In order to obtain an initial license for an ICF/PMI, the
applicant must comply with the rules and standards contained in Iowa Code
chapter 135C and the standards in 481-Chapter 61. Waivers from 481-Chapter 61
regulations are allowed under rule
481-61.2 (135C). An application
must be submitted to the department which states the type and category of
license for which the facility is applying.
(1) Each application shall include:
a. A floor plan of each floor of the facility
drawn on 81/2- × 11-inch paper showing room areas in proportion, room
dimensions, room numbers for all rooms, including bathroom, and designation of
the use to which room will be put and window and door location;
b. A photograph of the front and side
elevation of the facility;
c. The
statutory fee for an intermediate care facility license;
d. Evidence of a certificate signed by the
state fire marshal or deputy state fire marshal as to compliance with fire
safety rules.
(2) A
résumé of care with a narrative which includes the following
information shall be submitted:
a. The
purpose of the facility;
b. A
description of the target population and limitations on resident
eligibility;
c. An identification
and description of the services the facility will provide. This shall include
at least specific and measurable goals and objectives for each service
available in the facility and a description of the resources needed to provide
each service including staff, physical facilities and funds;
d. A description of the human service system
available in the area, including, but not limited to, social, public health,
visiting nurse, vocational training, employment services, sheltered living
arrangements, and services of private agencies; and
e. A description of working relationships
with the human service agencies when applicable which shall include at least
how the facility will coordinate with:
(1)
The department of human services to facilitate continuity of care and
coordination of services to residents; and
(2) Other agencies to identify unnecessary
duplication of services and plan for development and coordination of needed
services.
(3) In order to obtain a
renewal or change of ownership license of the ICF/PMI the applicant must:
a. Submit to the department the completed
application form 30 days prior to annual license renewal or change of ownership
date of the ICF/PMI license;
b.
Submit the statutory license fee for an ICF/PMI with the application for
renewal or change of ownership;
c.
Have an approved current certificate signed by the state fire marshal or deputy
state fire marshal as to compliance with fire safety rules; and
d. Submit documentation of review of
résumé of care pursuant to subrule 65.2(1), paragraph
"a," and a copy of any revisions to the plan.
This rule is intended to implement Iowa Code sections
135C.7 and
135C.9.
Notes
Iowa Code r.
481-65.2
ARC 1205C, IAB
12/11/13, effective 1/15/14; ARC
5719C, IAB 6/16/21, effective 7/21/21
Amended by
IAB
June 16, 2021/Volume XLIII, Number 26, effective
7/21/2021
