135C.14 - RULES.
135C.14 RULES.
The department shall, in accordance with chapter 17A and with the
approval of the state board of health, adopt and enforce rules
setting minimum standards for health care facilities. In so doing,
the department, with the approval of the state board of health, may
adopt by reference, with or without amendment, nationally recognized
standards and rules, which shall be specified by title and edition,
date of publication, or similar information. The rules and standards
required by this section shall be formulated in consultation with the
director of human services or the director's designee, with the state
fire marshal, and with affected industry, professional, and consumer
groups, and shall be designed to further the accomplishment of the
purposes of this chapter and shall relate to:
1. Location and construction of the facility, including plumbing,
heating, lighting, ventilation, and other housing conditions, which
shall ensure the health, safety and comfort of residents and
protection from fire hazards. The rules of the department relating
to protection from fire hazards and fire safety shall be promulgated
by the state fire marshal in consultation with the department, and
shall be in keeping with the latest generally recognized safety
criteria for the facilities covered of which the applicable criteria
recommended and published from time to time by the national fire
protection association are prima facie evidence. To the greatest
extent possible, the rules promulgated by the state fire marshal
shall be consistent with the rules adopted by the department under
this chapter.
2. Number and qualifications of all personnel, including
management and nursing personnel, having responsibility for any part
of the care provided to residents.
3. All sanitary conditions within the facility and its
surroundings including water supply, sewage disposal, food handling,
and general hygiene, which shall ensure the health and comfort of
residents.
4. Diet related to the needs of each resident and based on good
nutritional practice and on recommendations which may be made by the
physician attending the resident.
5. Equipment essential to the health and welfare of the resident.
6. Requirements that a minimum number of registered or licensed
practical nurses and nurses' aides, relative to the number of
residents admitted, be employed by each licensed facility.
Staff-to-resident ratios established under this subsection need not
be the same for facilities holding different types of licenses, nor
for facilities holding the same type of license if there are
significant differences in the needs of residents which the
respective facilities are serving or intend to serve.
7. Social services and rehabilitative services provided for the
residents.
8. Facility policies and procedures regarding the treatment,
care, and rights of residents. The rules shall apply the federal
resident's rights contained in the federal Omnibus Budget
Reconciliation Act of 1987, Pub. L. No. 100-203, and the regulations
adopted pursuant to the Act and contained in 42 C.F.R. § 483.10,
483.12, 483.13, and 483.15, as amended to February 2, 1989, to all
health care facilities as defined in this chapter and shall include
procedures for implementing and enforcing the federal rules. The
department shall also adopt rules relating to the following:
a. The transfer of residents to other rooms within a
facility.
b. The involuntary discharge or transfer of residents from a
facility including provisions for notice and agency hearings and for
the development of a patient discharge or transfer plan and for
providing counseling services to a patient being discharged or
transferred.
c. The required holding of a bed for a resident under
designated circumstances upon payment of a prescribed charge for the
bed.
d. The notification of resident advocate committees by the
department of all complaints relating to health care facilities and
the involvement of the resident advocate committees in resolution of
the complaints.
e. For the recoupment of funds or property to residents when
the resident's personal funds or property have been used without the
resident's written consent or the written consent of the resident's
guardian.
f. The involuntary discharge of a resident of the Iowa
veterans home including provisions for notice and agency hearings,
the development of a resident discharge plan, and for providing
counseling services to a resident being discharged. As used in this
paragraph "f", "collaborative care plan" and
"interdisciplinary resident care committee" mean as defined in
section 35D.15, subsection 2. The rules shall provide that a
resident shall be involuntarily discharged for any of the following
reasons:
(1) (a) The resident has been diagnosed with a substance use
disorder but continues to abuse alcohol or an illegal drug in
violation of the resident's conditional or provisional agreement
entered into at the time of admission, and all of the following
conditions are met:
(i) The resident has been provided sufficient notice of any
changes in the resident's collaborative care plan.
(ii) The resident has been notified of the resident's commission
of three offenses and has been given the opportunity to correct the
behavior through either of the following options:
(A) Being given the opportunity to receive the appropriate level
of treatment in accordance with best practices for standards of care.
(B) By having been placed on probation by the Iowa veterans home
for a second offense.
(b) Notwithstanding the resident's meeting the criteria for
discharge under this subparagraph (1), if the resident has
demonstrated progress toward the goals established in the resident's
collaborative care plan, the interdisciplinary resident care
committee and the commandant may exercise discretion regarding the
discharge. Notwithstanding any provision to the contrary, a resident
may be immediately discharged under this subparagraph (1) if the
resident's actions or behavior jeopardizes the life or safety of
other residents or staff.
(2) (a) The resident refuses to utilize the resources available
to address issues identified in the resident's collaborative care
plan, and all of the following conditions are met:
(i) The resident has been provided sufficient notice of any
changes in the resident's collaborative care plan.
(ii) The resident has been notified of the resident's commission
of three offenses and the resident has been placed on probation by
the Iowa veterans home for a second offense.
(b) Notwithstanding the resident's meeting the criteria for
discharge under this subparagraph (2), if the resident has
demonstrated progress toward the goals established in the resident's
collaborative care plan, the interdisciplinary resident care
committee and the commandant may exercise discretion regarding the
discharge. Notwithstanding any provision to the contrary, the
resident may be immediately discharged under this subparagraph (2) if
the resident's actions or behavior jeopardizes the life or safety of
other residents or staff.
(3) The resident's medical or life skills needs have been met to
the extent possible through the services provided by the Iowa
veterans home and the resident no longer requires a residential or
nursing level of care, as determined by the interdisciplinary
resident care committee.
(4) The resident requires a level of licensed care not provided
at the Iowa veterans home. Section History: Early Form
[C50, 54, § 135C.5; C58, 62, 66, 71, 73, 75, 77, 79, 81, §
135C.14; 81 Acts, ch 60, § 1] Section History: Recent Form
83 Acts, ch 96, § 157, 159; 83 Acts, ch 101, § 18; 89 Acts, ch
241, § 1, 2; 90 Acts, ch 1204, § 14; 99 Acts, ch 129, §3; 2001 Acts,
ch 30, §3, 4; 2009 Acts, ch 62, §2
Referred to in § 35D.15, 135C.2, 135C.36