Iowa Administrative Code
Agency 481 - INSPECTIONS AND APPEALS
INSPECTIONS DIVISION
Chapter 57 - RESIDENTIAL CARE FACILITIES
Rule 481-57.6 - Special classifications
Universal Citation: IA Admin Code 481-57.6
Current through Register Vol. 46, No. 19, March 20, 2024
(1) Memory care.
a.
Designation and application. A residential care facility may
choose to care for residents who require memory care in a distinct part of the
facility or designate the entire residential care facility as one that provides
memory care. Residents in the memory care unit or facility shall meet the level
of care requirements for a residential care facility. "Memory care" in a
residential care facility means the care of persons with early Alzheimer's-type
dementia or other disorders causing dementia. (I, II, III)
(1) Application for approval to provide this
category of care shall be submitted by the licensee on a form provided by the
department. (III)
(2) Plans to
modify the physical environment shall be submitted to the department for review
based on the requirements of 481-Chapter 60. (III)
(3) If the unit or facility is to be a locked
unit or facility, all locking devices shall meet the Life Safety Code and any
requirements of the state fire marshal. If the unit or facility is to be
unlocked, a system of security monitoring is required. (I, II, III)
b.
Résumé of
care. A résumé of care shall be submitted to the
department for approval at least 30 days before a separate memory care unit or
facility is opened. For facilities with a memory care unit, this
résumé of care is in addition to the résumé of care
required by subrule 57.3(2). A new résumé of care shall be
submitted when services are substantially changed. The résumé of
care shall:
(1) Describe the population to be
served;
(2) State the philosophy
and objectives;
(3) List criteria
for transfer to and from the memory care unit or facility;
(4) Include a copy of the floor
plan;
(5) List the titles of
policies and procedures developed for the unit or facility;
(6) Propose a staffing pattern;
(7) Set out a plan for specialized staff
training;
(8) State visitor,
volunteer, and safety policies;
(9)
Describe programs for activities, social services and families; and
(10) Describe the interdisciplinary team and
the role of each team member.
c.
Policies and procedures.
Separate written policies and procedures shall be implemented in the memory
care unit or facility and shall address the following:
(1) Criteria for admission and the
preadmission evaluation process. The policy shall require a statement from the
primary care provider approving the placement before a resident may be moved
into a memory care unit or facility. (II, III)
(2) Safety, including a description of the
actions required of staff in the event of a fire, natural disaster, emergency
medical event or catastrophic event. Safety procedures shall also explain steps
to be taken when a resident is discovered to be missing from the unit or
facility and when hazardous cleaning materials or potentially dangerous
mechanical equipment is being used in the unit or facility and explain the
manner in which the effectiveness of the security system will be monitored.
(II, III)
(3) Staffing
requirements, including the minimum number, types and qualifications of staff
in the unit or facility in accordance with resident needs. (II, III)
(4) Visitation policies, including suggested
times for visitation and ensuring the residents' rights to free access to
visitors unless visits are contraindicated by the interdisciplinary team. (II,
III)
(5) The process and criteria
which will be used to monitor and to respond to risks specific to the
residents, including but not limited to drug use, restraint use, infections,
incidents and acute behavioral events. (II, III)
d.
Assessment prior to transfer or
admission. Prior to the transfer or admission of a resident applicant
to the memory care unit or facility, a complete assessment of the resident
applicant's physical, mental, social and behavioral status shall be completed
to determine whether the applicant meets admission criteria. This assessment
shall be completed by facility staff and shall become part of the resident's
permanent record upon admission. (II, III)
e.
Staff training. All staff
working in a memory care unit or facility shall have training appropriate to
the needs of the residents. (I, II, III)
(1)
Upon assignment to the unit or facility, all staff working in the unit or
facility shall be oriented to the needs of residents requiring memory care.
Staff members shall have at least six hours of special training appropriate to
their job descriptions within 30 days of assignment to the unit or facility.
(I, II, III)
(2) Training shall
include the following topics: (II, III)
1. An
explanation of Alzheimer's disease and related disorders, including symptoms,
behavior and disease progression;
2. Skills for communicating with persons with
dementia;
3. Skills for
communicating with family and friends of persons with dementia;
4. An explanation of family issues such as
role reversal, grief and loss, guilt, relinquishing the caregiving role, and
family dynamics;
5. The importance
of planned and spontaneous activities;
6. Skills in providing assistance with
activities of daily living;
7.
Skills in working with challenging residents;
8. Techniques for cueing, simplifying, and
redirecting;
9. Staff support and
stress reduction;
10. Medication
management and nonpharmacological interventions.
(3) Nursing staff, certified medication
aides, medication managers, social services personnel, housekeeping and
activity personnel shall have a minimum of six hours of in-service training
annually. This training shall be related to the needs of memory care residents.
The six-hour initial training required in subparagraph
57.6(1)"e"(1) shall count toward the required annual
in-service training. (II, III)
f.
Staffing. There shall be
at least one staff person on a memory care unit at all times. (I, II,
III)
g.
Others living in
the memory care unit. A resident not requiring memory care services
may live in the memory care unit if the resident's spouse requiring memory care
services lives in the unit or if no other beds are available in the facility
and the resident or the resident's legal representative consents in writing to
the placement. (II, III)
h.
Revocation, suspension or denial. The memory care unit license
or facility license may be revoked, suspended or denied pursuant to Iowa Code
chapter 135C and 481-Chapter 50.
(2) Residential care facility for persons with an intellectual disability (RCF/ID).
a.
Definition. For purposes
of this rule, the following term shall have the meaning indicated.
"Qualified intellectual disability professional" means a psychologist, physician, physician assistant, registered nurse, educator, social worker, physical or occupational therapist, speech therapist or audiologist who meets the educational requirements for the profession, as required in the state of Iowa, and has one year's experience working with persons with an intellectual disability.
b.
Designation and
application. A residential care facility may choose to care for
persons with an intellectual disability in a distinct part of the facility or
designate the entire residential care facility as a residential care facility
for persons with an intellectual disability. Residents shall meet the level of
care requirements for a residential care facility. (I, II, III)
(1) Application for approval to provide this
category of care shall be submitted by the licensee on a form provided by the
department. (III)
(2) Plans to
modify the physical environment shall be submitted to the department for review
based on the requirements of 481-Chapter 60. (III)
c.
Résumé of
care. A résumé of care shall be submitted to the
department for approval at least 30 days before a residential care facility for
persons with an intellectual disability is opened. A new résumé
of care shall be submitted when services are substantially changed. The
résumé of care shall:
(1)
Describe the population to be served;
(2) Include a copy of the floor
plan;
(3) List the titles of
policies and procedures developed for the unit or facility;
(4) Set out a plan for specialized staff
training;
(5) State visitor,
volunteer, and safety policies;
(6)
Describe programs for activities, social services and families; and
(7) Describe the interdisciplinary team and
the role of each team member.
d.
Policies and procedures.
Separate written policies and procedures shall be implemented in the
residential care facility for persons with an intellectual disability and shall
address the following:
(1) Criteria for
admission and the preadmission evaluation process. The policy shall require a
statement from the primary care provider approving the placement before a
resident may be moved into a residential care facility for persons with an
intellectual disability. The policy shall require a primary diagnosis of an
intellectual disability for admission. (II, III)
(2) Safety, including a description of the
actions required of staff in the event of a fire, natural disaster, emergency
medical event or catastrophic event. (II, III)
(3) Staffing requirements, including the
minimum number, types and qualifications of staff in the facility in accordance
with resident needs. (II, III)
(4)
Visitation policies, including suggested times for visitation and ensuring the
residents' rights to free access to visitors unless visits are contraindicated
by the interdisciplinary team. (II, III)
(5) The process and criteria which will be
used to monitor and to respond to risks specific to the residents, including
but not limited to drug use, restraint use, infections, incidents and acute
behavioral events. (II, III)
e.
Assessment prior to transfer or
admission. Prior to the transfer or admission of a resident applicant
to the facility, a complete assessment of the resident applicant's physical,
mental, social and behavioral status shall be completed to determine whether
the applicant meets admission criteria. This assessment shall be completed by
facility staff and shall become part of the resident's permanent record upon
admission. (II, III)
f.
Administrator qualifications. In addition to meeting the
requirements of subrule 57.10(1), the administrator of a residential care
facility for persons with an intellectual disability shall have at least one
year's documented experience in direct care or supervision of persons with an
intellectual disability. An individual employed as an administrator on May 16,
2018, will be deemed to meet the requirements of this subrule.
g.
In-service educational
programming. The in-service educational programming required by
paragraph 57.10(2)"c" shall include educational programming
specific to serving persons with an intellectual disability.
h.
Revocation, suspension or
denial. The facility license may be revoked, suspended or denied
pursuant to Iowa Code chapter 135C and 481-Chapter 50.
This rule is intended to implement Iowa Code sections 135C.2(3) "b" and 135C.14.
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