481—57.35 (135C) Residents’ rights in general.
57.35(1) Each facility shall ensure that policies and procedures are written and implemented which
include, at a minimum, all of the following provisions (subrules 57.35(2) to 57.35(6)) and which govern
all areas of service provided by the facility. These policies and procedures shall be available to staff,
residents, their families or legal representatives and the public and shall be reviewed annually. (II)
57.35(2) Policies and procedures regarding the admission, transfer, and discharge of residents shall
ensure that:
a. Only those persons are accepted whose needs can be met by the facility directly or in
cooperation with community resources or other providers of care with which it is affiliated or contracts. (II)
b. As changes occur in residents’ physical or mental condition, necessitating services or care
which cannot be adequately provided by the facility, they are transferred promptly to other appropriate facilities. (II)
57.35(3) Policies and procedures regarding the use of chemical and physical restraints shall define
the use of restraints and identify the individual who may authorize the application of physical restraints
in emergencies, and describe the mechanism for monitoring and controlling their use. (II)
57.35(4) Policies and procedures shall include a method for submitting complaints and
recommendations by residents or their responsible party and for ensuring a response and disposition by the facility. (II)
57.35(5) Policies and procedures shall include provisions governing access to, duplication of, and
dissemination of information from the residents’ records. (II)
57.35(6) Policies and procedures shall include a provision that each resident shall be fully informed
of the resident’s rights and responsibilities as a resident and of all rules governing resident conduct and
responsibilities. This information must be provided upon admission, or in the case of residents already
in the facility, upon the facility’s adoption or amendment of residents’ rights policies. (II)
a. The facility shall make known to residents what they may expect from the facility and its staff,
and what is expected from them. The facility shall communicate these expectations during the period of
not more than two weeks before or five days after admission. The communication shall be in writing,
e.g., in a separate handout or brochure describing the facility, and interpreted verbally, e.g., as part of
a preadmission interview, resident counseling, or in individual or group orientation sessions following admission. (II)
b. Residents’ rights and responsibilities shall be presented in language understandable to the
resident. If the facility serves residents who are non-English speaking or deaf, steps shall be taken to
translate the information into a foreign or sign language. In the case of blind residents, either Braille
or a recording shall be provided. Residents shall be encouraged to ask questions about their rights and
responsibilities and these questions shall be answered. (II)
c. A statement shall be signed by the resident, or the resident’s responsible party, if applicable,
indicating an understanding of these rights and responsibilities, and shall be maintained in the record.
The statement shall be signed no later than five days after admission, and a copy of the signed statement
shall be given to the resident or responsible party. In the case of an intellectually disabled resident, the
signature shall be witnessed by a person not associated with or employed by the facility. The witness
may be a parent, guardian, Medicaid agency representative, etc. (II)
d. In order to ensure that residents continue to be aware of these rights and responsibilities during
their stay, a written copy shall be prominently posted in a location that is available to all residents. (II)
e. All residents shall be advised within 30 days following changes made in the statement
of residents’ rights and responsibilities. Appropriate means shall be utilized to inform non-English
speaking, deaf or blind residents of changes. (II)
57.35(7) Each resident or responsible party shall be fully informed in a contract as required in rule
57.14(135C), prior to or at the time of admission and during the resident’s stay, of services available in
the facility, and of related charges not covered by the facility’s basic per diem rate. (II)
57.35(8) Each resident or responsible party shall be fully informed by a physician of the resident’s
health and medical condition unless medically contraindicated (as documented by a physician in the
resident’s record). Each resident shall be afforded the opportunity to participate in the planning of
the resident’s total care and medical treatment, which may include, but is not limited to, nursing care,
nutritional care, rehabilitation, restorative therapies, activities, and social work services. Each resident
only participates in experimental research conducted under the U.S. Department of Health and Human
Services protection from research risks policy and then only upon the resident’s informed written
consent. Each resident has the right to refuse treatment except as provided by Iowa Code chapter 229.
In the case of a confused or intellectually disabled individual, the responsible party shall be informed
by the physician of the resident’s medical condition and be afforded the opportunity to participate in
the planning of the resident’s total care and medical treatment, to be informed of the medical condition,
and to refuse to participate in experimental research. (II)
a. The requirement that residents shall be informed of their conditions, involved in the planning
of their care, and advised of any significant changes in either shall be communicated to every physician
responsible for the medical care of residents in the facility. (II)
b. The administrator or designee shall be responsible for working with attending physicians in
the implementation of this requirement. (II)
c. If the physician determines or in the case of a confused or intellectually disabled resident the
responsible party determines that informing the resident of the resident’s condition is contraindicated,
this decision and reasons for it shall be documented in the resident’s record by the physician. (II)
d. Any clinical investigation involving residents must be under the sponsorship of an institution
with a human subjects review board functioning in accordance with the requirements of Public Law
93-348, as implemented by Part 46 of Title 45 of the Code of Federal Regulations, as amended to
December 1, 1981 (45 CFR 46). A resident being considered for participation in experimental research
must be fully informed of the nature of the experiment, e.g., medication, treatment, and understand the
possible consequences of participating or not participating. The resident’s(or responsible party’s) written
informed consent must be received prior to participation. (II)
57.35(9) In residential care facilities which are also county care facilities, policies and procedures
shall address the admission and retention of persons with histories of dangerous and disturbing behavior.
For the purpose of this subrule, persons with histories of dangerous or disturbing behavior are those
persons who have been committed for evaluation and found to be seriously mentally impaired pursuant
to Iowa Code section 229.13 or 812.1 within six months of the request for admission to the facility. In
addition to establishing the criteria for admission and retention of persons so defined, the policies and
procedures shall provide for:
a. Reasonable precautionsto prevent the resident from harming self, other residents, or employees
of the facility.
b. Treatment of persons with mental illness as defined in Iowa Code section 229.1(1) which is
provided in accordance with the individualized health care plan.
c. Ongoing and documented staff training on individualized health care planning for persons with
mental illness
481—57.37(135C) Residents’ rights.
Each resident shall be encouraged and assisted throughout
the resident’s period of stay, to exercise the resident’s rights as a resident and as a citizen and may
voice grievances and recommend changes in policies and services to administrative staff or to outside
representatives of the resident’s choice, free from interference, coercion, discrimination, or reprisal. (II)
57.37(1) The facility shall provide ongoing opportunities for residents to be aware of and to exercise
their rights as residents. Residents shall be kept informed of issues or pending decisions of the facility
that affect them and their views shall be solicited prior to action. (II)
57.37(2) The facility shall implement a written procedure for registering and resolving grievances
and recommendations by residents or their responsible party. The procedure shall ensure protection of
the resident from any form of reprisal or intimidation. The written procedure shall include:
a. Designation of an employee responsible for handling grievances and recommendations. (II)
b. A method of investigating and assessing the validity of a grievance or recommendation. (II)
c. Methods of resolving grievances. (II)
d. Methods of recording grievances and actions taken. (II)
57.37(3) The facility shall post in a prominent area the name, telephone number, and address of the
ombudsman, survey agency, local law enforcement agency, and resident advocate committee members
and the text of Iowa Code section 135C.46 to provide to residents a further course of redress. (II)