Current through Register Vol. 47, No. 6, September 18, 2024
(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 license
shall state the number of beds in the unit or facility. (III)
a. Application for this category of care
shall be submitted on a form provided by the department. (III)
b. Plans to modify the physical environment
shall be submitted to the department. The plans shall be reviewed based on the
requirements of 481-Chapter 61. (III)
(2) A statement of philosophy shall be
developed for each unit or facility which states the beliefs upon which
decisions will be made regarding the CCDI unit or facility. Objectives shall be
developed for each CCDI unit or facility as a whole. The objectives shall be
stated in terms of expected results. (II, III)
(3) A resume of the program of care shall be
submitted to the department for approval at least 60 days before a separate
CCDI unit or facility is opened. A new resume of the program of care shall be
submitted when services are substantially changed. (II, III)
The resume of the program of care shall:
a. Describe the population to be served; (II,
III)
b. State philosophy and
objectives; (II, III)
c. List
admission and discharge criteria; (II, III)
d. Include a copy of the floor plan; (II,
III)
e. List the titles of policies
and procedures developed for the unit or facility; (II, III)
f. Propose a staffing pattern; (II,
III)
g. Set out a plan for
specialized staff training; (II, III)
h. State visitor, volunteer, and safety
policies; (II, III)
i. Describe
programs for activities, social services and families; (II, III) and
j. Describe the interdisciplinary care
planning team. (II, III)
(4) Separate written policies and procedures
shall be implemented in each CCDI unit or facility. There shall be:
a. Admission and discharge policies and
procedures which state the criteria to be used to admit residents and the
evaluation process which will be used. These policies shall require a statement
from the attending physician agreeing to the placement before a resident can be
moved into a CCDI unit or facility. (II, III)
b. Safety policies and procedures which state
the actions to be taken by staff in the event of a fire, natural disaster,
emergency medical 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. The facility shall
identify its method for security of the unit or facility and the manner in
which the effectiveness of the security system will be monitored. (II,
III)
c. Program and service
policies and procedures which explain programs and services offered in the unit
or facility including the rationale. (III)
d. Policies and procedures concerning staff
which state minimum numbers, types and qualifications of staff in the unit or
facility. (II, III)
e. Policies
about visiting which suggest times and ensure the residents' rights to free
access to visitors. (II, III)
f.
Quality assurance policies and procedures which list the process and criteria
which will be used to monitor and to respond to risks specific to the
residents. This shall include, but not be limited to, drug use, restraint use,
infections, incidents and acute behavioral events. (II,
III)
(5) Preadmission
assessment of physical, mental, social and behavioral status shall be completed
to determine whether the applicant meets admission criteria. This assessment
shall be completed by a registered nurse and a staff social worker or social
work consultant and shall become part of the permanent record upon admission of
the resident. (II, III)
(6) All
staff working in a CCDI unit or facility shall have training appropriate to the
needs of the residents. (II, III)
a. Upon
assignment to the unit or facility, everyone working in the unit or facility
shall be oriented to the needs of people with chronic confusion or dementing
illnesses. They shall have special training appropriate to their job
description within 30 days of assignment to the unit or facility. (II, III) The
orientation shall be at least six hours. The following topics shall be covered:
(1) Explanation of the disease or disorder;
(II, III)
(2) Symptoms and
behaviors of memory-impaired people; (II, III)
(3) Progression of the disease; (II,
III)
(4) Communication with CCDI
residents; (II, III)
(5) Adjustment
to care facility residency by the CCDI unit or facility residents and their
families; (II, III)
(6)
Inappropriate and problem behavior of CCDI unit or facility residents and how
to deal with it; (II, III)
(7)
Activities of daily living for CCDI residents; (II, III)
(8) Handling combative behavior; (II, III)
and
(9) Stress reduction for staff
and residents. (II, III)
b. Licensed nurses, certified aides,
certified medication aides, 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 CCDI residents. The
six-hour training shall count toward the required annual in-service training.
(II, III)
(7) There shall
be at least one nursing staff person on a CCDI unit at all times. (I, II,
III)
(8) The CCDI unit or facility
license may be revoked, suspended or denied pursuant to Iowa Code chapter 135C
and Iowa Administrative Code 481-Chapter 50.
