20,160 sections across 1,928 Iowa regulatory chapters.
R.481—64.52 Rescinded IAB 7/26/89, effective 7/7/89
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R.481—64.53 Rescinded IAB 7/26/89, effective 7/7/89
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R.481—64.54 Rescinded IAB 7/26/89, effective 7/7/89
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R.481—64.55 Rescinded IAB 7/26/89, effective 7/7/89
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R.481—64.56 Rescinded IAB 7/26/89, effective 7/7/89
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R.481—64.57 Rescinded IAB 7/26/89, effective 7/7/89
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R.481—64.58 Rescinded IAB 7/26/89, effective 7/7/89
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R.481—64.59 County care facilities. Rescinded ARC 0764C, IAB 5/29/13, effective 7/3/13
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R.481—64.6 Veteran eligibility
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64.6(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 …
R.481—64.60 Federal regulations adopted—conditions of participation. Regulations in 42 CFR
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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, Iow…
R.481—64.61 Federal regulations adopted—rights. Rescinded ARC 6972C, IAB 4/5/23, effective
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5/10/23.
R.481—64.62 Another business or activity in a facility. A facility is allowed to have another
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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 appro…
R.481—64.63 Respite care services. Respite care services means an organized program of temporary
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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 serv…
R.481—64.7 Licenses for distinct parts
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64.7(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. 64.7(…
R.481—64.8 Rescinded IAB 7/26/89, effective 7/7/89
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R.481—64.9 Rescinded IAB 7/26/89, effective 7/7/89
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R.481—65.1 Definitions. For the purposes of these rules, the following terms shall have the meaning
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indicated in this chapter. The definitions set out in Iowa Code section 135C.1 shall be considered incorporated verbatim in the rules. The use of the words “shall” and “must” indicate these standards are mandatory. “Academic services” means those activities provided to assist a p…
R.481—65.10 General admission policies. There shall be admission policies which address the
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following: 1. No resident shall be admitted or retained who is in need of greater services than the facility can provide. (II, III) 2. Residents shall be admitted only on a written order signed by a physician. (II, III) 3. A preplacement visit shall be completed prior to admissio…
R.481—65.11 Evaluation services. Each resident admitted shall have a physical examination and
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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 h…
R.481—65.12 Individual program plan (IPP). An initial program plan shall be developed within 24
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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 …
R.481—65.13 Activity program. Each ICF/PMI shall have an organized activity program which is
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directed by a person qualified as required by 65.9(3)“d.” 65.13(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. (III) 65.13(2) Activi…
R.481—65.14 Crisis intervention. There shall be written policies and procedures concerning crisis
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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 livi…
R.481—65.15 Restraint or seclusion. Physician’s orders are required to use any kind of mechanical
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restraints or seclusion. (I, II, III) Restraints are defined as the following: 1. Type I is physical restraint which uses equipment to promote the safety of the individual. It is not applied directly to a person. Examples: divided doors and side rails. 2. Type II is mechanical re…
R.481—65.16 Discharge or transfer. Procedures for the discharge or transfer of the resident shall be
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established and followed. (II, III) 65.16(1) Discharge plan. The decision to discharge a person and the plan for doing so shall be established through the participation of the resident, members of the interdisciplinary team and other resource personnel as appropriate for the welf…
R.481—65.17 Medication management. Medications shall be prescribed on an individual basis by a
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person who is authorized by Iowa law to prescribe. (I, II) 1. Medication orders shall be correctly implemented by qualified personnel. (II) 2. Qualified staff shall ensure that residents are able to take their own medication. (I, II) 3. Each physician order allowing a resident to…
R.481—65.18 Resident property and personal affairs. The admission of a resident does not give the
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facility or any employee of the facility the right to manage, use, or dispose of any property of the resident except with the written authorization of the resident or the resident’s legal guardian. (II, III) 65.18(1) The admission of a resident shall not grant the ICF/PMI the aut…
R.481—65.19 Financial affairs. Residents who have not been assigned a guardian or conservator by
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the court may manage their personal financial affairs, and to the extent, under written authorization by the residents that the facility assists in management, the management shall be carried out in accordance with Iowa Code section 135C.24. (II) 65.19(1) Written account of resid…
R.481—65.2 Application for license. In order to obtain an initial license for an ICF/PMI, the
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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 …
R.481—65.20 Records
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65.20(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…
R.481—65.21 Health and safety
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65.21(1) Physician. Each resident shall have a designated licensed physician who may be called when needed. (III) 65.21(2) Emergency care. Each facility shall have written policies and procedures for emergency medical or psychiatric care to include: a. A written agreement with a …
R.481—65.22 Nutrition. There shall be policies and procedures written and implemented for dietary
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staffing. 1. The person responsible for planning menus and monitoring the kitchens in each facility shall have completed training, approved by the department, in sanitation and food preparation. (III) 2. In facilities licensed for over 15 beds, food service personnel shall be on …
R.481—65.23 Physical facilities and maintenance
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65.23(1) Housekeeping. The facility shall have written procedures for daily and weekly cleaning (III) which include, but need not be limited to: a. All rooms including furnishings, all corridors, storage areas, linen closets, attics, and basements shall be kept in a clean, orderl…
R.481—65.24 Care review committee. Rescinded ARC 1205C, IAB 12/11/13, effective 1/15/14
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R.481—65.25 Residents’ rights in general. Each facility shall ensure that policies and procedures are
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written and implemented which include at least provisions in subrules 65.25(1) to 65.25(21). These shall govern all services provided to staff, residents, their families or legal representatives. The policies and procedures shall be available to the public and shall be reviewed a…
R.481—65.26 Incompetent residents. Each facility shall provide that all rights and responsibilities of
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incompetent residents devolve to the legal guardian when a hearing has been held and the resident is judged incompetent in accordance with state law. (II) A facility is not absolved from advising incompetent residents of their rights to the extent the resident is able to understa…
R.481—65.27 County care facilities. In addition to these rules, county care facilities licensed as
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intermediate care facilities for persons with mental illness must also comply with department of human services rules 441—Chapter 37. Violation of any standard established by the department of human services is a Class II violation pursuant to 481—56.2(135C). This rule is intende…
R.481—65.28 Violations. Classification of violations is I, II and III, determined by the division using
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the provisions in 481—Chapter 56, “Fining and Citations,” to enforce a fine to cite a facility.
R.481—65.29 Another business or activity in a facility. A facility is allowed to have another
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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 appro…
R.481—65.3 Licenses for distinct parts. Separate licenses may be issued for distinct parts which are
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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 d…
R.481—65.30 Respite care services. Respite care services means an organized program of temporary
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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 serv…
R.481—65.4 Waivers. Waivers from these rules may be granted by the director of the department
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when: 1. The need for a waiver has been established consistent with the résumé 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…
R.481—65.5 General requirements
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65.5(1) A valid license shall be posted in each facility so the public can easily see it. (III) 65.5(2) Each license is valid only for the premises and person named on the license and is not transferable. 65.5(3) The posted license shall accurately reflect the current status of t…
R.481—65.6 Notification required by the department. The department shall be notified within 48
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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) 65.6(1)…
R.481—65.7 Administrator. Each ICF/PMI shall have one person in charge, duly approved by the
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department or acting in a provisional capacity in accordance with these regulations. (II, III) 65.7(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…
R.481—65.8 Administration
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65.8(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 depart…
R.481—65.9 Personnel
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65.9(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 relati…
R.481—650.1 Definitions. The following definitions are applicable to the rules of the board of
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medicine: “Acupuncture” means a form of health care developed from traditional and modern oriental medical concepts that employs oriental medical diagnosis and treatment, and adjunctive therapies and diagnostic techniques, for the promotion, maintenance, and restoration of health…
R.481—650.2 Purpose of board. The purpose of the board is to administer and enforce the provisions
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of Iowa Code chapters 147, 148, 148E, and 272C with regard to the practice of medicine and surgery, osteopathic medicine and surgery, and acupuncture. [ARC 9109C, IAB 4/16/25, effective 5/21/25; Editorial change: IAC Supplement 6/11/25]
R.481—650.3 Organization of board
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650.3(1) The board: a. Makes policy relative to matters involving medical and acupuncture education, licensure, practice, and discipline. b. Conducts business according to board-approved policy. c. Elects a chairperson, vice chairperson and a secretary from its membership at the …
R.481—650.4 Official communications. All official communications, including submissions and
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requests, should be addressed to the Executive Director, Iowa Board of Medicine, 6200 Park Avenue, Suite 100, Des Moines, Iowa 50321. [ARC 9109C, IAB 4/16/25, effective 5/21/25; Editorial change: IAC Supplement 6/11/25]