Iowa Admin. Code r. 481-57.6 - Special classifications
(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.
Notes
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