Iowa: Overview of Assisted Living Licensing

What types of facilities provide assisted living services for seniors in Iowa?

How Iowa handles inspections of assisted living facilitiesIn the state of Iowa there are several types of facilities that provide care services for adults. Facilities that specifically provide assisted living services for the elderly are called assisted living programs, elder group homes and residential care facilities.

  • An assisted living program is a facility that provides services that include assistance with activities of daily living, health-related care or personal care to three or more residents as per Iowa Administrative Code (IAC) 481 Ch. 69.1. Along with receiving housing and services, residents should also expect to participate in decisions that emphasize their dignity, independence and individuality.
  • An elder group home is a single-family residence where personal care, room and board, and health-related services are provided to less than five residents who are unrelated to the residence’s owner as per IAC 481 Ch. 68.1. A manager is required to be on site 24 hours a day, seven days a week.
  • Residential care facilities provide room, board and assistance with activity of daily living to residents who are unable to care for themselves because of conditions such as disease or mental infirmity. These facilities may be designated as solely providing memory care. Except for emergencies, residents do not require the services of a registered or licensed practical nurse.

Who licenses Assisted Living Programs, Elder Group Homes or Residential Care Facilities in Iowa?

Within the Iowa Department of Inspections & Appeals is the Health Facilities Division which is charged with certification and monitoring of assisted living programs, elder group homes and residential care facilities.

An assisted living program may be nonaccredited or accredited by the Commission of Rehabilitation Facilities and this determines the licensing or certification process.

  • For nonaccredited programs, following approval of the application materials, a provisional certification is issued as per IAC 481 Ch. 69.5. Within 180 calendar days of issuance, a monitoring visit occurs to determine compliance with applicable requirements. Full certification is issued if there is demonstrated compliance, and the certification lasts for two years.
  • For an accredited program, following approval of the application materials, an assisted living program will receive certification which shall not exceed their accreditation period by their program’s governing organization.

Both nonaccredited and accredited programs must visibly display their current certificate within the designated operation area of the program as per IAC 481 Ch. 69.2. In addition the latest monitoring report, food establishment inspection report and state fire marshal report must also be available upon request.

For an elder group home, a provisional certificate is issued following approval of the application materials. Within 180 calendar days following issuance of provisional certification, a monitoring visit is conducted to determine a program’s compliance. Full certification is issued if there is compliance with applicable requirements as per IAC 481 Ch. 68.5(7), and the certification is good for two years.

  •  IAC 481 Ch. 68.2(2) requires that the current certificate shall be visibly displayed within the designated operation area of the program.

A residential care facility is issued a license following approval of the application materials and the license is good for one year.

  • The license of a residential care facility is required to be displayed in a conspicuous place accessible by the public as per IAC 481 Ch. 57.7(1).

What is required to obtain an Assisted Living Programs, Elder Group Homes or Residential Care Facilities license?

For assisted living programs that are nonaccredited, applicants must complete an application packet which requires submission of documents that include blueprints, policy and procedures, method of funding and ownership information.

The certification process for an accredited program follows a similar process: an application packet is submitted, along a copy of the current accreditation from the accrediting entity and demonstrated compliance with life safety requirements as per IAC 481 Ch. 69.9.

To receive certification for an elder group home, an applicant must submit application materials that include operational polices and ownership information as per IAC 481 Ch. 68.4. State fire marshal approval is also required.

IAC 481 Ch. 57.3 outlines the documents required to obtain a license for a residential care facility, and these documents include letter of intent and a written resume of the resident care program, floor plans and a certificate signed by the state fire marshal or deputy state fire marshal.

How do I know whether an Assisted Living Program, Elder Group Home or Residential Care Facility is licensed?

The Health Facilities Division has an online directory that lists all the licensed facilities in Iowa; however, the search is only accessible through the Health Facilities Division webpage by clicking on Entity Search. A directory is also available under Entities Book.

How frequently are Assisted Living Programs, Elder Group Homes or Residential Care Facilities inspected?

A recertification monitoring visit of a nonaccredited assisted living program occurs once every two years and will take place between 60-90 days prior to the program’s expiration as per IAC 481 Ch. 69.8(2). For accredited programs, they also receive a recertification monitoring visit once every two years.

  • The latest monitoring report, food establishment inspection report and state fire marshal report must also be available upon request as per IAC 481 Ch. 69.2.

For elder group homes a certificate monitoring visit occurs between 60-90 days prior to expiration of the program’s certification.

  • The latest monitoring report, food establishment inspection report and state fire marshal report must also be available upon request as per IAC 481 Ch. 68.2(2).

Residential care facilities receive a recertification survey at least every 24 months.

  • IAC 481 Ch. 68.7(6) requires that the citations considered class I or class II violations should be prominently displayed in plain view of the residents, visitors and families inquiring about placement into the facility until the violations are corrected and approved by the department.

Monitoring visits may also occur throughout the year if there is a complaint filed against a facility.

Where can I find the inspection reports of an Assisted Living Program, Elder Group Home or Residential Care Facility?

The Health Facilities Division has an online directory that lists all the licensed facilities in Iowa; however, the search is only accessible through the Health Facilities Division webpage by clicking on Entity Search.

How long is an Assisted Living Programs, Elder Group Home or Residential Care Facility required to retain their copy of the inspection reports?

There is no state statute that specifies the length of time that facilities are required to maintain their copy of monitoring visit reports once they are superseded by a new monitoring visit report.

How can I file a complaint against an Assisted Living Program, Elder Group Home or Residential Care Facility and what is the complaint process?

Complaints against assisted living programs, residential care facilities and elder group homes are sent to the division’s complaint division within the Department of Inspection & Appeals, which then assigns the complaint to the Health Facilities Division. The complaint’s severity determines how quickly a surveyor will visit the facility; if a resident is in immediate danger, a visit will occur within 48 hours.

To file a complaint, you may either call (877) 686-0027, fax the complaint to (515) 281-7106 or submit the complaint online. Complaints may also be submitted via mail.

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