Iowa Administrative Code

resident does not have a guardian, conservator or other person signing the admission agreement, the term “responsible party” shall include the resident’s sponsoring agency, e.g., the department of human services, the U.S. Department of Veterans Affairs, religious groups, fraterna…

58.14(1) Each resident in a nursing facility shall designate a licensed physician who may be called when needed. Professional management of a resident’s care shall be the responsibility of the hospice program when: a. The resident is terminally ill, and b. The resident has electe…

58.15(1) Resident admission record. The licensee shall keep a permanent record on all residents admitted to a nursing facility with all entries current, dated, and signed. This shall be a part of the resident clinical record. (III) The admission record form shall include: a. Name…

58.16(1) Beds shall be made daily and adjusted as necessary. A complete change of linen shall be made at least once a week and more often if necessary. (III) 58.16(2) Residents shall receive sufficient supervision so that their personal cleanliness is maintained. (II, III) 58.16(…

58.18(1) Individual health care plans shall be based on resident treatment decisions, the nature of the illness or disability, treatment, and care prescribed. Goals shall be developed by each discipline providing service, treatment, and care. These plans shall be in writing, revi…

shall provide, as appropriate, the following required nursing services under the 24-hour direction of qualified nurses with ancillary coverage as set forth in these rules: 58.19(1) Activities of daily living. a. Bathing; (II, III) b. Daily oral hygiene (denture care); (II, III) c…

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 indiv…

supervisor who shall: 58.20(1) Direct the implementation of the physician’s orders; (I, II) 58.20(2) Plan for and direct the nursing care, services, treatments, procedures, and other services in order that each resident’s needs and choices, where practicable, are met; (II, III) 5…

58.21(1) Drug storage for residents who are unable to take their own medications and require supervision shall meet the following requirements: a. A cabinet with a lock, convenient to nursing service, shall be provided and used for storage of all drugs, solutions, and prescriptio…

or improve the resident’s ability to carry out the activities of daily living. 58.22(1) Physical therapy services. a. Each facility shall have a written agreement with a licensed physical therapist to provide physical therapy services. (III) b. Physical therapy shall be rendered …

58.23(1) Dental services. a. The nursing facility personnel shall assist residents to obtain regular and emergency dental services. (III) b. Transportation arrangements shall be made when necessary for the resident to be transported to the dentist’s office. (III) c. Dental servic…

58.24(1) Organization of dietetic services. The facility shall meet the needs of the residents and provide the services listed in this standard. If a service is contracted out, the contractor shall meet the same standard. A written agreement shall be formulated between the facili…

58.25(1) The administrator or designee shall be responsible for developing a written, organized orientation program for all residents. (III) 58.25(2) The program shall be planned and implemented to resolve or reduce personal, family, business, and emotional problems that may inte…

58.26(1) Organized activities. Each nursing facility shall provide an organized resident activity program for the group and for the individual resident which shall include suitable activities for evenings and weekends. (III) a. The activity program shall be designed to meet the n…

IAB 5/31/23, effective 7/5/23.

maintenance of a safe environment for residents and personnel. (III) 58.28(1) Fire safety. a. All nursing facilities shall meet the fire safety rules and regulations as promulgated by the state fire marshal. (I, II) b. The size of the facility and needs of the residents shall be …

58.29(1) There shall be a readily available supply of self-help and ambulation devices such as wheelchairs, walkers, and such other devices maintained in good repair that will meet the current needs of all residents. (III) 58.29(2) The facility shall ensure that each ambulatory r…

58.3(1) Initial application and licensing. In order to obtain an initial nursing facility license, for a nursing facility which is currently licensed, the applicant must: a. Meet all of the rules, regulations, and standards contained in 481—Chapters 58 and 61. Applicable exceptio…

58.31(1) Written procedures shall be established and implemented for daily and weekly cleaning schedules. (III) 58.31(2) Each resident unit shall be cleaned on a routine schedule. (III) 58.31(3) All rooms, corridors, storage areas, linen closets, attics, and basements shall be ke…

58.32(1) Each facility shall establish a maintenance program in writing to ensure the continued maintenance of the facility, to promote good housekeeping procedures, and to ensure sanitary practices throughout the facility. (III) 58.32(2) The building, grounds, and other building…

58.33(1) All soiled linens shall be collected in and transported to the laundry room in closed, leakproof laundry bags or covered, impermeable containers. (III) 58.33(2) Except for related activities, the laundry room shall not be used for other purposes. (III) 58.33(3) Procedure…

58.34(1) All garbage shall be gathered, stored, and disposed of in a manner that will not permit transmission of disease, create a nuisance, or provide a breeding or feeding place for vermin or insects. (III) 58.34(2) All containers for refuse shall be watertight, rodent-proof, a…

58.35(1) Buildings—general requirements. a. For purposes of computation of usable floor space in bedrooms and other living areas of the facility, that part of the room having no less than seven feet of ceiling height shall be used. Usable floor space may include irregularities in…

58.36(1) Children under 14 years of age shall not be allowed into the service areas. (III) 58.36(2) The residents’ bedrooms shall not be occupied by employees or family members of the licensee. (III) 58.36(3) In facilities where the total occupancy of family, employees, and resid…

department and under controlled conditions. (III)

58.38(1) Linen supplies. a. There shall be an adequate supply of linen so that each resident shall have at least three washcloths, hand towels, and bath towels per week. (III) b. A complete change of bed linens shall be available in the linen storage area for each bed. (III) c. S…

58.39(1) Each facility shall ensure that policies and procedures are written and implemented which include, at a minimum, all of the following provisions (subrules 58.39(2) to 58.39(6)) and which govern all areas of service provided by the facility. These policies and procedures …

58.4(1) The license shall be displayed in a conspicuous place in the facility which is viewed by the public. (III) 58.4(2) The license shall be valid only in the possession of the licensee to whom it is issued. 58.4(3) The posted license shall accurately reflect the current statu…

58.40(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…

resident’s period of stay, to exercise rights as a resident and as a citizen and may voice grievances and recommend changes in policies and services to administrative staff or to outside representatives of the resident’s choice, free from interference, coercion, discrimination, o…

or conservator by the court may manage the resident’s own personal financial affairs, and to the extent, under written authorization by the resident that the facility assists in management, the management shall be carried out in accordance with Iowa Code section 135C.24. (II) 58.…

times and shall be free from mental, physical, sexual, and verbal abuse, exploitation, neglect, and physical injury. Each resident shall be free from chemical and physical restraints except as follows: when authorized in writing by a physician for a specified period of time; when…

information contained in the resident’s records, including information contained in an automatic data bank. The resident’s written consent shall be required for the release of information to persons not otherwise authorized under law to receive it. (II) 58.44(1) The facility shal…

recognition of dignity and individuality, including privacy in treatment and in care for personal needs. (II) 58.45(1) Staff shall display respect for residents when speaking with, caring for, or talking about them, as constant affirmation of their individuality and dignity as hu…

as provided by Iowa Code sections 35D.14 and 347B.5. Residents may perform services for the facility if such services are performed in accordance with 42 CFR 483.10(f)(9). (II) [ARC 7033C, IAB 5/31/23, effective 7/5/23]

persons of the resident’s choice, unless to do so would infringe upon the rights of other residents, and may send and receive personal mail unopened. (II) 58.47(1) Residents shall be permitted to receive visitors in accordance with 42 CFR 483.10(f)(4) and the federal interpretive…

community groups at the resident’s discretion unless contraindicated for reasons documented by the attending physician or qualified intellectual disabilities professional as appropriate in the resident’s record. (II) 58.48(1) Residents who wish to meet with or participate in acti…

as space permits and provided such use is not otherwise prohibited by these rules. (II) 58.49(1) Residents shall be permitted to keep reasonable amounts of personal clothing and possessions for their use while in the facility. The personal property shall be kept in a safe locatio…

58.5(1) Within 48 hours of any reduction or loss of nursing or dietary staff lasting more than seven days which places the staffing requirements below those required for licensing. No additional residents shall be admitted until the minimum staffing requirements are achieved; (II…

resident’s spouse; if both are residents in the facility, they shall be permitted to share a room if available. (II) 58.50(1) The facility shall provide for needed privacy in visits between spouses. (II) 58.50(2) Spouses who are residents in the same facility shall be permitted t…

physician. Each resident shall have the right to choose the resident’s Medicare prescription drug benefit plan (Part D) pursuant to Section 1860D of the Social Security Act, and the facility shall utilize a pharmacy(ies) that recognizes the Part D plans chosen by that facility’s …

58.52(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 und…

dementing illness (CCDI unit or facility). 58.54(1) A nursing facility which chooses to care for residents in a distinct part shall obtain a license for a CCDI unit or facility. In the case of a distinct part, this license will be in addition to its nursing facility license. The …

business or activity in a health care facility or in the physical structure of the facility, if the other business or activity meets the requirements of applicable state and federal laws, administrative rules, and federal regulations. To obtain the approval of the department and …

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 nursing facility which chooses to provide respite care services must meet the following requirements related to respite s…

58.57(1) Subject to the availability of funding, all nursing facility inspectors shall receive 12 hours of annual continuing education in gerontology, wound care, dementia, falls, or a combination of these subjects. 58.57(2) An inspector shall not be personally liable for financi…