Health Facilities Division Goal

Through education, regulation and enforcement, protect and enhance the health, safety, welfare and quality of life of people receiving care and services from licensed and/or certified entities.

 

 

 

Welcome to the home page for the Health Facilities Division of the Iowa Department of Inspections and Appeals.  The Division is the designated state survey and certification agency responsible for inspecting and licensing/certifying various health care entities, as well as health care providers and suppliers operating in the State of Iowa. Entities subject to the Department's oversight and regulation include nursing facilities, skilled nursing facilities, residential care facilities, intermediate care facilities for the intellectually disabled, hospitals, hospices, home health agencies, programs and facilities caring for children, assisted living programs and elder group homes.  Health Facilities Division personnel also investigate complaints alleging improper care or treatment of patients, residents, and tenants in licensed and certified entities.

 

Visitors to this web site will find a variety of useful information to assist them in the selection of a long-term health care provider, such as the directory of long-term care facilities and the Department's Report Cards web page.  Visitors are encouraged to review the materials found on this web site as it contains many tools to help them become better consumers. Providers, too, will find valuable information such as the latest rules and regulations governing their operations. Links to other useful web sites are also provided for easy access to relevant information.

 

Affordable Care Act Section 6103

The following links are provided to consumers in accordance with section 6103 of the Affordable Care Act:

 

The Health Facilities Division's web site is constantly evolving to include new and expanded information. We welcome public comments on ways to improve this web site, and encourage visitors to e-mail their thoughts and suggestions to webmaster@dia.iowa.gov.

 

For additional information, you can contact us at:

 

Iowa Department of Inspections and Appeals

Health Facilities Division

Lucas State Office Building

321 East 12th Street

Des Moines, Iowa 50319-0083

Phone: (515) 281-4115

Fax: (515) 242-5022

 

Assistance with Account IDs and Passwords

 

Account IDs and passwords used by Health Care Entities and Direct Care Workers to access this website are maintained by the Health Facilities Division of the Iowa Department of Inspections and Appeals.

 

Health Care Entities that experience problems logging into the website should contact either Terry Ventling at (515) 281-6968 (terry.ventling@dia.iowa.gov) or Geri Paul at (515) 281-4548 (geri.paul@dia.iowa.gov).

 

Direct Care Workers who experience problems accessing the website should contact either Greg DeMoss at (515) 281-4077 (greg.demoss@dia.iowa.gov) or Stacey Siepmann at (515) 281-0108 (stacey.siepmann@dia.iowa.gov).

 

 

 

 

Sharing in Our Goal: Improving Residents’ Lives

Handouts and presenters’ materials for the April 15-16 joint DIA-health care provider training, “Sharing in Our Goal: Improving Residents’ Lives,” are available for download on the Department’s website at http://dia.iowa.gov/page11.html.  The material is located at the bottom of the page.  Participants should download the materials prior to the training as they will not be distributed during the sessions.

 

Independent Reviewers to Begin in February

Three attorneys have been awarded contracts by the Iowa Department of Inspections and Appeals (DIA) to serve as independent reviewers.  Contracts have been awarded to Jeffrey A. Boehlert, Des Moines; Thais Ann Folta, Cresco; and Gerry W. Smeader, Ankeny.  The awarding of contracts finalizes DIA’s implementation of Senate File 394, which outlined the process for informal conferences on contested citations.  Administrative rules to implement the 2013 legislation were adopted by the Department last September.  The independent reviewers will start on February 3rd.

 

Elopement Reminder

The Department of Inspections and Appeals would like to remind providers of the importance of ensuring the safety of wandering residents, especially during the harsh winter months.  It is vitally important to remind staff of the need to check the wander guard system as directed by the manufacturers and as facility policy requires, to ensure mechanical problems are promptly identified, reported, and repaired.  Remember, if a construction project requires the disengagement of the wander guard system, or you are completing repair work on the locking system/wander guard system, it is critical to ensure that wandering residents are adequately supervised during the outage to prevent an elopement. 

 

Additionally, in some instances, it has been reported that a wandering resident left a facility when a visitor exited.  It is especially important in the winter months to ensure that visitors and family members are educated regarding the importance of not assisting a resident out the door without staff knowledge.  While alarms can help to monitor a resident’s activities, staff must be vigilant in order to respond to the alarms in a timely manner.  Alarms do not replace necessary supervision.

 

A reminder of Iowa Administrative Code chapter 481—50.7(10A, 135C) Additional notification. The director or the director’s designee shall be notified within 24 hours, or the next business day, by the most expeditious means available:

 

50.7 (4) When a resident elopes from a facility.  For the purposes of this subrule, “elopes” means when a resident who has impaired decision-making ability leaves the facility without the knowledge or authorization of staff.

 

Background Checks FAQ

The Department routinely receives questions related to record checks.  A list of the most commonly asked questions and their answers has been posted to the Documents section of this website. 

 

Hot Water Temperatures in Nursing Facilities

The Department recently received questions about hot water temperatures in nursing facilities. Previously, Iowa Administrative Code 481—chapter 61 generally required hot water temperatures of between 110 (resident areas) and 120 (dietary). However, on July 3, 2013, a new chapter 61 became effective, which incorporates by reference the Facility Guidelines Institute’s (FGI) Guidelines for Design and Construction of Health Care Facilities, 2010 edition. [rule 61.2(3)]. The FGI Guidelines require temperatures of 95 to 110 degrees Fahrenheit (35-43 degrees Centigrade) in resident care areas and a minimum of 140 degrees Fahrenheit (60 degrees Centigrade) in dietary and laundry. (See Table 4.1-2) Please find the document located in the Documents tab at the left side of the page.

MDS 3.0 Dischage Assessments

The Centers for Medicare & Medicaid Services (CMS) is clarifying steps to take to address Minimum Data Set (MDS) 3.0 discharge assessments that have not been completed and/or submitted as required under 42 CFR §483.20(g) and 42 CFR §483.20(f)(1). The Survey & Certification memo (S&C:13-56-NH) is intended to help surveyors understand both (a) what nursing homes should do to address inactive residents remaining on their resident roster due to incomplete and/or unsubmitted discharge assessments and (b) how nursing homes can ensure compliance with discharge assessment requirements.  The memo can be found in the documents section of this website.

Restraint Alternative Guide

Federal and state laws require nursing homes attempt alternative methods or interventions prior to the use of physical restraints.  Telligen has produced a seven-page Restraint Alternative Guide to help facilities identify appropriate restraint alternatives for residents who have restraints.  The Guide is available in the 'Documents' section of this website.  (12/19/12)

 

Minimum Data Set (MDS) 3.0 Quality Measures (QM) version 6

The MDS 3.0 QM User's Manual V6.0 and QM ID by CMS Reporting Module V1.0 for User's Manual V6.0 were posted by the Centers for Medicare & Medicaid Services (CMS) at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIQualityMeasures.html.  The new QM User's Manual V6 is effective immediately.

 

New Long-term Care Survey Regions

Effective November 2, 2012, Health Facilities Surveyors will no longer be assigned to specific long-term care areas.  Rather, Surveyors will be subject to assignment in any of five new geographic regions, which allows them to be utilized in the most efficient manner depending upon workloads.  Each geographic region (Northwest, Northeast, East Central, Southeast, and Southwest) has an assigned Program Coordinator who is responsible for nursing facilities in their respective region.  Polk County nursing facilities are divided among four of the Program Coordinators.  The new geographic areas are defined in the "Contacts" document found on this page.

 

Improving Antipsychotic Appropriateness in Dementia Patients (IA-ADAPT) Website

Developed by the University of Iowa with the support of the Agency for Healthcare Research and Quality, the IA-ADAPT website helps clinicians, providers, and consumers better understand, assess and address challenging behaviors in people with dementia using evidence-based approaches.  It includes user-friendly resources such as brief videos, written content, quick reference guides for clinicians and providers, and information for families or patients on the risks and benefits of antipsychtic for people with dementia.  The University of Iowa is offering continuing educaton credit for prescribers, nurses, and pharmacists.  You can also request laminated quick reference guides to use in your practice, which can help you put the strategies you learn about into practice. https://www.healthcare.uiowa.edu/igec/IAADAPT

 

"Under Appeal" Designation on the Report Card Website

In the past, pending appeals have been indicated on the Health Facilities Division's Report Card website by a red asterisk (*).  Beginning this month, the "under appeal" designation will be noted only when a facility has requested a formal administrative hearing pursuant to Iowa Code chapter 17A.  This change is necessitated by budgetary constraints and the availability of personnel to monitor and update the "under appeal" designation.  Appeal information is still available upon request from Division staff.

 

Reporting Reasonable Suspicion of a Crime in a LTC Facility

June 30, 2011 - The federal Centers for Medicare & Medicaid Services (CMS) has issued a memorandum (S&C: 11-30) requiring specific individuals in applicable long-term care facilities to report any reasonable suspicion of crimes committed against a resident of that facility.  S&C: 11-30 is available in the Documents section of this website.

 

Surveyors Are to Have Unrestricted Access to Medical Records

April 19, 2011 - Medicare-certified health care providers and suppliers are reminded that surveyors are to be provided unrestricted access to medical records regardless of whether the facilities use paper-based records or Electronic Health Records (EHRs).  For providers and suppliers using EHRs, the survey team must request during the entrance conference that a terminal(s) be provided where surveyors may access records.  In the case of a hospital or other provider or supplier with terminals at multiple care locations, surveyors must be provided access to a terminal at each care location. Surveyors must be able to conduct the survey process in a consistent manner in all facilities regardless of whether the facility uses paper based or electronic records. In the August 2009 Survey and Certification Letter, CMS cautioned providers and suppliers that impeding the survey process by unnecessarily delaying or restricting access to medical records may lead to termination from the Medicare Program.

 

Reducing Restraint Use in Nursing Homes

November 17, 2010 - The Iowa Foundation for Medical Care (IFMS) has produced a guide for residents and families regarding the use of restraints in nursing homes, and how to reduce them.  The guide can be found in the Documents section of this website.

 

New MDS 3.0 Section Q Information

October 1, 2010 - The federal Centers for Medicare and Medicaid Services (CMS) will implement a new version of the Minimum Data Set (MDS) assessment required to be used by all Medicaid certified nursing facilities, beginning October 1, 2010. Included in the new MDS 3.0 are a series of questions known as "Section Q Return to Community Referral".  For more information see the CMS memo in the Documents section of this website.

 

DHS Clarifies Record Check Evaluations

September 1, 2010 - The Iowa Department of Human Services (DHS) has issued a clarification regarding the submission of employees' names for criminal history record evaluations.  See the clarification posted in the Documents section of this web site.

 

Status Change Requirements for Non-LTC Medicare-Certified Entities

April 22, 2010 - Recently, some Medicare-certified entities have failed to report status changes to the Department of Inspections and Appeals (DIA).  A new clarification has been issued by the Department regarding status change requirements for non-LTC Medicare-Certified Entities.  The clarification can be found in the Documents section of this website.

 

Lfe Safety Code (LSC) Documents

The Kansas City Regional Office of the federal Centers for Medicare and Medicaid Services (CMS) has asked that the following documents be posted to survey agency web sites:

Laundry Fire Prevention Suggestions

Federal LSC Survey Plans of Correction, Appeals and Alternatives

Waiver Request of Specific Life Safety Code Provisions

To access these documents, click the Documents button in the navigation bar.  Links to these documents should be at the top of the web page.  Questions related to these documents should be referred to the Iowa State Fire Marshal's Office at (515) 725-6168. 

 

Major Injury Determination Form

If a facility is relying on a physician, a designee, or an extender to determine whether a major injury to a resident has occurred, then the facility must complete a portion of the Major Injury Determination Form and submit it to the physician for a determination.  If the physician, designee, or extender determines that a major injury has occurred, then notification must be made to the Department of Inspections and Appeals.  The Major Injury Determination Form is available from the Health Facilities Division's web site or from the Department's web site. The form is available in the Documents section of this website.

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