135C.6 - LICENSE REQUIRED -- EXEMPTIONS.
135C.6 LICENSE REQUIRED -- EXEMPTIONS.
1. A person or governmental unit acting severally or jointly with
any other person or governmental unit shall not establish or operate
a health care facility in this state without a license for the
facility. A supported community living service, as defined in
section 225C.21, is not required to be licensed under this chapter,
but is subject to approval under section 225C.21 in order to receive
public funding.
2. A health care facility suitable for separation and operation
with distinct parts may, where otherwise qualified in all respects,
be issued multiple licenses authorizing various parts of such
facilities to be operated as health care facilities of different
license categories.
3. No change in a health care facility, its operation, program,
or services, of a degree or character affecting continuing
licensability shall be made without prior approval thereof by the
department. The department may by rule specify the types of changes
which shall not be made without its prior approval.
4. No department, agency, or officer of this state or of any of
its political subdivisions shall pay or approve for payment from
public funds any amount or amounts to a health care facility under
any program of state aid in connection with services provided or to
be provided an actual or prospective resident in a health care
facility, unless the facility has a current license issued by the
department and meets such other requirements as may be in effect
pursuant to law.
5. No health care facility established and operated in compliance
with law prior to January 1, 1976, shall be required to change its
corporate or business name by reason of the definitions prescribed in
section 135C.1, provided that no health care facility shall at any
time represent or hold out to the public or to any individual that it
is licensed as, or provides the services of, a health care facility
of a type offering a higher grade of care than such health care
facility is licensed to provide. Any health care facility which, by
virtue of this section, operates under a name not accurately
descriptive of the type of license which it holds shall clearly
indicate in any printed advertisement, letterhead, or similar
material, the type of license or licenses which it has in fact been
issued. No health care facility established or renamed after January
1, 1976, shall use any name indicating that it holds a different type
of license than it has been issued.
6. A health care facility operated by and for the exclusive use
of members of a religious order, which does not admit more than two
individuals to the facility from the general public, may be operated
without obtaining a license under this chapter and shall not be
deemed to be licensed by the state.
7. A freestanding hospice facility which operates a hospice
program in accordance with 42 C.F.R. § 418 may be operated without
obtaining a license under this chapter and shall not be deemed to be
licensed by the state.
8. The following residential programs to which the department of
human services applies accreditation, certification, or standards of
review shall not be required to be licensed as a health care facility
under this chapter:
a. Residential programs providing care to not more than four
individuals and receiving moneys appropriated to the department of
human services under provisions of a federally approved home and
community-based services waiver for persons with mental retardation
or other medical assistance program under chapter 249A. In approving
a residential program under this paragraph, the department of human
services shall consider the geographic location of the program so as
to avoid an overconcentration of such programs in an area. In order
to be approved under this paragraph, a residential program shall not
be required to involve the conversion of a licensed residential care
facility for persons with mental retardation.
b. Not more than forty residential care facilities for
persons with mental retardation that are licensed to serve not more
than five individuals may be authorized by the department of human
services to convert to operation as a residential program under the
provisions of a medical assistance home and community-based services
waiver for persons with mental retardation. A converted residential
program operating under this paragraph is subject to the conditions
stated in paragraph "a" except that the program shall not serve
more than five individuals.
c. A residential program approved by the department of human
services pursuant to this paragraph "c" to receive moneys
appropriated to the department of human services under provisions of
a federally approved home and community-based services waiver for
persons with mental retardation may provide care to not more than
five individuals. The department shall approve a residential program
under this paragraph that complies with all of the following
conditions:
(1) Approval of the program will not result in an
overconcentration of such programs in an area.
(2) The county in which the residential program is located
submits to the department of human services a letter of support for
approval of the program.
(3) The county in which the residential program is located
provides to the department of human services verification in writing
that the program is needed to address one or more of the following:
(a) The quantity of services currently available in the county is
insufficient to meet the need.
(b) The quantity of affordable rental housing in the county is
insufficient.
(c) Implementation of the program will cause a reduction in the
size or quantity of larger congregate programs.
9. Contingent upon the department of human services receiving
federal approval, a residential program which serves not more than
eight individuals and is licensed as an intermediate care facility
for persons with mental retardation may surrender the facility
license and continue to operate under a federally approved medical
assistance home and community-based services waiver for persons with
mental retardation, if the department of human services has approved
a plan submitted by the residential program.
10. Notwithstanding section 135C.9, nursing facilities which are
accredited by the joint commission on accreditation of health care
organizations shall be licensed without inspection by the department,
if the nursing facility has chosen to be inspected by the joint
commission on accreditation of health care organizations in lieu of
inspection by the department. Section History: Early Form
[C50, 54, § 135C.2; C58, 62, 66, 71, 73, 75, 77, 79, 81, § 135C.6]
Section History: Recent Form
85 Acts, ch 141, §2; 86 Acts, ch 1245, § 1113; 90 Acts, ch 1107, §
2; 92 Acts, ch 1043, § 3; 96 Acts, ch 1053, § 2; 97 Acts, ch 169,
§18, 26; 98 Acts, ch 1181, § 11, 14; 99 Acts, ch 160, §17; 2002 Acts,
ch 1120, §1; 2003 Acts, ch 101, §2, 4
Referred to in § 135.63, 135C.9 Footnotes
Subsection 10 is effective contingent upon passage of federal
legislation; see 96 Acts, ch 1053, § 3