Current through Register Vol. 46, No. 19, March 20, 2024
(1)
Physician. Each resident shall have a designated licensed
physician who may be called when needed. (Ill)
(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 hospital or psychiatric facility or documentation of attempt
to obtain a written agreement for the timely admission of a resident who, in
the opinion of the attending physician, requires inpatient services; (II,
III)
b. Provisions consistent with
Iowa Code chapter 229; (II, III) and
c. Immediate notification by the person in
charge to the physician or QMHP, as appropriate, of any accident, injury or
adverse change in the resident's condition. (I, II)
(3)
First-aid kit. A
first-aid emergency kit shall be available on each floor in every facility.
(II, III)
(4)
Infection
control. Each facility shall have a written and implemented infection
control program addressing the following:
a.
Techniques for hand washing consistent with Guidelines for Handwashing and
Hospital Control, 1985, Centers for Disease Control, U.S. Department of Health
and Human Services, PB85-923404; (I, II, III)
b. Techniques for handling of blood, body
fluids, and body wastes consistent with Guideline for Isolation Precautions in
Hospitals, Centers for Disease Control, U.S. Department of Health and Human
Services, PB96-138102; (I, II, III)
c. Decubitus care; (I, II, III)
d. Infection identification; (I, II,
III)
e. Resident care procedures to
be used when there is an infection present consistent with Guideline for
Isolation Precautions in Hospitals, Centers for Disease Control, U.S.
Department of Health and Human Services, PB96-138102; (I, II, III)
f. Sanitation techniques for resident care
equipment; (I, II, III)
g.
Techniques for sanitary use and reuse of enteral feeding bags, feeding syringes
and urine collection bags; (I, II, III)
h. Techniques for use and disposal of
needles, syringes, and other sharp instruments consistent with Guideline for
Isolation Precautions in Hospitals, Centers for Disease Control, U.S.
Department of Health and Human Services, PB96-138102; (I, II, III)
and
i. Aseptic techniques when
using:
(1) Intravenous or central line
catheter consistent with Guideline for Prevention of Intravascular Device
Related Infections, Centers for Disease Control, U.S. Department of Health and
Human Services, PB97-130074, (I, II, III)
(2) Urinary catheter, (I, II, III)
(3) Respiratory suction, oxygen or
humidification, (I, II, III)
(4)
Dressings, soaks, or packs, (I, II, III)
(5) Tracheostomy, (I, II, III)
(6) Nasogastric or gastrostomy tubes, (I, II,
III)
(7) Sanitary use and reuse of
feeding syringes and single-resident uses and reuse of urine collection bags.
(I, II, III)
CDC Guidelines may be obtained from the U.S. Department of
Commerce, Technology Administration, National Technical Information Service,
5285 Port Royal Rd., Springfield, Virginia 22161 (1-800-553-6847).
(5)
Disposable items. There shall be disposable or one-time use
items available with provisions for proper disposal to prevent reuse except as
allowed by 65.21(4)"g. "
(6)
Infection control
committee. Each facility shall establish an infection control
committee of representative professional staff responsible for overall
infection control in the facility. (Ill)
a.
The committee shall annually review and revise the infection control policies
and procedures to monitor effectiveness and suggest improvement.
(Ill)
b. The committee shall meet
at least quarterly, submit reports to the administrator, and maintain minutes
in sufficient detail to document its proceedings and actions. (Ill)
c. The committee shall monitor the health
aspect and the environment of the facility. (Ill) These rules are intended to
implement Iowa Code sections 135C. 14(3), 135C. 14(5) and 135C.
14(8).
(7)
Dental services. The facility shall assist residents to obtain
regular and emergency dental services and provide necessary transportation.
Dental services shall be performed only on the request of the resident or legal
guardian. The resident's physician shall be advised of the resident's dental
problems. (HI)
(8)
Safe
environment. The licensee of an ICF/PMI is responsible for the
provision and maintenance of a safe environment for residents and personnel.
(I, II) The ICF/PMI may have locked exit doors and shall meet the fire and
safety rules and regulations as promulgated by the state fire marshal. (I,
II)
(9)
Disaster
The licensee shall have a written emergency plan to be followed in the event of
fire, tornado, explosion, or other emergency. (II, III)
a. The plan shall be posted. (II,
III)
b. Training shall be provided
to ensure that all employees and residents are knowledgeable of the emergency
plan. The training shall be documented. (II, III)
c. Residents shall be permitted to smoke only
in posted areas where proper facilities are provided. Smoking by residents
considered to be careless shall be prohibited except under direct supervision
and in accordance with the IPP. (II, III)
(10)
Safety precautions. The
facility shall take reasonable measures to ensure the safety of residents and
shall involve the residents in learning the safe handling of household supplies
and equipment in accordance with the policies and procedures established by the
facility. (II)
All potent, poisonous, or caustic materials shall be plainly
labeled and stored in a specific locked, well-illuminated cabinet, closet, or
storeroom and made accessible only to authorized persons. (I, II)
(11)
Hazards.
Entrances, exits, steps, and outside steps and walkways shall be cleared of ice
and snow as soon as possible, and kept free of other hazards. (II,
III)
(12)
Laundry.
All soiled linens shall be collected in and transported to the laundry room in
closed, leakproof laundry bags or covered, impermeable containers. (Ill)
a. Except for related activities, the laundry
room shall not be used for other purposes. (Ill)
b. Personal laundry shall be marked with an
identification unless the residents are responsible for doing their own laundry
as indicated in the individual program plan. (Ill)
c. There shall be an adequate supply of
clean, stain-free linens so that each resident shall have at least three
washcloths, hand towels, and bath towels per week. (Ill)
d. Each bed shall be provided with clean,
stain-free washable bedspreads and sufficient lightweight serviceable blankets.
A complete change of bed linens shall be available for each bed. Linens on beds
shall be clean, stain-free and in good repair at all times. (Ill)
(13)
Supplies, equipment,
and storage. Each facility shall provide a variety of supplies and
equipment of a nature calculated to fit the needs and interests of the
residents. These may include: books (standard and large print), magazines,
newspapers, radio, television, bulletin boards, board games, game equipment,
songbooks, cards, craft supplies, record player, movie projector, piano, and
outdoor equipment. Supplies and equipment shall be appropriate to the
chronological age of the residents. (Ill)
Storage shall be provided for recreational equipment and
supplies. (Ill)
This rule is intended to implement Iowa Code section
135C.14(I).
