Current through Register Vol. 47, No. 6, September 18, 2024
(1)
Complaint. The process for filing a complaint is as follows:
a. Any person with concerns regarding a
facility may file a complaint with the Department of Inspections and Appeals,
Complaint/Incident Bureau, Lucas State Office Building, Third Floor, 321 E.
12th Street, Des Moines, Iowa 50319-0083; by use of the complaint hotline,
1-877-686-0027; by facsimile sent to (515)281-7106; or through the website
address dia-hfd.iowa.gov.
b. When the nature of the complaint is
outside the department's authority, the department shall forward the complaint
or refer the complainant to the appropriate investigatory entity.
c. The complainant shall include as much of
the following information as possible in the complaint: the complainant's name,
address and telephone number; the complainant's relationship to the facility or
resident; and the reason for the complaint.
d. The complainant's name shall be
confidential information and shall not be released by the department.
e. The department shall act on anonymous
complaints unless the department determines that the complaint is intended to
harass the facility.
f. If the
department, upon preliminary review, determines that the complaint is intended
as harassment or is without a reasonable basis, the department may dismiss the
complaint.
(2)
Self-reported incident. When the facility is required pursuant
to rule 481- 50.7(10A,135C) or other requirements to report an incident, the
facility shall make the report to the department via:
a. The web-based reporting tool accessible
from the following Internet site, dia-hfd.iowa.gov,
under the "Login" tab and then access "Add self report";
b. Mail by sending the self-report to the
Department of Inspections and Appeals, Complaint/Incident Bureau, Lucas State
Office Building, Third Floor, 321 E. 12th Street, Des Moines, Iowa
50319-0083;
c. The
complaint/incident hotline, 1-877-686-0027; or
d. Facsimile sent to
(515)281-7106.
(3)
Time frames for investigation of complaint or self-reported
incident. The following guidelines shall be used for determining the
time frame in which an on-site inspection of the facility shall be initiated:
a.
Immediate jeopardy
situation. Within 2 working days for a complaint or self-reported
incident determined by the department to be an alleged immediate jeopardy
situation. For purposes of this rule, "immediate jeopardy situation" means a
situation in which the facility's alleged noncompliance with Iowa Code chapter
135C, or rules adopted pursuant thereto, has caused or is likely to cause,
serious injury, harm, impairment, or death to a resident.
b.
High-level nonimmediate jeopardy
situation. Within 10 days for nursing facilities and within 20 working
days for intermediate care facilities and residential care facilities for a
complaint or self-reported incident determined by the department to be an
alleged high-level nonimmediate jeopardy situation. For purposes of this rule,
"high-level nonimmediate jeopardy situation" means the alleged noncompliance
with Iowa Code chapter 135C, or rules adopted pursuant thereto, may have caused
harm that negatively impacts the resident's mental, physical, or psychosocial
status and is of such consequence to the resident's well-being that a rapid
response is warranted.
c.
Other nonimmediate jeopardy situation. Within 45 calendar days
for a complaint or self-reported incident determined by the department to be an
alleged nonimmediate jeopardy situation, other than a high-level nonimmediate
jeopardy situation. For purposes of this rule, "other nonimmediate jeopardy
situation" means a situation that is not a high-level nonimmediate jeopardy
situation where the alleged noncompliance with Iowa Code chapter 135C, or rules
adopted pursuant thereto, may cause harm of limited consequence and does not
significantly impair the individual's mental, physical, or psychosocial status
or function.
d.
No
inspection of facility-reported incidents. The department may
determine not to institute an inspection of a self-reported incident using
criteria including, but not limited to, the following:
(1) There is no evident deficiency on the
part of the facility, and the facility has taken appropriate measures to
address the situation; or
(2) There
is a potential deficiency but:
1. The
facility has taken appropriate measures to address the situation;
2. The facility does not have a recent
history of identified deficiency similar to or related to the incident being
reported;
3. A complaint has not
been filed regarding the incident being reported; and
4. The resulting injury does not cause a
significant negative impact to the resident's quality of
life.
(4)
Standard for determining whether
a complaint or self-reported incident is substantiated. The department
shall apply a preponderance of the evidence standard in determining whether a
complaint or self-reported incident is substantiated.
(5)
Notification of program and
complainant. The department shall notify the facility and, if known,
the complainant of the findings of the complaint investigation. The department
shall also notify the complainant, if known, if the department does not
investigate a complaint, and the reasons for not investigating the complaint
shall be included in the notification.
(6)
Process for complaint and
self-reported incident. The department and facility shall follow the
process outlined in rule
481-50.10 (135C), as applicable,
when conducting or responding to a complaint or self-reported incident
investigation.
