMI shall have an organized activity program which
				  is directed by a person qualified as required by 65.9(3)
"d. "
(1) An activity program plan for the
				facility shall be based on needs identified in IPPs and on other interests
				expressed by residents. The activity program shall include leisure time
				management. (Ill)
(2) Activities
				shall be offered at least daily during the daytime hours if residents are
				present, twice weekly in the evening and twice on the weekend. (Ill)
(3) Activities offered shall be varied and
				shall be planned for individuals, small groups or large groups. (Ill)
(4) Monthly calendars shall be prepared in
				advance and shall be kept for review by the department. Substitutions and
				cancellations shall be noted. (Ill)
(5) Activities department personnel shall
				coordinate programs with other facility personnel. (Ill)
Iowa Administrative Code › Agency 481 - Inspections and Appeals Department › Inspections Division › Chapter 65 - Intermediate Care Facilities for Persons With Mental Illness (ICF/PMI) › Rule 481-65.14 - Crisis Intervention

Current through Register Vol. 47, No. 3, July 24, 2024
There shall be written policies and procedures concerning
				  crisis intervention. (II) These policies and procedures shall be:
1. Directed to maximizing the growth and
				development of the individual by incorporating a hierarchy of available
				alternative methods that emphasize positive approaches; (II, III)
2. Available in each program area and living
				unit; (II, III)
3. Available to
				individuals and their families; (II, III) and
4. Developed with the participation, as
				appropriate, of individuals served. (II, III)
(1) Corporal punishment, physical abuse, and
				verbal abuse, for example, shouting, screaming, swearing, name calling, or any
				other activity which might damage an individual's self-respect shall be
				prohibited. All residents shall be treated with fairness and respect as
				required by rule 65.25(135C). (II)
(2) Medication shall not be used as
				punishment, for the convenience of staff, or as a substitute for a program.
				Direct care staff shall monitor residents on medication and notify the
				physician if a resident is too sedated to participate in the IPP. (I,
				II)